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Joseph M. Day, Ann M. Lucado, R. Barry Dale, Harold Merriman, Craig D. Marker and Tim L. Uhl

Context: There is a lack of consensus on the best management approach for lateral elbow tendinopathy (LET). Recently, scapular stabilizer strength impairments have been found in individuals with LET. Objective: The purpose of this study was to compare the effectiveness of local therapy (LT) treatment to LT treatment plus a scapular muscle-strengthening (LT + SMS) program in patients diagnosed with LET. Design: Prospective randomized clinical trial. Setting: Multisite outpatient physical therapy. Patients: Thirty-two individuals with LET who met the criteria were randomized to LT or LT + SMS. Interventions: Both groups received education, a nonarticulating forearm orthosis, therapeutic exercise, manual therapy, and thermal modalities as needed. Additionally, the LT + SMS group received SMS exercises. Main Outcome Measure: The primary outcome measure was the patient-rated tennis elbow evaluation; secondary outcomes included global rating of change (GROC), grip strength, and periscapular muscle strength. Outcomes were reassessed at discharge, 6, and 12 months from discharge. Linear mixed-effect models were used to analyze the differences between groups over time for each outcome measure. Results: The average duration of symptoms was 10.2 (16.1) months, and the average total number of visits was 8.0 (2.2) for both groups. There were no significant differences in gender, age, average visits, weight, or height between groups at baseline (P > .05). No statistical between-group differences were found for any of the outcome measures. There were significant within-group improvements in all outcome measures from baseline to all follow-up points (P < .05). Conclusion: The results of this pilot study suggest that both treatment approaches were equally effective in reducing pain, improving function, and increasing grip strength at discharge as well as the 6- and 12-month follow-ups. Our multimodal treatment programs were effective at reducing pain and improving function up to 1 year after treatment in a general population of individuals with LET.

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Samantha M. Ross, Ellen Smit, Joonkoo Yun, Kathleen R. Bogart, Bridget E. Hatfield and Samuel W. Logan

A secondary data analysis of 33,093 children and adolescents age 6–17 years (12% with disabilities) from a 2016–2017 National Survey of Children’s Health nonrepresentative sample aimed to identify (a) unique clusters of sociodemographic characteristics and (b) the relative importance of disability status in predicting participation in daily physical activity (PA) and sports. Exploratory classification tree analyses identified hierarchical predictors of daily PA and sport participation separately. Disability status was not a primary predictor of daily PA. Instead, it emerged in the fifth level after age, sex, body mass index, and income, highlighting the dynamic intersection of disability with sociodemographic factors influencing PA levels. In comparison, disability status was a second-level predictor for sport participation, suggesting that unique factors influencing PA level are likely experienced by disabled children and adolescents. The authors employ an intersectionality lens to critically discuss implications for research in adapted PA.

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Charles S. Urwin, Rodney J. Snow, Dominique Condo, Rhiannon Snipe, Glenn D. Wadley and Amelia J. Carr

This review aimed to identify factors associated with (a) physiological responses, (b) gastrointestinal (GI) symptoms, and (c) exercise performance following sodium citrate supplementation. A literature search identified 33 articles. Observations of physiological responses and GI symptoms were categorized by dose (< 500, 500, and > 500 mg/kg body mass [BM]) and by timing of postingestion measurements (in minutes). Exercise performance following sodium citrate supplementation was compared with placebo using statistical significance, percentage change, and effect size. Performance observations were categorized by exercise duration (very short < 60 s, short ≥ 60 and ≤ 420 s, and longer > 420 s) and intensity (very high > 100% VO2max and high 90–100% VO2max). Ingestion of 500 mg/kg BM sodium citrate induced blood alkalosis more frequently than < 500 mg/kg BM, and with similar frequency to >500 mg/kg BM. The GI symptoms were minimized when a 500 mg/kg BM dose was ingested in capsules rather than in solution. Significant improvements in performance following sodium citrate supplementation were reported in all observations of short-duration and very high–intensity exercise with a 500 mg/kg BM dose. However, the efficacy of supplementation for short-duration, high-intensity exercise is less clear, given that only 25% of observations reported significant improvements in performance following sodium citrate supplementation. Based on the current literature, the authors recommend ingestion of 500 mg/kg BM sodium citrate in capsules to induce alkalosis and minimize GI symptoms. Supplementation was of most benefit to performance of short-duration exercise of very high intensity; further investigation is required to determine the importance of ingestion duration and timing.

