Chronic severe somatoform disorder (SFD) is resistant to treatment. In a prospective observational study, we evaluated an intensive multidisciplinary treatment focusing on body-related mentalization and acceptance. Patients included in the study were 183 (146 women, 37 men) of 311 eligible patients with chronic severe SFD, referred consecutively to a specialized tertiary care center between 2002 and 2009. Primary outcome measures were somatic symptoms (SCL-90) and health-related quality of life (EuroQol 5-Dimensional [EQ-5D]). These measures were assessed four times before treatment (on intake, twice during an observation period, at start of treatment) and four times after treatment (during follow-up for 2 years). Multilevel analysis was used to separate effects of time (maturation) and treatment. Results revealed significant improvements in SCL-90 somatic symptoms (d = 0.51), EQ-5D index (d = 0.27), and EQ visual analogue scale (d = 0.56). Significant reductions were also observed in SCL-90 anxiety, depression, and overall psychopathology as well as in medical consumption associated with psychiatric illness (Trimbos/iMTA Questionnaire for Costs Associated With Psychiatric Illness). Large interindividual differences were found in treatment outcome. The long-term improvement seen in many patients suggests that intensive multidisciplinary tertiary care treatment is a useful approach to chronic severe SFD.

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Mechanical power output is a key performance-determining variable in many cyclic sports. In rowing, instantaneous power output is commonly determined as the dot product of handle force moment and oar angular velocity. The aim of this study was to show that this commonly used proxy is theoretically flawed and to provide an indication of the magnitude of the error. To obtain a consistent dataset, simulations were performed using a previously proposed forward dynamical model. Inputs were previously recorded rower kinematics and horizontal oar angle, at 20 and 32 strokes∙min. From simulation outputs, true power output and power output according to the common proxy were calculated. The error when using the common proxy was quantified as the difference between the average power output according to the proxy and the true average power output (P̅), and as the ratio of this difference to the true average power output (ratio). At stroke rate 20, P̅ was 27.4 W and ratio was 0.143; at stroke rate 32, P̅ was 44.3 W and ratio was 0.142. Power output in rowing appears to be underestimated when calculated according to the common proxy. Simulations suggest this error to be at least 10% of the true power output.

For a valid determination of a rower's mechanical power output, the anterior-posterior (AP) acceleration of a rower's centre of mass (CoM) is required. The current study was designed to evaluate the accuracy of the determination of this acceleration using a full-body inertial measurement units (IMUs) suit in combination with a mass distribution model. Three methods were evaluated. In the first two methods, IMU data were combined with either a subject-specific mass distribution or a standard mass distribution model for athletes. In the third method, a rower's AP CoM acceleration was estimated using a single IMU placed at the pelvis. Experienced rowers rowed on an ergometer that was placed on two force plates, while wearing a full-body IMUs suit. Correspondence values between AP CoM acceleration based on IMU data (the three methods) and AP CoM acceleration obtained from force plate data (reference) were calculated. Good correspondence was found between the reference AP CoM acceleration and the AP CoM accelerations determined using IMU data in combination with the subject-specific mass model and the standard mass model (intraclass correlation coefficients [ICC] > 0.988 and normalized root mean square errors [nRMSE] 3.81%). Correspondence was lower for the AP CoM accelerations determined using a single pelvis IMU (0.877 < ICC < 0.960 and 6.11% < nRMSE < 13.61%). Based on these results, we recommend determining a rower's AP CoM acceleration using IMUs in combination with the standard mass model. Finally, we conclude that accurate determination of a rower's AP CoM acceleration is not possible on the basis of the pelvis acceleration only.

van der Zwaard, S, Hooft Graafland, F, van Middelkoop, C, and Lintmeijer, LL. Validity and reliability of facial rating of perceived exertion scales for training load monitoring. J Strength Cond Res 37(5): e317-e324, 2023-Rating of perceived exertion (RPE) is often used by coaches and athletes to indicate exercise intensity, which facilitates training load monitoring and prescription. Although RPE is typically measured using the Borg's category-ratio 10-point scale (CR10), digital sports platforms have recently started to incorporate facial RPE scales, which potentially have a better user experience. The aim of this study was to evaluate the validity and reliability of a 5-point facial RPE scale (FCR5) and a 10-point facial RPE scale (FCR10), using the CR10 as a golden standard and to assess their use for training load monitoring. Forty-nine subjects were grouped into 17 untrained (UT), 19 recreationally trained (RT), and 13 trained (T) individuals Subjects completed 9 randomly ordered home-based workout sessions (3 intensities 3 3 RPE scales) on the Fitchannel.com platform. Heart rate was monitored throughout the workouts. Subjects performed 3 additional workouts to assess reliability. Validity and reliability of both facial RPE scales were low in UT subjects (intraclass correlation [ICC] # 0.44, p # 0.06 and ICC # 0.43, p $ 0.09). In RT and T subjects, validity was moderate for FCR5 (ICC $ 0.72, p , 0.001) and good for FCR10 (ICC $ 0.80, p , 0.001). Reliability for these groups was rather poor for FCR5 (ICC 5 0.51, p 5 0.006) and moderate for FCR10 (ICC 5 0.74, p , 0.001), but it was excellent for CR10 (ICC 5 0.92, p , 0.001). In RT and T subjects, session RPE scores were also strongly related to Edward's training impulse scores (r $ 0.70, p , 0.001). User experience was best supported by the FCR10 scale. In conclusion, researchers, coaches, strength and conditioning professionals, and digital sports platforms are encouraged to incorporate the valid and reliable FCR10 and not FCR5 to assess perceived exertion and internal training load of recreationally trained and trained individuals.