Context: Though previous research has focused on examining the effects of concussion history using a dual-task paradigm, the influence of factors like symptoms (unrelated to concussion), gender, and type of sport on gait in college athletes is unknown. Objective: To examine the effect of concussion history, symptoms, gender, and type of sport (noncontact/limited contact/contact) individually on gait among college athletes. Design: Exploratory cross-sectional study. Setting: Laboratory. Participants: In total, 98 varsity athletes (age, 18.3 [1.0] y; height, 1.79 [0.11] m; mass, 77.5 [19.2] kg; 27 with concussion history, 58 reported at least one symptom, 44 females; 8 played noncontact sports and 71 played contact sports) walked under single- and dual-task (walking while counting backward by 7) conditions. Interventions: Not applicable. Main Outcome Measures: Dual-task cost (DTC; % difference between single task and dual task) of gait speed, cadence, step length and width, percentage of swing and double-support phases, symptom score, and total symptom severity score. Independent samples t tests and 1-way analysis of variance were conducted (α value = .05). Results: Self-reported concussion history resulted in no significant differences (P > .05). Those who reported symptoms at testing time showed significantly greater DTC of step length (mean difference [MD], 2.7%; 95% confidence interval [CI], 0.3% to 5.1%; P = .012), % of swing phase (MD, 1.0%; 95% CI, −0.2 to 2.1%; P = .042), and % of double-support phase (MD, 3.9%; 95% CI, 0.2% to 7.8%; P = .019). Females demonstrated significantly higher DTC of gait speed (MD, 5.3%; 95% CI, 1.3% to 9.3%; P = .005), cadence (MD, 4.0%; 95% CI, 1.4% to 6.5%; P = .002), % of swing phase (MD, 1.2%; 95% CI, 0.1% to 2.3%; P = .019), and % of double-support phase (MD, 4.1%; 95% CI, 0.4% to 7.9%; P = .018). Noncontact sports athletes had significantly greater step width DTC than contact sports athletes (MD, 14.2%; 95% CI, 0.9% to 27.6%; P = .032). Conclusions: Reporting symptoms at testing time may influence gait under dual-task conditions. Additionally, female athletes showed more gait changes during a dual task. Sports medicine professionals should be aware that these variables, while unrelated to injury, may affect an athlete’s gait upon analysis.
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Emily L. Messerschmidt, Eric E. Hall, Caroline J. Ketcham, Kirtida Patel and Srikant Vallabhajosula
Damien Murphy, Quinette A. Louw, Colum Moloney, Dominique Leibbrandt and Amanda M. Clifford
Purpose: Anterior cruciate ligament (ACL) injuries are among the most severe injuries in the Gaelic Athletic Association. Hop tests measure functional performance after ACL reconstruction as they replicate the key requirements for a match situation. However, research examining functional recovery of ACL-reconstructed Gaelic athletes is lacking. The objective of this study is to determine if athletes restore normal hop symmetry after ACL reconstruction and to examine if bilateral deficiencies persist in hop performance following return to sport. Methods: A cross-sectional design was used to evaluate hop performance of 30 ACL-reconstructed Gaelic athletes who had returned to competition and 30 uninjured controls in a battery of hop tests including a single, 6-m, triple, and triple-crossover hop test. Results: In each test, the mean symmetry score of the ACL reconstruction group was above the cutoff for normal performance of 90% adopted by this study (98%, 99%, 97%, and 99% for the single, 6-m, triple, and triple-crossover hop, respectively). No significant differences in absolute hop scores emerged between involved and control limbs, with the exception of the single-hop test where healthy dominant limbs hopped significantly further than ACL-reconstructed dominant limbs (P = .02). No significant deficits were identified on the noninvolved side. Conclusions: The majority of ACL-reconstructed Gaelic athletes demonstrate normal levels of hop symmetry after returning to competition. Suboptimal hop performance can persist on the involved side compared with control limbs. Targeted rehabilitation may be warranted after returning to competition to restore performance to levels of healthy uninjured athletes.
