The validity and reliability of the back saver sit-and-reach test in middle school girls and boys

Associations Between Motor Competence and Physical Activity, Physical Fitness and Psychosocial Characteristics in Adolescents: A Systematic Review and Meta-analysis

BACKGROUND

Motor competence is an integral component of the health and performance of youth. Numerous studies support the hypothesis that motor competence interacts with perceived motor competence and physical fitness during childhood to induce positive (e.g. healthy weight status) or negative (e.g. reduced physical activity engagement) trajectories. Yet, while adolescence is a key period of rapid growth and maturation, no systematic reviews and meta-analyses have examined the association between motor competence and physical activity, physical fitness and psychosocial characteristics solely within adolescents.

OBJECTIVES

This study aimed to (1) analyse the scientific literature evaluating associations between motor competence and physical activity, physical fitness and/or psychosocial characteristics amongst adolescents; (2) evaluate the associations between motor competence and physical activity, physical fitness characteristics and/or psychosocial characteristics amongst adolescents; and (3) investigate the impact of moderator variables (i.e., age, sex, type of motor competence assessment) on the associations.

METHODS

A systematic search of electronic databases was conducted, followed by a qualitative synthesis of study methods. Random-effects meta-analyses were performed to establish the magnitude and orientation of pooled correlation coefficients between motor competence and physical activity, physical fitness and psychosocial characteristics of adolescents, whilst considering potential moderators (i.e., age, sex, type of motor competence assessment).

RESULTS

Sixty-one studies were included, totalling 22,256 adolescents. Twenty-seven different assessments of motor competence were used, with 31 studies utilising product-orientated (i.e. outcome) motor competence assessments. Meta-analyses of 43 studies showed that motor competence was positively associated with physical activity (r = 0.20 to 0.26), some physical fitness characteristics (e.g. muscular strength, cardiovascular endurance; r = 0.03 to 0.60) and psychosocial characteristics (r = 0.07 to 0.34), and inversely associated with weight status (r =  - 0.36 to - 0.10), speed (r =  - 0.31) and agility (r =  - 0.37 to 0.41). Associations with flexibility were unclear.

CONCLUSIONS

The results of this systematic review and meta-analysis support the hypothesised interactions of motor competence with physical activity (positive), physical fitness (positive except for weight status, speed and agility) and psychosocial characteristics (positive) in adolescence. However, methodological approaches vary considerably (e.g. variety of motor competence assessments utilised), with limitations of the current literature including an inadequate assessment of motor competence, a lack of longitudinal observations and a failure to account for biological maturation. Future research assessing associations between motor competence and physical activity, physical fitness and psychosocial characteristics of adolescents should include longitudinal observations of a combined motor competence assessment (i.e. process and product) and account for biological maturation. Improved evaluation using these recommendations could provide more accurate data, leading to more targeted interventions to improve adolescents' physical and psychosocial outcomes.

CLINICAL TRIAL REGISTRATION

CRD42021233441 (PROSPERO ID).

The Case for Retiring Flexibility as a Major Component of Physical Fitness

Flexibility refers to the intrinsic properties of body tissues that determine maximal joint range of motion without causing injury. For many years, flexibility has been classified by the American College of Sports Medicine as a major component of physical fitness. The notion flexibility is important for fitness has also led to the idea static stretching should be prescribed to improve flexibility. The current paper proposes flexibility be retired as a major component of physical fitness, and consequently, stretching be de-emphasized as a standard component of exercise prescriptions for most populations. First, I show flexibility has little predictive or concurrent validity with health and performance outcomes (e.g., mortality, falls, occupational performance) in apparently healthy individuals, particularly when viewed in light of the other major components of fitness (i.e., body composition, cardiovascular endurance, muscle endurance, muscle strength). Second, I explain that if flexibility requires improvement, this does not necessitate a prescription of stretching in most populations. Flexibility can be maintained or improved by exercise modalities that cause more robust health benefits than stretching (e.g., resistance training). Retirement of flexibility as a major component of physical fitness will simplify fitness batteries; save time and resources dedicated to flexibility instruction, measurement, and evaluation; and prevent erroneous conclusions about fitness status when interpreting flexibility scores. De-emphasis of stretching in exercise prescriptions will ensure stretching does not negatively impact other exercise and does not take away from time that could be allocated to training activities that have more robust health and performance benefits.

