Beyond yellow flags: The Big-Five personality traits and psychologically informed musculoskeletal rehabilitation.

BACKGROUND: Psychosocial variables are known to play an important role in musculoskeletal pain. Recent efforts incorporating psychological theory into rehabilitative medicine, as part of patient-centred care or psychologically informed physical therapy, have gained broader acceptance. The fear-avoidance model is the dominant psychosocial model and has introduced a variety of phenomena which assess psychological distress (i.e., yellow flags). Yellow flags, such as fear, anxiety and catastrophizing, are useful concepts for musculoskeletal providers but reflect a narrow range of psychological responses to pain. OBJECTIVE: Clinicians lack a more comprehensive framework to understand psychological profiles of each patient and provide individualised care. This narrative review presents the case for applying personality psychology and the Big-Five trait model (extraversion, agreeableness, conscientiousness, neuroticism and openness to experience) to musculoskeletal medicine. These traits have strong associations with various health outcomes and provide a robust framework to understand patient emotion, motivation, cognition and behaviour. KEY RESULTS: High conscientiousness is associated with positive health outcomes and health promoting behaviours. High neuroticism with low conscientiousness increases the odds of negative health outcomes. Extraversion, agreeableness and openness have less direct effects but have positive correlations with important health behaviours, including active coping, positive affect, rehabilitation compliance, social connection and education level. CLINICAL APPLICATION: The Big-Five model offers an evidence-based way for MSK providers to better understand the personality of their patients and how it relates to health. These traits offer the potential for additional prognostic factors, tailored treatments and psychological intervention.

Sport Participation Associations With Child Friend Selection and Physical Activity While at Summer Care Programs.

Child physical activity (PA) declines during summer reducing PA-related health benefits. Summer care programs (e.g., Boys & Girls Clubs) can promote active play while providing opportunities for friendships. Sport participation is a positive influence on PA and social development. Purpose: This article investigates the role of sport participation in PA attainment, perceived skill competency, and social connection at a summer care program. Methods: Children self-reported PA, sport participation, and the names of up to five peers whom they played with most at the program at the start (T1; n = 100; M age = 9.94 years; SD = 1.34; 47% male) and end (T2; n = 77; M age = 9.83 years; SD = 1.46; 51% male) of summer. Network autocorrelation models were used to determine if child sport participation was significantly associated with those they played with at the program. Results:Children who reported sport participation reported significantly more PA than those who did not at T1, but not T2. Child sport participation was significantly related to that of the peers they said they spent time with while at the program for T1 (ß = 0.07, p < .01), but not T2 (ß = 0.06, p = .10). Additionally, PA (ß = 0.08, p < .01; ß = 0.07, p = .01) and skill competency (ß = 0.11, p = .02; ß = 0.15, p < .01) were significantly associated with sport participation at both time points. While sports participation was a key factor in child friendships at the start of summer, the program allowed children, regardless of sport participation, to become friends outside of sports. Conclusions: These results suggest summer care programs promote PA through play and provide opportunities for children to facilitate friendships regardless of sport participation.

¿Qué Pasa Con Papá? Exploring Paternal Responsibilities and Physical Activity in Mexican-Heritage Families.

Mexican-heritage children often achieve less physical activity (PA) than their counterparts and are at greater risk for associated comorbidities. Child PA is greatly influenced by their parents, yet researchers have rarely involved fathers in community health promotion. The purpose of this study is to examine Mexican-heritage fathers' perceptions of responsibilities and self-reported activities. Promotoras recruited fathers (n = 300) from colonies on the Texas-Mexico border and administered Spanish-language surveys including paternal responsibilities, father PA, and PA co-participation. Two researchers coded responses. Open-ended items were coded and cross-tabulations between responsibilities and activities with children were examined. Fathers reported feeling monetary responsibilities most often. Fathers reported engaging in more activities with their sons than daughters; however, fathers engaged in very few activities specifically with their children. Feeling responsible for family expenses was associated with paternal PA co-participation with family and children. This study adds clarity to the role of Mexican-heritage fathers in child PA. Findings highlight potential areas for intervention including supporting fathers to take an active role in their children's PA.

When helping helps: exploring health benefits of cancer survivors participating in for-cause physical activity events.

