The objective of the study was to examine the feasibility and benefits of a group resistance training exercise programme for improving muscle function in institutionalised older adults. A feasibility and acceptability study was designed for a residential aged care (RAC) facility, based on the Gold Coast, Australia. Thirty-seven adults, mean age 86.8 ± 6.1 years (30 females) living in a RAC facility. Participants were allocated into an exercise (n = 20) or control (n = 17) group. The exercise group, the Group Aged Care Exercise (GrACE) programme, performed 12 weeks of twice weekly resistance exercises. Feasibility was measured via recruitment rate, measurement (physiological and surveys) completion rate, loss-to-follow-up, exercise session adherence, adverse events, and ratings of burden and acceptability. Muscle function was assessed using gait speed, sit-to-stand and handgrip strength assessments. All intervention participants completed pre- and post-assessments, and the exercise intervention, with 85% (n = 17) of the group attending ≥ 18 of the 24 sessions and 15% (n = 3) attending all sessions. Acceptability was 100% with exercise participants, and staff who had been involved with the programme strongly agreed that the participants “Benefited from the programme.” There were no adverse events reported by any participants during the exercise sessions. When compared to the control group, the exercise group experienced significant improvements in gait speed ( F (4.078) = 8.265, p = 0.007), sit to stand performance ( F (3.24) = 11.033, p = 0.002) and handgrip strength ( F (3.697) = 26.359, p < 0.001). Resistance training via the GrACE programme is feasible, safe and significantly improves gait speed, sit-to-stand performance and handgrip strength in RAC adults.
Background. There has been a continual increase in injury rates in cricket, with hamstring strain injuries (HSIs) being the most prominent. Eccentric knee flexor weakness and bilateral asymmetries are major modifiable risk factors for future HSIs. However, there is a lack of data relating to eccentric hamstring strength in cricket at any skill level. The objective of this study was to compare eccentric knee flexor strength and bilateral asymmetries in elite, sub-elite and school level cricket players; and to determine if playing position and limb role influenced these eccentric knee flexor strength indices. Methods. Seventy four male cricket players of three distinct skill levels performed three repetitions of the Nordic hamstring exercise on the experimental device. Strength was assessed as the absolute and relative mean peak force output for both limbs, with bilateral asymmetries. Differences in mean peak force outputs between skill level and playing positions were measured. Results. There were no significant differences between elite, sub-elite and school level athletes for mean peak force and bilateral asymmetries of the knee flexors. There were no significant differences observed between bowler's and batter's mean peak force and bilateral asymmetries. There were no significant differences between front and back limb mean peak force outputs. Discussion. Skill level, playing position and limb role appeared to have no significant effect on eccentric knee flexor strength and bilateral asymmetries. Future research should seek to determine whether eccentric knee flexor strength thresholds are predictive of HSIs in cricket and if specific eccentric knee flexor strengthening can reduce these injuries.
The block phase in the swimming start requires a quick reaction to the starting signal and a large take-off velocity that is primarily horizontal in direction. Due to the principle of specificity of training, there is a potential benefit of performing a greater proportion of horizontal force production exercises in a swimmers' dry-land resistance training sessions. Therefore, the purpose of this pilot study was to provide an insight into the effects of a horizontal- (HF) vs vertical-force (VF) training intervention on swim start performance.Eleven competitive swimmers (six males (age 20.9 ± 1.8 years, body mass 77.3 ± 9.7 kg, height 1.78 ± 0.05 m) and five females (age 21.4 ± 2.0 years, body mass 67.5 ± 7.4 kg, height 1.69 ± 0.05 m)) completed 2 weekly sessions of either a horizontal- or vertical-force focused resistance training programme for 8 weeks. Squat jump force-time characteristics and swim start kinetic and kinematic parameters were collected pre- and post-intervention.Across the study duration, the swimmers completed an average of nine swimming sessions per week with an average weekly swim volume of 45.5 ± 17.7 km (HF group) and 53 ± 20.0 km (VF group), but little practice of the swim start per week (n = 9). Within-group analyses indicated a significant increase in predicted one repetition maximum (1RM) hip thrust strength in the HF group, as well as significant increases in grab resultant peak force but reductions in resultant peak force of the block phase for the VF group. No significant between-group differences in predicted 1RM hip thrust and back squat strength, squat jump force-time and swim start performance measures were observed after 8 weeks of training. Significant correlations in the change scores of five block kinetic variables to time to 5 m were observed, whereby increased block kinetic outputs were associated with a reduced time to 5 m. This may be indicative of individual responses to the different training programmes.The results of this current study have been unable to determine whether a horizontal- or vertical-force training programme enhances swim start performance after an 8-week training intervention. Some reasons for the lack of within and between group effects may reflect the large volume of concurrent training and the relative lack of any deliberate practice of the swim start. Larger samples and longer training duration may be required to determine whether significant differences occur between these training approaches. Such research should also look to investigate how a reduction in the concurrent training loads and/or an increase in the deliberate practice of the swim start may influence the potential changes in swim start performance.
