Comprehensive Assessment and Early Prediction of Gross Motor Performance in Toddlers With Graph Convolutional Networks-Based Deep Learning: Development and Validation Study

BACKGROUND

Accurate and timely assessment of children's developmental status is crucial for early diagnosis and intervention. More accurate and automated developmental assessments are essential due to the lack of trained health care providers and imprecise parental reporting. In various areas of development, gross motor development in toddlers is known to be predictive of subsequent childhood developments.

OBJECTIVE

The purpose of this study was to develop a model to assess gross motor behavior and integrate the results to determine the overall gross motor status of toddlers. This study also aimed to identify behaviors that are important in the assessment of overall gross motor skills and detect critical moments and important body parts for the assessment of each behavior.

METHODS

We used behavioral videos of toddlers aged 18-35 months. To assess gross motor development, we selected 4 behaviors (climb up the stairs, go down the stairs, throw the ball, and stand on 1 foot) that have been validated with the Korean Developmental Screening Test for Infants and Children. In the child behavior videos, we estimated each child's position as a bounding box and extracted human keypoints within the box. In the first stage, the videos with the extracted human keypoints of each behavior were evaluated separately using a graph convolutional networks (GCN)-based algorithm. The probability values obtained for each label in the first-stage model were used as input for the second-stage model, the extreme gradient boosting (XGBoost) algorithm, to predict the overall gross motor status. For interpretability, we used gradient-weighted class activation mapping (Grad-CAM) to identify important moments and relevant body parts during the movements. The Shapley additive explanations method was used for the assessment of variable importance, to determine the movements that contributed the most to the overall developmental assessment.

RESULTS

Behavioral videos of 4 gross motor skills were collected from 147 children, resulting in a total of 2395 videos. The stage-1 GCN model to evaluate each behavior had an area under the receiver operating characteristic curve (AUROC) of 0.79 to 0.90. Keypoint-mapping Grad-CAM visualization identified important moments in each behavior and differences in important body parts. The stage-2 XGBoost model to assess the overall gross motor status had an AUROC of 0.90. Among the 4 behaviors, "go down the stairs" contributed the most to the overall developmental assessment.

CONCLUSIONS

Using movement videos of toddlers aged 18-35 months, we developed objective and automated models to evaluate each behavior and assess each child's overall gross motor performance. We identified the important behaviors for assessing gross motor performance and developed methods to recognize important moments and body parts while evaluating gross motor performance.

A Home-Based Exercise Program With Active Video Games for Balance, Motor Proficiency, Foot and Ankle Ability, and Intrinsic Motivation in Children With Chronic Ankle Instability: Feasibility Randomized Controlled Trial

Background

Children with chronic ankle instability (CAI) frequently experience ankle unsteadiness, causing trips, falls, and ankle sprain injuries resulting in poor quality of life. A specific exercise program focused on physical and psychological purposes in children with CAI is needed.

Objective

The purpose of this study was to investigate the feasibility of a 4-week home-based exercise training program using active video games (AVGs) for balance, motor proficiency, foot and ankle ability, and intrinsic motivation in children with CAI.

Methods

Sixty children with CAI (mean age 10, SD 2 years) were randomly assigned to an experimental group (AVG group; n=30) or a control group (CG; n=30). The AVG group played 2 selected video games, Catching Fish and Russian Block, while the CG received the traditional exercise program for CAI. Both programs were scheduled for 30 minutes per day, 3 times per week, for 4 weeks at home. The single-leg stance test was used to assess static balance. The walking forward on a line and standing long jump tests were used to assess motor proficiency. The Foot and Ankle Ability Measure (FAAM) and the Intrinsic Motivation Inventory questionnaire were used to assess foot and ankle ability and intrinsic motivation, respectively. Assessments were conducted at baseline and after 4 weeks.

Results

In the AVG group, the single-leg stand test (eyes open; on floor and on foam conditions), the FAAM (activities of daily living subscale), and intrinsic motivation (interest/enjoyment, pressure/tension, and value/usefulness dimensions) were improved compared with the CG (all P<.05). Motor proficiency did not differ between the 2 groups at the end of the 4-week program (P=.31 for the walking forward on a line, P=.34 for the standing long jump test).

Conclusions

A 4-week home-based exercise training program using AVGs can be beneficial and may be an effective approach for improving balance, foot and ankle ability, and enhancing positive motivation by increasing the interest/enjoyment and value/usefulness dimensions and lowering the pressure/tension dimension in children with CAI that require long-term rehabilitation sessions.

Validity of Neural Networks to Determine Body Position on the Bicycle

Purpose: With the increased access to neural networks trained to estimate body segments from images and videos, this study assessed the validity of some of these networks in enabling the assessment of body position on the bicycle. Methods: Fourteen cyclists pedaled stationarily in one session on their own bicycles while video was recorded from their sagittal plane. Reflective markers attached to key bony landmarks were used to manually digitize joint angles at two positions of the crank (3 o'clock and 6 o'clock) extracted from the videos (Reference method). These angles were compared to measurements taken from videos generated by two deep learning-based approaches designed to automatically estimate human joints (Microsoft Research Asia-MSRA and OpenPose). Results: Mean bias for OpenPose ranged between 0.03° and 1.81°, while the MSRA method presented errors between 2.29° and 12.15°. Correlation coefficients were stronger for OpenPose than for the MSRA method in relation to the Reference method for the torso (r = 0.94 vs. 0.92), hip (r = 0.69 vs. 0.60), knee (r = 0.80 vs. 0.71), and ankle (r = 0.23 vs. 0.20). Conclusion: OpenPose presented better accuracy than the MSRA method in determining body position on the bicycle, but both methods seem comparable in assessing implications from changes in bicycle configuration.

Elastic Taping Application on the Neck: Immediate and Short-Term Impacts on Pain and Mobility of Cervical Spine

The aim of this study was to measure the effects on three-planar active cervical range of motion (ACROM) and self-perceived pain of elastic taping (ET) application in the cervical area. Thirty participants (n: 22-M and 8-F, age 35.4 ± 4.4 years; body height 173.1 ± 8.4 cm; body mass 73.5 ± 12.8 kg) in the study group (SG) and twenty participants (n: 11-M and 9-F, age 32.6 ± 3.9 years; body height 174.9 ± 10.9 cm; body mass 71.2 ± 12.9 kg) in the control group (CG) were recruited. All subjects had neck and cervical pain in baseline condition. Each group performed an ACROM test and measured the perceived pain in the neck based on the Numerical Rating Scale (NRS 0--10, a.u.) at the baseline (T0), after 20' from the ET application (T1), and after three days of wearing the ET application (T2). Between T0 and T1, an ET was applied to the cervical area of the SG participants. Statistical analysis did not show any significant change in CG in any measurement session for ACROM and neck pain parameters. Conversely, the SG showed significant improvements for ACROM rotation to the left (T0 64.8 ± 7.7°-T2 76.0 ± 11.1° p < 0.000) and right (T0 66.0 ± 11.9°-T2 74.2 ± 9.6° p < 0.000), lateral inclination to the left (T0 37.5 ± 6.9°-T2 40.6 ± 10.8° p < 0.000) and right (T0 36.5 ± 7.9°-T2 40.9 ± 5.2° p < 0.000), extension (T0 47.0 ± 12.9°-T2 55.1 ± 12.3° p < 0.001), and flexion (T0 55.0 ± 3.6°-T2 62.9 ± 12.0° p < 0.006). A significant decrease was also measured in SG for pain NRS between T0 and T2 (T0 7.5 ± 1.0°-T1 5.5 ± 1.4-T2 1.4 ± 1.5° p < 0.000). In conclusion, a bilateral and symmetrical ET cervical application is useful to enhance multiplanar ACROM and reduce subjective self-perceived cervical pain when it is needed. Based on the evidence, the use of ET on the neck is recommended for managing neck motion restrictions and pain in adult individuals.

The Rehabilitation Interventions and Adaptive Technologies Used for Treating Patients With Cerebral Palsy

Cerebral palsy (CP) is one of the most common disorders in pediatric patients. The prevalence of CP is 2-3 in 1,000 live births, but various changes in some trends are seen in different groups. This article is a systematic review of multiple sources available for interventions and new adaptive techniques used for treating patients for their better lifestyles. With recent advancements, it is possible to diagnose a child who is below six months to two years. For achieving goals, proper interventions and techniques are necessary in the early stages of the disease. This article summarizes the rehabilitation and interventions available for treating these children with the best procedures.

