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Cindy Y. Lin, Trever J. Ball, Nicole L. Gentile, Valerie F. McDonald, and Andrew T. Humbert

Background: Physical inactivity is a risk factor for many chronic conditions. This retrospective cohort study examined associations between physical activity (PA) with health care utilization (HU). Methods: A PA vital sign was recorded in clinics from January 2018 to December 2020. Patients were categorized as inactive, insufficiently active, or sufficiently active by US PA aerobic guidelines. Associations between PA vital sign and visits (inpatient admissions, emergency department, urgent care, and primary care) were estimated using population average regression by visit type. Results: 23,721 patients had at least one PA vital sign recorded, with a mean age of 47.3 years and mean body mass index (BMI) of 28; 52% were female and 63% were White. Sufficiently active patients were younger, male, White, and had lower BMI than insufficiently active patients. Achieving 150 minutes per week of moderate to vigorous PA per 1000 patient years was associated with 34 fewer emergency department visits (P < .001), 19 fewer inpatient admissions (P < .001), and 38 fewer primary care visits (P < .001) compared with inactive patients. Stronger associations between lower PA and higher HU were present among those who were older or had a higher comorbidity. BMI, sex, ethnicity, and race did not modify the association between PA and HU. Conclusions: Meeting aerobic guidelines was associated with reduced HU for inpatient, primary care, and emergency department visits.

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Fabián Arroyo-Rojas, A. Chloe Simpson, Paige Laxton, Marie Leake, Jamie Linker, and Justin A. Haegele

In this expository paper, we reflect upon our understanding of how disabled people are discussed and treated in kinesiology and adapted physical activity in higher education and explore potential areas of unintentional harm that may be present in our everyday practice. There are three particular aspects of kinesiology in higher education that we discuss: access, language, and assessment. We discuss the challenges of access of disabled people in positions in higher education, language in higher education which serves as centers for knowledge creation, and the problematic nature of assessments based on societal norms, and for us, it is important to shine a spotlight on the many systemic limitations and barriers that disabled persons experience, in hope to amplify the importance of these issues.

Open access

Joey Murphy, Karen Milton, Matthew Mclaughlin, Trevor Shilton, Gabriella M. McLoughlin, Lindsey J. Reece, Jacqueline L. Mair, Artur Direito, Katharina E. Kariippanon, Kelly J. Mackenzie, Myrto F. Mavilidi, Erin M. Shellington, Masamitsu Kamada, Leonie Heron, Edtna Jauregui, Chalchisa Abdeta, Ilaria Pina, Ryan Pinto, and Rachel Sutherland

Background: There is limited understanding of the challenges experienced and supports required to aid effective advocacy of the Global Action Plan on Physical Activity (GAPPA). The purpose of this study was to assess the challenges experienced and supports needed to advocate for the GAPPA across countries of different income levels. Methods: Stakeholders working in an area related to the promotion of physical activity were invited to complete an online survey. The survey assessed current awareness and engagement with the GAPPA, factors related to advocacy, and the perceived challenges and supports related to advocacy for implementation of the GAPPA. Closed questions were analyzed in SPSS, with a Pearson’s chi-square test used to assess differences between country income level. Open questions were analyzed using inductive thematic analysis. Results: Participants (n = 518) from 81 countries completed the survey. Significant differences were observed between country income level for awareness of the GAPPA and perceived country engagement with the GAPPA. Challenges related to advocacy included a lack of support and engagement, resources, priority, awareness, advocacy education and training, accessibility, and local application. Supports needed for future advocacy included guidance and support, cooperation and alliance, advocacy education and training, and advocacy resources. Conclusions: Although stakeholders from different country income levels experience similar advocacy challenges and required supports, how countries experience these can be distinct. This research has highlighted some specific ways in which those involved in the promotion of physical activity can be supported to scale up advocacy for the GAPPA. When implementing such supports, consideration of regional, geographic, and cultural barriers and opportunities is important to ensure they are effective and equitable.

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Natália Mendes Guardieiro, Gabriel Barreto, Felipe Miguel Marticorena, Tamires Nunes Oliveira, Luana Farias de Oliveira, Ana Lucia de Sá Pinto, Danilo Marcelo Leite do Prado, Bryan Saunders, and Bruno Gualano

