Total knee arthroplasty (TKA) surgery improves knee joint kinematics and kinetics during gait for most patients, but a lack of evidence exists for the level and incidence of improvement that is achieved. The objective of this study was to quantify patient-specific improvements in knee biomechanics relative to osteoarthritis (OA) severity levels. Seventy-two patients underwent 3-dimensional (3D) gait analysis before and 1 year after TKA surgery, as well as 72 asymptomatic adults and 72 with moderate knee OA. A combination of principal component analysis and discriminant analyses were used to categorize knee joint biomechanics for patients before and after surgery relative to asymptomatic, moderate, and severe OA. Post-TKA, 63% were categorized with knee biomechanics consistent with moderate OA, 29% with severe OA, and 8% asymptomatic. The magnitude and pattern of the knee adduction moment and angle (frontal plane features) were the most significant contributors in discriminating between pre-TKA and post-TKA knee biomechanics. Standard of care TKA improves knee biomechanics during gait to levels most consistent with moderate knee OA and predominately targets frontal plane features. These results provide evidence for the level of improvement in knee biomechanics that can be expected following surgery and highlight the biomechanics most targeted by surgery.
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Jereme B. Outerleys, Michael J. Dunbar, Glen Richardson, Cheryl L. Hubley-Kozey and Janie L. Astephen Wilson
Jennifer T. Coletti, Veronica Allan and Luc J. Martin
A child’s first contact with media and culture typically comes from books they are exposed to in the home and at school. The narratives presented contribute to the early reinforcement of gender roles and norms and can greatly influence the way that young girls perceive and experience sport. The purpose of this study was to explore the narratives within sport-based books geared toward a young female audience to determine the extent to which they promote the engagement of girls in sport. A pragmatic literature search was conducted to obtain books that met our inclusion criteria. Books (n = 28) were analyzed based on the age of their intended audience (aged 3–5, 6–8, and 9–12 years) using thematic narrative analysis. Although the authors promoted the engagement of girls in sport, underlying gender stereotypes were nevertheless salient. Across the books, themes involved the emphasis of “feminine” sports as a context for diversity and learning, the need to understand development as a process, the importance of relationships, and implications pertaining to perceptions of capability as female athletes. Most importantly, the application of a critical feminist lens enabled us to identify an underlying theme—the reinforcement of gender stereotypes—that permeated the storylines and served to undermine the potential adaptive messaging intended by authors. These findings suggest the need for greater attention toward the complexity of female sport and a cultural shift in thinking toward gender equity rather than simply increasing sport access for female participants.
Emily A. Roper and José A. Santiago
The purpose of this study was to examine how and how often athletic girls were represented on the cover art of young adult (YA) sport fiction. In this research, 154 YA sport fiction books were analyzed using quantitative content analysis. Using existing sport research and theory focused on women’s representation in sport media, the researchers developed a coding scheme to assess cover art for each of the following categories: (a) presence and racial representation of female character/s on cover; (b) portrayal of female body on cover (whole body, partial body/with head, or partial body/without head); (c) portrayal of female character as active or passive; (d) portrayal of female character in or out of athletic uniform; (e) portrayal of female character in or out of the sport setting; (f) presence of sport equipment; and (g) type of cover. Findings revealed that 81% of the book covers had a female character in which 29% of the covers displayed the whole body, 47% displayed partial body/with head, and 23% displayed partial body/with no head of the female character. Only 0.06% of the book covers had a female character of color. Approximately 31% of the female characters were displayed in active positioning, 58% in athletic attire, and 44% in the sport setting. Of the books reviewed, 55% displayed equipment on the cover. The findings indicate that athletic girls have few images on YA sport fiction cover art that accurately represent their athleticism, and there is a clear absence of diverse representation. It is critical that those responsible for the design and layout of book covers clearly represent active females in action, in uniform, and in the sport context.