Exercise prescription and strategies to promote the cross-education of strength: a scoping review

The cross-education of strength is moderated by exercise design and prescription in clinical and non-clinical populations. This review synthesizes the available evidence regarding exercise design strategies for unilateral resistance training and provides evidence-based recommendations for the prescription of unilateral training to maximize the cross-education of strength. Greater insights regarding the timing and effectiveness of cross-education interventions in clinical scenarios will strengthen the use of unilateral resistance training for individuals who may benefit from its use.

Kinesiologists in Clinical Exercise Interventional Research for Stroke and Coronary Artery Disease: A Scoping Review

Background: Kinesiology contributions to research and implementation of programs for cardiovascular disease have not been documented. This scoping review assesses kinesiology affiliates participation in exercise interventional research. Methods: The review followed the Preferred Reporting Items for Systematic review and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) Checklist. Eligible studies included individuals diagnosed with coronary artery (CAD) or heart disease (CHD) or stroke participating in exercise interventions supervised or designed by a kinesiologist affiliate (exercise physiologist, kinesiologist, exercise trainer, exercise therapist). Results: The search in MEDLINE, Embase, Scopus, PsychINFO, SPORTDiscus, and CINAHL yielded 219 studies, including 13,874 participants (5,242 CAD, 4,526 CHD, and 4,106 post-stroke). Randomized controlled trials were the most common study design (52%). Kinesiologists were involved in 70% of the studies and supervised 23%. Forty percent did not specify the supervisor. Kinesiologists are involved in prevention and rehabilitation exercise studies that look to improve feasibility of practice, aerobic fitness, muscle and body composition, functional capacity, gait, neurological, psychosocial, and cardiovascular outcomes. Conclusions: Documentation of kinesiology contributions to research for patients with cardiovascular disease may enhance their acceptance in research and care for people with impaired cardiovascular health.

The Features of Foot Morphology and Intrinsic Foot Muscle Property in Adolescent Swimmers: An Ultrasound-Based Study

This cross-sectional study aimed to investigate the relationship between foot shape and intrinsic foot muscles (IFMs) in adolescent swimmers compared with other athletes. Foot morphology of swimmers was compared with other athletes of comparable age and a competition level (n = 32 [64 feet]; a total of 64 feet; 128 feet in two groups). Foot morphology and variables of IFMs were measured using a three-dimensional foot scanner and an ultrasound imaging system, respectively. Multiple linear regression analysis with forced entry was performed to clarify the association of the thickness and the cross-sectional area (CSA) of IMFs with the navicular height in both sitting and standing positions. Navicular height in a standing position, the thickness of the abductor hallucis (AbH) and the flexor digitorum brevis (FDB), as well as the CSA were significantly lower in swimmers compared with other athletes (p < 0.05). A larger CSA for the flexor hallucis brevis (FHB) was observed in swimmers than in other athletes (p < 0.01). The navicular height of swimmers in sitting and standing positions was positively correlated with the thickness and the CSA of the FHB and the FDB (p < 0.05). Multiple regression analysis showed that navicular height was associated with the CSA of the FDB in both sitting and standing positions (β = 0.395; p < 0.002, β = 0.201; p < 0.018). This study showed that the navicular height of elite adolescent swimmers was lower than that of other athletes. Furthermore, the swimmers' high navicular height was associated with the CSA of the FDB, suggesting that the FDB might be more involved in the formation of the medial longitudinal arch than the AbH.

Relation between Photogrammetry and Spinal Mouse for Sagittal Imbalance Assessment in Adolescents with Thoracic Kyphosis

The evaluation of postural alignment in childhood and adolescence is fundamental for sports, health, and daily life activities. Spinal Mouse (SM) and photogrammetry (PG) are two of the most debated tools in postural evaluation because choosing the proper instrument is also important to avoid false or misleading data. This research aims to find out the best linear regression models that could relate the analytic kyphosis measurements of the SM with one or more PG parameters of body posture in adolescents with kyphotic posture. Thirty-four adolescents with structural and non-structural kyphosis were analyzed (13.1 ± 1.8 years; 1.59 ± 0.13 m; 47.0 ± 12.2 kg) using SM and PG on the sagittal plane in a standing and forward-bending position, allowing us to measure body vertical inclination, trunk flexion, and sacral inclination and hip position during bending. The stepwise backward procedure was assessed to estimate the variability of the grade of inclination of the spine and thoracic spine curvature with fixed upper and lower limits, evaluated with SM during flexion. In both models, the PG angle between the horizontal line and a line connecting the sacral endplate-C7 spinous process and the PG hip position were the best regressors (adjusted-R² SM bend = 0.804, p < 0.001; adjusted-R² SM fixed bending = 0.488, p < 0.001). Several Spinal Mouse and photogrammetry parameters showed significant correlations, especially when the Spinal Mouse measurements were taken when the adolescents were in the forward-bending position. Physicians and kinesiologists may consider photogrammetry as a good method for spinal curve prediction.

Assessing the Subjective Effectiveness of Sensorimotor Insoles (SMIs) in Reducing Pain: A Descriptive Multicenter Pilot Study

This pilot study aimed to investigate the use of sensorimotor insoles in pain reduction, different orthopedic indications, and the wearing duration effects on the development of pain. Three hundred and forty patients were asked about their pain perception using a visual analog scale (VAS) in a pre-post analysis. Three main intervention durations were defined: VAS_post: up to 3 months, 3 to 6 months, and more than 6 months. The results show significant differences for the within-subject factor "time of measurement", as well as for the between-subject factor indication (p < 0.001) and worn duration (p < 0.001). No interaction was found between indication and time of measurements (model A) or between worn duration and time of measurements (model B). The results of this pilot study must be cautiously and critically interpreted, but may support the hypothesis that sensorimotor insoles could be a helpful tool for subjective pain reduction. The missing control group and the lack of confounding variables such as methodological weaknesses, natural healing processes, and complementary therapies must be taken into account. Based on these experiences and findings, a RCT and systematic review will follow.

Can we reposition finite element human body model like dummies?

Rapidly repositioning finite element human body models (FE-HBMs) with high biofidelity is an important but notorious problem in vehicle safety and injury biomechanics. We propose to reposition the FE-HBM in a dummy-like manner, i.e., through pose parameters prescribing joint configurations. Skeletons are reconfigured along the trajectories inferred from model-specific bone geometries. We leverage differential geometry to steer equidistant moves along the congruent articulated bone surfaces. Soft tissues are subsequently adapted to reconfigured skeletons through a series of operations. The morph-contact algorithm allows the joint capsule to slide and wrap around the repositioned skeletons. Nodes on the deformed capsule are redistributed following an optimization-based approach to enhance element regularity. The soft tissues are transformed accordingly via thin plate spline. The proposed toolbox can reposition the Total Human Body Model for Safety (THUMS) in a few minutes on a whole-body level. The repositioned models are simulation-ready, with mesh quality maintained on a comparable level to the baseline. Simulations of car-to-pedestrian impact with repositioned models exhibiting active collision-avoidance maneuvers are demonstrated to illustrate the efficacy of our method. This study offers an intuitive, effective, and efficient way to reposition FE-HBMs. It benefits all posture-sensitive works, e.g., out-of-position occupant safety and adaptive pedestrian protection. Pose parameters, as an intermediate representation, join our method with recently prosperous perception and reconstruction techniques of the human body. In the future, it is promising to build a high-fidelity digital twin of real-world accidents using the proposed method and investigate human biomechanics therein, which is of profound significance in reshaping transportation safety studies in the future.

Influence of the Backward Fall Technique on the Transverse Linear Acceleration of the Head during the Fall

BACKGROUND

The formation of large accelerations on the head and cervical spine during a backward fall is particularly dangerous due to the possibility of affecting the central nervous system (CNS). It may eventually lead to serious injuries and even death. This research aimed to determine the effect of the backward fall technique on the linear acceleration of the head in the transverse plane in students practicing various sports disciplines.

METHODS

The study involved 41 students divided into two study groups. Group A consisted of 19 martial arts practitioners who, during the study, performed falls using the side aligning of the body technique. Group B consisted of 22 handball players who, during the study, performed falls using the technique performed in a way similar to a gymnastic backward roll. A rotating training simulator (RTS) was used to force falls, and a Wiva^® Science apparatus was used to assess acceleration.

RESULTS

The greatest differences in backward fall acceleration were found between the groups during the buttocks' contact with the ground. Larger changes in head acceleration were noted in group B.

CONCLUSIONS

The lower changes in head acceleration obtained in physical education students falling with a lateral body position compared to students training handball indicate their lower susceptibility to head, cervical spine, and pelvis injuries when falling backwards as caused by horizontal force.

