#WhatWouldYouDo? A cross-sectional study of sports medicine physicians assessing their competency in managing harassment and abuse in sports

OBJECTIVES

To assess the clinical competence of sports medicine physicians to recognise and report harassment and abuse in sports, and to identify barriers to reporting and the need for safeguarding education.

METHODS

We implemented a cross-sectional cohort study design recruiting through social media and international sports medicine networks in 2023. The survey captured participant perceptions related to the harmfulness of harassment and abuse. The survey incorporated the reasoned action approach as a theoretical framework to design survey questions to identify attitudes and self-efficacy to detect and report suspicions of harassment and abuse and to identify barriers to reporting.

RESULTS

Sports medicine physicians (n=406) from 115 countries completed the survey. The situations of harassment and abuse presented in the survey were described by sports medicine physicians as having occurred in the 12 months before participating in the survey. Despite recognising the situations as harmful, sports medicine physicians were somewhat uncomfortable being vigilant for the signs and symptoms and reporting suspicions and disclosures of harassment and abuse (M=2.13, SD=0.67). In addition, just over one-quarter (n=101, 26.9%) was unaware of where to report harassment and abuse, and over half did not know (n=114, 28.1%), or were uncertain (n=95, 23.4%) of who the safeguarding officer was in their sports organisation. Participants identified many barriers to reporting harassment and abuse, including concerns regarding confidentiality, misdiagnosis, fear of reprisals, time constraints and lack of knowledge. Over half felt insufficiently trained (n=223, 57.6%), and most respondents (n=324, 84.6%) desired more education in the field.

CONCLUSIONS

Educational programmes to better recognise and report harassment and abuse in sports are needed for sports medicine trainees and practising clinicians. An international safeguarding code for sports medicine physicians should be developed.

Nutrition and Golf Performance: A Systematic Scoping Review

BACKGROUND

Golf is played both recreationally and professionally by approximately 66.6 million people worldwide. Despite the potential for nutrition to influence golf performance, research in this area is somewhat limited.

OBJECTIVE

To identify the existing literature regarding nutrition and golf and where the current research gaps lie.

DESIGN

Scoping review. Online databases were used to retrieve data from 2003 to the present day.

DATA SOURCES

A three-step search strategy identified relevant primary and secondary articles as well as grey literature. Published and unpublished articles in the English language, identified by searching electronic databases (ProQuest Central, Web of Science, Scopus, SPORTDiscus and PubMed) and reference searching.

REVIEW METHODS

Relevant identified studies were screened for final inclusion. Data were extracted using a standardised tool to create a descriptive analysis and a thematic summary. In summary, studies were included if they focused on nutrition, hydration, energy requirements, supplements, or body composition in relation to golf.

RESULTS AND DISCUSSION

Our initial search found 3616 relevant articles. Eighty-two of these articles were included for the scoping review. Nutrition has the potential to impact golf performance in areas including the maintenance of energy levels, cognitive function, and body composition. Currently, there is limited research available discussing the effects of nutrition interventions related specifically to golf performance.

CONCLUSION

This scoping review highlights that more work is needed to provide golfers and practitioners with golf-specific nutrition research. The key areas for future golf-specific nutrition research include nutrition on cognitive performance, body composition, energy requirements, supplementation, and the potential role of nutrition for the travelling golfer. Systematic reviews could also be used to identify future priorities for nutrition and golf research.

Correction: Robinson et al. Relationships and Within-Group Differences in Physical Attributes and Golf Performance in Elite Amateur Female Players. Life 2024, 14, 674

Addition of an Author [...].

Defining an Ageing-Related Pathology, Disease or Syndrome: International Consensus Statement

Background

Around the world, individuals are living longer, but an increased average lifespan does not always equate to an increased healthspan. With advancing age, the increased prevalence of ageing-related diseases can have a significant impact on health status, functional capacity, and quality of life. It is therefore vital to develop comprehensive classification and staging systems for ageing-related pathologies, diseases and syndromes. This will allow societies to better identify, quantify, understand, and meet the healthcare, workforce, wellbeing, and socioeconomic needs of ageing populations, while supporting the development and utilisation of interventions to prevent or to slow, halt or reverse the progression of ageing-related pathologies.

Methods

The foundation for developing such classification and staging systems is to define the scope of what constitutes an ageing-related pathology, disease or syndrome. To this end, a consensus meeting was hosted by the International Consortium to Classify Ageing-Related Pathologies (ICCARP), on February 19 th , 2024, in Cardiff, UK, and was attended by 150 recognised experts. Discussions and voting were centred on provisional criteria that had been distributed prior to the meeting. The participants debated and voted on these. Each criterion required a consensus agreement of ≥70% for approval.