Effectiveness of Deep Dry Needling vs Ischemic Compression in the Latent Myofascial Trigger Points of the Shortened Triceps Surae from Triathletes on Ankle Dorsiflexion, Dynamic, and Static Plantar Pressure Distribution: A Clinical Trial

OBJECTIVE

To determine the immediate efficacy of a single session of deep dry needling (DDN) vs ischemic compression (ICT) in a latent myofascial trigger point (MTrP) of the shortened triceps surae from triathletes for ankle dorsiflexion and redistribution of plantar pressures and stability.

DESIGN

A randomized simple blind clinical trial (NCT03273985).

SETTING

An outpatient clinic.

SUBJECTS

Thirty-four triathletes with a latent MTrP in the shortened gastrocnemius.

METHODS

Triathletes were randomized to receive a single session of DDN (N = 17) or ICT (N = 17) in a latent MTrP of the shortened triceps surae. The primary outcome was ankle dorsiflexion range of motion (ROM) by a universal goniometer. Secondary objectives were distribution of dynamic and static plantar pressures by T-Plate platform pressure, with measurements both before and after five, 10, 15, 20, and 25 minutes of treatment.

RESULTS

There were no statistically significant differences (P > 0.05) for ankle dorsiflexion ROM or dynamic and static plantar pressures between the experimental group treated with DDN and the control group treated with ICT before and after treatment.

CONCLUSIONS

DDN vs ICT carried out in latent MTrPs of the shortened gastrocnemius of triathletes did not present differences in terms of dorsiflexion ROM of the tibiofibular-talar joint or in static and dynamic plantar pressure changes before and immediately after treatment.

Multicomponent training with different frequencies on body composition and physical fitness in obese children

INTRODUCTION

The aim of the study was to compare the effects of ten-week multicomponent training with different exercise frequencies on body composition (BC) and physical fitness (PF) in overweight and obese young children.

METHODS

40 children, aged 12-15 (14.77±1.49), were randomly selected and assigned to experimental groups to train three times/week (EG1) or two times/week (EG2) for 10 weeks and a CG group (no training program).

RESULTS

It was shown that experimental groups (EG1 and EG2) improved similarly aerobic capacity (3.8% and 3.5%, respectively), muscular strength (29.7% and 25.2%), flexibility (6.1% and 9.9%), body mass index (5.0% and 4.6%), and body fat (6.4% and 5.6%) from pre- to post-training. CG group showed no significant improvements on BC and PF variables.

CONCLUSION

Short-term multicomponent training seems to be effective on PF improvements, independently of the exercise frequency, in overweight and obese young children. However, it seems to be more effective to perform a multicomponent exercise training three times/week to improve muscular strength, body mass index, and decrease body fat percentage. This knowledge should be considered by professionals in physical education or youth sport in order to adapt practical tasks depending on the training purposes.

Sex differences in physical activity among Ghanaian patients with sickle cell disease

Introduction

Musculoskeletal pain and functional limitations experienced by patients with Sickle Cell Disease (SCD) impact their physical activity and social behaviour. Yet, we know little about physical activity behaviour in patients with SCD. The aim of this study was to investigate gender differences in physical activity, sedentary time and measures of fitness among Ghanaian adults with SCD. The study also determined the association between outcome variables in this population.

Methods

Patients with SCD attending a sickle cell clinic in a tertiary hospital in Accra, Ghana participated in this cross-sectional study. Physical activity, sedentary time, body composition, flexibility and cardiovascular endurance were assessed. Demographic data were also collected by self-report.

Results

Fifty three participants enrolled in the study. Of these, more than half were females (60.4%) and the average age of the participants was (M: 26.8, SD: 8.5 years). The total physical activity reported by the participants was different between males and females (t = 2.610, p = 0.012). However, there were no gender differences in sedentary time, body composition, flexibility and cardiovascular endurance. A moderately significant association was found between sedentary time and cardiovascular endurance (r = 0.437, p = 0.001).

Conclusion

The findings suggest that gender differences in physical activity are apparent in patients with SCD. Investigations into the mechanisms underpinning these differences are warranted. Additionally, longitudinal observations of objectively measured physical activity may be useful to validate these results in a larger sample.

