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Sharififar S, Sein M, Diehl E, Tham SY, Nixon RM, Sheppard C, Bolling J, Majid M, Apfelbaum C, Vincent HK. Pilot Study on Therapeutic Horticulture for Chronic Low Back Pain: A Mixed Methods Study. Altern Ther Health Med 2024:AT10082. [PMID: 38702158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
Background Chronic low back pain (LBP) is common and associated with disability worldwide. Therapists trained in Therapeutic Horticulture (TH) use gardening activities and proximity to nature for therapy and rehabilitation. Patients seeking care for LBP would benefit physically and psychologically from participating in TH. Primary study objectives The first aim of this study was to determine if and which patients who were receiving care for chronic LBP were interested in TH to help manage their pain. The second aim of the project was to quantify changes in LBP, functional tasks and anxiety upon completion of a TH session in patients with LBP. Methods/Design This was a 2-part study with a mixed methods design: the cross-sectional survey Group and the pilot experimental Group. The Cross-sectional Survey component comprised a total of 170 patients; age 55.9±17.3 years; 58% women. The Pilot Experimental component comprised a total of 9 patients; age 48±14.7 years; 78% women. Participants Cross-sectional component Patients receiving medical care for LBP with or without additional joint pain sites (n=170; age 55.9 ± 17.3 years; 58% women. Participants Pilot experimental component A total of 9 patients (7 women); mean age 48 ± 14.7 years and mean duration of back pain 12.6 ± 8.1 years. Setting Patients were receiving medical care at the University of Florida Health Comprehensive Spine Center in the United States, in the tertiary care health system. Intervention 1-hour TH session that involved trained therapists using propagating and harvesting herbs planted at various heights in an outdoor setting for therapy and rehabilitation. Primary outcome measures A therapeutic horticulture interest survey, PROMIS Pain Interference and Physical Function scores, functional tests (timed-get-up-and-go [TUG], spine range of motion), Roland Morris Disability Questionnaire (RMDQ), 11-point Numerical Pain Rating Scale (NRSpain), 10-item PROMIS Global Health Questionnaire, Tampa Scale of Kinesiophobia-11 and patient enjoyment. Results Cross-sectional survey component: A total of 2% of patients had not previously heard of TH and 68% were interested in learning more about it. Patients who expressed interest in TH reported a higher level of agreement that TH could improve mood, improve muscle strength, lower stress level, increase movement and enable patients to perform self-care activities with less pain (all P < .001). PROMIS Pain Interference and Physical Function scores did not differ by interest in TH (P > .05). Pilot Experimental component: In the pilot session, 44% reported using pain medication to manage their low back pain and 66% believed gardening could provide pain relief. Improvements were observed in anxiety (55.3%; P =.017), spine flexion (31.4%; P =.003) and spine rotation to the left (26.7%; P =.005). All participants believed that gardening improved overall health and spine motion while reducing low back pain. All patients reported having gardening experience at home and none had TH experience. Conclusion Patients presenting to an outpatient spine clinic may be receptive to trying TH in conjunction with or in place of conventional medicine to promote health and well-being. The pilot experimental group data suggested that acute TH is enjoyable and may confer the benefits of reducing anxiety and improving spine motion. Future larger studies could use different dose response approaches, explore different TH activity types and involve participants from different geographic locations while controlling for LBP history and psychological status.
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Vasilopoulos T, Drozda D, Vincent HK. Physical activity positively impacts disability outcomes during transition from midlife to early older age irrespective of body mass index. Arch Gerontol Geriatr 2024; 120:105339. [PMID: 38340391 DOI: 10.1016/j.archger.2024.105339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024]
Abstract
We examined the effects of physical activity (PA) and body mass index (BMI) longitudinal patterns (trajectories) on subjective measures of mobility, function, and disability in adults and assessed whether effects of PA trajectories on function varied due to BMI. Group-based trajectory analyses were used to determine patterns of change in PA and BMI using data from the Health and Retirement Study 1931-1941 birth cohort (n = 10,507). Physical function was assessed by Mobility Limitations (0-5 scale) and Large Muscle Function (0-4 scale) Indexes, as well as with score for activities of daily living (ADLs) and instrumental activities of daily living (IADLs), with higher scores being worse. Our analyses estimated four distinct PA trajectories: decreasing, (2) fluctuating, (3) stable high, and (4) emergent (previously low/sedentary with increased PA over the study period). Worse mobility limitations, large muscle function, ADLs, and IADLs were associated with Decreasing and Fluctuating PA groups. Better outcomes were associated with Emergent and Stable High PA groups. The five BMI trajectories were stable normal/overweight, modest decreasing, fluctuating, steep decreasing, and increasing. No significant interaction existed between PA and BMI trajectories for Mobility Limitations (P= 0.577), Large Muscle Function (P= 0.511), ADLs (P= 0.600), and IADLs (P= 0.152). These findings may empower clinicians to promote messages to midlifers that meaningful changes in PA can improve function in older age.
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Affiliation(s)
- Terrie Vasilopoulos
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA; Department of Orthopaedic Surgery and Sports Medicine, College of Medicine, University of Florida, Gainesville, FL 32611, USA.
| | - David Drozda
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32611, USA
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32611, USA
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McGargill S, Sein M, Sibille KT, Thompson Z, Brownstein M, Vincent HK. Considerations beyond spine pain: do different co-occurring lower body joint pains differentially influence physical function and quality of life ratings? BMC Musculoskelet Disord 2024; 25:269. [PMID: 38589851 PMCID: PMC11000411 DOI: 10.1186/s12891-024-07393-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 03/28/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Patients seeking medical care for back pain often have coexisting painful joints and the effects of different combinations and number of coexisting pain sites (hip, knee, foot/ankle) to back pain on physical function domains and quality of life rating are not yet established. The purpose of this study was to determine the differences in functional outcomes and QOL among individuals with back pain who have concurrent additional pain sites or no pain sites. METHODS Data from the Osteoarthritis Initiative (OAI) cohort were used for this cross-sectional analysis. Men and women aged 45-79 years with back pain were binned into nine groups by presence or not of coexisting hip, knee, ankle/foot pain and combinations of these sites (N = 1,642). Healthy controls reported no joint pain. Main outcomes included Knee Injury and Osteoarthritis Outcome score (KOOS; quality of life and function-sports-and-recreation), Western Ontario McMaster Universities Osteoarthritis Index (WOMAC; Activities of Daily Living, Pain), Medical Outcomes Short Form-12 (SF-12) Physical Component score, and self-reported function in last 7-30 days (lifting 25-pound objects, housework). 20-m and 400-m walk times and gait speed and repeated chair rise test times were collected. RESULTS Compared to back pain alone, pain at all five sites was associated with 39%-86% worse KOOS, WOMAC, and SF-12 scores (p < .0001). Back-Hip and Back-Knee did not produce worse scores than Back pain alone, but Back-Hip-Knee and Back-Knee-Ankle/Foot did. The 20-m, 400-m walk, and repeated chair times were worse among individuals with pain at all five sites. Additional hip and knee sites to back pain, but not ankle/foot, worsened performance-based walk times and chair rise scores. CONCLUSIONS The number and type of coexistent lower body musculoskeletal pain among patients with back pain may be associated with perceived and performance-based assessments. Management plans that efficiently simultaneously address back and additional coexistent pain sites may maximize treatment functional benefits, address patient functional goals in life and mitigate disability.
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Affiliation(s)
- Shawn McGargill
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, PO Box 112730, Gainesville, FL, 32611, USA
| | - Michael Sein
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, PO Box 112730, Gainesville, FL, 32611, USA
| | - Kimberly T Sibille
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, PO Box 112730, Gainesville, FL, 32611, USA
| | - Zane Thompson
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, PO Box 112730, Gainesville, FL, 32611, USA
| | - Michael Brownstein
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, PO Box 112730, Gainesville, FL, 32611, USA
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, PO Box 112730, Gainesville, FL, 32611, USA.
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Wasser JG, Bruner ML, Chen C, Vincent HK. Identifying Risk Factors for Preexisting or Developing Low Back Pain in Youth, High School, and Collegiate Lacrosse Players Using 3-Dimensional Motion Analysis. Orthop J Sports Med 2024; 12:23259671241231958. [PMID: 38496334 PMCID: PMC10943740 DOI: 10.1177/23259671241231958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/06/2023] [Indexed: 03/19/2024] Open
Abstract
Background Low back pain (LBP) is a common condition that can affect athletes of all ages. The risk factors for LBP onset and worsening associated with the lacrosse shooting motion are not yet known. Purpose To identify training and biomechanical factors associated with preexisting LBP and development of LBP over 6 months in youth, high school, and collegiate lacrosse players. Study Design Case-control study; Level of evidence, 3. Methods A total of 128 lacrosse players were enrolled in this study between January 2016 and January 2019. Player characteristics, lacrosse experience, and participation in other sports were self-reported. At baseline and 2-, 4-, and 6-month follow-ups, the players self-rated the presence and severity of LBP using a numeric pain rating scale (0-10 points). Participants were grouped according to LBP symptoms: no LBP at any time point (n = 102), preexisting LBP (n = 17), or developed LBP within the 6-month period (n = 9). The lacrosse shooting motion was captured via 3-dimensional motion analysis, and kinematic and kinetic variables were recorded. A Low Back Stress Index was used to estimate lumbar stress as a function of pelvic acceleration at the time of maximum lateral trunk lean during the shot. Univariate analyses of covariance and logistic regression models were used to address study aims. Results Compared with the no-LBP group, the preexisting LBP group demonstrated 13.9% to 22.9% lower maximum angular velocities at the pelvis, trunk, and shoulders in the transverse plane (P < .05), 19.3% less collective pelvis-shoulder rotation in the transverse plane (P = .015), and 4.5% more knee flexion excursion (P = .063). The developed-LBP group produced 2.3% to 11.1% higher angular velocities in the pelvis, trunk, and shoulder and generated maximum pelvic acceleration values 36% to 42% higher than the remaining groups (P < .05 for both). Mean Low Back Stress Index values were not statistically significant among the groups (no LBP: 12,504 ± 13,076 deg2/s2; preexisting LBP: 8808 ± 10,174 deg2/s2; developed LBP: 19,389 ± 13,590 deg2/s2; P = .157). Conclusion Preexisting LBP was associated with significantly restricted motion of the pelvis, trunk, and shoulders during a lacrosse shot. Excessive pelvic acceleration may be related to the development of LBP in lacrosse players.
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Affiliation(s)
- Joseph G. Wasser
- Department of Physical Medicine & Rehabilitation, University of Florida, Gainesville, Florida, USA
| | - Michelle L. Bruner
- Department of Orthopaedics, University of Florida, Gainesville, Florida, USA
| | - Cong Chen
- Department of Orthopaedics, University of Florida, Gainesville, Florida, USA
| | - Heather K. Vincent
- Department of Physical Medicine & Rehabilitation, University of Florida, Gainesville, Florida, USA
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Vincent HK, Johnson AJ, Sibille KT, Vincent KR, Cruz-Almeida Y. Author Correction: Weight-cycling over 6 years is associated with pain, physical function and depression in the Osteoarthritis Initiative cohort. Sci Rep 2024; 14:1738. [PMID: 38242955 PMCID: PMC10798958 DOI: 10.1038/s41598-024-52366-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024] Open
Affiliation(s)
- Heather K Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida, PO Box 112730, Gainesville, FL, 32608, USA.
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA.
| | - Alisa J Johnson
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
- Phenotyping and Assessment in Neuroscience Lab, University of Florida, Gainesville, FL, USA
| | - Kim T Sibille
- Department of Physical Medicine and Rehabilitation, University of Florida, PO Box 112730, Gainesville, FL, 32608, USA
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
- Translational Research in Assessment and Intervention Lab, University of Florida, Gainesville, FL, USA
| | - Kevin R Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida, PO Box 112730, Gainesville, FL, 32608, USA
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
- Phenotyping and Assessment in Neuroscience Lab, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, University of Florida, Gainesville, FL, USA
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
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Woolnough LU, Lentini L, Bhavsar PH, Thomas MF, Casella ZM, Vincent HK. Child and Caregiver Beliefs of Importance of Physical Function and Quality of Life in Juvenile Idiopathic Arthritis: A Survey Study. Pediatr Phys Ther 2024; 36:88-93. [PMID: 37820355 DOI: 10.1097/pep.0000000000001060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
PURPOSE To evaluate patient-caregiver beliefs of relative importance across 4 domains while living with juvenile idiopathic arthritis (JIA). METHODS This was a cross-sectional, anonymous survey study conducted in an academic medical center. Participants with JIA and caregivers (N = 151) completed a Likert-style survey to rate items by importance of knowledge about 4 domains: medications, physical activity, routine measures, and quality of life. RESULTS Knowledge of medication issues ranked higher than the remaining 3 domains (4.2 ± 0.7 points vs 4.0 ± 0.7, 4.1 ± 0.8, and 4.0 ± 0.9 points, respectively; P = .026; P = .026). Compared with caregivers, participants rated importance lower for all 4 domains. CONCLUSIONS Gait and physical activity and well-being are not uniformly measured as part of routine clinical care and disease tracking in JIA. Both participants and caregivers ranked knowledge of physical activity similarly to routine office measures and quality of life. Inclusion of these measures in routine care could improve people centeredness and inform treatment plans.