Faculty Perspective Regarding Practical Experience of Adapted Physical Education for Undergraduate Students

Preparing future physical education professionals to teach adapted physical education (APE) is a responsibility of physical education teacher education (PETE) programs. Furthermore, there is limited literature on practicum and/or field experiences as a part of APE courses from the perspective of faculty members. The purpose of this qualitative study was to explore faculty views in relation to the practical experiences in undergraduate APE courses. Structured interviews were conducted with faculty members of higher education institutions in the U.S. There were five study participants in this study. Thematic analysis was employed for data analysis. The findings included three subthemes: (a) quality of quantity, (b) need for diversity in practical experiences, and (c) practical experience pertaining to APE courses. Practical experience in APE courses is an integral part of professional preparation for undergraduate students in kinesiology programs. There are no exact criteria for requirements across the states; however, students could maximize their learning by engaging in diverse APE practicum settings. The instructor of APE courses should provide clear guidelines and feedback for students. Instructors of APE courses must also consider the institutional and environmental context prior to planning and implementing practical experiences to provide successful learning experiences for students.

Does muscle growth mediate changes in a nonspecific strength task?

The purpose of this study was to determine if muscle growth mediates increases in a strength task which was not directly trained. One hundred fifty-one participants were randomized into control, one-repetition maximum training (1RM-TRAIN), or traditional training (TRAD-TRAIN). Training groups performed isotonic elbow flexion 3x/week for 6 weeks. Anterior muscle thickness at 50%, 60% and 70% upper arm length, and maximal isokinetic torque at 60°/sec were assessed pre- and post-training. Change-score mediation models (adjusted for sex, pre-muscle thickness, and pre-strength) were constructed for each muscle thickness site. The effects of each training group were evaluated relative to the control. Data is presented as coefficient (95% CI). There were no significant relative direct effects on nonspecific strength for either training group outside of the 60% model (1.7 [0.13, 3.27] Nm). The relative effect of 1RM-TRAIN on muscle thickness was greater in 60% (0.09 [0.01, 0.17] cm) and 70% (0.09 [0.00, 0.17] cm) models; while TRAD-TRAIN was greater in all three: (50% = 0.24 [0.15, 0.32]; 60% = 0.24 [0.16, 0.33]; 70% = 0.22 [0.14, 0.31] cm). The effect of muscle thickness on nonspecific strength was only significant for the 60% (-3.06 [-5.7, -0.35] Nm) model. The relative indirect effect on nonspecific strength was not significant for the 1RM-TRAIN or TRAD-TRAIN. Similar to previous findings on specific strength, we did not find evidence for a mediating effect of muscle growth on training induced increases in nonspecific strength. The importance of muscle growth for changes in nonspecifically trained strength may need to be reconsidered.

A public data set of walking full-body kinematics and kinetics in individuals with Parkinson's disease

Background

To our knowledge, there is no Parkinson's disease (PD) gait biomechanics data sets available to the public.

Objective

This study aimed to create a public data set of 26 idiopathic individuals with PD who walked overground on ON and OFF medication.

Materials and methods

Their upper extremity, trunk, lower extremity, and pelvis kinematics were measured using a three-dimensional motion-capture system (Raptor-4; Motion Analysis). The external forces were collected using force plates. The results include raw and processed kinematic and kinetic data in c3d and ASCII files in different file formats. In addition, a metadata file containing demographic, anthropometric, and clinical data is provided. The following clinical scales were employed: Unified Parkinson's disease rating scale motor aspects of experiences of daily living and motor score, Hoehn & Yahr, New Freezing of Gait Questionnaire, Montreal Cognitive Assessment, Mini Balance Evaluation Systems Tests, Fall Efficacy Scale-International-FES-I, Stroop test, and Trail Making Test A and B.

Results

All data are available at Figshare (https://figshare.com/articles/dataset/A_dataset_of_overground_walking_full-body_kinematics_and_kinetics_in_individuals_with_Parkinson_s_disease/14896881).

Conclusion

This is the first public data set containing a three-dimensional full-body gait analysis of individuals with PD under the ON and OFF medication. It is expected to contribute so that different research groups worldwide have access to reference data and a better understanding of the effects of medication on gait.

Academic Acculturation of International Doctoral Students in the U.S.: A Qualitative Inquiry

The aim of this phenomenological inquiry is to explore the academic acculturation experiences of international kinesiology professionals during their doctoral programs in higher education institutions in the U.S. Purposive sampling technique was used which include six study participants. The data collected from a demographic questionnaire and a focused interview. Using acculturation theory as a conceptual framework, the subjects' academic acculturation as former international PhD students were described. There are three subthemes: (1) graduate program and requirements, (2) the academic environment of graduate program, and (3) professional development for a career in kinesiology. Findings are discussed in light of academic acculturation with a focus on assimilation (proactive adaptation in a new environment), and integration (flexibly to embrace the life experiences, learning experiences, and current experiences of the students in a new context). Particularly, findings examine how international kinesiology professionals perceived their doctoral degree experiences and sustained academic acculturation, pertaining to research and professional development at their programs. Exploring the academic acculturation of international PhD students is crucial for diversity awareness in higher education in the U.S. Often described as a minority with a narrower status, these international students undergoing academic acculturation should be assisted with aligning to their contextual frames, in terms of degree level and its characteristics in their field of study.

Postural Evaluation in Young Healthy Adults through a Digital and Reproducible Method

Different tools for the assessment of posture exist, from the simplest and cheap plumb line to complex, expensive, 3D-marker-based systems. The aim of this study is to present digital postural normative data of young adults collected through a mobile app to expand the possibilities of digital postural evaluation. A sample of 100 healthy volunteers, 50 males and 50 females, was analyzed with the mobile app Apecs-AI Posture Evaluation and Correction System® (Apecs). The Student’s t-test evaluated differences between gender to highlight if the digital posture evaluation may differ between groups. A significant difference was present in the anterior coronal plane for axillary alignment (p = 0.04), trunk inclination (p = 0.03), and knee alignment (p = 0.01). Head inclination (p = 0.04), tibia shift (p = 0.01), and foot angle (p < 0.001) presented significant differences in the sagittal plane, while there were no significant differences in the posterior coronal plane. The intraclass correlation coefficient (ICC) was considered to evaluate reproducibility. Thirteen parameters out of twenty-two provided an ICC > 0.90, three provided an ICC > 0.60, and six variables did not meet the cut-off criteria. The results highlight that digital posture analysis of healthy individuals may present slight differences related to gender. Additionally, the mobile app showed good reproducibility according to ICC. Digital postural assessment with Apecs could represent a quick method for preventing screening in the general population. Therefore, clinicians should consider this app’s worth as an auxiliary posture evaluation tool.

30 Year Trends of Reduced Physical Fitness in Undergraduate Students Studying Human Movement

The physical fitness of Canadian adults has decreased over the past 30 years, while sedentary time has increased. However, it is unknown if university students studying human movement exhibit similar population declines. Physical fitness (i.e., anthropometrics, musculoskeletal fitness, and aerobic fitness) and habitual activity (e.g., physical activity, stationary time, etc.) was measured in a cohort of kinesiology students (Post30; 2010-2016; n = 129 males, 224 females) using standardized fitness testing and accelerometry, respectively. Physical fitness was compared to data collected on a cohort of students from the same institution and program, 30 years prior (i.e., Pre, 1984-1987, n = 103 males, 73 females). Post30 had greater waist circumference (males: 83.6 ± 9.1 cm vs. 77.8 ± 8.3 cm, females: 77.1 ± 9.7 cm vs. 70.3 ± 5.2 cm, both p < 0.001) and lower estimated maximal aerobic fitness (males: 55 ± 11 vs. 63 ± 7, females: 45 ± 10 vs. 50 ± 7 mLO₂/kg/min, both, p < 0.001). Compared to Pre, male Post30 vertical jump (53.6 ± 10.2 vs. 57.0 ± 8.4 cm, p = 0.04) and female Post30 broad jump (178.7 ± 22.1 vs. 186.0 ± 15.5 cm, p < 0.001) were lower. A subsample (n = 65) of Post30 whose habitual activity was assessed, met the aerobic portion of Canadian physical activity guidelines (~400 min/week), but spent excessive amounts of time stationary (10.7 h/day). Current kinesiology students may not be immune to population decreases in physical fitness. Relative to previous group of students interested in movement, fitness was lower in our sample, potentially attributed to excessive stationary time. Regular assessment of physical fitness in kinesiology curriculums may be valuable to understand these declining trends in undergraduate students that mimic population declines in fitness.

