Introduction: Sports-related concussions (SRCs) have received attention due to their prevalence in youth. An SRC results from a strong force causing neurological impairment. Recent research has recommended rehabilitation within the first week post-SRC after 24 to 48 hours of rest. The postacute phase is defined as 48 hours to 7 days post-SRC. It is imperative to evaluate the most effective mode and intensity of physical activity to reduce symptoms and improve outcomes. Methods: CINAHL, PubMed, SPORTDiscus, and Web of Science databases were used to search the terms “brain concussion” AND “exercise” and variations of these terms. The evidence level for each study was evaluated using the 2011 Oxford Center for Evidence-Based Medicine Guide. The methodological rigor of each study was evaluated using a scale adapted from Medlicott and Harris. Results: Two thousand sixty-eight records were identified. Six studies were included in this systematic review. Three studies were classified as moderately strong. The remaining 3 studies were considered weak. Five of the studies used either a cycle ergometer or a treadmill. The sixth study used walking, cycling, and swimming, as well as sports drills. All of these modes of exercise were determined to be safe. All studies utilized low- and moderate-intensity interventions, which were found to be nondetrimental and showed improved recovery time and symptom resolution. Five of the studies also incorporated components of high-intensity exercise that was also found to be nondetrimental, and they showed a positive influence on recovery time and symptom resolution. However, all activity in each of the reviewed studies started at a low level and progressed up to a higher level only as each individual client’s symptoms permitted. Discussion: Overall, this review found that various modes of activity at light-, moderate-, and high-intensity levels are efficacious and can be safely used during the postacute phase of SRC. Conclusion: Though the volume of literature at this time is limited, therapists should consider prescribing closely monitored individualized exercise programs utilizing progressive intensities when treating patients during the postacute phase of SRC.
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Barbara Baker, Eric Koch, Kevin Vicari and Kyle Walenta
Christopher J. Stevens, Megan L.R. Ross, Amelia J. Carr, Brent Vallance, Russ Best, Charles Urwin, Julien D. Périard and Louise Burke
Purpose: Hot-water immersion (HWI) after training in temperate conditions has been shown to induce thermophysiological adaptations and improve endurance performance in the heat; however, the potential additive effects of HWI and training in hot outdoor conditions remain unknown. Therefore, this study aimed to determine the effect of repeated postexercise HWI in athletes training in a hot environment. Methods: A total of 13 (9 female) elite/preelite racewalkers completed a 15-day training program in outdoor heat (mean afternoon high temperature = 34.6°C). Athletes were divided into 2 matched groups that completed either HWI (40°C for 30–40 min) or seated rest in 21°C (CON), following 8 training sessions. Pre–post testing included a 30-minute fixed-intensity walk in heat, laboratory incremental walk to exhaustion, and 10,000-m outdoor time trial. Results: Training frequency and volume were similar between groups (P = .54). Core temperature was significantly higher during immersion in HWI (38.5 [0.3]) than CON (37.8°C [0.2°C]; P < .001). There were no differences between groups in resting or exercise rectal temperature or heart rate, skin temperature, sweat rate, or the speed at lactate threshold 2, maximal O2 uptake, or 10,000-m performance (P > .05). There were significant (P < .05) pre–post differences for both groups in submaximal exercising heart rate (∼11 beats·min−1), sweat rate (0.34–0.55 L·h−1) and thermal comfort (1.2–1.5 arbitrary units), and 10,000-m racewalking performance time (∼3 min). Conclusions: Both groups demonstrated significant improvement in markers of heat adaptation and performance; however, the addition of HWI did not provide further enhancements. Improvements in adaptation appeared to be maximized by the training program in hot conditions.
Matthew D. Watson, George J. Davies and Bryan L. Riemann
Context: A recent report demonstrated moderate to strong relationships between seated single-arm shot-put (SSASP) test performance and isokinetic pushing forces at varying velocities, directly supporting the SSASP test as a reflection of multijoint upper-extremity strength. Yet, no previous work appears to have assessed whether the SSASP test is more reflective of shoulder flexion or elbow extension strength. Objective: To examine the relationship between isokinetic shoulder flexion and elbow extension strength and SSASP test performance and to compare limb symmetry indices (LSI) between the 2 tests. Design: Correlational design. Setting: Biomechanics laboratory. Patients (or Other Participants): A total of 30 healthy and physically active young adults. Intervention(s): Participants completed the SSASP test and concentric isokinetic (60°/s and 180°/s) shoulder flexion and elbow extension using their dominant and nondominant arms. Main Outcome Measures: SSASP test performance and isokinetic shoulder flexion and elbow extension peak torques as well as LSI between the 2 tests. Results: Strong relationships were observed between SSASP ranges and isokinetic peak torques at each velocity for both shoulder and elbow (r ≥ .804, P < .001). While the Bland–Altman results on the LSI only demonstrated a significant bias for the shoulder (60°/s, P = .009), limits of agreement results demonstrated extremely wide intervals (32.5%–52.1%). Conclusions: The SSASP test is a multijoint upper-extremity functional performance test that is reflective of equal shoulder flexion and elbow extension contributions; however, there was large variability regarding the agreement between the SSASP LSI and isokinetic shoulder and elbow strength LSI.
