Exploring actual and perceived levels of physical activity intensity during virtual reality active games.

Background: Research suggests that engaging in active virtual reality (VR) video games can elicit light to moderate levels of physical activity (PA), making it a novel and fun mode of exercise. Further research is needed to understand the influence of VR on perceptions of exertion and enjoyment during PA. Objective: The objectives of this study are (1) to compare actual and perceived exertion within and between active VR games with varying levels of difficulty and (2) to determine how playing active VR games influences PA enjoyment during gameplay. Methods: A total of 18 participants completed four separate study sessions, during which they engaged in either a 15-min bout of traditional exercise (stationary cycling) or played one VR game. Heart rate (HR) and ratings of perceived exertion (RPE) using the Borg CR10 scale were assessed during VR gameplay and cycling. Enjoyment was measured after gameplay. VR games included playing Holopoint at level 2 and level 3 and Hot Squat. Repeated measures ANOVAs were used to examine (1) changes in HR and RPE across time within games and (2) differences in actual and perceived levels of intensity and enjoyment between games. Bivariate correlations examined the relationship between the degree of change in actual intensity and the degree of change in perceived intensity during each VR game and cycling. Results: The analyses revealed that RPE and HR significantly increased from baseline during each condition and generally increased across the 15-min of gameplay. Hot Squat and cycling elicited a significantly higher percentage of heart rate reserve (%HRR) than Holopoint at levels 2 and 3. Holopoint level 3 elicited a higher %HRR than Holopoint level 2. The participants reported greater average and max RPE during Hot Squat and cycling compared with Holopoint at levels 2 and 3. The correlations revealed a significant positive correlation between the degree of change in HR and RPE for cycling, but no significant correlations were observed for any of the VR conditions. The physical activity during Holopoint at both levels was rated as more enjoyable than Hot Squat and cycling. Conclusion: Our data support the notion that VR has the potential to alter individuals' perceptions of exertion during PA and, in particular, may reduce their awareness of increases in actual exertion.

Physical Activity to Prevent the Age-Related Decline of Endogenous Pain Modulation.

As humans age, the capacity of the central nervous system to endogenously modulate pain significantly deteriorates, thereby increasing the risk for the development of chronic pain. Older adults are the least physically active cohort of all age groups. We hypothesize that a sedentary lifestyle and decreased physical activity may contribute to the decline of endogenous pain modulation associated with aging.

Kinesiophobia Predicts Physical Function and Physical Activity Levels in Chronic Pain-Free Older Adults.

Advanced aging is associated with a general decline in physical function and physical activity. The current evidence suggests that pain-related fear of movement (i.e., kinesiophobia) is increased in the general older adult population and impacts physical activity levels in patients with chronic pain. However, whether kinesiophobia could impact physical activity and function in relatively healthy, chronic pain-free older adults remain unclear. Thus, the purpose of this study was to examine whether fear of movement due to pain predicted self-reported and objective levels of physical function and physical activity in healthy older adults without chronic pain. Fifty-two older adults were enrolled in this study. The participants completed the International Physical Activity Questionnaire (IPAQ) and wore an accelerometer on the hip for 7 days to measure physical activity. Measures of sedentary time, light physical activity, and moderate to vigorous physical activity were obtained from the accelerometer. Measures of physical function included the Physical Functioning subscale of the Short Form-36, Short Physical Performance Battery (SPPB), the 30-s Chair Stand test, and a maximal isometric hand-grip. The Tampa Scale of Kinesiophobia (TSK) was used to measure fear of movement or re-injury associated with pain. Potential covariates included self-reported activity-related pain and demographics. Hierarchical linear regressions were conducted to determine the relationship of kinesiophobia with levels of physical activity and physical function while controlling for activity-related pain and demographics. TSK scores did not predict self-reported physical activity on the IPAQ. However, TSK scores predicted self-reported physical function (Beta = -0.291, p = 0.015), 30-s Chair Stand test scores (Beta = -0.447, p = 0.001), measures from the SPPB (Gait speed time: Beta = 0.486, p < 0.001; Chair stand time: Beta = 0.423, p = 0.003), percentage of time spent in sedentary time (Beta = 0.420, p = 0.002) and light physical activity (Beta = -0.350, p = 0.008), and moderate to vigorous physical activity (Beta = -0.271, p = 0.044), even after controlling for significant covariates. These results suggest that greater pain-related fear of movement/re-injury is associated with lower levels of light and moderate to vigorous physical activity, greater sedentary behavior, and worse physical function in healthy, chronic pain-free older adults. These findings elucidate the potential negative impact of kinesiophobia in older adults who don't report chronic pain.

