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Sara Birch, Torben Bæk Hansen, Maiken Stilling, and Inger Mechlenburg

Background: Pain catastrophizing is associated with pain both before and after a total knee arthroplasty (TKA). However, it remains uncertain whether pain catastrophizing affects physical activity (PA). The aim was to examine the influence of pain catastrophizing on the PA profile, knee function, and muscle mass before and after a TKA. Methods: The authors included 58 patients with knee osteoarthritis scheduled for TKA. Twenty-nine patients had a score >22 on the Pain Catastrophizing Scale (PCS), and 29 patients had a score <11. PA was measured with a triaxial accelerometer preoperative, 3 months, and 12 months after TKA. Other outcome measures consisted of the Knee Osteoarthritis Outcome Score and dual-energy X-ray absorptiometry scans. Results: The authors found no difference in PA between patients with a better/low or a worse/high score on the PCS, and none of the groups increased their mean number of steps/day from preoperative to 12 months postoperative. Patients with better/low PCS scores had higher/better preoperative scores on the Knee Osteoarthritis Outcome Score subscales (symptoms, pain, and activity of daily living), and they walked longer in the 6-min walk test. Further, they had lower body mass index, lower percent fat mass, and higher percent muscle mass than patients with worse/high PCS scores both before and after a TKA. Conclusion: Preoperative pain catastrophizing did not influence PA before or after a TKA. Although the patients improved substantially in self-reported knee function, their PA did not increase. This may be important to consider when the clinicians are informing the patients about the expected benefits from the operation.

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Isabel B. Rodrigues, Matteo Ponzano, Debra A. Butt, Joan Bartley, Zahra Bardai, Maureen C. Ashe, Philip D. Chilibeck, Lehana Thabane, John D. Wark, Jackie Stapleton, and Lora M. Giangregorio

Walking is a common activity among older adults. However, the effects of walking on health-related outcomes in people with low bone mineral density (BMD) are unknown. The authors included randomized controlled trials comparing walking to control in individuals aged ≥50 years with low BMD and at risk of fractures. The authors identified 13 randomized controlled trials: nine multicomponent interventions including walking, one that was walking only, and three Nordic walking trials. Most studies had a high risk of bias. Nordic walking may improve the Timed Up-and-Go values (1.39 s, 95% CI [1.00, 1.78], very low certainty). Multicomponent interventions including walking improved the 6-min walk test (39.37 m, 95% CI [21.83, 56.91], very low certainty) and lumbar spine BMD (0.01 g/cm2, 95% CI [0.00, 0.03], low certainty evidence). The effects on quality of life or femoral neck BMD were not significant. There were insufficient data on fractures, falls, or mortality. Nordic walking may improve physical functioning. The effects on other outcomes are less certain; one may need to combine walking with other exercises to be of benefit.

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Naroa Etxebarria, Jackson Wright, Hamish Jeacocke, Cristian Mesquida, and David B. Pyne

Negative or evenly paced racing strategies often lead to more favorable performance outcomes for endurance athletes. However, casual inspection of race split times and observational studies both indicate that elite triathletes competing in Olympic-distance triathlon typically implement a positive pacing strategy during the last of the 3 disciplines, the 10-km run. To address this apparent contradiction, the authors examined data from 14 International Triathlon Union elite races over 3 consecutive years involving a total of 725 male athletes. Analyses of race results confirm that triathletes typically implement a positive running pace strategy, running the first lap of the standard 4-lap circuit substantially faster than laps 2 (∼7%), 3 (∼9%), and 4 (∼12%). Interestingly, mean running pace in lap 1 had a substantially lower correlation with 10-km run time (r = .82) than both laps 2 and 3. Overall triathlon race performance (ranking) was best associated with run performance (r = .82) compared with the swim and cycle sections. Lower variability in race pace during the 10-km run was also reflective of more successful run times. Given that overall race outcome is mainly explained by the 10-km run performance, with top run performances associated with a more evenly paced strategy, triathletes (and their coaches) should reevaluate their pacing strategy during the run section.