Determining the Initial Predictive Validity of the Lifelong Physical Activity Skills Battery

Participation in lifelong physical activities, such as yoga, golf, tennis, or running, are common endeavors in adolescence and adulthood. However, there is a lack of understanding of how competent individuals are in the skills needed for these activities and how competency in these skills relates to physical activity and fitness. This study aimed to determine the initial predictive validity of the Lifelong Physical Activity Skills Battery related to physical activity and health-related fitness. One-hundred and nine adolescents from four schools (55 males, 54 females; Mage = 15.82 years, SD = 0.37 years) completed: demographic information (survey), height (stadiometer), weight (digital scale), motor skill assessment (jog, grapevine, squat, push-up, upward dog, warrior one, tennis forehand, golf swing), health-related fitness (standing long jump, back-saver sit and reach, 3-min submaximal step test, 90° push-up test), and physical activity (GENEActiv accelerometers). Correlations and multiple regression models were conducted in SPSS version 24.0. Motor competence was associated with muscular fitness (standing long jump, β = 0.24, p = .002; push-ups, β = 0.42, p < .001), cardiorespiratory fitness (β = 0.21, p = .031), and flexibility (β = 0.23, p = .025), but not physical activity (β = 0.17, p = .154) or body mass index (β = −0.05, p = .622). Motor competence has a stronger association with health-related fitness parameters rather than physical activity.

Assessment and comparison of the effects of two techniques on hamstring flexibility

Introduction There are several stretching techniques that help increase flexibility, however, there are still questions regarding which method leads to the most effective gains. Objectives To assess and compare the effects of two stretching techniques, namely proprioceptive neuromuscular facilitation (PNF) and static stretching on the flexibility of hamstring muscles of young women. Methods The study sample consisted of 45 young women, mean age 20.45 (± 1.66),assigned to one of three groups: static stretching group (SSG, n = 15), proprioceptive neuromuscular facilitation group (PNFG, n = 15) and control group (CG, n = 15). Both SSG and PNFG carried out three weekly stretching sessions over a four-week period. The sit and reach and popliteal angle tests were used at the beginning and end of the intervention. Normally distributed data were analyzed using Student’s t-test, whereas data with non-normal distribution were analyzed using the Wilcoxon test, to compare initial and end measurements for each technique. Finally, we used the Mann-Whitney U test to compare both techniques with each other. A significance level of 5% (p < 0.05) was adopted. Results There was a significant increase in hamstring flexibility when analyzing the assessments and reassessments of both stretching protocols. Conclusions Both techniques were effective in increasing hamstring flexibility and there were no significant differences to indicate which one is better in increasing the flexibility of this muscle group.

Determination of the criterion-related validity of hip joint angle test for estimating hamstring flexibility using a contemporary statistical approach

OBJECTIVE

To examine the criterion-related validity of the horizontal hip joint angle (H-HJA) test and vertical hip joint angle (V-HJA) test for estimating hamstring flexibility measured through the passive straight-leg raise (PSLR) test using contemporary statistical measures.

DESIGN

Validity study.

SETTING

Controlled laboratory environment.

PARTICIPANTS

One hundred thirty-eight professional trampoline gymnasts (61 women and 77 men).

ASSESSMENT OF RISK FACTORS

Hamstring flexibility.

MAIN OUTCOME MEASURES

Each participant performed 2 trials of H-HJA, V-HJA, and PSLR tests in a randomized order. The criterion-related validity of H-HJA and V-HJA tests was measured through the estimation equation, typical error of the estimate (TEEST), validity correlation (β), and their respective confidence limits.

RESULTS

The findings from this study suggest that although H-HJA and V-HJA tests showed moderate to high validity scores for estimating hamstring flexibility (standardized TEEST = 0.63; β = 0.80), the TEEST statistic reported for both tests was not narrow enough for clinical purposes (H-HJA = 10.3 degrees; V-HJA = 9.5 degrees). Subsequently, the predicted likely thresholds for the true values that were generated were too wide (H-HJA = predicted value ± 13.2 degrees; V-HJA = predicted value ± 12.2 degrees).

CONCLUSIONS

The results suggest that although the HJA test showed moderate to high validity scores for estimating hamstring flexibility, the prediction intervals between the HJA and PSLR tests are not strong enough to suggest that clinicians and sport medicine practitioners should use the HJA and PSLR tests interchangeably as gold standard measurement tools to evaluate and detect short hamstring muscle flexibility.

Feasibility and initial effectiveness of home exercise during maintenance therapy for childhood acute lymphoblastic leukemia

PURPOSE

Children with acute lymphoblastic leukemia (ALL) are at increased risk of obesity and deconditioning from cancer therapy. This pilot study assessed feasibility/initial efficacy of an exercise intervention for patients with ALL undergoing maintenance therapy.

METHODS

Participants were aged 5 to 10 years, receiving maintenance therapy, in first remission. A 6-month home-based intervention, with written and video instruction, was supervised with weekly calls from an exercise coach. Pre- and poststudy testing addressed strength, flexibility, fitness, and motor function.