Purpose: Investigate whether a cloth facemask could affect physiological and perceptual responses to exercise at distinct exercise intensities in untrained individuals. Methods: Healthy participants (n = 35; 17 men, age 30 [4] y, and 18 women, age 28 [5] y) underwent a progressive square wave test at 4 intensities: (1) 80% of ventilatory anaerobic threshold; (2) ventilatory anaerobic threshold; (3) respiratory compensation point; and (4) exercise peak (Peak) to exhaustion, 5-minute stages, with or without a triple-layered cloth facemask (Mask or No-Mask). Several physiological and perceptual measures were analyzed. Results: Mask reduced inspiratory capacity at all exercise intensities (P < .0001). Mask reduced respiratory frequency (P = .001) at Peak (−8.3 breaths·min−1; 95% confidence interval [CI], −5.8 to −10.8), respiratory compensation point (−6.9 breaths·min−1; 95% CI, −4.6 to −9.2), and ventilatory anaerobic threshold (−6.5 breaths·min−1; 95% CI, −4.1 to −8.8), but not at Baseline or 80% of ventilatory anaerobic threshold. Mask reduced tidal volume (P < .0001) only at respiratory compensation point (−0.5 L; 95% CI, −0.3 to −0.6) and Peak (−0.8 L; 95% CI, −0.6 to −0.9). Shallow breathing index was increased with Mask only at Peak (11.3; 95% CI, 7.5 to 15.1). Mask did not change HR, lactate, ratings of perceived exertion, blood pressure, or oxygen saturation. Conclusions: A cloth facemask reduced time to exhaustion but had no major impact on cardiorespiratory parameters and had a slight but clinically meaningless impact on respiratory variables at higher intensities. Moderate to heavy activity is safe and tolerable for healthy individuals while wearing a cloth facemask. ClinicalTrials.gov: NCT04887714.

Open access

Mingke You, Lingcheng Wang, Ruipeng Huang, Kaibo Zhang, Yunhe Mao, Gang Chen, and Jian Li

Context: Meniscal injury is a common pathology, and the postoperative rehabilitation program is essential to patients after surgery. However, the optimal rehabilitation plan after meniscus suture is still controversial. Objective: To compare the clinical outcomes between accelerated rehabilitation and restricted programs in patients with meniscus suture (with or without anterior cruciate ligament reconstruction, ACLR). Evidence Acquisition: Four databases, including PubMed, Ovid, Embase, and the Cochrane Library, were searched up to November 2021. This study only included studies comparing the clinical outcomes between accelerated (immediate range of motion and weight-bearing) and restricted rehabilitation (immobilization and progressive weight-bearing) for meniscus suture. All selected studies were divided into 2 subgroups: isolated meniscus suture or combined with ACLR. The Lysholm score, Tegner score, and Knee Injury and Osteoarthritis Outcome Score were evaluated in simple meniscus sutures no less than 1 year. Failure rate was evaluated in both groups, and the tunnel enlargement was additionally evaluated in patients who underwent ACLR. Evidence Synthesis: Eleven studies with 612 patients were eligible for analysis. The accelerated group included 4 studies with 330 participants, while the restricted group included 7 studies with 282 participants. For the patients after isolated meniscus suture, the accelerated group achieved higher Lysholm scores (mean difference = −4.66; 95% confidence interval, −8.6 to −0.73; P = .02; I 2 = 88%) than the restricted group. For the patients after meniscus suture with ACLR, patients undergoing accelerated rehabilitation were associated with a significantly larger tibial tunnel enlargement in the anterior–posterior view (mean difference = −7.08; 95% confidence interval, −10.92 to −3.24; P = .0003; I 2 = 0%) and lateral view (mean difference = −10.33; 95% confidence interval, −16.9 to −3.75; P = .002; I 2 = 17%). Conclusion: This meta-analysis evaluated the effects of postoperative rehabilitation in either accelerated or restricted programs in patients with meniscus lesions after repair. A significant higher mean self-reported function was discovered at final follow-ups in the accelerated group. However, a significant increase in tibial tunnel enlargement was also found in accelerated group.

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Harry Pope, Max Davis, M. Begona Delgado-Charro, Oliver J. Peacock, Javier Gonzalez, and James A. Betts

Phosphate is integral to numerous metabolic processes, several of which strongly predict exercise performance (i.e., cardiac function, oxygen transport, and oxidative metabolism). Evidence regarding phosphate loading is limited and equivocal, at least partly because studies have examined sodium phosphate supplements of varied molar mass (e.g., mono/di/tribasic, dodecahydrate), thus delivering highly variable absolute quantities of phosphate. Within a randomized cross-over design and in a single-blind manner, 16 well-trained cyclists (age 38 ± 16 years, mass 74.3 ± 10.8 kg, training 340 ± 171 min/week; mean ± SD) ingested either 3.5 g/day of dibasic sodium phosphate (Na2HPO4: 24.7 mmol/day phosphate; 49.4 mmol/day sodium) or a sodium chloride placebo (NaCl: 49.4 mmol/day sodium and chloride) for 4 days prior to each of two 30-km time trials, separated by a washout interval of 14 days. There was no evidence of any ergogenic benefit associated with phosphate loading. Time to complete the 30-km time trial did not differ following ingestion of sodium phosphate and sodium chloride (3,059 ± 531 s vs. 2,995 ± 467 s). Accordingly, neither absolute mean power output (221 ± 48 W vs. 226 ± 48 W) nor relative mean power output (3.02 ± 0.78 W/kg vs. 3.08 ± 0.71 W/kg) differed meaningfully between the respective intervention and placebo conditions. Measures of cardiovascular strain and ratings of perceived exertion were very closely matched between treatments (i.e., average heart rate 161 ± 11 beats per minute vs. 159 ± 12 beats per minute; Δ2 beats per minute; and ratings of perceived exertion 18 [14–20] units vs. 17 [14–20] units). In conclusion, supplementing with relatively high absolute doses of phosphate (i.e., >10 mmol daily for 4 days) exerted no ergogenic effects on trained cyclists completing 30-km time trials.

