Despite the recognized benefits of physical activity (PA) for children and adolescents with disabilities (CAWD), collective information on this is lacking in Lithuania. The purpose of this study was to investigate the current “state of the nation” PA levels of CAWD, based on the 10 indicators from the Active Healthy Kids Global Alliance Global Matrix 4.0 methodology. Scientific articles, practical reports, and published theses related to the 10 indicators from the Global Matrix 4.0 on CAWD age 6–19 years were reviewed, and data were converted to grades from A to F. (A) Strengths, Weaknesses, Opportunities, and Threats analysis was carried out to interpret the grades by four experts. Data on organized sport participation (F), school (D), community & environment (D), and government (C) were available. Data on other indicators are largely missing yet are needed for policymakers and researchers to be aware of the current state of PA among CAWD.
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Jurate Pozeriene, Arūnas Emeljanovas, Vida Ostaseviciene, Kestutis Skucas, Kristina Bradauskiene, Renatas Mizeras, Ausrine Packeviciute, Kristina Venckuniene, Vaida Pokvytyte, Diana Reklaitiene, and Kwok Ng
José Francisco López-Gil, Susana Aznar, Blanca Roman-Viñas, Javier Brazo-Sayavera, Rocío Izquierdo-Gómez, Sabina Barrios-Fernández, Olga Rodríguez Ferrán, and Salome Aubert
This report aims to provide a better understanding of physical activity (PA) and related factors among Spanish children and adolescents living with disabilities. The 10 indicators used for the Global Matrix on Para Report Cards of children and adolescents living with disabilities were evaluated based on the best available data in Spain. An analysis of strengths, weaknesses, opportunities, and threats based on data provision was drafted by three experts and critically reviewed by the authorship team to provide a national perspective for each evaluated indicator. Government was the indicator with the highest grade (C+), followed by Sedentary Behaviors (C−), School (D), Overall PA (D−), and Community & Environment (F). The remaining indicators received an incomplete grade. There were low levels of PA in Spanish children and adolescents living with disabilities. Yet, opportunities to improve the current surveillance of PA among this population exist.
Yeshayahu Hutzler, Sharon Barak, Salomé Aubert, Kelly Arbour-Nicitopoulos, Riki Tesler, Cindy Sit, Diego Augusto Santos Silva, Piritta Asunta, Jurate Pozeriene, José Francisco López-Gil, and Kwok Ng
The purpose was to synthesize information gathered from the interpretation and conclusion sections of the Global Matrix of Para Report Cards on the physical activity of children and adolescents with disabilities. The synthesis was based on the strengths, weaknesses, opportunities, and threats framework. The procedure consisted of three stages: (a) the application of the International Classification of Functioning, Disability and Health as the theoretical framework; (b) identifying and aligning Global Matrix indicators and benchmarks with the International Classification of Functioning, Disability and Health components through a Delphi approach; and (c) using content analysis to identify themes from specific report cards. Outcomes reveal that further attention toward including children and adolescents with disabilities in fitness assessments is needed as well as adapted assessment methods. Program availability, equipment and facilities, and professional training emerged as strengths but need further development to overcome weaknesses. Paralympic inspiration was an opportunity, whereas extreme weather conditions presented potential threats to physical activity participation among children and adolescents with disabilities.
Lee T. Atkins, Michael Lowrey, Sarah Reagor, Kirsten Walker, and Dhalston Cage
Research indicates that increasing trunk flexion may optimize patellofemoral joint loading. However, this postural change could cause an excessive Achilles tendon force (ATF) and injury risk during movement. This study aimed to examine the effects of increasing trunk flexion during stair ascent on ATF, ankle biomechanics, and vertical ground reaction force in females. Twenty asymptomatic females (age: 23.4 [2.5] y; height: 1.6 [0.8] m; mass: 63.0 [12.2] kg) ascended stairs using their self-selected and flexed trunk postures. Compared with the self-selected trunk condition, decreases were observed for peak ATF (mean differences [MD] = 0.14 N/kg; 95% confidence interval [CI], 0.06 to 0.23; Cohen d = −1.2; P = .003), average rate of ATF development (MD = 0.25 N/kg/s; 95% CI, 0.07 to 0.43; Cohen d = −0.9; P = .010), ankle plantar flexion moment (MD = 0.08 N·m/kg; 95% CI, 0.03 to 0.13; Cohen d = −1.1; P = .005), and vertical ground reaction force (MD = 38.6 N/kg; 95% CI, 20.3 to 56.90; Cohen d = −1.8; P < .001). Increasing trunk flexion did not increase ATF. Instead, this postural change was associated with a decreased ATF rate and magnitude and may benefit individuals with painful Achilles tendinopathy.
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.
Hannah Bennett, Robert Owens, and Tanya Prewitt-White
Mark L. Latash
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.
Matthew R. Kutz
Athletic training and the environment in which it is practiced is constantly changing. The emergent environment is volatile, uncertain, complex, and ambiguous. This new environment necessitates an adjustment to athletic training education particularly as it pertains to the instruction and development of the nonclinical skills (meta-skills) needed for clinical settings. One such meta-skill is contextual intelligence. Contextual intelligence is the capacity to recognize the convergence of different variables and respond to the emerging context as it is developing. Practicing contextual intelligence includes integrating 12 specific behaviors and the 3D thinking framework of hindsight, insight, and foresight into clinical decision making.