How should interventions to treat hand oedema be delivered? An online Delphi Consensus Method

Introduction

Hand oedema (swelling) is a common consequence of hand trauma or surgery, but there is little agreement on how interventions to treat hand oedema should be delivered in practice. The purpose of this study was to engage a group of self-identified hand therapy experts to develop consensus on how four commonly used oedema management treatments should be implemented, which could be used in clinical practice or future clinical trials.

Method

A web-based Delphi study was conducted with eight volunteer hand therapists who met the pre-defined eligibility criteria for an 'expert' and were members of the British Association of Hand Therapists (BAHT). An a priori level of agreement was set at 75%. Interventions requiring consensus were decided on as a result of a previous national survey of practice and consisted of compression, elevation, massage and kinesiology tape.

Results

A total of 25 items were discussed across 3 rounds. This ranged from 23 items in round 1, to three items in round 3. In round 1, consensus was reached on 7/23 (30%) items. The required 75% consensus was reached on 14 items in round 2 and 1/3 items achieved consensus in round 3. Massage was the only treatment that required a third round.

Discussion

Consensus was reached on intervention description for three of the four modalities including the materials used (what), method of application including duration and frequency (when and how much) and tailoring or modifications. Two questions relating to massage did not reach the required consensus threshold and a majority agreement was accepted. The small panel size is a limitation and may affect the credibility of the consensus reached.

Participation value of undergraduate students leading STEM outreach: evaluation of academic, personal, and professional effects

This study explores the academic, professional, and personal career benefits of leading science, technology, engineering, and mathematics (STEM) outreach, from the perspective of undergraduate student leaders. We consider traditional and nontraditional STEM university students, gender, and type of position (paid or volunteer) in this evaluation. Data were collected through an online survey completed by 30 former student STEM outreach leaders from the University of British Columbia. Self-reported survey data indicated that STEM outreach had a moderately strong average impact of 6.89 ± 1.55 out of 10 on participants' personal, academic, and professional development, with no significant differences between these areas. Outcomes did not differ between genders, and paid work was found to contribute to greater personal and professional impact. The positive influence of outreach on academic and professional decision making was higher in traditional STEM fields than STEM-based health-science studies. The outcomes of this research adds insight into positive impacts of STEM outreach on university student instructors.

Influence of the Backward Fall Technique on the Sagittal Linear Acceleration of the Head during a Fall

(1) Background: This research aimed to determine the effect of the backward fall technique on the sagittal linear acceleration of the head in students training in different sports. (2) Methods: The study involved 41 students divided into two study groups. Group A included 19 students training in martial arts who practised falls with side aligning of the body. Group B included 22 handball players who practised falls performed in a way similar to a gymnastic backward roll. A rotating training simulator (RTS) was used to force falls, and Wiva ^® Science apparatus was used to assess acceleration. (3) Results: Significant changes in head acceleration were only obtained between immediate fall tests (IFTs) and forced fall tests (FFTs) in group B. Significant differences were noted between groups for the IFT and FFT. Greater changes in head acceleration were noted in group B. (4) Conclusions: Smaller changes in head acceleration in group A students indicate a lower susceptibility to head, pelvic and cervical spine injuries in falls performed backward with side aligning of the body. This technique in group A limited the differences in head acceleration between IFTs and FFTs. Negative acceleration values obtained in group B confirmed that the head may suffer a moment of force, tilting it backwards, but then forward when the buttocks hit the ground.

Faculty perceptions of the exercise science student learning experience during the coronavirus pandemic

Significant disruptions in higher education course delivery occurred during the coronavirus (COVID-19) global pandemic. The implementation of emergency remote teaching (ERT) offered exercise science faculty a safe method to continue educating students in courses generally taught face-to-face. The purpose of this investigation was to explore faculty perceptions of their ERT efforts with respect to student successes, challenges, and faculty expectations. Through an electronic survey, participants (n = 112) from higher education institutions in 31 states and three Canadian provinces provided feedback on their perceptions of the student experience across 315 fall 2020 courses. Data analysis included a thematic analysis to identify themes and trends in participant responses. Faculty identified student adaptability, increased autonomy of learning, and maintenance of learning as successes. Also noted was the increased flexibility of alternative pedagogy methods. Participants perceived student challenges related to technology, time management, and well-being. Faculty perceived students expected increased accommodations and instructor responsiveness during fall 2020. While faculty and students were challenged to adapt during the global pandemic, the perceived ERT experiences during COVID-19 highlight the resiliency of higher education students and underscores changes needed by educational institutions to provide resources and training upon return to traditional education or in response to a future crisis.

Dr. Richard C. Nelson: Respected as the Father of the Japanese Society of Biomechanics

The reasons for the renaming of the Japanese Society of Kinesiology to the Japanese Society of Biomechanics are explained, and the importance of the International Congress of Biomechanics, the International Society of Biomechanics, and Richard Nelson are outlined.

[Efficiency of the application of miorelaxants in lower cross myofascial syndrome]

OBJECTIVE

To evaluate the efficacy of the drug Tolperisone (Calmirex) in patients with inferior cross syndrome against the background of standard therapy.

MATERIAL AND METHODS

The study involved male and female patients aged 25-55 years with inferior cross syndrome. The main research method was clinical, which was supplemented by biomechanical examination and the use of scales and questionnaires (VAS, Oswestry, McGill).

RESULTS AND CONCLUSION

The effectiveness of the use of muscle relaxants in the treatment of the lower cross syndrome has been studied and proved with the identification of the most reliable and effective methods for correcting this pathology. The effectiveness of the use of muscle relaxants in the treatment of lower cross syndrome was studied, with the identification of the most reliable and effective methods for correcting this pathology. The presented clinical study of biomechanical and statodynamic disorders of the musculoskeletal system in myofascial pain syndromes, taking into account the peculiarities of the lesion of the sanogenetic and pathogenetic region, will be useful in prescribing personalized treatment not only for neurologists, but also for primary care physicians, chiropractors, osteopaths, rheumatologists and rehabilitologists.

Sedentary time, physical activity, and serum SPARC in a middle-aged population

The influence of habitual physical activity (PA) on the circulating levels of secreted protein acidic and rich in cysteine (SPARC) remains unclear. The purpose of the current study was to clarify the effects of sedentary time, light-intensity PA (LPA), and moderate- to vigorous-intensity PA (MVPA) on the serum SPARC in a general middle-aged population. The current study is a cross-sectional study of 4,000 men and 6,040 women (40-69 years). Sedentary time, LPA, and MVPA were objectively measured by an accelerometer. The serum SPARC concentration was measured by enzyme-linked immunosorbent assay. Using an isotemporal substitution model, cross-sectional associations of replacing sedentary time with either LPA or MVPA on serum SPARC levels were analysed according to sex. Interactions with subject characteristics, such as the body mass index (BMI), smoking, and alcohol consumption, were also examined. In men, replacing 60 min of sedentary time with 60 min of MVPA was significantly associated with 23 ng/mL lower serum SPARC levels (confidence interval: -43, -2) after adjusting for confounders, including the BMI (P = 0.028). A significant interaction between replacing sedentary behaviour with LPA and the BMI on SPARC was detected in women (P = 0.029), although the stratified associations for each BMI level (<25 or ≥25 kg/m²) did not reach significance. The current study suggests that replacing sedentary time with MVPA is associated with reduced serum SPARC levels in middle-aged men, but not in women. In addition, a potential interaction between LPA and the BMI on SPARC was also found in women.

The Hamstrings: Anatomic and Physiologic Variations and Their Potential Relationships With Injury Risk

The incidence and recurrence of hamstrings injuries are very high in sports, posing elevated performance and financial-related costs. Attempts to identify the risk factors involved in predicting vulnerability to hamstrings injury is important for designing exercise-based programs that aim to mitigate the rate and severity of hamstrings injuries and improve rehabilitation strategies. However, research has shown that non-modifiable risk factors may play a greater role than modifiable risk factors. Recognizing non-modifiable risk factors and understanding their implications will afford the prescription of better suited exercise programs, i.e., that are more respectful of the individual characteristics. In a nutshell, non-modifiable risk factors can still be acted upon, even if indirectly. In this context, an underexplored topic is how intra and inter- individual anatomic and physiologic variations in hamstrings (e.g., muscle bellies, fiber types, tendon length, aponeurosis width, attachment sites, sex- and age-related differences) concur to alter hamstrings injuries risk. Some anatomic and physiologic variations may be modifiable through exercise interventions (e.g., cross-sectional area), while others may not (e.g., supernumerary muscle bellies). This apparent dichotomy may hide a greater complexity, i.e., there may be risk factors that are partially modifiable. Therefore, we explored the available information on the anatomic variations of the hamstrings, providing a deeper insight into the individual risk factors for hamstrings injuries and contributing with better knowledge and potential applications toward a more individualized exercise prescription.

