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Mathieu Michaud, William J. Harvey, and Gordon A. Bloom

The purpose of this scoping review was to examine how mixed methods research (MMR) has been applied in adapted physical activity (APA) research about children and adolescents age 5–18 years with a disability. Six electronic databases were searched to retrieve relevant studies published between 2003 and 2020. Sixty-four studies were identified and analyzed. The findings were organized into five categories of interest: publication information, study objectives, mixed methods research design, participants’ information, and data integration. Challenges related to the design and publication of MMR in APA were uncovered, and suggestions for improvement are provided. This study adds to the knowledge of MMR design, and it provides an understanding of the underlying processes and methodological strategies that have guided this approach in APA research. This article will encourage APA researchers to engage in MMR while also aligning future studies with contemporary MMR literature and publication standards.

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Tess M.R. Carswell, Brenton G. Hordacre, Marc D. Klimstra, and Joshua W. Giles

Research addressing lower limb amputee gait and prosthetic design often focuses on men, despite female lower limb amputees having different risk factors and lower success with their prosthetics overall. It is widely agreed that sex differences exist in able-bodied gait, but research analyzing sex differences in amputee gait is rare. This study compared male and female transtibial amputee gait to ascertain potential sex differences. Forty-five transtibial amputees were asked to walk at their self-selected speed, and spatiotemporal gait data were obtained. Both the mean and variability metric of parameters were analyzed for 10 male and 10 female participants. For all participants, amputated limbs had a shorter stance time, longer swing time, and larger step length. Females had a 10% shorter stance time and 26% larger normalized step and stride length than males. Female participants also walked over 20% faster than male participants. Finally, significant interactions were found in the mean and variability metric of stride velocity, indicating greater variability in women. These findings suggest that sex differences exist in transtibial amputee gait, offering possible explanations for the different comorbidities experienced by female lower limb amputees. These results have major implications for female amputees and for sex-specific research, rehabilitation, and prosthetic design.

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Li-Shan Chang, Xiong-Wen Ke, Weerawat Limroongreungrat, and Yong Tai Wang

The purpose of this study was to determine shoulder joint reaction forces and muscle moments during 2 speeds (1.3 and 2.2 m/s) of wheelchair propulsion and to investigate the relationship between joints reaction forces, muscle moments, and shoulder pain. The measurements were obtained from 20 manual wheelchair users. A JR3 6-channel load sensor (±1% error) and a Qualisys system were used to record 3-dimensional pushrim kinetics and kinematics. A 3-dimensional inverse dynamic model was generated to compute joint kinetics. The results demonstrated significant differences in shoulder joint forces and moments (P < .01) between the 2 speeds of wheelchair propulsion. The greatest peak shoulder joint forces during the drive phase were anterior directed (Fy, 184.69 N), and the greatest joint moment was the shoulder flexion direction (flexion moment, 35.79 N·m) at 2.2 m/s. All the shoulder joint reaction forces and flexion moment were significantly (P < .05) related to shoulder pain index. The forces combined in superior and anterior direction found at the shoulder joint may contribute to the compression of subacromial structure and predispose manual wheelchair users to potential rotator cuff impingement syndrome.

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Jessica Prebor, Brittany Samulski, Cortney Armitano-Lago, and Steven Morrison

It is widely accepted that the general process of aging can be reflected by changes in motor function. Typically, optimal performance of a given motor task is observed for healthy young adults with declines being observed for individuals at either end of the lifespan. This study was designed to examine differences in the average and variability (i.e., intraindividual variability) of chewing, simple reaction time, postural control, and walking responses. For this study, 15 healthy children, 15 young adults, and 15 older adults participated. Our results indicated the movement performance for the reaction time and postural sway followed a U shape with young adults having faster reaction times and decreased postural sway compared to the children and older adults. However, this pattern was not preserved across all motor tasks with no age differences emerging for (normalized) gait speed, while chewing rates followed a U-shaped curve with older adults and children chewing at faster rates. Taken together, these findings would indicate that the descriptive changes in motor function with aging are heavily influenced by the nature of the task being performed and are unlikely to follow a singular pattern.

