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Afroditi Stathi and Piers Simey

Life in the Fourth Age has been typified as a time of continued functional decline and reduced quality of life. Exercise might positively affect this experience. This study explored the exercise experiences of nursing home residents age 86–99 years who participated in a 6-month exercise intervention. An interpretive phenomeno-logical approach was adopted. Twenty-one interviews were held with 14 residents at baseline and 7 residents at follow-up. Although their expectations were initially conservative, by the end of the intervention participants noted improved quality of life through better mobility, decreased fear of falling, and feelings of achievement and success. They valued the program as an opportunity to do something for themselves, to add something to their weekly routine, to meet other people, and to be more active generally. The professionalism of the exercise instructor appears to have been critical, balancing principles of safe and effective practice with the need to ensure that participants had fun in a supportive environment.

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Mary Ann Devine

College years are an experimental phase in young adulthood and can lay the foundation for lifelong behaviors. One type of behavior developed during these years is the use of leisure-time physical activity (LTPA). LTPA experiences of typical college students have been examined, but there is a lack of studies examining the experiences of students with disabilities. The purpose of this inquiry is to understand the experiences of college students with disabilities and their LTPA, with focus on factors that facilitate or create barriers to engagement. Grounded theory was used to understand LTPA with undergraduates with mobility or visual impairments. Results indicated a theme of culture of physical activity and disability as they received a message that engagement in LTPA was “unnecessary” or “heroic,” which altered their LTPA experiences. Barriers to LTPA can be understood through a social relational lens to recognize the multidimensionality of barriers and facilitators to LTPA.

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Brett Krueger, Laura Becker, Greta Leemkuil and Christopher Durall

Clinical Scenario:

Ankle sprains account for roughly 10% of sport-related injuries in the active population. The majority of these injuries occur from excessive ankle inversion, leading to lateral ligamentous injury. In addition to pain and swelling, limitations in ankle range of motion (ROM) and self-reported function are common findings. These limitations are thought to be due in part to loss of mobility in the talocrural joint. Accordingly, some investigators have reported using high-velocity, low-amplitude thrust-manipulation techniques directed at the talocrural joint to address deficits in dorsiflexion (Df) ROM and function. This review was conducted to ascertain the impact of talocrural joint-thrust manipulation (TJM) on DF ROM, selfreported function, and pain in patients with a history of ankle sprain.

Focused Clinical Question:

In patients with a history of inversion ankle sprain, does TJM improve outcomes in DF ROM, self-reported function, and/or pain?

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James M. Gladden, Richard L. Irwin and William A. Sutton

Following a decade that produced astonishing player salaries, continued player mobility, widespread corporate involvement, and skyrocketing ticket prices and broadcast rights fees, North American major league professional sport teams enter the 21st century encountering a number of significant challenges. An analysis of the aforementioned trends yields valuable insight into the future of professional team sport management in North America and leads to the identification of a primary concern of team owners and operators, that of managing the franchise's brand equity. With team owners increasingly reaping profits from the long-term appreciation of the team's value while continuing to lose money on a yearly basis, there will be an increased focus on strengthening team brands. This new focus will lead management to build and maintain brand equity through two primary means: the acquisition of assets and the enhancement of customer relationships. Each of these predictions is explained in depth in this paper and examples are provided.

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Roberta E. Rikli and C. Jessie Jones

Preventing or delaying the onset of physical frailty is an increasingly important goal because more individuals are living well into their 8th and 9th decades. We describe the development and validation of a functional fitness test battery that can assess the physiologic parameters that support physical mobility in older adults. The procedures involved in the test development were (a) developing a theoretical framework for the test items, (b) establishing an advisory panel of experts, (c) determining test selection criteria, (d) selecting the test items, and (e) establishing test reliability and validity. The complete battery consists of 6 items (and one alternative) designed to assess the physiologic parameters associated with independent functioning—lower and upper body strength, aerobic endurance, lower and upper body flexibility, and agility/dynamic balance. We also assessed body mass index as an estimate of body composition. We concluded that the tests met the established criteria for scientific rigor and feasibility for use in common community settings.