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Tomasz Skowronek, Grzegorz Juras and Kajetan J. Słomka

Purpose: To estimate the influence of global anaerobic fatigue on rhythm performance. Methods: Fifteen young males participated in the experiment. Anaerobic fatigue was induced with 2 consecutive running-based anaerobic sprint tests (RAST). The level of lactate was controlled before the first RAST and 3 minutes after each RAST. The rhythm performance was assessed by using Optojump Next (Microgate, Bolzano, Italy). The rhythm test was conducted 3 times, before fatigue and immediately after each RAST. Eight variables of the rhythm test were analyzed: the mean frequency of jumps for the assisted and unassisted phase (XfAP and XfUAP), SD of jump frequency for the assisted and unassisted phase (SDfAP and SDfUAP), and mean absolute error for the assisted and unassisted phases of the test (XERAP and XERUAP, respectively). Results: One-way repeated-measures analysis of variance showed a significant main effect of anaerobic effort on rhythm variables only in the unassisted phase of the test. Statistically significant differences were observed in XfUAP between the first and third rhythm measurements (F 2,28 = 4.98, P < .014, ηp2=26.23%), SD of jump frequency for the unassisted phase (SDfUAP; F 2,28 = 3.48, P = .05, ηp2=19.9%), and mean absolute error for the unassisted phase (XERUAP; F 2,28 = 3.36, P = .006, ηp2=19.43%). Conclusions: The results show that rhythm of movement may be negatively influenced after intensive anaerobic fatigue. The exact mechanism of this phenomenon is not precisely defined, but both central and peripheral fatigue are suspected to be involved.

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Leeann M. Lower-Hoppe, James O. Evans, Richard L. Bailey and Shea M. Brgoch

Coopetition is a strategic concept that integrates elements of competition and cooperation. This strategy focuses on creating an environment where working together develops additional value for all entities involved, but there is still competition for this newly established value. Mock trial is an experiential learning technique that can serve as a platform to implement coopetitive strategies, providing students the opportunity to cooperatively apply theory to practice in a competitive courtroom simulation. This extended abstract details implementation of coopetition through mock trial for the sport management classroom. Implications for enhancing the coopetitive environment through course format, mentorship, and facilitation are also discussed.

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Thomas Sawczuk, Ben Jones, Mitchell Welch, Clive Beggs, Sean Scantlebury and Kevin Till

Purpose: To evaluate the relative importance and predictive ability of salivary immunoglobulin A (s-IgA) measures with regards to upper respiratory illness (URI) in youth athletes. Methods: Over a 38-week period, 22 youth athletes (age = 16.8 [0.5] y) provided daily symptoms of URI and 15 fortnightly passive drool saliva samples, from which s-IgA concentration and secretion rate were measured. Kernel-smoothed bootstrapping generated a balanced data set with simulated data points. The random forest algorithm was used to evaluate the relative importance (RI) and predictive ability of s-IgA concentration and secretion rate with regards to URI symptoms present on the day of saliva sampling (URIday), within 2 weeks of sampling (URI2wk), and within 4 weeks of sampling (URI4wk). Results: The percentage deviation from average healthy s-IgA concentration was the most important feature for URIday (median RI 1.74, interquartile range 1.41–2.07). The average healthy s-IgA secretion rate was the most important feature for URI4wk (median RI 0.94, interquartile range 0.79–1.13). No feature was clearly more important than any other when URI symptoms were identified within 2 weeks of sampling. The values for median area under the curve were 0.68, 0.63, and 0.65 for URIday, URI2wk, and URI4wk, respectively. Conclusions: The RI values suggest that the percentage deviation from average healthy s-IgA concentration may be used to evaluate the short-term risk of URI, while the average healthy s-IgA secretion rate may be used to evaluate the long-term risk. However, the results show that neither s-IgA concentration nor secretion rate can be used to accurately predict URI onset within a 4-week window in youth athletes.

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Carolina Franco Wilke, Samuel P. Wanner, Eduardo M. Penna, André Maia-Lima, Weslley H.M. Santos, Flávia C. Müller-Ribeiro, Thiago T. Mendes, Rubio S. Bruzzi, Guilherme P. Ramos, Fábio Y. Nakamura and Rob Duffield

Purpose: To compare the posttraining recovery timeline of elite Brazilian futsal athletes before (Pre-PS) and after 10 weeks of the preseason (Post-PS) period of high-intensity technical–tactical training. Methods: At the start (n = 13) and at the end of the preseason (n = 7), under-20 male futsal players undertook fitness testing for maximal aerobic power, the countermovement jump (CMJ), and the 10-m sprint with change of direction. Furthermore, at both Pre-PS and Post-PS, the players participated in a training session where performance and psychophysiological measures were recorded before, immediately, 3, 24, and 48 hours postsession. The measures included CMJ, 10-m sprint, creatine kinase, Total Quality Recovery Scale, and Brunel Mood Scale. Effect size (ES) analyses compared fitness and posttraining recovery values for each parameter at Pre-PS versus Post-PS. Results: Only trivial ES (−0.02 to 0.11) was evident in maximal aerobic power, CMJ, and 10-m sprint at Post-PS compared with Pre-PS. For the timeline of recovery, only trivial and small ESs were evident for the 10-m sprint (−0.12 to 0.49), though CMJ recovery was improved at 3 hours (0.87) and 48 hours (1.27) at Post-PS and creatine kinase was lower at 48 hours (−1.33) at Post-PS. Perception of recovery was improved in Post-PS at 3 hours (1.50) and 24 hours postsession (0.92). Furthermore, perception of effort was lower immediately after the session (−0.29), fatigue was lower at 3 hours (−0.63), and vigor responses were improved in all postseason assessments (0.59 to 1.13). Conclusion: Despite minimal changes in fitness, preseason training attenuated players’ perception of effort and fatigue and improved their recovery profile following a high-intensity technical–tactical training session.

