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Catherine Draper, Susan Basset, Anniza de Villiers, Estelle V. Lambert and the HAKSA Writing Group

Background:

There is current concern for the health and well-being of children and youth in South Africa, including habits of physical activity (PA) and sedentary behavior. The 2014 Healthy Active Kids South Africa Report Card evaluates the current activity status of children and youth.

Methods:

The Research Working Group was comprised of 23 experts in physical education, nutrition, sport science, public health and journalism. The search was based on a systematic review of peer-reviewed literature (previous 5 years), dissertations, and nonpeer-reviewed reports (‘gray’ literature) dealing with the PA and nutritional status of South African children and youth 6−18 years of age. Key indicators were identified and data extracted. Grades for each indicator were discussed and assigned.

Results:

Overall PA levels received a D grade, as roughly 50% or more of children and youth were not meeting recommended levels. Organized sports participation fared better with a C, and government policies were promising, receiving a B. Screen time and sedentary behavior were a major concern and received a grade of F. Under- and over-weight were highlighted, but overweight is on the rise and this indicator was assigned a D grade. Most of the other indicators in South Africa remained the same or became worse so that grades declined from C- to D. In particular, sedentary behavior, soft-drink and fast food consumption, and an ineffectual regulatory environment to control advertising to children were a concern. There is need to engage parents and communities for advocacy and social mobilization.

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Bradley M. Appelhans and Hong Li

Purpose:

This study tested associations of organized sports participation and unstructured active play with overall moderate and vigorous physical activity (MVPA) in low-income children and examined factors associated with participation frequency.

Method:

Research staff visited 88 low-income Chicago households with children ages 6–13 years. MVPA was assessed through 7-day accelerometry. Researchers documented the home availability of physical activity equipment. Caregivers reported on child participation in organized sports and unstructured active play, family support for physical activity, perceived neighborhood safety, and access to neighborhood physical activity venues.

Results:

Despite similar participation in organized sports and unstructured active play, boys accumulated more MVPA than girls. MVPA was predicted by an interaction between gender and unstructured active play. Boys accumulated 23–45 additional minutes of weekday MVPA and 53–62 additional minutes of weekend MVPA through unstructured active play, with no such associations in girls. Higher reported neighborhood safety and family support for physical activity were associated with engagement in unstructured active play for both genders, and with participation in organized sports for girls.

Conclusion:

Physical activity interventions for low-income, urban children should emphasize unstructured active play, particularly in boys. Fostering family support for physical activity and safe play environments may be critical intervention components.

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Mary Jo Kane

This study examined the impact of Title IX on media coverage given to female athletes to determine if there has been a shift away from negative social stereotypes traditionally associated with women’s sports participation toward a more socially accepting view of the female athlete. A content analysis of feature articles within 1,228 issues of Sports Illustrated was undertaken for the years 1964-1987. These represented three 8-year time spans before (1964-71), during (1972-79), and after (1980-87) Title IX. In order to assess whether attitudes have changed toward female athletes as related to a Title IX timeline, amount and type of coverage were considered. Chi-square analyses revealed mixed results. There was a significant increase in the proportion of coverage given to women in athletic (e.g., professional golfer) versus nonathletic (e.g., swimsuit model) roles. However, feature articles about female athletes gave significantly more coverage to women in "sex-appropriate" sports such as tennis versus "sex-inappropriate" sports such as rugby, regardless of the Title IX time frame. Results are discussed in terms of challenging current beliefs that women’s athletics have gained widespread social acceptance following the enactment of Tide IX. Implications for practitioners and academics within sport management are presented.

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Vincent O. Onywera, Stella K. Muthuri, Sylvester Hayker, Lucy-Joy M. Wachira, Florence Kyallo, Robert O. Mang’eni, Peter Bukhala and Caleb Mireri

Background:

Kenya’s 2016 report card aimed to highlight the health and well-being of Kenyan children and youth using the best available evidence on the physical activity of Kenyan children and youth. The report pointed at areas where Kenya was succeeding and areas where more action is required.

Methods:

Inclusive analyses of available data sources on the core indicators related to physical activity and body weights of Kenyan children and youth (5 to 17 years) were conducted. These were assigned grades based on a set of specific criteria.

Results:

Results show that Active Play, Active Transportation, Overweight and Obesity, and Sedentary Behavior were favorable with a grade of B. Overall Physical Activity, Organized Sport Participation, and School (infrastructure, policies, and programs) each received a grade of C, while Family and Peers, Government and Nongovernment organizations, as well as the Community and the Built Environment were assigned grade D.

Conclusions:

Over 72% of Kenyan children and youth use active transportation to and from school and in their daily lives. Although majority of the children and youth have normal body weight, there is need to ensure that they meet and maintain the physical activity levels recommended by the World Health Organization. More needs to be done especially in relation to the governmental and nongovernmental organizations, organized sports participation, as well as involvement of family and peers in promoting healthy active lifestyles among Kenyan children and youth. More representative data for all indicators are required in Kenya.

