Browsing by Author "Naugle, Kelly"
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Item Active Gaming and Energy Expenditure in Healthy Adults(Office of the Vice Chancellor for Research, 2016-04-08) Carey, Christopher; Naugle, Keith; Ohlman, Tom; Mikesky, Alan; Naugle, KellyThe rise in sedentary behavior in US society, along with the associated health risks, makes it necessary to find effective solutions to increase physical activity at all levels. Studies on active gaming have shown promising results in the use of active gaming as a viable exercise tool that combines physical activity with entertainment. However, the research is still mixed on whether active games can elicit similar responses as traditional cardiovascular exercise, such as jogging on a treadmill. This study examined whether participants playing active games could reach a moderate intensity level as defined by the American College of Sports Medicine as 3.0 METs while playing with and without specific instructions designed to maximize physical activity. Twenty young adult participants completed one training session and four experimental sessions. During each session, participants played two 15-minute periods of either Kinect tennis, Kinect boxing, Wii tennis, and Wii boxing. In period one, participants played at a self-selected intensity. During period two, participants were given specific instructions on how to play which were designed to maximize movement during play and down time. During game play, participants wore a portable gas (VO2/VCO2) analyzer to measure energy expenditure. Metabolic equivalents (METS) were analyzed with a repeated measures ANOVA. During period 1, Kinect boxing was able to elicit the highest METs, 3.097±0.3, from the participants. METS during period 2 was significantly greater than during period 1 across all games (p<.001). Participants were able to reach higher than 3.0 METs while playing each of the games during period 2. Regardless of the period, Kinect boxing elicited greater METS than Wii boxing and Wii Tennis (P<.001). This shows evidence that active gaming not only can elicit a moderate intensity level of physical activity, but that specialized instructions can enhance the effects of the active games.Item Application of Transcranial Direct Current Stimulation During Motor Skill Acquisition(2024-03) Meek, Anthony Wilhite; Riley, Zachary; Munk, Niki; Naugle, Kelly; Streepey, JakeTranscranial direct current stimulation has been used to influence the acquisition of motor skills; however, most studies investigate relatively simple laboratory based motor skills tasks. Since the regions where structural and functional changes support motor learning are dependent on the qualities of the task, translation of the findings to real-world skills has been limited. In general, anodal current stimulation is associated with functional facilitation and cathodal current is associated with functional inhibition. The purpose of this dissertation is to explore the effect of transcranial direct current stimulation of the primary motor cortex and the cerebellum upon the acquisition of novel motor skills that possess varied demands comparable to everyday tasks. In order to study motor skill learning, we investigated 4 unilateral tasks made novel by using the non-dominant hand, ensuring a discernible fast phase of learning in which to observe skill acquisition. In study one, anodal stimulation applied over the primary motor cortex during a 20 minute practice session skill acquisition in a complex dart throwing task compared to cathodal motor cortex stimulation or SHAM. In study two, 20 minutes of anodal motor cortical stimulation while practicing a dexterous tweezer task significantly reduced postpractice pin-placing time compared to SHAM. In study three, anodal motor cortical stimulation during 20 minutes practicing a dexterous rhythmic-timing video game led to significantly higher performance scores compared to SHAM. In study four, in the same videogame task, concurrently stimulating the primary motor cortex with 2 milliamp anodal current while stimulating the cerebellum with 2 milliamp cathodal current during 20 minutes of practice led to significantly higher performance scores compared to SHAM, whereas 2 milliamp anodal primary motor cortex, anodal cerebellar, and cathodal cerebellar stimulation alone was not different than SHAM. These data altogether show that motor cortical transcranial direct current stimulation can facilitate skill acquisition in everyday tasks with a range of gross, fine, and visuomotor demands. They also provide the first evidence of a synergistic effect on motor learning from concurrent