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Tobias Alt, Igor Komnik, Jannik Severin, Yannick T. Nodler, Rita Benker, Axel J. Knicker, Gert-Peter Brüggemann and Heiko K. Strüder

Purpose: Concentric hip and eccentric knee joint mechanics affect sprint performance. Although the biarticular hamstrings combine these capacities, empirical links between swing phase mechanics and corresponding isokinetic outcome parameters are deficient. This explorative study aimed (1) to explain the variance of sprint velocity, (2) to compare maximal sprints with isokinetic tests, (3) to associate swing phase mechanics with isokinetic parameters, and (4) to quantify the relation between knee and hip joint swing phase mechanics. Methods: A total of 22 sprinters (age = 22 y, height = 1.81 m, weight = 77 kg) performed sprints and eccentric knee flexor and concentric knee extensor tests. All exercises were captured by 10 (sprints) and 4 (isokinetics) cameras. Lower-limb muscle balance was assessed by the dynamic control ratio at the equilibrium point. Results: The sprint velocity (9.79 [0.49] m/s) was best predicted by the maximal knee extension velocity, hip mean power (both swing phase parameters), and isokinetic peak moment of concentric quadriceps exercise (R 2 = 60%). The moment of the dynamic control ratio at the equilibrium point (R 2 = 39%) was the isokinetic parameter with the highest predictive power itself. Knee and hip joint mechanics affected each other during sprinting. They were significantly associated with isokinetic parameters of eccentric hamstring tests, as well as moments and angles of the dynamic control ratio at the equilibrium point, but restrictedly with concentric quadriceps exercise. The maximal sprints imposed considerably higher loads than isokinetic tests (eg, 13-fold eccentric knee joint peak power). Conclusions: Fast sprinters demonstrated distinctive knee and hip mechanics in the late swing phase, as well as strong eccentric hamstrings, with a clear association to the musculoarticular requirements of the swing phase in sprinting. The transferability of isokinetic knee strength data to sprinting is limited inter alia due to different hip joint configurations. However, isokinetic tests quantify specific sprint-related muscular prerequisites and constitute a useful diagnostic tool due to their predicting value to sprint performance.

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Jessica Amie Hill, Karen Mary Keane, Rebecca Quinlan and Glyn Howatson

The aim of this study was to determine the efficacy of tart cherry (TC) supplementation on recovery following strenuous exercise. A systematic review and meta-analysis were conducted using studies investigating TC supplementation on measures of muscle soreness, muscular strength, muscular power, creatine kinase, C-reactive protein, Interleukin-6, and tumor necrosis factor alpha. A literature search ending in July 2020 was conducted in three databases (SPORTDiscus, Web of Science, and PubMed). Data from 14 studies were extracted and pooled for analysis. Tart cherry supplementation had a small beneficial effect in reducing muscle soreness (effect size [ES] = −0.44, 95% confidence interval [CI] [−0.87, −0.02]). A moderate beneficial effect was observed for recovery of muscular strength (ES = −0.78, 95% CI [−1.11, −0.46]). A moderate effect was observed for muscular power (ES = −0.53, 95% CI [−0.77, −0.29]); a further subgroup analysis on this variable indicated a large effect of TC supplementation on recovery of jump height (ES = −0.82, 95% CI [−1.18, −0.45]) and a small significant effect of supplementation on sprint time (ES = −0.32, 95% CI [−0.60, −0.04]). A small effect was observed for both C-reactive protein (ES = −0.46, 95% CI [−0.93, −0.00]) and Interleukin-6 (ES = −0.35, 95% CI [−0.68, −0.02]. No significant effects were observed for creatine kinase and tumor necrosis factor alpha. These results indicate that the consumption of a TC supplement can aid aspects of recovery from strenuous exercise.

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Angelo Sabag, Ric Lovell, Neil P. Walsh, Nick Grantham, Mathieu Lacome and Martin Buchheit

Purpose: During heavily congested schedules, professional soccer players can experience exacerbated fatigue responses, which are thought to contribute to an increased risk of injury. Given that match-induced residual fatigue can last up to 72 hours, many coaches naturally prioritize recovery in the days immediately following match day. While it is intuitive for coaches and training staff to decrease the amount of auxiliary training practices to focus on recovery, prescribing upper-body resistance training on the day after match play has recently emerged as a specific training modality in this context. While these sessions may be implemented to increase training stimulus, there are limited data available regarding the efficacy of such a practice to improve recovery kinetics. Methods: In this narrative review, the authors look at the theoretical implications of performing upper-body resistance training on the day after match play on the status of various physiological and psychological systems, including neuromuscular, metabolic, hormonal, perceptual, and immunological recovery. Results: The available evidence suggests that in most cases this practice, as currently implemented (ie, low volume, low intensity), is unlikely to be complementary (ie, does not accelerate recovery) but is potentially compatible (ie, does not impair recovery). Conclusion: Overall, because the perception of such sessions may be player dependent, their programming requires an individualized approach and should take into account match dynamics (eg, fixture scheduling, playing time, travel).