Results

The accepted criteria for an ageing-related pathology, disease or syndrome were: Develops and/or progresses with increasing chronological age.Should be associated with, or contribute to, functional decline, or an increased susceptibility to functional decline.Evidenced by studies in humans.

Conclusions

Criteria for an ageing-related pathology, disease or syndrome have been agreed by an international consortium of subject experts. These criteria will now be used by the ICCARP for the classification and ultimately staging of ageing-related pathologies, diseases and syndromes.

Continuous quality improvement in a community-wide TB screening and prevention programme in Papua New Guinea

SETTING

Daru Island in Papua New Guinea (PNG) has a high prevalence of TB and multidrug-resistant TB (MDR-TB).

OBJECTIVE

To evaluate the early implementation of a community-wide project to detect and treat TB disease and infection, outline the decision-making processes, and change the model of care.

DESIGN

A continuous quality improvement (CQI) initiative used a plan-do-study-act (PDSA) framework for prospective implementation. Care cascades were analysed for case detection, treatment, and TB preventive treatment (TPT) initiation.

RESULTS

Of 3,263 people screened for TB between June and December 2023, 13.7% (447/3,263) screened positive (CAD4TB or symptoms), 77.9% (348/447) had Xpert Ultra testing, 6.9% (24/348) were diagnosed with TB and all initiated treatment. For 5-34-year-olds without active TB (n = 1,928), 82.0% (1,581/1,928) had tuberculin skin testing (TST), 96.1% (1,519/1,581) had TST read, 23.0% (350/1,519) were TST-positive, 95.4% (334/350) were TPT eligible, and 78.7% (263/334) initiated TPT. Three PDSA review cycles informed adjustments to the model of care, including CAD4TB threshold and TPT criteria. Key challenges identified were meeting screening targets, sputum unavailability from asymptomatic individuals with high CAD4TB scores, and consumable stock-outs.

CONCLUSION

CQI improved project implementation by increasing the detection of TB disease and infection and accelerating the pace of screening needed to achieve timely community-wide coverage.

Quantifying the training demands of a highly trained male youth basketball players by year, term and position

This study describes the training demands of highly trained male youth basketball players, based on training year, term and playing position. Data was collected from 41 male youth basketballers over two seasons from all on-court coach-led training sessions utilising an LPS. Linear mixed-models and pairwise comparisons were used to analyse by training year (Y1, Y2 and Y3), term (T1, T2, T3 and T4) and playing position (Backcourt, Frontcourt). Results showed no differences in external load metrics between training years. Significant differences existed between training terms, with total distance greater in both T3 and T4 than T1 and 2 (p < 0.03). Total PlayerLoad was significantly greater in T4 than T1 (p < 0.001) and T3 (p = 0.004). Distance/min was greater in T2, T3 and T4 than T1 (p < 0.01). PlayerLoad/min was higher in T4 than T1 and T2 (p < 0.01). Backcourt players showed significantly greater distance/min (p = 0.011), PlayerLoad/min (p = 0.011) and deceleration counts (p < 0.001). Overall, limited year-on-year change existed in external training load metrics (p > 0.05), though volume (p < 0.001) and intensity (p < 0.001) differed between terms. Backcourt players completed higher intensities (p = 0.011) than Frontcourt players. This study provides a description of external loads of training in highly trained youth basketball players assisting coaches and performance practitioners to better understand physical demands within youth basketball development pathways.

Life-sustaining treatment decisions and family evaluations of end-of-life care for Veteran decedents in Department of Veterans Affairs nursing homes

BACKGROUND

Modeled after the Physician Orders for Life Sustaining Treatment program, the Veterans Health Administration (VA) implemented the Life-Sustaining Treatment (LST) Decisions Initiative to improve end-of-life outcomes by standardizing LST preference documentation for seriously ill Veterans. This study examined the associations between LST documentation and family evaluation of care in the final month of life for Veterans in VA nursing homes.

METHODS

Retrospective, cross-sectional analysis of data for decedents in VA nursing homes between July 1, 2018 and January 31, 2020 (N = 14,575). Regression modeling generated odds for key end-of-life outcomes and family ratings of care quality.

RESULTS

LST preferences were documented for 12,928 (89%) of VA nursing home decedents. Contrary to our hypothesis, neither receipt of wanted medications and medical treatment (adjusted odds ratio [OR]: 0.85, 95% confidence interval [CI] 0.63, 1.16) nor ratings of overall care in the last month of life (adjusted OR: 0.96, 95% CI 0.76, 1.22) differed significantly between those with and without completed LST templates in adjusted analyses.