RESULTS

Seventeen patients enrolled (participation 63%). Twelve (71%) finished the intervention, completing 81.7 ± 7.2% of prescribed sessions. Improvements of 5% or more occurred in 67% for knee and 75% for grip strength, 58% for hamstring/low-back and 83% for ankle flexibility, 75% for the 6-Minute Walk Test, and 33% for performance on the Bruininks-Oseretsky Test of Motor Proficiency Version 2.

CONCLUSIONS

This pilot study demonstrated that exercise intervention during ALL therapy is feasible and has promise for efficacy.

Confiabilidade intra-avaliador da medida de amplitude de movimento da flexão e extensão do joelho pelo método de fotogrametria

Apesar de existirem diversos métodos para a determinação da amplitude de movimento (ADM), a baixa confiabilidade, a pouca sensibilidade, a subjetividade ou a ausência de valores do erro típico da medida (ETM) de alguns desses métodos comprometem a interpretação adequada dos resultados. O objetivo deste estudo foi determinar a confiabilidade intra-avaliador da medida e do método de fotogrametria para a ADM de extensão ativa e flexão passiva do joelho (FPJ), realizada no mesmo dia (consistência interna) e em dias diferentes (estabilidade). Participaram 18 sujeitos do sexo masculino (24,5±3,7 anos, 79,3±10,1 kg e 174,8±4,2 cm). Após a marcação dos pontos anatômicos de referência, a angulação dos movimentos foi registrada em fotografia, por meio da ferramenta de dimensão angular no software CorelDRAW®. A confiabilidade da medida e do instrumento foi estabelecida pelo coeficiente de correlação intraclasse (CCI) e pelo cálculo do ETM. A distribuição dos erros dos dados foi verificada pela representação gráfica de Bland e Altman. O método apresentou confiabilidade perfeita (ETM=0,01 e CCI=1,0) para ambos os movimentos. Para a confiabilidade da medida, foram encontrados os valores 0,97 e 0,93 para consistência interna e 0,96 e 0,83 para estabilidade (ETM=2,9 e 4,0%; p<0,001) na extensão e flexão do joelho, respectivamente. O método mostrou excelente confiabilidade e baixo erro na determinação da ADM de extensão e flexão do joelho, sendo assim, adequado para a aplicação em dimensão clínica e de pesquisa.

Reproducibility and criterion-related validity of the sit and reach test and toe touch test for estimating hamstring flexibility in recreationally active young adults

OBJECTIVE

1) to examine the test-retest reproducibility and criterion-related validity of the sit and reach test (SRT) and the toe touch test (TT) for estimating hamstring flexibility measured through the passive straight leg raise test (PSLR); and 2) to determine whether the SRT cut-off scores may be used for the TT test to identify participants in this sample of young healthy adults as having short hamstring flexibility.

DESIGN

Test-retest design.

SETTING

Controlled laboratory environment.

PARTICIPANTS

243 active recreationally young adults.

MAIN OUTCOME MEASURES

Participants performed the SRT, the TT test and PSLR twice in a randomized order with a 4-week interval between trials. Reproducibility was examined using typical percentage error (coefficient of variation [CV]) and intraclass correlation coefficient (ICC) as well as their respective confidence limits. Regression and Kappa correlation statistical analyses were performed to study the association of the SRT and TT test with the PSLR test and the 95% limits of agreement (LoA) between SRT and TT test were calculated to explore differences in the mean differences between these measurements.

RESULTS

The finding showed acceptable reproducibility measures for SRT (8.74% CV; 0.92 ICC), TT test (9.86% CV; 0.89 ICC) and PSLR (5.46% CV; 0.85 ICC). The SRT (R² = 0.63) and TT test (R² = 0.49) were significantly associated with PSLR. The 95% LoA between SRT and TT test reported systematic bias (2.84 cm) and wide 95% random error (±9.72 cm).

CONCLUSIONS

Reproducibility of SRT, TT test and PSLR is acceptable and the criterion-related validity of SRT and TT test is moderate. Furthermore, the SRT cut-off scores should not be used for TT test for the detection of short hamstring muscles.

Accuracy and feasibility of video analysis for assessing hamstring flexibility and validity of the sit-and-reach test

The accuracy of video analysis of the passive straight-leg raise test (PSLR) and the validity of the sit-and-reach test (SR) were tested in 60 men and women. Computer software measured static hip-joint flexion accurately. High within-session reliability of the PSLR was demonstrated (R > .97). Test-retest (separate days) reliability for SR was high in men (R = .97) and women R = .98) moderate for PSLR in men (R = .79) and women (R = .89). SR validity (PSLR as criterion) was higher in women (Day 1, r = .69; Day 2, r = .81) than men (Day 1, r = .64; Day 2, r = .66). In conclusion, video analysis is accurate and feasible for assessing static joint angles, PSLR and SR tests are very reliable methods for assessing flexibility, and the SR validity for hamstring flexibility was found to be moderate in women and low in men.