Effect of different Kinesio tape tensions on experimentally-induced thermal and muscle pain in healthy adults.

Athletes and rehabilitation specialists have used Kinesio tape (KT) to help alleviate pain symptoms. Currently, no clear mechanism exists as to why pain is relieved with the use of KT and whether the pain relieving effect is simply a placebo effect. Additionally, the most effective taping parameters (tension of tape) for pain reduction remain unknown. We used quantitative sensory testing to address these key gaps in the KT and pain literature. Using a repeated-measures laboratory design, we examined whether KT applied at different tensions reduces experimentally-induced pain compared to a no tape condition and KT with minimal tension. Heat pain thresholds (HPT's), pressure pain thresholds (PPT's), and pressure pain suprathreshold (PPS: 125% of PPT) tests were administered to the forearm prior to and during KT and no tape conditions. Tape was applied to the ventral forearm at 25% of max tension, 75% of max tension, and no tension (placebo). Repeated measures ANOVA's evaluated the pain outcomes between conditions and across time. KT had no significant effect on PPT's and HPT's (p's >0.05). The ANOVA on PPS revealed that KT applied at 25% of tension significantly reduced pain ratings from the pretest (M = 34.4, SE = 5.5) to post-test 1 (M = 30.3, SE = 4.7) and post-test 2 (M = 30.4, SE = 4.7). No other conditions significantly reduced suprathreshold pressure pain. However, pain ratings at posttest-1 during the no-tape condition (M = 36.4, SE = 5.3) were significantly greater than pain ratings during post-test 1 and post-test 2 of all three tape conditions. In conclusion, the current study revealed that KT applied at low tension is the optimal tension to reduce pressure-evoked muscle pain. Additionally, the results suggested that KT applied at low, high, or no tension may acutely prevent increased muscle sensitivity with repeated pressure stimulation.

Physical Activity Intensity, Perceived Exertion, and Enjoyment During Head-Mounted Display Virtual Reality Games.

Objectives: The purpose of this study was to determine the following: (1) the level of physical activity (PA) achieved during commercial active virtual reality (VR) games, and (2) which active VR games elicit higher enjoyment levels in young, healthy adults. Materials and Methods: Thirty-six participants completed four study sessions, each devoted to playing one of the following head-mounted display VR games for 15 minutes: Beat Saber (BS), Holopoint (HP), Hot Squat (HS), and Relax Walk VR. PA intensity measures included percentage of heart rate reserve (%HRR), ratings of perceived exertion (RPE), and accelerometry. Enjoyment was measured with the Physical Activity Enjoyment Scale (PACES) following each gaming session. Mixed-model analysis of variances were used to analyze the outcome measures. Results: The analyses showed that HS elicited significantly higher %HRR and RPE than BS, HP, and Relax Walk. HS was the only game to reach moderate intensity via %HRR. Accelerometer data showed that time in whole-body moderate-to-vigorous physical activity (MVPA) for HS was significantly greater than HP, which was greater than BS and Relax Walk. Also, males exhibited significantly more whole-body and upper limb MVPA compared with females during gameplay. BS and HP were rated significantly more enjoyable than HS and Relax Walk. Conclusions: Results from this study suggest that active VR games can elicit varying degrees of PA intensity levels in young healthy adults, with HS eliciting moderate intensity activity. The games rated highest in enjoyment required mostly arm movement and a perceived light exertion. ClinicalTrials: NCT04221139.

