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Fascia training follows the following principles: |
Preparatory counter-movement (increasing elastic recoil by pre-stretching involved fascial tissues); |
The Ninja principle (focus on effortless movement quality); |
Dynamic stretching (alternation of melting static stretches with dynamic stretches that include mini-bounces, with multiple directional variations); |
Proprioceptive refinement (enhancing somatic perceptiveness by mindfulness oriented movement explorations); |
Hydration and renewal (foam rolling and similar tool-assisted myofascial self-treatment applications); |
Sustainability: respecting the slower adaptation speed but more sustaining effects of fascial tissues (compared with muscles) by aiming at visible body improvements of longer time periods, usually said to happen over 3 to 24 months. |
Evidence |
While good to moderate scientific evidence exists for several of the included training principles – e.g. the inclusion of elastic recoil as well as a training of proprioceptive refinement – there is currently insufficient evidence for the claimed beneficial effects of a fascia oriented exercises program as such, consisting of a combination of the above described four training elements.Self-myofascial release using a foam roller or roller massager pre- and post-exercise has been observed to decrease soreness due to DOMS. Self-myofascial release appears to have no negative effect on performance. |
References |
Habit reversal training |
Habit reversal training (HRT) is a "multicomponent behavioral treatment package originally developed to address a wide variety of repetitive behavior disorders".Behavioral disorders treated with HRT include tics, trichotillomania, nail biting, thumb sucking, skin picking, temporomandibular disorder (TMJ), lip-cheek biting and stuttering. It consists of five components: awareness training, competing response training, contingency management, relaxation training, and generalization training.Research on the efficacy of HRT for behavioral disorders have produced consistent, large effect sizes (approximately 0.80 across the disorders). It has met the standard of a well-established treatment for stuttering, thumb sucking, nail biting, and TMJ disorders. According to a meta-analysis from 2012, decoupling, a self-help variant of HRT, also shows efficacy. |
For tic disorders |
In case of a tic, these components are intended to increase tic awareness, develop a competing response to the tic, and build treatment motivation and compliance. HRT is based on the presence of a premonitory urge, or sensation occurring before a tic. HRT involves replacing a tic with a competing response—a more comfortable or acceptable movement or sound—when a patient feels a premonitory urge building.Controlled trials have demonstrated that HRT is an acceptable, tolerable, effective and durable treatment for tics; HRT reduces the severity of vocal tics, and results in enduring improvement of tics when compared with supportive therapy. HRT has been shown to be more effective than supportive therapy and, in some studies, medication. HRT is not yet proven or widely accepted, but large-scale trials are ongoing and should provide better information about its efficacy in treating Tourette syndrome. Studies through 2006 are "characterized by a number of design limitations, including relatively small sample sizes, limited characterization of study participants, limited data on children and adolescents, lack of attention to the assessment of treatment integrity and adherence, and limited attention to the identification of potential clinical and neurocognitive mechanisms and predictors of treatment response". Additional controlled studies of HRT are needed to address whether HRT, medication, or a combination of both is most effective, but in the interim, "HRT either alone or in combination with medication should be considered as a viable treatment" for tic disorders. |
Comprehensive Behavioral Intervention for Tics |
Comprehensive Behavioral Intervention for Tics (CBIT), based on HRT, is a first-line treatment for Tourette syndrome and tic disorders. With a high level of confidence, CBIT has been shown to be more likely to lead to a reduction in tics than other supportive therapies or psychoeducation. Some limitations are: children younger than ten may not understand the treatment, people with severe tics or ADHD may not be able to suppress their tics or sustain the required focus to benefit from behavioral treatments, there is a lack of therapists trained in behavioral interventions, finding practitioners outside of specialty clinics can be difficult, and costs may limit accessibility. Whether increased awareness of tics through HRT/CBIT (as opposed to moving attention away from them) leads to further increases in tics later in life is a subject of discussion among TS experts. |
See also |
Cognitive behavioral therapy |
Operant conditioning |
Behaviour therapy |
Decoupling |
References and notes |
Hypoventilation training |
Hypoventilation training is a physical training method in which periods of exercise with reduced breathing frequency are interspersed with periods with normal breathing. The hypoventilation technique consists of short breath holdings and can be performed in different types of exercise: running, cycling, swimming, rowing, skating, etc. |
Generally, there are two ways to carry out hypoventilation: at high lung volume or at low lung volume. At high lung volume, breath holdings are performed with the lungs full of air (inhalation then breath hold). Conversely, during hypoventilation at low lung volume, breath holdings are performed with the lung half full of air. To do so, one has to first exhale normally, without forcing, then hold one's breath. This is called the exhale-hold technique. |
