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Characterizing Longitudinal Alterations in Postural Control Following Lower Limb Injury in Professional Rugby Union Players

Molly F. McCarthy-Ryan, Stephen D. Mellalieu, Holly Jones, Adam Bruton, and Isabel S. Moore

Assessment of player’s postural control following a lower limb injury is of interest to sports medicine practitioners due to its fundamental role in daily tasks and sporting activities. The aim was to longitudinally monitor professional rugby union players’ postural control during each phase of the rehabilitation program (acute, middle, and late) following a lower limb injury. Seven male rugby union players (height 1.80 [0.02] m; mass 100.3 [11.4] kg; age 24 [4] y) sustained a time loss, noncontact lower limb injury. Static postural control was assessed via sway path (in meters), and dynamic postural control was assessed via vertical postural stability index. Group differences (P < .05) were reported across the acute, middle, and late phase. Smaller magnitudes of sway path were observed for eyes-open sway path, and for the middle and late phase smaller magnitudes of vertical postural stability index (P < .05) at the end session compared with first session. Whereas larger magnitudes of vertical postural stability index were found between baseline and the last session (P < .05). Large interindividual and intraindividual variation was apparent across the 3 phases of rehabilitation. Postural control improvements were identified during rehabilitation. However, postural control did not return to baseline, with altered kinetics throughout each rehabilitation phase.

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From Frozen Ponds to Organized Competitions: The Growth of Skating and Ice Hockey in Korea, 1886–1938

Kyoungho Park and Karam Lee

The encounter of American Protestant evangelicalism and Japanese imperialism formed in Korean society in the late 19th and early 20th centuries became a steppingstone for the acceptance of modern winter sports in Korea. In particular, skates introduced by American Protestant missionaries and the Young Men’s Christian Association formed an imaginary space to counter Japanese imperialism in Korea during Japanese colonial era. Ice hockey introduced along with skating is a representative product that evolved in this process. The history of the introduction of American ice hockey to Korea also had a dual imperial influence between the United States and Japan, and in another direction, there was a voluntary acceptance process by Koreans who recognized ice hockey as a modern product.

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Physical Activity Among Utah Cancer Survivors: Analysis From a Population-Based Statewide Survey

Morgan M. Millar, Sandra L. Edwards, Rachel R. Codden, Blessing S. Ofori-Atta, Kimberly A. Herget, Marjorie E. Carter, Anne C. Kirchhoff, Adriana M. Coletta, and Carol Sweeney

Background: Regular physical activity improves cancer survivors’ health-related quality of life and physical function. We estimated the proportion of Utah cancer survivors meeting U.S. Department of Health and Human Services guidelines for weekly physical activity (aerobic plus strength exercise) and identify sociodemographic, cancer, and health-related factors associated with meeting guidelines. Methods: Survivors randomly sampled from Utah Cancer Registry records were surveyed from 2018 to 2022 to ascertain physical activity. We calculated the percent of survivors meeting guidelines and conducted logistic regression to assess predictors of meeting guidelines. Analyses were weighted to account for complex survey sample design and nonresponse and age adjusted. Results: Among Utah cancer survivors, 20.7% (95% CI, 18.5%–23.2%) met guidelines for both aerobic activity and strength exercise. 22.4% reported no aerobic exercise in a typical week, and 59.4% reported no strength exercise. Survivors 75 or older were less likely to meet physical activity guidelines than those under 55 (adjusted odds ratio: 0.40; 95% CI, 0.25–0.65). Survivors with a bachelor’s degree or higher were more likely to meet physical activity guidelines than those without a college degree. Individuals with poorer overall health were less likely to report sufficient physical activity. Individuals treated with both chemotherapy and radiation had decreased odds of meeting guidelines compared to no treatment (adjusted odds ratio: 0.54; 95% CI, 0.29–0.99). Conclusions: Most Utah cancer survivors, and particularly those who received multiple modes of adjuvant treatment, are not participating in sufficient physical activity to improve longevity and quality of life after cancer.

