Context: Ultrasound imaging is a clinically feasible tool to assess femoral articular cartilage and may have utility in tracking early knee osteoarthritis development. Traditional assessment techniques focus on measurements at a single location, which can be challenging to adopt for novice raters. Objective: To introduce a novel semiautomated ultrasound segmentation technique and determine the intrarater and interrater reliability of average regional femoral articular cartilage thickness and echo intensity of a novice and expert rater. Design: Descriptive observational study. Setting: Orthopedic clinic. Patients or Other Participants: Fifteen participants (mean [SD]; age 23.5 [4.6] y, height = 172.6 [9.3] cm, mass = 79.8 [15.7] kg) with a unilateral history of anterior cruciate ligament reconstruction participated. Intervention: None. Main Outcome Measures: One rater captured anterior femoral cartilage images of the participants’ contralateral knees using a transverse suprapatellar ultrasound assessment. The total femoral cartilage cross-sectional area of each image was segmented by a novice and expert rater. A novel custom program automatically separated the cartilage segmentations into medial, lateral, and intercondylar regions to determine the cross-sectional area and cartilage length. The average cartilage thickness in each region was calculated by dividing the cross-sectional area by the cartilage length. Echo intensity was calculated as the average gray-scale pixel value of each region. Two-way random effect intraclass correlations coefficient (ICC) for absolute agreement were used to determine the interrater reliability between a novice and expert rater, as well as the intrarater reliability of the novice rater. Results: The novice rater demonstrated excellent intrarater (ICC [2,k] range = .993–.997) and interrater (ICC [2,k] range = .944–.991) reliability with the expert rater of all femoral articular cartilage average thickness and echo intensity regions. Conclusions: The novel semiautomated average cartilage thickness and echo-intensity assessment is efficient, systematic, and reliable between an expert and novice rater with minimal training.
Caroline Lisee, Melanie L. McGrath, Christopher Kuenze, Ming Zhang, Matt Salzler, Jeffrey B. Driban and Matthew S. Harkey
Harry E. Routledge, Stuart Graham, Rocco Di Michele, Darren Burgess, Robert M. Erskine, Graeme L. Close and James P. Morton
The authors aimed to quantify (a) the periodization of physical loading and daily carbohydrate (CHO) intake across an in-season weekly microcycle of Australian Football and (b) the quantity and source of CHO consumed during game play and training. Physical loading (via global positioning system technology) and daily CHO intake (via a combination of 24-hr recall, food diaries, and remote food photographic method) were assessed in 42 professional male players during two weekly microcycles comprising a home and away fixture. The players also reported the source and quantity of CHO consumed during all games (n = 22 games) and on the training session completed 4 days before each game (n = 22 sessions). The total distance was greater (p < .05) on game day (GD; 13 km) versus all training days. The total distance differed between training days, where GD-2 (8 km) was higher than GD-1, GD-3, and GD-4 (3.5, 0, and 7 km, respectively). The daily CHO intake was also different between training days, with reported intakes of 1.8, 1.4, 2.5, and 4.5 g/kg body mass on GD-4, GD-3, GD-2, and GD-1, respectively. The CHO intake was greater (p < .05) during games (59 ± 19 g) compared with training (1 ± 1 g), where in the former, 75% of the CHO consumed was from fluids as opposed to gels. Although the data suggest that Australian Football players practice elements of CHO periodization, the low absolute CHO intakes likely represent considerable underreporting in this population. Even when accounting for potential underreporting, the data also suggest Australian Football players underconsume CHO in relation to the physical demands of training and competition.
Maureen R. Weiss
Children and youth participate in physical activities to develop and demonstrate physical competence, attain social acceptance and approval, and experience enjoyment. Satisfying these motives enhances interest in sustaining physical activity, which contributes to improved motor skills, self-confidence, social relationships, and other positive outcomes. My essay explores motor skill development and youth physical activity through a social psychological lens and the benefits of integrating scientific knowledge from our respective fields to inform research and professional practice. Motor development and sport psychology researchers can collaborate to address critical issues related to motor and perceived competence and physical activity. I recommend five ways for integrating knowledge: (1) applying social psychological theory to guide research questions, (2) using more longitudinal designs, (3) using a variety of quantitative and qualitative methods, (4) designing studies on physical literacy, and (5) employing a positive youth development (PYD) approach for improving motor and social-emotional skills. These efforts can assist teachers, coaches, and parents in creating opportunities for youth to learn and improve fundamental motor and sport skills and to achieve feelings of competence, autonomy, relatedness, and joy for motivating a lifetime of physical activity.