CONCLUSIONS

Among Community Living Center (CLC) decedents, 89% had documented LST preferences. No significant differences were observed in family ratings of care between Veterans with and without documentation of LST preferences. Interventions aimed at improving family ratings of end-of-life care quality in CLCs should not target LST documentation in isolation of other factors associated with higher family ratings of end-of-life care quality.

Longitudinal Internal Training Load and Exposure in a High-Performance Basketball Academy

ABSTRACT

Lever, JR, Duffield, R, Murray, A, Bartlett, JD, and Fullagar, HHK. Longitudinal internal training load and exposure in a high-performance basketball academy. J Strength Cond Res 38(8): 1464-1471, 2024-This study describes the longitudinal training exposure (session counts) and internal training load (Rating of Perceived Exertion [RPE] and Session Rating of Perceived Exertion [sRPE]) of youth basketball players at a high-performance academy, based on the training year, training term, and playing position. Historical internal training load and training exposure data were collated from 45 male high-performance youth basketball athletes between 2015 and 2019. Data included session duration, RPE, sRPE, training type, and date. Linear mixed models and pairwise comparisons were performed on the weekly means and categorized by training year (year 1, year 2, year 3), term (term 1, term 2, term 3, term 4), and playing position (Backcourt, Frontcourt). Linear mixed models indicate that the individual athlete had the greatest influence on variance in training load and exposure. Significant differences were observed for increased session count, duration, and sRPE ( p < 0.001) in year 2 compared with year 1. These measures also increased within each year whereby term 3 and term 4 ( p < 0.001) were significantly greater than term 1 and term 2. No significant differences were observed between playing position ( p > 0.05). Training exposure and internal training load increase in year 2 from year 1 for high-performance youth basketball academy athletes. Differences between training load and exposure for terms (i.e., training blocks) suggest the phase of season influences training prescription, while playing position has limited effect.

A prospective study of injuries and illnesses among 910 amateur golfers during one season

ABSTRACT

Objectives

Our aims were (a) to describe the prevalence and incidence of self-reported injuries and illnesses of amateur golfers over a 5-month period and (b) to investigate potential risk factors for injury.

Methods

We recruited 910 amateur golfers (733 males [81%] and 177 females [19%]) from golf clubs in the USA and Switzerland. The median age was 60 (IQR: 47-67) and the median golfing handicap was 12 (IQR: 6-18). Participants' health was monitored weekly for 5 months using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Players also completed a baseline questionnaire on personal and golf-specific characteristics and their medical history.

Results

We distributed 19 406 questionnaires and received 11 180 responses (57.6%). The prevalence of injuries was 11.3% (95% CI: 9.8 to 12.8) and of illnesses was 2% (95% CI 1.7 to 2.2). The incidence of injuries and illnesses was 3.79 (95% CI 3.54 to 4.06) and 0.94 (95% CI 0.81 to 1.07) per golfer per year, respectively. The injury regions with the highest burden of injury (time-loss days per player per year) were lumbosacral spine (5.93), shoulder (3.47) and knee (2.08). Injury risk was higher with increased age, osteoarthritis and previous injury.

Conclusion

The prevalence and incidence of injury and illness in amateur golf were low compared with many other sports. To further reduce the burden of injury, future research attention should be directed towards the lumbosacral spine, knee and shoulder.

Associations Between Physical Characteristics and Golf Clubhead Speed: A Systematic Review with Meta-Analysis

BACKGROUND

Historically, golf does not have a strong tradition of fitness testing and physical training. However, in recent years, both players and practitioners have started to recognise the value of a fitter and healthier body, owing to its potential positive impacts on performance, namely clubhead speed (CHS).

OBJECTIVE

The aim of this meta-analysis was to examine the associations between CHS (as measured using a driver) and a variety of physical characteristics.

METHODS

A systematic literature search with meta-analysis was conducted using Medline, SPORTDiscus, CINAHL and PubMed databases. Inclusion criteria required studies to have (1) determined the association between physical characteristics assessed in at least one physical test and CHS, (2) included golfers of any skill level but they had to be free from injury and (3) been peer-reviewed and published in the English language. Methodological quality was assessed using a modified version of the Downs and Black Quality Index tool and heterogeneity assessed via the Q statistic and I2. To provide summary effects for each of the physical characteristics and their associations with CHS, a random effects model was used where z-transformed r values (i.e. zr) were computed to enable effect size pooling within the meta-analysis.

