The objective of this dissertation was to understand how individuals post-ACLr reduce sagittal plane knee loading in the surgical limb in the absence of observable deficits in gait during early ...rehabilitation. Currently, quantification of reduced extensor moments using standard inverse dynamics equations provides limited information regarding the contributions of specific muscles to knee joint loading as the result of these calculations is a net joint moment (NJM). It is conceivable that increased hamstring activity would contribute to an underestimation of knee extensor loading in the surgical limb during loading response. Appropriate interpretation of net knee moments is needed to guide the goals of gait interventions to either focus on increasing knee extensor loading or to reduce quadriceps hamstring co-contraction. Therefore, the primary objective of Chapter III was to investigate lower extremity muscle contributions underlying sagittal plane knee moments during gait in individuals following ACL reconstruction and healthy controls. Eighteen individuals 111 ± 17 days post-ACLr and eighteen age-, sex-, height-, and weight-matched healthy controls walked at 1.4 m/s. Knee flexion range of motion, net knee extensor moment impulse, quadriceps and hamstring activity, and co-contraction during loading response were identified. A hybrid lower extremity musculoskeletal model estimated knee flexor moments from joint kinematics and hamstring EMG. Knee flexor moments were then scaled based on hamstring strength for each participant. Knee extensor moments were estimated from the sum of net knee and knee flexor moments; extensor moment impulses were calculated during loading response. Separate 2x2 (group by limb) repeated measures ANOVAs were performed; paired and independent t-tests for post hoc testing. An exploratory sub-analysis (n=13) was performed to assess if disruption of the knee extensor mechanism during surgery influenced neuromuscular control. Consistent with previous literature, deficits in knee mechanics were observed in the surgical limb compared to the non-surgical limb and healthy controls. Additionally, relative increases in activity of both quadriceps and hamstrings in the surgical limb resulted in no differences in co-contraction ratio between groups and limbs. When accounting for the torque-producing capabilities of the knee flexors, estimated knee extensor moment impulse remained reduced in the surgical limb. This study is the first to investigate the underlying control associated with reduced knee extensor moments during loading response of gait post-ACLr. These data support the interpretation of reduced extensor moments as an underloading of the knee extensors in the sagittal plane during gait and support rehabilitation programs that target knee extensor moment deficits in early rehabilitation. Thus, the primary objective of Chapter IV was to investigate the mechanics underlying reduced knee extensor moments by determining the strongest predictor of knee extensor moment asymmetries during gait following ACLr from between limb asymmetries in knee flexion range of motion, ground reaction forces, and shank angular velocity. Thirty individuals 108 ± 17 days post-ACLr walked at a self-selected speed. Paired t-tests compared limbs; Pearson's correlations determined associations between variables in surgical and non-surgical limbs; and stepwise linear regression determined the best predictor of knee extensor moment asymmetries during gait. Reduced vertical and posterior ground reaction forces and shank angular velocity were strongly associated with reduced knee loading in both limbs. Less knee flexion range of motion was associated with reduced knee loading only in the surgical limb. Additionally, deficits in posterior ground reaction force and knee flexion range of motion underlie knee loading asymmetries during gait, predicting almost half of the variance. The development of gait interventions targeted at modifying posterior ground reaction forces and knee flexion may be beneficial to help restore gait mechanics in this population. As about 50% of the variance in knee loading asymmetries remained unexplained, individuals post-ACLr likely utilize additional strategies that underlie reductions in knee extensor moments in the surgical limb. In the absence of observable gait deviations, it is conceivable that subtle adjustments in whole body mechanics, particularly during a time of double limb support, are present and help to reduce knee loading. The primary objective of Chapter V was to characterize whole body mechanics in individuals following ACL reconstruction during gait. Twenty individuals 112 ± 17 days post-ACLr walked without observable gait deviations at 1.4 m/s. Vector coding techniques were used to quantify inter-plane coordination in COM velocity and GRF during loading response into categories: in-phase, anti-phase, vertical phase, and anteroposterior phase. Paired t- tests compared peaks between limbs; non-parametric Wilcoxon signed-rank tests compared frequency of coordination patterns. Reductions in knee mechanics, posterior GRF, and anterior COM velocity were observed in the surgical limb. Additional alterations in COM velocity and GRF coordination may allow individuals to compensate for whole body control while maintaining forward progression during gait. (Abstract shortened by ProQuest.)