Craig Pickering, Dylan Hicks and John Kiely
Elite sprint performances typically peak during an athlete’s 20s and decline thereafter with age. The mechanisms underpinning this sprint performance decline are often reported to be strength-based in nature with reductions in strength capacities driving increases in ground contact time and decreases in stride lengths and frequency. However, an as-of-yet underexplored aspect of Masters sprint performance is that of age-related degradation in neuromuscular infrastructure, which manifests as a decline in both strength and movement coordination. Here, the authors explore reductions in sprint performance in Masters athletes in a holistic fashion, blending discussion of strength and power changes with neuromuscular alterations along with mechanical and technical age-related alterations. In doing so, the authors provide recommendations to Masters sprinters—and the aging population, in general—as to how best to support sprint ability and general function with age, identifying nutritional interventions that support performance and function and suggesting useful programming strategies and injury-reduction techniques.
Steven M. Davi, Colleen K. Woxholdt, Justin L. Rush, Adam S. Lepley and Lindsey K. Lepley
Context: Traditionally, quadriceps activation failure after anterior cruciate ligament reconstruction (ACLR) is estimated using discrete isometric torque values, providing only a snapshot of neuromuscular function. Sample entropy (SampEn) is a mathematical technique that can measure neurologic complexity during the entirety of contraction, elucidating qualities of neuromuscular control not previously captured. Objective: To apply SampEn analyses to quadriceps electromyographic activity in order to more comprehensively characterize neuromuscular deficits after ACLR. Design: Cross-sectional. Setting: Laboratory. Participants: ACLR: n = 18; controls: n = 24. Interventions: All participants underwent synchronized unilateral quadriceps isometric strength, activation, and electromyography testing during a superimposed electrical stimulus. Main Outcome Measures: Group differences in strength, activation, and SampEn were evaluated with t tests. Associations between SampEn and quadriceps function were evaluated with Pearson product–moment correlations and hierarchical linear regressions. Results: Vastus medialis SampEn was significantly reduced after ACLR compared with controls (P = .032). Vastus medialis and vastus lateralis SampEn predicted significant variance in activation after ACLR (r 2 = .444; P = .003). Conclusions: Loss of neurologic complexity correlates with worse activation after ACLR, particularly in the vastus medialis. Electromyographic SampEn is capable of detecting underlying patterns of variability that are associated with the loss of complexity between key neurophysiologic events after ACLR.
Haiko B. Zimmermann, Débora Knihs, Fernando Diefenthaler, Brian MacIntosh and Juliano Dal Pupo
Purpose: The objective of this study was to analyze the effects of a conditioning activity (CA) composed of continuous countermovement jumps on twitch torque production and 30-m sprint times. Methods: A total of 12 sprint athletes, 10 men (23.5 [7.7] y) and 2 women (23.0 [2.8] y), volunteered to participate in this study. The participants were evaluated in 2 sessions as follows: (1) to determine the effects of the CA (3 sets of 5 continuous vertical jumps with a 1-min interval between sets) on 30-m sprint performance over time (2, 4, 6, 8, and 10 min) and (2) to evaluate twitch peak torque to determine the magnitude and time course of the induced postactivation potentiation at the same recovery intervals. Results: Mixed-model analysis of variance with Bonferroni post hoc verified that there was a decrease on the 30-m sprint time at 2 minutes (P = .01; Δ = 2.78%; effect size [ES] = 0.43) and 4 minutes (P = .02; Δ = 2%, ES = 0.30) compared with pre when the CA preceded the sprints. The peak torque of quadriceps also showed significant increase from pretest to 2 minutes (P < .01; Δ = 17.0% [12.2%]; ES = 0.45) and 4 minutes (P = .02; Δ = 7.2% [8.8%]; ES = 0.20). Conclusion: The inclusion of CA composed of continuous countermovement jumps in the warm-up routine improved 30-m sprint performance at 2- and 4-minute time intervals after the CA (postactivation performance enhancement). Since postactivation potentiation was confirmed with electrical stimulation at the time when sprint performance increased, it was concluded that postactivation potentiation may have contributed to the observed performance increases.
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.
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.
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.
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,