Bradford C. Bennett
Thomas Hanna’s somatic work has been essential to the development of the field of somatic education. From redefining the word “somatic” and developing the concept of somatics as a field of study, to starting the magazine/journal Somatics, to developing theories and practices of somatic education, Hanna greatly influenced this fledgling area of work. This article presents the somatic philosophy, theories, and education techniques of Hanna, focusing on the aspects that are unique to this somatic explorer. Hanna’s techniques are contrasted to the traditional somatic movement training of Tai Chi. The difficulties of researching a learning such as somatic education are discussed. Ideas are presented on how kinesiology and somatic education can inform each other.
Harry G. Banyard, James J. Tufano, Jonathon J.S. Weakley, Sam Wu, Ivan Jukic and Kazunori Nosaka
Purpose: To compare the effects of velocity-based training (VBT) and 1-repetition-maximum (1RM) percentage-based training (PBT) on changes in strength, loaded countermovement jump (CMJ), and sprint performance. Methods: A total of 24 resistance-trained males performed 6 weeks of full-depth free-weight back squats 3 times per week in a daily undulating format, with groups matched for sets and repetitions. The PBT group lifted with fixed relative loads varying from 59% to 85% of preintervention 1RM. The VBT group aimed for a sessional target velocity that was prescribed from pretraining individualized load–velocity profiles. Thus, real-time velocity feedback dictated the VBT set-by-set training load adjustments. Pretraining and posttraining assessments included the 1RM, peak velocity for CMJ at 30%1RM (PV-CMJ), 20-m sprint (including 5 and 10 m), and 505 change-of-direction test (COD). Results: The VBT group maintained faster (effect size [ES] = 1.25) training repetitions with less perceived difficulty (ES = 0.72) compared with the PBT group. The VBT group had likely to very likely improvements in the COD (ES = −1.20 to −1.27), 5-m sprint (ES = −1.17), 10-m sprint (ES = −0.93), 1RM (ES = 0.89), and PV-CMJ (ES = 0.79). The PBT group had almost certain improvements in the 1RM (ES = 1.41) and possibly beneficial improvements in the COD (ES = −0.86). Very likely favorable between-groups effects were observed for VBT compared to PBT in the PV-CMJ (ES = 1.81), 5-m sprint (ES = 1.35), and 20-m sprint (ES = 1.27); likely favorable between-groups effects were observed in the 10-m sprint (ES = 1.24) and nondominant-leg COD (ES = 0.96), whereas the dominant-leg COD (ES = 0.67) was possibly favorable. PBT had small (ES = 0.57), but unclear differences for 1RM improvement compared to VBT. Conclusions: Both training methods improved 1RM and COD times, but PBT may be slightly favorable for stronger individuals focusing on maximal strength, whereas VBT was more beneficial for PV-CMJ, sprint, and COD improvements.
Marcelo Toledo-Vargas, Patricio Perez-Contreras, Damian Chandia-Poblete and Nicolas Aguilar-Farias
Background: The purpose was to determine the proportion of 9- to 11-year-old children meeting the 24-hour movement guidelines (24-HMG) in a low-income town from Chile. Methods: Physical activity, sedentary behavior (recreational screen), and sleep times were measured with both questionnaire and accelerometer in 258 children from third to sixth grade. Meeting the 24-HMG was defined as having ≥60 minutes per day of moderate to vigorous physical activity, ≤2 hour day of screen time, and 9 to 11 hours of sleep per night. Compliance rates were calculated as self-reported 24-HMG, with all estimations based on questionnaires, and mixed 24-HMG, in which physical activity and sleep were determined with an accelerometer and sedentary behavior was determined with a questionnaire. Results: About 198 children (10.1 [0.8] y, range 9–11 y) provided valid data for estimating self-reported 24-HMG, and 141 for mixed 24-HMG. Only 3.2% and 0.7% met the 24-HMG when using the self-reported and mixed methods, respectively. When assessing individual recommendations, 13.1% and 3.7% of the sample were physically active based on the self-report and accelerometer, respectively. About a quarter met the sedentary behavior recommendations, while around 50% met the sleep recommendations with both self-reported and mixed methods. Conclusions: An extremely low percentage of the participants met the 24-HMG. Multicomponent initiatives must be implemented to promote healthy movement behaviors in Chilean children.
Gina M. Besenyi, Emi B. Hayashi and Richard W. Christiana
Background: Health care providers (HCPs) promoting physical activity (PA) through programs such as Park Prescriptions (ParkRx) are gaining momentum. However, it is difficult to realize provider PA practices and program interest, and differences in program success exist by provider type (eg, primary vs secondary). This study explored HCPs’ (1) PA counseling practices, (2) knowledge/interest in ParkRx, (3) barriers and resources needed to implement PA counseling and ParkRx programs, and (4) differences in primary versus secondary HCPs. Methods: An e-survey administered in Spring/Summer 2018 to HCPs in 3 states examined study objectives. Results: Respondents (n = 278) were mostly primary (58.3%) HCPs. The majority asked about patient PA habits and offered PA counseling (mean = 5.0, SD = 1.5; mean = 4.8, SD = 1.5), but few provided written prescriptions (mean = 2.5, SD = 1.6). Providers were satisfied with their PA counseling knowledge (mean = 3.8, SD = 1.0) but not with prescribing practices (mean = 3.2, SD = 1.1). Secondary HCPs placed higher importance (P = .012) and provided significantly more written PA prescriptions (P = .005). Time was a common barrier to prescribing PA (mean = 3.4, SD = 1.2), though more so for primary HCPs (P = .000). Although few HCPs knew about ParkRx programs, 81.6% expressed interest. Access to park information and community partnerships was an important resource for program implementation. Conclusions: HCPs underutilize PA prescriptions. Despite little awareness, HCPs were interested in ParkRx programs.