Active Gaming: It Is Not Just for Young People.

Whether active gaming is an appropriate method to facilitate moderate-intensity physical activity in older adults remains unclear. The purpose of this study was to evaluate the intensity of physical activity and enjoyment while playing three active video games in older adults compared with younger adults. Ten younger and 10 older adults played three active games on separate days. Participants played two 15-min periods per game: one period at a self-selected intensity and one period with structured instructions to maximize the movement. Physical activity intensity and enjoyment were measured during gameplay. The results indicated that older adults played games at significantly higher intensities (5.3 + 1.8 vs. 3.6 + 1.8 metabolic equivalents), spent less time in whole-body sedentary activity, and rated games more enjoyable compared with younger adults. With physical activity intensity being consistent with moderate-to-vigorous intensity for older adults during gameplay, the results suggest that active video games could be used as a cardiovascular tool for older adults.

Effect of Acute Bouts of Volume-Matched High-Intensity Resistance Training Protocols on Blood Glucose Levels.

Monroe, JC, Naugle, KM, and Naugle, KE. Effect of acute bouts of volume-matched high-intensity resistance training protocols on blood glucose levels. J Strength Cond Res 34(2): 445-450, 2020-Resistance exercise has the capability to alter glucose metabolism in healthy adults; however, to what extent single sessions of varying intensities of resistance exercise affect capillary glucose levels is not completely understood. The purpose of this study was to compare the effect of different resistance training intensities on capillary blood glucose levels in healthy adults. Thirteen resistance-trained men (age 24.4 ± 2.7 years) participated in an evaluation and 2 separate experimental resistance training sessions. The experimental sessions were a high-intensity resistance training session (HT) consisting of 7 sets of 3 repetitions at 90% of the participant's estimated 1 repetition maximum (e1RM), and a moderate-/high-intensity resistance training session (MT) consisting of 3 sets of 9 repetitions at 70% of the participant's e1RM. At least 7 days separated the completion of each session. Four glucose readings during each session were recorded using a capillary glucometer: G1 (baseline); G2 (pre-exercise); G3 (after exercise); and G4 (10 minutes after exercise). Results were analyzed using repeated-measures analysis of variances. Analysis revealed a significant decrease in blood glucose levels between G2 and G3, and G2 and G4 in both the HT and MT experimental sessions (p = 0.045). In addition, there was a significant difference in the magnitude of change in glucose levels from G2 to G3 between HT and MT (HT = -38.2 ± 5.3% SE, p = 0.042, MT = -22.2 ± 5.9% SE). Although both of the acute resistance exercise protocols decreased blood glucose levels in healthy men, a greater decrease in blood glucose levels from pre-exercise to post-exercise was observed in HT group compared with MT group.

The Decline of Endogenous Pain Modulation With Aging: A Meta-Analysis of Temporal Summation and Conditioned Pain Modulation.

The purpose of this article was to examine age-related changes in conditioned pain modulation (CPM) and temporal summation (TS) of pain using meta-analytic techniques. Five electronic databases were searched for studies, which compared measures of CPM and TS among healthy, chronic pain-free younger, middle-aged, and older adults. Eleven studies were included in the final review for TS and 11 studies were included in the review of CPM. The results suggested a moderate magnitude of difference in TS among younger and middle-aged/older adults, with the older cohorts exhibiting enhanced TS of pain. Considerable variability existed in the magnitude of the effect sizes, which was likely due to the different experimental methodologies used across studies (ie, interstimulus interval, stimulus type, and body location). In regards to CPM, the data revealed a large magnitude of difference between younger and older adults, with younger adults exhibiting more efficient pain inhibition. Differences in CPM between middle-aged and older adults were minimal. The magnitude of pain inhibition during CPM in older adults may depend on the use of concurrent versus nonconcurrent protocols. In summary, the data provided strong quantitative evidence of a general age-related decline in endogenous pain modulatory function as measured by TS and CPM. PERSPECTIVE: This review compared CPM and TS of pain among younger, middle-aged, and older adults. These findings enhance our understanding of the decline in endogenous pain modulatory function associated with normal aging.

