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Jarmo J. Malmberg, Seppo I. Miilunpalo, Matti E. Pasanen, Ilkka M. Vuori and Pekka Oja

The authors investigated the associations of the amount, frequency and intensity, and type of leisure-time physical activity (LTPA) with the risk of self-reported difficulty in walking (WD) and stair climbing (SCD) over 16 years in a population-based cohort age 40–64 years at the onset of the study. Their results indicated that the risk for SCD was highest among men and women with a low amount of weekly LTPA. The risk was high also among women with weekly light LTPA compared with women with weekly vigorous LTPA. The risk for WD was highest among men who engaged in fitness activity once a week compared with men who engaged in fitness activity at least three times a week. A low amount of weekly LTPA, light LTPA twice or more a week, and LTPA for keeping fit and healthy less than three times a week are associated with future risk of mobility difficulties among middle-aged and older adults.

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David Promis, Nirmala Erevelles and Jerry Matthews

In this essay, we explore and expand the meaning of “inclusion,” as it relates specifically to the sports and recreation programs that are made available to students with mobility impairments enrolled at colleges and universities. In the first part of the essay we examine how the two disciplinary areas of disability sport and disability studies address the politics of inclusion. In the second section of the paper, we will use one public university. South State (a pseudonym), as an example to demonstrate how certain social institutions interpret the concept of inclusion. Finally, we expand this discussion to offer an alternative theorization of the concept of inclusion that will impact not only students with disabilities but also students marked by race, class, gender, and sexuality who are also excluded despite the university’s espousal of the popular rhetoric of “inclusion.”

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Donald Sabo, Merrill J. Melnick and Beth E. Vanfossen

This study examines the impact of race and gender differences on the social mobility of high school athletes using the longitudinal, panel data of the High School and Beyond study. Regressions of educational and occupational attainment measures on sports participation were estimated for subgroups differentiated by race/ethnic status, gender, and school location (urban, suburban, and rural). It was found that participation in high school sports was most likely to affect the postsecondary status attainment of white males and, to a lesser extent, suburban white females and rural Hispanic females. High school athletic participation had almost no effect on the college-going behavior or educational expectations of black males and females. Interscholastic athletic participation was generally unrelated to postsecondary occupational status and aspirations.

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Leslie A. Pruitt, Nancy W. Glynn, Abby C. King, Jack M. Guralnik, Erin K. Aiken, Gary Miller and William L. Haskell

The authors explored using the ActiGraph accelerometer to differentiate activity levels between participants in a physical activity (PA, n = 54) or “successful aging” (SA) program (n = 52). The relationship between a PA questionnaire for older adults (CHAMPS) and accelerometry variables was also determined. Individualized accelerometry-count thresholds (ThreshIND) measured during a 400-m walk were used to identify “meaningful activity.” Participants then wore the ActiGraph for 7 days. Results indicated more activity bouts/day ≥10 min above ThreshIND in the PA group than in the SA group (1.1 ± 2.0 vs 0.5 ± 0.8, p = .05) and more activity counts/day above ThreshIND for the PA group (28,101 ± 27,521) than for the SA group (17,234 ± 15,620, p = .02). Correlations between activity counts/hr and CHAMPS ranged from .27 to .42, p < .01. The ActiGraph and ThreshIND might be useful for differentiating PA levels in older adults at risk for mobility disability.

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Amy K. Hegarty, Max J. Kurz, Wayne Stuberg and Anne K. Silverman

The goal of this pilot study was to characterize the effects of gait training on the capacity of muscles to produce body accelerations and relate these changes to mobility improvements seen in children with cerebral palsy (CP). Five children (14 years ± 3 y; GMFCS I-II) with spastic diplegic CP participated in a 6-week gait training program. Changes in 10-m fast-as-possible walking speed and 6-minute walking endurance were used to assess changes in mobility. In addition, musculoskeletal modeling was used to determine the potential of lower-limb muscles to accelerate the body’s center of mass vertically and forward during stance. The mobility changes after the training were mixed, with some children demonstrating vast improvements, while others appeared to be minimal. However, the musculoskeletal results revealed unique responses for each child. The most common changes occurred in the capacity for the hip and knee extensors to produce body support and the hip flexors to produce body propulsion. These results cannot yet be generalized to the broad population of children with CP, but demonstrate that therapy protocols may be enhanced by modeling analyses. The pilot study results provide motivation for gait training emphasizing upright leg posture, mediolateral balance, and ankle push-off.