BACKGROUND: Over 15.5 million Americans live with cancer and 5-year survival rates have risen to 69%. Evidence supports important health benefits of regular physical activity for cancer survivors, including increased strength and quality of life, and reduced fatigue, recurrence, and mortality. However, physical activity participation among cancer survivors remains low. Cancer organizations provide various resources and support for cancer survivors, including emotional, instrumental, informational, and appraisal support. Many cancer organizations, like the LIVESTRONG Foundation, support the cancer community by sponsoring and hosting for-cause physical activity events, providing opportunities for anyone (including cancer survivors) to "help"/support those living with cancer. The concept of helping others has been positively related with wellbeing, physical activity, and multiple health behaviors for those helping. However, the role of helping others has not been examined in the context of being physically active to help others or its relationship with overall physical activity and quality of life among those helping. Therefore, we developed a path model to examine relationships between cancer survivors' (1) desire to help others with cancer, (2) physically active LIVESTRONG participation to help others, (3) regular physical activity engagement, and (4) quality of life. METHODS: In 2010, 3257 cancer survivors responded to an online survey sent to all people involved with the LIVESTRONG organization at any level. The hypothesized path model was tested using path analysis (Mplus 8). RESULTS: After list-wise deletion of missing responses, our final sample size was 3122 (61.8% female, mean age: 48.2 years [SD = 12.7]). Results indicated that the model yielded perfect fit indexes. Controlling for age, sex, income, and survivorship length, desire to help was positively related with physically active LIVESTRONG participation (ß = .11, p < .001), which was positively related with regular physical activity (ß = .30, p < .001), and regular physical activity was positively related with quality of life (ß = .194, p < .001). CONCLUSIONS: Results suggest that cancer survivors can benefit from participating in for-cause physical activity events, including more regular physical activity. Researchers need to further investigate the role of helping others when examining health behaviors and outcomes, and cancer organizations should continue encouraging cancer survivors to help others by participating in physical activity events.

Biomechanical model to assess injury reduction during impact.

This paper implements a biomechanical model and actual tipover trajectory data to assess the risk of head and neck injuries in standup forklift accidents. Seven accident scenarios were analyzed for right tipover, left tipover and off-dock accidents both with and without a door on the operator compartment. Each model had specific data including human anthropometry and trajectory input into the modeling and analysis software packages, Visual-Safe MAD and MADYMO. For all three accident scenarios, each of the seven biomechanical models was analyzed for Injury Assessment Reference Values (IARVs) including angular velocity (omega, omega), angular acceleration (alpha, alpha), Head Injury Criterion (HIC), Neck Injury Criterion--shear, tension and bending (NIC) and the biomechanical Neck Injury Predictor (N(ij)). The study concluded that, in general, the addition of a door to the standup forklift operator compartment leads to a reduction in injury during tipover and off-dock accidents. The ability to brace for impact is not included in these MADYMO models. Bracing is far more effective with an enclosed compartment provided by a latching rear door.

Modeling initial contact dynamics during ambulation with dynamic simulation.

Ankle-foot orthoses are frequently used interventions to correct pathological gait. Their effects on the kinematics and kinetics of the proximal joints are of great interest when prescribing ankle-foot orthoses to specific patient groups. Mathematical Dynamic Model (MADYMO) is developed to simulate motor vehicle crash situations and analyze tissue injuries of the occupants based multibody dynamic theories. Joint kinetics output from an inverse model were perturbed and input to the forward model to examine the effects of changes in the internal sagittal ankle moment on knee and hip kinematics following heel strike. Increasing the internal ankle moment (augmentation, equivalent to gastroc-soleus contraction) produced less pronounced changes in kinematic results at the hip, knee and ankle than decreasing the moment (attenuation, equivalent to gastroc-soleus relaxation). Altering the internal ankle moment produced two distinctly different kinematic curve morphologies at the hip. Decreased internal ankle moments increased hip flexion, peaking at roughly 8% of the gait cycle. Increasing internal ankle moments decreased hip flexion to a lesser degree, and approached normal at the same point in the gait cycle. Increasing the internal ankle moment produced relatively small, well-behaved extension-biased kinematic results at the knee. Decreasing the internal ankle moment produced more substantial changes in knee kinematics towards flexion that increased with perturbation magnitude. Curve morphologies were similar to those at the hip. Immediately following heel strike, kinematic results at the ankle showed movement in the direction of the internal moment perturbation. Increased internal moments resulted in kinematic patterns that rapidly approach normal after initial differences. When the internal ankle moment was decreased, differences from normal were much greater and did not rapidly decrease. This study shows that MADYMO can be successfully applied to accomplish forward dynamic simulations, given kinetic inputs. Future applications include predicting muscle forces and decomposing external kinetics.