Improving Active Gaming's Energy Expenditure in Healthy Adults Using Structured Playing Instructions for the Nintendo Wii and Xbox Kinect.

Naugle, KE, Carey, C, Ohlman, T, Godza, M, Mikesky, A, and Naugle, KM. Improving active gaming's energy expenditure in healthy adults using structured playing instructions for the Nintendo Wii and Xbox Kinect. J Strength Cond Res 33(2): 549-558, 2019-Professionals work constantly to increase energy expenditure and improve cardiovascular outcomes. A newer form of physical activity used to improve cardiovascular outcomes and increase energy expenditure while also providing entertainment is active gaming. The purpose was to determine energy expenditure and enjoyment levels during participation in different games played with a directed set of instructions designed to enhance movement. Twenty-one adults completed 6 sessions (1 familiarization and 5 experimental) on separate days. During 4 of the experimental sessions, participants played 1 of 4 active games for two 15-minute periods. Two active games were from Xbox Kinect and 2 were from Nintendo Wii. During the first period, participants played at a self-selected level of activity. During the second period, participants were given specific instructions for play during both active and down times within games. Participants wore a portable gas analyzer to measure energy expenditure. Resting energy expenditure was measured during session 6. Outcome measures were analyzed with 4 Game × 2 Period repeated-measures analyses of variance. Energy expenditure, measured in metabolic equivalents (METS), was greatest while playing Kinect Fighter Within. METS, enjoyment levels, and percentage of time spent in whole-body activity were greater during the period with specific instructions compared to the self-selected levels of activity, regardless of active game. When played at a self-selected level of activity, energy expenditure during the active games was similar to that of light physical activity. However, energy expenditure improved during the second period of game play showing that specific instructions created energy expenditure of moderate intensity.

Physical Activity Levels Predict Exercise-induced Hypoalgesia in Older Adults.

Prior research indicates that older adults exhibit a deficient capacity to activate multiple pain inhibitory mechanisms, including pain inhibition after acute exercise termed exercise-induced hypoalgesia (EIH). The influence of physical activity levels and psychological processes on EIH in older adults remains unclear. PURPOSE: This study examined potential psychological and physical activity predictors of the magnitude of EIH after submaximal isometric exercise in healthy older adult men and women. METHODS: Fifty-two healthy older adults completed a test of EIH, the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia, and wore an accelerometer on the hip for 1 wk to assess physical activity levels. For the test of EIH, participants complete a 3-min isometric handgrip at 25% of maximum voluntary contraction. Pressure pain thresholds (PPT) and a 30-s continuous heat pain test were completed before and immediately after the exercise. RESULTS: Mixed-model ANOVA revealed that older adults demonstrated significantly decreased PPT after isometric exercise (P = 0.030), and no changes on the heat pain trials from pretest to posttest (P > 0.05). A multiple regression revealed that accumulated moderate to vigorous physical activity (MVPA) per week significantly predicted the change in PPT after exercise (ß = 0.35, P = 0.012). Participants who averaged greater MVPA experienced a greater increase in PPT after exercise. No relationships were found with EIH and the psychological variables. CONCLUSIONS: Older adults did not exhibit EIH after submaximal isometric exercise. However, those who did more MVPA per week experienced a greater magnitude of pain inhibition after acute exercise.

Active Gaming as a Form of Exercise to Induce Hypoalgesia.

