Faster, Higher, Stronger, More Inclusive: The Paralympic Games

Welcome to one of the most exciting and chronically underrated international sporting events of the 21^st century: the International Paralympic Games. The 2018 Winter Paralympics will be held from Mar 8, 2018 – Mar 18, 2018 in Pyeongchang, South Korea.

This Paralympic games, originating in 1948 as a competition for wheelchair-using war veterans today have over 500 medal events, and host thousands of athletes from all over the world [1]. Today, the Paralympic Games occur in the same location as the Olympics, and are scheduled after the main events. To many, this may seem like an afterthought, but in reality is an incredible showcase of human diversity, athletic prowess, and the merits of inclusionary sport.

Meet Your Athletes
Who competes in the Paralympics? According to the official guidelines of the International Paralympic Committee, there are three major categories: visual, intellectual, and physical disabilities. The latter category is also broken down into 8 different subtypes, reflecting muscle function, limb loss/deficiency, and abnormalities in stature [1,2]. It should also be noted that the category of intellectual disability has strict limits about the age and nature of diagnosis. Some readers may be more familiar with the Special Olympics World Games, which are open to a broader range of participants [3].

PARTICIPATION IS BASED ON ABILITY

Up until the 1980s, eligibility for the Paralympics was determined purely by medical diagnosis, i.e. the reasons for a certain disability. Using these guidelines, a person who lost use of their arms due to a neurodegenerative disorder would not be able to compete with another individual whose arms were amputated [1]. However, today most sports include athletes based on ability, i.e. the degree to which an individual can perform an activity and compete fairly with others. The exception to these rules are sports for the visually impaired, where more rigid definitions and thresholds for vision loss are employed [1,2].

Let’s Play
Within most sports in the Paralympics, there are several sub-categories, reflecting different levels of ability. For example, table tennis has two major categories: players who compete using a wheelchair vs. standing. Within these two major categories, there are also subgroups, reflecting impairment in the playing arm, trunk stability, and other physical factor which can affect game outcome [4]. There is also a special class for athletes with an intellectual disability. These classes and categories differ from sport to sport, reflecting the demands of each discipline.
In addition, some sports in the Paralympics use ‘equalizing’ techniques to even the playing field for everyone involved. For example, in wheelchair rugby, individual players are given a score based on their abilities (use and dexterity of limbs, core stability, etc.). These scores are added up, and a team may not have players with more than a cumulative number of points on the field at any time [1].  On the other hand, goalball, a ball-throwing team sport for the visually impaired, requires that all players wear eye coverings to completely block vision. Thus, participants who are totally blind are still on the same level as those with milder visual impairments.

Paralympics, via Wikimedia Commons

Something for Everyone (Maybe Even You?)
The Paralympics thus include very diverse athletes, and a broad range of sporting opportunities. The most famous sports are generally those closest to events in the regular Olympics. For example, wheelchair basketball or Paralympic triathlon are close to Olympic contemporaries, with the addition of mobility-assisting devices such as wheelchairs or prosthetic devices. Other examples include wheelchair fencing, para-snowboarding, or para-equestrian events. However, some Paralympic sports are unique. These include goalball (see above) and boccia, a sport similar to boules or curling.
Interestingly, there is also significant participation of non-disabled athletes at the Paralympics. Indeed, these assistants/guides are an integral part of the team, and receive medals along with their disabled teammates. In boccia, for example, teammates can also help severely disabled athletes prepare for ball throws. Sighted athletes also play a major role in events for visually impaired participants, by running alongside them in track events, or steering a tandem bicycle during cycling races.
In recent years, unfortunately, the Paralympics have not been without controversy: as with other Olympic sports, there have been allegations of doping, along with accusations of ‘understating’ athletes’ level of disability [5]. But a lot of ongoing issues within (and at the fringes of) the Paralympics touch on much more troubling questions. How can the Paralympics be opened up to better funding, recognition, and respect? Should Paralympic athletes be allowed to compete directly against regularly-abled ones (think Oscar Pistorious)? It’s difficult to say exactly where these discussions will lead... but do tune in  Mar 8, 2018 – Mar 18, 2018, and see what all the excitement is about.