Progression of Fatigue Modifies Primary Contributors to Ground Reaction Forces During Drop Landing

Few studies have focused on the effect of fatigue severity on landing strategy. This study aimed to investigate the effect of fatigue progression on ground reaction force during landing. Eighteen participants performed a fatigue exercise protocol. Then participants performed drop landings at three levels of fatigue: no fatigue, medium fatigue, and severe fatigue. Multiple linear regression was conducted to identify the predictors of the peak vertical ground reaction force at each level of fatigue. Two-way ANOVAs were conducted to test the effect of fatigue on the vertical ground reaction force and the predictors. For the vertical ground reaction force, the knee joint stiffness and the knee angle at initial contact were the main predictors at no fatigue. The peak knee flexion angle and knee power were the main predictors at medium fatigue. However, the peak ankle plantarflexion moments became the main predictor at severe fatigue. The vertical ground reaction force decreased from no to medium fatigue (p = 0.001), and then increased from medium to severe fatigue (p = 0.034). The knee joint stiffness decreased from no to medium fatigue (p = 0.049), and then remained unchanged from medium to severe fatigue. The peak knee flexion angle increased from no to medium fatigue (p = 0.001), and then slightly decreased from medium to severe fatigue (p = 0.051). The results indicate that fatigue progression causes a transition from stiff to soft landing, and then to stiff landing. Participants used ankle joints more to control the landing intensity at severe fatigue.

Effect of Glenohumeral Internal Rotation Deficit on Shoulder in Baseball Pitchers during Fastball Pitching

Previous studies have reported that pitchers with glenohumeral internal rotation deficit (GIRD) may increase the risk of shoulder injury. However, limited information is available regarding the specific effects of GIRD in baseball pitching. The purpose of this study was to investigate whether baseball pitchers with GIRD change their pitching mechanism. Fifteen baseball pitchers with GIRD and 15 pitchers without GIRD were recruited from university or senior high-school teams. A three-dimensional motion analysis system (Eagle System, Motion Analysis Corporation, Santa Rosa, CA, USA) was used to capture the pitching motion while performing fastball pitches. The kinematics and kinetics of the throwing shoulder and trunk were analyzed based on motion captured data. The Mann-Whitney U test was used to test the differences of the analyzed parameters between two groups. At the instant of ball release, the GIRD group showed lower shoulder external rotation and trunk rotation, and larger shoulder horizontal adduction. In addition, the GIRD group exhibited a significantly larger shoulder inferior force in the cocking and acceleration phase, and a significantly larger internal rotation torque in the acceleration phase. The present results suggested that pitchers with GIRD need stretch training to enlarge joint range of motion, and to improve trunk strength and flexibility to alleviate potential problems associated with pitching in GIRD pitchers.

Critical Appraisal of Surface Electromyography (sEMG) as a Taught Subject and Clinical Tool in Medicine and Kinesiology

The characteristics and state of knowledge of bioelectric signals such as ECG, EEG, and EMG are initially discussed. This serves as the basis for exploration of the degree of scholastic coverage and understanding of the level of clinical acceptance of respective bioelectric signal subtypes during the last 60 or so years. The review further proceeds to discuss surface EMG (sEMG). The status of the field in terms of teaching and academic training related to sEMG is examined, and its clinical acceptance in several areas of medicine and kinesiology, including neurology, psychology, psychiatry, physiatry, physical medicine and rehabilitation, biomechanics and motor control, and gnathology, is evaluated. A realistic overview of the clinical utility of the measurement of sEMG signals and their interpretation and usage, as well as of perspectives on its development, are then provided. The main focus is on the state of the field in Croatia. EMG signals are viewed as "windows" into the function of the neuro-muscular system, a complex and hierarchically organized system that controls human body posture and gross body movement. New technical and technological means to enable the detection and measurement of these signals will contribute to increased clinical acceptance, provided current scientific, educational, and financial obstacles can be removed.

Analysis and Biophysics of Surface EMG for Physiotherapists and Kinesiologists: Toward a Common Language With Rehabilitation Engineers

Recent decades have seen a move toward evidence-based medicine to inform the clinical decision-making process with reproducible findings from high-quality research studies. There is a need for objective, quantitative measurement tools to increase the reliability and reproducibility of studies evaluating the efficacy of healthcare interventions, particularly in the field of physical and rehabilitative medicine. Surface electromyography (sEMG) is a non-invasive measure of muscle activity that is widely used in research but is under-utilized as a clinical tool in rehabilitative medicine. Other types of electrophysiological signals (e.g., electrocardiography, electroencephalography, intramuscular EMG) are commonly recorded by healthcare practitioners, however, sEMG has yet to successfully transition to clinical practice. Surface EMG has clear clinical potential as an indicator of muscle activation, however reliable extraction of information requires knowledge of the appropriate methods for recording and analyzing sEMG and an understanding of the underlying biophysics. These concepts are generally not covered in sufficient depth in the standard curriculum for physiotherapists and kinesiologists to encourage a confident use of sEMG in clinical practice. In addition, the common perception of sEMG as a specialized topic means that the clinical potential of sEMG and the pathways to application in practice are often not apparent. The aim of this paper is to address barriers to the translation of sEMG by emphasizing its benefits as an objective clinical tool and by overcoming its perceived complexity. The many useful clinical applications of sEMG are highlighted and examples provided to illustrate how it can be implemented in practice. The paper outlines how fundamental biophysics and EMG signal processing concepts could be presented to a non-technical audience. An accompanying tutorial with sample data and code is provided which could be used as a tool for teaching or self-guided learning. The importance of observing sEMG in routine use in clinic is identified as an essential part of the effective communication of sEMG recording and signal analysis methods. Highlighting the advantages of sEMG as a clinical tool and reducing its perceived complexity could bridge the gap between theoretical knowledge and practical application and provide the impetus for the widespread use of sEMG in clinic.

BioMove: Biometric User Identification from Human Kinesiological Movements for Virtual Reality Systems

Virtual reality (VR) has advanced rapidly and is used for many entertainment and business purposes. The need for secure, transparent and non-intrusive identification mechanisms is important to facilitate users’ safe participation and secure experience. People are kinesiologically unique, having individual behavioral and movement characteristics, which can be leveraged and used in security sensitive VR applications to compensate for users’ inability to detect potential observational attackers in the physical world. Additionally, such method of identification using a user’s kinesiological data is valuable in common scenarios where multiple users simultaneously participate in a VR environment. In this paper, we present a user study (n = 15) where our participants performed a series of controlled tasks that require physical movements (such as grabbing, rotating and dropping) that could be decomposed into unique kinesiological patterns while we monitored and captured their hand, head and eye gaze data within the VR environment. We present an analysis of the data and show that these data can be used as a biometric discriminant of high confidence using machine learning classification methods such as kNN or SVM, thereby adding a layer of security in terms of identification or dynamically adapting the VR environment to the users’ preferences. We also performed a whitebox penetration testing with 12 attackers, some of whom were physically similar to the participants. We could obtain an average identification confidence value of 0.98 from the actual participants’ test data after the initial study and also a trained model classification accuracy of 98.6%. Penetration testing indicated all attackers resulted in confidence values of less than 50% (<50%), although physically similar attackers had higher confidence values. These findings can help the design and development of secure VR systems.

Factors That Influence Participation in Classroom-Based Physical Activity Breaks in Head Start Preschoolers

BACKGROUND

Activity breaks are an established way physical activity may be incorporated into the preschool day. The purpose of this study was to examine what factors influenced moderate to vigorous physical activity (MVPA) during a teacher-implemented classroom-based activity break (CBAB) in a Head Start population.

METHODS

Ten-minute CBAB was conducted over 2 days in a quasi-experimental design; 99 preschoolers (mean age 3.80 [0.65] y; 49.5% male) from a convenience sample participated. Accelerometers measured MVPA, fundamental motor skill competency was assessed using the Test of Gross Motor Development-second edition, and weight classification status used body mass index percentiles.

RESULTS

A significant, moderate regression was found (r = .328, P = .001) between fundamental motor skill and MVPA. There was no significant correlation between body mass index percentile and MVPA during the CBAB. In addition, the locomotor subscale was the best predictor for MVPA for children during the CBAB (r = .32, β = 0.82, P < .001).