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Jacob Benzinger, Jeff R. Crane, Angela M. Coppola, and David J. Hancock

Schools can support physical education (PE) among students with mobility disabilities (SMDs). However, previous research has indicated that people and resources in the school environment have served as facilitators and barriers to engaging SMDs in PE. Thus, the purpose of this pragmatic, qualitative study was to explore physical educators’ perceptions and experiences of teaching SMDs to learn how to develop a PE environment supportive of SMDs. Eleven K-8 PE teachers who taught SMDs engaged in semistructured interviews. A thematic analysis revealed three themes describing facilitators and barriers of a supportive PE environment for SMDs: (a) teacher planning, (b) students in the PE environment, and (c) resources and support. These findings provide context to PE environments for SMDs and highlight a need for increased communication and collaboration with students with or without mobility disabilities, training or professional development for PE teachers to develop skills for adapted PE, and financial and personnel support.

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Michal Vagner, Daniel J. Cleather, Petr Kubový, Vladimír Hojka, and Petr Stastny

Contemporary descriptions of motor control suggest that variability in movement can be indicative of skilled or unskilled performance. Here we used principal component analysis to study the kicking performance of elite and sub-elite soldiers who were highly familiar with the skill in order to compare the variability in the first and second principal components. The subjects kicked a force plate under a range of loaded conditions, and their movement was recorded using optical motion capture. The first principal component explained >92% of the variability across all kinematic variables when analyzed separately for each condition, and both groups and explained more of the variation in the movement of the elite group. There was more variation in the loading coefficient of the first principal component for the sub-elite group. In contrast, for the second principal component, there was more variation in the loading coefficient for the elite group, and the relative magnitude of the variation was greater than for the first principal component for both groups. These results suggest that the first principal component represented the most fundamental movement pattern, and there was less variation in this mode for the elite group. In addition, more of the variability was explained by the hip than the knee angle entered when both variables were entered into the same PCA, which suggests that the movement is driven by the hip.

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Eivind Aadland, Einar Ylvisåker, Kjersti Johannessen, and Ada Kristine Ofrim Nilsen

Background: Limited evidence exists regarding prospective associations for physical activity (PA) and sedentary time (SED) with body mass index (BMI) and muscle strength in young children. We aimed to determine prospective associations for PA and SED with change in BMI and standing long jump over 2 and 4 years in children aged 3–5 years at baseline. Methods: A sample of 262 Norwegian children (50% girls) was followed from 2015 to 2017 and/or 2019. PA and SED (hip-worn ActiGraph GT3X+) were measured at baseline and BMI and standing long jump at baseline and at follow-ups. Multivariate pattern analysis was used to determine prospective associations between the triaxial PA intensity spectrum (0–99 to ≥15,000 counts per minute) and the change in outcomes. Results: We found significant prospective associations between the PA intensity spectrum and standing long jump at 2- (explained variance = 5.8%–7.7%) and 4-year (explained variance = 4.8%–5.6%) follow-ups. Associations were negative for SED and positive for all PA intensities. We found no associations between PA/SED and BMI. Conclusions: Our findings suggest that PA and SED can predict future lower body muscle strength but not BMI in early childhood.

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Steph Doehler

During the Tokyo 2020 Olympics, Team USA athlete Simone Biles withdrew from several gymnastics events midcompetition, citing mental health issues. Biles, one of the most recognizable stars of the Games, faced intense scrutiny from both the world’s media and the general public in the immediate aftermath. The purpose of this study was to analyze the Facebook narrative surrounding Biles’s withdrawal within the theoretical context of framing, as crafted through user comments on various public high-profile Facebook pages. A total of 87,714 user comments were collected and analyzed using the qualitative software Leximancer. The themes emerging from the data suggested a polarizing narrative, with many users supporting Biles, engaging in the wider discussion surrounding athlete mental health, while others condemned her action, suggesting she quit on the biggest sporting stage.