The aim of this study was to examine the time to task failure for two different fatiguing tasks (force vs. position task) on elbow flexion exercise, in order to explore potential mechanisms of muscle ...fatigue. Twenty healthy and recreationally active individuals (10 men and 10 women) participated in this 3-visit investigation. At least 48 hours after the first visit as the familiarization, the subject returned for one of the experimental visits (order randomized). During the force task visit, the subject performed maximal voluntary contractions (MVCs), several submaximal trapezoid isometric contractions with different intensities (40% and 70% of MVC), and followed by ample rest and the time to failure task. For the position task visit, similar tests were conducted, but only with the position task setup. A minimum of 48 hours of rest was provided between visits. A paired samples t -test was used to compare the maximal force values. A two-way repeated measures (sex Men vs. Women × condition Force task vs. Position task) analysis of variance (ANOVA) was used to examine the time to task failure between two tasks. In addition, separate three-way mixed factorial (sex × condition × time) ANOVAs and three-way mixed factorial (sex × condition × intensity) ANOVAs were used to examine EMG parameters during the isometric fatiguing contractions and submaximal trapezoid contractions, respectively. There was no significant difference in time to task failure between two tasks, however, the time to task failure for men was significantly longer than women. In addition, the normalized EMG amplitude values of biceps brachii and triceps brachii for women were significantly higher than for men during the fatiguing contractions, and the normalized EMG median frequency value of triceps brachii for force task was significantly higher than the position task. In conclusion, during the fatiguing contractions, the muscle activities of women’s angonist and antagonist increased quicker than those of men’s, which led to a briefer time to task failure for women. Although no difference in time to task failure was found between tasks, motor control strategies for the antagonist muscle seem to be different.
Students who choose to pursue degrees in nutrition have been noted as having an elevated risk for developing disordered eating practices (Houston, 2008). Perhaps this is due to having a ...hyper-awareness of "correct" eating behaviors and thus attempting to meet the standards of their future profession. Orthorexia Nervosa is a particularly troubling pattern of behavior characterized by a fixation on eating healthy food, or an obsession with proper nutrition (Bratman, 2000). The purpose of this study was to determine if students at a university majoring in nutrition differed from students with health and non-health majors, with respect to disordered eating behaviors and Orthorexia. The hypothesis was that nutrition students would report more disordered eating and Orthorexic practices than health and non-health students. In a cross-sectional design, 49 nutrition students, 85 health students and 45 non-health students completed the ORTO-15, Eating Pathology Symptoms Inventory (EPSI) and Eating Habits Questionnaire (EHQ). Results showed there were no significant differences between nutrition students and other students on measures used to evaluate Orthorexia (EHQ and ORTO-15). Nutrition students did, however, indicate significantly higher levels of binge eating, cognitive restraint, excessive exercise, negative attitudes toward obesity and muscle building. Nutrition students, also exhibit disordered eating behaviors more than other students. Future research is warranted to identify stronger measures and additional constructs for Orthorexia Nervosa.
Context: Much Research has been done to study what muscles best support the medial longitudinal arch (MLA). However these studies look at intrinsic or extrinsic muscles individually rather than ...comparing their effects at support of the MLA in a static stance. Researchers have yet to examine the changes to the MLA in the gait cycle rather than just looking at it from a static point of view. Objective: To study the effectiveness of two strengthening protocols for supporting the medial longitudinal arch during stance and gait. Design: Single-blinded, randomized control trial. Setting: Testing was completed in two athletic training facilities. Patients or Other Participants: A total of 24 recreationally active patients (14 females, 10 males) participated. Interventions: Individual strengthening protocols for intrinsic and extrinsic muscles respectively.Main Outcome Measure(s): Static measurements of navicular drop.Dynamic measurement of plantar pressure measuring contact area in square centimeters of the midfoot. To compare the effects of the intervention, two, one-way ANOVAs were used to compare change scores for the 3 intervention groups. Results: A significant difference between groups was found for the change in navicular drop (p=0.001), but not plantar pressure area (p=0.37). Post hoc comparisons for the change in navicular drop revealed a significant difference between the extrinsic and control group (p=0.001, effect size=2.15, 95% CI=0.92 to 3.38) and the extrinsic and intrinsic group (p=0.03, effect size=1.31, 95% CI=0.23 to 2.39), but no difference between the control and intrinsic group (p=0.31). Conclusions: These results appear to demonstrate that extrinsic muscles of the foot have a greater effect in support of the medial longitudinal arch during static stance. However, when dynamic measurements of plantar pressures were measured, there were no significant results noted for either intervention group. These results suggest that static standing exercises have no effect on dynamic support on the medial longitudinal arch of the foot. This can lead to future research to study what specifically causes dynamic changes of foot posture to occur.