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Affiliation(s)
- Leandra U Woolnough
- Departments of Pediatrics (Dr Woolnough and Mr Lentini) and Physical Medicine and Rehabilitation (Dr Vincent), College of Medicine, University of Florida, Gainesville, Florida; Applied Physiology and Kinesiology Program (Mss Bhavsar and Thomas and Mr Casella), University of Florida, Gainesville, Florida
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Vincent HK, Bhavsar P, Bernier A. Short-Term Impact of Exercise Fitness Testing in a Pediatric Metabolic and Obesity Clinic: Initiative to Improve Health Care Quality. Clin Pediatr (Phila) 2023; 62:1551-1561. [PMID: 37029649 DOI: 10.1177/00099228231165580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
This 2-phase pilot initiative determined whether (1) fitness testing could feasibly be implemented in pediatric practice, and (2) short-term changes in fitness and body mass index occur with Specific, Measurable, Attainable, Relevant, and Time-based (SMART) goals. Phase 1 (N = 580), clinic feasibility: evidence-based prognostic tests were successfully performed to measure cardiorespiratory fitness (CRF; 3-minute bench step), strength (handgrip dynamometry), and flexibility (sit-and-reach distance). Mean CRF percentile was 58.1 (worst >95 percentile, best <5 percentile), strength percentile was 73.5, and flexibility was 42.3 (worst <5 percentile, best >95 percentile). Phase 2, goal setting and follow-up: SMART fitness goals were developed. In phase 2, patients demonstrated 11.9% and 12.4% improvements in CRF and strength percentiles (P < .05) respectively. All patients who were assigned a strength goal improved handgrip strength. Body mass index percentile changes were not different by SMART goal target. Fitness testing was feasible and successfully improved CRF and strength in children at high risk of metabolic complications and future disability.
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Affiliation(s)
| | - Prachi Bhavsar
- College of Medicine, University of Florida, Gainesville, FL, USA
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Sharififar S, Ghasemi H, Geis C, Azari H, Adkins L, Speight B, Vincent HK. Telerehabilitation service impact on physical function and adherence compared to face-to-face rehabilitation in patients with stroke: A systematic review and meta-analysis. PM R 2023; 15:1654-1672. [PMID: 37139741 DOI: 10.1002/pmrj.12988] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/27/2023] [Accepted: 04/05/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES The purposes of this systematic review and meta-analysis were to (1) appraise the available evidence of telerehabilitation program effects on functional outcomes, adherence, and patient satisfaction compared to face-to-face programs after stroke; and (2) provide direction for future outcome measure selection and development for clinical research purposes. TYPE: Systematic review and meta analysis of randomized controlled trials. LITERATURE SURVEY MEDLINE, CINAHL, Embase, Scopus, Proquest Theses and Dissertations, Physiotherapy Evidence Database (PEDro), and Clinicaltrials.gov were searched for studies published in English from 1964 to the end of April 2022. METHODOLOGY A total of 6450 studies were identified, 13 were included in the systematic review, and 10 with at least 3 reported similar outcomes were included the meta-analysis. Methodological quality of results was evaluated using the PEDro checklist. SYNTHESIS Telerehabilitation demonstrated equivalency in outcomes across several domains and was favored compared to conventional face to face alone or when paired with semisupervised physical therapy on Wolf Motor Function performance score (mean difference [MD] 1.69 points, 95% confidence interval [CI] 0.21-3.17) and time score (MD 2.07 seconds, 95% CI -4.04 to -0.10, Q test = 30.27, p < .001, I2 = 93%), and Functional Mobility Assessment in the upper extremities (MD 3.32 points, 95% CI 0.90-5.74, Q test = 5.60, p = .23, I2 = 29% alone or when paired with semisupervised physical therapy). The Barthel Index participation measures of function demonstrated improvement (MD 4.18 points, 95% CI, 1.79-6.57, Q test = 3.56, p = .31, I2 = 16%). Over half of summarized study ratings were determined to be of good to excellent quality (PEDro score 6.6 ± 2.3 points). Adherence varied in available studies from 75%-100%. Satisfaction levels of telerehabilitation were highly variable. CONCLUSIONS Telerehabilitation can improve functional outcomes and promote therapy adherence after stroke. Therapy protocols and functional assessments need substantial refinement and standardization to improve interpretation and clinical outcomes.
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Affiliation(s)
- Sharareh Sharififar
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Hanieh Ghasemi
- Shahid Sadoughi University of Medical Sciences, School of Medicine, Yazd, Iran
| | - Carolyn Geis
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Hassan Azari
- School of Podiatric Medicine, Barry University, Miami Shores, Florida, USA
| | - Lauren Adkins
- University of Florida Health Science Center Libraries, Gainesville, Florida, USA
| | - Bailey Speight
- College of Health and Human Performance, University of Florida, Gainesville, Florida, USA
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, Florida, USA
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Prine BR, Pazik MN, Prine A, Haley H, Bruner ML, Vincent HK. Characteristics and reported injuries of recreational and competitive archers. J Sports Med Phys Fitness 2023; 63:1202-1207. [PMID: 37695565 DOI: 10.23736/s0022-4707.23.15257-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND The aim of this cross-sectional study was to describe basic characteristics of archery athletes and examine injuries reported among archers of a variety of demographic and experience levels. METHODS Participants at various archery competitions were asked to complete a 27-item survey that included demographics, bow type, archery experience, archery training patterns and volume, and injury incidence and anatomical location. RESULTS Two hundred and thirty-four complete surveys were included in the analysis. No significant differences were noted between archery experience groups for age, height, weight, or draw length. A significant difference for draw weight was noted between beginners and advanced level (P=0.045) and between intermediate and advanced archers (P=0.013). Expert level archers reported participating in archery the most days per week (4.9±1.6) and months per year (11.6±0.9) out of all experience levels. Archers using recurve bow types reported more injuries (54 in total) than archers using compound bows (that were 47). The highest percentage of injuries due to archery was found at the expert/professional level with 50% of that group acquiring an injury. The shoulder was the most reported anatomical site of injury (with a total of 69 cases) followed by the back (30 cases) and elbow (19 in total). CONCLUSIONS Injury rates in archery are comparable to other sports such as golf and tennis, thus establishing archery as a sport with legitimate risks to athletes. Also, there are several factors within the sport that predispose participants to injury. It is crucial that participants are informed of these risks and that appropriate training and equipment decisions are made to optimize the reduction of injury prevalence.
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Affiliation(s)
- Bryan R Prine
- Department of Orthopedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA -
| | - Marissa N Pazik
- Department of Orthopedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA
| | - Amanda Prine
- Department of Orthopedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA
| | - Hunter Haley
- Oxford Orthopedics and Sports Medicine, Oxford, MS, USA
| | - Michelle L Bruner
- Department of Orthopedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, FL, USA
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Vincent HK, Johnson AJ, Sibille KT, Vincent KR, Cruz-Almeida Y. Weight-cycling over 6 years is associated with pain, physical function and depression in the Osteoarthritis Initiative cohort. Sci Rep 2023; 13:17045. [PMID: 37813940 PMCID: PMC10562481 DOI: 10.1038/s41598-023-44052-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 10/03/2023] [Indexed: 10/11/2023] Open
Abstract
Body weight significantly impacts health and quality of life, and is a leading risk factor for the development of knee osteoarthritis (OA). Weight cycling may have more negative health consequences compared to steady high or low weight. Using the Osteoarthritis Initiative dataset, we investigated the effects of weight cycling on physical function, quality of life, and depression over 72-months compared to stable or unidirectional body weight trajectories. Participants (n = 731) had knee OA and were classified as: (1) stable-low (BMI < 25), (2) stable-overweight (BMI = 25-29.9), and (3) stable-obese (BMI ≥ 30); (4) steady-weight-loss; (5) steady-weight-gain (weight loss/gain ≥ 2.2 kg every 2-years); (6) gain-loss-gain weight cycling, and (7) loss-gain-loss weight cycling (weight loss/gain with return to baseline), based on bi-annual assessments. We compared Knee Injury and Osteoarthritis Outcome Knee-Related Quality of Life, Function in Sports and Recreation, Physical Activity in the Elderly, Short Form SF-12, repeated chair rise, 20-m gait speed, and Center for Epidemiological Studies Depression using repeated-measures ANOVA. The steady weight loss group demonstrated the worst pain, physical function, and depressive symptoms over time (p's < 0.05). More research is needed to confirm these findings, and elucidate the mechanisms by which steady weight loss is associated with functional decline in knee OA.
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Affiliation(s)
- Heather K Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida, PO Box 112730, Gainesville, FL, 32608, USA.
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA.
| | - Alisa J Johnson
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
- Phenotyping and Assessment in Neuroscience Lab, University of Florida, Gainesville, FL, USA
| | - Kim T Sibille
- Department of Physical Medicine and Rehabilitation, University of Florida, PO Box 112730, Gainesville, FL, 32608, USA
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
- Translational Research in Assessment and Intervention Lab, University of Florida, Gainesville, FL, USA
| | - Kevin R Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida, PO Box 112730, Gainesville, FL, 32608, USA
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
- Phenotyping and Assessment in Neuroscience Lab, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, University of Florida, Gainesville, FL, USA
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
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Vincent HK, Sharififar S, McLaren C, May J, Vincent KR. Acute and chronic cardiovascular responses to concentric and eccentric exercise in older adults with knee osteoarthritis. BMC Sports Sci Med Rehabil 2023; 15:95. [PMID: 37528468 PMCID: PMC10394881 DOI: 10.1186/s13102-023-00708-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/25/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Muscle contraction type in resistance exercise training may confer benefits besides strength in individuals with osteoarthritis and cardiovascular disease (CVD) risks. The purpose of the study was to explore whether Eccentric-resistance training (RT) improved hemodynamic responses to acute walking exercise stress compared to Concentric-RT among individuals with knee OA over four months. METHODS This was a secondary analysis from a randomized, controlled, single-blinded study. Participants (N = 88; 68.3 ± 6.4 yrs; 67.4% female) were randomized to one of two work-matched resistance training (RT) programs against a non-RT control group. Pre-training and month four, participants completed a self-paced Six-Minute Walk Test (6MWT) and progressive treadmill exercise test. Heart rates, blood pressures and mean arterial pressures (MAP) were captured during each test. Antihypertensive medications use was documented at each time point. RESULTS Leg strength improved in both training groups by month four (p < .05). Changes in 6MWT distance and progressive treadmill test time were not different across groups over four months. Neither Concentric or Eccentric RT produced different hemodyamic responses during the 6MWT compared to the control group post-training. However, Concentric RT was associated with 6.0%-7.4% reductions in systolic blood pressure during the graded treadmill walking test at 50%, 75% and 100% of the test time compared to Eccentric RT and the controls (p = .045). MAP values were lower at 75% and 100% of the treadmill test after Concentric RT (5.7%-6.0% reductions) compared to Eccentric RT (1.0%-2.4% reductions) and controls (1.5% and 4.0% elevations) post-training (p = .024). Antihypertensive medication use did not change in any group. CONCLUSIONS The repeated, progressive exposures of Concentric RT-induced blunted the hypertensive responses to acute exercise compared to Eccentric-RT. Among people with knee OA, Concentric-RT may confer strength benefits to manage OA and possibly reduce cardiovascular stress during exercise.