Nicholas Stanger and Susan H. Backhouse
Moral identity and moral disengagement have been linked with doping likelihood. However, experiments testing the temporal direction of these relationships are absent. The authors conducted one cross-sectional and two experimental studies investigating the conjunctive effects of moral identity and moral disengagement on doping likelihood (or intention). Dispositional moral identity was inversely (marginally), and doping moral disengagement, positively, associated with doping intention (Study 1). Manipulating situations to amplify opportunities for moral disengagement increased doping likelihood via anticipated guilt (Study 2). Moreover, dispositional moral identity (Study 2) and inducing moral identity (Study 3) were linked with lower doping likelihood and attenuated the relationship between doping moral disengagement and doping likelihood. However, the suppressing effect of moral identity on doping likelihood was overridden when opportunities for moral disengagement were amplified. These findings support multifaceted antidoping efforts, which include simultaneously enhancing athlete moral identity and personal responsibility alongside reducing social opportunities for moral disengagement.
Kelsey M. Rynkiewicz, Lauren A. Fry and Lindsay J. DiStefano
Clinical Scenario: Chronic exertional compartment syndrome (CECS) is a condition related with ischemia of the body’s tissue due to increases in intracompartmental pressures, which involves, among other symptoms, pain with exertion. CECS is often overlooked or misdiagnosed due to an ambiguous presentation. Diagnostic accuracy of CECS and subsequent management can be improved when contributing factors are known. Research is lacking on the type of patient most likely to experience CECS, highlighting the need for identification of common demographic characteristics among affected individuals. Clinical Question: What are the common demographic characteristics among patients exhibiting CECS of the lower leg? Summary of Key Findings: Four studies were identified (1 prospective consecutive study, 2 retrospective reviews, and 1 retrospective cohort study) that examined common characteristics among patients with CECS. Conflicting evidence exists on whether CECS is more commonly seen in men or in women. CECS has often been reported in young, active individuals but may present in older populations as well. Soccer, field hockey, lacrosse, competitive running, and speed skating have been associated with an increased likelihood of CECS development. Clinical Bottom Line: Current evidence has identified commonalities in sex, age, and sport participation as characteristics often present among individuals experiencing lower leg CECS. Other factors, such as overuse, trauma, diabetes, and gait mechanics, have also been identified in association with CECS. Further data through future prospective studies will help confirm the type of patient mostly likely to experience CECS. Strength of Recommendation: Grade B evidence exists that certain sex, age, and sport participation demographic characteristics are common among patients with CECS of the lower leg.
David S. Walsh and Paul M. Wright
Alison Griffin, Tim Roselli and Susan L. Clemens
Background: Health benefits of physical activity (PA) accrue with small increases in PA, with the greatest benefits for those transitioning from inactivity to any level of PA. This study examined whether self-reported PA time in Queensland adults changed between 2004 and 2018. Methods: The Queensland government conducts regular cross-sectional telephone surveys. Between 2004 and 2018, adults aged 18–75 years answered identical questions about their weekly minutes of walking, moderate PA, and vigorous PA. Hurdle regression estimated the average annual change in weekly minutes of PA overall and by activity type, focusing on sociodemographic differences in trends. Results: The sample size averaged 1764 (2004–2008) and 10,188 (2009–2018), totaling 107,171 participants aged 18–75 years. Unadjusted PA increased by 10 minutes per week per year (95% confidence interval [CI], 8.8–11.1) overall, with increases for most subgroups. Adjusted PA increased by 10.5 minutes per week per year (95% CI, 9.4–11.7). Trends differed by employment—employed adults and those not in the labor force increased by 14.3 (95% CI, 12.8–15.8) and 2.2 minutes per week per year (95% CI, 0.4–4.0), respectively, with no increase for unemployed adults. The increases were due to both an increased prevalence of doing any activity and an increased average duration among active adults. Conclusions: Since 2004, PA time has increased for Queensland adults, with substantial variability by employment status.
Paul M. Wright and David Walsh
Don Hellison (1938–2018) was a leader and trailblazer in sport and physical education pedagogy. Early in his career, he was an advocate for humanistic physical education. His engaged approach to scholarship culminated in the development of the Teaching Personal and Social Responsibility (TPSR) model, which is now recognized as a best practice for promoting social and emotional learning in physical education. The TPSR model has also been widely applied in the field of sport-based youth development. This is the introduction to the special issue devoted to Don’s life and legacy. It provides opening comments from the guest editors and a brief overview of the articles in the special issue.