The current study tested if athlete patients differed from non-athlete patients in measures of eating disorder (ED) and related pathology. Athlete (n = 91 in Study 1; n = 39 in Study 2) and non-athlete (n = 76 in Study 1; n = 26 in Study 2) patients completed self-report measures, and body mass index (BMI) was calculated. Athlete patients had significantly lower ED symptomatology and depression than non-athlete patients (ps < .05). ED impairment, worry, psychosocial functioning, BMI, obsessive-compulsiveness, and compulsive exercise did not significantly differ between groups (ps > .08). Greater ED symptomatology was associated with higher psychosocial functioning among athlete patients and higher obsessive-compulsive symptoms and compulsive exercise among non-athlete patients. This is a novel study comparing ED symptomatology and related measures of mental health in athlete and non-athlete patients engaged in residential or partial hospitalization ED treatment. Future research should further investigate how participation in high-level sport impacts the presentation, treatment, and outcome of individuals with EDs.
Laura K. Fewell, Riley Nickols, Amanda Schlitzer Tierney and Cheri A. Levinson
Jenny H. Conviser, Amanda Schlitzer Tierney and Riley Nickols
Eating disorders (EDs) and disordered-eating behaviors (DEBs), pose a high risk of morbidity and mortality, threatening physical health, emotional health, and overall quality of life. Unfortunately, among athletes, prevalence rates continue to increase. This document summarizes the challenges of establishing and navigating the multidisciplinary care needed to effectively treat EDs and DEBs among athletes. The benefits of timely and frequent communication within the multidisciplinary treatment team (MDTT) are emphasized and discussed. Authors advise who should be selected as members of the MDTT and suggest that all personnel, including athletic coaches, athletic trainers, physical therapists, and certified fitness professionals be ED-informed and ED-sensitive. Vital components of care are noted including use of a variety of evidence-based psychotherapeutic modalities, interventions which target emotional regulation, and prioritize values based compassionate care. Authors caution that performance decrements and medical/physiological changes are not always easily observable in individuals with EDs and DEBs and therefore, attuned, consistent, and ongoing monitoring is needed. Consensus regarding previously established parameters for return to play and careful titration of physical activity throughout the ED recovery process are suggested as important for preserving health, preventing re-injury, or relapse and facilitating successful return to sport participation.
Laura K. Fewell, Riley Nickols, Amanda Schlitzer Tierney and Cheri A. Levinson
Understanding the unique needs of athletes who undergo eating disorder (ED) treatment is sorely needed. This study explores changes of strength and power in athlete (n = 21) and non-athlete (n = 36) patients from intake to discharge. Maximal oxygen consumption, vertical jump, push-ups, hand grip strength, and body mass index (in anorexia nervosa; AN) were measured among treatment center patients. The number of push-ups and hand grip strength were significantly improved upon discharge in the full sample (ps < .005) and in AN only (ps < .001). Body mass index was also significantly higher in AN (p < .001). Maximal oxygen consumption and vertical jump did not significantly improve between admission and discharge in either group (ps > .40). This study is the first to investigate measures of strength in athletes engaged in intensive eating disorder treatment and indicates the need to address the psychological mindset around physical activity using exercise education as part of a comprehensive program. Recommendations for incorporating exercise into an intensive ED treatment center are also provided.
Carrie B. Scherzer and Justine J. Reel
In this commentary, we try to present a balanced look at the issues surrounding the implementation of the certification exam for recertification purposes. We recognize that the changes to certification are complex and varied, as were reactions by the membership of the Association for Applied Sport Psychology (AASP). As long-standing AASP members who are also certified consultants, we look at the costs, benefits, and ultimately the reality of the CMPC exam for recertification.
Ken Pitetti, Ruth Ann Miller and E. Michael Loovis
Male youth (8–18 years) with intellectual disability (ID) demonstrate motor proficiency below age-related competence capacities for typically developing youth. Whether below-criteria motor proficiency also exists for females with ID is not known. The purpose of this study was to determine if sex-specific differences exist in motor proficiency for youth with ID. The Bruininks-Oseretsky Test of Motor Proficiency was used to measure motor proficiency: six items for upper limb coordination, seven items for balance, and six items for bilateral coordination. One hundred and seventy-two (172) males and 85 females with ID but without Down syndrome were divided into five age groups for comparative purposes: 8–10, 11–12, 13–14, 15–16, and 17–21 years. Males scored sufficiently higher than females to suggest that sex data should not be combined to established Bruininks-Oseretsky Test of Motor Proficiency standards for upper limb coordination, balance, and bilateral coordination subtests.
