Placebo effects in sports and exercise
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The aim of this review was to determine the magnitude of the placebo and nocebo effect on sport performance. Articles published before March 2019 were located using Medline, Web of Science, PubMed, EBSCO, Science Direct, and Scopus.... more
The aim of this review was to determine the magnitude of the placebo and nocebo effect on sport performance. Articles published before March 2019 were located using Medline, Web of Science, PubMed, EBSCO, Science Direct, and Scopus. Studies that examined placebo and nocebo effects of an objective dependent variable on sports Performance, which included a control or baseline condition, were included in the analysis. Studies were classified into two categories of ergogenic aids: 1) nutritional and 2) mechanical. Cohen’s d effect sizes were calculated from 32 studies involving 1,513 participants. Small to moderate placebo effects were found for both placebo (d = 0.36) and nocebo (d = 0.37) effects and when separated by nutritional (d = 0.35) and mechanical (d = 0.47) ergogenic aids. The pooled effect size revealed a small to moderate effect size across all studies (d = 0.38). Results suggest that placebo and nocebo effects can exert a small to moderate effect on sports performance.
The placebo effect is traditionally viewed as a positive outcome resulting from a person’s belief that an inert substance is in fact an active drug. In this context, it is often viewed as an intrapsychic phenomenon. However, most placebo... more
The placebo effect is traditionally viewed as a positive outcome resulting from a person’s belief that an inert substance is in fact an active drug. In this context, it is often viewed as an intrapsychic phenomenon. However, most placebo effects reported in scientific research result from social interactions. These might be explicit, such as the description and administration of a treatment by a practitioner, or less explicit, for example, the recipient’s perceptions of the practitioner’s credibility, expertise, or confidence. On this basis, placebo effects are arguably social in origen. Many phenomena in sport are likewise social in origen, from the facilitation effects of a home field crowd or a cohesive team, to anxiety induced by an expert opponent or perceived underperformance. Such social effects have been the subject of research not only in social psychology, but also in experimental physiology. Emergent research in cognitive and evolutionary anthropology suggests that these social effects can be examined as a form of placebo effect. This suggestion is not a speculative position
predicated on social and placebo effects sharing similar environmental cues and outcomes, but one based on a growing database indicating that drug, placebo, and social effects operate via common neurobiological mechanisms. In this paper, we examine the theoretical and empirical overlap between placebo and social effects and describe emergent research reporting specific brain pathways activated by socio-environmental cues as well as by drugs and placebos. We do so from
three perspectives: the competitor, the teammate, the researcher.
predicated on social and placebo effects sharing similar environmental cues and outcomes, but one based on a growing database indicating that drug, placebo, and social effects operate via common neurobiological mechanisms. In this paper, we examine the theoretical and empirical overlap between placebo and social effects and describe emergent research reporting specific brain pathways activated by socio-environmental cues as well as by drugs and placebos. We do so from
three perspectives: the competitor, the teammate, the researcher.
In June 2017 a group of experts in anthropology, biology, kinesiology, neuroscience, physiology, and psychology convened in Canterbury, UK, to address questions relating to the placebo effect in sport and exercise. The event was supported... more
In June 2017 a group of experts in anthropology, biology, kinesiology, neuroscience, physiology, and psychology convened in Canterbury, UK, to address questions relating to the placebo effect in sport and exercise. The event was supported exclusively by Quality Related (QR) funding from the Higher Education Funding Council for England (HEFCE). The funder did not
influence the content or conclusions of the group. No competing interests were declared by any delegate. During the meeting and in follow-up correspondence, all delegates agreed the need to communicate the outcomes of the meeting via a brief consensus statement. The two specific aims of this statement are to encourage researchers in sport and exercise science to
1. Where possible, adopt research methods that more effectively elucidate the role of the brain in mediating the effects of treatments and interventions.
2. Where possible, adopt methods that factor for and/or quantify placebo effects that could explain a percentage of inter-individual variability in response to treatments and intervention.
influence the content or conclusions of the group. No competing interests were declared by any delegate. During the meeting and in follow-up correspondence, all delegates agreed the need to communicate the outcomes of the meeting via a brief consensus statement. The two specific aims of this statement are to encourage researchers in sport and exercise science to
1. Where possible, adopt research methods that more effectively elucidate the role of the brain in mediating the effects of treatments and interventions.
2. Where possible, adopt methods that factor for and/or quantify placebo effects that could explain a percentage of inter-individual variability in response to treatments and intervention.
Placebo and nocebo effects are a factor in sports performance. However, the majority of published studies in sport science are descriptive and speculative regarding mechanisms. It is therefore not unreasonable for the sceptic to argue... more
Placebo and nocebo effects are a factor in sports performance. However, the majority of published studies in sport science are descriptive and speculative regarding mechanisms. It is therefore not unreasonable for the sceptic to argue that placebo and nocebo effects in sport are illusory, and might be better explained by variations in phenomena such as motivation. It is likely that, in sport at least, placebo and nocebo effects will remain in this empirical grey area until researchers provide stronger mechanistic evidence. Recent research in neuroscience has identified a number of consistent, discrete and interacting neurobiological and physiological pathways associated with placebo and nocebo effects, with many studies reporting data of potential interest to sport scientists, for example relating to pain, fatigue and motor control. Findings suggest that placebos and nocebos result in activity of the opioid, endocannabinoid and dopamine neurotransmitter systems, brain regions including the motor cortex and striatum, and measureable effects on the autonomic nervous system. Many studies have demonstrated that placebo and nocebo effects associated with a treatment, for example an inert treatment presented as an analgesic or stimulant, exhibit mechanisms similar or identical to the verum or true treatment. Such findings suggest the possibility of a wide range of distinct placebo and nocebo mechanisms that might influence sports performance. In the present paper, we present some of the findings from neuroscience. Focussing on fatigue as an outcome and caffeine as vehicle, we propose three approaches that researchers in sport might incorporate in their studies in order to better elucidate mechanisms of placebo/nocebo effects on performance.
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