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Affiliation(s)
- Heather K Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA.
| | - Sharareh Sharififar
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA
| | - Christian McLaren
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA
| | - James May
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA
| | - Kevin R Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA
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12
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Buck AN, Vincent HK, Newman CB, Batsis JA, Abbate LM, Huffman KF, Bodley J, Vos N, Callahan LF, Shultz SP. Evidence-Based Dietary Practices to Improve Osteoarthritis Symptoms: An Umbrella Review. Nutrients 2023; 15:3050. [PMID: 37447376 PMCID: PMC10347206 DOI: 10.3390/nu15133050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/27/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
While there is some research investigating whole foods or diets that are easily understood and accessible to patients with osteoarthritis, specific nutrients or nutraceuticals are more commonly identified. Unfortunately, guidelines and evidence surrounding individual nutrients, extracts, and nutraceuticals are conflicting and are more difficult to interpret and implement for patients with osteoarthritis. The purpose of this umbrella review is to provide a comprehensive understanding of the existing evidence of whole foods and dietary patterns effects on osteoarthritis-related outcomes to inform evidence-based recommendations for healthcare professionals and identify areas where more research is warranted. A literature search identified relevant systematic reviews/meta-analyses using five databases from inception to May 2022. Five systematic reviews/meta-analyses were included in the current umbrella review. Most evidence supported the Mediterranean diet improving osteoarthritis-related outcomes (e.g., pain, stiffness, inflammation, biomarkers of cartilage degeneration). There was little to no evidence supporting the effects of fruits and herbs on osteoarthritis-related outcomes; however, there was some suggestion that specific foods could potentiate symptom improvement through antioxidative mechanisms. The overall lack of homogeneity between the studies limits the conclusions that can be made and highlights the need for quality research that can identify consumer-accessible foods to improve osteoarthritis-related symptoms.
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Affiliation(s)
- Ashley N. Buck
- Kinesiology Department, Seattle University, Seattle, WA 98122, USA;
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC 27402, USA
- Osteoarthritis Action Alliance, Chapel Hill, NC 27599, USA; (H.K.V.); (C.B.N.); (J.A.B.); (L.M.A.); (K.F.H.); (N.V.); (L.F.C.)
| | - Heather K. Vincent
- Osteoarthritis Action Alliance, Chapel Hill, NC 27599, USA; (H.K.V.); (C.B.N.); (J.A.B.); (L.M.A.); (K.F.H.); (N.V.); (L.F.C.)
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 33865, USA
| | - Connie B. Newman
- Osteoarthritis Action Alliance, Chapel Hill, NC 27599, USA; (H.K.V.); (C.B.N.); (J.A.B.); (L.M.A.); (K.F.H.); (N.V.); (L.F.C.)
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - John A. Batsis
- Osteoarthritis Action Alliance, Chapel Hill, NC 27599, USA; (H.K.V.); (C.B.N.); (J.A.B.); (L.M.A.); (K.F.H.); (N.V.); (L.F.C.)
- Division of Geriatric Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC 27402, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27402, USA
| | - Lauren M. Abbate
- Osteoarthritis Action Alliance, Chapel Hill, NC 27599, USA; (H.K.V.); (C.B.N.); (J.A.B.); (L.M.A.); (K.F.H.); (N.V.); (L.F.C.)
- VA Eastern Colorado Geriatric Education and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO 80045, USA
| | - Katie F. Huffman
- Osteoarthritis Action Alliance, Chapel Hill, NC 27599, USA; (H.K.V.); (C.B.N.); (J.A.B.); (L.M.A.); (K.F.H.); (N.V.); (L.F.C.)
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Jennifer Bodley
- Lemieux Library, Seattle University, Seattle, WA 98122, USA;
| | - Natasha Vos
- Osteoarthritis Action Alliance, Chapel Hill, NC 27599, USA; (H.K.V.); (C.B.N.); (J.A.B.); (L.M.A.); (K.F.H.); (N.V.); (L.F.C.)
- North Carolina Center for Health and Wellness, University of North Carolina, Asheville, NC 28804, USA
| | - Leigh F. Callahan
- Osteoarthritis Action Alliance, Chapel Hill, NC 27599, USA; (H.K.V.); (C.B.N.); (J.A.B.); (L.M.A.); (K.F.H.); (N.V.); (L.F.C.)
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC 27599, USA
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Sarah P. Shultz
- Kinesiology Department, Seattle University, Seattle, WA 98122, USA;
- Osteoarthritis Action Alliance, Chapel Hill, NC 27599, USA; (H.K.V.); (C.B.N.); (J.A.B.); (L.M.A.); (K.F.H.); (N.V.); (L.F.C.)
- School of Nursing and Health Studies, Monmouth University, West Long Branch, NJ 07764, USA
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Kelshaw PM, Eyerly DR, Herman DC, Vincent HK, Hepburn L, Lincoln AE, Caswell SV. Pilot study to explore girls' lacrosse players' attitudes toward headgear. Res Sports Med 2023; 31:873-880. [PMID: 35410546 DOI: 10.1080/15438627.2022.2064222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
Abstract
Headgear adoption is a controversial issue in girls' lacrosse due to concerns that headgear use will facilitate greater risk-taking by players and contribute to more aggressive game play behaviours. The purpose of this pilot study was to evaluate high school girls' lacrosse players' attitudes towards headgear before and after a season of use. Twenty-five high school girls' lacrosse athletes wore headgear for one competitive season and completed a pre- and post-season survey. The survey evaluated players' attitudes towards headgear use, with Aggressiveness, and Anger scales. Wilcoxon ranked tests were conducted to compare scores pre- and post-season. Players' attitude towards headgear largely remained unchanged and "neutral" after a season of wearing headgear. Players endorsed slightly greater agreement for three Headgear survey items post-season compared to pre-season: " … headgear allows me to be more aggressive … " (p = .01), " … players should wear more protective equipment " (p = .04) and " … wearing headgear increases how often I am hit in the head … " (p = .04). However, Aggressiveness and Anger scale scores were not changed following headgear use. Our findings suggest the perception of headgear use in high school girls' lacrosse is complex and could be associated with minor perceived changes in game play behaviours.
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Affiliation(s)
- Patricia M Kelshaw
- Department of Kinesiology, Brain Research & Assessment Initiative of New Hampshire (BRAIN) Laboratory, University of New Hampshire, Durham, NH, USA
| | - Dana R Eyerly
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Daniel C Herman
- Department of Physical Medicine and Rehabilitation, University of California at Davis, Davis, CA, USA
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, FL, USA
| | - Lisa Hepburn
- MedStar Sports Medicine Research Center, MedStar Health, Baltimore, MD, USA
| | - Andrew E Lincoln
- Health Research & Evaluation, Special Olympics, Washington, DC, USA
| | - Shane V Caswell
- School of Kinesiology, Virginia Concussion Initiative, Advancing Healthcare Initiatives for Underserved Students (ACHIEVES) Project, Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA, USA
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Driban JB, Vincent HK, Trojian TH, Ambrose KR, Baez S, Beresic N, Berkoff DJ, Callahan LF, Cohen B, Franek M, Golightly YM, Harkey M, Kuenze CM, Minnig MC, Mobasheri A, Naylor A, Newman CB, Padua DA, Pietrosimone B, Pinto D, Root H, Salzler M, Schmitt LC, Snyder-Mackler L, Taylor JB, Thoma LM, Vincent KR, Wellsandt E, Williams M. Preventing Osteoarthritis After an Anterior Cruciate Ligament Injury: An Osteoarthritis Action Alliance Consensus Statement. J Athl Train 2023; 58:193-197. [PMID: 37130278 PMCID: PMC10176846 DOI: 10.4085/1062-6050-0255.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
After an anterior cruciate ligament (ACL) injury, people need secondary prevention strategies to identify osteoarthritis at its earliest stages so that interventions can be implemented to halt or slow the progression toward its long-term burden. The Osteoarthritis Action Alliance formed an interdisciplinary Secondary Prevention Task Group to develop a consensus on recommendations to provide clinicians with secondary prevention strategies that are intended to reduce the risk of osteoarthritis after a person has an ACL injury. The group achieved consensus on 15 out of 16 recommendations that address patient education, exercise and rehabilitation, psychological skills training, graded-exposure therapy, cognitive-behavioral counseling (lacked consensus), outcomes to monitor, secondary injury prevention, system-level social support, leveraging technology, and coordinated care models. We hope this statement raises awareness among clinicians and researchers on the importance of taking steps to mitigate the risk of osteoarthritis after an ACL injury.
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Affiliation(s)
- Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Heather K. Vincent
- UF Health Sports Performance Center, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville
| | | | - Kirsten R. Ambrose
- Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina, Chapel Hill
| | - Shelby Baez
- Department of Kinesiology, Michigan State University, East Lansing
| | - Nicholas Beresic
- Department of Orthopaedics, University of North Carolina, Chapel Hill
| | | | - Leigh F. Callahan
- Department of Orthopaedics, University of North Carolina, Chapel Hill
| | | | - Madison Franek
- Wellness Center at Meadowmont, Department of Therapy Services, University of North Carolina, Chapel Hill
| | | | - Matthew Harkey
- Department of Kinesiology, Michigan State University, East Lansing
| | | | - Mary Catherine Minnig
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Ali Mobasheri
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Finland
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
- Department of Joint Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
| | - Adam Naylor
- Telos SPC, Boston, MA
- Deloitte US, Boston, MA
| | - Connie B. Newman
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, School of Medicine, New York University
| | - Darin A. Padua
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill
| | - Brian Pietrosimone
- Department of Orthopaedics, University of North Carolina, Chapel Hill
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill
| | - Daniel Pinto
- Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Hayley Root
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff
| | - Matthew Salzler
- Division of Sports Medicine, Department of Orthopaedic Surgery, School of Medicine, Tufts Medical Center, Boston, MA
| | - Laura C. Schmitt
- Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | | | - Jeffrey B. Taylor
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, NC
| | - Louise M. Thoma
- Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina, Chapel Hill
| | - Kevin R. Vincent
- UF Health Sports Performance Center, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville
| | - Elizabeth Wellsandt
- Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha
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15
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Driban JB, Vincent HK, Trojian TH, Ambrose KR, Baez S, Beresic N, Berkoff DJ, Callahan LF, Cohen B, Franek M, Golightly YM, Harkey M, Kuenze CM, Minnig MC, Mobasheri A, Naylor A, Newman CB, Padua DA, Pietrosimone B, Pinto D, Root H, Salzler M, Schmitt L, Snyder-Mackler L, Taylor JB, Thoma LM, Vincent KR, Wellsandt E, Williams M. Evidence Review for Preventing Osteoarthritis After an Anterior Cruciate Ligament Injury: An Osteoarthritis Action Alliance Consensus Statement. J Athl Train 2023; 58:198-219. [PMID: 37130279 PMCID: PMC10176847 DOI: 10.4085/1062-6050-0504.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
CONTEXT The Osteoarthritis Action Alliance formed a secondary prevention task group to develop a consensus on secondary prevention recommendations to reduce the risk of osteoarthritis after a knee injury. OBJECTIVE Our goal was to provide clinicians with secondary prevention recommendations that are intended to reduce the risk of osteoarthritis after a person has sustained an anterior cruciate ligament injury. Specifically, this manuscript describes our methods, literature reviews, and dissenting opinions to elaborate on the rationale for our recommendations and to identify critical gaps. DESIGN Consensus process. SETTING Virtual video conference calls and online voting. PATIENTS OR OTHER PARTICIPANTS The Secondary Prevention Task Group consisted of 29 members from various clinical backgrounds. MAIN OUTCOME MEASURE(S) The group initially convened online in August 2020 to discuss the target population, goals, and key topics. After a second call, the task group divided into 9 subgroups to draft the recommendations and supportive text for crucial content areas. Twenty-one members completed 2 rounds of voting and revising the recommendations and supportive text between February and April 2021. A virtual meeting was held to review the wording of the recommendations and obtain final votes. We defined consensus as >80% of voting members supporting a proposed recommendation. RESULTS The group achieved consensus on 15 of 16 recommendations. The recommendations address patient education, exercise and rehabilitation, psychological skills training, graded-exposure therapy, cognitive-behavioral counseling (lacked consensus), outcomes to monitor, secondary injury prevention, system-level social support, leveraging technology, and coordinated care models. CONCLUSIONS This consensus statement reflects information synthesized from an interdisciplinary group of experts based on the best available evidence from the literature or personal experience. We hope this document raises awareness among clinicians and researchers to take steps to mitigate the risk of osteoarthritis after an anterior cruciate ligament injury.
