Back to 'normal'? BMI, physical fitness and health-related quality of life of children from North East England before, during and after the COVID-19 lockdowns.

We assessed whether changes in children's body mass index (BMI), physical fitness and health-related quality of life observed post-2020 United Kingdom COVID-19 lockdown remained 12 and 18 months later. Twenty-metre shuttle run test (20mSRT), handgrip strength, standing broad jump, sit-and-reach, height, body mass, and health-related quality of life (Kidscreen27 questionnaire) were measured in 90 children (8-9 years) during October 2019 ("T0"), November 2020 ("T1"), November 2021 ("T2") and June 2022 ("T3"). Mixed-effects models showed age- and sex-normalised BMI increased from T0 (mean: 0.71) to T1 (0.97), remaining elevated at T2 (0.95) and T3 (0.89). Decreases in 20mSRT performance were observed from T0 (22.0) to T1 (19.3), then increased at T2 (23.5) and T3 (28.3). Standing broad jump and handgrip strength increased over time. The proportion of children with overweight/obesity increased from T0 (32%) to T3 (48%). Health-related quality of life decreased for "Physical Wellbeing" yet increased for "Autonomy & Parents". Our findings highlight that lockdowns may have had lasting implications for children's health, and the urgent need to reduce overweight and obesity in North East England. Improving health and fitness behaviours to maximise long-term health outcomes and build resilience to future emergencies and disruptions to health behaviours is also paramount.

Sweat Characteristics and Fluid Balance Responses During Two Heat Training Camps in Elite Female Field Hockey Players.

We examined the sweat characteristics and fluid balance of elite female field hockey players during two heat training camps. Fourteen elite female field hockey players from the Australian national squad participated in two heat training camps held ∼6 months apart, following winter- (Camp 1) and summer-based training (Camp 2). Daily waking body mass (BM) and urine specific gravity (USG) were collected, along with several markers of sweat and fluid balance across two matches per camp. There was a 19% mean reduction in estimated whole-body sweat sodium concentration from Camp 1 (45.8 ± 6.5 mmol/L) to Camp 2 (37.0 ± 5.0 mmol/L; p < .001). Waking urine specific gravity ≥ 1.020 was observed in 31% of samples, with no significant differences in mean urine specific gravity or BM between camps (p > .05), but with substantial interindividual variation. Intramatch sweat rates were high (1.2-1.8 L/hr), with greater BM losses in Camp 1 (p = .030), resulting in fewer players losing ≥2% BM in Camp 2 (0%-8%), as compared with Camp 1 (36%-43%; p = .017). Our field data suggest that elite female field hockey players experience substantial sweat losses during competition in the heat regardless of the season. In agreement with previous findings, we observed substantial interindividual variation in sweat and hydration indices, supporting the use of individualized athlete hydration strategies.

High-Intensity Running During International Male Field Hockey Involves Frequent Changes of Direction and Repeated Accelerations but Seldom Reaches Sprint Velocities.

ABSTRACT: Goods, PS, Appleby, B, Scott, BR, Peeling, P, and Galna, B. High-intensity running during international male field hockey involves frequent changes of direction and repeated accelerations but seldom reaches sprint velocities. J Strength Cond Res XX(X): 000-000, 2024-The aim of this investigation was to quantify the characteristics of high-intensity running in international male field hockey. Player movement data were collected through wearable player tracking devices across 3 tournaments (17 matches) from 27 members of the Australian male field hockey team (totaling 266 player matches). Active duration (minute), high-intensity efforts (>2.5 m·s-2 for >1 second), repeated high-intensity efforts (≥3 efforts with ≤45-second recovery between efforts), and sprints (>7 m·s-1) were extracted and aggregated for each player match. The duration, distance, mean and peak speed, mean change of direction and straightness for each high-intensity effort, and peak deceleration at the conclusion of each effort were calculated. Mixed-effects models were used to estimate the mean for each outcome (fixed effect), with random intercepts modeled for player and match. On average, players completed 42.2 high-intensity efforts and 2.1 sprints per match. High-intensity efforts were short (3.61 seconds, 12.9 m), failed to reach high velocities (average peak velocity: 4.8 m·s-1), and involved frequent changes of direction (56% of efforts were not straight). There were 4.7 bouts of repeated high-intensity efforts per player, per match (comprising 3.8 efforts, with 3.53 seconds per effort separated by 16.2-second recovery). Last, we also found that 29% of high-intensity efforts involved a high-speed deceleration (>3.5 m·s-2), and these occurred frequently when in conjunction with a >45° (86%) or >90° (89%) change of direction. We recommend practitioners focus on developing players' ability to repeatedly accelerate, decelerate, and change direction over short distances and adopt testing and monitoring programs that assess these qualities.