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Spaced Use of Social Media Apps Among Motor Practice Trials Impacts Performance Without Influencing Mental Fatigue and Motor Learning

Marina Gonçalves Leal, José Eduardo dos Martírios Luz, Ana Kariele da Silva Santos, Cicero Luciano Alves Costa, Paulo Felipe Ribeiro Bandeira, Cassio de Miranda Meira Jr, and Giordano Marcio Gatinho Bonuzzi

We aimed to investigate the impact of smartphone use during intertrial intervals within a distributed practice regime on mental fatigue, performance, and learning of a balance motor skill. One hundred and thirty-six participants were randomly divided into two groups: the smartphone use group (SMARTPHONE) and the control group (CONTROL). The SMARTPHONE accessed social media during the rest periods within a distributed practice of a balance task, whereas the CONTROL rested passively during the rest periods. The participants practiced the toe-touch task. The participants underwent a pretest consisting of one trial. Subsequently, the participants were engaged in practice, completing six trials interspersed with 2-min intervals of either rest or smartphone use. Following the practice phase, a posttest was conducted, and after 24 hr, we administered a retention test and a transfer test. The number of touches and the number of errors (contacting the ground with the free leg to regain balance) were performance measures. We evaluated the participants’ mental fatigue after the practice session using a visual analog scale. The groups demonstrated similar mental fatigue after practice. Our results suggest that using social media on smartphones during rest periods within a distributed practice impairs performance but not motor learning.

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Cohesion and Heterosexist Attitudes in Men’s Collegiate Athletics

Elizabeth M. Mullin, Meghan K. Halbrook, Ryan Socolow, and Anna Bottino

While attitudes toward gay men in sport have improved, sexual prejudice persists in sport, with the potential to decrease team social bonds. We examined the relationship between heterosexist attitudes and cohesion in men’s collegiate sports. Male college athletes (N = 264) completed the Heterosexist Attitudes in Sport–Gay Men scale and the Group Environment Questionnaire. We found a significant multivariate relationship among heterosexist attitudes and cohesion, Λ = .88, F(8, 518) = 4.28, p < .001, with 10.6% overlapping variance between the two variate sets. Cognitive/affective heterosexist attitudes, attraction to group-task, group integration-task, and group integration-social contributed to the relationship. Heterosexism and sexual prejudice may serve as distractions from team objectives. Mental performance consultants working within men’s college sport should challenge negative stereotypes of lesbian, gay, bisexual, and queer individuals; reward inclusive efforts; and leverage team building to reduce heterosexism in sport.

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Governance and Policy in Sport Organizations, 5th ed.

Andrew Sellers

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A Novel Behavioral Intervention to Enhance Physical Activity for Older Veterans in a Skilled Nursing Facility

Julie A. Stutzbach, Kristine S. Hare, Allison M. Gustavson, Danielle L. Derlein, Andrea L. Kellogg, and Jennifer E. Stevens-Lapsley

Physical activity levels during skilled nursing facility (SNF) rehabilitation fall far below what is needed for successful community living and to prevent adverse events. This feasibility study’s purpose was to evaluate the feasibility, acceptability, and preliminary effectiveness of an intervention designed to improve physical activity in patients admitted to SNFs for short-term rehabilitation. High-Intensity Rehabilitation plus Mobility combined a high-intensity (i.e., high weight, low repetition), progressive (increasing in difficulty over time), and functional resistance rehabilitation intervention with a behavioral economics-based physical activity program. The behavioral economics component included five mobility sessions/week with structured goal setting, gamification, and loss aversion (the idea that people are more likely to change a behavior in response to a potential loss over a potential gain). SNF physical therapists, occupational therapists, and a mobility coach implemented the High-Intensity Rehabilitation plus Mobility protocol with older Veterans (n = 18) from a single SNF. Participants demonstrated high adherence to the mobility protocol and were highly satisfied with their rehabilitation. Treatment fidelity scores for clinicians were ≥95%. We did not observe a hypothesized 40% improvement in step counts or time spent upright. However, High-Intensity Rehabilitation plus Mobility participants made clinically important improvements in short physical performance battery scores and gait speed from admission to discharge that were qualitatively similar to or slightly higher than historical cohorts from the same SNF that had received usual care or high-intensity rehabilitation alone. These results suggest a structured physical activity program can be feasibly combined with high-intensity rehabilitation for SNF residents following a hospital stay.