Health-related fitness in children and adolescents

PURPOSE

The American Physical Therapy Association Section on Pediatrics developed a task force to summarize fitness guidelines for children and adolescents. The purposes of this article were to review components, measurement methods, and consequences of physical fitness, and to summarize evidence-based activity recommendations for youth.

SUMMARY OF KEY POINTS

Health-related fitness is comprised of body composition, flexibility, cardiorespiratory endurance, and muscular strength and endurance. Each of these components is reviewed in terms of definition, assessment, normative values, and recommendations.

CONCLUSIONS

The task force supports the guidelines of the US Department of Health and Human Services, which state that to promote overall health and wellness, youth should participate in 60 minutes or more of physical activity every day.

RECOMMENDATIONS FOR CLINICAL PRACTICE

Physical therapists should apply research relevant to health-related fitness when treating youth. Promoting fitness, health, and wellness in our communities is a responsibility all therapists should assume.

Reliability and validity of the FITNESSGRAM: quality of teacher-collected health-related fitness surveillance data

The purpose of this study was to investigate the quality (reliability and validity) of large-scale fitness testing in Texas and determine if reliabilities and validities were related to potential confounding variables. Four test administration scenarios were conducted to investigate the quality of data collected statewide as part of the Texas Youth Evaluation Project. Teachers and/or expert test administrators tested individual students (N=1010) on two occasions. Criterion-referenced reliabilities were very good to generally acceptable for all FITNESSGRAM test items, with musculosheletal items having the lowest reliabilities. The validity of teacher-administered tests was good. Reliability and validity of teacher-obtained health-related fitness measures were generally unrelated to potentially confounding student or school characteristics. Administrators, teachers, parents, and students can feel comfortable with the reliability and validity of the statewide health-related fitness testing in Texas.

Hip flexibility is the main determinant of the back-saver sit-and-reach test in adolescents

Although flexibility field tests are commonly used in research, sport, and school settings, there is no conclusive evidence about what they actually assess. The first aim of this study was to assess the contributions of the main joints involved in the back-saver sit-and-reach test using angular kinematic analysis. The second aim was to measure the inter-method agreement between the back-saver sit-and-reach test and the sit-and-reach test. A total of 138 adolescents (57 females, 81 males) aged 14.5 +/- 1.7 years performed the back-saver sit-and-reach test and the sit-and-reach test. Hip, lumbar, and thoracic angles were assessed by angular kinematic analysis while the participants were performing the back-saver sit-and-reach test. Stepwise linear regression models and the Bland-Altman method were used. The hip angle independently explained 42% (P < 0.001) of the variance in the back-saver sit-and-reach test, the lumbar angle explained an additional 30% (P < 0.001) of the variance, and the thoracic angle an additional 4% (P < 0.001). The inter-method mean difference between back-saver sit-and-reach (BSSR) and sit-and-reach (SR) measures (BSSR - SR) was 0.41 cm (P = 0.21). The results suggest that hip flexibility is the main determinant of the back-saver sit-and-reach test score in adolescents, followed by lumbar flexibility. The back-saver sit-and-reach test can therefore be considered an appropriate and valid test for assessing hip and low-back flexibility in this age group. The back-saver sit-and-reach and sit-and-reach tests provide comparable values.

Reliability of health-related physical fitness tests in European adolescents. The HELENA Study

OBJECTIVE

To examine the reliability of a set of health-related physical fitness tests used in the European Union-funded Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study on lifestyle and nutrition among adolescents.

DESIGN

A set of physical fitness tests was performed twice in a study sample, 2 weeks apart, by the same researchers.

PARTICIPANTS

A total of 123 adolescents (69 males and 54 females, aged 13.6+/-0.8 years) from 10 European cities participated in the study.

MEASUREMENTS

Flexibility, muscular fitness, speed/agility and aerobic capacity were tested using the back-saver sit and reach, handgrip, standing broad jump, Bosco jumps (squat jump, counter movement jump and Abalakov jump), bent arm hang, 4 x 10 m shuttle run, and 20-m shuttle run tests.

RESULTS

The ANOVA analysis showed that neither systematic bias nor sex differences were found for any of the studied tests, except for the back-saver sit and reach test, in which a borderline significant sex difference was observed (P=0.044). The Bland-Altman plots graphically showed the reliability patterns, in terms of systematic errors (bias) and random error (95% limits of agreement), of the physical fitness tests studied. The observed systematic error for all the fitness assessment tests was nearly 0.