More than 160 million US adults aged 20 years and older are overweight or obese. The greatest increase in the prevalence of overweight and obesity has occurred among young adults aged 18 to 29 years. ...College students represent a subpopulation at a higher risk for excess weight gain, which is often perpetuated by daily health behaviors, particularly, how time is spent in sleep, sedentary time (SED), and physically active behaviors. This study applied a novel isotemporal substitution model approach to investigate how reallocating time spent in SED activities to sleep and physically active behaviors influenced body mass index (BMI). College-age (20.1±1.5 years) students (n=1,533) of normal weight ( (BMI=24.4±4.7 kg/m2) provided self-reported BMI (height and weight), sleep, SED, and physical activity data anonymously through an online survey. Sleep and physical activity (SED and physically active behaviors) were assessed via the Pittsburgh Sleep Quality Index and International Physical Activity questionnaires. Sleep (r=-.070) and moderate-to-vigorous intensity physical activity (MVPA) (r=-.068) behaviors were weakly but significantly associated with BMI (all P<.05). SED (r=.043) and light-intensity-physical activity (LPA) (r=-.014) behaviors were not associated with BMI (all P>.05). In both the single and partition models, sleep (B=-.223 and B=-.238) and MVPA (B= -.333 and B=-.348) were inversely associated with BMI (all P<.05). Among the total sample (BMI: 24.4±4.7 kg/m2), reallocating 60-min of SED behavior with sleep (B=-.277, 95% CIs: -.461, -.093) or MVPA (B=-.386, 95% CIs: -.635, -.147) resulted in small but significant reductions in BMI. When limited to individuals with overweight and obesity (n=543, BMI: 29.2±4.3 kg/m2), reallocating 60-min of SED behavior with sleep (B=-.384, 95% CIs: -.667, -.108) or MVPA (B = -.796, 95% CIs: -1.15, -.436) resulted in small to large reductions in BMI, with the greatest effect coming from MVPA in overweight/obese individuals, was inversely associated with a lower BMI. Reallocating 60-min of sedentary time with sleep or MVPA produced favorable effects on BMI among college students. Reductions in BMI were greater among overweight and obese individuals, especially when SED was replaced with 60-min of MVPA.
Elite athletes are mentally focus and stable during their performance through constantly trained and their skills become automatic stage and automaticity. Long-term and systematic concentration ...training can help athletes maintain their focus during competition. The purpose of this study was to examine the effect of focus training which assists by BrainLink wearable brain wave device on golf putting’s concentration and performance. Participants were 30 golf participants (17 males and 13 females). The experiment of this study was a single group pre-post test design. Participants were attended a four-week focus training. Participants’ 10 times putting performance and their brain waves during putting were recorded. The results of pair-t test indicated that participants post-test of golf putting performance significantly better than their pre-test performance. The results of this study conclude that focus training by using simple brain Device such as BrianLink can improve the golf putting concentration and perform
PURPOSE: To determine Nebraska's population of cancer survivors’ accessibility to exercise programs designed exclusively for their needs as well as general exercise facilities with potential to offer ...such programs. METHODS: Geographic Information Science (GIScience) was used to analyze spatial relationships between cancer survivors and nearest exercise program designed for their needs and nearest general fitness facility in a metropolitan statistical area (MSA) or micropolitan statistical area (μSA) based upon U.S. Census Bureau’s Core Based Statistical Area definitions for 2013 and the balance, rural. FINDINGS: Approximately 59%, 19%, and 22% of survivors respectively, resided in counties designated as MSA, μSA, or rural. Survivors living in an MSA had a mean distance of 16.1 ± 28.8 miles from the nearest exercise program and 3.2 ± 5.2 miles from the nearest exercise facility. Survivors living in an μSA had a mean distance of 149.3 ± 113.7 miles to the nearest exercise program for cancer survivors and 6.4 ± 8.4 miles to the nearest exercise facility. Rural survivors had a mean distance of 164.6 ± 115.7 miles from an exercise program and 24.9 ± 19.5 miles from the nearest exercise facility. CONCLUSION: Exercise facilities are accessible to cancer survivors throughout Nebraska, however, exercise programs for cancer survivors are not located within reasonable distances to rural survivors. Further trainings for fitness and health professionals in exercise and cancer survivorship may yield greater access across the state.