As participants who engage in CrossFit training and competition perform a large volume of high intensity overhead activities, injuries to the shoulder are one of the most common in this sport. Previous research in other sports has indicated that the isokinetic force power profile of the shoulder joint (IPSJ) rotator muscles may assist in the prediction of shoulder injury.Therefore, the objective of this study was to determine the IPSJ in males engaged in CrossFit training at different competitive levels.In a cross-sectional study design, participants (age, 24.1 ± 2.7 years) classified as 'beginner' (n = 6), 'intermediate' (n = 7) or 'advanced' (n = 9) provided informed consent to participate in this study. The IPSJ assessment involved rotational and diagonal movements, including internal and external shoulder rotator muscles, at both 180°.s-1 and 300°.s-1. The variables analysed were peak torque/body mass (%), mean power (W) and the external/internal peak torque/body mass ratio (%). A Kruskal-Wallis test was used to compare the IPSJ of the three groups, with Dunn's test used for post-hoc analysis. The alpha level was set at p < 0.05.The IPSJ showed greater torque and power values in those who competed at the advanced level as compared to those at a lower competitive level (i.e. intermediate, beginner). This was observed mainly for the internal rotation and internal diagonal movements at both 180°.s-1 and 300°.s-1. However, such differences between competitive levels were, in general, absent for the external rotation and external diagonal movements. Moreover, the participants from the advanced competitive level exhibited an imbalance of peak torque between the muscles responsible for the external-internal rotational and external-internal diagonal movements of the shoulder (i.e. peak torque external/internal ratio <66%), particularly in the dominant shoulder.These findings suggest greater development of the shoulder internal rotators and a higher probability of shoulder injury in CrossFit athletes at the advanced competitive level. Based on these results, participants engaged in CrossFit training and competition may wish to increase the volume of training for the shoulder external rotator muscles to complement the large increases in shoulder internal rotator strength that occur as a part of their regular training regimes.
Background Anecdotally, a wide variety of benefits of barefoot running have been advocated by numerous individuals. The influence of the alterations in the properties of the shoe on the running movement has been demonstrated in adults at submaximal jogging speeds. However, the biomechanical differences between shod and barefoot running in children at sprinting speeds and the potential developmental implications of these differences are still less examined. The purpose was to determine the potential differences in habitually shod children’s sprint kinematics between shod and barefoot conditions. Methods Ninety-four children (51 boys and 43 girls; 6–12 years-old; height, 135.0 ± 0.12 m; body mass, 29.0 ± 6.9 kg) performed 30 m maximal sprints from standing position for each of two conditions (shod and barefoot). To analyze sprint kinematics within sagittal plane sprint kinematics, a high-speed camera (300 fps) was set perpendicular to the runway. In addition, sagittal foot landing and take-off images were recorded for multiple angles by using five high-speed cameras (300 fps). Spatio-temporal variables, the kinematics of the right leg (support leg) and the left leg (recovery leg), and foot strike patterns: rear-foot strike (RFS), mid-foot strike (MFS), and fore-foot strike (FFS) were investigated. The paired t -test was used to test difference between shod and barefoot condition. Results Barefoot sprinting in habitually shod children was mainly characterized by significantly lower sprint speed, higher step frequency, shorter step length and stance time. In shod running, 82% of children showed RFS, whereas it decreased to 29% in barefoot condition. The touch down state and the subsequent joint movements of both support and recovery legs during stance phase were significantly altered when running in condition with barefoot. Discussion The acute effects of barefoot sprinting was demonstrated by significantly slower sprinting speeds that appear to reflect changes in a variety of spatiotemporal parameters as well as lower limb kinematics. It is currently unknown whether such differences would be observed in children who typically run in bare feet and what developmental benefits and risks may emerge from increasing the proportion of barefoot running and sprinting in children. Future research should therefore investigate potential benefits that barefoot sprinting may have on the development of key physical fitness such as nerve conduction velocity, muscular speed, power, and sprinting technique and on ways to minimize the risk of any acute or chronic injuries associated with this activity.