primary motor cortex and cerebellar stimulation, which may contribute to the development of novel stimulation protocols.Item Augmenting the Health Belief Model to Promote Knee Massage as Self-Management Among Individuals with Knee Osteoarthritis: A Roadmap for Future Research and Intervention Development(2023-08) Nemati, Raheleh; Munk, Niki; Kaushal, Navin; Keith, NiCole; Naugle, KellySelf-administered massage is a form of self-management that has been shown to alleviate symptoms among individuals with knee osteoarthritis. However, existing interventions have yielded inconsistent results in terms of promoting the practice of self-administered massage, highlighting a critical gap in the application of a theoretical or conceptual model. The current study utilized an expanded health belief model that integrates constructs from the theory of planned behavior aimed to identify the behavioral determinants associated with the practice of self-administered knee massage. An observational study was designed to address the objectives using an online survey. A total of 268 participants with knee osteoarthritis completed the survey. Data regarding the clinical characteristics of participants, including the year of diagnosis, chronicity of pain, affected knee(s), and the intensity of pain in terms of current, average, and worst levels, were collected. Structural equation modeling was used to test the predictive validity of the proposed model. The model revealed self-administered massage behavior to be predicted by intention (β = .21, p < .014). Intention was predicted by cues (β = .29, p <.001), task self-efficacy (β = .29, p <.001), affective attitudes (β = .14, p =.011), perceived severity (β = .27, p <.001), and perceived facilitators (β = .22, p <.001), but not response self-efficacy, instrumental attitudes, or barriers. Intention mediated the effects between cues (β = .06, 95% CI .025, .129) and perceived severity (β = .06, 95% CI .014, .127) and behavior. Model determinants were found to mediate between age and behavior (β = -.16, 95% CI -.224, -.093). Interventions aimed at promoting self-administered massage should focus on enhancing individuals' perception of the severity of their knee OA progression and their confidence in performing the massage by teaching them the common massage techniques.Item Comparison of Psychological Response between Concussion and Musculoskeletal Injury in Collegiate Athletes(American Psychological Association, 2017) Turner, Samantha; Langdon, Jody; Shaver, George; Graham, Victoria; Naugle, Kelly; Buckley, Thomas; Kinesiology, School of Physical Education and Tourism ManagementThe psychological response to musculoskeletal injuries has been well documented, however, research on the psychological response to concussion is limited. The Profile of Mood States (POMS) and the State-Trait Anxiety Inventory (STAI) have recently been used to assess the psychological recovery of concussions. Although some studies indicate that psychological response is different for musculoskeletal injuries and concussion, there is currently not enough information to indicate this difference occurs at specific clinical milestones. The purpose of this study was to compare the psychological responses of student-athletes who have been diagnosed with a concussion to those of athletes diagnosed with musculoskeletal injuries with similar recovery duration. Fifteen collegiate athletes who sustained a musculoskeletal injury were recruited and matched with 15 previously collected concussion participants. The main outcome measures were the scores of POMS constructs: tension-anxiety, anger-hostility, fatigue-inertia, depression-dejection, vigor-activity, confusion-bewilderment, and total mood disturbance and STAI (state anxiety only). Two-way MANOVAs was run to determine the effects of group and time on POMS and STAI constructs. There were no significant interactions identified, but follow-up ANOVAs identified a main effect for time for most POMS subscales, with POMS scores improving over time in both groups. Analyses also revealed that tension-anxiety, vigor-activity and the STAI were not affected by time or group. The findings of this study, that both groups' psychological response to injury improves over time and at similar clinical milestones suggests reduction in sports and team related activities may play a substantial role in the psychological response to either concussion or musculoskeletal injury.Item The Effect of Anterior Cruciate Ligament Reconstruction on Leg-Spring Stiffness During Hopping(2020-12) Wolfe, David K.; Bahamonde, Rafael; Streepey, Jefferson; Riley, Zachary; Naugle, Kelly; Beekley, MatthewLeg-Spring