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Barbara Resnick, Marcia G. Ory, Kerrie Hora, Michael E. Rogers, Phillip Page, Jane N. Bolin, Roseann M. Lyle, Cody Sipe, Wojtek Chodzko-Zajko and Terry L. Bazzarre

The Exercise Assessment and Screening for You (EASY) is a tool developed to help older individuals, their health care providers, and exercise professionals identify different types of exercise and physical activity regimens that can be tailored to meet the existing health conditions, illnesses, or disabilities of older adults. The EASY tool includes 6 screening questions that were developed based on an expert roundtable and follow-up panel activities. The philosophy behind the EASY is that screening should be a dynamic process in which participants learn to appreciate the importance of engaging in regular exercise, attending to health changes, recognizing a full range of signs and symptoms that might indicate potentially harmful events, and becoming familiar with simple safety tips for initiating and progressively increasing physical activity patterns. Representing a paradigm shift from traditional screening approaches that focus on potential risks of exercising, this tool emphasizes the benefits of exercise and physical activity for all individuals.

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James F. Sallis and Kevin Patrick

The International Consensus Conference on Physical Activity Guidelines for Adolescents convened to review the effects of physical activity on the health of adolescents, to establish age-appropriate physical activity guidelines, and to consider how these guidelines might be implemented in primary health care settings. Thirty-four invited experts and representatives of scientific, medical, and governmental organizations established two main guidelines. First, all adolescents should be physically active daily or nearly every day as part of their lifestyles. Second, adolescents should engage in three or more sessions per week of activities that last 20 min or more and that require moderate to vigorous levels of exertion. Available data suggest that the vast majority of U.S. adolescents meet the first guideline, but only about two thirds of boys and one half of girls meet the second guideline. Physical activity has important effects on the health of adolescents, and the promotion of regular physical activity should be a priority for physicians and other health professionals.

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Rebecca L. Vivrette, Laurence Z. Rubenstein, Jennifer L. Martin, Karen R. Josephson and B. Josea Kramer

Objective:

To determine seniors’ beliefs about falls and design a fall-risk self-assessment and educational materials to promote early identification of evidence-based fall risks and encourage prevention behaviors.

Methods:

Focus groups with community-dwelling seniors, conducted in two phases to identify perceptions about fall risks and risk reduction and to assess face validity of the fall-risk self-assessment and acceptability of educational materials.

Results:

Lay perception of fall risks was in general concordance with evidence-based research. Maintaining independence and positive tone were perceived as key motivators for fall prevention. Seniors intended to use information in the educational tool to stimulate discussions about falls with health care providers.

Implications:

An evidence-based, educational fall-risk self-assessment acceptable to older adults can build on existing lay knowledge about fall risks and perception that falls are a relevant problem and can educate seniors about their specific risks and how to minimize them.

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Cecilia Winberg, Gunilla Carlsson, Christina Brogårdh and Jan Lexell

Maintaining regular physical activity (PA) can be challenging for persons with late effects of polio. This qualitative study of ambulatory persons with late effects of polio explored their perceptions of PA, as well as facilitators of and barriers to PA. Semistructured interviews were conducted with 15 persons and analyzed with content analysis using the International Classification of Functioning, Disability and Health (ICF) as a framework. The participants described positive perceptions of PA and its health benefits. PA was used to prevent further decline in functioning, and the type and frequency of activities had changed over time. Past experiences and personal characteristics impacted PA. Support from close relatives, knowledgeable health care professionals, mobility devices, and accessible environments facilitated PA, whereas impairments, inaccessible environments, and cold weather were the main barriers. To perform PA regularly, persons with late effects of polio may benefit from individualized advice based on their disability and personal and environmental factors.

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Troy R. Garrett and Peter J. Neibert

Clinical Scenario:

Injury to the plantar fascia, whether acute or chronic, is common among many populations. A conventional multiple-treatment approach is commonly administered by health care providers, consisting of controlling inflammation, managing pain, and promoting healing. Frequently, the initial treatment for plantar fasciitis is targeted at increasing dorsiflexion range of motion by stretching the gastroc-soleus musculature. It has been theorized that inflexibility of the gastroc-soleus complex can lead to excessive pronation and overcompensation of the plantar fascia at the first metatarsal phalangeal joint, therefore increasing the stress at the medial calcaneal insertion. Therefore, it is deemed that gastrocnemius–soleus stretches are a beneficial treatment in the initial stage of a plantar fasciitis treatment or rehabilitation program.

Focused Clinical Question:

Is a gastrocnemius–soleus stretching program, as a stand-alone treatment variable, effective in the treatment of plantar fasciitis?

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Stephan R. Walk

Recent work has suggested that masculinist sport subcultures (e.g., Young & White, 1995) and “conspiratorial” sports organizations (Nixon, 1992a) foster the acceptance of pain and injury by athletes. Using semistructured interviews, this study examined the experiences and beliefs of 22 student athletic trainers at a large university. The study found that student athletic trainers had conflicting alliances to student athletes and to staff trainers, held competing beliefs about athlete pain and injury, and struggled with athletes who did not properly use health care services and advice. It is recommended that future studies focus upon processes of negotiation and conflict, that more attention be directed to medical treatment of injured women athletes, and that recommendations to change medical services for athletes await further research.

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Ross E. Andersen and John M. Jakicic

The aim of this review is to provide a scientific update on the current guidelines for both health and weight management. There has been confusion among health professionals as to which physical activity guidelines should be used to help various specific populations adopt more active lifestyles. We first review the history of the physical activity guidelines. Using the physical activity guidelines in clinical practice is also explored. We also describe common barriers to physical that overweight individuals report and we discuss when it is appropriate for a health care professional to seek a referral from an exercise scientist to help sedentary adults increase their levels of activity. It is important for individuals who care for overweight patients and sedentary adults to understand the current physical guidelines and how these guidelines can be worked into clinical practice.

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Dominic Malcolm

In this article I examine the role and working practice of rugby union club doctors in England. While medicine is widely perceived to be one of the most powerful professions in Western societies, sociologists of sport have argued that sport clinicians often wield relatively limited power over their athlete-patients. In this article I therefore attempt to shed further light on the “peculiar” character of sports medicine. Using data drawn from interviews and questionnaires, I argue that this phenomenon can be understood only by looking at the structure of the sports medicine profession, the specificities of the rugby club as a workplace setting, and the relationships club doctors have with clients (coaches and athletes) and other health care providers (physiotherapists).

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the Latest From the Health Care in Action Campaign After the success of NATA’s 2019 Own Your Impact campaign, the association is continuing the conversation in 2020 with the Health Care in Action campaign. Throughout this year-long campaign, NATA will provide resources to members that help them tell

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Paul Comper, Michael Hutchison, Doug Richards and Lynda Mainwaring

Along with the ever growing awareness among the scientific community and the general public that concussion is a serious health care issue at all levels of sport, with potentially devastating long term health effects, the number of concussion surveillance clinical monitoring programs has significantly increased internationally over the past 10–15 years. An effective concussion program (a “best practice” model) is clinically prudent and evidence-based, one that is an interdisciplinary model involving health professionals who manage, educate, and provide psychosocial support to athletes. The integration of neuropsychological assessment is a component of many present day programs, and therefore, the neuropsychologist is an integral member of the concussion management team. The University of Toronto Concussion Program, operational since 1999, integrates best practices and current evidence into a working model of concussion management for university athletes. The model uses an interdisciplinary approach to monitor and assess athletes with concussions, as well as to educate its athletes, coaches, and administrators. A research component is also integral to the program.