A review of the literature has indicated that lower body stiffness, defined as the extent to which the lower extremity joints resists deformation upon contact with the ground, may be a useful measure for assessing Achilles injury risk in triathletes. The nature of overuse injuries suggests that a variety of different movement patterns could conceivably contribute to the final injury outcome, any number and combination of which might be observed in a single individual. Measurements which incorporate both kinetics and kinematics (such as stiffness) of a movement may be better able to shed light on individuals at risk of injury, with further analysis then providing the exact mechanism of injury for the individual. Stiffness can be measured as vertical, leg or joint stiffness to model how the individual interacts with the environment upon landing. However, several issues with stiffness assessments limit the effectiveness of these measures to monitor athletes' performance and/or injury risk. This may reflect the variety of common biomechanical stiffness calculations (dynamic, time, true leg and joint) that have been used to examine these three stiffness levels (vertical, leg and joint) across a variety of human movements (i.e. running or hopping) as well as potential issues with the reliability of these measures, especially joint stiffness. Therefore, the aims of this study were to provide a comparison of the various methods for measuring stiffness during two forms of human bouncing locomotion (running and hopping) along with the measurement reliability to determine the best methods to assess links with injury risk in triathletes.Vertical, leg and joint stiffness were estimated in 12 healthy male competitive triathletes on two occasions, 7 days apart, using both running at 5.0 ms-1 and hopping (2.2 Hz) tasks.Inter-day reliability was good for vertical (ICC = 0.85) and leg (ICC = 0.98) stiffness using the time method. Joint stiffness reliability was poor when assessed individually. Reliability was improved when taken as the sum of the hip, knee and ankle (ICC = 0.86). The knee and ankle combination provided the best correlation with leg stiffness during running (Pearson's Correlation = 0.82).The dynamic and time methods of calculating leg stiffness had better reliability than the "true" method. The time and dynamic methods had the best correlation with the different combinations of joint stiffness, which suggests that they should be considered for biomechanical screening of triathletes. The knee and ankle combination had the best correlation with leg stiffness and is therefore proposed to provide the most information regarding lower limb mechanics during gait in triathletes.
Objectives To explore the relationships between physical fitness and i) technical skills and ii) time-loss from Australian football injury in female players across the talent and participation pathways. Methods This study uses a subset of data from two cross-sectional and one prospective cohort studies. A total of 223 female Australian football players across five competition levels (elite/non-elite senior, high-level junior, and non-elite junior (14–17 years)/(10–13 years)) were included in this study. Comprehensive physical fitness assessments and modified Australian football kicking and handballing tests were conducted in the 2018/19 pre-seasons. During the respective competitive in-season, time-loss injuries were recorded by team personnel. Stepwise multiple linear regressions were performed to determine the relationship between physical fitness and kicking and handballing scores. Cox proportional regressions were conducted to identify physical fitness factors associated with injury. Results Increased running vertical jump height, greater hip abduction strength, and faster timed 6 m hop speed demonstrated a relationship with kicking accuracy when adjusted for years of Australian football playing experience (adjusted R 2 = 0.522, p < 0.001). Faster agility time and increased lean mass were associated with better handballing accuracy (adjusted R 2 = 0.221, p < 0.001). Multivariate Cox regression revealed an increased risk for sustaining a time-loss injury in less agile players (adjusted HR 2.41, 95% CI 1.23, 4.73, p = 0.010). However, this relationship no longer remained when adjusted for age and years of Australian football experience (adjusted HR 1.68, 95% CI 0.81, 3.50, p = 0.166). Conclusions Physical fitness may be a significant factor contributing to development of Australian football technical skills in female players. However, its role is unclear in protecting against injury risk in this athlete population. Further research is needed to explore the multifactorial and complex phenomenon of talent development and injury risk reduction in female Australian football players.
Background Kettlebell lifting has gained increased popularity as both a form of resistance training and as a sport, despite the paucity of literature validating its use as a training tool. Kettlebell sport requires participants to complete the kettlebell snatch continuously over prolonged periods of time. Kettlebell sport and weightlifting involve similar exercises, however, their traditional uses suggest they are better suited to training different fitness qualities. This study examined the three-dimensional ground reaction force (GRF) and force applied to the kettlebell over a 6 min kettlebell snatch set in 12 kettlebell-trained males. Methods During this set, VICON was used to record the kettlebell trajectory with nine infrared cameras while the GRF of each leg was recorded with a separate AMTI force plate. Over the course of the set, an average of 13.9 ± 3.3 repetitions per minute were performed with a 24 kg kettlebell. Significance was evaluated with a two-way ANOVA and paired t -tests, whilst Cohen’s F (ESF) and Cohen’s D (ESD) were used to determine the magnitude. Results The applied force at the point of maximum acceleration was 814 ± 75 N and 885 ± 86 N for the downwards and upwards phases, respectively. The absolute peak resultant bilateral GRF was 1,746 ± 217 N and 1,768 ± 242 N for the downwards and upwards phases, respectively. Bilateral GRF of the first and last 14 repetitions was found to be similar, however there was a significant difference in the peak applied force ( F (1.11) = 7.42, p = 0.02, ESF = 0.45). Unilateral GRF was found have a significant difference for the absolute anterior–posterior ( F (1.11) = 885.15, p < 0.0001, ESF = 7) and medio-lateral force vectors ( F (1.11) = 5.31, p = 0.042, ESF = 0.67). Discussion Over the course of a single repetition there were significant differences in the GRF and applied force at multiple points of the kettlebells trajectory. The kettlebell snatch loads each leg differently throughout a repetition and performing the kettlebell snatch for 6 min will result in a reduction in peak applied force.