RESULTS

Of the 3039 studies initially identified, 20 were included in the final analysis. CHS was significantly associated with lower body strength (zr = 0.47 [95% confidence intervals {CI} 0.24-0.69]), upper body strength (zr = 0.48 [95% CI 0.28-0.68]), jump displacement (zr = 0.53 [95% CI 0.28-0.78]), jump impulse (zr = 0.82 [95% CI 0.63-1.02]), jumping peak power (zr = 0.66 [95% CI 0.53-0.79]), upper body explosive strength (zr = 0.67 [95% CI 0.53-0.80]), anthropometry (zr = 0.43 [95% CI 0.29-0.58]) and muscle capacity (zr = 0.17 [95% CI 0.04-0.31]), but not flexibility (zr = - 0.04 [95% CI - 0.33 to 0.26]) or balance (zr =  - 0.06 [95% CI - 0.46 to 0.34]).

CONCLUSIONS

The findings from this meta-analysis highlight a range of physical characteristics are associated with CHS. Whilst significant associations ranged from trivial to large, noteworthy information is that jump impulse produced the strongest association, upper body explosive strength showed noticeably larger associations than upper body strength, and flexibility was not significant. These findings can be used to ensure practitioners prioritise appropriate fitness testing protocols for golfers.

Relationships and Within-Group Differences in Physical Attributes and Golf Performance in Elite Amateur Female Players

The aim of the present study was to examine the association between a comprehensive physical testing battery and measures of golf performance in elite female amateur players. Nineteen category one (handicap ≤ 5) or better golfers (age: 16.26 ± 1.28 years, height: 166.26 ± 3.62 cm, mass: 64.04 ± 11.27 kg, wingspan: 146.53 ± 15.59 cm, handicap: +1.45 ± 0.7) volunteered to participate in this investigation. All golfers attended a single 90 min testing session where golf shot data (clubhead speed [CHS], ball speed, carry distance, and smash factor) were measured with a Trackman 4 launch monitor and a battery of physical assessments were carried out. These included anthropometric data and assessments for seated thoracic rotation, the isometric mid-thigh pull (IMTP), isometric bench press, countermovement jump (CMJ), and seated medicine ball throws for distance. Pearson's r correlations showed CHS was the golf metric that most commonly demonstrated large associations with physical testing data, most notably with force at 100 ms during the isometric bench press (r = 0.70). Median split analysis was also conducted for the IMTP (force at 200 ms), isometric bench press (force at 100 ms), and CMJ (positive impulse). The results showed that players who produced more force at 200 ms during the IMTP exhibited a greater CHS (g = 1.13), ball speed (g = 0.90), and carry distance (g = 1.01). In addition, players with a greater positive impulse during the CMJ showed a greater ball speed (g = 0.93), carry distance (g = 1.29), and smash factor (g = 1.27). Collectively, these results highlight the relevance of explosive force production capabilities in both the lower and upper body for female golfers. This information can be used by practitioners to better target key physical attributes during testing and training of female players.

A Scoping Review of the Epidemiology, Management, and Outcomes of Golf-Related Fractures

ABSTRACT

Golf is a popular sport; however, there is a paucity of data in relation to golf-associated fractures, and the rate and timing of returning to golf. The aim of this review is to describe golf-associated fractures, including epidemiology, management, and timing of returning to golf following treatment. A literature search was performed using MEDLINE/PubMed, Embase, and Web of Science. Data were extracted and summarized in a narrative synthesis. A total of 436 articles were identified with an initial search of which 58 met the inclusion criteria. Twelve anatomical sites of golf swing-related fractures were identified, of which 10 sites were specific for stress fractures. The most common sites of golf swing-related stress fractures were the ribs followed by the hook of hamate. There was a common theme of delay to diagnosis, being initially assigned to a soft tissue injury. Most golfers with swing-related stress fractures were able to return to golf with the exception of osteoporotic associated vertebral stress fractures. Timing of returning to golf was between 4 and 12 months for most of the golfers with stress fractures following conservative management. Operative intervention was an option of hook of hamate nonunion, following a stress fracture, and tibial shaft stress fractures. Golf equipment-related fractures were not rare and were associated with major trauma and in some cases associated with significant persistent morbidity. Golf-related stress fractures commonly involve the ribs and hook of hamate; knowledge of this may aid in early diagnosis and appropriate treatment when symptomatic golfers are encountered. Although golf is a noncontact sport, fractures associated with golf equipment can be life changing, and safety training guidelines should be established.