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Affiliation(s)
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Heather K. Vincent
- UF Health Sports Performance Center, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville
| | - Thomas H. Trojian
- UF Health Sports Performance Center, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville
| | | | - Shelby Baez
- Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill
| | | | - David J. Berkoff
- Department of Kinesiology, Michigan State University, East Lansing
| | - Leigh F. Callahan
- Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill
| | | | - Madison Franek
- University of North Carolina Therapy Services, UNC Wellness Center at Meadowmont, Chapel Hill
| | - Yvonne M. Golightly
- Department of Epidemiology, Thurston Arthritis Research Center, Injury Prevention Research Center, Osteoarthritis Action Alliance, University of North Carolina at Chapel Hill
| | - Matthew Harkey
- Department of Kinesiology, Michigan State University, East Lansing
| | | | - Mary Catherine Minnig
- Department of Epidemiology, Thurston Arthritis Research Center, Injury Prevention Research Center, Osteoarthritis Action Alliance, University of North Carolina at Chapel Hill
| | - Ali Mobasheri
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Finland; Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania; Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
| | | | - Connie B. Newman
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, NYU Grossman School of Medicine, New York, NY
| | - Darin A. Padua
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Brian Pietrosimone
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, NC
| | - Daniel Pinto
- Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Hayley Root
- Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Matthew Salzler
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff
| | - Laura Schmitt
- Division of Physical Therapy, School of Health and Rehabilitation Sciences, Ohio State University, Columbus
| | | | - Jeffrey B. Taylor
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, NC
| | - Louise M. Thoma
- Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill
| | - Kevin R. Vincent
- UF Health Sports Performance Center, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville
| | - Elizabeth Wellsandt
- Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha
| | - Monette Williams
- Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha
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Madsen A, Sharififar S, Oberhaus J, Vincent KR, Vincent HK. Anxiety state impact on recovery of runners with lower extremity injuries. PLoS One 2022; 17:e0278444. [PMID: 36454920 PMCID: PMC9714898 DOI: 10.1371/journal.pone.0278444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/16/2022] [Indexed: 12/05/2022] Open
Abstract
This prospective cohort study examined the impact of high anxiety levels on psychological state and gait performance during recovery in runners with lower body injuries. Recreational runners diagnosed with lower body injuries who had reduced running volume (N = 41) were stratified into groups using State Trait Anxiety Inventory (STAI) scores: high anxiety (H-Anx; STAI ≥40 points) and low anxiety (L-Anx; STAI <40 points). Runners were followed through rehabilitation to return-to-run using monthly surveys. Main outcome measures included kinesiophobia (Tampa Scale of Kinesiophobia, TSK-11), Positive and Negative Affect Schedule (PANAS; Positive and negative scores), Lower Extremity Function Scale (LEFS), running recovery (University of Wisconsin Running Injury and Recovery Index [UWRI]) and CDC Healthy Days modules for general health, days of anxiety/tension, disrupted sleep and work/usual activities. Running biomechanics were assessed at baseline and the final visit using 3D motion capture and a force-plated treadmill. The time to return-to-running for was 5.0±3.1 and 7.9±4.1 months for L-Anx and H-Anx, respectively and participants who withdrew (n = 15) did so at 7.7±6.2 months. L-Anx maintained low anxiety and H-Anx reduced anxiety from baseline to final visit (STAI = 31.5 to 28.4 points, 50.4 to 37.8 points, respectively), whereas the withdrawn runners remained clinically anxious at their final survey (41.5 to 40.3 points; p < .05). Group by time interactions were found for PANAS positive, LEFS UWRI, general health scores, and days feeling worry, tension and anxiety (all p < .05). Final running performance in L-Anx compared to H-Anx was most improved with cadence (8.6% vs 3.5%; p = .044), impact loading rate [-1.9% vs +8.9%] and lower body stiffness [+14.1% vs +3.2%; all p < .05). High anxiety may identify runners who will experience a longer recovery process, health-related functional disruptions, and less optimization of gait biomechanics during rehabilitation after a lower extremity injury.
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Affiliation(s)
- Aimee Madsen
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Sharareh Sharififar
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Jordan Oberhaus
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Kevin R. Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Heather K. Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, Florida, United States of America,* E-mail:
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Vincent HK, Vincent KR. Healthy Running Habits for the Distance Runner: Clinical Utility of the American College of Sports Medicine Infographic. Curr Sports Med Rep 2022; 21:463-469. [PMID: 36508604 DOI: 10.1249/jsr.0000000000001019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
ABSTRACT Healthy running form is characterized by motion that minimizes mechanical musculoskeletal injury risks and improves coactivation of muscles that can buffer impact loading and reduce stresses related to chronic musculoskeletal pain. The American College of Sports Medicine Consumer Outreach Committee recently launched an infographic that describes several healthy habits for the general distance runner. This review provides the supporting evidence, expected acute motion changes with use, and practical considerations for clinical use in patient cases. Healthy habits include: taking short, quick, and soft steps; abdominal bracing; elevating cadence; linearizing arm swing; controlling forward trunk lean, and; avoiding running through fatigue. Introduction of these habits can be done sequentially one at a time to build on form, or more than one over time. Adoption can be supported by various feedback forms and cueing. These habits are most successful against injury when coupled with regular dynamic strengthening of the kinetic chain, adequate recovery with training, and appropriate shoe wear.
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Affiliation(s)
- Heather K Vincent
- Department of Physical Medicine and Rehabilitation, UF Health Running Medicine and Sports Performance Center, College of Medicine, University of Florida, Gainesville, FL
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Vincent HK, Sharififar S, Abdelmalik B, Lentini L, Chen C, Woolnough LU. Gait parameters, functional performance and physical activity in active and inactive Juvenile Idiopathic Arthritis. Gait Posture 2022; 98:226-232. [PMID: 36191581 DOI: 10.1016/j.gaitpost.2022.09.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/04/2022] [Accepted: 09/19/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Children with Juvenile Idiopathic Arthritis (JIA) may adopt different movement patterns and participate in physical activity during different states of disease. RESEARCH QUESTION Which specific features of gait and physical function performance differ among children with active or inactive JIA compared to healthy children? METHODS Forty-three children participated (14.5 ± 4.2 yrs; 60 % female). 3D-motion analysis methods were coupled with force measures from an instrumented treadmill captured gait mechanical measures. The 30-second Chair Rise Test (repetitions) and stair ascent-descent tests were performed, and the 11-point Wong-Baker face scale assessed pain after each test. RESULTS Compared to healthy controls children with active and inactive JIA had worse outcomes (12-21 % slower self-selected and fast walking speeds, 28-34 % slower stair navigation times, 28 % fewer chair rise repetitions in 30 s; all p < .05). Children with active JIA had 8-13 % slower gait speeds, 4 % fewer chair rise repetitions and 14-16 % slower stair navigation times. At faster walking speed, children with active JIA had less hip joint flexion/extension excursion in the sagittal plane during the gait cycle, produced higher leg stiffness, and demonstrated greater interlimb asymmetry in GRF vertical impulse during loading than healthy children (all p < .05). The Pedi-FABS subscore of "Duration: performing athletic activity for as long as you would like without stopping" was rated lower in children with active JIA compared to controls (p < .05). CONCLUSION Gait speed, specific load-bearing functional tasks and leg stiffness features of gait may be informative 'functional biomarkers' for assessing JIA burden and tracking treatment efficacy. Additional prospective studies are needed to determine how these features change over time with pain change, and understand impact on quality of life and physical activity participation.
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Affiliation(s)
- Heather K Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida, PO Box 112730, Gainesville, FL 32607, United States.
| | - Sharareh Sharififar
- Department of Physical Medicine and Rehabilitation, University of Florida, PO Box 112730, Gainesville, FL 32607, United States.
| | - Bishoy Abdelmalik
- Department of Physical Medicine and Rehabilitation, University of Florida, PO Box 112730, Gainesville, FL 32607, United States.
| | - Logan Lentini
- Department of Pediatrics, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, United States.
| | - Cong Chen
- Department of Orthopaedics, University of Florida, PO Box112727, Gainesville, FL 32611, United States.
| | - Leandra U Woolnough
- Department of Pediatrics, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, United States
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Herman DC, Caswell SV, Kelshaw PM, Vincent HK, Lincoln AE. Association of headgear mandate and concussion injury rates in girls' high school lacrosse. Br J Sports Med 2022; 56:970-974. [PMID: 36002286 DOI: 10.1136/bjsports-2021-105031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Headgear use is a controversial issue in girls' lacrosse. We compared concussion rates among high school lacrosse players in an American state with a headgear mandate (HM) to states without an HM. METHODS Participants included high schools with girls' lacrosse programmes in the USA. Certified athletic trainers reported athlete exposure (AE) and injury data via the National Athletic Treatment, Injury and Outcomes Network during the 2019-2021 seasons. The HM cohort was inclusive of high schools from the state of Florida, which mandates the use of ASTM standard F3137 headgear, while the non-HM (NHM) cohort was inclusive of high schools in 31 states without a state-wide HM. Incidence rate ratios (IRRs) and 95% CIs were calculated. RESULTS 141 concussions (HM: 25; NHM: 116) and 357 225 AEs were reported (HM: 91 074 AEs; NHM: 266 151 AEs) across all games and practices for 289 total school seasons (HM: 96; NHM: 193). Overall, the concussion injury rate per 1000 AEs was higher in the NHM cohort (0.44) than the HM cohort (0.27) (IRR=1.59, 95% CI: 1.03 to 2.45). The IRR was higher for the NHM cohort during games (1.74, 95% CI: 1.00 to 3.02) but not for practices (1.42, 95% CI: 0.71 to 2.83). CONCLUSIONS These findings suggest a statewide HM for high school girls' lacrosse is associated with a lower concussion rate than playing in a state without an HM. Statewide mandates requiring ASTM standard F3137 headgear should be considered to reduce the risk of concussion.
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Affiliation(s)
- Daniel C Herman
- Department of Physical Medicine and Rehabilitation, University of California Davis, Sacramento, California, USA
| | - Shane V Caswell
- School of Kinesiology; College of Education and Human Development, Exercise, Fitness and Health Promotion; Sports Medicine Assessment, Research & Testing (SMART) Laboratory, Advancing Healthcare Initiative for Underserved Students (ACHIEVES), George Mason University, Manassas, Virginia, USA.,Virginia Concussion Initiative, George Mason University, Manassas, Virginia, USA
| | - Patricia M Kelshaw
- Virginia Concussion Initiative, George Mason University, Manassas, Virginia, USA.,Department of Kinesiology, Brain Research & Assessment Initiative of New Hampshire (BRAIN) Laboratory, University of New Hampshire, Durham, New Hampshire, USA
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, Florida, USA
| | - Andrew E Lincoln
- Virginia Concussion Initiative, George Mason University, Manassas, Virginia, USA.,Special Olympics, Washington, DC, USA
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Vincent HK, Leonardo TA, Bernier A. Impact Of Fitness Testing In Pediatric Obesity-Metabolic Clinics: A Multidisciplinary Pilot Project. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000877908.29957.be] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Woolnough LU, Lentini L, Sharififar S, Chen C, Vincent HK. The relationships of kinesiophobia and physical function and physical activity level in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2022; 20:73. [PMID: 36050703 PMCID: PMC9438303 DOI: 10.1186/s12969-022-00734-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Kinesiophobia may hinder physical performance measures and functional quality of life in children with juvenile idiopathic arthritis (JIA). This study aims to quantify differences in physical function in patients with JIA compared to healthy controls, and determine the effects of kinesiophobia on physical function and physical activity. METHODS This was a comparative study of participants with JIA and healthy controls (JIA n = 26, control n = 17). All children with JIA had lower extremity joint involvement. Performance-based measures included gait speed, chair and stair navigation performance. Self-reported measures included Patient Reported Outcome Measurement Information System (PROMIS®) Physical Function Mobility, and Pain Interference and the Pediatric Functional Activity Brief Scale (Pedi-FABS). The Tampa Scale of Kinesiophobia (TSK-11) assessed patient fear of movement due to pain. Linear regression models were used to determine the contribution of TSK-11 scores on performance test and Pedi-FABS scores. RESULTS Gait speeds were 11-15% slower, chair rise repetitions were 28% fewer, and stair ascent and descent times were 26-31% slower in JIA than controls (p < .05). PROMIS® Physical Function Mobility scores were 10% lower and Pain Interference scores were 2.6 times higher in JIA than healthy controls (p = .003). TSK-11 scores were higher in JIA than controls (p < .0001). After controlling for covariates, TSK-11 scores explained 11.7-26.5% of the variance of regression models for stair climb time, chair rise performance and Pedi-FABS scores (p < .05). CONCLUSIONS Children with JIA experience difficulty with tasks related to body transfers. Kinesiophobia is a significant contributor to the functional task performance and may impact clinical outcomes.