The scientific studies have shown that only hypoventilation at low lung volume could lead to both a significant decrease in oxygen (O2) concentrations in the body and an increase in carbon dioxide concentrations (CO2), which are indispensable for the method to be effective. |
History |
The first known form of hypoventilation occurred in the 1950s during training of the runners of Eastern Europe and former USSR. One of the most famous athletes to have used this method is Emil Zátopek, the Czech long-distance runner, four times Olympic gold medalist and former holder of 18 world records. Zátopek, who was a precursor in training, regularly used to run by holding his breath to harden his training and simulate the conditions of competition. However, at that time, the effects of hypoventilation training were completely unknown and the method was applied very empirically. |
At the beginning of the 1970s, American swim coach James Counsilman used a new training technique which involved taking a limited number of inhalations while swimming laps in a pool. The effect of this kind of training was determined to decrease the body's O2 content and simulate altitude training. Due to the method's efficacy, hypoventilation became a common training method for many swimmers. |
It is especially from the 1980s that the scientific studies on exercise with reduced breathing frequency began to be published. While the method advocated by Counsilman attracted a following in some runners and athletics coaches, the results of the studies contradicted the hypotheses put forward by the World of Sport. They showed that this training method did not decrease body O2 concentrations and provoked only a hypercapnic effect, i.e. an increase in CO2 concentrations. Both the effectiveness and legitimacy of hypoventilation training were strongly challenged. |
Since the middle of the 2000s, a series of studies has been conducted by French researchers of Paris 13 University to propose a new approach to hypoventilation training. Xavier Woorons and his team hypothesized that if breath holdings were carried out with the lungs half-full of air, rather than full of air as performed so far, it would be possible to significantly reduce body oxygenation. The results that were published confirmed the hypotheses. They demonstrated that through hypoventilation at low lung volume, that is the exhale-hold technique, it was possible, without leaving sea level, to decrease O2 concentrations in the blood and in the muscles at levels corresponding to altitudes above 2000 m. |
Physiological effects |
When exercise is being performed, if the exhale-hold technique is properly applied, a decrease in O2 concentrations and an increase in CO2 concentrations occur in the lungs, the blood and the muscles. The combined effect of hypoxia and hypercapnia act as a strong stimulus whose main consequence is to increase lactic acid and hydrogen ions production, and therefore to provoke a strong acidosis in the body. Thus, during exercise with hypoventilation, the blood and muscle acid–base homeostasis is highly disturbed. The studies have also reported an increase in all heart activity when hypoventilation is carried out in terrestrial sports. Cardiac output, heart rate, stroke volume and sympathetic modulation to the heart are greater when exercise with hypoventilation is performed in running or cycling. A slightly higher blood pressure has also been recorded. In swimming on the other hand, no significant change in the heart activity has been found.After several weeks of hypoventilation training, physiological adaptations occur that delay the onset of acidosis during a maximal exertion test. The studies have shown that at a given workload, pH and blood bicarbonate concentrations were higher, whereas lactate concentrations had a tendency to decrease. The reduction in acidosis would be due to an improvement in buffer capacity at the muscle level. However, no change advantageous to aerobic metabolism has been found. Maximal oxygen uptake (VO2max), the number of red blood cells and the anaerobic threshold were not modified after hypoventilation training. |
Benefits of the method |
By delaying acidosis, hypoventilation training would also delay the onset of fatigue and would therefore improve performance during strenuous exertions of short to moderate durations. After several weeks of hypoventilation training, performance gains between 1 and 4% have been reported in running and swimming. The method could be interesting to use in sports requiring strenuous repeated or continuous exertions, whose duration does not exceed a dozen minutes: swimming, middle-distance running, cycling, combat sports, team sports, racquet sports, etc.Another advantage of hypoventilation training is to stimulate the anaerobic metabolism without using high exercise intensities, which are more traumatizing for the locomotor system and therefore increase the risk of injuries. Athletes who return progressively to their sporting activity after being injured, and who therefore have to protect their muscles, joints and tendons, could train at low or moderate intensity with hypoventilation. |
Disadvantages of the method |
Hypoventilation training is physically demanding. This method is intended for highly motivated athletes, who do not have pulmonary or cardiovascular issues and whose primary objective is performance. Furthermore, exercising with hypoventilation can provoke headaches if the breath holdings are maintained too long or repeated over a too long period of time. Finally, this training method does not seem to be beneficial for endurance sports. |