CONCLUSIONS

Neither a learning nor a fatigue effect was found for any of the physical fitness tests when repeated. The results also suggest that reliability did not differ between male and female adolescents. Collectively, it can be stated that the reliability of the set of physical fitness tests examined in this study is acceptable. The data provided contribute to a better understanding of physical fitness assessment in young people.

Effects of the Youth Fit for Life Protocol on Physiological, Psychological, and Behavioral Factors at YMCA Calgary After-School Care Sites

Youth inactivity and inappropriately high weight is a problem in the United States, Canada, and much of the industrialized world. Physiological and behavioral changes associated with the Youth Fit For Life protocol, a physical activity and nutrition education treatment based on self-efficacy theory, were assessed in 7- to 12-yr.-olds ( N = 43) from Calgary, Alberta, Canada. Body Mass Index, strength, and cardiorespiratory endurance significantly improved over a 12-wk. period when contrasted with changes based on normative data. Significant within-group improvements in measures of self-efficacy, vegetable intake, and voluntary moderate-to-vigorous physical activity were also found over 12 wk. Multiple regression analysis indicated that score changes in measures of self-regulatory and task self-efficacy, and general self, accounted for changes in voluntary physical activity. Implications for use of behaviorally based methods for large-scale obesity prevention treatments in preadolescents were discussed.

Fitness, motor competence, and body composition are weakly associated with adolescent back pain

STUDY DESIGN

Cross-sectional survey.

OBJECTIVES

To assess the associations between adolescent back pain and fitness, motor competence, and body composition.

BACKGROUND

Although deficits in physical fitness and motor control have been shown to relate to adult back pain, the evidence in adolescents is less clear.

METHODS AND MEASURES

In this cross-sectional study, 1608 "Raine" cohort adolescents (mean age, 14 years) answered questions on lifetime, month, and chronic prevalence of back pain, and participated in a range of physical tests assessing aerobic capacity, muscle performance, flexibility, motor competence, and body composition.A history of any diagnosed back pain in the adolescent was obtained from the primary caregiver.

RESULTS

After multivariate logistic regression analysis, increased likelihood of back pain in boys was associated with greater aerobic capacity, greater waist girth, and both reduced and greater flexibility. Back pain in girls was associated with greater abdominal endurance, reduced kinesthetic integration, and both reduced and greater back endurance. Lower likelihood of back pain was associated with greater bimanual dexterity in boys and greater lower extremity power in girls.

CONCLUSION

Physical characteristics are commonly cited as important risk factors in back pain development. Although some factors were associated with adolescent back pain, and these differed between boys and girls, they made only a small contribution to logistic regression models for back pain. The results suggest future work should explore the interaction of multiple domains of risk factors (physical, lifestyle, and psychosocial) and subgroups of adolescent back pain, for whom different risk factors may be important.

A comparison of the spine posture among several sit-and-reach test protocols

The purpose of the study was to compare the thoracic and lumbar spine posture among different sit-and-reach tests. Fifty-eight men and 47 women were asked to perform three trials of sit-and-reach test (SR), toe-touch test (TT), back-saver sit-and-reach test (BS) right and left, unilateral seated sit-and-reach test (USR) right and left, and V sit-and-reach test (VSR). Thoracic and lumbar angles were assessed with an inclinometer when subjects reached forward maximally. Women had a lower thoracic angle than men on all tests (p<0.05). No differences were found in the lumbar angle between genders. The thoracic angle was the highest in VSR (75.3 degrees in men and 65.8 degrees in women) and the lowest in TT (61.7 degrees in men and 53.1 degrees in women). No differences were found among some pairwise comparisons (SR-BS in both genders, SR-TT, SR-VSR and others in women). The VSR test presented the highest values in lumbar spine when compared to other tests (30.5 degrees in men and 32.0 degrees in women). Unilateral seated sit-and-reach test presented the lowest lumbar angle in men (24.2 degrees for right leg and 23.9 degrees for left leg) and women (23.9 degrees in both legs) and there were significant differences with respect to the other tests. Characteristics and administration procedures of tests, such us uni- or bilateral, sitting or standing, measuring with or without box, parallel or V position, and hip position influence thoracic and lumbar postures.

