Clinical Question: Is there sufficient evidence to determine which low back instability tests should be incorporated into a stabilization classification exam for athletes? Clinical Bottom Line: There is moderate level 2 evidence to include, but not to use in isolation, the prone instability test along with other instability tests in a stabilization classification exam.
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Kristen M. Metcalf, Elena M. Letuchy, Steven M. Levy and Kathleen F. Janz
Purpose: Most pediatric physical activity and bone health research has focused on the period immediately around puberty; few have addressed bone structural strength outcomes. This study assessed the magnitude and consistency of the longitudinal relationships between device-measured vigorous-intensity physical activity (VPA) and structural bone strength outcomes across adolescence to emerging adulthood. Methods: Participants with 3 to 5 bone scans between the age of 11 and 19 years were studied (N = 439, 220 females, 1838 records). Dual-energy X-ray absorptiometry scans of the hip (hip structural analysis) and peripheral quantitative computed tomography scans of the tibia were obtained. Outcomes included femoral neck section modulus, femoral neck cross-sectional area, tibial Bone Strength Index, and tibial torsion strength (polar Strength Strain Index). Sex-specific bone mixed growth models were developed using biological age (chronological age − age at peak height velocity) as the time variable, and height, weight, and device-measured VPA as time-varying covariates. Models also included the VPA–biological age interaction. Results: Individual-centered VPA and the VPA–biological age interaction were significantly, positively associated (P < .05) with Bone Strength Index, polar Strength Strain Index, section modulus, and cross-sectional area in males and females, indicating accumulative effects of VPA throughout maturation and beyond. Conclusion: Bone remains responsive to the mechanical loading of physical activity throughout adolescence and into emerging adulthood. Attention should be placed on promoting bone-strengthening physical activity after the prepubertal years when adult exercise patterns are likely formed.
Mark Ward, Sarah Gibney, David O’Callaghan and Sinead Shannon
Despite the benefits, one in three older adults in Ireland has low activity levels. This study examined associations between the local social and built environment and physical activity of older adults to identify age-friendly factors that support physical activity among the aging population. Data were from the population-representative Healthy and Positive Ageing Initiative Age-Friendly City and Counties Survey (N = 10,540). Physical activity was measured using a short-form of the International Physical Activity Questionnaire. Mixed-effects negative binomial regression models were adjusted for known health and sociodemographic correlates of physical activity. Results are reported as unstandardized beta coefficients (β) with standard errors. Loneliness, community participation, and difficulty in accessing green spaces partially explained the differences in the number of minutes that respondents were physically active. Combined with individual-level behavior change interventions, improvements to the local environment and promoting social connectedness may also be useful in promoting physical activity among older adults.
Xiaoxia Zhang, Xiangli Gu, Tao Zhang, Priscila Caçola and Jing Wang
Purpose: Using 2012 National Health and Nutrition Examination Survey (NHANES) National Youth Fitness Survey data, the authors conducted a cross-sectional secondary analysis to examine the associations of movement behaviors (ie, physical activity [PA] and screen-based sedentary behaviors) and fundamental motor skills (FMS) with fitness (ie, muscular fitness) and fatness (ie, body mass index and waist circumference) in 3- to 5-year-old children. The effect of ethnicity (Hispanic vs non-Hispanic) on these associations was also examined. Methods: A total of 352 children (173 girls; mean age = 4.02 y) from the 2012 NHANES data set were included. Parents reported their child’s PA and screen-based sedentary behaviors. FMS (ie, locomotor and object control) were assessed with the Test of Gross Motor Development, 2nd edition. Other variables used were body mass index, waist circumference, and plank. Results: Hispanic children demonstrated lower levels of PA than non-Hispanic children (P < .05). Children’s FMS emerged as significant predictors of muscular fitness and waist circumference, but not for body mass index in the Hispanic group. In the non-Hispanic group, FMS (ie, object control skills) and PA accounted for significant variances of muscular fitness and waist circumference, respectively. Conclusion: The associations of movement behaviors and FMS with fitness and fatness are different between Hispanic and non-Hispanic young children. Changes in policy or early childhood curriculum may be tailed to promote FMS for an impact on fitness and fatness in both Hispanic and non-Hispanic children.
Ka Man Leung and Pak-Kwong Chung
This study examined the associations between physical environment, social environment, and walking for transportation and recreation among older adults in Hong Kong. Cross-sectional data from 450 older adults (79 years or younger [71.9%], female [79.7%]) from 18 districts in Hong Kong were used. The participants’ perceptions of their physical and social environments were collected, and their walking behaviors were self-reported. The results revealed that positive physical environment facilitators and social environments were associated with increased total walking. Only positive physical environment facilitators were associated with increased walking for transportation, and physical and social environments had no notable effect on walking for recreation. These findings suggest that policy makers and walking intervention designers should develop strategies to enhance physical and social environments to promote total walking and walking for transportation.