Open access

Mohamed G. Al-Kuwari, Izzeldin A. Ibrahim, Eiman M. Al Hammadi and John J. Reilly

Background:

The first Qatar Active Healthy Kids (QAHK) Report Card was developed in 2015–2016. It is a synthesis of the available evidence on physical activity in children and youth in the state of Qatar—an assessment of the state of the nation. The report card is important for future physical activity advocacy, policy, and program development.

Methods:

The QAHK Report Card was inspired by the Active Healthy Kids Scotland 2013 Report Card. The methodology used in Scotland’s report card was adapted for Qatar. A Working Group identified indicators for physical activity and related health behaviors, and evaluated the available data on these indicators. The card grades were determined by the percentage of children meeting guidelines or recommendations.

Results:

The 2016 QAHK Report Card consisted of 9 indicators: 6 Physical Activity and Health Behaviors and Outcomes, and 3 Settings and Influences on these health behaviors and outcomes. The indicator National Policy, Strategy, and Investment was assigned the highest grade (B). Four indicators were assigned D grades: Sedentary Behavior, Dietary Habits, Organized Sports Participation, and Family and Peer Influence. Physical Activity and Obesity were both graded F. Two indicators could not be graded due to insufficient data and/or absence of a recommendation: Active and Outdoor Play, and Community and School Influence.

Conclusions:

The QAHK Report Card identified weaknesses and gaps in the evidence on physical activity and health in children and youth in Qatar. The quality of evidence was poor for some indicators, with some data collection methods of limited validity and reliability, or only available for a limited age range, so the grades are best estimates of the current situation in Qatar. Future surveys and research using objective physical activity measures will support the development of a second QAHK Report Card by 2018.

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Caroline Westwood, Carolyn Killelea, Mallory Faherty and Timothy Sell

Context: Concussions are consequence of sports participation. Recent reports indicate there is an increased risk of lower-extremity musculoskeletal injury when returning to sport after concussion suggesting that achieving “normal” balance may not fully indicate the athlete is ready for competition. The increased risk of injury may indicate the need to refine a screening tool for clearance. Objective: Assess the between-session reliability and the effects of adding a cognitive task to static and dynamic postural stability testing in a healthy population. Setting: Clinical laboratory. Participants: Twelve healthy subjects (6 women; age 22.3 [2.9] y, height 174.4 [7.5] cm, weight 70.1 [12.7] kg) participated in this study. Design: Subjects underwent static and dynamic postural stability testing with and without the addition of a cognitive task (Stroop test). Test battery was repeated 10 days later. Dynamic postural stability testing consisted of a forward jump over a hurdle with a 1-legged landing. A stability index was calculated. Static postural stability was also assessed with and without the cognitive task during single-leg balance. Variability of each ground reaction force component was averaged. Main Outcome Measures: Interclass correlation coefficients (ICC2,1) were computed to determine the reliability. Standard error of measure, mean standard error, mean detectable change, and 95% confidence interval were all calculated. Results: Mean differences between sessions were low, with the majority of variables having moderate to excellent reliability (static .583–.877, dynamic .581–.939). The addition of the dual task did not have any significant effect on reliability of the task; however, generally, the ICC values improved (eyes open .583–.770, dual task .741–.808). Conclusions: The addition of a cognitive load to postural stability assessments had moderate to excellent reliability in a healthy population. These results provide initial evidence on the feasibility of dual-task postural stability testing when examining risk of lower-extremity musculoskeletal injury following return to sport in a concussed population.

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Felecia Theune

Despite the tremendous growth in female sports participation opportunities under Title IX, black females have not benefited to the same degree as their white female counterparts. While gender complaints about female athletes still lagging behind males in participatory opportunities, scholarships, facilities and equipment are being discussed, larger structural inequities associated with being black and female remain absent from the Title IX conversation, demonstrating the dual invisibility of black females. Not only is this true at predominantly white institutions, it’s also true at historically black colleges and universities (HBCUs), academic institutions which have been sources of educational and athletic opportunities for black females long before the passage of Title IX prohibited sex discrimination in any federally funded educational programs and activities.

Malgré l’importante croissance d’opportunités de participation en sport féminin grâce à Title IX, les femmes noires n’ont pas bénéficié autant que les femmes blanches. Alors que les plaintes au sujet des femmes athlètes étaient encore à la traîne des hommes en ce qui concerne les opportunités de participation, les bourses, les installations et l’équipement font l’objet de discussions, les plus grandes injustices structurales associées au fait d’être noire et d’être une femme demeurent absentes de la conversation au sujet de Title IX, démontrant la double invisibilité des femmes noires. Non seulement estce vrai dans les établissements à prédominance blanche, cela est également vrai dans les collèges et universités historiquement noirs, des établissements scolaires qui ont été des sources d’opportunités éducationnelles et athlétiques bien avant que Title IX ne vienne interdire la discrimination en fonction du sexe dans tous les programmes et activités éducationnels financés par le gouvernement fédéral.

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Brett Aefsky, Niles Fleet, Heather Myers and Robert J. Butler

Context:

Currently, hip-rotation range of motion (ROM) is clinically measured in an open kinetic chain in either seated or prone position using passive or active ROM. However, during activities of daily living and during sports participation the hip must be able to rotate in a loaded position, and there is no standard measurement for this.