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David J. Ralston

The RAMP system of athletic-injury rehabilitation, its name an acronym representing its component phases, has its foundation in the frequent reassessment of the injury condition. The patient is progressed systematically through a sequence of rehabilitation goals: management of the acute responses to injury, restoration of mobility, and successful completion of performance goals. The RAMP system designates the current highest-priority rehabilitation goal as the primary objective and any other goals as secondary. This ensures that the pursuit of 1 rehabilitation goal is not at the expense of another, more currently relevant goal. The RAMP system provides a systematic format to help less-experienced clinicians progress injured athletes through the phases of recovery from injury. Daily reassessment of an injury allows the rehabilitation plan to be current and appropriate. The goal-based progression of the system ensures maximum resolution of each rehabilitation objective, contributing to athletes’ optimal return to sport or activity

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Elizabeth A. Taylor and Robin Hardin

This study examined the experiences and challenges of 10 female Division I athletic directors. Four themes emerged from the interviews: (a) lack of female role models; (b) females are not qualified to manage football programs; (c) scrutiny about (lack of) ability and experience, and (d) benefits of intercollegiate coaching experience. The findings of this study suggest these are the central causes for females’ inability to reach maximum career mobility in the intercollegiate athletics industry. Participants encouraged women trying to enter the intercollegiate athletics industry to find a mentor who can advocate for them as they navigate through their career. In addition, participants encouraged those entering the industry to gain experience in as many facets of the athletic department as possible.

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Philippe C. Dixon and David J. Pearsall

The purpose of this study was to determine the effect of cross-slope on gait dynamics. Ten young adult males walked barefoot along an inclinable walkway. Ground reaction forces (GRFs), lower-limb joint kinematics, global pelvis orientation, functional leg-length, and joint reaction moments (JRMs) were measured. Statistical analyses revealed differences across limbs (up-slope [US] and down-slope [DS]) and inclinations (level; 0°; and cross-sloped, 6°). Adaptations included increases of nearly 300% in mediolateral GRFs (p < .001), functional shortening the US-limb and elongation of the DS-limb (p < .001), reduced step width (p = .024), asymmetrical changes in sagittal kinematics and JRM, and numerous pronounced coronal plane differences including increased US-hip adduction (and adductor moment) and decreased DS-hip adduction (and adductor moment). Data suggests that modest cross-slopes can induce substantial asymmetrical changes in gait dynamics and may represent a physical obstacle to populations with restricted mobility.

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Gregory S. Kolt, Ruth P. Driver and Lynne C. Giles

Research on variables that encourage older adults to exercise is limited. This study was carried out to identify the participation motives of older Australians involved in regular exercise and sport. The 815 participants (399 men, 416 women) ranged in age from 55 to 93 years (M = 63.6, SD = 7.8) and were participating in their activities of choice at least once per week. All participants completed the Participation Motivation Questionnaire for Older Adults. The most common exercise/sport activities that participants were involved in were walking, golf, lawn bowls, tennis, and swimming. The most highly reported motives for participation were to keep healthy, liking the activity, to improve fitness, and to maintain joint mobility. Principal-components analysis of the questionnaire revealed 6 factors: social, fitness, recognition, challenge/benefits, medical, and involvement. Analyses of variance showed significant differences in reasons for participation in exercise and sport based on gender, age, education level, and occupation.

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Sachiko Inoue, Takashi Yorifuji, Masumi Sugiyama, Toshiki Ohta, Kazuko Ishikawa-Takata and Hiroyuki Doi

Few epidemiological studies have examined the potential protective effects of physical activity on insomnia. The authors thus evaluated the association between physical activity and insomnia in a large population-based study in Shizuoka, Japan. Individual data were obtained from participants in an ongoing cohort study. A total of 14,001 older residents who completed questionnaires were followed for 3 yr. Of these, 10,211 and 3,697 participants were eligible for the cross-sectional and longitudinal analyses, respectively. The authors obtained information about the frequency of physical activity and insomnia. Then, the adjusted odds ratios and 95% confidence intervals between physical activity and insomnia were estimated. Habitual physical activity was related to lower prevalence of insomnia. Frequent physical activity also reduced the incidence of insomnia, especially difficulty maintaining sleep. For elderly people with sufficient mobility and no preexisting disease, high-frequency physical activity (e.g., 5 or more days/wk) may help reduce insomnia.