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Guneet Chawla, Madelon Hoppe, Nina Browner and Michael D. Lewek

The purpose of this study was to determine the difference in spatiotemporal gait measures induced by stepping to the beat of a metronome and to music cues of various frequencies in individuals with Parkinson’s disease. Twenty-one participants with Parkinson’s disease were instructed to time their steps to a metronome and music cues (at 85%, 100%, and 115% of overground cadence). The authors calculated cadence, cadence accuracy, and step length during each cue condition and an uncued control condition. The music and metronome cues produced comparable results in cadence manipulation, with reduced cadence accuracy noted at slower intended frequencies. Nevertheless, the induced cadence elicited a concomitant alteration in step length. The music and metronome cues produced comparable changes to gait, but suggest that temporal control is more limited at slower frequencies, presumably by the challenge of increasing the step length.

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Taylor K. Dinyer, Pasquale J. Succi, M. Travis Byrd, Caleb C. Voskuil, Evangeline P. Soucie and Haley C. Bergstrom

This study determined the load- and limb-dependent neuromuscular responses to fatiguing, bilateral, leg extension exercise performed at a moderate (50% one-repetition maximum [1RM]) and high load (80% 1RM). Twelve subjects completed 1RM testing for the bilateral leg extension, followed by repetitions to failure at 50% and 80% 1RM, on separate days. During all visits, the electromyographic (EMG) and mechanomyographic (MMG), amplitude (AMP) and mean power frequency (MPF) signals were recorded from the vastus lateralis of both limbs. There were no limb-dependent responses for any of the neuromuscular signals and no load-dependent responses for EMG AMP, MMG AMP, or MMG MPF (p = .301–.757), but there were main effects for time that indicated increases in EMG and MMG AMP and decreases in MMG MPF. There was a load-dependent decrease in EMG MPF over time (p = .032) that suggested variability in the mechanism responsible for metabolite accumulation at moderate versus high loads. These findings suggested that common drive from the central nervous system was used to modulate force during bilateral leg extension performed at moderate and high loads.

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Liana M. Tennant, Erika Nelson-Wong, Joshua Kuest, Gabriel Lawrence, Kristen Levesque, David Owens, Jeremy Prisby, Sarah Spivey, Stephanie R. Albin, Kristen Jagger, Jeff M. Barrett, James D. Wong and Jack P. Callaghan

Spinal stiffness and mobility assessments vary between clinical and research settings, potentially hindering the understanding and treatment of low back pain. A total of 71 healthy participants were evaluated using 2 clinical assessments (posteroanterior spring and passive intervertebral motion) and 2 quantitative measures: lumped mechanical stiffness of the lumbar spine and local tissue stiffness (lumbar erector spinae and supraspinous ligament) measured via myotonometry. The authors hypothesized that clinical, mechanical, and local tissue measures would be correlated, that clinical tests would not alter mechanical stiffness, and that males would demonstrate greater lumbar stiffness than females. Clinical, lumped mechanical, and tissue stiffness were not correlated; however, gradings from the posteroanterior spring and passive intervertebral motion tests were positively correlated with each other. Clinical assessments had no effect on lumped mechanical stiffness. The males had greater lumped mechanical and lumbar erector spinae stiffness compared with the females. The lack of correlation between clinical, tissue, and lumped mechanical measures of spinal stiffness indicates that the use of the term “stiffness” by clinicians may require reevaluation; clinicians should be confident that they are not altering mechanical stiffness of the spine through segmental mobility assessments; and greater resting lumbar erector stiffness in males suggests that sex should be considered in the assessment and treatment of the low back.

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Behnam Gholami-Borujeni, Ali Yalfani and Leila Ahmadnezhad

This study was conducted to evaluate the effects of 8-week inspiratory muscle training on activity in the ankle muscles of athletes with chronic low-back pain. A randomized controlled trial involving 45 men and women with chronic low-back pain was carried out. Electromyography activity in the tibialis anterior, peroneus longus, gastrocnemius medialis, and gastrocnemius lateralis muscles of the dominant leg was recorded. Secondary outcomes included biopsychosocial indices, such as pain, disability, anxiety and depression, fear-avoidance beliefs, and fear of (re)injury. Static and dynamic overhead squat tests showed that inspiratory muscle training decreased activity in the tibialis anterior, peroneus longus, and gastrocnemius medialis muscles. In the static single-leg squat test and the descending phase of the dynamic equivalent, such a decrease was observed in all the 4 muscles. Inspiratory muscle training significantly reduced pain severity and activity in the tibialis anterior, peroneus longus, and gastrocnemius medialis muscles during the ascending phase of the dynamic single-leg squat test. On the basis of the findings, 8 weeks of inspiratory muscle training may constitute useful rehabilitation for reducing excessive activity in ankle joint muscles and aiding chronic low-back pain recovery.