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Kate M. Luckin-Baldwin, Claire E. Badenhorst, Ashley J. Cripps, Grant J. Landers, Robert J. Merrells, Max K. Bulsara, and Gerard F. Hoyne

Purpose: The completion of concurrent strength and endurance training can improve exercise economy in cyclists and runners; however, the efficacy of strength training (ST) implementation to improve economy in long-distance (LD) triathletes has not yet been investigated. The purpose of this study was to investigate physiological outcomes in LD triathletes when ST was completed concurrently to endurance training. Methods: A total of 25 LD triathletes were randomly assigned to either 26 weeks of concurrent endurance and ST (n = 14) or endurance training only (n = 11). The ST program progressed from moderate (8–12 repetitions, ≤75% of 1-repetition maximum, weeks 0–12) to heavy loads (1–6 repetitions, ≥85% of 1-repetition maximum, weeks 14–26). Physiological and performance indicators (cycling and running economy, swim time, blood lactate, and heart rate) were measured during a simulated triathlon (1500-m swim, 60-min cycle, and 20-min run) at weeks 0, 14, and 26. Maximal strength and anthropometric measures (skinfolds and body mass) were also collected at these points. Results: The endurance strength group significantly improved maximal strength measures at weeks 14 and 26 (P < .05), cycling economy from weeks 0 to 14 (P < .05), and running economy from weeks 14 to 26 (P < .05) with no change in body mass (P > .05). The endurance-only group did not significantly improve any economy measures. Conclusions: The addition of progressive load ST to LD triathletes’ training programs can significantly improve running and cycling economy without an increase in body mass.

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Tayo Moss, Stephen Samendinger, Norbert L. Kerr, Joseph Cesario, Alan L. Smith, Deborah J. Johnson, and Deborah L. Feltz

The authors describe two research experiments exploring the influence of race on the Köhler motivation gain effect with exercise tasks. Experiment 1 tested whether partner racial dissimilarity affects individual performance. Experiment 2 created a team identity recategorization intervention to potentially counter the influence on performance observed in Experiment 1. White male participants were partnered with either a Black or Asian partner (Experiment 1) or with a Black partner utilizing team names and shirt colors as a team identity recategorization strategy (Experiment 2). Racially dissimilar dyads completed two sets of abdominal plank exercises with a Köhler conjunctive task paradigm (stronger partner; team performance outcome dependent upon the weaker-ability participant’s performance). The results of Experiment 1 suggest attenuation of the previously successful group motivation gain effect in the racially dissimilar condition. The simple recategorization strategy utilized in Experiment 2 appeared to reverse motivation losses under conjunctive-task conditions in racially dissimilar exercise dyads.

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Michael W. Supples, Madison K. Rivard, Rebecca E. Cash, Kirsten Chrzan, Ashish R. Panchal, and Henderson D. McGinnis

Background: Emergency medical services (EMS) professionals demonstrate low adherence to physical activity guidelines and experience a high prevalence of obesity and incidence of injury. The authors investigate the barriers to participating in physical activity among EMS professionals. Methods: The EMS professionals employed by 15 North Carolina EMS agencies were surveyed with validated items. Multivariable logistic regression models were used to estimate the odds (odds ratio, 95% confidence interval) of not meeting physical activity guidelines for each barrier to being active, controlling for age, sex, body mass index category, race/ethnicity, certification and education level, and work hours. Results: A total of 1367 EMS professionals were invited to participate, and 359 complete responses were recorded. Half of the respondents (48.2%) met Centers for Disease Control and Prevention physical activity guidelines. According to standard body mass index categories, 55.9% were obese. There were increased odds of not meeting physical activity guidelines for the following barriers: lack of energy (5.32, 3.12–9.09), lack of willpower (4.31, 2.57–7.22), lack of time (3.55, 2.12–5.94), social influence (3.02, 1.66–5.48), and lack of resources (2.14, 1.12–4.11). The barriers of fear of injury and lack of skill were not associated with meeting physical activity guidelines. Conclusion: Half of EMS professionals did not meet physical activity guidelines, and the majority were obese. Significant associations exist between several modifiable barriers and not meeting physical activity guidelines.