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Affiliation(s)
- Leandra U. Woolnough
- grid.15276.370000 0004 1936 8091Department of Pediatrics and Physical Medicine and Rehabilitation, University of Florida, 1600 SW Archer Rd HD-409, PO Box 100296, Gainesville, FL 32610 USA
| | - Logan Lentini
- grid.15276.370000 0004 1936 8091Department of Pediatrics and Physical Medicine and Rehabilitation, University of Florida, 1600 SW Archer Rd HD-409, PO Box 100296, Gainesville, FL 32610 USA
| | - Sharareh Sharififar
- grid.15276.370000 0004 1936 8091Department of Pediatrics and Physical Medicine and Rehabilitation, University of Florida, 1600 SW Archer Rd HD-409, PO Box 100296, Gainesville, FL 32610 USA
| | - Cong Chen
- grid.15276.370000 0004 1936 8091Department of Pediatrics and Physical Medicine and Rehabilitation, University of Florida, 1600 SW Archer Rd HD-409, PO Box 100296, Gainesville, FL 32610 USA
| | - Heather K. Vincent
- grid.15276.370000 0004 1936 8091Department of Pediatrics and Physical Medicine and Rehabilitation, University of Florida, 1600 SW Archer Rd HD-409, PO Box 100296, Gainesville, FL 32610 USA
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22
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Vincent KR, Vincent HK. Runners With Chronic Back Pain Are At Elevated Risk For Developing Chronic Knee Pain: Implications For Rehabilitation. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000875112.33723.f7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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23
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McDermott CE, Vincent HK, Mathews AE, Cautela BG, Sandoval M, Tremblay A, Langkamp-Henken B. Impact of probiotic supplementation on exercise endurance among non-elite athletes: study protocol for a randomized, placebo-controlled, double-blind, clinical trial. Trials 2022; 23:603. [PMID: 35897037 PMCID: PMC9326435 DOI: 10.1186/s13063-022-06552-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 07/15/2022] [Indexed: 12/15/2022] Open
Abstract
Background Some probiotics appear to improve athletic performance, endurance, and recovery after intense exercise. Other formulations may provide performance-related benefits via immune and gastrointestinal functions in athletic individuals. However, few formulations have been studied for both types of effects among non-elite athletes. The primary objective of this study is to assess the ergogenic effects of a probiotic on high-intensity endurance running performance in non-elite runners. Secondary objectives include assessment of perceived exertion, blood chemistry, immune and stress biomarkers, cold and flu symptoms, and gastrointestinal health after the probiotic intervention. Methods This 9-week randomized, placebo-controlled, double-blind, parallel trial will assess the ergogenic effects of a probiotic (5 billion colony-forming units/day, for 6 weeks) in healthy, non-elite runners (N=32; 18–45 years). Participants will be monitored via daily and weekly questionnaires during the 2-week pre-baseline, 6-week intervention, and 1-week washout. Questionnaires will inquire about activity, muscle soreness, gastrointestinal symptoms, cold and flu symptoms, stool form and frequency, and adverse events. During the pre-baseline visit, maximal oxygen uptake (V̇O2 max) is assessed to set appropriate individualized workload settings for the treadmill time-to-exhaustion endurance tests. These time-to-exhaustion endurance running tests will be completed at an intensity of 85% VO2max at baseline and final visits. During these tests, self-perceived exercise effort will be rated via the Borg Rating of Perceived Exertion scale and finger sticks assessing capillary blood glucose and lactate concentrations will be collected every 3 min. Additional questionnaires will assess diet and motivation to exercise. Body composition will be assessed using air displacement plethysmography at the baseline and final visits. Hypotheses will be tested using two-sided tests, and a linear model and with a type I error rate of α=0.05. Primary and secondary outcomes will be tested by comparing results between the intervention groups, adjusting for baseline values. Discussion These results will build evidence documenting the role of probiotics on running endurance performance and physiological responses to exercise in non-elite athletes. Understanding the potential mechanisms of probiotic effects and how they mitigate the intestinal or immune discomforts caused by running could provide additional strategy means to help runners improve their performance. Trial registration number ClinicalTrials.govNCT04588142. Posted on October 19, 2020. Protocol version: July 2, 2021, version 1.2
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Affiliation(s)
- Caitlin E McDermott
- Department of Food Science and Human Nutrition, University of Florida, 572 Newell Drive, PO Box 110370, Gainesville, FL, 32611-0370, USA
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, UF Health Sports Performance Center, University of Florida, 3450 Hull Road, PO Box 112730, Gainesville, FL, USA. .,UF Health Sports Performance Center, University of Florida, Gainesville, USA.
| | - Anne E Mathews
- Department of Food Science and Human Nutrition, University of Florida, 572 Newell Drive, PO Box 110370, Gainesville, FL, 32611-0370, USA
| | | | | | | | - Bobbi Langkamp-Henken
- Department of Food Science and Human Nutrition, University of Florida, 572 Newell Drive, PO Box 110370, Gainesville, FL, 32611-0370, USA
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Buck AN, Shultz SP, Huffman KF, Vincent HK, Batsis JA, Newman CB, Beresic N, Abbate LM, Callahan LF. Mind the Gap: Exploring Nutritional Health Compared With Weight Management Interests of Individuals with Osteoarthritis. Curr Dev Nutr 2022; 6:nzac084. [PMID: 35702382 PMCID: PMC9188467 DOI: 10.1093/cdn/nzac084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/02/2022] [Accepted: 04/12/2022] [Indexed: 11/28/2022] Open
Abstract
Background For persons with osteoarthritis (OA), nutrition education may facilitate weight and OA symptom management. Objectives The primary aim of this study was to determine preferred OA-related nutritional and weight management topics and their preferred delivery modality. The secondary aim was to determine whether there is a disconnect between what patients want to know about nutrition and OA management and what information health-care professionals (HCPs) are providing to patients. Methods The Osteoarthritis Action Alliance surveyed individuals with OA to identify their preferences, categorized in 4 domains: 1) strategies for weight management and a healthy lifestyle; 2) vitamins, minerals, and other supplements; 3) foods or nutrients that may reduce inflammation; and 4) diets for weight loss. HCPs were provided these domains and asked which topics they discussed with patients with OA. Both groups were asked to select currently utilized or preferred formats of nutritional resources. Results Survey responses from 338 individuals with OA and 104 HCPs were included. The highest preference rankings in each domain were: 1) foods that make OA symptoms worse (65%), foods and nutrients to reduce inflammation (57%), and healthy weight loss (42%); 2) glucosamine (53%), vitamin D (49%), and omega-3 fatty acids (45%); 3) spices and herbs (65%), fruits and vegetables (58%), and nuts (40%); and 4) Mediterranean diet (21%), low-carbohydrate diet (18%), and fasting or intermittent fasting (15%). There was greater than 20% discrepancy between interests reported by individuals with OA and discussions reported by HCPs on: weight loss strategies, general information on vitamins and minerals, special dietary considerations for other conditions, mindful eating, controlling caloric intake or portion sizes, and what foods worsen OA symptoms. Most respondents preferred to receive nutrition information in a passive format and did not want information from social media messaging. Conclusions There is disparity between the nutrition education content preferred by individuals with OA (which often lacks empirical support) and evidence-based topics being discussed by HCPs. HCPs must communicate evidence-based management of joint health and OA symptoms in patient-preferred formats. This study explored the information gap between what individuals with OA want to know and what HCPs believe they need to know.
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Affiliation(s)
- Ashley N Buck
- Kinesiology Department, Seattle University, Seattle, WA, USA
| | - Sarah P Shultz
- Kinesiology Department, Seattle University, Seattle, WA, USA
- Osteoarthritis Action Alliance, Chapel Hill, NC, USA
| | | | - Heather K Vincent
- Osteoarthritis Action Alliance, Chapel Hill, NC, USA
- Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, FL, USA
| | - John A Batsis
- Osteoarthritis Action Alliance, Chapel Hill, NC, USA
- Division of Geriatric Medicine, School of Medicine, and Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Connie B Newman
- Osteoarthritis Action Alliance, Chapel Hill, NC, USA
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, New York University Grossman School of Medicine, New York, NY, USA
| | | | - Lauren M Abbate
- Osteoarthritis Action Alliance, Chapel Hill, NC, USA
- VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO, USA
- Department of Emergency Medicine University of Colorado School of Medicine, Aurora, CO, USA
| | - Leigh F Callahan
- Osteoarthritis Action Alliance, Chapel Hill, NC, USA
- Division of Rheumatology, Allergy and Immunology, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Vincent HK, Patel S, Zaremski JL. Impact of COVID on Sports Injury Patterns, Changes in Mental Well-Being, and Strategies to Prepare for Future Pandemics in Sport. Curr Sports Med Rep 2022; 21:196-204. [PMID: 35703746 DOI: 10.1249/jsr.0000000000000966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT This review describes the available evidence of the acute respiratory syndrome coronavirus 2 (SARS-CoV-2, referred to COVID-19) pandemic on musculoskeletal injury patterns and prevalence in athletes. A brief overview of the epidemiology of COVID-19 and prevalence in active populations from youth through professional are provided. Responses to COVID-19 regarding sport participation at regional, national, and international organizations are summarized. Downstream effects of complete or partial training shutdown on injury risk and mental health are discussed. Strategies to maintain athletic potential and overall well-being include maintaining safe access to training facilities and resources, implementation of injury prevention programs, organization of athlete support networks, and incorporation of resilience and coping training.
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Affiliation(s)
- Heather K Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL
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Vincent HK, Brownstein M, Vincent KR. Injury Prevention, Safe Training Techniques, Rehabilitation, and Return to Sport in Trail Runners. Arthrosc Sports Med Rehabil 2022; 4:e151-e162. [PMID: 35141547 PMCID: PMC8811510 DOI: 10.1016/j.asmr.2021.09.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/22/2021] [Indexed: 12/31/2022] Open
Abstract
This current concept, narrative review provides the latest integrated evidence of the musculoskeletal injuries involved with trail running and therapeutic strategies to prevent injury and promote safe participation. Running activities that comprise any form of off-road running (trail running, orienteering, short-long distance, different terrain, and climate) are relevant to this review. Literature searches were conducted to 1) identify types and mechanisms of acute and chronic/overuse musculoskeletal injuries in trail runners, 2) injury prevention techniques most relevant to running trails, 3) safe methods of participation and rehabilitation timelines in the sport. The majority of acute and chronic trail running-related musculoskeletal injuries in trail running occur in the lower leg, primarily in the knee and ankle. More than 70% are due to overuse, and ankle sprains are the most common acute injury. Key mechanisms underlying injury and injury progression include inadequate neuromotor control-balance-coordination, running through fatigue, and abnormal kinematics on variable terrain. Complete kinetic chain prehabilitation programs consisting of dynamic flexibility, neuromotor strength and balance, and plyometrics exercise can foster stable, controlled movement on trails. Patient education about early musculoskeletal pain symptoms and training adjustment can help prevent injury from progressing to serious overuse injuries. Real-time adjustments to cadence, step length, and knee flexion on the trail may also mitigate impact-related risk for injury. After injury occurs, rehabilitation will involve similar exercise components, but it will also incorporate rest and active rest based on the type of injury. Multicomponent prehabilitation can help prevent musculoskeletal injuries in trail runners through movement control and fatigue resistance.
