The influence of a multidisciplinary intervention program on Achilles tendon structure in children with overweight and obesity.

The effects of childhood obesity on tendon structure and its relation to physical activity are barely known. We aimed to investigate the influence of a 6-month multidisciplinary childhood obesity management program (which included dietary intervention and an exercise program) on Achilles tendon structure in overweight/obese children. Twenty-five overweight/obese children (overweight group) who participated in a 6-month multidisciplinary childhood obesity program, and 27 normal-weight controls were examined for anthropometric measurements and for Achilles tendon structure (using ultrasound tissue characterization to capture a three-dimensional structure of four echo type fibers and the cross-sectional area) at baseline, 3, and 6 months. The BMI of the overweight group significantly decreased from the pre- to the post-intervention period, (p = .002, η2 = .229), yet among the control group, the BMI significantly increased (p = .002, η2 = .222). Interactions (pre-post × group) showed a significant decrease in the prevalence of echo type I and in echo type III fibers and a significant increase in the prevalence of echo type II fibers and in the cross-sectional area along the intervention. No significant changes in echo type fibers were found in the control group along the 6 months.Conclusion: At pre-intervention, the overweight group had significantly "worse" tendon structure, with a lower prevalence of echo type II fiber and a higher prevalence of echo type III fibers compared with the control group. Following the 6-month intervention, the tendon structure of the overweight group was "positively" changed, with reduced echo type III fibers and increased echo type II fibers. What is Known: • Physical activity and weight reduction programs are efficient for obese children. • Obese children tend to suffer orthopedic problems and pain during physical activity. What is New: • Pre-intervention, obese children had 'worse' tendon structure compared to controls. • Following 6-month program, tendon structure of obese children 'positively' changed.

Achilles Tendon Tissue Structure in Children with Overweight and Children with Obesity.

Aim: To investigate differences in Achilles tendon structure between children with overweight/obesity and children with normal weight.Methods: Twenty-two children with obesity, 10 children with overweight, and 44 children with normal weight participated in the study. BMI% was calculated. The Achilles tendon was examined using ultrasound tissue characterization (UTC) imaging to capture a three-dimensional structure of four echo-type fibers and a cross-sectional area.Results: A significantly higher percentile of echo-types II, a lower percentile of echo-types III and IV, and a lower cross-sectional area were found for children with normal weight compared with children with overweight/obesity (p < .05). Following a piecewise linear regression model according to tendon structure, a BMI percentile of 75% was found to be the most accurate cutoff point of the children into the "unaffected" (BMI% <75%) and "affected" tendon structure groups (BMI% ≥ 75%), as the children with BMI%≥75% already had an Achilles tendon structure similar to that of the children with overweight/obesity.Conclusions: Tendon integrity as examined with UTC differs between children with obesity and children with normal weight. Children with a BMI percentile of ≥75 already demonstrate a different tendon structure pattern compared with children with BMI percentile of <75. This may put children with obesity at a greater risk of injury and should be addressed when applying an exercise program for children with overweight/obesity.

Preference-Performance Dissociation in Golf Putting.

The purpose of the current study was to examine the effectiveness of providing autonomy to learners and the phenomenon of preference-performance dissociation on a closed, self-paced motor task - putting in golf, when using different placements of a visual aid (a large circle) around a golf hole. Seventy-six participants were assigned to four experimental groups: (a) a visual aid placed behind the hole (V-behind group), (b) a visual aid placed in front of the hole (V-in-front group), (c) a visual aid placed around the hole (V-around group), and (d) a visual aid placed according to the participant's preference (V-pref group). Participants performed five pre-trials, 50 training putts from a distance of 2 m, a retention task (12 putts) from a distance of 2 m, and a transfer task (12 putts) from a distance of 2.5 m. The retention putts and transfer putts were performed 48 h after the training putts. The participants' subjective assessment of the helpfulness of the circle was also measured. It was found that in the retention task, putting consistency was lower in the V-in-front group compared to the V-around and V-pref groups. However, the subjective assessment of the helpfulness of the circle was higher in the V-in-front group. In addition, the low consistency of the V-in-front group was alleviated in the participants in the V-pref group who chose to place the circle in front of the hole. In contrast, the subjective assessment of the helpfulness of the circle was low in the V-in-front group. These findings suggest that while providing autonomy - that is, when the participant is able to choose for him/herself - can improve motor learning, there may be a dissociation between an individual's subjective assessment and the actual helpfulness of a visual aid. This dissociation may be termed preference-performance dissociation, and coaches and instructors who teach closed, self-paced motor skills should be aware of the fact that when providing learners with the autonomy to choose a practice aid in order to improve their skills, some may not choose the aid that is effective for them.