[1] http://bit.ly/1MD7zs1
[2] http://bit.ly/1SURPNP
[3] http://bit.ly/1XEy8xF
[4] http://bit.ly/23StO1x
[5] http://bit.ly/26az4jh

by Constance Holman, PhD Student AG Schmitz
this article originally appeared June 2016 in Volume 09 Issue 2 "The Sporty Brain"

How Do Sports Affect Our Mind?

Sports are well-known to be good for our physical health. Many studies have confirmed the effectiveness of regular physical activity in the primary and secondary prevention of several diseases like cardiovascular disease, diabetes, cancer, hypertension, obesity, osteoporosis and premature death. Exercising appears to have a direct relationship with many aspects of our health status, i.e., exercising more leads to further improvement in physical well-being [1]. The next question is: what is the effect of sports on our mind?
 

Source: http://bit.ly/1U7mgoT

Physical activity helps our brain in many ways. It decreases anxiety and depression, protects from loss of cognitive function in people with a risk of Alzheimer's and conserves cognitive brain functions across one's lifespan. Likewise, it helps healthy people by improving sleep, reducing the risk of Alzheimer's and other neurodegenerative diseases [2,3,4,5].

Excercise Improves Mood Instantly

Our mood also benefits from physical activity. Regular exercise was verified to improve mental well-being in the general population. It increases our quality of life by enhancing self-esteem, improving mood and reducing stress [2]. Not only do sports help us in the long run, but they were shown to improve our mood almost instantaneously. Most likely, if you do 20 sit-ups right now, you will feel happier immediately (once you catch your breath) [6].

So the next time you go for a run, know that you are not only taking care of your body but also of your brain!

[1] Warburton et al., CMAJ, 2006
[2] Fox, Public Health Nutr, 1999
[3] Lautenschlager et al., JAMA, 2008
[4] Scarmeas et al., JAMA, 2009
[5] Kramer and Erickson, Trends Cogn Sci, 2007
[6] Yeung, J Psychosom Res, 1996

By Michelle Livne, PhD Student AG Sobesky

The Olympic Games and Their Historic Values

The 2018 Olympic Winter Games in south Corea are coming up, an over two-week event offering an innumerable amount of sports. Who came up with the idea of the Olympics, though? The Olympics are always considered to be of Greek descent, but are they really?

The Ancient Games
The first Olympic Games were held in 776 BC in ancient Greece. The Games were held in the city of Olympia, at the foot of Mount Olympus, the mountain where the Greek Gods were said to live. This location was chosen, as the Games were one of the two great religious events celebrated in honor of the Greek Gods. Honor was what drove athletes of every city to participate as well. Winners were awarded with an olive wreath, the symbol of peace and distinction, and eternal prestige. In 394 AD, the Games were banned by the Roman emperor Theodosius I, who considered the Greek celebrations a pagan event [1].

Revival of the Games
For almost 1500 years no-one thought of this Greek festivity. But then the French baron Pierre de Coubartin started sharing his dream of reviving the Ancient Games. His lobbying resulted in the first Modern Olympic Games, held in Greece in 1896. The foundation of the Games was based on what de Coubartin said: ‘The important thing in life is not the triumph but the struggle, the essential thing is not to have conquered but to have fought well’. He founded the International Olympic Committee, which today still decides where the Olympics will be held and which sports will be a part of the Games [2]. In memory of its founder, the Pierre de Coubartin medal was invented and awarded to athletes who show true sportsmanship.

The olympic rings, source: http://bit.ly/1VpM2Gs

Symbols and Traditions
The Olympic motto ‘Citius, Altius, Fortius’ (Latin for ‘faster, higher, stronger’) exists since 1896. The symbol and flag, with the five colored rings intertwined on a white background, were designed in 1914. Both the motto and symbol come from Pierre de Coubartin. The symbol contains all the colors necessary to make the flags of all participating countries at the time. The rings resemble continuity and the human body [3]. New traditions have been added since - the relay carrying the Olympic fire from Greece to the host city of the Games, was started for the 1936 Berlin Games.