Stiffness (LSS) is the measure of the musculoskeletal, neuromuscular, and biomechanical functions of the human body, and an appropriate evaluation metric for changes brought on by Anterior Cruciate Ligament Reconstruction (ACLr). ACLr can lead to flexion and extension loss, resulting in increased stiffness of the musculotendinous units of the ACLr leg and thus changes in LSS. LSS can be measured using Kleg, but little is known about the validity and reliability of the different methods of LSS and Kleg calculations. The purpose of this study was to determine if ACLr leads to a change in LSS (as measured by Kleg) during hopping, and to compare results of the Spring-Mass calculation and knee Joint Torsional stiffness methods in the computation of the overall Kleg. Video data synchronize with GRF were used to compute the kinematic and kinetic variables. Mann-Whitney U tests were used to determine significant differences between the control and experimental group for the Spring-Mass method of calculation (p = 0.004), Joint Torsional method (p =0.44), Kknee (p = 0.29), and Kankle (p = 0.17). Cohen’s effect calculations showed small to medium effects for the KKnee, (d = 0.383) but moderate effect size for the KAnkle, (d = 0.541). Wilcoxon Signed Rank comparison for all the legs and (N=42) between computational methods were significant differences between computational methods (Z = 5.65, p = 0.000), and with a large effect size (Cohen’s d = 3.14). Similar results were found when comparing only the ACLr leg values (p = 0.005, Cohen’s d = 4.88). The comparison between ACL Leg vs Non-ACL leg for experimental group subjects was not significant in either calculation method (Spring-Mass p = 0.20, Z = -1.27; torque calculation p = 0.96, Z = -0.05). The spring-mass method was more stable and able to detect differences between the control and ACLr group. The lack of statistical differences in the joint torsion calculation method, as well as in comparing the unaffected leg to the ACLr leg in the experimental group, suggests that LSS may not be a precise enough measurement to determine the effects of an ACLr.Item Exploring Exercise Outcomes, Preferences, and Barriers in Adolescent and Young Adult Cancer Survivors(2024-08) Sherman, Melissa Marie; Keith, NiCole R.; Kaushal, Navin; Naugle, Kelly; Renbarger, JamiePhysical activity (PA) improves physiology and cognition including Quality of Life (QoL), fatigue, depression, anxiety, and emotional well-being. Despite the positive effects of PA, adolescent, and young adult (AYA) cancer survivors (15-39 yrs.) do not meet the American College of Sports Medicine (ACSM) recommended PA guidelines to elicit positive health outcomes. AYA survivors may have unique physical and psychological experiences that impact motivation, barriers, and preferences for participation in PA. The overarching purpose of this dissertation is to better understand the outcomes, motivation, preferences, and barriers to exercise adherence when completing exercise and PA interventions among AYA survivors of cancer. This dissertation addresses this purpose through three distinct studies: AYA Cancer Survivors and One-on-One Exercise in an In-person setting, AYA Cancer Survivors and One-on-One Exercise in a Virtual Setting, and subsequent focus groups that utilized the participants from both virtual and in-person studies. Results indicated that the nature of cancer and cancer treatment, type of cancer, age at diagnosis, and experience within treatment (i.e. surgery, radiation, chemotherapy, stem cell transplants) varied significantly across AYA survivors of cancer. Despite the differences in experience, cancer-related fear and anxiety were common among participants but were offset by a sense of control and accountability experienced during the larger study. Working one-on-one with a wellness coach or exercise trainer provided participants with a sense of accountability and a sense of control that otherwise was missing post-cancer treatment and remission. The extra support is needed to help alleviate fears and anxiety and to promote accountability, acceptability, and adherence to exercise. A multi-disciplinary approach with wellness coaching and individualized PA guidance is suggested for future programming in this population group. While AYA survivors of cancer are an often understudied population, future research must target more racially and ethnically diverse groups to understand this group as a whole better.Item Multifocal Transcranial Direct Current Stimulation to Modulate Motor Learning(2025-03) Greenwell, Davin