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Case Study: Nutritional and Lifestyle Support to Reduce Infection Incidence in an International-Standard Premier League Soccer Player

Mayur K. Ranchordas, Laurent Bannock, and Scott L. Robinson

Professional soccer players are exposed to large amounts of physiological and psychological stress, which can increase infection risk and threaten availability for training and competition. Accordingly, it is important for practitioners to implement strategies that support player well-being and prevent illness. This case study demonstrates how a scientifically supported and practically applicable nutrition and lifestyle strategy can reduce infection incidence in an illness-prone professional soccer player. In the 3 months before the intervention, the player had 3 upper-respiratory tract infections (URTIs) and subsequently missed 3 competitive matches and 2 weeks’ training. He routinely commenced morning training sessions in the fasted state and was estimated to be in a large daily energy deficit. Throughout the 12-week intervention, the amount, composition, and timing of energy intake was altered, quercetin and vitamin D were supplemented, and the player was provided with a daily sleep and hygiene protocol. There was a positive increase in serum vitamin D 25(OH) concentration from baseline to Week 12 (53 n·mol-1 to 120 n·mol-1) and salivary immunoglobulin-A (98 mg·dl-1 to 135 mg·dl-1), as well as a decline in the number of URTI symptoms (1.8 ± 2.0 vs. 0.25 ± 0.5 for Weeks 0–4 and Weeks 8–12, respectively). More important, he maintained availability for all training and matches over the 12-week period. We offer this case study as a real-world applied example for other players and practitioners seeking to deploy nutrition and lifestyle strategies to reduce risk of illness and maximize player availability.

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Gastrocnemius Stretching Program: More Effective in Increasing Ankle/Rear-Foot Dorsiflexion When Subtalar Joint Positioned in Pronation Than in Supination

Marie A. Johanson, Megan Armstrong, Chris Hopkins, Meghan L. Keen, Michael Robinson, and Scott Stephenson


Stretching exercises are commonly prescribed for patients and healthy individuals with limited extensibility of the gastrocnemius muscle.


To determine if individuals demonstrate more dorsiflexion at the ankle/rear foot and less at the midfoot after a gastrocnemius-stretching program with the subtalar joint (STJ) positioned in supination compared with pronation.


Randomized controlled trial.


Biomechanical laboratory.


22 volunteers with current or recent history of lower-extremity cumulative trauma and gastrocnemius tightness (10 women and 4 men, mean age 28 y) randomly assigned to stretching groups with the STJ positioned in either pronation (n = 11) or supination (n = 11).


3-wk home gastrocnemius-stretching program using a template to place the subtalar joint in either a pronated or a supinated position.

Main Outcome Measures:

A 7-camera Vicon motion-analysis system measured ankle/rear-foot dorsiflexion and midfoot dorsiflexion of all participants during stretching with the STJ positioned in both pronation and supination before and after the 3-wk gastrocnemius-stretching program.


A 2-way mixed-model ANOVA revealed a significant interaction (P = .019). At posttest, the group who performed the 3-week stretching program with the STJ positioned in pronation demonstrated more increased ankle/rear-foot dorsiflexion when measured with the STJ in pronation than the group who performed the 3-wk stretching program with the STJ positioned in supination. No significant main effect of stretching group or interaction for dorsiflexion at the midfoot was detected (P = .755 and P = .820, respectively).


After a 3-wk gastrocnemius-stretching program, when measuring dorsiflexion with the STJ positioned in supination, the participants who completed a 3-wk gastrocnemius stretching program with the STJ positioned in pronation showed more increased dorsiflexion at the ankle/rear foot than participants who completed the stretching program with the STJ positioned in supination.

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Associations Between Physical Activity and Gross Motor Skills in Parent–Child Dyads

Katherine Q. Scott-Andrews, Rebecca E. Hasson, Alison L. Miller, Thomas J. Templin, and Leah E. Robinson

This study examines the associations of physical activity and gross motor skills in parent–child dyads. Parent–child dyads (N = 61, 84% mothers, children aged 8–11 years) participated in this study. Anthropometrics were self-reported through Qualtrics. Physical activity was assessed using accelerometers. Motor skills were measured through four skills: catch, kick, throw, and jump. These skills were assessed using process (i.e., performance criteria of the Test of Gross Motor Development-3) and product (i.e., catch percentage and jump distance) measures. A complete motor skill score was computed by standardizing both process and product scores and summing them. Correlation coefficients and ordinary least square regressions were computed to examine the associations of physical activity and motor skills. Parents’ and children’s moderate to vigorous physical activity were significantly associated (β = 0.30 ± 0.11; p = .008). Parents’ and children’s motor skills were significantly associated (β = 0.46 ± 0.18; p = .012). Understanding parent determinants can support effective interventions targeting children’s low physical activity levels and improving motor competence. Our results highlight the importance of parents’ physical activity and motor skills, which are significantly associated with those of their children. These parent factors may be a key consideration for effective family-based physical activity interventions.

Open access

Statistical Learning Methods to Identify Nonwear Periods From Accelerometer Data

Sahej Randhawa, Manoj Sharma, Madalina Fiterau, Jorge A. Banda, Farish Haydel, Kristopher Kapphahn, Donna Matheson, Hyatt Moore IV, Robyn L. Ball, Clete Kushida, Scott Delp, Dennis P. Wall, Thomas Robinson, and Manisha Desai

Background: Accelerometers are used to objectively measure movement in free-living individuals. Distinguishing nonwear from sleep and sedentary behavior is important to derive accurate measures of physical activity, sedentary behavior, and sleep. We applied statistical learning approaches to examine their promise in detecting nonwear time and compared the results with commonly used wear time (WT) algorithms. Methods: Fifteen children, aged 4–17, wore an ActiGraph wGT3X-BT monitor on their hip during overnight polysomnography. We applied Hidden Markov Models (HMM) and Gaussian Mixture Models (GMM) to classify states of nonwear and wear in triaxial acceleration data. Performance of methods was compared with WT algorithms across two conditions with differing amounts of consecutive nonwear. Clinical scoring of polysomnography served as the gold standard. Results: When the length of nonwear was less than or equal to WT algorithms’ predefined thresholds for consecutive nonwear time, GMM methods yielded improved classification error, specificity, positive predictive value, and negative predictive value over commonly used algorithms. HMM was superior to one algorithm for sensitivity and negative predictive value. When the length of nonwear was longer, results were mixed, with the commonly used algorithms performing better on some parameters but GMM with the greatest specificity. However, all approached the upper limits of performance for almost all metrics. Conclusions: GMM and HMM demonstrated robust, consistently strong performance across multiple conditions, surpassing or remaining competitive with commonly used WT algorithms which had marked inaccuracy when nonwear time periods were shorter. Of the two statistical learning algorithms, GMM was superior to HMM.