Sports
In its final days, the Ancient Games included 7 sports while in the very beginning the festival consisted purely of running events [1]. The first Modern Olympics consisted of nine sports, a number that has risen over the years and has been set to a maximum of 28 sports in the early 2000s. As a rule, a sport can only be admitted to the Summer Olympic program when it is widely practiced in at least 75 countries spread over four continents. Since 1936, the only changes in sports have been the dismissal of baseball and softball in the Olympics of 2008. The 2016 Olympics will see the addition of golf and rugby. The first Winter Games were organized in 1924, and always included skiing, skating, and ice hockey. The maximum number of sports in the Winter Games is seven, and to be included they need to be practiced by 25 countries, spread over three continents [4].

“IMPORTANT IS NOT THE TRIUMPH BUT THE STRUGGLE”

Olympism
The values and ideals of the Olympic Games are written down in the Olympic charter. The philosophy following these fundamental guidelines is called Olympism. The Olympic Movement has six pillars: Sport for All, Development through Sport, Women and Sport, Education through Sport, Peace through Sport, as well as Sport and Environment [1].
To conclude, the Modern Olympic Games, though based on the Greek Ancient Olympic Games, were invented by the French Pierre de Coubartin. The number and types of sports have changed over time, however, fundamental values of sportsmanship and honor have always been the basis of the Olympic Games. As for relations to Greece, one of the traditions of the Modern Games, carrying the Olympic fire from Olympia, Greece, to the host city of the current Games, hints that people still prefer a mythical touch to this event of great emotion and mighty athletes fighting for honor, as it was more than two eras ago in Greece.

Differences between the Ancient and Modern Games:

	Ancient Games	Modern Games
First edition	776 BC	1896 AD
Last edition	394 AD	ongoing
Inventor	'Greek Mythology'	Pierre de Coubartin
Number of sports	7	28
Participants	Free Greek men	Athletes from all over the world
Length	5 days	17 days
Philosophy	Mythology: offerings to Zeus	Olympism

[1] www.olympic.org 
[2] http://bit.ly/1XCUoH4
[3] http://bit.ly/1Q9JZ0S
[4] http://bit.ly/1SPJydY

by Judith Houtman, PhD Student AG Heppner
this article originally appeared June 2016 in Volume 09 Issue 2 "The Sporty Brain" 

High Impact: Consequences of Brain Injury in Athletes

Who has watched the Super Bowl last night? It had more than 111 million spectators. Besides watching a great sports game and an amazing halftime show, viewers were also witnessing series of brain concussions.

In football, players run like bulldozers, ramming everyone in their way. If the heads of two football players collide, the impact can reach up to more than 100 g [1], similar to forces in a car crash; a high school football player experiences about thousand blows to the head each season [2]!

Rising Awareness Since 2005
Football has been played since 1869, but awareness that repetitive concussions and sub-concussive hits to the head may have long term neurodegenerative effects has been rising only since 2005. It all started when Bennet Omalu autopsied the brain of Mike Webster, a four-time winner of the Super Bowl who died at the age 50. After retiring from a long football career, he developed depression, took drugs, had memory and concentration problems, as well as shaking hands.
Mike Webster’s brain showed amyloid plaques and neurofibrillary tangles in the neocortex, reminiscent of Alzheimer's disease (AD). Omalu diagnosed chronic traumatic encephalopathy (CTE) and hypothesised that head-to-head collisions were the cause [3]. With accumulating case studies, he also started making connections between repetitive mild brain injuries and depression. Later, a second group led by Ann McKee reported CTE in a larger cohort of post-mortem samples and confirmed many of Omalu's hypotheses [4].

Upon Impact, the Brain Hits the Skull
Helmets worn by the players only prevent skull fractures, but not internal damage; the brain hits the skull from the inside, referred to as “Brain Slosh”. The shearing of brain tissue leads to excessive toxic release of neurotransmitters, changes in glucose-metabolism, immune activation, and damage of blood vessels. This leads to secondary injury: breakdown of the blood brain barrier, disturbances in cerebral blood flow, formation of hematomas, neuroinflammation and so on.
The results are neurological symptoms during acute injury (dizziness, headache, nausea) which collectively persist in long-term deficits [5]. Neuronal damage and traumatic axonal injury further lead to accumulation of a-beta amyloid, tau and ApoE components [5]. Though sharing many similarities with AD, CTE-associated tauopathy differs with regard to the distribution: in CTE, tau is most prominent in superficial cortical layers and sulci, and tends to surround blood vessels [5].