Rationale. Many cancer patients and survivors do not meet nutritional and physical activity guidelines, thus healthier eating and greater levels of physical activity could have considerable benefits for these individuals. While research has investigated cancer survivors' perspective on their challenges in meeting the nutrition and physical guidelines, little research has examined how health professionals may assist their patients meet these guidelines. Cancer nurses are ideally placed to promote healthy behaviours to their patients, especially if access to dieticians or dietary resources is limited. However, little is known about cancer nurses' healthy eating promotion practices to their patients. The primary aim of this study was to examine current healthy eating promotion practices, beliefs and barriers of cancer nurses in Australia and New Zealand. A secondary aim was to gain insight into whether these practices, beliefs and barriers were influenced by the nurses' hospital or years of work experience. Patients and Methods. An online questionnaire was used to obtain data. Sub-group cancer nurse comparisons were performed on hospital location (metropolitan vs regional and rural) and years of experience (<25 or ≥25 years) using ANOVA and chi square analysis for continuous and categorical data respectively. Results. A total of 123 Australasian cancer nurses responded to the survey. Cancer nurses believed they were often the major provider of nutritional advice to their cancer patients (32.5%), a value marginally less than dieticians (35.9%) but substantially higher than oncologists (3.3%). The majority promoted healthy eating prior (62.6%), during (74.8%) and post treatment (64.2%). Most cancer nurses felt that healthy eating had positive effects on the cancer patients' quality of life (85.4%), weight management (82.9%), mental health (80.5%), activities of daily living (79.7%) and risk of other chronic diseases (79.7%), although only 75.5% agreed or strongly agreed that this is due to a strong evidence base. Lack of time (25.8%), adequate support structures (17.3%) nutrition expertise (12.2%) were cited by the cancer nurses as the most common barriers to promoting healthy eating to their patients. Comparisons based on their hospital location and years of experience, revealed very few significant differences, indicating that cancer nurses' healthy eating promotion practices, beliefs and barriers were largely unaffected by hospital location or years of experience. Conclusion. Australasian cancer nurses have favourable attitudes towards promoting healthy eating to their cancer patients across multiple treatment stages and believe that healthy eating has many benefits for their patients. Unfortunately, several barriers to healthy eating promotion were reported. If these barriers can be overcome, nurses may be able to work more effectively with dieticians to improve the outcomes for cancer patients.
Measuring joint range of motion is an important skill for many allied health professionals. While the Universal Goniometer is the most commonly utilised clinical tool for measuring joint range of motion, the evolution of smartphone technology and applications (apps) provides the clinician with more measurement options. However, the reliability and validity of these smartphones and apps is still somewhat uncertain. The aim of this study was to systematically review the literature regarding the intra- and inter-rater reliability and validity of smartphones and apps to measure joint range of motion. Eligible studies were published in English peer-reviewed journals with full text available, involving the assessment of reliability and/or validity of a non-videographic smartphone app to measure joint range of motion in participants >18 years old. An electronic search using PubMed, Medline via Ovid, EMBASE, CINAHL, and SPORTSDiscus was performed. The risk of bias was assessed using a standardised appraisal tool. Twenty-three of the eligible 25 studies exceeded the minimum 60% score to be classified as a low risk of bias, although 3 of the 13 criteria were not achieved in >50% of the studies. Most of the studies demonstrated adequate intra-rater or inter-rater reliability and/or validity for >50% of the range of motion tests across all joints assessed. However, this level of evidence appeared weaker for absolute (e.g. mean difference ± limit of agreement, minimal detectable change) than relative (e.g. intraclass correlation, correlation) measures; and for spinal rotation than spinal extension, flexion and lateral flexion. Our results provide clinicians with sufficient evidence to support the use of smartphones and apps in place of goniometers to measure joint motion. Future research should address some methodological limitations of the literature, especially including the inclusion of absolute and not just relative reliability and validity statistics.
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