Flexibilidade anterior do tronco no adolecente após o pico da velocidade de crescimento em estatura

Flexibilidade anterior do tronco (FAT) é um componente importante dos exames clínico e de aptidão física utilizado como indicador da função vertebral. O teste mais utilizado para sua quantificação é o sentar-e-alcançar (TSA), que considerara como padrão de normalidade o toque das mãos nos pés, com critérios e parâmetros de análise que independem das variáveis. Neste estudo, investigou-se a FAT em adolescentes, após o pico da velocidade de crescimento em estatura, em função do sexo, da velocidade de execução e dos dados antropométricos. Os índices foram obtidos em centímetros; o peso corporal em kg. Participaram 102 adolescentes, sendo 45 mulheres e 57 homens, entre 16 e 20 anos de idade. Resultados indicam que o fator sexo, dados antropométricos e a velocidade de execução do teste influenciam os índices de flexibilidade; a avaliação da função vertebral não pode ter como critério de normalidade atingir os pés pelo TSA, e que a velocidade rápida leva a melhores resultados. Em resumo, os resultados indicam que tocar os pés, é um critério que exclui da normalidade da função vertebral aproximadamente 50% dos adolescentes. Assim, o critério para tomada de decisão quanto ao encaminhamento do adolescente para recuperação de maiores índices de flexibilidade precisa ser revisto.

Effects of a 12-week physical activity protocol delivered by YMCA after-school counselors (Youth Fit for Life) on fitness and self-efficacy changes in 5-12-year-old boys and girls

To address reduced physical education (PE) in elementary schools, a 12-week physical activity protocol was tested on 5-12-year-old, primarily African American, girls (n = 226) and boys (n = 344) at 14 YMCA after-school care sites. The 3 times/week, 45-min session curriculum included cardiovascular, resistance, and flexibility training, in which all children could participate simultaneously, and a behavioral skills education component. After-school counselors, formerly untrained in PE methods, administered the sessions, with periodic supervision by YMCA wellness staff members. Analyses of the eight Age x Sex subsamples indicated significant improvements on body composition, strength, and endurance, both within-groups and when predicted changes due to maturation were accounted for. Exercise barriers self-efficacy significantly increased in subsamples of 9-10- and 11-12-year-old girls only. The need for replication across ethnic groups was suggested. Limitations and the need for extension of research on supplementation of elementary school PE were discussed.

Shortwave diathermy and prolonged stretching increase hamstring flexibility more than prolonged stretching alone

STUDY DESIGN

A randomized, counterbalanced 2x3x5 repeated-measures design.

OBJECTIVE

To compare changes in hamstring flexibility after treatments of pulsed shortwave diathermy and prolonged stretch, sham diathermy and prolonged stretch, and control.

BACKGROUND

Heat and stretch techniques have been touted for years. To date, the effect of shortwave diathermy and hamstring stretching has not been studied. Because diathermy heats a large area and penetrates deep into the muscle, use of this device prior to or during hamstring stretching may increase flexibility.

METHODS AND MEASURES

Thirty college-age students (mean age, 21.5 years) with tight hamstrings (inability to achieve greater than 160 degrees knee extension at 90 degrees hip flexion) participated. Subjects were assigned to 1 of 3 groups: diathermy and stretch, sham diathermy and stretch, and control). Range of motion was recorded before and after each treatment for 5 days and on day 8. A straight leg-raise stretch was performed using a mechanical apparatus. Subjects in the diathermy-and-stretch group received 10 minutes of diathermy (distal hamstrings) followed by 5 minutes of simultaneous diathermy and stretch, followed by 5 minutes of stretching only. Subjects in the sham-diathermy-and-stretch group followed the same protocol, but with the diathermy unit turned off. Subjects in the control group lay on the table for 20 minutes. Data were analyzed using an ANOVA and post hoc t tests.

RESULTS

Mean (+/- pooled SE) increases in knee extension after 5 days were 15.8 degrees 2.2 degrees for the diathermy-and-stretch group, 5.2 degrees +/- 2.2 degrees for the sham-diathermy-and-stretch group, and -0.3 degrees +/- 2.2 degrees for the control group. Seventy-two hours after the last treatment, the diathermy-and-stretch group lost 1.9 degrees +/- 2.2 degrees, the sham-diathermy-and-stretch group lost 3.0 degrees +/- 2.2 degrees, and the control group changed -0.4 degrees +/- 2.2 degrees.

CONCLUSION

These results suggest that hamstring flexibility can be greatly improved when shortwave diathermy is used in conjunction with prolonged stretching.

Comparison of three different sit and reach tests for measurement of hamstring flexibility in female university students

BACKGROUND

The sit and reach test is the most common flexibility test used in health related fitness test batteries.

OBJECTIVE

To examine and compare three different sit and reach tests as a measure of hamstring flexibility in 102 female students.

METHOD

The traditional sit and reach test, the chair sit and reach test, the back saver sit and reach test, and passive straight leg raise were administered in three trials to all 102 students (mean (SD) age 22 (1) years) on the same day.