Validity and Reliability of the FlightScope Mevo+ Launch Monitor for Assessing Golf Performance

ABSTRACT

Brennan, A, Murray, A, Coughlan, D, Mountjoy, M, Wells, J, Ehlert, A, Xu, J, Broadie, M, Turner, A, and Bishop, C. Validity and reliability of the FlightScope Mevo+ launch monitor for assessing golf performance. J Strength Cond Res 38(4): e174-e181, 2024-The purpose of this study was to (a) assess the validity of the FlightScope Mevo+ against the TrackMan 4 and (b) determine the within-session reliability of both launch monitor systems when using a driver and a 6-iron. Twenty-nine youth golfers, with a minimum of 3 years of playing experience, volunteered for this study. All golfers completed 10 shots with a 6-iron and a driver, with 8 metrics concurrently monitored from both launch monitor systems in an indoor biomechanics laboratory. For both clubs, Pearson's r values ranged from small to near perfect ( r range = 0.254-0.985), with the strongest relationships evident for clubhead speed (CHS) and ball speed ( r ≥ 0.92). Bland-Altman plots showed almost perfect levels of agreement between devices for smash factor (mean bias ≤-0.016; 95% CI: -0.112, 0.079), whereas the poorest levels of agreement was for spin rate (mean bias ≤1,238; 95% CI: -2,628, 5,103). From a reliability standpoint, the TrackMan showed intraclass correlation coefficients (ICCs) ranging from moderate to excellent (ICC = 0.60-0.99) and coefficient of variation (CV) values ranged from good to poor (CV = 1.31-230.22%). For the Mevo+ device, ICC data ranged from poor to excellent (ICC = -0.22 to 0.99) and CV values ranged from good to poor (CV = 1.46-72.70%). Importantly, both devices showed similar trends, with the strongest reliability consistently evident for CHS, ball speed, carry distance, and smash factor. Finally, statistically significant differences ( p < 0.05) were evident between devices for spin rate (driver: d = 1.27; 6-iron: d = 0.90), launch angle (driver: d = 0.54), and attack angle (driver: d = -0.51). Collectively, these findings suggest that the FlightScope Mevo+ launch monitor is both valid and reliable when monitoring CHS, ball speed, carry distance, and smash factor. However, additional variables such as spin rate, launch angle, attack angle, and spin axis exhibit substantially greater variation compared with the TrackMan 4, suggesting that practitioners may wish to be cautious when providing golfers with feedback relating to these metrics.

Inequities in the Training Environment and Health of Female Golfers Participating in the 2022 International Golf Federation World Amateur Team Championships

OBJECTIVE

To assess health problems and training environment of female golfers participating in the 2022 World Amateur Team Championships (WATC) and to compare golfers (a) with and without health problems prior the WATC and (b) living and training in countries ranking in the upper versus lower 50% of the team results at the 2022 WATC.

DESIGN

Cross-sectional cohort study using an anonymous questionnaire.

SETTING

International Golf Federation WATC.

PARTICIPANTS

One hundred sixty-two female golfers from 56 countries.

INTERVENTIONS

N/A.

MAIN OUTCOME MEASURES

Golfers' answers on the presence and characteristics of health problems, their training environment, and to the Oslo Sport Trauma Research Centre Questionnaire.

RESULTS

Almost all golfers (n = 162; 96%) answered the questionnaire. In the 4 weeks before the WATC, 101 golfers (63.1%) experienced 186 musculoskeletal complaints, mainly at the lumbar spine/lower back, wrist, or shoulder. Just half of the golfers (50.6%) performed injury prevention exercises always or often. More than a third (37.4%) of the golfers reported illness complaints and 32.5% mental health problems in the 4 weeks preceding the WATC. General anxiety, performance anxiety, and low mood/depression were the most frequent mental health problems. Golfers with injury complaints rated their daily training environment poorer. Golfers ranking in the lower 50% at the WATC had significantly less support staff, rated their training environment poorer, and had a higher prevalence of illness complaints and mental health problems.

CONCLUSIONS

Effective illness and injury prevention programs should be implemented and better access to education and health support in the daily training environment provided.

Effects of Physical Training and Associations Between Physical Performance Characteristics and Golf Performance in Female Players: A Systematic Review With Meta-Analysis