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Affiliation(s)
- Heather K Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida, U.S.A
| | - Michael Brownstein
- Department of Physical Medicine and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida, U.S.A
| | - Kevin R Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida, U.S.A
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Flynn LS, Richard GJ, Vincent HK, Bruner M, Chen C, Matthias RC, Zaremski JL, Farmer KW. Swing Type and Batting Grip Affect Peak Pressures on the Hook of Hamate in Collegiate Baseball Players. Orthop J Sports Med 2021; 9:23259671211060807. [PMID: 34926710 PMCID: PMC8671670 DOI: 10.1177/23259671211060807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/24/2021] [Indexed: 11/15/2022] Open
Abstract
Background Bat swing and grip type may contribute to hook of hamate fractures in baseball players. Purpose To compare the effects of swing type and batting grip on the pressure and rate of pressure development over the hook of hamate in collegiate baseball players. Study Design Descriptive laboratory study. Level of evidence, 3. Methods This was an experimental quasi-randomized study of bat grip and swing differences in National Collegiate Athletic Association Division I baseball players (N = 14; age, 19.6 ± 1.1 years [mean ± SD]). All participants performed swings under 6 combinations: 3 grip types (all fingers on the bat shaft [AO], one finger off the bat shaft [OF], and choked up [CU]) and 2 swing types (full swing and check swing). Peak pressure and rate of pressure generation over the area of the hamate were assessed using a pressure sensor fitted to the palm of the bare hand over the area of the hamate. Wrist angular velocities and excursions of radial ulnar deviation were obtained using 3-dimensional motion analysis. Results The OF-check swing combination produced the highest peak pressure over the hamate (3.72 ± 2.64 kg/cm2) versus the AO-full swing (1.36 ± 0.73 kg/cm2), OF-full swing (1.68 ± 1.17 kg/cm2), and CU-full swing (1.18 ± 0.96 kg/cm2; P < .05 for all). There was a significant effect of condition on rate of pressure development across the 6 conditions (P = .023). Maximal wrist angular velocities were 44% lower in all check swing conditions than corresponding full swing conditions (P < .0001). The time to achieve the maximal wrist angular velocity was longest with the AO-full swing and shortest with the CU-check swing (100.1% vs 7.9% of swing cycle; P = .014). Conclusion The OF-check swing condition produced the highest total pressure reading on the hook of hamate. Check swing conditions also had the steepest rate of pressure development as compared with the full swing conditions. Clinical Relevance Batters who frequently check their swings and use an OF or AO grip may benefit from bat modifications or grip adjustment to reduce stresses over the hamate. Athletic trainers and team physicians should be aware of these factors to counsel players in the context of previous or ongoing hand injury.
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Affiliation(s)
| | - George J Richard
- Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, Florida, USA
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, Florida, USA
| | - Michelle Bruner
- Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, Florida, USA
| | - Cong Chen
- Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, Florida, USA
| | - Robert C Matthias
- Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, Florida, USA
| | - Jason L Zaremski
- Department of Physical Medicine and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, Florida, USA
| | - Kevin W Farmer
- Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, Florida, USA
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Conic RRZ, Geis C, Vincent HK. Social Determinants of Health in Physiatry: Challenges and Opportunities for Clinical Decision Making and Improving Treatment Precision. Front Public Health 2021; 9:738253. [PMID: 34858922 PMCID: PMC8632538 DOI: 10.3389/fpubh.2021.738253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/11/2021] [Indexed: 11/15/2022] Open
Abstract
Physiatry is a medical specialty focused on improving functional outcomes in patients with a variety of medical conditions that affect the brain, spinal cord, peripheral nerves, muscles, bones, joints, ligaments, and tendons. Social determinants of health (SDH) play a key role in determining therapeutic process and patient functional outcomes. Big data and precision medicine have been used in other fields and to some extent in physiatry to predict patient outcomes, however many challenges remain. The interplay between SDH and physiatry outcomes is highly variable depending on different phases of care, and more favorable patient profiles in acute care may be less favorable in the outpatient setting. Furthermore, SDH influence which treatments or interventional procedures are accessible to the patient and thus determine outcomes. This opinion paper describes utility of existing datasets in combination with novel data such as movement, gait patterning and patient perceived outcomes could be analyzed with artificial intelligence methods to determine the best treatment plan for individual patients in order to achieve maximal functional capacity.
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Affiliation(s)
- Rosalynn R Z Conic
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, United States
| | - Carolyn Geis
- Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, FL, United States
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, FL, United States
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Abstract
OBJECTIVE To determine the prevalence and risk factors associated with musculoskeletal injuries sustained in female adolescent volleyball players. METHODS Volleyball players (n = 276; 13-18 years), with any level of volleyball experience, were recruited. Participants completed a study-specific survey about their overall sport(s) involvement, training modalities, volleyball experience (beginner, intermediate, advanced), annual volume of volleyball play, injuries accrued during volleyball, and care received for injury. RESULTS Annual volume of volleyball play was higher in advanced than beginner/intermediate players (490.0 hr/yr versus 302.3 hr/yr; p < 0.0001). Nearly 67% (188/276) of participants incurred one or more volleyball-related injuries over the last year. The ankle (40.6%), fingers (36.6%), knee (21.2%), and shoulder (15.5%) were the most frequently reported injury. Injury prevalence was higher in advanced than beginner/intermediate players (73.5% versus 62.0%; p = 0.04). Beginner/intermediate players have significantly higher odds ratio (OR) of sustaining an elbow injury than advanced players (OR 5.88; p = 0.025). 21.5% of injured players missed more than one month of play. CONCLUSION More competitive and experienced adolescent female players may incur injuries due to progressively higher volumes of play as experience and competition level increase. Players who have committed to only playing volleyball participated in greater volumes of volleyball play, which increases the odds of sustaining an injury. CLINICAL RELEVANCE Understanding injury risk factors may improve clinical management and injury prevention.
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Affiliation(s)
- Joseph G Wasser
- Department of Orthopaedics and Rehabilitation, Divisions of Physical Medicine and Rehabilitation, Sports Medicine and Research, University of Florida, Gainesville, FL, USA
| | - Brady Tripp
- College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Michelle L Bruner
- Department of Orthopaedics and Rehabilitation, Divisions of Physical Medicine and Rehabilitation, Sports Medicine and Research, University of Florida, Gainesville, FL, USA
| | - Daniel R Bailey
- Department of Orthopaedics and Rehabilitation, Divisions of Physical Medicine and Rehabilitation, Sports Medicine and Research, University of Florida, Gainesville, FL, USA
| | - Rachel S Leitz
- Department of Orthopaedics and Rehabilitation, Divisions of Physical Medicine and Rehabilitation, Sports Medicine and Research, University of Florida, Gainesville, FL, USA
| | - Jason L Zaremski
- Department of Orthopaedics and Rehabilitation, Divisions of Physical Medicine and Rehabilitation, Sports Medicine and Research, University of Florida, Gainesville, FL, USA
| | - Heather K Vincent
- Department of Orthopaedics and Rehabilitation, Divisions of Physical Medicine and Rehabilitation, Sports Medicine and Research, University of Florida, Gainesville, FL, USA
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Herman DC, Kelshaw PM, Vincent HK, Caswell SV, Lincoln AE. Player Perceptions Of Headgear Safety In High School Girls’ Lacrosse. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000763052.02270.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Vincent HK, Summerville LH, Cordier SF, Chen C, Vincent KR. Recreational Runners With Obesity Can Maintain Cardiorespiratory, Metabolic And Gait Parameters Similar To Runners With Healthy Weight Over A 30 Minute Run. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000759400.70816.ae] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sanchez J, Chen C, Bruner MIL, Wasser JG, Vincent KR, Vincent HK. Impact Of Crosse Hold And Lower Body Running Mechanics On Musculoskeletal Pain And Injury In Lacrosse Athletes. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000760760.83007.d1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Lincoln AE, Kelshaw PM, Vincent HK, Caswell SV, Herman DC. Coaches’ Perceptions Of Headgear Safety In High School Girls’ Lacrosse. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000763056.53758.e0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
ABSTRACT Children with obesity experience musculoskeletal pain and reduced physical function and well-being, which collectively impact their fitness, strength, motor skills, and even their ability to undertake simple tasks, like walking and climbing stairs. Disrupting obesity-related disability may be critical to increasing children's physical activity. Thus, barriers to movement should be considered by health practitioners to improve the efficacy of prescribed physical activity. This applied clinical review highlights key subjective and objective findings from a hypothetical case scenario, linking those findings to the research evidence, before exploring strategies to enhance movement and increase physical activity.
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Affiliation(s)
- Margarita D Tsiros
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, Adelaide, SA, AUSTRALIA
| | - Heather K Vincent
- Department of Orthopaedics and Rehabilitation, Division of Physical Medicine and Rehabilitation, University of Florida, Gainesville, FL
| | - Nancy Getchell
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
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Albadi M, Horodyski M, Vincent HK. Choosing a Robust, Easy to Administer Functional Screen for Chronic Ankle Instability. Curr Sports Med Rep 2021; 20:231. [PMID: 33908904 DOI: 10.1249/jsr.0000000000000834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Majed Albadi
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL
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Caswell SV, Kelshaw PM, Lincoln AE, Herman DC, Hepburn LH, Vincent HK, Dunn RE, Cortes N. The Effects of Headgear in High School Girls' Lacrosse. Orthop J Sports Med 2021; 8:2325967120969685. [PMID: 33447621 PMCID: PMC7780324 DOI: 10.1177/2325967120969685] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/17/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Girls’ lacrosse headgear that met the ASTM International performance standard (ASTM F3137) became available in 2017. However, the effects of headgear use on impact forces during game play are unknown. Purpose: To evaluate potential differences in rates, magnitudes, and game-play characteristics associated with verified impacts among players with and without headgear during competition. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 49 female high school participants (mean age, 16.2 ± 1.2 years; mean height, 1.66 ± 0.05 m; mean weight, 61.2 ± 6.4 kg) volunteered for this study, which took place during the 2016 (no headgear; 18 games) and 2017 (headgear; 15 games) seasons. Wearable sensors synchronized with video verification were used. Descriptive statistics, impact rates, and chi-square analyses described impacts and game-play characteristics among players with and without headgear. Differences in mean peak linear acceleration (PLA) and peak rotational velocity (PRV) between the no headgear and headgear conditions were evaluated using a linear generalized estimating equation regression model to control for repeated within-player measurements. Results: Overall, 649 sensor-instrumented player-games were recorded. A total of 204 impacts ≥20g recorded by the wearable sensors were verified with video analysis (102 no headgear; 102 headgear). Most impacts were imparted to the player’s body (n = 152; 74.5%) rather than to the player’s head (n = 52; 25.5%). Impact rates per player-game did not vary between the no headgear and headgear conditions (0.30 vs 0.34, respectively; impact rate ratio, 0.88 [95% CI, 0.37-2.08]). There was no association between impact frequency by mechanism or penalties administered between the no headgear and headgear conditions for overall or direct head impacts. The generalized estimating equation model estimated a significant reduction in mean impact magnitudes overall (PLA: –7.9g [95% CI, –13.3 to –2.5]; PRV: –212 deg/s [95% CI, –359 to –64]) with headgear relative to no headgear. No game-related concussions were reported during this study. Conclusion: Lacrosse headgear use was associated with a reduction in the magnitude of overall impacts but not a significant change in the rate of impacts, how they occur, or how penalties were administered for impacts sustained during competition. Further research is needed with a larger sample and different levels of play to evaluate the consequences of headgear use in girls’ lacrosse.
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Affiliation(s)
- Shane V Caswell
- Sports Medicine Assessment Research and Testing (SMART) Laboratory, School of Kinesiology, George Mason University, Fairfax, Virginia, USA
| | - Patricia M Kelshaw
- Sports Medicine Assessment Research and Testing (SMART) Laboratory, School of Kinesiology, George Mason University, Fairfax, Virginia, USA.,Department of Kinesiology, College of Health and Human Services, University of New Hampshire, Durham, New Hampshire, USA
| | - Andrew E Lincoln
- MedStar Sports Medicine Research Center, MedStar Health, Baltimore, Maryland, USA.,Department of Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC, USA
| | - Daniel C Herman
- Divisions of Physical Medicine & Rehabilitation, Sports Medicine, and Research, Department of Orthopaedics and Rehabilitation, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Lisa H Hepburn
- MedStar Sports Medicine Research Center, MedStar Health, Baltimore, Maryland, USA
| | - Heather K Vincent
- Human Performance Laboratory and Sports Performance Center, University of Florida, Gainesville, Florida, USA
| | - Reginald E Dunn
- MedStar Sports Medicine Research Center, MedStar Health, Baltimore, Maryland, USA
| | - Nelson Cortes
- Sports Medicine Assessment Research and Testing (SMART) Laboratory, School of Kinesiology, George Mason University, Fairfax, Virginia, USA
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Vincent HK, Bruner M, Obermayer C, Griffin B, Vincent KR. Musculoskeletal pain in lacrosse officials impacts function on the field. Res Sports Med 2020; 29:486-497. [PMID: 33350867 DOI: 10.1080/15438627.2020.1860046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study determined the prevalence of joint pain among lacrosse officials and described the impact of pain thereof on current officiating duties on the field. Members of the US Lacrosse Officials Development Programme were provided with an electronic survey (a 15.7% response rate resulted in N = 1,441 of completed surveys). Pain sites and severity, previous injuries and current impact of musculoskeletal pain on officiating duties were captured. Pain was present in 18.1-40.1% of respondents at the foot, shoulder, back and knee. A total of 437 officials reported diagnoses of osteoarthritis ([OA]; knee 48.7%, hip 10.5%, spine 10.1%, shoulder 8.0%) and 247 reported OA in more than one joint (p < .05). Officials with OA or previous lacrosse-related injuries reported frequent difficulty with running the entire field distance (p < 0.0001), starting and stopping on the field (p < 0.0001), keeping pace (p < 0.0001), focusing on multiple actions of players at once (p < 0.0001), and enjoyment (all p < 0.0001). Musculoskeletal pain is a common, unrecognized issue in this population that interferes with sport officiating functions. Additional study is needed to objectively determine the impact of OA pain and musculoskeletal injuries on measurable performance outcomes on the field and subjective measures of focus, attention and enjoyment.
