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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.

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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.

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Levi Frehlich, Christine Friedenreich, Alberto Nettel-Aguirre, Jasper Schipperijn and Gavin R. McCormack

Despite continued interest in neighborhood correlates of physical activity, few self-report questionnaires exist that capture neighborhood-based physical activity. Furthermore, there is little evidence about the measurement validity of self-report measures of neighborhood-based physical activity. Notably, self-reported neighborhood physical activity has not been validated against combined accelerometer and global positioning system (GPS)–assessed physical activity. Thus, the purpose of this study was to estimate the concurrent validity of a recently adapted tool for capturing self-reported neighborhood-based physical activity (i.e., the Neighborhood International Physical Activity Questionnaire; N-IPAQ). Adults (n = 75) from four Calgary (Alberta, Canada) neighborhoods wore an accelerometer and GPS monitor for 7 consecutive days after which they self-reported their physical activity from the past week using the N-IPAQ. Bland-Altman plots and Spearman correlations estimated the concurrent validity between N-IPAQ and accelerometer/GPS physical activity (estimated for the administrative boundary, 400-m and 800-m radial buffers). The mean (95% Confidence Interval [CI]) difference between the N-IPAQ and accelerometer/GPS estimated total daily minutes of physical activity differed for the 400-m (1.9 min, −26.2 to 29.9), 800-m (10.6 min, −16.0 to 37.1), and administrative boundary buffers (14.7 min, −11.5 to 41.0). The strongest Spearman correlations were found between the N-IPAQ and 800-m radial buffer accelerometer-captured vigorous-intensity physical activity (r = .41 [95% CI: .18 to .60]), and the N-IPAQ and administrative boundary accelerometer-captured vigorous-intensity physical activity (r = .43 [95% CI: .20 to .62]). Our findings suggest that the N-IPAQ provides good estimates of neighborhood-based physical activity and could be used when investigating neighborhood correlates of physical activity.

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Tamara Vehige Calise, William DeJong, Timothy Heren, Chloe Wingerter and Harold W. Kohl III

Background: Older age groups are less likely than their younger counterparts to be regularly active and women are even less active. Ecological models suggest that multiple levels of influence with each level influencing the next level impacts physical activity behaviors. Methods: Hierarchical multiple regressions were used to determine factors within and across the ecological model that predicted both total physical activity and walking for recreation. Findings: The overall predictors of total physical activity were different than those of walking for recreation, with the exception of dog ownership and perceived barriers. Gender and age were significant predictors of walking for recreation, but these associations were not present for total physical activity. Women and older adults walked more for recreation in a mixed-use community, Mueller, (and thus engaged in more total physical activity) compared with men and younger adults. Conclusion: Behavior-specific physical activity as well as total physical activity led to a better understanding of factors that may impact behavior among an overall aging population, especially women. This level of specificity is important in understanding specific factors that are associated with physical activity among vulnerable populations and can help guide the development of tailored, cost-effective, and efficient policies and interventions.

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Wojtek Chodzko-Zajko, Erica M. Taylor and T. Gilmour Reeve

The American Kinesiology Association identified the essential core content for undergraduate kinesiology-based academic programs. The core includes 4 content elements: physical activity in health, wellness, and quality of life; scientific foundations of physical activity; cultural, historical, and philosophical dimensions of physical activity; and the practice of physical activity. This article, expanding on the development of the core, describes the 4 elements in more detail, suggests methods for assessing student learning outcomes for the core content, and provides examples of the inclusion of the core in undergraduate curricula. Finally, a case study is presented that addresses how a department revised its kinesiology curriculum using the core elements to refocus its undergraduate degree program.

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Aaron J. Coutts

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George B. Cunningham, Erin Buzuvis and Chris Mosier

The purpose of this article is to articulate the need for a strong commitment to transgender inclusion in sport and physical activity, including in locker rooms and team spaces. The authors begin by defining key constructs and offering a theoretical overview of stigma toward transgender individuals. The focus then shifts to the changing opportunities for transgender athletes at all participation levels, case law and rulings germane to the topic, and the psychological, physical, and social outcomes associated with inclusion and exclusion. Next, the authors present frequently voiced concerns about transgender inclusion, with an emphasis on safety and privacy. Given the review, the authors present the case for inclusive locker rooms, which permit access by transgender athletes to facilities that correspond to their gender identity. The authors conclude with the official AKA position statement—“The American Kinesiology Association endorses inclusive locker rooms, by which we mean sex-segregated facilities that are open to transgender athletes on the basis of their gender identity”—and implications for sport and physical activity.

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Mark Messina, Heidi Lynch, Jared M. Dickinson and Katharine E. Reed

Much attention has been given to determining the influence of total protein intake and protein source on gains in lean body mass (LBM) and strength in response to resistance exercise training (RET). Acute studies indicate that whey protein, likely related to its higher leucine content, stimulates muscle protein synthesis to a greater extent than proteins such as soy and casein. Less clear is the extent to which the type of protein supplemented impacts strength and LBM in long-term studies (≥6 weeks). Therefore, a meta-analysis was conducted to compare the effect of supplementation with soy protein to animal protein supplementation on strength and LBM in response to RET. Nine studies involving 266 participants suitable for inclusion in the meta-analysis were identified. Five studies compared whey with soy protein, and four studies compared soy protein with other proteins (beef, milk, or dairy protein). Meta-analysis showed that supplementing RET with whey or soy protein resulted in significant increases in strength but found no difference between groups (bench press: χ2 = 0.02, p = .90; squat: χ2 = 0.22, p = .64). There was no significant effect of whey or soy alone (n = 5) on LBM change and no differences between groups (χ2 = 0.00, p = .96). Strength and LBM both increased significantly in the “other protein” and the soy groups (n = 9), but there were no between-group differences (bench: χ2 = 0.02, p = .88; squat: χ2 = 0.78, p = .38; and LBM: χ2 = 0.06, p = .80). The results of this meta-analysis indicate that soy protein supplementation produces similar gains in strength and LBM in response to RET as whey protein.

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Marie H. Murphy, Angela Carlin, Catherine Woods, Alan Nevill, Ciaran MacDonncha, Kyle Ferguson and Niamh Murphy

Background: Time spent in university represents a period of transition and may be an appropriate time to promote physical activity among young adults. The aim of this study was to assess participation of university students in sport and physical activity in Ireland and to explore the association between physical activity and perceptions of overall health, mental health, and happiness. Methods: The Student Activity and Sport Study Ireland was a cross-sectional online survey among a representative sample (n = 8122) of university students in Ireland. Binary logistic regressions were performed to examine associations between self-reported physical activity and gender (predictor variables) and individual perceptions of overall health, mental health, and happiness (binary outcomes). Results: Only 64.3% of respondents met the recommended level of 150 minutes of moderate to vigorous physical activity per week with males significantly more active than females (72.1% vs 57.8% meeting guidelines). Those meeting physical activity guidelines were more likely to report greater overall health and higher mental health and happiness scores compared with their inactive peers. Conclusions: Active students enjoy better health (overall and mental) and are happier than their inactive peers. This provides a clear rationale for providing students with opportunities to be active at university. The data provide a baseline to monitor changes in physical activity patterns.