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.
Mathieu Michaud, William J. Harvey, and Gordon A. Bloom
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.
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.
Hannah Bennett, Robert Owens, and Tanya Prewitt-White
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.
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.
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.
Thomas Jacob, Swarnab Dutta, Salai Jeyaseelan Annamalai, and Varadhan SKM
The efficient coordination of fingertip forces to maintain static equilibrium while grasping an object continues to intrigue scientists. While many studies have explored this coordination, most of these studies assumed that interactions of hands primarily occur with rigid inanimate objects. Instead, our daily interactions with living and nonliving entities involve many dynamic, compliant, or fragile bodies. This paper investigates the fingertip force coordination on a manipulandum that changes its shape while grasping it. We designed a five-finger perturbation system with linear actuators at positions corresponding to each finger that would protrude outward from the center of the handle or retract toward the center of the handle as programmed. The behavior of the perturbed fingers and the other fingers while grasping this device was studied. Based on previous experiments on expanding and contracting handles, we hypothesized that each finger would exhibit a comparable response to similar horizontal perturbations. However, the response of the little finger was significantly different from the other fingers. We speculate that the central nervous system demonstrates preferential recruitment of some fingers over others while performing a task.
Hangue Park, Alexander N. Klishko, Kyunggeune Oh, Celina Zhang, Gina Grenga, Kinsey R. Herrin, John F. Dalton IV, Robert S. Kistenberg, Michel A. Lemay, Mark Pitkin, Stephen P. DeWeerth, and Boris I. Prilutsky
Cutaneous feedback from feet is involved in regulation of muscle activity during locomotion, and the lack of this feedback results in motor deficits. We tested the hypothesis that locomotor changes caused by local unilateral anesthesia of paw pads in the cat could be reduced/reversed by electrical stimulation of cutaneous and proprioceptive afferents in the distal tibial nerve during stance. Several split-belt conditions were investigated in four adult female cats. In addition, we investigated the effects of similar distal tibial nerve stimulation on overground walking of one male cat that had a transtibial, bone-anchored prosthesis for 29 months and, thus, had no cutaneous/proprioceptive feedback from the foot. In all treadmill conditions, cats walked with intact cutaneous feedback (control), with right fore- and hindpaw pads anesthetized by lidocaine injections, and with a combination of anesthesia and electrical stimulation of the ipsilateral distal tibial nerve during the stance phase at 1.2× threshold of afferent activation. Electrical stimulation of the distal tibial nerve during the stance phase of walking with anesthetized ipsilateral paw pads reversed or significantly reduced the effects of paw pad anesthesia on several kinematic variables, including lateral center of mass shift, cycle and swing durations, and duty factor. We also found that stimulation of the residual distal tibial nerve in the prosthetic hindlimb often had different effects on kinematics compared with stimulation of the intact hindlimb with paw anesthetized. We suggest that stimulation of cutaneous and proprioceptive afferents in the distal tibial nerve provides functionally meaningful motion-dependent sensory feedback, and stimulation responses depend on limb conditions.