CONCLUSIONS

CBAB equally elicited MVPA for normal and overweight preschoolers. Fundamental motor skill competency was associated with MVPA during the CBAB; in particular, locomotor skills were the best predictor for physical activity. Structured activity opportunities that focus on locomotor skills may be a useful integration to prompt more MVPA in a preschool-age population.

Myoelectric Responses of Lower-Body Muscles Performing Squat and Lunge Exercise Variations Adopting Visual Feedback With a Laser Sensor

STUDY DESIGN

Cross-over study.

CONTEXT

The squat, single-leg squat, forward lunge, and reverse lunge are fundamental movements often performed in activities of daily living, sports competitions, and sport-specific training.

OBJECTIVE

The purpose of this study was to investigate the effect of visual feedback with a laser sensor (VFLS) versus a control condition on the myoelectric activity (surface electromyography [sEMG]) of the vastus medialis oblique (VMO), vastus lateralis, gluteus medius (Gmed), and erector spinae muscles during the performance of several squat variations with bodyweight.

METHODS

Nineteen female college students (20 [2.5] y, 165.3 [10.2] cm, 66.4 [4.1] kg, 2 [1.2] y of resistance training experience) with a background in strength or sports training volunteered to participate in this study. Over 4 separate visits, subjects performed 2 sets of 10 repetitions of a squat variation exercise in random order (ie, squat, single-leg squat, forward lunge, and reverse lunge). The first set of a given squat variation condition was considered a control set, and then after 3-minute rest, a second set was performed with VFLS.

RESULTS

Significant decreases in VMO and Gmed myoelectric activity were observed during the VFLS set versus the control set for the forward lunge exercise (P = .03). No differences were observed between the control set and VFLS set in the sEMG normalized signal for all muscles analyzed for the squat and single-leg squat, respectively. However, the sample entropy of the sEMG signal for the erector spinae became more irregular during the VFLS set versus the control set for the squat exercise (P = .01), whereas the Gmed presented a more irregular sEMG signal during the VFLS set versus the control set for the single-leg squat (P = .08).

CONCLUSION

Laser sensor biofeedback may induce significant decreases in VMO and Gmed activation performing forward lunge exercise. Therefore, laser sensor biofeedback may induce a reduction in muscle activity of neutralizers muscles during a few squat bodyweight variations (bilateral, single-leg, forward, and reverse lunge).

Using Physical Activity to Enhance Health Outcomes Across the Life Span

Physical activity has been widely recognized as one of the primary determinants that proliferates positive psychophysiological health in individuals. Despite the numerous benefits of engaging in physical activity, a majority of the global population continues to be physically inactive or sedentary. The aim of this brief commentary is to capture the benefits of engaging in regular physical activity across the life span. In particular, this paper will highlight the benefits of engaging in regular physical activity with respect to age, gender, atypical populations, and lifestyle. Future research and recommendations have also been addressed.

Spike jump biomechanics in male versus female elite volleyball players

There are well-known biological differences between women and men, especially in technical-coordinative variations that contribute to sex differences in performance of complex movements like the most important offensive action in volleyball, the spike jump. The aim of this study was to investigate sex-dependent performance and biomechanical characteristics in the volleyball spike jump. Thirty female and male sub-elite volleyball players were analysed while striking a stationary ball with maximal spike jump height. Twelve MX13 Vicon cameras with a cluster marker set, two AMTI force plates, surface EMG, and a Full-Body 3D model in Visual3D were used. Main findings include sex differences (P< .05) in jump height (pη² = .73), approach [speed (pη² = .61), step length], transition strategy [plant angle, neuromuscular activation (pη² = .91), horizontal force maxima and impulses], acceleration distances [centre of mass displacement (pη² = .21), minimal knee and hip angles], use of torso and arms [incline, angular velocity (pη² = .23)]. Correlations support that the results cannot be explained fully by strength and power differences between sexes but represent the product of technical-coordinative variations. Their relevance is acknowledged for both sexes and numerous performance determinants displayed sex differences. The integration of such attributes into sex-specific training seems promising but its effect requires further investigation.

Impact of Lifting of Two Types of Barrels on Postural Control, Trunk Muscle Recruitment, and Kinematic Measures in Manual Workers

The aim of this study was to evaluate the impact of 2 types of beer barrels on postural control, trunk activation, and kinematic measures in adult workers. Twelve (12) males randomly performed 4 tasks on a force platform for 20 s: (1) hold an empty recyclable barrel, (2) hold a full recyclable barrel (30 L), (3) hold an empty steel barrel, and (4) hold a full steel barrel (30 L). Trunk muscular activation, force platform and kinematic measures at the trunk, hip, and knee joints were computed. The full steel barrel produced greater postural oscillation than other conditions. Higher trunk activity was also reported during the full steel barrel task. Significant kinematic changes only in the trunk were observed between the empty steel barrel and the full recyclable barrel tasks. In conclusion, the full steel barrel produced a negative impact on postural control, increasing trunk activity and changing trunk flexion angle in adult workers.

[The modern trends in the treatment and prevention of lymphedema of the lower extremities]

This article was designed to describe the main pathogenetic factors underlying the development of lymphedema of the lower extremities, the social implications of this condition, its prevalence throughout the world, and the impact of this disease on the quality of life of patients. In addition, the review presents the modern data on the management of patients with chronic lymphatic edema of the lower extremities. Special attention is given to the principles and methods of its combined conservative treatment, including the use of medications, compression therapy, physiotherapy, thalassotherapy, and balneotherapy. Moreover, the results of the analysis of the effectiveness of the treatment as a whole and of the individual methods, such as intermittent pneumatic compression (SPC), electrical myostimulation, laser therapy, magnetic-laser therapy (MLT) are reported with special reference to their outcomes when applied as isolated interventions and the components of the combined therapy. The review is devoted to the systematization of information about the currently available methods for the prevention and treatment of lymphadema of the lower extremities and the evaluation of the treatment regimens applied in this country and leading foreign clinical centres. Also considered are both the classical scheme of the combined treatment of lymphedema of the lower extremities and the schemes including novel therapeutic modalities. The most promising methods for the treatment of this condition including those proposed during a few recent years (such as kinesiotaping, LPG-engineering, and gravity therapy) are highlighted, and their influence on the generally accepted schemes of the combined treatment of lymphedema of the lower extremities is evaluated. The basic principles of modern pharmacotherapy and its role in the system of methods for the treatment of lymphedema of the lower extremities including phlebotomies, lymphokinesia, antibacterial drugs are considered.

Comparison of kinesio taping and occlusal splint in the management of myofascial pain in patients with sleep bruxism

OBJECTIVES

To evaluate the efficacy of Kinesio taping (KT) in patients with sleep bruxism (SB) and to determine whether KT may be an alternative for occlusal splint (OS) for the treatment of SB.

MATERIALS AND METHODS

Sixteen patients with SB were treated with KT (kinesio group) and 18 patients were treated with OS (splint group). Masseter and temporal muscle pressure pain thresholds (MPPT and TPPT), visual analogue scale (VAS) values and mouth opening measurements of patients were compared before treatment, and at the 1st and 5th weeks of treatment.

RESULTS

Both KT and OS treatments significantly reduced muscle pain, decreased VAS values, and increased mouth opening measurements. No statistically significant difference was found between the kinesio and splint groups in terms of MPPT, TPPT, VAS and mouth opening values before treatment and at the 1st and 5th weeks of treatment except for TPPT values at 1st week of treatment where the TPPT values of the kinesio group were significantly higher than the splint group (p< 0.05).

CONCLUSIONS

KT was identified as an easy-to-use treatment method for bruxism and was found to reduce muscle pain and increase mouth opening. KT is at least as effective as OS for the treatment of SB.

Addition of Kinesio Taping of the orbicularis oris muscles to speech therapy rapidly improves drooling in children with neurological disorders

OBJECTIVE

To evaluate the effects of Kinesio Taping (KT) of the orbicularis oris muscles as an adjunct to standard therapy for drooling.

METHODS

Fifteen children with neurological disorders and drooling received speech therapy and twice-weekly KT of the orbicularis muscles over a 30-day period. Drooling was assessed by six parameters: impact on the life of the child and caregiver; severity of drooling; frequency of drooling; drooling volume (estimated by number of bibs used); salivary leak; and interlabial gap. Seven markers of oral motor skills were also assessed.

RESULTS

KT of the orbicularis oris region reduced the interlabial gap. All oral motor skills and almost all markers of drooling improved after 15 days of treatment.