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Affiliation(s)
- Heather K Vincent
- Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, FL, USA
| | - Michelle Bruner
- Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, FL, USA
| | | | - Bruce Griffin
- Management Advisory & Compliance Services, Towson University, Sparks Glencoe, MD, USA
| | - Kevin R Vincent
- Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, FL, USA
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Bruggeman BS, Vincent HK, Chi X, Filipp SL, Mercado R, Modave F, Guo Y, Gurka MJ, Bernier A. Simple tests of cardiorespiratory fitness in a pediatric population. PLoS One 2020; 15:e0238863. [PMID: 32886730 PMCID: PMC7473550 DOI: 10.1371/journal.pone.0238863] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 08/25/2020] [Indexed: 12/16/2022] Open
Abstract
A progressive, treadmill-based VO2max is the gold standard of cardiorespiratory fitness determination but is rarely used in pediatric clinics due to time requirements and cost. Simpler and shorter fitness tests such as the Squat Test or Step Test may be feasible and clinically useful alternatives. However, performance comparisons of these tests to treadmill VO2max tests are lacking. The primary aim of this cross-sectional study was to assess the correlation between Squat and Step Test scores and VO2max in a pediatric population. As secondary outcomes, we calculated correlations between Rated Perceived Exertion Scale (RPE) scores, NIH PROMIS Physical Activity scores, and BMI z-score with VO2max, and we also evaluated the ability of each fitness test to discriminate low and high-risk patients based on the FITNESSGram. Forty children aged 10–17 completed these simple cardiorespiratory fitness tests. Statistically significant correlations were observed between VO2max and the Step Test (r = -0.549) and Squat Test (r = -0.429) scores, as well as participant BMI z-score (r = -0.458). RPE and PROMIS scores were not observed to be correlated with VO2max. Area Under the Receiver Operator Curve was relatively high for BMI z-scores and the Step Test (AUC = 0.813, 0.713 respectively), and lower for the Squat Test (AUC = 0.610) in discriminating risk according to FITNESSGram Scores. In this sample, the Step Test performed best overall. These tests were safe, feasible, and may add great value in assessing cardiorespiratory fitness in a clinical setting.
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Affiliation(s)
- Brittany S. Bruggeman
- Division of Endocrinology, Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, United States of America
| | - Heather K. Vincent
- Division of Research, Department of Orthopedics and Rehabilitation, University of Florida College of Medicine, Gainesville, FL, United States of America
| | - Xiaofei Chi
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, United States of America
| | - Stephanie L. Filipp
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, United States of America
| | - Rebeccah Mercado
- Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, United States of America
| | - François Modave
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, United States of America
| | - Yi Guo
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, United States of America
| | - Matthew J. Gurka
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, United States of America
| | - Angelina Bernier
- Division of Endocrinology, Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, United States of America
- * E-mail:
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Hacherl SL, Kelshaw PM, Lincoln AE, Vincent HK, Herman DC, Caswell SV. Characterizing Impacts In Girls’ High School Lacrosse Using Video Analysis. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000687084.92666.9b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Vincent HK, Bruner ML, Chen C, Sharififar S, Vincent KR. Crosse Use Effects On Running And Drop Jump Mechanics In Male And Female Lacrosse Players. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000676452.05598.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Vincent KR, Vasilopoulos T, Montero C, Vincent HK. Eccentric and Concentric Resistance Exercise Comparison for Knee Osteoarthritis. Med Sci Sports Exerc 2020; 51:1977-1986. [PMID: 31033900 DOI: 10.1249/mss.0000000000002010] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION This study aimed to compare the efficacy of eccentrically focused resistance exercise (ECC RT) to concentrically focused resistance exercise (CNC RT) on knee osteoarthritis (OA) symptoms and strength. METHODS Ninety participants consented. Participants were randomized to CNC RT, ECC RT, or a wait-list, no-exercise control group. Four months of supervised exercise training was completed using traditional weight machines (CNC RT) or modified-matched machines that overloaded the eccentric action (ECC RT). Main outcomes included one-repetition maximal strength (knee extension, leg flexion, and leg press), weekly rate of strength gain, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) total score and subscores. RESULTS Fifty-four participants (60-85 yr, 61% women) completed the study. Both CNC RT and ECC RT groups showed 16%-28% improvement relative to the wait-list, no-exercise control group (P = 0.003-0.005) for all leg strength measures. The rate of weekly strength gain was greater for CNC RT than for ECC RT for leg press and knee flexion (by 2.9%-4.8%; both, P < 0.05) but not knee extension (0.7%; P = 0.38). There were no significant differences in WOMAC total and subscores across groups over time. Leg press strength change was the greatest contributor to change in WOMAC total scores (R = 0.223). The change in knee flexion strength from baseline to month 4 was a significant predictor of the change in WOMAC pain subscore (F ratio = 4.84, df = 45, P = 0.032). Both modes of strength training were well tolerated. CONCLUSIONS Both resistance training types effectively increased leg strength. Knee flexion and knee extension muscle strength can modify function and pain symptoms irrespective of muscle contraction type. Which mode to pick could be determined by preference, goals, tolerance to the contraction type, and equipment availability.
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Affiliation(s)
- Kevin R Vincent
- Department of Orthopaedics and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL
| | - Terrie Vasilopoulos
- Department of Orthopaedics and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL.,Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL
| | - Cindy Montero
- Department of Orthopaedics and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL
| | - Heather K Vincent
- Department of Orthopaedics and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL
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Tripp B, Vincent HK, Bruner M, Smith MS. Comparison of wet bulb globe temperature measured on-site vs estimated and the impact on activity modification in high school football. Int J Biometeorol 2020; 64:593-600. [PMID: 31863179 DOI: 10.1007/s00484-019-01847-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/01/2019] [Accepted: 12/11/2019] [Indexed: 06/10/2023]
Abstract
Exertional heat stroke is one of the top three causes of death in young athletes, particularly high school football players. Despite evidence that these deaths are completely avoidable with appropriate prevention and treatment, deaths still occur at an alarming rate. Wet bulb globe temperature (WBGT) is the preferred method of both the National Athletic Trainers' Association and American College of Sports Medicine to measure heat intensity. Based on the WBGT, activity modification guidelines (AMG) dictate work-to-rest ratios, activity levels and duration, protective equipment worn, and length and frequency of hydration breaks. Due to the cost of handheld WBGT monitors, smartphone apps that estimate WBGT have been considered an alternative. However, it is unclear how WBGT values estimated by these smartphone apps compare to those measured on-site using handheld WBGT monitors. We compared WBGT values estimated by a commercial smartphone app to those taken on-site at the same time and place. Thirteen athletic trainers measured WBGT in the field during high school football practices over a three-month season in North Central Florida. A paired sample t-test indicated the smartphone app significantly overestimated WBGT (29.0°C ± 4.1°C) compared to on-site measures (26.4°C ± 3.2°C) ( r =0.580; t(943)=-23.38, p <0.0001). The smartphone app-estimated values were consistently greater than on-site measures, resulting in potentially unnecessary activity modifications and cancellations if the app was used in place of on-site handheld WBGT monitors. Despite being significantly cheaper than handheld WBGT monitors, at this time, smartphone apps are not ready for widespread use to guide activity modification decisions.
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Affiliation(s)
- Brady Tripp
- University of Florida, Gainesville, FL, USA.
| | - Heather K Vincent
- Department of Orthopaedics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Michelle Bruner
- University of Florida, Department of Orthopedics and Rehabilitation, Gainesville, FL, USA
| | - Michael Seth Smith
- University of Florida, Department of Orthopedics and Rehabilitation, Gainesville, FL, USA
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Zdziarski-Horodyski L, Vasilopoulos T, Horodyski M, Hagen JE, Sadasivan KS, Sharififar S, Patrick M, Guenther R, Vincent HK. Can an Integrative Care Approach Improve Physical Function Trajectories after Orthopaedic Trauma? A Randomized Controlled Trial. Clin Orthop Relat Res 2020; 478:792-804. [PMID: 32032087 PMCID: PMC7282578 DOI: 10.1097/corr.0000000000001140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 01/07/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Orthopaedic trauma patients frequently experience mobility impairment, fear-related issues, self-care difficulties, and work-related disability []. Recovery from trauma-related injuries is dependent upon injury severity as well as psychosocial factors []. However, traditional treatments do not integrate psychosocial and early mobilization to promote improved function, and they fail to provide a satisfying patient experience. QUESTIONS/PURPOSES We sought to determine (1) whether an early psychosocial intervention (integrative care with movement) among patients with orthopaedic trauma improved objective physical function outcomes during recovery compared with usual care, and (2) whether an integrative care approach with orthopaedic trauma patients improved patient-reported physical function outcomes during recovery compared with usual care. METHODS Between November 2015 and February 2017, 1133 patients were admitted to one hospital as orthopaedic trauma alerts to the care of the three orthopaedic trauma surgeons involved in the study. Patients with severe or multiple orthopaedic trauma requiring one or more surgical procedures were identified by our orthopaedic trauma surgeons and approached by study staff for enrollment in the study. Patients were between 18 years and 85 years of age. We excluded individuals outside of the age range; those with diagnosis of a traumatic brain injury []; those who were unable to communicate effectively (for example, at a level where self-report measures could not be answered completely); patients currently using psychotropic medications; or those who had psychotic, suicidal, or homicidal ideations at time of study enrollment. A total of 112 orthopaedic trauma patients were randomized to treatment groups (integrative and usual care), with 13 withdrawn (n = 99; 58% men; mean age 44 years ± 17 years). Data was collected at the following time points: baseline (acute hospitalization), 6 weeks, 3 months, 6 months, and at 1 year. By 1-year follow-up, we had a 75% loss to follow-up. Because our data showed no difference in the trajectories of these outcomes during the first few months of recovery, it is highly unlikely that any differences would appear months after 6 months. Therefore, analyses are presented for the 6-month follow-up time window. Integrative care consisted of usual trauma care plus additional resources, connections to services, as well as psychosocial and movement strategies to help patients recover. Physical function was measured objectively (handgrip strength, active joint ROM, and Lower Extremity Gain Scale) and subjectively (Patient-Reported Outcomes Measurement Information System-Physical Function [PROMIS®-PF] and Tampa Scale of Kinesiophobia). Higher values for hand grip, Lower Extremity Gain Scale (score range 0-27), and PROMIS®-PF (population norm = 50) are indicative of higher functional ability. Lower Tampa Scale of Kinesiophobia (score range 11-44) scores indicate less fear of movement. Trajectories of these measures were determined across time points. RESULTS We found no differences at 6 months follow-up between usual care and integrative care in terms of handgrip strength (right handgrip strength β = -0.0792 [95% confidence interval -0.292 to 0.133]; p = 0.46; left handgrip strength β = -0.133 [95% CI -0.384 to 0.119]; p = 0.30), or Lower Extremity Gain Scale score (β = -0.0303 [95% CI -0.191 to 0.131]; p = 0.71). The only differences between usual care and integrative care in active ROM achieved by final follow-up within the involved extremity was noted in elbow flexion, with usual care group 20° ± 10° less than integrative care (t [27] = -2.06; p = 0.05). Patients treated with usual care and integrative care showed the same Tampa Scale of Kinesiophobia score trajectories (β = 0.0155 [95% CI -0.123 to 0.154]; p = 0.83). CONCLUSION Our early psychosocial intervention did not change the trajectory of physical function recovery compared with usual care. Although this specific intervention did not alter recovery trajectories, these interventions should not be abandoned because the greatest gains in function occur early in recovery after trauma, which is the key time in transition to home. More work is needed to identify ways to capitalize on improvements earlier within the recovery process to facilitate functional gains and combat psychosocial barriers to recovery. LEVEL OF EVIDENCE Level II, therapeutic study.