OBJECTIVE: An acute bout of moderate-to-vigorous exercise temporarily reduces pain sensitivity in healthy adults. Recently, active gaming has been rising in popularity as a means of light-to-moderate exercise and may be particularly suitable for deconditioned individuals. Whether the physical activity elicited in active games can produce a hypoalgesic effect remains unknown. The purpose of this study was to determine whether active videogames can reduce pressure and heat pain sensitivity in healthy adults. We also evaluated the relationship between the physical activity elicited by the games and the magnitude of the hypoalgesic response. MATERIALS AND METHODS: Twenty-one healthy adults played four different active games on separate days, including Microsoft® Kinect Xbox® One's Fighter Within and Sports Rival's Tennis, and Nintendo® Wii™ Sports' Boxing and Tennis. Heat pain thresholds on the forearm and pressure pain thresholds (PPTs) on the trapezius and forearm were assessed immediately before and after a 15-minute active gaming or control session. Minutes spent in sedentary time and moderate-to-vigorous physical activity (MVPA) during active gaming were measured with an accelerometer. RESULTS: The analyses revealed that PPTs at the forearm and trapezius significantly increased from pretest to posttest following Kinect Fighter Within. PPTs at the trapezius also significantly increased from pretest to posttest following Wii Boxing. The magnitude of the hypoalgesic response was significantly correlated with MVPA and sedentary time during gameplay. CONCLUSION: These results suggest that an active gaming session played at a moderate intensity is capable of temporarily reducing pain sensitivity.

Physical activity behavior predicts endogenous pain modulation in older adults.

Older adults compared with younger adults are characterized by greater endogenous pain facilitation and a reduced capacity to endogenously inhibit pain, potentially placing them at a greater risk for chronic pain. Previous research suggests that higher levels of self-reported physical activity are associated with more effective pain inhibition and less pain facilitation on quantitative sensory tests in healthy adults. However, no studies have directly tested the relationship between physical activity behavior and pain modulatory function in older adults. This study examined whether objective measures of physical activity behavior cross-sectionally predicted pain inhibitory function on the conditioned pain modulation (CPM) test and pain facilitation on the temporal summation (TS) test in healthy older adults. Fifty-one older adults wore an accelerometer on the hip for 7 days and completed the CPM and TS tests. Measures of sedentary time, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) were obtained from the accelerometer. Hierarchical linear regressions were conducted to determine the relationship of TS and CPM with levels of physical activity, while controlling for demographic, psychological, and test variables. The results indicated that sedentary time and LPA significantly predicted pain inhibitory function on the CPM test, with less sedentary time and greater LPA per day associated with greater pain inhibitory capacity. Additionally, MVPA predicted pain facilitation on the TS test, with greater MVPA associated with less TS of pain. These results suggest that different types of physical activity behavior may differentially impact pain inhibitory and facilitatory processes in older adults.

Reduced Modulation of Pain in Older Adults After Isometric and Aerobic Exercise.

UNLABELLED: Laboratory-based studies show that acute aerobic and isometric exercise reduces sensitivity to painful stimuli in young healthy individuals, indicative of a hypoalgesic response. However, little is known regarding the effect of aging on exercise-induced hypoalgesia (EIH). The purpose of this study was to examine age differences in EIH after submaximal isometric exercise and moderate and vigorous aerobic exercise. Healthy older and younger adults completed 1 training session and 4 testing sessions consisting of a submaximal isometric handgrip exercise, vigorous or moderate intensity stationary cycling, or quiet rest (control). The following measures were taken before and after exercise/quiet rest: 1) pressure pain thresholds, 2) suprathreshold pressure pain ratings, 3) pain ratings during 30 seconds of prolonged noxious heat stimulation, and 4) temporal summation of heat pain. The results revealed age differences in EIH after isometric and aerobic exercise, with younger adults experiencing greater EIH compared with older adults. The age differences in EIH varied across pain induction techniques and exercise type. These results provide evidence for abnormal pain modulation after acute exercise in older adults. PERSPECTIVE: This article enhances our understanding of the influence of a single bout of exercise on pain sensitivity and perception in healthy older compared with younger adults. This knowledge could help clinicians optimize exercise as a method of pain management.

Cardiovascular and affective outcomes of active gaming: using the nintendo wii as a cardiovascular training tool.