ABSTRACT

Robinson, L, Murray, A, Ehlert, A, Wells, J, Jarvis, P, Turner, A, Glover, D, Coughlan, D, Hembrough, R, and Bishop, C. Effects of physical training and associations between physical performance characteristics and golf performance in female players: A systematic review with meta-analysis. J Strength Cond Res 37(12): e646-e655, 2023-The aims of this systematic review were to assess the association between physical performance and measures of golf performance, and the effects of physical training on measures of golf performance, in female golfers. A systematic literature search was conducted in PubMed, SPORTDiscus, Medline, and CINAHL. Inclusion criteria required studies to (a) have conducted a physical training intervention of any duration in female players and determine the effects on measures of golf performance, (b) determine the association between physical performance in at least one test and golf performance in female players, and (c) be peer-reviewed and published in English language. Methodological quality was assessed using a modified version of the Downs and Black Quality Index tool, and heterogeneity was examined through the Q statistic and I2 . Pooled effect sizes were calculated using standardized mean differences (SMDs) (with 95% confidence interval [CI]s) within a random-effects model, with Egger's regression test used to assess small study bias (inclusive of publication bias). Of the 2,378 articles screened, only 9 were included in the final review, with 3 of these being associative by design and 6 being training interventions. From an associative standpoint, clubhead speed (CHS) was reported in all 3 studies and was associated with measures of strength ( r = 0.54), lower-body power ( r = 0.60), upper-body power ( r = 0.56-0.57), and flexibility ( r = 0.52-0.71). When assessing the effects of physical training interventions, CHS was again the most commonly reported golf outcome measure ( n = 5). The random-effect model indicated that CHS significantly improves within each training group following training interventions (SMD = 0.73 [95% CIs: 0.32-1.14], Z = 3.50, p < 0.001), with trivial heterogeneity ( I2 = 0.00%, Q = 0.18; p = 0.9963) and no prevalence of small study bias depicted through the Egger's regression test ( z = -0.28, p = 0.78). From the available research, it seems that CHS can be positively affected from strength, power, and flexibility training interventions. From an associative standpoint, only 3 studies have been conducted solely in female players, with one showcasing questionable methodology. Future research should aim to carefully select test measures which better represent the physical capacities needed for the sport when determining the effects of and relationships with golf performance.

Improved Physical Health in Middle-Older Aged Golf Caddies Following 24 Weeks of High-Volume Physical Activity

BACKGROUND

The physical demands of golf caddying, including walking while carrying a golf bag, may potentially affect body composition, and markers of metabolic, cardiovascular, and musculoskeletal health. Therefore, this study examined the impact of 24 weeks of caddying on physical health in middle-older aged males.

METHODS

Eleven full-time experienced male caddies (age: 59 [8] y; caddying experience: 14 [12] y) were recruited from a local golf course. The following were assessed at preseason and after 24 weeks of caddying (March-September 2022): body composition, heart rate, blood pressure, blood lipids, and performance tests (static and dynamic balance, strength, and submaximal fitness). Physical activity (PA) levels were assessed at preseason and at the mid-point of the caddying season. Across the caddying season, participants completed a monthly average of 24.0 (3.8) rounds.

RESULTS

Following the caddying season, improvements in static balance (Δ = 13.5 s), dynamic balance (Δ = -1.8 s), and lower back absolute strength (Δ = 112.8 N), and muscle quality (Δ = 2.0 N·kg-1) were observed (all P < .05). Additionally, blood lipids, including total cholesterol (Δ = -0.6 mmol·L-1), high-density lipoprotein cholesterol (Δ = 0.1 mmol·L-1), low-density lipoprotein cholesterol (Δ = -0.6 mmol·L-1) (all P < .05), and body composition, including body mass (Δ = -2.7 kg), fat mass (Δ = -1.9 kg), fat percentage (Δ = -1.4%), fat-to-muscle ratio (Δ = -0.03), and body mass index (Δ = -0.9 kg·m-2) (all P < .05) improved. Caddying did not offer beneficial changes to cardiovascular variables or cardiorespiratory fitness (P > .05), while coronary heart disease risk score decreased (Δ = -3.3%) (P < .05). In relation to PA, light- (Δ = 145 min) and moderate-intensity (Δ = 71 min) PA, moderate to vigorous PA (Δ = 73 min), and total PA (Δ = 218 min) between preseason and the mid-point of the caddying season increased, while sedentary time (Δ = -172 min) decreased (all P < .05).

CONCLUSION

Golf caddying can provide several physical health benefits such as improvements in various markers of cardiometabolic health, lower back absolute strength, and static and dynamic balance. The physical health improvements that caddying offers is likely contributed to by increased PA volume and intensity through walking on the golf course. Therefore, caddying may represent a feasible model for increasing PA volume and intensity and achieve physical health-related benefits.