CONCLUSION

In this sample of children with neurological disorders, adding KT of the orbicularis oris muscles to speech therapy caused rapid improvement in oral motor skills and drooling.

The influence of hip mobility and quadriceps fatigue on sagittal spinal posture and muscle activation in rugby scrum performance

Rugby Union scrumming puts the spine under a high degree of loading. The aim of the current study was to determine how sagittal hip range of motion and quadriceps fatigue influence force output, spinal posture, and activation of the trunk and quadriceps muscles in rugby scrumming. Measures of sagittal hip flexion/extension range of motion were collected from 16 male varsity and club first XV level participants. Sagittal spine motion (electromagnetic motion capture), trunk and quadriceps activation (electromyography), and applied horizontal compressive force (force plate) were measured during individual machine scrumming. Participants performed a 5-trial scrum block involving 5 s of contact with 1-2 min recovery between each trial. They then performed a fatiguing protocol (wall sit to failure) and immediately returned to the scrum machine to perform another five trials. Though there was no significant influence of fatigue on the horizontal compressive force applied during contact (P = .83), there was a 52% increase in cervical flexion (P < .001), as well as decreased (18-23% lower) abdominal and erector spinae muscle activation (P < .05). Furthermore, quadriceps activation decreased (12-25% lower) over the course of the initial scrum block but increased (13-15% higher) in the post fatigue block (P < .05). Although athletes were able to maintain force output following the fatiguing wall sit task, there is the potential that they may be at an increased risk of spinal injury due to the combination of increased flexion and high-applied compressive force; a combination which has been shown to increase the likelihood of intervertebral disc herniation.

Effect of exercise order with barbell and machine modalities on upper body volume load and myoelectric activity

The purpose of this study was to investigate the influence of exercise order on volume load (VL) and myoelectric activation (EMG) during the bench press (BP), military press (MP) and close-grip bench press (CGBP) exercises executed with a barbell and Smith machine. Twelve men experienced in resistance training performed four different exercise sessions in randomised order. Each session consisted of four sets of a given exercise order: O1 = CGBP + MP + BP with barbell; O2 = inverse O1 with barbell, O3 = same O1 with Smith Machine; O4 = same O2 with Smith machine. EMG was assessed for the Clavicular head pectoralis major (PMC), anterior deltoid (AD), triceps brachii long head (TBLH) and biceps brachii (BB). Results showed that VL in BP was affected by exercise order, independent of the mode (p < 0.05). However, the CGBP showed higher VL in O1. Moreover, when the BP was positioned last in the sequence (O1 and O3), myoelectric activity was higher for PMC, AD and TBLH (p < 0.05). Findings were similar in the CGBP (PMC and TBLH), but for the AD (Smith machine > barbell, p < 0.05). Therefore, it appears that the order and modes of exercises influence both volume load and myoelectric activation patterns during multiple set of resistance training.

From the Editors: A Guide for Peer Review in the Field of Exercise Science

Since its inception, the mission of the International Journal of Exercise Science (IJES) has been to engage student researchers, to provide an outlet for peer-review and possible publication of their work, and to grant an opportunity for them to gain experience as peer-reviewers. The Editors of IJES take pride in providing these opportunities for student involvement, and we are constantly seeking new and innovative ways to enhance students' professional development. As our readership has expanded across the globe and our scope has broadened to cross many Kinesiology related disciplines, we believe it is timely to revisit the purpose of peer-review, give advice on best practices, and provide a template for reviews. Presenting these guiding principles should simplify and streamline both the review and the revision processes for students and professionals alike.

Kinesiology taping reduces the pain of finger osteoarthritis: a pilot single-blinded two-group parallel randomized trial

Objectives

Osteoarthritis (OA) is the most common arthropathy of the hand, and current treatments carry risks of adverse events. Supportive (kinesiology) tape may be analgesic and provide functional improvement, with a low risk of adverse outcomes. We experimented with supportive tape for OA of the proximal interphalangeal joint (PIPJ) of the finger in this pilot randomized trial.

Methods

This two-group parallel randomized trial recruited adults with OA of the PIPJ of the finger. We excluded patients lacking capacity or the ability to safely apply the tape. Participants were randomized to receive kinesiology tape on the dorsum of the finger, blind to grouping. Pain was the primary outcome, which was recorded on a visual analog scale (VAS). Secondary outcomes were hand function and adverse reactions. Bootstrapped between-group analyses are reported.

Results

Ten patients were included and randomized and provided complete data. There was no significant difference in pain between the groups (mean difference of 0.4 VAS units [95% confidence interval {CI} –1.6, 0.7], p=0.4). Overall, the application of kinesiology tape reduced reported pain by 6% (mean reduction of 0.6 VAS units [95% CI 0, 1.2], p=0.04). Taping did not affect hand function or digital range of motion. There were difficulties in recruiting individuals owing to the lack of dedicated research staff.

Conclusion

Kinesiology taping may reduce the pain of OA in the finger; however, whether this is a true effect, placebo effect, Hawthorne phenomenon, or due to a statistical error (ie, type 1 error due to underpowering) is unclear. Hence, further trials are required.

Visual-Motor Control of Drop Landing After Anterior Cruciate Ligament Reconstruction

CONTEXT

  Visual feedback is crucial in the control of human movement. When vision is obstructed, alterations in landing neuromuscular control may increase movements that place individuals at risk for injury. Anterior cruciate ligament (ACL) injury may further alter the motor-control response to alterations in visual feedback. The development of stroboscopic glasses that disrupt visual feedback without fully obscuring it has enabled researchers to assess visual-motor control during movements that simulate the dynamic demands of athletic activity.

OBJECTIVE

  To investigate the effect of stroboscopic visual-feedback disruption (SVFD) on drop vertical-jump landing mechanics and to determine whether injury history influenced the effect.

DESIGN

  Cohort study.

SETTING

  Movement-analysis laboratory.

PATIENTS OR OTHER PARTICIPANTS

  A total of 15 participants with ACL reconstruction (ACLR; 7 men, 8 women; age = 21.41 ± 2.60 years, height = 1.72 ± 0.09 m, mass = 69.24 ± 15.24 kg, Tegner Activity Scale score = 7.30 ± 1.30, time since surgery = 36.18 ± 26.50 months, hamstrings grafts = 13, patellar tendon grafts = 2) and 15 matched healthy control participants (7 men, 8 women; age = 23.15 ± 3.48 years, height = 1.73 ± 0.09 m, mass = 69.98 ± 14.83 kg, Tegner Activity Scale score = 6.77 ± 1.48).

INTERVENTION(S)

  Drop vertical-jump landings under normal and SVFD conditions.

MAIN OUTCOME MEASURE(S)

  The SVFD effect for knee sagittal- and frontal-plane excursions, peak moments, and vertical ground reaction force were calculated during landing and compared with previously established measurement error and between groups.

RESULTS

  The SVFD altered knee sagittal-plane excursion (4.04° ± 2.20°, P = .048) and frontal-plane excursion (1.98° ± 1.53°, P = .001) during landing above within-session measurement error. Joint-moment difference scores from full vision to the SVFD condition were not greater than within-session error. We observed an effect of ACLR history only for knee flexion (ACLR group = 3.12° ± 3.76°, control group = -0.84° ± 4.45°; P = .001). We did not observe an effect of side or sex.

CONCLUSIONS

  The SVFD altered sagittal- and frontal-plane landing knee kinematics but did not alter moments. Anterior cruciate ligament reconstruction may induce alterations in sagittal-plane visual-motor control of the knee. The group SVFD effect was on a level similar to that of an in-flight perturbation, motor-learning intervention, or plyometric-training program, indicating that visual-motor ability may contribute to knee neuromuscular control on a clinically important level. The individual effects of the SVFD indicated possible unique sensorimotor versus visual-motor movement strategies during landing.

Ultrasound Assessment of the Transverse Abdominis During Functional Movement

OBJECTIVES

The traditional activation ratio divides contracted muscle thickness by resting muscle thickness while an abdominal draw-in maneuver is performed during hook lying. Ultrasound imaging during function, such as standing or gait, or peak knee flexion in a single-leg squat allows for further visualization of muscle activity. The goal of this study was to examine activation ratio calculations for transverse abdominis function in supine versus loaded conditions to determine the most informative normalization strategy for muscle activity based on thickness values.

