Effectiveness of a night positioning programme on ankle range of motion in patients after hemiparesis: a prospective randomized controlled pilot study.

OBJECTIVE: To investigate the effect of night positioning on ankle motion in patients after stroke or brain injury. DESIGN: Prospective randomized controlled pilot study with 3 groups: bivalve cast; pressure-relieving ankle-foot orthosis; and control. SUBJECTS/PATIENTS: Adults (n = 46) in inpatient rehabilitation with lower extremity paresis following stroke or brain injury. METHODS: Intervention group participants wore a custom bivalve cast or pre-fabricated orthosis 8-12 h/night. The primary outcome variable was passive ankle dorsiflexion. Muscle spasticity (Modified Ashworth Scale) and functional mobility (Functional Independence Measure) were also assessed. RESULTS: No significant differences were found between groups for all outcome measures at the pilot sample size (p > 0.05). Control and pressure-relieving ankle-foot orthosis groups showed improvement in ankle dorsiflexion, and the bivalve cast group demonstrated a trend toward decreased spasticity. Positioning interventions were tolerated for approximately 11 h/night. Baseline range of motion was measured and a retrospective power analysis determined that a sample size of 234 is needed for 80% power to establish significance. CONCLUSION: Future research with a larger sample size is re-commended to determine significance and whether a more specific subset of patients would benefit from night positioning to maximize treatment time during daytime therapy sessions.

The food environment of youth baseball.

BACKGROUND: Sports, such as youth baseball (YB), are popular outlets for increasing activity, yet there has been no investigation of food environments surrounding them. The aim of this study was to observe the types of foods available and consumed by players and spectators at YB events. METHODS: This was an observational assessment, by environmental scan, of foods consumed by players and family members at a YB field in northwest North Carolina. RESULTS: Participants included boys from six YB teams (n=51) between 8 and 11 years of age and families. A total of 12 YB games were observed. Most team snacks (72%) consisted of high-calorie food items, including French fries, candy, and cookies; most beverages (53%) consumed by players were sugar sweetened. We observed 313 spectators and players, who consumed a total of 249 foods and 276 beverages. Most food and beverage items (89%) were purchased from the concession stand, of which 73% were considered less-healthy options. CONCLUSIONS: High-calorie snacks and sugar-sweetened beverages dominate the YB environment. Despite the benefits of participating in sports, families of children participating in sports leagues may be increasing their risk for poor nutritional habits as a result of increased exposure to unhealthy foods and disruption of meal times.