Zachary R. Weber, Divya Srinivasan and Julie N. Côté
The objectives of this study were to assess the sex-specific relationships between motor and sensory adaptations to repetitive arm motion–induced neck/shoulder fatigue, and to measure how additional sensory stimulation affects these adaptations. Twenty-three participants performed two sessions of a repetitive pointing task until scoring 8 on the Borg CR10 scale for neck/shoulder exertion or for a maximum of 45 min, with and without sensory stimulation (i.e., light touch) applied on the fatiguing shoulder. Just before reaching the task termination criteria, all participants showed changes in mean and variability of arm joint angles and experienced a fivefold increase in anterior deltoid sensory threshold in the stimulus-present condition. Women with the greatest increases in anterior deltoid sensory thresholds demonstrated the greatest increases in shoulder variability (r = .66), whereas men with the greatest increases in upper-trapezius sensory thresholds demonstrated the greatest changes in shoulder angle (r = −.60) and coordination (r = .65) variability. Thus, sensory stimulation had no influence on time to termination but affected how men and women differently adapted, suggesting sex differences in sensorimotor fatigue response mechanisms.
Karin Lobenius-Palmér, Birgitta Sjöqvist, Anita Hurtig-Wennlöf and Lars-Olov Lundqvist
This study compared accelerometer-assessed habitual physical activity (PA), sedentary time, and meeting PA recommendations among 102 youth with disabilities (7–20 years) in four subgroups—physical/visual impairments, intellectual disability, autism spectrum disorders, and hearing impairment—and 800 youth with typical development (8–16 years). Low proportions of youth with disabilities met PA recommendations, and they generally were less physically active and more sedentary than youth with typical development. The hearing impairment and autism spectrum disorder groups were the most and least physically active, respectively. Older age and to some extent female sex were related to less PA and more sedentary time. Considering the suboptimal levels of PA in youth with disabilities, effective interventions directed at factors associated with PA among them are needed.
Kelly P. Arbour-Nicitopoulos, Viviane Grassmann, Krystn Orr, Amy C. McPherson, Guy E. Faulkner and F. Virginia Wright
The objective of this study was to comprehensively evaluate inclusive out-of-school time physical activity programs for children/youth with physical disabilities. A search of the published literature was conducted and augmented by international expertise. A quality appraisal was conducted; only studies with quality ratings ≥60% informed our best practice recommendations. Seventeen studies were included using qualitative (n = 9), quantitative (n = 5), or mixed (n = 3) designs. Programs had a diversity of age groups, group sizes, and durations. Most programs were recreational level, involving both genders. Rehabilitation staff were the most common leaders. Outcomes focused on social skills/relationships, physical skill development, and psychological well-being, with overall positive effects shown in these areas. The best practice recommendations are consistent with an abilities-based approach emphasizing common group goals and interests; cooperative activities; mastery-oriented, individualized instruction; and developmentally appropriate, challenging activities. Results indicate that inclusive out-of-school time physical activity programs are important for positive psychosocial and physical skill development of children/youth with physical disabilities.
Tomomasa Nakamura, Yuriko Yoshida, Hiroshi Churei, Junya Aizawa, Kenji Hirohata, Takehiro Ohmi, Shunsuke Ohji, Toshiyuki Takahashi, Mitsuhiro Enomoto, Toshiaki Ueno and Kazuyoshi Yagishita
The aim of this study was to analyze the effect of teeth clenching on dynamic balance at jump landing. Twenty-five healthy subjects performed jump-landing tasks with or without teeth clenching. The first 3 trials were performed with no instruction; subsequently, subjects were ordered to clench at the time of landing in the following 3 trials. We collected the data of masseter muscle activity by electromyogram, the maximum vertical ground reaction force (vGRFmax) and center of pressure (CoP) parameters by force plate during jump-landing. According to the clenching status of control jump-landing, all participants were categorized into a spontaneous clenching group and no clenching group, and the CoP data were compared. The masseter muscle activity was correlated with vGRFmax during anterior jump-landing, while it was not correlated with CoP. In comparisons between the spontaneous clenching and the no clenching group during anterior jump-landing, the spontaneous clenching group showed harder landing and the CoP area became larger than the no clenching group. There were no significant differences between pre- and postintervention in both spontaneous clenching and no clenching groups. The effect of teeth clenching on dynamic balance during jump-landing was limited.
Bente R. Jensen, Line Hovgaard-Hansen and Katrine L. Cappelen
Running on a lower-body positive-pressure (LBPP) treadmill allows effects of weight support on leg muscle activation to be assessed systematically, and has the potential to facilitate rehabilitation and prevent overloading. The aim was to study the effect of running with weight support on leg muscle activation and to estimate relative knee and ankle joint forces. Runners performed 6-min running sessions at 2.22 m/s and 3.33 m/s, at 100%, 80%, 60%, 40%, and 20% body weight (BW). Surface electromyography, ground reaction force, and running characteristics were measured. Relative knee and ankle joint forces were estimated. Leg muscles responded differently to unweighting during running, reflecting different relative contribution to propulsion and antigravity forces. At 20% BW, knee extensor EMGpeak decreased to 22% at 2.22 m/s and 28% at 3.33 m/s of 100% BW values. Plantar flexors decreased to 52% and 58% at 20% BW, while activity of biceps femoris muscle remained unchanged. Unweighting with LBPP reduced estimated joint force significantly although less than proportional to the degree of weight support (ankle).It was concluded that leg muscle activation adapted to the new biomechanical environment, and the effect of unweighting on estimated knee force was more pronounced than on ankle force.