by Jack Kurzenknabe, via flickr

Diagnostic Difficulties
The clinical phenotype of CTE is still incomplete, because most of the knowledge comes from post-mortem analyses and retrospective data. In the 158 autopsy cases analysed so far, 80% showed signs of CTE [6]. However it is difficult to asses how natural age-related changes, unrelated psychiatric illness, alcohol/drug use or coexisting cognitive impiarment contribute to the current picture of CTE; due to the long latency of CTE, co-morbidities are often present.
As of yet, there have been no established diagnostic criteria or in vivo biomarkers, meaning that CTE can only be diagnosed post mortem. But there is hope: Recent research developed means for premorbid identification of neurodegeneration in contact-sports athletes. NFL players with histories of mood and cognitive symptoms were subjected to positron emission tomography (PET) scans, which revealed that they had higher tau deposits than controls in all subcortical regions and the amygdala, areas known to produce tau deposits following trauma [7].

INCIDENCE AND PREVALENCE STILL UNKNOWN

However the incidence and prevalence of CTE are still unknown and, to date, there is no consensus regarding which intensity of head blows is tolerable. Large-scale prospective, longitudinal studies of concussed and non-concussed individuals are needed to provide a better picture.
To further advance the research on biomarkers and treatment approaches, a mouse model has been developed. It uses controlled closed-head impacts on unanaesthetized mice to recapitulate the spectrum of behavioural symptoms noted in patients diagnosed with CTE [8].

What are the Consequences?
Until recently, the National Football league (NFL) did not recognize these injuries as consequence of the sport itself. Rather, a common argument suggests that former players can’t cope with not being the focus of attention anymore, which is why they develop depression and take drugs, which then goes on to eventually cause neurodegeneration. Several former NFL players sued the league for allegedly misleading them about the risks of brain injury and one player even resigned from the NFL because he feared the consequences of the daily brain trauma.

Is This the End for Football?
Football has been played for 150 years. In 1905, 19 players died in a single season, most due to head and spine injuries. President Roosevelt, an avid football fan, ordered football coaches to reform the rules eliminating the more brutal features of the game. Since then, the sport has changed time and again. As a reaction to the current discoveries, President Barack Obama also expressed concern about college football players and the “problems with concussions and so forth” [9]. Football is just too big of a cult for this to be the end. New rules will hopefully be enforced to make the games safer for the athletes and still satisfying for fans.

[1] Funk et al, Ann Biomed Eng, 2012
[2] Beckwith et al, Med Sci Sports Exerc. 2013
[3] Omalu et al, Neurosurgery, 2005
[4] Stein et al,  Alzheimers Res Ther, 2014
[5] Chauhan, Restor Neurol Neurosci,  2014
[6] Gardner et al, Br J Sports Med,  2014
[7] Small et al,  Am J Geriatr Psychiatry, 2013
[7] Petraglia et al, J Neurotrauma, 2014
[9] Foer and Hughes, New Republic, 2013

by Claudia Willmes, PhD Alumna AG Eickholt / AG Schmitz
this article originally appeared June 2016 in Volume 09 Issue 2 "The Sporty Brain"

Interesting movies to watch:

• 1954: On the Waterfront
• 2015: Concussions

The Neuroscience of Yoga: Bridging the Gap Between Spirituality and Science

Yoga has become increasingly popular in the last decades and anyone who has attended a handful of yoga classes would agree to feeling an increased sense of emotional stability and mental clarity after practice. Nowadays, thanks to sophisticated brain imaging techniques, neuroscience is revealing exciting and transformative insights about the art and science of yoga. Western science is finally confirming what eastern practitioners have been reporting and documenting for over 2,000 years: that yoga and meditation can literally rewire the structure of the brain. 

What Is Yoga, Anyway?

Yoga (from Sanskrit meaning “unity”) is an ancient practice that unites the innate capacity of human beings to realize their true potential. We recognize our highest potential through the practices of the various yoga disciplines, such as yoga asana or physical postures, breathing regulation, meditation, study of teachings, devotional chanting, among others. In the West, we became familiarized with yoga asana, which only represents one aspect that the practice uses to align us with our highest potential and develop higher qualities, such as more love, compassion, humbleness, kindness, empathy, insight and service.

