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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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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.

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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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.

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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.

Open access

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.

Open access

Monika Uys, Susan Bassett, Catherine E. Draper, Lisa Micklesfield, Andries Monyeki, Anniza de Villiers, Estelle V. Lambert and the HAKSA 2016 Writing Group

Background:

We present results of the 2016 Healthy Active Kids South Africa (HAKSA) Report Card on the current status of physical activity (PA) and nutrition in South African youth. The context in which we interpret the findings is that participation in PA is a fundamental human right, along with the right to “attainment of the highest standard of health.”

Methods:

The HAKSA 2016 Writing Group was comprised of 33 authorities in physical education, exercise science, nutrition, public health, and journalism. The search strategy was based on peer-reviewed manuscripts, dissertations, and ‘gray’ literature. The core PA indicators are Overall Physical Activity Level; Organized Sport Participation; Active and Outdoor Play; Active Transportation; Sedentary Behaviors; Family and Peer Influences; School; Community and the Built Environment; and National Government Policy, Strategies, and Investment. In addition, we reported on Physical Fitness and Motor Proficiency separately. We also reported on nutrition indicators including Overweight and Under-nutrition along with certain key behaviors such as Fruit and Vegetable Intake, and policies and programs including School Nutrition Programs and Tuck Shops. Data were extracted and grades assigned after consensus was reached. Grades were assigned to each indicator ranging from an A, succeeding with a large majority of children and youth (81% to 100%); B, succeeding with well over half of children and youth (61% to 80%); C, succeeding with about half of children and youth (41% to 60%); D, succeeding with less than half but some children and youth (21% to 40%); and F, succeeding with very few children and youth (0% to 20%); INC is inconclusive.

Results:

Overall PA levels received a C grade, as we are succeeding with more than 50% of children meeting recommendations. Organized Sports Participation also received a C, and Government Policies remain promising, receiving a B. Screen time and sedentary behavior were a major concern. Under- and over-weight were highlighted and, as overweight is on the rise, received a D grade.

Conclusions:

In particular, issues of food security, obesogenic environments, and access to activity-supportive environments should guide social mobilization downstream and policy upstream. There is an urgent need for practice-based evidence based on evaluation of existing, scaled up interventions.

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Jen D. Wong, Julie S. Son, Stephanie T. West, Jill J. Naar and Toni Liechty

’s participation in competitive softball in late adulthood. By better identifying the challenges and opportunities that older women face in competitive team sports participation, we have the opportunity to better determine the needs of female athletes aging in place at the local community level. According to Baker

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Sarah A. Amin, Paula J. Duquesnay, Catherine M. Wright, Kenneth Chui, Christina D. Economos and Jennifer M. Sacheck

sports/organized activities to a mere 27% ( 36 ). Studies suggest that the benefits of sports participation transcend physical benefits and correspond with social and psychological benefits, including important self-perceptions, such as PAC ( 9 ). These effects may be even more critical for underserved

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Jonathan Miller, Mark Pereira, Julian Wolfson, Melissa Laska, Toben Nelson and Dianne Neumark-Sztainer

associated with physical activity, 23 screen time has been negatively associated with physical activity, 6 , 7 sports participation has been positively associated with physical activity, 24 substance use has been negatively associated with physical activity, 12 , 23 depression has been negatively