Active-video gaming is purported to produce similar cardiovascular responses as aerobic fitness activities. This study compared the emotional and cardiovascular effects of Wii games with those of traditional exercise in college-aged adults with different exercise backgrounds. Specifically, the percentage of heart rate reserve, rate of perceived exertion (RPE), level of enjoyment, and Positive and Negative Affect Schedule scores were compared between subjects who reported exercising frequently at high intensities (high-intensity exerciser group: age = 20.18 years [0.87]; Height = 165.23 cm [9.97]; Mass = 62.37 kg [11.61]), N = 11 and those who exercise more often at lower intensities (low-intensity exercisers group: age = 20.72 years [1.19]; Height = 164.39 cm [8.05]; Mass = 68.04 kg [10.71]), N = 11. The subjects completed six 20-minute exercises sessions: treadmill walking, stationary cycling, and Wii's Tennis, Boxing, Cycling, and Step. The low-intensity exerciser group achieved a greater percentage of heart rate reserve (a) during traditional exercise compared with that during Wii boxing, (b) playing Wii boxing compared with that for Wii tennis, and (c) playing Wii boxing compared with that when the high-intensity exercisers group played any Wii games (p < 0.05). The RPE was greater for boxing and cycling compared with that for tennis and step (p < 0.05). Ratings of enjoyment and the increase in positive emotion were greater for boxing and for tennis compared with those for traditional exercises (p < 0.05). Results suggest that Wii boxing shows the greatest potential as a cardiovascular fitness tool among the Wii games, particularly for individuals who typically exercise at lower intensities.

Intensity thresholds for aerobic exercise-induced hypoalgesia.

INTRODUCTION: Despite many studies investigating exercise-induced hypoalgesia, there is limited understanding of the optimal intensity of aerobic exercise in producing hypoalgesic effects across different types of pain stimuli. Given that not all individuals are willing or capable of engaging in high-intensity aerobic exercise, whether moderate-intensity aerobic exercise (MAE) is associated with a hypoalgesic response and whether this response generalizes to multiple pain induction techniques needs to be substantiated. PURPOSE: This study's purpose is to test for differences in the magnitude of pressure and heat pain modulation induced by MAE and vigorous-intensity aerobic exercise (VAE). METHODS: Twelve healthy young males and 15 females completed one training session and three testing sessions consisting of 25 min of 1) stationary cycling at 70% HR reserve, 2) stationary cycling at 50% HR reserve, or 3) quiet rest (control). Pain testing was conducted on both forearms before and immediately after each condition and included the following tests: pressure pain thresholds, suprathreshold pressure pain test, static continuous heat test, and repetitive pulse heat pain test. Repeated-measures ANOVA was conducted on each pain measure. RESULTS: VAE and MAE reduced pain ratings during static continuous heat stimuli and repetitive heat pulse stimuli, with VAE producing larger effects. VAE also increased pressure pain thresholds, whereas neither exercise influenced suprathreshold pressure pain ratings. CONCLUSION: These results suggest that MAE is capable of producing a hypoalgesic effect using continuous and repetitive pulse heat stimuli. However, a dose-response effect was evident as VAE produced larger effects than MAE.

Isometric exercise as a test of pain modulation: effects of experimental pain test, psychological variables, and sex.

OBJECTIVE: Little is known regarding whether exercise-induced hypoalgesia (EIH) produced by isometric exercise is influenced by psychological factors or systematically varies across multiple experimental psychophysical pain tests. Thus, this study sought to determine the influence of experimental pain test, psychological factors, and sex on the hypoalgesic response of submaximal isometric exercise. METHODS: Healthy young males (N = 12) and females (N = 15) completed one training and two testing sessions consisting of quiet rest (control condition) or a 3-minute isometric handgrip performed at 25% of maximum voluntary contraction. Pain testing was conducted on both forearms prior to and following exercise and quiet rest. The pain tests included: pressure pain thresholds (PPT), suprathreshold pressure pain test, static prolonged heat test, and temporal summation of heat pain. Participants completed the Pain Catastrophizing Scale during the training session and the State-Trait Anxiety Inventory-State version prior to each session. The data were analyzed with mixed model analyses of variance, partial Pearson correlations, and hierarchical regression analyses. RESULTS: Isometric exercise increased PPTs for men and women, reduced pain perception during static prolonged heat stimuli for women, and reduced temporal summation of pain for men and women. Greater pain catastrophizing was associated with smaller reductions in temporal summation following isometric exercise. CONCLUSIONS: These findings demonstrate that the hypoalgesic response to submaximal isometric exercise is partially a function of sex and experimental pain test. Furthermore, the relationship between EIH and pain catastrophizing was psychophysical pain test specific, with greater pain catastrophizing predicting diminished EIH only during the temporal summation of pain trials.