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A Practice Guide for Physical Therapists Prescribing Physical Exercise for Older Adults

Frederico M. Baptista, Rosa Andias, Nelson P. Rocha, and Anabela G. Silva

Introduction: Physical activity and exercise are protective factors for physical and cognitive decline in older adults, but recent studies reveal that a large percentage of this population do not practice exercise at the levels recommended by international guidelines. The frequency, intensity, type, time, volume, and progression (FITT-VP) principles are a widely used method for prescribing physical exercise, allowing the development of a personalized exercise program that meets the needs of each individual. Objectives: This masterclass is intended to serve as a professional application tool for physical therapists who prescribe physical exercise for older adults. We present a section for each FITT-VP principle to facilitate handling these principles individually when prescribing exercise for this population. Methods: Review of the scientific literature and international guidelines on the prescription of physical exercises for older adults. Results: Aerobic, mobility, resistance, balance, and flexibility exercises, as well as functional training, should be included in an exercise program for older adults, which should be progressed using different methods for each of the exercise modalities. Conclusions: An exercise program for older adults should integrate different exercise modalities. Exercise progression should be performed following the FITT-VP principles and some specific progression factors recommended for each exercise modality. Significance: Considering the challenge faced by clinicians in designing a viable exercise program for older adults that responds to international recommendations, with this masterclass we hope to help physical therapists to plan an exercise program that is feasible and at the same time, responds to the expected needs of this population.

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Relationship Between External Training Load and Session Rating of Perceived Exertion Training Impulse in Elite Sprinters

Matthew Thome, Sophia Nimphius, Matthew J. Jordan, and Robin T. Thorpe

Purpose: To quantify the change in session rating of perceived exertion training impulse (RPE-TRIMP) that may occur in response to increased running distance at 3 running velocity ranges in elite sprinters. Methods: We monitored training load in elite sprinters (women: n = 7; men: n = 11) using wearable Global Positioning System technology and RPE-TRIMP for a total of 681 individual training sessions during a 22-week competition-preparation period. Internal training load was operationalized by RPE-TRIMP, and external training load was operationalized by distance covered in 3 velocity ranges. A linear mixed-effects model with athlete as a random effect was fit to RPE-TRIMP with total distance covered at ≤69.99% (low-velocity running [LVR]), 70% to 84.99% (high-velocity running [HVR]), and 85% to 100% (very-high-velocity running [VHVR]) of individual maximum velocity. Results: Increased running distance in all 3 velocity ranges (LVR, HVR, and VHVR) resulted in a significant (P < .001) increase in RPE-TRIMP. Coefficients (95% CIs) were .10 (.08–.11) for LVR, .23 (.18–.28) for HVR, and .44 (.35–.53) for VHVR. A 50-m increase in running distance covered in the LVR, HVR, and VHVR velocity ranges was associated with increases in RPE-TRIMP of 5, 11.5, and 22 arbitrary units, respectively. Conclusions: Internal training load, calculated as RPE-TRIMP, increased with increases in total distance covered in the LVR, HVR, and VHVR velocity ranges (P < .001). RPE-TRIMP can be a practical solution for monitoring global training-session load in elite sprinters.

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Sex Differences in Self-Reported Causes, Symptoms, and Recovery Strategies Associated With Underperformance in Endurance Athletes

Aarón Agudo-Ortega, Rune Kjøsen Talsnes, Hanna Eid, Øyvind Sandbakk, and Guro Strøm Solli

Purpose: This study investigated sex differences in self-reported causes, symptoms, and recovery strategies associated with underperformance in endurance athletes. Methods: A total of 82 athletes (40 women) meeting the inclusion criteria (performance level ≥tier 3, used training diaries, and experienced 1 or more periods of underperformance during their career) completed an online questionnaire. The questionnaire encompassed inquiries regarding load monitoring and experiences with underperformance, focusing on causes, symptoms, and recovery strategies. Results: The most frequently reported symptoms associated with underperformance included psychological (31%), physiological (23%), and health-related (12%) symptoms. Notably, female athletes were more likely to report psychological symptoms associated with underperformance (38% vs 25%, P = .01) compared with male athletes. The leading causes of underperformance comprised illness (21%), mental/emotional challenges (20%), training errors (12%), lack of recovery (10%), and nutritional challenges (5%). Female athletes reported nutritional challenges more frequently as the cause of underperformance compared with males (9% vs 1%, P = .01), whereas male athletes more often attributed underperformance to training errors (15% vs 9%, P = .03). Overall, 67% of athletes reported recovering from underperformance, with a tendency for more male than female athletes to recover (76% vs 58%, P = .07). Furthermore, a higher proportion of male than female athletes reported implementing changes in the training process as a recovery strategy (62% vs 35%, P = .02). Conclusions: This study offers valuable insights into sex differences in experiences with underperformance in endurance athletes. The findings could inform coaches and athletes in both the prevention and treatment of such incidents.