Practices and perceptions of strength and conditioning training in female golf: A cross-sectional survey study of high-level amateur players

This study aims to ascertain an in-depth understanding of current practices and perceptions of S&C training in high-level amateur female golfers. A cross-sectional, explorative survey study was constructed which asked questions relating to four key areas: i) general participant information, ii) current strength and conditioning (S&C) practices, iii) the perceived influence of S&C training on golf performance, and iv) knowledge and awareness of S&C. Results showed that the majority of female players had participated in some form of S&C training in the past, with the majority believing that clubhead speed and carry distance were the primary golfing metrics which could be positively impacted. More specifically, 91-97% of the players "Strongly agreed" or "Agreed" that the key physical characteristics for golf were strength and power for the lower and upper body, and flexibility. Interestingly, 58% of the players believed that S&C training should mimic the movement of the golf swing, which based off current evidence, is not how drive metrics and ultimately shots gained, can be maximised. This survey study provides useful information relating to the practices and perceptions of S&C training in high-level female amateur players and areas where education may be able to further advance player understanding of physical preparation.

Transforaminal lumbar interbody fusion with placement of steerable banana cage: A single-center retrospective analysis of radiographic parameters of success

INTRODUCTION

The transforaminal lumbar interbody fusion (TLIF) is among the most utilized methods for the surgical treatment of lumbar degenerative disc disease. The TLIF has advanced significantly with several iterative changes since its inception in the early 1980s, with the advent of several generations of interbody types, shapes, and materials. Steerable curvilinear interbodies are among the most recent innovations in this space and may offer biomechanical advantages, namely in preservation of lumbar and segmental lordosis. While radiographic parameters have been investigated for other cage shapes and lumbar interbody fusion techniques, no study has investigated postoperative radiographic outcomes specific to TLIFs done with curvilinear interbodies.

METHODS

This study is a retrospective review of TLIFs performed with curvilinear interbodies between 2019 and 2022 at a single institution. Upright radiographs were obtained preoperatively and at several timepoints postoperatively. Radiographic variables including interspace height and segmental lordosis were collected.

RESULTS

26 surgeries with 32 curvilinear interbodies were performed across 3 years. There was significant increase in segmental lordosis at the L4-L5 (p = 0.0183) and L5-S1 levels (p = 0.004) as well as interspace height postoperatively at levels L3-L4 (p = 0.011) and L4-L5 (p = 0.002). Pain as measured with the numeric rating scale significantly improved in the overall cohort postoperatively (p<0.001).

CONCLUSIONS

TLIF with curvilinear interbody placement increases segmental lordosis and interspace height at the L4-L5 and L5-S1 levels, and increased interspace height at the L3-L4 and L4-L5 levels. Further investigation into additional radiographic parameters is warranted and expanded cohort size would benefit deeper analysis of other spinal levels.

IMPLICATIONS FOR PRACTICE

As an increasing number of cage designs and materials are brought to market, studies such as this allow for better understanding of cage specific outcomes allowing for better informed device selection.

Trackman 4: Within and between-session reliability and inter-relationships of launch monitor metrics during indoor testing in high-level golfers

The aims of the present study were to: 1) investigate the within and between-session reliability of the Trackman 4 launch monitor system, and 2) determine the inter-relationships of some of these commonly used metrics. Golfers attended two test sessions at an indoor golf academy and performed 10 shots using their own driver. Results showed excellent within and between-session reliability for CHS (ICC = 0.99; SEM = 1.64-1.67 mph), ball speed (ICC = 0.97-0.99; SEM = 2.46-4.42 mph) and carry distance (ICC = 0.91-0.97; SEM = 7.80-14.21 mph). In contrast, spin rate showed the worst reliability (ICC = 0.02-0.60; SEM = 240.93-454.62 º/s) and also exhibited significant differences between test sessions (g = -0.41; p < 0.05), as did smash factor (g = 0.47; p < 0.05) and dynamic loft (g = -0.21; p < 0.05). Near perfect associations were evident in both test sessions between CHS and ball speed (r = 0.98-0.99), CHS and carry distance (r = 0.94-0.95), ball speed and carry distance (r = 0.97-0.98), and launch angle and dynamic loft (r = 0.98-0.99). Collectively, CHS, ball speed and carry distance serve as the most consistently reliable metrics making them excellent choices for practitioners working with golfers.

Cognitive and biomarker responses in healthy older adults to a 18-hole golf round and different walking types: a randomised cross-over study

Introduction

The global burden of age-related cognitive decline is increasing, with the number of people aged 60 and over expected to double by 2050. This study compares the acute effects of age-appropriate cognitively demanding aerobic exercises involving walking, on cognitive functions and exerkine responses such as brain-derived neurotrophic factor (BDNF) and cathepsin B (CTSB) in older, healthy adults.