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Rafael E.A. Muchaxo, Sonja de Groot, Lucas H.V. van der Woude, Thomas W.J. Janssen and Carla Nooijen

The classification system for handcycling groups athletes into five hierarchical classes, based on how much their impairment affects performance. Athletes in class H5, with the least impairments, compete in a kneeling position, while athletes in classes H1 to H4 compete in a recumbent position. This study investigated the average time-trial velocity of athletes in different classes. A total of 1,807 results from 353 athletes who competed at 20 international competitions (2014–2018) were analyzed. Multilevel regression was performed to analyze differences in average velocities between adjacent pairs of classes, while correcting for gender, age, and event distance. The average velocity of adjacent classes was significantly different (p < .01), with higher classes being faster, except for H4 and H5. However, the effect size of the differences between H3 and H4 was smaller (d = 0.12). Hence, results indicated a need for research in evaluating and developing evidence-based classification in handcycling, yielding a class structure with meaningful performance differences between adjacent classes.

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Nathan Waite, John Goetschius and Jakob D. Lauver

Runners experience repeated impact forces during training, and the culmination of these forces can contribute to overuse injuries. The purpose of this study was to compare peak vertical tibial acceleration (TA) in trained distance runners on 3 surface types (grass, asphalt, and concrete) and 3 grades (incline, decline, and level). During visit 1, subjects completed a 1-mile time trial to determine their pace for all running trials: 80% (5%) of the average time trial velocity. During visit 2, subjects were outfitted with a skin-mounted accelerometer and performed 18 separate running trials during which peak TA was assessed during the stance phase. Each subject ran 2 trials for each condition with 2 minutes of rest between trials. Peak TA was different between decline (8.04 [0.12] g) and incline running (7.31 [0.35] g; P = .020). On the level grade, peak TA was greater during grass (8.22 [1.22] g) compared with concrete (7.47 [1.65] g; P = .017). On the incline grade, grass (7.68 [1.44] g) resulted in higher peak TA than asphalt (6.99 [1.69] g; P = .030). These results suggest that under certain grade conditions grass may result in higher TA compared with either concrete or asphalt.

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Rena F. Hale, Sandor Dorgo, Roger V. Gonzalez and Jerome Hausselle

Auditory feedback is a simple, low-cost training solution that can be used in rehabilitation, motor learning, and performance development. The use has been limited to the instruction of a single kinematic or kinetic target. The goal of this study was to determine if auditory feedback could be used to simultaneously train 2 lower-extremity parameters to perform a bodyweight back squat. A total of 42 healthy, young, recreationally active males participated in a 4-week training program to improve squat biomechanics. The Trained group (n = 22) received 4 weeks of auditory feedback. Feedback focused on knee flexion angle and center of pressure under the foot at maximum squat depth. The Control group (n = 20) performed squats without feedback. Subjects were tested pre, post, and 1 week after training. The Trained group achieved average target knee flexion angle within 1.73 (1.31) deg (P < .001) after training and 5.36 (3.29) deg (P < .01) at retention. While achieving target knee flexion angle, the Trained group maintained target center of pressure (P < .001). The Control group improved knee range of motion, but were not able to achieve both parameter targets at maximum squat depth (P < .90). Results from this study demonstrate that auditory feedback is an effective way to train 2 independent biomechanical targets simultaneously.

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Faezeh Mohammadi Sanjani, Abbas Bahram, Moslem Bahmani, Mina Arvin and John van der Kamp

It has been shown that texting degrades driving performance, but the extent to which this is mediated by the driver’s age and postural stability has not been addressed. Hence, the present study examined the effects of texting, sitting surface stability, and balance training in young and older adults’ driving performance. Fifteen young (mean age = 24.3 years) and 13 older (mean age = 62.8 years) participants were tested in a driving simulator with and without texting on a smartphone and while sitting on a stable or unstable surface (i.e., a plastic wobble board), before and after a 30-min sitting balance training. Analyses of variance showed that texting deteriorated driving performance but irrespective of sitting surface stability. Balance training decreased the negative effects of texting on driving, especially in older adults. Perceived workload increased when drivers were texting, and balance training reduced perceived workload. Perceived workload was higher while sitting on the unstable surface, but less so after balance training. Path analyses showed that the effects on driving performance and perceived workload were (indirectly) associated with changes in postural stability (i.e., postural sway). The study confirms that texting threatens safe driving performance by challenging postural stability, especially in older adults. The study also suggests that it is important to further investigate the role balance training can play in reducing these negative effects of texting.