RESULTS

A Pearson correlation coefficient analysis was significant (p<0.01) for the traditional sit and reach test with back saver sit and reach test and flexibility of hamstrings (r = 0.45 and 0.65 for left and right legs, and 0.63 and 0.53 for left and right legs respectively). Also, the back saver sit and reach test for the left (p<0.01) and right (p<0.05) leg was significantly associated with hamstring flexibility (r = 0.37 and 0.25 for the left leg and 0.50 and 0.44 for the right leg respectively).

CONCLUSION

The results indicate that the back saver sit and reach test produces reasonably accurate and stable measures of hamstring flexibility. Moreover, it appears that this test is a safe and acceptable alternative to the traditional and chair sit and reach tests as a measure of hamstring flexibility in young women.

Stretching Techniques to Improve Flexibility in Special Olympics Athletes and Their Coaches

Objective/Context:

To examine the effects of static and proprioceptive neuromuscular facilitation (PNF) stretching in Special Olympics athletes and their coaches on sit-and-reach performance.

Design/Participants:

Repeated-measures ANOVA with Scheffé post hoc analyses on 2 groups: Special Olympics athletes (n = 18, mean age = 15.7) and their coaches without mental retardation (n = 44, mean age = 22.2).

Intervention/Outcome Measures:

Stretching performance was measured in centimeters using a sit-and-reach flexibility box, examining 2 series of 3 stretches. For both groups, the first set of 3 stretches was performed in the following order: baseline, static, PNF. Three to 4 weeks later, the order of the stretches was reversed: baseline, PNF, static.

Results:

PNF stretching improved performance regardless of stretching order after baseline and static measures. Static stretching improved performance only from baseline.

Conclusions:

Individuals of various ages and cognitive abilities can apparently perform and benefit from PNF stretching.

Fitness testing of pediatric liver transplant recipients

Liver transplantation is accepted as the standard management for end-stage liver disease in children. Pediatric heart and heart-lung transplant recipients have shown significantly diminished exercise capacities compared with age-matched, able-bodied, control subjects. The primary aim of this study is to compare the fitness levels of a group of pediatric liver transplant (LT) recipients (LT group, 20 boys, 9 girls; age, 8.9 +/- 4.8 years; 56 +/- 35 months posttransplantation) with a group of able-bodied control subjects (22 boys, 12 girls; age, 8.4 +/- 3.8 years). The secondary aim is to compare the performance of the LT group against the Fitnessgram criterion standards. We assessed muscular endurance by means of a partial curl-up, flexibility by means of the back-saver sit and reach, and cardiorespiratory fitness by means of the progressive aerobic cardiovascular endurance run (PACER). The only significant (P <.05) difference between the 2 groups was the number of shuttles run in the PACER (control, 16.8 +/- 9.8 v LT, 11.5 +/- 8.4 shuttles). Other differences between the 2 groups were not significant. With regard to satisfying the Fitnessgram criterion standards, only 35% of the LT group achieved the standards for the partial curl-up, 88% of the LT group achieved the criterion standards for flexibility, and 0% achieved the standards for the PACER. These results indicate that the LT group has diminished exercise capacity. The origins of exercise limitations deserve further investigation.

The reliability and validity of a chair sit-and-reach test as a measure of hamstring flexibility in older adults

The purpose of this study was to examine the test-retest reliability and the criterion validity of a newly developed chair sit-and-reach (CSR) test as a measure of hamstring flexibility in older adults CSR performance was also compared to sit-and-reach (SR) and back-saver sit-and-reach (BSR) measures of hamstring flexibility. To estimate reliability, 76 men and women (M age = 70.5 years) performed the CSR on 2 different days, 2-5 days apart. In the validity phase of the study, scores of 80 men and women (M age = 74.2 years) were obtained on three field test measures of hamstring flexibility (CSR, SR, and BSR) and on a criterion test (goniometer measurement of a passive straight-leg raise). Results indicate that the CSR has good intraclass test-retest reliability (R = .92 for men; r = .96 for women), and has a moderate-to-good relationship with the criterion measure (r = .76 for men; r = .81 for women). The criterion validity of the CSR for the male and female participants is comparable to that of the SR (r = .74 and r = .71, respectively) and BSR (r = .70 and r = .71, respectively). Results indicate that the CSR test produces reasonably accurate and stable measures of hamstring flexibility. In addition, it appears that the CSR is a safe and socially acceptable alternative to traditional floor sit-and-reach tests as a measure of hamstring flexibility in older adults.