Perceptions of wellness and burnout among certified athletic trainers: sex differences.

CONTEXT: Athletic trainers are exposed to various stressors, increasing the potential for burnout and decreasing perceived wellness. Burnout and decreased perceived wellness can result from many factors: years of experience, hours per week worked, or decreased levels of physical activity. Another factor that accounts for a portion of the variance is sex differences. OBJECTIVE: To determine the differences in burnout, physical activity, and perceived wellness scores relating to sex in District 9 of the National Athletic Trainers' Association (NATA). DESIGN: Cross-sectional study. SETTING: Web-based questionnaire. PATIENTS OR OTHER PARTICIPANTS: Athletic trainers who were included in the e-mail directory of NATA District 9 (men = 232, women = 158). INTERVENTION(S): A 19-item questionnaire for burnout, a 36-item questionnaire for perceived wellness, and a 16-item activity questionnaire for physical activity and demographics. MAIN OUTCOME MEASURE(S): The variables included demographics (hours per week worked, years of experience, sex), Copenhagen Burnout Inventory (CBI; scores range from 0-100, and higher scores represent a higher level of burnout), Perceived Wellness Survey (PWS; scores range from 1-36, and scores close to 29 are considered healthy), and Baecke Physical Activity Questionnaire (BPAQ; scores range from 1-15, and higher scores represent more physical activity). RESULTS: Of the 1560 members contacted, 390 responded (response rate = 25%), and 59.5% (n = 232) were male. The mean scores were 38.73 ± 16.9 for men and 46.2 ± 17.1 for women for the CBI, 16.68 ± 2.76 for men and 16.41 ± 2.81 for women for the PWS, and 8.42 ± 1.32 for men and 8.77 ± 1.36 for women for the BPAQ. Men and women worked an average of 55.60 ± 26.03 and 47.86 ± 20.57 hours per week, respectively, and had a mean experience of 14.79 ± 9.86 and 8.92 ± 6.51 years, respectively. Women reported a higher level of burnout (t388 = -4.255, P = .001) and greater levels of physical activity (t388 = -2.52, P = .01) than men. Men reported working more hours (t388 = 3.131, P = .002) and having more years of experience (t388 = 6.568, P = .001) than women. Perceived wellness was not different between sexes (t388 = 0.958, P = .34). CONCLUSIONS: Our results suggest that women experienced moderate to high burnout and men experienced moderate burnout. Interestingly, men reported lower levels of burnout but worked more hours than women. Future researchers should focus on why women experience higher levels of burnout but work fewer hours. These findings may lead to educational interventions that might reduce burnout and increase professional longevity and quality of work.

Discriminating between copers and people with chronic ankle instability.