Ross; Riley, Zachary; Kaleth, Anthony; Naugle, Kelly; Streepey, Jake; Metzler-Wilson, KristenTranscranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that modulates neural excitability in targeted brain regions, influencing processes such as motor learning. While tDCS has been previously shown to benefit motor skill acquisition, much of this research has focused on relatively simple, unimanual tasks. Conversely, the effects of tDCS on more complex, bimanual motor tasks remain understudied, with existing findings often yielding mixed results. This inconsistency poses challenges for translating laboratory findings to functional, real-world motor skills, which frequently involve coordinated, two-handed movements and heightened cognitive demands. Emerging evidence suggests that multifocal tDCS paradigms, which simultaneously target multiple brain regions, may provide enhanced learning effects, particularly for complex motor tasks. Unlike traditional monofocal stimulation protocols that focus on the primary motor cortex (M1) or cerebellum individually, multifocal approaches may better address the neural dynamics underlying bimanual coordination and interhemispheric interactions. The purpose of this dissertation was to investigate the potential of multifocal tDCS to enhance motor learning in complex tasks, examining both unimanual and bimanual skill acquisition. This research involved a series of studies beginning with monofocal tDCS applied to M1 and the cerebellum during a non-dominant unimanual rhythm-timing task and culminating in a multifocal “tri-focal” stimulation protocol during a bimanual motor learning task. In Study One, we compared the effects of excitatory M1 stimulation against excitatory and inhibitory cerebellar and sham stimulation. While none of the monofocal tDCS conditions significantly enhanced learning compared to sham, small, non-significant trends were observed which informed the design of Study Two. Here, we observed that combining excitatory M1 stimulation with inhibitory cerebellar stimulation resulted in significant and robust improvements in motor learning. In Study Three, we found that bilateral M1 stimulation significantly enhanced the early stages of bimanual skill learning at lower intensities. However, Study Four revealed that increasing stimulation intensity or adding inhibitory cerebellar stimulation impaired bimanual learning. Together, these findings contribute to a growing understanding of how multifocal stimulation paradigms can be tailored to enhance motor learning in real-world tasks while underscoring the importance of carefully optimizing stimulation parameters to task-specific demands.Item Physical activity and enjoyment of young adults while playing an active virtual reality game(Indiana University, 2024-07-25) Akinfeleye, Obapese; Cervantes, Xzaliya; Boots, Brendan; Naugle, Keith; Naugle, KellyOver the past few decades, there has been an upsurge in the number of adults who do not meet the recommended physical activity levels. One of the factors contributing to the sedentary lifestyle is connected to increased screen time, which could offer a potential solution. Objective: In this study, we tested an active video game in virtual reality (VR) as a potential tool to elicit physical activity. Specifically, this study measured participants' physical activity and enjoyment while playing the VR game Gorilla Tag to observe whether the game can elicit moderate to vigorous physical activity. Methodology: This study enrolled 28 healthy adults aged 18-39 who had not played Gorilla Tag in the last month. Participants completed 5 study sessions. For four sessions, participants played Gorilla Tag for 15 minutes, and for one session, participants rode a stationary bike for 15 minutes. A heart rate (HR) monitor was worn by the participants during game play and cycling to measure their physical activity intensity levels with the measure of percentage of heart rate reserve (%HRR). An 8-item physical activity enjoyment scale (PACES) was given to determine the participant's enjoyment level of playing Gorilla Tag and cycling. Results: The analysis revealed that HR increased significantly while participants played Gorilla Tag and rode the stationary cycle. The results also showed that participants had a higher %HRR while riding the stationary bike compared to while playing Gorilla Tag (p’s <.001). Based on %HRR values, Gorilla Tag elicited light to moderate intensity physical activity, while the stationary bike elicited moderate to vigorous intensity physical activity. Enjoyment levels did not differ between sessions of Gorilla Tag and cycling. Bivariate correlations indicated that greater intensity of physical activity