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by high levels of inflammation, pain, disability, and pre-mature mortality. RA places a significant burden on individuals and ...the healthcare system as people with RA are more likely to be disabled. Unfavourable changes in energy metabolism and body composition may contribute substantially to the disability and poor health-related quality of life associated with RA.The purpose of this project was to conduct a pilot trial exploring the feasibility and safety of a 12-week progressive resistance training program (PRT) on physical function in RA. A secondary objective was to explore potential mechanisms associated with changes in physical function including energy metabolism, body composition, and muscle strength. It was hypothesized that the 12-week program would result in improved physical function, body composition, muscle strength, and energy metabolism. Eighteen participants with RA (17 females, mean (SD) age 38 (19) years, weight of 65.1 (8.4) kg, RA duration of 8 (5) years) were included in this study. All were sedentary, under the care of a rheumatologist and had received clearance to exercise. At baseline, participants provided sociodemographic information and completed validated questionnaires assessing perceived physical function/disability (i.e., PROMIS-4a, MDHAQ, RA-FQ Physical Function). They also completed questionnaires that assessed disease activity (RAPID3 and RA-FQ), exercise self-efficacy, physical activity enjoyment, and daily physical activity. Participants also underwent tests assessing resting energy expenditure assessment (REE), body composition (dual energy x-ray absorptiometry), and physical function tests (Short Performance Physical Battery, 400-m walk, muscle strength). Participants were randomized to 12 weeks of either a resistance training + flexibility PRT+FLEX); or flexibility (FLEX). The PRF+FLEX group completed two supervised workouts using resistance training equipment and range of motion (FLEX) exercises, and one home-based workout per week using elastic resistance bands. The FLEX group completed the same range of motion (FLEX) exercises at home. Repeated measures ANOVA revealed statistically significant interaction effects in body fat percentage (p = .010), fat-mass index (p = .017), RA-FQ Physical Function (p = .002), RA-FQ disease activity (p = .002), RAPID3 (p = .002), and physical activity enjoyment (p = .026) that favoured the PRT+FLEX over the FLEX group. Additionally, there was an effect of time for appendicular lean mass (p = .028), lower body lean mass (p = .030), PROMIS-4a (p = .002), MDHAQ (p = .005), 400-m walk (p = .002), knee flexion strength (p = .008) and REE (p = .014) with the PRT+FLEX group improving more than the FLEX group. There was no between group differences for total body mass, bone mass, lean mass, SPPB, visceral fat, number of cachectic participants, knee extension strength, exercise self-efficacy, and daily physical activity. The findings of this study suggest that a 12-week resistance exercise program is feasible, safe, and enjoyable in people with RA and can improve physical function, body composition, and muscle strength.