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Satoshi Matsuno, Takuya Yoshiike, Atsushi Yoshimura, Sachiyo Morita, Yusuke Fujii, Motoyasu Honma, Yuji Ozeki, and Kenichi Kuriyama

Although standing plantar perception training (SPPT) may improve standing postural stability, the underlying neural mechanisms remain unclear. The authors investigated the relationship between regional cortical responses to SPPT using a balance pad and training outcomes in 32 older participants (mean ± SD:72.2 ± 6.0, range:60–87). Regional cortical activity was measured in the bilateral supplementary motor area, primary sensorimotor area, and parietal association area using near-infrared spectroscopy. Postural sway changes were compared before and after SPPT. Changes in two-point plantar discrimination and regional cortical activity during SPPT, associated with standing postural stability improvements, were examined using multiple regression and indicated improved standing postural stability after SPPT (p < .0001). Changes in right parietal association area activity were associated with standing postural stability improvements while barefoot. Overall, the results suggest that right parietal association area activation during SPPT plays a crucial role in regulating standing postural stability and may help develop strategies to prevent older adults from falling.

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Jennifer L. Etnier, Jarod C. Vance, and Aiko Ueno

Numerous studies show that exercise benefits memory and some show that acute exercise prior to encoding has larger benefits than exercise after encoding. This study was designed to investigate the effects of acute exercise on memory in middle-aged and older adults (M age = 64.71 years) and to explore the influence of the timing of the exercise on these effects. Using a within-subjects design, moderate-intensity exercise (20 min) was either not performed (control), performed before the task (exercise prior), or performed after the task (exercise post). Memory was assessed using the Rey Auditory Learning Verbal Test. For short- and long-term memory and learning, significantly more words were remembered in the exercise-prior condition than the others. For 24-hr recall, participants remembered significantly more words in the exercise-prior condition than exercise post, which was better than control. Exercise benefits memory for healthy middle-aged and older adults, with the greatest benefits when performed prior to encoding.

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Rona Macniven, Rachel Wilson, Tim Olds, and John Evans

Background: Emerging evidence suggests that Indigenous children have higher physical activity levels that non-Indigenous children, yet little is known of the factors that influence these levels or how they may be optimized. This study examines correlates of achieving ≥1 hour/day of physical activity among Indigenous Australian children aged 8–13 years. Methods: Data were collected through parental self-report in the Longitudinal Study of Indigenous Children. Proportions of children achieving ≥1 hour/day physical activity, approximating the Australian aerobic physical activity recommendations, were calculated, and associations with sociodemographic, family composition, and movement-related factors were quantified using multiple logistic regression analyses. Results: Half of the 1233 children achieved ≥1 hour/day physical activity. Children from families with low parental education and unemployment, remote residence, low socioeconomic status, and without a father in the household were more likely to meet the recommendations. Achieving ≥1 hour/day of physical activity was also associated with low levels of playing electronic games and total screen time. Conclusions: Sociodemographic correlates of physical activity among Indigenous Australian children run counter to those typically found in non-Indigenous Australian children. Further longitudinal examination of the predictors of these associations would provide a greater understanding of Indigenous physical activity determinants, to inform strategies to facilitate participation.

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Bruno Luiz Souza Bedo, Guilherme Manna Cesar, Renato Moraes, Fábio Pamplona Mariano, Luiz Henrique Palucci Vieira, Vitor Luiz Andrade, and Paulo Roberto Pereira Santiago

Noncontact anterior cruciate ligament ruptures generally occur during unanticipated sidestep cutting maneuvers when athletes have their visual attention focused on the opponent. The authors investigated the influence of uncertainty related to the side to perform the sidestep cutting maneuver on knee kinematics of female handball athletes. A total of 31 female handball athletes performed the sidestep cutting maneuver during anticipated and uncertain conditions. During the uncertain condition, visual cues indicated the direction of the reactive sidestep cutting maneuver. Between-condition differences were compared using the Student t test for paired samples calculated with statistical parametric mapping. Lower knee flexion angle was detected during the uncertain condition compared with the anticipated condition for the nondominant limb (0%–8% of the sidestep cycle). Knee abduction was larger during the uncertain condition for both the dominant (15%–41% of the sidestep cycle) and nondominant (0%–18% of the sidestep cycle) limbs compared with the anticipated condition. The nondominant leg showed higher knee abduction (36%–68% of the sidestep cycle) during the uncertain condition compared with the anticipated condition. The athletes’ approach velocity was slower during the uncertain condition. The uncertain condition impacted knee kinematics and potentially positioned the joint at greater risk of injury by decreasing the flexion angle in the nondominant leg and increasing the joint valgus bilaterally.