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Affiliation(s)
- Laura Zdziarski-Horodyski
- L. Zdziarski-Horodyski, T. Vasilopoulos, MB. Horodyski, J. E. Hagen, K. H. Sadasivan, S. Sharififar, M. Patrick, H. K. Vincent, Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA
- L. Zdziarski-Horodyski, Department of Orthopaedics and Sports Medicine, University of Utah, Salt Lake City, UT, USA
| | - Terrie Vasilopoulos
- L. Zdziarski-Horodyski, T. Vasilopoulos, MB. Horodyski, J. E. Hagen, K. H. Sadasivan, S. Sharififar, M. Patrick, H. K. Vincent, Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA
- T. Vasilopoulos, Department of Anesthesia, University of Florida, Gainesville, FL, USA
| | - MaryBeth Horodyski
- L. Zdziarski-Horodyski, T. Vasilopoulos, MB. Horodyski, J. E. Hagen, K. H. Sadasivan, S. Sharififar, M. Patrick, H. K. Vincent, Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA
| | - Jennifer E Hagen
- L. Zdziarski-Horodyski, T. Vasilopoulos, MB. Horodyski, J. E. Hagen, K. H. Sadasivan, S. Sharififar, M. Patrick, H. K. Vincent, Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA
| | - Kalia S Sadasivan
- L. Zdziarski-Horodyski, T. Vasilopoulos, MB. Horodyski, J. E. Hagen, K. H. Sadasivan, S. Sharififar, M. Patrick, H. K. Vincent, Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA
| | - Sharareh Sharififar
- L. Zdziarski-Horodyski, T. Vasilopoulos, MB. Horodyski, J. E. Hagen, K. H. Sadasivan, S. Sharififar, M. Patrick, H. K. Vincent, Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA
| | - Matthew Patrick
- L. Zdziarski-Horodyski, T. Vasilopoulos, MB. Horodyski, J. E. Hagen, K. H. Sadasivan, S. Sharififar, M. Patrick, H. K. Vincent, Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA
| | - Robert Guenther
- R. Guenther, Department of Clinical Psychology, University of Florida, Gainesville, FL, USA
| | - Heather K Vincent
- L. Zdziarski-Horodyski, T. Vasilopoulos, MB. Horodyski, J. E. Hagen, K. H. Sadasivan, S. Sharififar, M. Patrick, H. K. Vincent, Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA
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Vincent HK, Kilgore JE, Chen C, Bruner M, Horodyski M, Vincent KR. Impact of Body Mass Index on Biomechanics of Recreational Runners. PM R 2020; 12:1106-1112. [PMID: 31994820 DOI: 10.1002/pmrj.12335] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 01/17/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Some recreational runners with obesity successfully train or compete without musculoskeletal injury. Insight into the key kinetic strategies of injury-free heavier runners is necessary to appropriately guide development of safe training programs for this population. OBJECTIVE To determine key biomechanical strategies of running in individuals with body mass index (BMI) values above and equal to and higher than 30 kg/m2 . DESIGN This was a case-control study. PARTICIPANTS Runners with obesity (n =18; 42.7 years, 38.9% women) who were matched by sex, age, footstrike type, footwear characteristics, and running speed with healthy runners (n = 36; 41.7 years, 32.5% women). SETTING Research laboratory affiliated with an academic medical center. METHODS A seven-camera optical motion analysis system was used to capture running kinematics and an instrumented treadmill captured kinetic data. MAIN OUTCOMES Main outcomes were temporal spatial parameters, joint excursions, peak ground reaction forces (GRFs), joint moments, vertical average loading rate (VALR), impulses, and vertical stiffness (Kvert ). RESULTS Runners with obesity demonstrated 15% less vertical excursion of the center of mass, 18% wider strides, and 3% longer stance times than nonobese runners (P < .05). Normalized peak GRFs and VALRs were higher in the nonobese group. GRF impulse was higher in the group with obesity compared to the nonobese group (means ± SD; 339.6 ± 55.2 Ns vs. 255.0 ± 45.8 Ns; P = .0001). Kvert was higher in the obese group compared to the nonobese group (238.6 ± 50.3 N/cm vs. 183.1 ± 29.4 N/cm; P = .0001). Peak hip moments were higher in runners with obesity in the sagittal and frontal planes (P < .05). CONCLUSION Runners with obesity dampened impact forces and controlled loading rate more than nonobese runners by increasing lower body stiffness and constraining vertical displacement.
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Affiliation(s)
- Heather K Vincent
- Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, FL
| | - Jack E Kilgore
- Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, FL
| | - Cong Chen
- Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, FL
| | - Michelle Bruner
- Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, FL
| | - MaryBeth Horodyski
- Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, FL
| | - Kevin R Vincent
- Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, FL
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Herman DC, Riveros D, Jacobs K, Harris A, Massengill C, Vincent HK. Previous High School Participation in Varsity Sport and Jump-Landing Biomechanics in Adult Recreational Athletes. J Athl Train 2020; 54:1089-1094. [PMID: 31633413 DOI: 10.4085/1062-6050-412-18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Early sports sampling is associated with superior biomechanics in youth athletes; however, the effect of multisport participation on adult biomechanics is unknown. OBJECTIVE To compare jump-landing biomechanics between adult recreational athletes who previously participated in 0, 1, or 2 or more select high school varsity sports (VSs; basketball, lacrosse, soccer, volleyball) that feature landing and cutting tasks. DESIGN Descriptive laboratory study. SETTING University community setting. PATIENTS OR OTHER PARTICIPANTS Fifty adult recreational athletes (22 women, 28 men; age = 23.8 ± 2.5 years) with no high school VS experience or with high school VS experience in basketball, lacrosse, soccer, or volleyball. Athletes were grouped into those who participated in 0 (0VS, n = 11), 1 (1VS, n = 21), or 2 or more (2VSs, n = 18) of these sports at the high school level. MAIN OUTCOME MEASURE(S) The average Landing Error Scoring System (LESS) total score from 3 individual jump landings was determined. A 1-way analysis of covariance using sex as the covariate was calculated to compare groups. The Pearson R was used to test for the correlation between the LESS score and number of sports played, and a linear regression analysis was performed using the number of sports played to predict the LESS score. The α level was set a priori at .05. RESULTS The 0VS athletes produced similar LESS scores as the 1VS athletes (5.89 ± 1.2 versus 5.38 ± 1.93 points, respectively, P = .463), whereas the 2VSs athletes demonstrated lower LESS scores (3.56 ± 1.97 points) than the 0VS (P = .002) and 1VS (P = .004) athletes. The LESS scores were moderately negatively correlated with the number of high school VSs played (R2 = -0.491, P < .001). The linear regression analysis was significant (F1,37 = 9.416, P = .004) with R2 = 0.203. For every additional VS played at the high school level, the LESS score decreased by 1.28 points. CONCLUSIONS Landing Error Scoring System scores were lower in athletes who had a history of multisport high school varsity participation in basketball, lacrosse, soccer, or volleyball compared with those who had a history of single-sport or no participation in these sports at this level. Multisport high school varsity participation in these sports may result in improved neuromuscular performance and potentially reduced injury risks as adults.
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Affiliation(s)
- Daniel C Herman
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville
| | - Diego Riveros
- Department of Emergency Medicine, University of South Florida, Tampa
| | - Kimberly Jacobs
- Department of Pediatrics, Stanford University, Palo Alto, CA
| | - Andrew Harris
- College of Medicine, University of Florida, Gainesville
| | | | - Heather K Vincent
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville
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Kilgore JE, Vincent KR, Vincent HK. Correcting Foot Crossover While Running. Curr Sports Med Rep 2020; 19:4-5. [PMID: 31913915 DOI: 10.1249/jsr.0000000000000670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Jack E Kilgore
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL
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Barrow DR, Abbate LM, Paquette MR, Driban JB, Vincent HK, Newman C, Messier SP, Ambrose KR, Shultz SP. Exercise prescription for weight management in obese adults at risk for osteoarthritis: synthesis from a systematic review. BMC Musculoskelet Disord 2019; 20:610. [PMID: 31861990 PMCID: PMC6925458 DOI: 10.1186/s12891-019-3004-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 12/12/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The aim of this systematic review was to identify principles of exercise interventions associated with improved physical function, weight management or musculoskeletal pain relief among young and middle-aged adults with obesity and propose an evidence-based exercise prescription that could assist in secondary prevention of osteoarthritis. METHODS A structured electronic review was conducted using MEDLINE, PubMed, and SPORTDiscus. The search string included 1) "obes*" AND "exercise" AND "interven*" AND "musculoskeletal pain OR knee pain OR hip pain". Studies 1) were randomized controlled trials of humans, with a non-exercise control, 2) included participants aged 18-50 years, and 3) had outcomes that included physical function, musculoskeletal pain, and/or body composition. Studies were excluded if participants had peri-menopausal status, cancer, or obesity-related co-morbidities. A recommended exercise prescription was developed based on common principles used in the included exercise interventions with greatest change in function or pain. RESULTS Seven studies were included. Similarities in exercise intensity (40-80% VO2max), frequency (three times per week), duration (30-60 min), and exercise mode (treadmill, cross-trainer, stationary bike, aquatic exercise) were observed in exercise interventions that resulted in improved physical function and/or pain, compared to non-exercise control groups. CONCLUSION Common principles in exercise prescription for improvements in weight management, physical function and pain relief among otherwise healthy people with obesity. Exercise prescription including moderate intensity exercise for 30-60 min, three times per week can be considered an effective treatment for weight management and obesity-related musculoskeletal symptoms. Exercise should be recommended to at-risk individuals as part of secondary prevention of osteoarthritis.
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Affiliation(s)
- Dylan R Barrow
- School of Sport, Exercise and Nutrition, Massey University, Wellington, New Zealand
| | - Lauren M Abbate
- Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO, USA.,Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Max R Paquette
- School of Health Studies, University of Memphis, Memphis, TN, USA
| | - Jeffrey B Driban
- Division of Rheumatology, Allergy & Immunology, Tufts Medical Center, Boston, MA, USA
| | - Heather K Vincent
- UF Health Sports Performance Center, Department of Orthopedics and Rehabilitation, University of Florida, Gainesville, FL, USA
| | - Connie Newman
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, New York University School of Medicine, New York, NY, USA
| | - Stephen P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Kirsten R Ambrose
- Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
| | - Sarah P Shultz
- School of Sport, Exercise and Nutrition, Massey University, Wellington, New Zealand. .,Department of Kinesiology, Seattle University, 901 12th Avenue, Seattle, WA, 98122, USA.
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Vincent KR, Vincent HK. Seven Tips to Effective Running Shoe Sizing. Curr Sports Med Rep 2019; 18:379. [PMID: 31702717 DOI: 10.1249/jsr.0000000000000645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Kevin R Vincent
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL
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Abstract
Lacrosse imposes multiple simultaneous physical demands during play including throwing and catching a ball while holding a crosse, running, cutting, and jumping. Often, these skills are completed while experiencing contact from another player leading to both on-and-off platform movements. Other motions include defensive blocking and pushing past defenders. Repetitive motions over sustained durations in practice or competition impart mechanical stresses to the shoulder or elbow joints, supportive muscles, and connective tissue. Preparation for lacrosse participation involves bilateral optimization of strength and durability of stabilizer muscles. Passing and shooting skills are encouraged to be equally effective on both sides; therefore, symmetric strength and flexibility are vital for prehabilitation and rehabilitation efforts. This article will: 1) provide insights on the upper-extremity musculoskeletal demands of lacrosse and related sports with similar throwing motion and 2) describe prehabilitation and rehabilitation methods that improve athlete durability and reduce likelihood of upper-extremity injury.
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Affiliation(s)
- Heather K Vincent
- Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, FL
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Vincent HK, Mackenzie B, Vincent KR. Counseling Runners on Safely Transitioning to Minimal Shoes. Curr Sports Med Rep 2019; 18:315-316. [PMID: 31503040 DOI: 10.1249/jsr.0000000000000630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Heather K Vincent
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL
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