CONTEXT: Differences in various outcome measures have been identified between people who have sprained their ankles but have no residual symptoms (copers) and people with chronic ankle instability (CAI). However, the diagnostic utility of the reported outcome measures has rarely been determined. Identifying outcome measures capable of predicting who is less likely to develop CAI could improve rehabilitation protocols and increase the efficiency of these measures. OBJECTIVE: To determine the diagnostic utility and cutoff scores of perceptual, mechanical, and sensorimotor outcome measures between copers and people with CAI by using receiver operating characteristic curves. DESIGN: Case-control study. SETTING: Sports medicine research laboratory. PATIENTS OR OTHER PARTICIPANTS: Twenty-four copers (12 men, 12 women; age = 20.8 ± 1.5 years, height = 173 ± 11 cm, mass = 78 ± 27 kg) and 24 people with CAI (12 men, 12 women; age = 21.7 ± 2.8 years, height = 175 ± 13 cm, mass = 71 ± 13 kg) participated. INTERVENTION(S): Self-reported disability questionnaires, radiographic images, and a single-legged hop stabilization test. MAIN OUTCOME MEASURE(S): Perceptual outcomes included scores on the Foot and Ankle Disability Index (FADI), FADI-Sport, and a self-report questionnaire of ankle function. Mechanically, talar position was quantified by measuring the distance from the anterior tibia to the anterior talus in the sagittal plane. Sensorimotor outcomes were the dynamic postural stability index and directional indices, which were calculated during a single-legged hop stabilization task. RESULTS: Perceptual outcomes demonstrated diagnostic accuracy (range, 0.79-0.91), with 95% confidence intervals ranging from 0.65 to 1.00. Sensorimotor outcomes also were able to discriminate between copers and people with CAI but with less accuracy (range, 0.69-0.70), with 95% confidence intervals ranging from 0.37 to 0.86. The mechanical outcome demonstrated poor diagnostic accuracy (0.52). CONCLUSIONS: The greatest diagnostic utility scores were achieved by the self-assessed disability questionnaires, which indicated that perceptual outcomes had the greatest ability to accurately predict people who became copers after their initial injuries. However, the diversity of outcome measures that discriminated between copers and people with CAI indicated that the causal mechanism of CAI is probably multifactorial.

Self-assessed disability and functional performance in individuals with and without ankle instability: a case control study.

STUDY DESIGN: Single-blind case-control study. OBJECTIVE: To compare functional performance and self-assessed disability scores among individuals with and without chronic ankle instability (CAI) and uninjured controls. BACKGROUND: After an acute lateral ankle sprain, CAI develops in 40% to 75% of all individuals. However, some individuals, copers, maintain high-level activities after an ankle sprain and do not develop CAI. Studying differences between copers and those with CAI is the first step in developing a clinical battery of tests that can accurately determine which individuals are more likely to develop CAI after an acute lateral ankle sprain. METHODS AND MEASURES: Participants were 24 active adults with unilateral CAI (mean +/- SD age, 21.7 +/- 2.8 years), 24 copers (20.8 +/- 1.5 years), and 24 uninjured controls (21.8 +/- 2.6 years). Participants completed 3 questionnaires of self-assessed disability: (1) Foot and Ankle Disability Index, (2) Foot and Ankle Disability Index-Sport, and (3) a questionnaire of ankle function. Four hop tests were also completed: (1) figure-8 hop, (2) side-to-side hop, (3) triple-crossover hop, and (4) single-leg hop for distance. RESULTS: Self-assessed disability was significantly different among groups (P<.001), but hop test scores (P = .259) were not. Those with CAI had greater self-assessed disability than copers and uninjured controls. Copers and uninjured controls did not differ in self-assessed disability or functional performance. CONCLUSIONS: Self-assessed disability is significantly greater in those with CAI than copersand uninjured controls. However, functional performance, measured by hop tests, did not differ among groups.

The effects of a supervised resistance-training program on Special Olympics athletes.

OBJECTIVE: To examine the effects of a resistance-training program on athletes with intellectual disabilities (ID). DESIGN/PARTICIPANTS: 2-way (2 x 2), repeated-measures analysis of variance on 2 groups (males and females); 30 Special Olympics (SO) athletes, age 16-22 (16 males, 14 females). INTERVENTION/OUTCOME MEASURES: Resistance training, twice per week, for 3 months on Med-X weight equipment. Exercises tested: chest press, abdominal crunch, seated row, overhead press, seated dip, lower back extension, and biceps curl. The weight lifted and the number of repetitions performed were used to determine predicted 1-repetition max (1RM). RESULTS: All participants as a group increased significantly in predicted 1RM for each exercise performed. Males were stronger than females for 5 of the 7 exercises. A significant interaction effect between genders was demonstrated for the seated dip. CONCLUSION: Significant strength gains can be accomplished by adolescents with ID via a supervised resistance-training program.