Older adults are at a high risk for falls and diseases that can be prevented or controlled by achieving the recommended daily amounts of activity as outlined by the U.S. Department of Health and ...Human Services (2008). Despite this knowledge, older adults continue to be the least active demographic in the United States, not only placing them at higher risk for disease, but increased risk of falls and decreases in quality of life (Bean, Vora, & Frontera, 2004; Nelson, Rejeski, Blair, Duncan & Judge, 2007). The objective for this project was to implement a modified martial arts program for older adults over the age of 60, and determine its impact on physical performance measures and self-efficacy. Testing the working hypothesis that participating in a modified martial arts program increased strength, endurance, balance and self-efficacy of adults over the age of 60 achieved this aim. The approach to testing this hypothesis was to conduct a pre-post intervention study, where participants over the age of 60 were tested on the Sit to Stand, 8-foot Up and Go, Arm Curl, 4-point Balance Scale and Self-efficacy for Exercise Scale (SEE) before and after a 12-week modified martial arts program. The rationale of this research was based on preliminary findings that strongly suggested that martial arts programs have positive effects on participants, but studies had not fully addressed older populations or the modifications needed to make older adult training more effective. New findings in this regard provided further evidence of the effectiveness of a modified martial arts program in increasing the muscle strength, muscle endurance, balance and self-efficacy in adults over the age of 60. This project is significant in that it identified the extent to which martial arts training could be a safe, effective and engaging exercise opportunity, thereby encouraging greater participation in physical activity among older adults.
Context: Chronic onset of sacroiliac joint dysfunction (SIJD) is increasing in adolescent athletic populations including soccer. However, there is currently no pre-season screening tool for SIJD in ...this population. There are variables that are currently associated with SIJD, however, it is unknown if these variables developed into a screening tool can accurately predict the risk of sustaining SIJD. Objective: The purpose of this study was to create an effective screening tool for SIJD in adolescent soccer athletes and establish predictive values for SIJD injury risk. Design: A retrospective exploratory study to screen for risk factors contributing to SIJD in the adolescent soccer athletes. Setting: The testing took place in an athletic training facility at a mid-Atlantic high school. Only one clinician administered the testing procedures. Patients or other participants: This study included members of the varsity and junior varsity boys’ (n = 6, 16.33±1.37 yrs, 176.50±6.98 cm, 72.12±9.92 kg) and girls’ (n = 14, 16.00±1.11 yrs, 165.93±6.39 cm, 61.11±6.92 kg) soccer teams from one high school in north central West Virginia. All participants were members of these teams with a sports physical on file. Inclusion criteria included those subjects who are healthy, have no disorders affecting ability to perform any of the tests included in this study, no history of acute injury to the lower extremity or back in the past six months, and no history of surgeries to the core or back within the past year. Exclusion criteria included subjects who have a history of surgery to the core or back within the past year, and those who have a disorder affecting ability to perform any of the tests included in this study. Interventions: Each participant performed during one testing session the Functional Movement Screen (FMS), including all 7 functional movements and the 3 clearing tests, active knee extension test, Palpation Meter (PALM) measurement for pelvic angle, and goniometry assessment of active hip range of motion (flexion/extension/abduction/adduction /internal rotation/external rotation). Main outcome measures: The dependent variables that were measured are the final composite score of the FMS, angle measurement in degrees from the active knee extension test, pelvic tilt angle in degrees from the PALM, and angle measurement in degrees for active hip flexion, extension, abduction, adduction, internal rotation, and external rotation. Results: A significant correlation with large strength (PCC = 0.545, p = .013) was found between SIJ injury and active hip abduction. A significant correlation with large strength (PCC = 0.732, p <.01) was found between the PALM and active hip extension. A significant correlation with medium strength (PCC = 0.473, p = .035) was found between the AKET and active hip flexion. One model in the binary logistic regression created a best fit with an odds ratio of 1.115 (CI95 = 1.003, 1.239, p = .044) with the variables of SIJ injury and active hip abduction. Two nonsignificant models with moderate odds ratios were produced for the PALM (OR = 1.141, CI95 = .841, 1.547, p = .397) and years playing soccer (OR = 1.319, CI95 = .854, 2.036, p = .212). A stepwise binary logistic regression created a best fit model with an odds ratio of 1.168 (CI95 = 1.004, 1.359, p = .045) that included both active hip abduction and the FMS to detect and SIJ injury. Conclusion: The results from this study indicate that active hip abduction will significantly predict an SIJ injury. Years of playing soccer, the FMS, and pelvic positioning may also be clinically useful assessments to predict an SIJ injury.