In the early 2000s, Richard Davidson from the University of Wisconsin jump-started the convergence of both worlds with his famous research on meditating Buddhist monks, finding mental training in form of meditation may induce short and long-term neural changes in the brain [1]. Several other researchers have followed, including Sarah Lazar, who found that brain regions associated with attention and sensory processing were thicker in people practicing meditation. The changes were observed even in novice meditators with as little as two weeks experience. This means that not only meditation professionals benefit from the practice [2]. 

Sharpening Higher Cognitive Functions

In as little as 15 years, the emerging field has witnessed almost a 10-fold increase in published research papers on the impact of yoga in human health [3]. Several papers focus on the pre-frontal cortex and the attentional engagement that yoga requires. Positive changes in the brain structure and function of areas related to awareness, decision-making, executive functions, self-regulation and attention have been observed [4], leading to an efficient regulation of emotions, social behavior, impulsivity, fears and conflicting thoughts. This area is also strongly implicated in human qualities such as empathy, consciousness, social and emotional intelligence, insight, intuition and attuned communication [5]. One of the most interesting studies in this area found that 50 year-old meditators had similar cortical thickness as 25 year-olds, suggesting that yoga might offset age-related cortical thinning [2] .

via Flickr by Amila Tennakoon

Nowadays, one of the most prevalent health threats is stress. Everybody has experienced it in one way or another. Long-term stress can have significant adverse effects on health and is a risk factor for many major illnesses, such as heart disease, stroke and depression [6]. Neurobiological studies have implicated the amygdala as a crucial area involved in our stress response. A recent study found that participants following an 8-week yoga intervention reported significantly reduced perceived stress and a reduction in the right basolateral amygdala gray matter density [7], furthering our understanding of why we feel so good during and after a yoga class. 

Breathing Into Your Memory Center

The hippocampus plays a vital role in long-term memory, learning, navigation and spatial orientation. Recent studies have found an increased hippocampal volume in elderly participants over a period of 6-months, suggesting that yoga could have the potential to alleviate age-related neurosenescence, findings of particular importance for the field of neurodegenerative diseases, such as Alzheimer’s disease [8]. Furthermore, depression is a potential risk factor for cognitive decline and dementia and recent reviews suggest that a yoga intervention might effectively reduce these symptoms [9].  

I think everyone who has taken a yoga class can relate to the unique experience that this practice brings to one’s day. Our mind can be in an absolute turmoil when getting to class, thinking about the next deadline, the shopping list, answering our boss's email, and so on, but then we feel absolute peace when lying down in savasana, the final resting posture. Yoga has been shown to restore the autonomic nervous system to a healthy balance by stimulating the parasympathetic nervous system. It reduces our heart rate and blood pressure, eases our respiration and increases heart rate variability – all signs of improved parasympathetic tone and a peaceful smiling face after class [10].

Yoga might offset age-related cortical thinning

 

A number of published papers conclude that breathing, meditation, and posture-based yoga increases overall brain health and yoga practice may be an effective treatment for a clinical and healthy aging population, in addition to being relatively easy and cost-effective to implement [11]. So now, if you have not yet experienced a yoga class, I invite you to attend one and feel for yourself all the benefits this millennial practice has to offer. After a while, yoga becomes not what we do, but rather how we do something. When we invite an ever-present awareness to all that we do, yoga becomes a way of living, rather than just a disciplined practice we commit to one hour a day.

by Stephanie Bianchi, MSc in Neuroscience / Mindful Guatemala

This article originally appeared September 2017 in CNS Volume 10, Issue 3, Spirituality in Science

 
[1] Lutz et al., Proc Natl Acad Sci, 2014
[2] Lazar et al,. Neuroreport., 2005
[3] https://www.ncbi.nlm.nih.gov/pubmed/?term=yoga
[4] Afonso et al., Front Aging Neurosci., 2017
[5] Desai, Effects of Yoga Nidra and other Meditation Techniques, In: Yoga Nidra: The Art of Transformational Sleep, 2017
[6] Tawakol et al., The Lancet, 2017
[7] Hölzel et al., Soc Cogn Affect Neurosci., 2010
[8] Hariprasad et al., Indian J Psychiatry, 2013
[9] Mathersul et al., Evid Based Complement Alternat Med., 2016
[10] Stephens, Children (Basel)., 2017
[11] Desai et al., Complement Ther Clin Pract., 2015

How Wearing a Fitness Tracker Can Change You

Lately, a big market for fitness trackers has emerged. Different wearables and apps can measure a number of fitness-related parameters, including heart rate, GPS tracking, steps, distance covered, pace, calories burned or even sleep quality. In many cases, you can also log your caloric intake to get an even better profile of your performance. But the psychological aspect of fitness trackers is just as important as the technology behind them because they do more than inform: they reinforce, motivate and reward.