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David M. Wert, Jessie M. VanSwearingen, Subashan Perera and Jennifer S. Brach

The purpose of this study was to assess the relative and absolute reliability of metabolic measures of energy expenditure and gait speed during overground walking in older adults with mobility limitations. Thirty-three (mean age [SD] = 76.4 [6.6] years; 66% female) older adults with slow gait participated. Measures of energy expenditure and gait speed were recorded during two 6-min bouts of overground walking (1 week apart) at a self-selected “usual” walking pace. The relative reliability for all variables was excellent: ICC = .81−.91. Mean differences for five of the six outcome variables was less than or equal to the respected SEM, while all six mean differences fell below the calculated MDC95. Clinicians and researchers can be confident that metabolic measures of energy expenditure and gait speed in older adults with slow walking speeds can be reliably assessed during overground walking, providing an alternative to traditional treadmill assessments.

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Daniela Mirandola, Guido Miccinesi, Maria Grazia Muraca, Eleonora Sgambati, Marco Monaci and Mirca Marini

Background:

Physical activity interventions are known to be effective in improving the physical and psychological complaints of breast cancer survivors.

Purpose:

To investigate the impact of a specific exercise training program on upper limb mobility and quality of life in breast cancer survivors.

Methods:

The study included 55 women recruited at the Cancer Rehabilitation Centre in Florence after the completion of breast cancer treatment and rehabilitative physiotherapy. All participants underwent an 8-week specific exercise training to improve upper limb mobility function and quality of life. Anthropometric parameters were measured, and each subject underwent a battery of fitness tests to assess shoulder-arm mobility, range of motion, and back flexibility before and after specific exercise program. All participants filled out the Short Form-12 and numerical rating scale questionnaires to assess the quality of life and to quantify back and shoulder pain intensity.

Results:

The evaluation of shoulder-arm mobility and self-reported questionnaire data revealed a statistically significant improvement after completion of our specific exercise program.

Conclusion:

An organized specific program of adapted physical activity can be effective in reducing the main adverse effects of surgery and oncological therapy, and may significantly improve shoulder-arm mobility and quality of life in breast cancer survivors.

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Roger Ramsbottom, Anne Ambler, Janie Potter, Barbara Jordan, Alan Nevill and Carol Williams

Where strength training has been used in conjunction with functional-task training in older people, not only have there been improvements in leg strength but also improved function has been measured (e.g., Skelton & McLaughlin, 1996). Many studies use participants from care homes rather than community dwellers. We investigated changes in leg power, balance, and functional mobility in community-dwelling sedentary men and women over 70 years of age (n = 6 for training group [TR]; n = 10 for control group [CN]). Progressive training took place over 24 weeks using seated and nonseated exercise. For TR, leg power increased 40%, from 108 ± 40 to 141 ± 53 W (p < .01); dynamic balance increased 48%, from 22.3 ± 7.9 to 33.1 ± 6.1 cm (p < .01; functional reach); and functional mobility increased 12%, from 7.46 ± 1.32 to 6.54 ± 1.41 s (p < .05; timed walk). CN showed no significant change. In conclusion, a community-based exercise program led to large improvements in leg-extensor power, dynamic balance, and functional mobility.

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Valérie Martin-Lemoyne, Dany H. Gagnon, François Routhier, Lise Poissant, Michel Tousignant, Hélène Corriveau and Claude Vincent

Biomechanical evidence is needed to determine to what extent the use of a mobility assistance dog (ADMob) may minimize mechanical loads and muscular demands at the upper limbs among manual wheelchair users. This study quantified and compared upper limb efforts when propelling up a ramp with and without an ADMob among manual wheelchair users. Ten manual wheelchair users with a spinal cord injury who own an ADMob ascended a ramp with and without their ADMob. The movements of the wheelchair and upper limbs were captured and the forces applied at the pushrims were recorded to compute shoulder mechanical loading. Muscular demand of the pectoralis major, anterior deltoid, biceps, and the triceps was normalized against the maximum electromyographic values. The traction provided by the ADMob significantly reduced the total force applied at the pushrim and its tangential component while the mechanical effectiveness remained similar. The traction provided by the ADMob also resulted in a significant reduction in shoulder flexion, internal rotation, and adduction moments. The muscular demands of the anterior deltoid, pectoralis major, biceps, and triceps were significantly reduced by the traction provided by the ADMob. The use of ADMob represents a promising mobility assistive technology alternative to minimize upper limb mechanical loads and muscular demands and optimize performance during wheelchair ramp ascent.

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Daisuke Uritani, Takahiko Fukumoto, Daisuke Matsumoto and Masayuki Shima

Evaluating toe flexor strength may be an important method for predicting and preventing walking dysfunction and falls, particularly among older adults. In this study, toe grip strength (TGS), the functional reach (FR, a measure of dynamic balance) test, the timed up and go (TUG) test (a measure of functional ability), isometric knee extension strength (IKES), sex, age, weight, and height were analyzed among 665 healthy Japanese older adults. Statistical analyses were used to assess the relationships between TGS and FR or TUG and to investigate whether TGS was independently associated with FR or TUG. Our results indicate that, among both men and women, TGS was associated with TUG, independent of age, height, weight, and IKES, but TGS was not associated with FR. These results may facilitate the development of strategies for improving functional mobility through physical therapy.