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Jing Wen Pan, Pui Wah Kong, and John Komar

This study aimed to investigate individual trial-to-trial performance in three tests to define adaptive regulation as a key feature of expertise in nine-ball. Thirty-one male players were assigned into the low-skilled (n = 11), intermediate (n = 10), or high-skilled groups (n = 10). The power control, cue alignment, and angle tests were selected to assess participants’ ability to control the power applied in shots, strike the ball straight, and understand the ball paths, respectively. Error distance and correction of error distance were identified for each shot using 2D video analysis. Results of one-way analysis of variance showed that the high-skilled group performed better in two out of the three tests than the other two groups (p = .010 for the cue alignment test; p = .002 for the angle test). However, the adaptation effect represented by the decreased error distances across trials was not observed. Pearson correlation revealed only a few significant correlations between the error distance and its correction within each participant in all tests (p < .05), and hence, the hypothesis that “low correction happened after small error and vice versa” is not supported.

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Toshiaki Soga, Hiromi Saito, Kei Akiyama, and Norikazu Hirose

This crossover trial aimed to investigate whether additional loading of unilateral Nordic hamstring exercise on a sloped platform would increase the biceps femoris long head electromyographic activity. Participants were randomly allocated to unilateral Nordic hamstring exercise under three conditions: bodyweight only (BW) or BW with an added weighted ball of 3 kg (BW + 3 kg) or 6 kg (BW + 6 kg), respectively. The biceps femoris long head electromyographic activity was significantly higher for BW + 6 kg (p < .001) than for BW and BW + 3 kg (p < .01). Therefore, adding a load to unilateral Nordic hamstring exercise on a sloped platform might be effective for rehabilitation and prevention of hamstring strain injury recurrence.

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Taylor B. Chandler, Matthew J. Rivera, Elizabeth R. Neil, and Lindsey E. Eberman

Screening for behavioral health (BH) concerns is important for early identification, referral, and management. The purpose of this study was to examine collegiate athletic trainers use of BH screening tools. We used a cross-sectional design with a web-based survey. Approximately 49% (n = 198/405) of participants used BH screening tools in their practice; the most used tools were PHQ-9 (n = 112/198, 56.6%) and GAD-7 (n = 54/198, 27.3%). Practice integration considerations and practice advancements occurred as a result of BH screening. Given rising incidence and severity of BH conditions in collegiate athletics, more training on screening and prevention is needed.

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Larry R. Munger, Jean-Michel Brismée, Phillip S. Sizer, and C. Roger James

This study investigated whether the directional balance and reach with and without rotation is a reliable screening tool to measure dynamic balance and ability to control motion in three planes. Twenty healthy, collegiate athletes participated. The directional balance and reach exhibited good to excellent levels of intra- and interrater reliability (intraclass correlation coefficient = .77–.99). The directional balance and reach provides clinicians with a reliable method that requires minimum financial, spatial, and temporal costs to administer in small and large screening, training, and evaluation programs to recognize asymmetries and deficits in assessing dynamic balance in all three planes of motion.

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Alyssa N. Olivas, Emily A. Chavez, and Jeffrey D. Eggleston

Weighted vests have been used primarily as behavioral interventions for children and adolescents with autism. Contemporary research has begun to examine weighted vest effects on movement. Previous research in children with neurotypical development revealed 15% body mass loads modified spatial-temporal gait characteristics; however, a value applicable to children and adolescents with autism has not been established. The purpose of this study was to establish an appropriate mass value by examining spatial-temporal gait parameters in children and adolescents with autism with various loads in a weighted vest. Nine children and adolescents with autism, aged 8–17, walked without a weighted vest, with 5%, 10%, 15%, and 20% body mass while spatial-temporal data were captured. Repeated-measures analysis of variance (α = .05) were conducted among conditions for each variable, with a Holm–Bonferroni method correction. Analysis revealed significant decreases in right step length, but no differences in stride width, left step length, double-limb support time, or stride velocity were observed. Due to insignificant findings, an appropriate mass value could not be determined for weighted vests for children with autism. However, unchanged spatial-temporal gait parameters with increasing loads could be clinically relevant as weighted vest loads of 10% are typically used for behavioral interventions.