See also |
Buteyko method |
Hypoventilation |
Hypoxia |
Hypercapnia |
Recommended reading |
Woorons, Xavier, Hypoventilation training, push your limits!, Arpeh, 2014, 164p. (ISBN 978-2-9546040-1-5)Hypoventilation training, push your limits!, Arpeh, 2014, 164p. (ISBN 978-2-9546040-1-5) |
References |
External links |
Association for Research and Promotion of Hypoventilation Training (ARPEH) |
Infant sleep training |
Sleep training (sometimes known as sleep coaching) is a set of parental (or caregiver) intervention techniques with the end goal of increasing nightly sleep in infants and young children, addressing “sleep concerns”, and decreasing nightime signalling. Although the diagnostic criteria for sleep issues in infants is rare and limited, sleep training is usually approached by parent(s) or caregivers self indentifying supposed sleep issues.The idea of early independence and sleep training in babies was promoted by Dr. Luther Emmett who published The Care and Feeding of Children in 1894. This is widely believed to be the basis from which, modern sleep training has evolved. |
Popular methods of sleep training include extinction or “cry it out”, Ferber, The Chair Approach, and more improvised “gentle” methods. |
Sleep training tends to be popular in countries such as the USA and UK, and is mostly unheard of in societies that practice cultural cosleeping. |
The development of sleep over the first year |
During the first year of life, infants spend most of their time sleeping. An infant can go through several periods of change in sleep patterns. These can start at 1 week, occurring weekly or fortnightly, until 8 years of age due to innate and external factors that contribute to sleep.Developing infants also sleep within a large spectrum of sleep — falling into high and low needs categories — fragmented through 24 hours.These frequent night awakenings are an evolved trait, to feed frequently and playing a part in SIDS protection. However, this can be disruptive for the parent(s) or caregiver — for example, if maternity leave is non-existent or they feel the benefits of an undisturbed night can help with severe sleep deprivation. Parents who sleep trained perceive improvement in infant sleep. |
Good sleep conditions |
Sylvia Bell of Johns Hopkins University reported: by the end of the first year individual differences in crying reflect the history of maternal responsiveness rather than constitutional differences in infant irritability. She also notes: consistency and promptness of maternal response is associated with decline in frequency and duration of infant crying. When following through with this maternal response, Bell notes that it is most effective to apply physical contact with the infant.The sleep position is also important to prevent Sudden Infant Death Syndrome (SIDS). It is recommended that the proper position for children to sleep in to avoid SIDS is laying on their back throughout the night. Their bedding should be firm and crib should be free from toys or blankets that could cause injury or suffocation to the child. Loose blankets and toys in the crib can increase the child’s risk of SIDS. |
Controversies in sleep training |
Sleep training in a separate room, under 6 months is not recommended due to the SIDS reduction factors at play. A committed caregiver in the same room for all day and night sleeps reduces the risk of SIDS by 50 per cent.These guidelines for baby being in the same room differs from 6 months to 12 months in different countries. |
The ECAS study attributed 36 per cent of total SIDS deaths to sleeping alone in a room.Another key debate in sleep training revolves around getting the right balance between parental soothing and expecting baby to be independent. Attachment parenting is a parenting philosophy characterized by practices such as baby-wearing (carrying infants in slings or holding them frequently), long-term breastfeeding, co-sleeping (sharing the parental bed with the baby), and promptly responding to a baby's cries. Popular sleep training methods, such as the Ferber Method, rely on letting the baby cry for a certain number of minutes, to allow the child a chance to fall asleep more independently and move away from an over-reliance on parental assistance to fall asleep. Advocates of attachment parenting generally reject traditional sleep training methods that involve allowing a baby to cry, asserting that such practices do not align with meeting the child's immediate needs.A study conducted also showed that sleep trained babies displayed elevated cortisol levels (a proxy for stress, although this study did not have control babies without sleep training), but were simply not signalling to their parents.Another method is Behavioral Infant Sleep Intervention to effectively reduce infant sleep problems and associated maternal depression in the short- to medium-terms. This method randomized tried and found effective at reducing the short- to medium-term burden of infant sleep problems and maternal depression One study shows that 80% of infants from Asian countries shared a room with their parents. These parents reported less overall sleep compared to the Caucasian countries where 50% of infants were reported to be sharing a room with their parents during the infants' first couple months of life.One study reported parents waking up in the night less and feeling more parental competence in the group that was taught these behavioral techniques.Sleep coaching industry has been criticized for being unregulated, suffering from excessive fees. |
See also |
Insomnia |
Subsets and Splits