Jeffrey C. Cowley, Steven T. McCaw, Kelly R. Laurson and Michael R. Torry
Purpose: Children who are overweight typically do not perform motor skills as well as normal-weight peers. This study examined whether vertical jump kinetics and kinematics of children who are overweight differ from nonoverweight peers. Methods: Thirty-nine children completed maximum-effort countermovement vertical jumps. Motion capture was used to complete lower extremity kinematic and kinetic analyses. Results: The overweight group (body mass index ≥ 85th percentile; N = 11; age = 6.5 [1.6] y) jumped lower relative to their mass (0.381 cm/kg lower; P < .001) than normal-weight peers (N = 28; age = 6.4 [1.7] y). Compared with children who are normal weight, children who were overweight exhibited a shallower countermovement (knee: 12° less flexion, P = .02; hip: 10° less flexion, P = .045), lower hip torque (0.06 N·m/kg lower, P = .01) and hip work (40% less work, P = .01), and earlier peak joint angular velocities (knee: 9 ms earlier, P = .001; hip: 14 ms earlier, P = .004). Conclusion: Children who are overweight do not achieve optimal jumping mechanics and exhibit jumping characteristics of an earlier developmental stage compared with their peers. Interventions should help children who are overweight learn to execute a proper countermovement.
Julia C. Orri, Elizabeth M. Hughes, Deepa G. Mistry and Antone Scala
The authors compared the linear and nonlinear heart rate variability dynamics from rest through maximal exercise in postmenopausal women who trained at either moderate or high intensities. The outcome variables included the RR triangular index, TINN, SD1, SD2, SD1/SD2, DFA α1, DFA α2, and α1/α2. Maximal exercise reduced SD1, SD2, DFA α1, DFA α2, α1/α2, RRTri, and TINN in both groups and increased SD1/SD2 (p < .05). Two minutes of active recovery produced significant increases in SD1, SD2, DFA α1, and TINN, compared with exercise in both groups (p < .0001). There was also a significant main effect between groups for RRTri during exercise recovery, with the moderate group achieving higher levels (p < .04). The authors have shown that both moderate and vigorous exercise training can lead to a healthy response to maximal exercise and recovery, with the moderate group having a slightly improved recovery in the triangular index.
Werner F. Helsen, Nikola Medic, Janet L. Starkes and Andrew M. Williams
Inequalities in relative age distribution have previously been demonstrated to influence participation and performance achievements in Masters athletes. The purpose of the present study was to examine the participation- and performance-related constituent year effect among Masters athletes (N = 2,474) from the European Masters Track and Field Championships across subdisciplines and age. The results indicated that a participation-related constituent year effect was observed. The likelihood of participation was significantly higher for athletes in their first year of any 5-year age category (χ2 = 149.8, p < .001) and decreased significantly when they were in the fourth or fifth year. The results also indicated a performance-related constituent year effect. Masters athletes in their first year won significantly more medals than expected based on observed participation rate (χ2 = 23.39, p < .001). We compare our results with the existing literature and discuss potential mechanisms for this constituent year effect.
Yi-Ching Chen, I-Chen Lin, Yen-Ting Lin, Wei-Min Huang, Chien-Chun Huang and Ing-Shiou Hwang
This study contrasted the stochastic force component between young and older adults, who performed pursuit tracking/compensatory tracking by exerting in-phase/antiphase forces to match a sinusoidal target. Tracking force was decomposed into the force component containing the target frequency and the nontarget force fluctuations (stochastic component). Older adults with inferior task performance had higher complexity (entropy across time; p = .005) in total force. For older adults, task errors were negatively correlated with force fluctuation complexity (pursuit tracking: r = −.527 to −.551; compensatory tracking: r = −.626 to −.750). Notwithstanding an age-related increase in total force complexity (p = .004), older adults exhibited lower complexity of the stochastic force component than young adults did (low frequency: p = .017; high frequency: p = .035). Those older adults with a higher complexity of stochastic force had better task performance due to the underlying use of a richer gradation strategy to compensate for impaired oscillatory control.
Darryn S. Willoughby, Kaitlan N. Beretich, Marcus Chen and LesLee K. Funderburk
Elevated circulating C-terminal agrin fragment (CAF) is a marker of neuromuscular junction degradation and sarcopenia. This study sought to determine if resistance training (RT) impacted the serum levels of CAF in perimenopausal (PERI-M) and postmenopausal (POST-M) women. A total of 35 women, either PERI-M or POST-M, participated in 10 weeks of RT. Body composition, muscle strength, and serum estradiol and CAF were determined before and after the RT. The data were analyzed with two-way analysis of variance (p ≤ .05). Upper body and lower body strength was significantly increased, by 81% and 73% and 86% and 79% for the PERI-M and POST-M participants, respectively; however, there were no significant changes in body composition. Estradiol was significantly less for the POST-M participants at pretraining compared with the PERI-M participants. CAF moderately increased by 22% for the PERI-M participants in response to RT, whereas it significantly decreased by 49% for the POST-M participants. Ten weeks of RT reduced the circulating CAF in the POST-M women and might play a role in attenuating degenerative neuromuscular junction changes.