Enda Whyte, Tiarnán Ó Doinn, Miriam Downey and Siobhán O’Connor
Context: Deficits in the hip range of motion are associated with hip and groin injuries. Accurate and reliable goniometric measurements are important in identifying those at risk of injury and determining the efficacy of treatment interventions. Smartphone goniometric applications are regularly used to assess joint ranges of motion; however, there is limited knowledge on the reliability of this method in relation to the hip, particularly between clinicians with different levels of experience. Objective: To determine the intratester and intertester reliability of a smartphone clinometer application for the assessment of hip goniometric measurements in healthy volunteers by an experienced and novice clinician. Design: Reliability study. Setting: University Athletic Therapy facility. Participants: Physically active, university students. Main Outcome Measures: The study determined the intra- and intertester (experienced vs novice clinician) reliability of goniometric measurements of the hip joint (modified Thomas test and seated hip internal and external rotation) using a smartphone goniometric application. Intraclass correlation coefficients (ICCs), standard error of measurement, and minimal detectable change at a 95% confidence interval were used to assess reliability. Results: Goniometric measurements demonstrated good to excellent relative intratester reliability for the modified Thomas test (ICC = .94), external rotation (ICC = .93–.95), and internal rotation (ICC = .80–.81). Intertester reliability for expert and novice clinicians was also excellent for the modified Thomas test (ICC = .98), external rotation (ICC = .95), and internal rotation (ICC = .92). Intratester and intertester standard error of measurement and minimal detectable change at 95% confidence interval values were similar for both testers and ranged from 1.9° to 3.6° and 5° to 10.1° and from 1.1° to 2.3° and 2.9° to 6.5°, respectively. Conclusion: Smartphone-based goniometric measurements of hip range of motion have high intratester and intertester reliability for novice and expert clinicians. It may be a useful, simple, and inexpensive resource for clinicians.
Keramat Ullah Keramat and Mohammad Naveed Babar
Context: Serratus anterior tightness is associated with scapular dyskinesis and overall shoulder dysfunction, which affects the range of motion. The most effective intervention to stretch the serratus anterior is unknown. Objective: To evaluate the effect of a therapist-administered novel serratus anterior stretch (SAS) on shoulder range of motion. Method: This study recruited 30 healthy subjects of age 21.20 (1.69) years, height 1.65 (0.11) m, and weight 60.90 (10.36) kg in equal ratio of males and females who scored 1 or 2 on the shoulder mobility test of functional movement screening. A single intervention of a novel SAS was applied to the shoulder. Outcome variables before and after the SAS included the following: shoulder ROM (flexion, abduction, internal rotation, and external rotation) and functional movements of reaching up behind the back and reaching down behind the neck. Results: A paired t test was used to analyze the data. Following the acute SAS intervention, all shoulder ROM improved significantly (P < .000). The change in internal rotation was 6.00° (7.47°), external rotation was 5.66° (9.35°), abduction was 13.50° (11.82°), flexion was 20° (13.33°), reaching up behind the back was 5.10 (2.21) cm, and reaching down behind the neck was 5.41 (2.89) cm. The most marked improvement was in reaching up behind the back (24.48%) and reaching down behind the neck (22.78%). A very large effect size (>1) was observed across most of the variables. Conclusion: An acute SAS intervention improves shoulder mobility in healthy individuals. It is recommended for the trial on the prevention and rehabilitation of shoulder pathologies with restriction in shoulder mobility.
Gary B. Wilkerson, Dustin C. Nabhan and Ryan T. Crane
Context: Sport-related concussion (SRC) elevates risk for subsequent injury, which may relate to impaired perceptual-motor processes that are potentially modifiable. Objective: To assess a possible upper-extremity (UE) training effect on whole-body (WB) reactive agility performance among elite athletes with history of SRC (HxSRC) and without such history of SRC. Design: Cohort study. Setting: Residential training center. Participants: Elite athletes (12 males and 8 females), including 10 HxSRC and 10 without such history of SRC. Intervention: One-minute training sessions completed 2 to 3 times per week over a 3-week period involved verbal identification of center arrow direction for 10 incongruent and 10 congruent flanker test trials with simultaneous reaching responses to deactivate illuminated buttons. Main Outcome Measures: Pretraining and posttraining assessments of UE and WB reactive responses included flanker test conflict effect (incongruent minus congruent reaction time) and WB lateral average asymmetry derived from reaction time, speed, acceleration, and deceleration in opposite directions. Discrimination was assessed by receiver operating characteristic analysis, and training effect was assessed by repeated-measures analysis of variance. Results: Pretraining discrimination between HxSRC and without such history of SRC was greatest for conflict effect ≥80 milliseconds and WB lateral average asymmetry ≥18%. Each athlete completed 6 training sessions, which improved UE mean reaction time from 767 to 646 milliseconds (P < .001) and reduced mean conflict effect from 96 to 53 milliseconds (P = .039). A significant group × trial interaction was evident for WB lateral average asymmetry (P = .004), which was reduced from 24.3% to 12.5% among those with HxSRC. Conclusions: Suboptimal perceptual-motor performance may represent a subtle long-term effect of concussion that is modifiable through UE training, which appears to improve WB reactive capabilities.