during Gorilla tag was related to greater enjoyment of gameplay. Conclusion: The active VR game Gorilla Tag is rated as an enjoyable game that elicits light to moderate physical activity during gameplay in healthy younger adults.Item Propranolol Elicits Long Term Systemic Effects After Repetitive Mild Traumatic Brain Injury(2023-07) Smith, Jared Andre; Obukhov, Alexander; White, Fletcher; Hato, Takashi; Naugle, Kelly; Jin, Xiaoming; Truitt, William; Grimes, JaisonThere are almost 2 million new traumatic brain injuries (TBIs) every year in the US. Of these, 80% of these can be classified as mild TBI, also known as concussions, that can lead to pronounced long term symptoms months and years after injury. The presence of post traumatic headaches (PTH) is the most common chronic side effect with prevalence of 47-95% of mTBI patients within a week of injury. Though the mechanisms after TBI leading to these headaches and other post mTBI side effects are poorly understood, recent studies have suggested the role of the immune system after injury plays a causal role in this process. Peripheral immune cells can travel to the brain after mTBI as a result of blood brain barrier dysfunction, sympathetic nervous signaling, and the release of inflammatory mediators. Recent studies have shown sympathetic activation after injury can result in IL-10 dependent systemic immunosuppressive state after mTBI. In this study we sought to limit sympathetic dependent immune alterations after injury by injecting the beta blocker propranolol directly after injury and investigating the immune changes in the blood, brain, spleen, and bone marrow of mTBI animals. Together, these data show mTBI causes immune genetic and pathway level changes at least one month after injury and that propranolol alters genes important for metabolism, cytokine signaling, epigenetic modification, innate, and adaptive immunity. We also find that propranolol reduces the presence of Ly6C+ and increases the presence of Ly6C- monocytes in the blood one month after injury; however, it leads to increased Ly6C+ monocyte presence in the spleen of mTBI mice. In conclusion, propranolol administration directly after mTBI leads to immune changes that may lead to long-term improvement in post TBI symptomology.Item Virtual Reality: Its Effects on Physical Activity Intensity and Pain Sensitivity(2020-12) Evans, Eric Joseph; Naugle, Kelly; Arnold, Brent; Kaleth, Anthony; Naugle, KeithThe ability of virtual reality (VR) active games to elicit moderate-to-vigorous physical activity (MVPA) has yet to be fully understood. Also, whether VR combined with physical activity could have a greater pain reducing effect compared to non-active VR distraction remains unknown. The purpose of this study was to evaluate the effects of commercial VR active games on physical activity intensity levels, enjoyment, and pain sensitivity in young health adults. Thirty-six (18 males, 18 females) participants completed four study sessions, with each devoted to playing one VR game for fifteen minutes. The games included Beat Saber, Holopoint, Hot Squat, and Relax Walk VR. Levels of physical activity reached during VR gameplay were measured with percentage of heart rate reserve (%HRR), ratings of perceived exertion (RPE), and accelerometry. Enjoyment was measured with a visual analog scale and the Physical Activity Enjoyment Scale following each gaming session. Pressure pain thresholds (PPT’s) of the dominant forearm and ipsilateral thigh were conducted before and after VR gameplay. The primary outcome measures were analyzed with mixed model ANOVAs. The %HRR and RPE results showed that only Hot Squat consistently elicited moderate intensity activity. Accelerometry data showed that Hot Squat and Holopoint elicited higher whole body and lower body intensity levels than Beat Saber and Relax Walk VR. For enjoyment, Beat Saber and Holopoint were rated higher than Hot Squat and Relax Walk VR. Results for pressure pain thresholds (PPT’s) showed 1) an overall acute hypoalgesic effect on the forearm and thigh following all VR games, and 2) an enhanced hypoalgesic effect (combining MVPA and VR distraction) on the thigh following Hot Squat. Overall, results from this study suggest that active VR games can elicit varying degrees of physical activity intensity levels in young healthy adults, with Hot Squat eliciting moderate intensity activity. Thus, active VR games could be an alternative and enjoyable mode of obtaining physical activity. This study also showed that active VR games can elicit an acute hypoalgesic effect, with the effect potentially exacerbated with greater movement during gameplay.