Methods/design

Healthy older golfers (n=25, 16 male and 9 female, 69±4 years) were enrolled in a 5-day randomised cross-over study and completed three different exercise trials (18-hole golf round, 6 km Nordic walking, 6 km walking) in a real-life environment, in random order and at a self-selected pace. Differences in cognition (the Trail-Making Test (TMT) AB) and exerkines (BDNF and CTSB) were analysed within groups using the Wilcoxon signed-rank test and between groups using the Kruskal-Wallis test.

Results

All exercise types resulted in a significant decrease in the TMT A-test (p<0.05; golf: -4.43±1.5 s, Nordic walking: -4.63±1.6 s, walking: -6.75±2.26 s), where Nordic walking and walking demonstrated a decrease in the TMT B-test (p<0.05; Nordic walking: -9.62±7.2 s, walking: -7.55±3.2 s). In addition, all exercise types produced significant decreases in the TMT AB test scores (p<0.05), and Nordic walking (p=0.035) showed decreases in the TMTB-TMTA-test. There were no immediate postexercise changes in the levels of BDNF or CTSB.

Conclusion

Acute bouts of golf, Nordic walking and walking improved cognitive functions irrespective of exerkines in healthy older adults. In addition, Nordic walking and walking in general enhanced executive functions. No significant effects were seen on the levels of BDNF and CTSB.

Trial registration number

ISRCTN10007294.

Radiation Treatment Preparation Safety Risk Prediction

PURPOSE/OBJECTIVE(S)

To determine the effect of delays in radiation treatment preparation task timeliness on reported safety events.

MATERIALS/METHODS

For 2022, all patients treated at four community-based radiation oncology clinics were included for analysis. Safety reports which occurred during treatment preparation tasks (i.e., between CT simulation and the first treatment) were included for this analysis. Patients with a reported safety event were the report cohort and those without were the control cohort. Treatment preparation tasks are completed sequentially and included contouring, treatment planning, Radiation Oncologist review, Medical Physicist review, Therapist quality check. At baseline, each task was scheduled a standard interval for completion based on treatment technique. The time taken to complete each task was captured using ARIA v16.0 Care Path module (Varian Medical Systems, Palo Alto, CA) and extracted through database query. For each task, two metrics were quantified: Task (1) Completion Timeliness: the time (hours) to complete each task, relative to the time allocated to each task. A negative value indicated more time taken than scheduled. (2) Overall Timeliness: specific task timeliness (hours) relative to overall timeliness for the whole Care Path. A negative value indicated the tasks were behind schedule. A student's t-test with an alpha of 0.05 was used to indicate significance.

RESULTS

Over the study period, 66 courses had a reported treatment preparation safety event (report) and 2690 did not (control). Techniques include 54% and 56% 3DCRT, 35% and 35% IMRT, 3% and 3% SRS, and 6% and 8% SBRT, for the report and control groups, respectively. Disease sites include breast, GU, GI, head and neck, CNS, thoracic, skin, secondary, gynecological, sarcoma, and heme. Table 1 displays the timeliness for each of the five tasks. Of the courses with safety events, overall timeliness was significantly behind the control group from the in contouring, treatment planning, Radiation Oncologist review, and Medical Physicist review. Courses with safety events took significantly more time than scheduled early in treatment preparation with a significant increase at treatment planning and significantly less time towards the end with the therapist quality check.

CONCLUSION

Patient courses with reported safety events had significantly longer treatment planning times, and as a result inadequate time to perform each downstream pre-treatment activity. The implication of this analysis is that a flag could be created to indicate risk of a safety event early in the treatment preparation process.

Cost-Effective Modular Biosensor for SARS-CoV-2 and Influenza A Detection

A modular, multi-purpose, and cost-effective electrochemical biosensor based on a five-stranded four-way junction (5S-4WJ) system was developed for SARS-CoV-2 (genes S and N) and Influenza A virus (gene M) detection. The 5S-4WJ structure consists of an electrode-immobilized universal stem-loop (USL) strand, two auxiliary DNA strands, and a universal methylene blue redox strand (UMeB). This design allows for the detection of specific nucleic acid sequences using square wave voltammetry (SWV). The sequence-specific auxiliary DNA strands (m and f) ensure selectivity of the biosensor for target recognition utilizing the same USL and UMeB components. An important feature of this biosensor is the ability to reuse the USL-modified electrodes to detect the same or alternative targets in new samples. This is accomplished by a simple procedure involving rinsing the electrodes with water to disrupt the 5S-4WJ structure and subsequent re-hybridization of the USL strand with the appropriate set of strands for a new analysis. The biosensor exhibited minimal loss in signal after rehybridization, demonstrating its potential as a viable multiplex assay for both current and future pathogens, with a low limit of quantification (LOQ) of as low as 17 pM.