Marcel Ballin, Peter Nordström and Anna Nordström
In this cross-sectional study, the authors investigated the associations of objectively measured physical activity (PA) with the prevalence of metabolic syndrome (MetS) in older adults. Accelerometer-derived light-intensity PA, moderate to vigorous PA, and steps per day were measured in (N = 4,652) 70-year-olds in Umeå, Sweden, during May 2012–November 2019. The MetS was assessed according to the American Heart Association/ National Heart, Lung and Blood Institute criteria. The prevalence of MetS was 49.3%. Compared with the reference, the odds ratios for MetS in increasing quartiles of light-intensity PA were 0.91 (0.77–1.09), 0.75 (0.62–0.89), and 0.66 (0.54–0.80). For moderate to vigorous PA, the corresponding odds ratios were 0.79 (0.66–0.94), 0.67 (0.56–0.80), and 0.56 (0.46–0.67). For steps per day, the odds ratios were 0.65 (0.55–0.78), 0.55 (0.46–0.65), and 0.45 (0.36–0.55). In summary, this study shows that greater amounts of PA, regardless of intensity, are associated with lower odds of MetS. With the limitation of being an observational study, these findings may have implications for the prevention of MetS in older adults.
Elaine M. Ori, Tanya R. Berry and Lira Yun
It is unknown how lifelong digital media users such as young adult women perceive exercise information found online. A total of 141 women aged 18–30 years and residing in Canada were randomized to read either a factually incorrect or a factually correct blog article. Participants completed Go/No-Go tasks to measure automatically activated believability and evaluations and questionnaires to explicitly measure believability, affective evaluations, and intentions to exercise. Participants did not show evidence of automatically activated believability of the content found in either blog article. However, participants reading the factually correct article reported significantly greater explicit disbelief than those reading the factually incorrect article, though this did not predict intentions. Being factually correct may not be an important component of message believability. Exercise professionals need to remain aware of the content of popular online sources of information in an effort to curb misinformation.
Rachel Cholerton, Helen Quirk, Jeff Breckon and Joanne Butt
Adults aged 55+ years are most likely to be inactive, despite research suggesting that older adults experience multiple benefits when participating in physical activity and sport. Limited research focuses on long-term continuation of sport participation in this population, especially in “adapted sports” like walking football. This study explored the experiences of walking football maintenance in 55- to 75-year-old players. Semistructured interviews were conducted, with 17 older adults maintaining walking football play over 6 months. The inductive analysis revealed five higher-order themes representing maintenance influences and two higher-order themes relating to maintenance mechanisms (i.e., the conscious process by which players maintain). Influences when maintaining walking football included individual- and culture-level influences (e.g., perceived benefits of maintenance and ability acceptance). Maintenance mechanisms included cognitions and behaviors (e.g., scheduling sessions and redefining physical activity expectations). Findings highlight novel implications for policy and practice, which are important to consider when delivering walking football to older adults.
Nicholas L. Holt, Helene Jørgensen and Colin J. Deal
The purpose of this study was to identify and examine how sport parents engage in autonomy-supportive parenting in the family home setting. A total of 44 parents and children from 19 families were initially interviewed. Data from these families were profiled to identify seven families that adopted a highly autonomy-supportive parenting style. The seven families’ data were then examined using a theoretically focused qualitative analysis using the three dimensions of autonomy-supportive parenting. Sport parents engaged in autonomy support (vs. control) through flexible conversations and supporting decision making. The themes of boundary setting and establishing expectations based on values were indicative of structure. The authors found high levels of involvement across contexts. These findings depict the nature and types of social interactions in the family home that created an autonomy-supportive emotional climate, which often extended to sport, providing a foundation for future theoretical development and applied research in sport.
Francisco Timbó de Paiva Neto, Gabriel Claudino Budal Arins, Eleonora d’Orsi and Cassiano Ricardo Rech
This study aims to examine the association between neighborhood environment attributes and changes in walking for transportation among older adults. Longitudinal analysis was performed considering a population-based study (EpiFloripa Idoso), carried out in 2009–2010 with follow-up in 2013–2014. Changes in walking, obtained with the International Physical Activity Questionnaire during both waves were associated with data from the environment perception, evaluated using individual items from the Neighborhood Environment Walkability Scale (baseline only) performing multinomial logistic regression. A total of 1,162 older adults (65.2% women, mean age = 73.7 years) participated. Those who reported the presence of parks and squares (OR = 2.44, 95% confidence interval [CI; 1.70, 3.51]), sidewalks (OR = 1.66, 95% CI [1.03, 2.70]), crosswalks (OR = 1.69, 95% CI [1.05, 2.72]), illuminated streets (OR = 2.80, 95% CI [1.24, 6.33]), and safety for day walks (OR = 1.93, 95% CI [1.14, 3.24]) were more likely to remain active or become active when commuting (≥150 min/week). Older adults are more active in neighborhoods that present more favorable attributes regarding walking for transportation.