Feasibility of using low-cost markerless motion capture for assessing functional outcomes after lower extremity musculoskeletal cancer surgery.

BACKGROUND: Physical limitations are frequent and debilitating after sarcoma treatment. Markerless motion capture (MMC) could measure these limitations. Historically expensive cumbersome systems have posed barriers to clinical translation. RESEARCH QUESTION: Can inexpensive MMC [using Microsoft KinectTM] assess functional outcomes after sarcoma surgery, discriminate between tumour sub-groups and agree with existing assessments? METHODS: Walking, unilateral stance and kneeling were measured in a cross-sectional study of patients with lower extremity sarcomas using MMC and standard video. Summary measures of temporal, balance, gait and movement velocity were derived. Feasibility and early indicators of validity of MMC were explored by comparing MMC measures i) between tumour sub-groups; ii) against video and iii) with established sarcoma tools [Toronto Extremity Salvage Score (TESS)), Musculoskeletal Tumour Rating System (MSTS), Quality of life-cancer survivors (QoL-CS)]. Statistical analysis was conducted using SPSS v19. Tumour sub-groups were compared using Mann-Whitney U tests, MMC was compared to existing sarcoma measures using correlations and with video using Intraclass correlation coefficient agreement. RESULTS: Thirty-four adults of mean age 43 (minimum value-maximum value 19-89) years with musculoskeletal tumours in the femur (19), pelvis/hip (3), tibia (9), or ankle/foot (3) participated; 27 had limb sparing surgery and 7 amputation. MMC was well-tolerated and feasible to deliver. MMC discriminated between surgery groups for balance (p<0.05*), agreed with video for kneeling times [ICC = 0.742; p = 0.001*] and showed moderate relationships between MSTS and gait (p = 0.022*, r = -0.416); TESS and temporal outcomes (p = 0.016* and r = -0.0557*), movement velocity (p = 0.021*, r = -0.541); QoL-CS and balance (p = 0.027*, r = 0.441) [* = statistical significance]. As MMC uncovered important relationships between outcomes, it gave an insight into how functional impairments, balance, gait, disabilities and quality of life (QoL) are associated with each other. This gives an insight into mechanisms of poor outcomes, producing clinically useful data i.e. data which can inform clinical practice and guide the delivery of targeted rehabilitation. For example, patients presenting with poor balance in various activities can be prescribed with balance rehabilitation and those with difficulty in movements or activity transitions can be managed with exercises and training to improve the quality and efficiency of the movement. SIGNIFICANCE: In this first study world-wide, investigating the use of MMC after sarcoma surgery, MMC was found to be acceptable and feasible to assess functional outcomes in this cancer population. MMC demonstrated early indicators of validity and also provided new knowledge that functional impairments are related to balance during unilateral stance and kneeling, gait and movement velocity during kneeling and these outcomes in turn are related to disabilities and QoL. This highlighted important relationships between different functional outcomes and QoL, providing valuable information for delivering personalised rehabilitation. After completing future validation work in a larger study, this approach can offer promise in clinical settings. Low-cost MMC shows promise in assessing patient's impairments in the hospitals or their homes and guiding clinical management and targeted rehabilitation based on novel MMC outcomes affected, therefore providing an opportunity for delivering personalised exercise programmes and physiotherapy care delivery for this rare cancer.

Differences in Objective Physical Activity Between Children With Visual Impairment and Those With Normal Sight.

Purpose: To compare objective physical activity (PA) levels of children with visual impairment (VI) and children with normal sight. Methods: One hundred children with VI and 100 age- and gender-matched normal-sighted peers 7 to 17 years of age wore an ActiGraph for 1 week. Activity count per minute (cpm) was modeled using a series of generalized linear mixed-effects models including vision, age, sex, time of day, and vision by time of day interaction. PA outcomes included mean counts per minute and proportion of time spent on sedentary, light, moderate, and vigorous intensity PA. Results: Data of 83 children with VI and 77 normal-sighted peers were included. Mean counts per minute were lower in children with VI (P < 0.001), especially during and after school. Children with VI were less sedentary (55%; 95% confidence interval [CI], 53-57) than children with normal sight before school (62%; 95% CI, 60-64) and over weekends: children with VI, 41% (95% CI, 39-43); children with normal sight, 45% (95% CI, 43-47). Yet, children with VI were more sedentary during school (36%; 95% CI, 34-37) compared with children with normal sight (30%; 95% CI, 29-32). They also spent more time performing light PA and less time performing moderate PA at school and vigorous PA across all periods of day (P < 0.001). Conclusions: Children with VI participated in light and moderate PA but did not perform as much vigorous PA as children with normal sight, especially during school hours. Translational Relevance: There is a need to promote more intense PA programs in schools tailored for children with VI.