Objective:

To determine if a novel method for measuring hip rotation in weight bearing will result in good to very good reliability as demonstrated by an intraclass correlation coefficient (ICC) of >.80 and to investigate if weight-bearing hip measurements will result in significantly reduced hip ROM compared with non-weight-bearing methods.

Design:

Repeated measures.

Setting:

Outpatient sports physical therapy clinic.

Participants:

20 healthy participants (10 men, 10 women) recruited for hip-rotation measurements.

Methods:

Three trials of both internal and external rotation were measured in sitting, prone, and weight bearing. Two therapists independently measured each participant on the same day. The participants returned the following day to repeat the same measurements with the same 2 therapists.

Main Outcome Measures:

Degrees of hip internal and external rotation measured in prone, sitting, and loaded positions.

Results:

In general, the measurement of hip ROM across the different conditions was reliable. The intrarater reliability was .67–.95, while interrater reliability was .59–.96. Interrater reliability was improved when values were averaged across the measures (.75–.97). ICCs for active loaded ROM were .67–.81, while interrater ICCs were .53–.87. In general, prone hip ROM was greater than supine and supine was greater than loaded.

Conclusions:

Loaded hip rotation can be measured in a clinical setting with moderate to good reliability. The rotation ROM of a loaded hip can be significantly decreased compared with unloaded motion.

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Randon Hall, Kim Barber Foss, Timothy E. Hewett and Gregory D. Myer

Objectives:

To determine if sport specialization increases the risk of anterior knee pain in adolescent female athletes.

Design:

Retrospective cohort epidemiology study.

Methods:

Female basketball, soccer, and volleyball players (N = 546) were recruited from a single county public school district in Kentucky consisting of 5 middle schools and 4 high schools. A total of 357 multisport and 189 single-sport (66 basketball, 57 soccer, and 66 volleyball) athlete subjects were included due to their diagnosis of patellofemoral pain (PFP) on physical exam. Testing consisted of a standardized history and physician-administered physical examination to determine the presence of PFP. This study compared self-reported multisport athletes with sport-specialized athletes participating in only 1 sport. The sports-participation data were normalized by sport season, with each sport accounting for 1 season of exposure. Incidence rate ratios and 95% confidence intervals (CI) were calculated and used to determine significant differences between athletes who specialized in sport in early youth and multisport athletes.

Results:

Specialization in a single sport increased the relative risk of PFP incidence 1.5-fold (95% CI 1.0−2.2, P = .038) for cumulative PFP diagnoses. Specific diagnoses such as Sinding Larsen Johansson/patellar tendinopathy (95% CI 1.5−10.1, P = .005) and Osgood Schlatter disease (95% CI 1.5−10.1, P = .005) demonstrated a 4-fold greater relative risk in single-sport compared with multisport athletes. Incidence of other specific PFP diagnoses such as fat pad, plica, trauma, pes anserine bursitis, and iliotibial-band tendonitis was not different between single-sport and multisport participants (P > .05).

Conclusion:

Early sport specialization in female adolescents is associated with increased risk of anterior knee-pain disorders including PFP, Osgood Schlatter, Sinding Larsen-Johansson compared with multisport athletes.

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Mutlu Cug, Erik A. Wikstrom, Bahman Golshaei and Sadettin Kirazci

Context:

Both female athletes’ participation in soccer and associated injuries have greatly increased in recent years. One issue is the 2–9 times greater incidence of noncontact anterior cruciate ligament (ACL) injuries in female athletes relative to male athletes in comparable sports. Several factors such as limb dominance and sporting history have been proposed to play a role in ACL incidence rates between male and female athletes. However, evidence about the effects of these factors and how they interact with sex is mixed, and thus no consensus exists.

Objective:

To quantify the effects of sports participation, limb dominance, and sex on dynamic postural control and knee-joint proprioception.

Design:

Cross-sectional study.

Setting:

University research laboratory.

Participants:

19 male soccer players, 17 female soccer players, 19 sedentary men, and 18 sedentary women.

Intervention:

Joint-position sense was tested using reproduction of passive positioning on a Biodex isokinetic dynamometer (30°, 45°, and 60° from 90° of knee flexion). Three Star Excursion Balance Test directions were used to assess dynamic postural control.

Main Outcome Measure:

Normalized reach distance (% of leg length) in the anterior, posteromedial, and posterolateral directions on each leg quantified dynamic postural control. Average absolute error and constant error for both limbs quantified joint-position sense.

Results:

Posteromedial reach distance was significantly better in soccer players than sedentary individuals (P = .006). Anterior reach distance was significantly better (P = .04) in sedentary individuals than soccer players. No limb-dominance or sex differences were identified for dynamic postural control, and no differences in absolute- or constant-error scores were identified.

Conclusion:

Sporting history has a direction-specific impact on dynamic postural control. Sporting history, sex, and limb dominance do not influence knee-joint proprioception when tested in an open kinetic chain using passive repositioning.