The Advertised Effects
Fitness trackers and apps are advertised as beneficial for your health and lifestyle. They provide an objective measure of your activity so you can’t lie to yourself. Wearable trackers should get you to be more active, motivate you during exercise and provide information about your daily routine or workout without requiring manual calculations or notes. Furthermore, they should help you to reach your fitness goals.
These devices and apps are becoming increasingly popular in personal healthcare and promise easy lifestyle changes. These promising words fall on fertile soil. Most adults are aware of (or at least suspect) not meeting their recommended daily activity guidelines. However, there are no objective research results to bolster up their promise of improving physical activity levels.

Do They Work?
Fitness trackers are great for those who really have no idea how many calories they burn during an activity and can help those in need of a motivational tool to keep them going. However, one study found that using a pedometer did not significantly increase step count among overweight and obese adults [1]. Another study with overweight people showed that after 18 months, those who had used a device that tracked steps and calorie expenditure lost on average five pounds less than people without self-tracking [2]. Thus, devices that monitor and provide feedback on physical activity may not offer an advantage over standard behavioral weight-loss approaches after all.

A FITNESS TRACKER INITIALLY INCREASES MOTIVATION

 

From personal observations and a (non-representative) survey among colleagues, it became apparent that a fitness tracker motivated us to be more active initially . For nearly all it was fun to log and track our own health data and progress with colorful charts and badges for achievements. However, the excitement – as with all new toys – had died away at some point and most of us were back to our previous activity levels after a while. Until now, not a single long-term study has analyzed the effect of constantly wearing a fitness tracker on the average consumer.

The Author's Personal Records

What Else Do They Do?
However, many users also observed that they developed a guilty conscience if they had not moved enough. In some cases this led to abandoning the device altogether. Thus, wearing the device alone is not enough to lead a healthier life. Many devices and apps offer an online platform where users can compare themselves with others or even challenge a friend. This additionally increases the motivation, but also the pressure to perform and reach your goals as the wearer is held accountable by the device, app and group members. The motivation to be at the top of a ranking can also be amplified by the ability to broadcast your exercise statistics via social media.

USING A FITNESS TRACKER CAN WORSEN EATING DISORDERS

This can, for obvious reasons, also have negative consequences for some people. One study examined the relationship between use of calorie counting and fitness tracking devices with eating disorder-related behaviour in college students [3]. Participants using calorie and fitness trackers manifested higher levels of eating concern and dietary restraint. Interestingly, fitness tracking, but not calorie counting, emerged as a unique indicator of eating disorder symptomatology. These findings suggest that for some individuals, these devices do more harm than good.

Should I Track?
It is nice to know your daily step count, heart rate, caloric intake, and the like, but wouldn’t you also have an approximate idea about these parameters if you simply reflected on your daily routine? Depending on how important it is for you to know the exact parameters, it makes sense to wear such a device... or not. Many devices have a built-in alarm that goes off if you have not move for a certain time. This might come in handy, but can also be annoying if you are at work and just can’t go for a walk right now. In the end, it always depends on the individual who wears the device.
If you are not prone to being overly critical about your weight, tracking your workouts and food intake can be motivating. But tracking everything might become obsessive for some, as the numerical focus of the trackers is akin to the obsessive fixation characteristic for eating disorders and exercise addiction.
It's true that these devices make you be more aware of your health. However, this can also be achieved without fitness trackers but instead with good education about lifestyle and health.

[1] Takahashi et al, Clin Interv Aging. 2016
[2] Jakicic et al, JAMA. 2016 
[3] Simpson et al, Eat Behav. 2017

by Claudia Willmes, PhD Alumni AG Eickholt/Schmitz

this article originally appeared June 2017 in CNS Volume 10, Issue 2, Digital Health and Big Data