METHODS

Transverse abdominis thickness was measured via ultrasound in 35 healthy participants under 4 different conditions. Comparisons were made between the traditional activation ratio tabletop, standing activation ratio (standing abdominal draw-in maneuver thickness/quiet standing thickness), and functional activation ratio (single-leg squat thickness/quiet standing thickness). Additionally, a cued activation ratio (single-leg squat with cued abdominal draw-in maneuver thickness/single-leg squat thickness) during the single-leg squat was obtained. Activation ratios of greater than 1.0 indicated that participants could activate the muscle during activity, and values were compared by analysis of variance.

RESULTS

The participants included 23 women and 12 men with a mean age ± SD of 21.3 ± 2.7 years, mass of 66.1 ± 14.4 kg, and height of 168.5 ± 10.1 cm. Activation ratios exceeded 1.0 in 94.3% for the traditional activation ratio, 85.7% for the standing activation ratio, 82.9% for the cued activation ratio, and 82.9% for the functional activation ratio. With groups defined as tabletop activated or not, the standing, cued, and functional activation ratios were all significantly different (all P < .05).

CONCLUSIONS

Normalizing muscle thickness to the corresponding functional position quiet value provides a useful functional activation ratio and may help clinicians better understand the transverse abdominis role during complex functional tasks. Assessment techniques using various formulas for activation ratios reveal that the muscle functions differently during weight bearing compared to traditional measures.

Biomechanical insights into the determinants of speed in the fencing lunge

For fencing, speed of the lunge is considered critical to success. The aim of this study is to investigate determinants of lunge speed based on biomechanics. Ground reaction force (GRF) and three-dimensional kinematic data were collected from 7 elite fencers and 12 intermediate-level fencers performing maximum-effort lunges. The results showed that elite fencers acquired a higher horizontal peak velocity of the centre of gravity (HPV) and concomitantly a higher horizontal peak GRF exerted by rear leg (PGRF) than intermediate-level fencers (P < .01). Studying the affecting factors, elite fencers obtained higher joint peak power, joint peak moment, and range of motion of rear knee than intermediate-level fencers (P < .05) during the lunge, and these parameters were significantly correlated with both HPV and PGRF (P < .05). Both elite and intermediate-level fencers had joint flexion before the extension in forward knee; however, the latter showed greater flexion, higher peak angular velocity and less time for extension compared to the former (P ≤ .05). Our findings suggest that training aimed at enhancing strength and power of rear knee extensors is important for fencers to improve speed of the lunge. Also, increasing the extension of rear knee during the lunge, at the same time decreasing the flexion of the forward knee before extension are positive for lunge performance.

The Relationship of Static Tibial Tubercle-Trochlear Groove Measurement and Dynamic Patellar Tracking

BACKGROUND

The tibial tubercle to trochlear groove (TT-TG) distance is used for screening patients with a variety of patellofemoral joint disorders to determine who may benefit from patellar medialization using a tibial tubercle osteotomy. Clinically, the TT-TG distance is predominately based on static imaging with the knee in full extension; however, the predictive ability of this measure for dynamic patellar tracking patterns is unknown.

PURPOSE

To determine whether the static TT-TG distance can predict dynamic lateral displacement of the patella.

STUDY DESIGN

Cohort study (Diagnosis); Level of evidence, 2.

METHODS

The static TT-TG distance was measured at full extension for 70 skeletally mature subjects with (n = 32) and without (n = 38) patellofemoral pain. The dynamic patellar tracking patterns were assessed from approximately 45° to 0° of knee flexion by use of dynamic cine-phase contrast magnetic resonance imaging. For each subject, the value of dynamic lateral tracking corresponding to the exact knee angle measured in the static images for that subject was identified. Linear regression analysis determined the predictive ability of static TT-TG distance for dynamic patellar lateral displacement for each cohort.

RESULTS

The static TT-TG distance measured with the knee in full extension cannot accurately predict dynamic lateral displacement of the patella. There was weak predictive ability among subjects with patellofemoral pain ( r² = 0.18, P = .02) and no predictive capability among controls. Among subjects with patellofemoral pain and static TT-TG distances 15 mm or more, 8 of 13 subjects (62%) demonstrated neutral or medial patellar tracking patterns.

CONCLUSION

The static TT-TG distance cannot accurately predict dynamic lateral displacement of the patella. A large percentage of patients with patellofemoral pain and pathologically large TT-TG distances may have neutral to medial maltracking patterns.

Survey of kinesiologists' functional capacity evaluation practice in Canada

BACKGROUND

In Canada, functional capacity evaluations (FCEs) are commonly administered by several health care professions including kinesiologists. Kinesiologists have been recently regulated as health care professionals in Ontario and we know little about their demographics, the frequency of FCE administration, or the types of FCEs used by this group.

OBJECTIVE

The purposes of this study were to identify: 1) the demographic characteristics and FCE education of kinesiology FCE practitioners; 2) the FCE systems most used by these practitioners and 3) the constructs from assessments used to determine functional capacity.

METHODS

A survey was distributed to members of the Canadian Kinesiology Alliance. Descriptive statistics and frequency distributions were calculated from the survey responses (n = 77).

RESULTS

FCE practitioners were represented by kinesiologists (79%) practicing more than 15 years and 1-5 years, who received FCE training from a certification course. ARCON (23%) was the most common FCE system used. Low-level lifting (43%), mid-lift (38%), pulling (38%) and walking (38%) are the most common FCE task components used to assess functional capacity. Although kinesiologists consider multiple factors when making decisions about task component endpoints, biomechanical observations/body mechanics are the primary methods used.

CONCLUSIONS

Kinesiologists are conducting FCEs for the primary purpose of preparing return-to-work or workplace accommodation recommendations. Although functional capacity is determined using multiple factors, there is an emphasis on biomechanics and body mechanics. Focusing FCE training and research on these constructs may provide opportunities to further strengthen the reliability and validity of FCE outcomes.

Performance on the Functional Movement Screen Is Related to Hop Performance But Not to Hip and Knee Strength in Collegiate Football Players

OBJECTIVE

To define the relationship between Functional Movement Screen (FMS) scores and hop performance, hip strength, and knee strength in collegiate football players.

DESIGN

Cross-sectional cohort.

PARTICIPANTS

Freshmen of a Division I collegiate American football team (n = 59).

MAIN OUTCOME MEASURES

The athletes performed the FMS, and also a variety of hop tests, isokinetic knee strength, and isometric hip strength tasks. We recorded total FMS score, peak strength, and hop performance, and we calculated asymmetries between legs on the different tasks. Spearman correlation coefficients quantified the relationships between these measures, and χ analyses compared the number of athletes with asymmetries on the different tasks.

RESULTS

We observed significant correlations (r = 0.38-0.56, P ≤ 0.02) between FMS scores and hop distance but not between FMS scores and hip or knee strength (all P ≥ 0.21). The amount of asymmetry on the FMS test was significantly correlated to the amount of asymmetry on the timed 6-m hop (r = 0.44, P < 0.01) but not to hip or knee strength asymmetries between limbs (all P ≥ 0.34).

CONCLUSIONS

Functional Movement Screen score was positively correlated to hop distance, and limb asymmetry in FMS tasks was correlated to limb asymmetry in 6-m hop time in football players. No significant correlations were observed between FMS score and hip and knee strength or between FMS asymmetry and asymmetries in hip and knee strength between limbs. These results indicate that a simple hop for distance test may be a time-efficient and cost-efficient alternative to FMS testing in athletes and that functional asymmetries between limbs do not coincide with strength asymmetries.

Genetic characterization of physical activity behaviours in university students enrolled in kinesiology degree programs

Studies of physical activity behaviours have increasingly shown the importance of heritable factors such as genetic variation. Nonsynonymous polymorphisms of alpha-actinin 3 (ACTN3) and the β-adrenergic receptors 1 and 3 (ADRB1 and ADRB3) have been previously associated with exercise capacity and cardiometabolic health. We thus hypothesized that these polymorphisms are also related to physical activity behaviours in young adults. To test this hypothesis we examined relationships between ACTN3 (R577X), ARDB1 (Arg389Gly), ADRB3 (Trp64Arg), and physical activity behaviours in university students. We stratified for student enrollment in kinesiology degree programs compared with nonmajors as we previously found this to be a predictor of physical activity. We did not identify novel associations between physical activity and ACTN3. However, the minor alleles of ADRB1 and ADRB3 were significantly underrepresented in kinesiology students compared with nonmajors. Furthermore, carriers of the ADRB1 minor allele reported reduced participation in moderate physical activity and increased afternoon fatigue compared with ancestral allele homozygotes. Together, these findings suggest that the heritability of physical activity behaviours in young adults may be linked to nonsynonymous polymorphisms within β-adrenergic receptors.