Measurement properties of Brief-BESTest scores from children, adolescents, and youth with visual impairments.

Purpose: This study aimed to vet the measurement properties of Brief-BESTest scores in children, adolescents, and youth with visual impairment and blindness (YVI). Methods: A cross-sectional sample of YVI (N = 101) completed the Brief-BESTest, a modified version of the Y-Balance Test, the 360-degree turn test, bipedal quiet stance, and Activity-Specific Balance Confidence Scales. Thirty-seven YVI completed test-retest of the Brief-BESTest using a one-year interval. Using classical test theory, various forms of total and item-level Brief-BESTest score reliability and validity were investigated in YVI. Results: All inter-rater reliability coefficients were ≥ .80. When considering the eight items of the Brief-BESTest, 27 of the 28 possible correlations were statistically significant (p<.05). Various internal consistency and item difficulty results were strong. When taking total Brief-BESTest scores and their association with the complementary balance tasks/metrics into account, 11 of 13 associations were statistically significant (p<.05) providing strong convergent validity evidence. Being multimorbid and degree of vision significantly predicted total Brief-BESTest scores (p<.001) suggesting construct (i.e. known groups) validity. Numerous test-retest results (e.g. coefficients, limits of agreement) following the one-year interval were indicative of score stability. Conclusion: Practitioners and researchers should have confidence in, and consider adopting, the Brief-BESTest to examine multidimensional balance in YVI.

Rehabilitation, motor, and health professionals should view the Brief-BESTest as the preeminent clinical balance assessment for children, adolescents, and youth with visual impairment and blindness (YVI).Brief-BESTest scores may be used to investigate multidimensional balance, provide 'systems-based' balance profiles, and inform targeted balance interventions in YVI.Practitioners and researchers may now investigate Brief-BESTest scores alongside pertinent health- or movement-relevant outcomes of interest (e.g., gait, mobility, falls).

Dietary nitrate ingested with and without pomegranate supplementation does not improve resistance exercise performance.

This study tested the hypothesis that co-ingesting nitrate (NO3-)-rich beetroot juice (BR) and pomegranate powder (POM) would enhance neuromuscular performance during vertical countermovement jumps, explosive kneeling countermovement push-ups, and back squats compared to BR ingestion alone. Fifteen recreationally-active males were assigned in a double-blind, randomized, crossover design, to supplement in 3 conditions: (1) NO3--depleted beetroot juice (PL; 0.10 mmol NO3-) with two empty gelatin capsules; (2) NO3--rich beetroot juice (BR; 11.8 mmol NO3-) with two empty gelatin capsules, and (3) BR with 1,000 mg of POM powder in two capsules (BR + POM). Participants completed 5 countermovement jumps and 5 kneeling countermovement push-ups interspersed by 1 min of recovery. Subsequently, participants performed 2 sets of 2 × 70% one-repetition maximum back squats, interspersed by 2 min of recovery. Plasma [NO3-] and nitrite ([NO2-]) were elevated following BR and BR + POM compared with PL and POM (p < 0.001) with no differences between BR and BR + POM (p > 0.05) or PL and POM (p > 0.05). Peak power during countermovement jumps increased by 3% following BR compared to BR + POM (88.50 ± 11.46 vs. 85.80 ± 10.14 W/Kg0.67, p = 0.009) but not PL (88.50 ± 11.46 vs. 85.58 ± 10.05 W/Kg0.67, p = 0.07). Neuromuscular performance was not different between conditions during explosive kneeling push-ups and back squats (p > 0.05). These data provide insight into the efficacy of NO3- to modulate explosive resistance exercise performance and indicate that supplementing with BR alone or combined with POM has limited ergogenic potential on resistance exercise. Furthermore, caution is required when combining BR with POM, as this could compromise aspects of resistance exercise performance, at least when compared to BR ingested independently.

Effects of Dietary Nitrate Supplementation on Back Squat and Bench Press Performance: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis investigated the influence of dietary nitrate supplementation on resistance exercise performance according to the PRISMA guidelines. Searches were conducted on MEDLINE, PubMed, ScienceDirect, Scopus and SPORTDiscus databases up to April 2023. Inclusion criteria were adult resistance-trained males who supplemented with a nitrate-rich supplement and nitrate-deficient placebo to assess repetitions-to-failure (RTF), peak power, mean power, peak velocity, and/or mean velocity during back squat and bench press exercise. A random effects model was performed on six studies and showed that nitrate supplementation improved RTF (standardized mean difference [SMD]: 0.43, 95% confidence intervals [95% CI]: 0.156 to 0.699, p = 0.002), mean power (SMD: 0.40, 95% CI: 0.127 to 0.678, p = 0.004), and mean velocity (SMD: 0.57, 95% CI: 0.07 to 1.061, p = 0.025) but had no effect on peak power (SMD: 0.204, 95% CI: -0.004 to 0.411, p = 0.054) or peak velocity (SMD: 0.00, 95% CI: -0.173 to 0.173, p = 1.000) when back squat and bench press were combined. Subgroup analyses revealed that back squats were more likely to be enhanced and that a dosing regimen may influence the efficacy of nitrate supplementation. Overall, nitrate supplementation had a small beneficial effect on some aspects of resistance exercise performance, but there were limited studies available and the variability was large. Additional studies that focus on upper and lower body resistance exercise and nitrate dosage are required to elucidate the efficacy of dietary nitrate supplementation on resistance exercise performance.

Performance Metrics From Product-Oriented Measures of Fundamental Motor Skills-A Comparison and Developmental Perspective.

This study (a) examined the associations among different performance metrics derived from different strategies (i.e., maximum and average scores) and trials from product-oriented measures of motor skills, and (b) explored how different performance metrics from product-oriented assessments of motor skills change in young children with typical development. Children (N = 279; 156 girls; Mage = 4.44 years) completed a battery of product-oriented assessments for throwing (in meters per second, five trials); kicking (in meters per second, five trials); jumping (in centimeters, five trials); running (in meters per second, two trials); and hopping (in meters per second, four trials-two preferred foot, two nonpreferred foot). A total of 36 performance metrics were derived-throw (n = 7), kick (n = 7), jump (n = 7), run (n = 4), and hop (n = 11). Intraclass correlations examined reliability among performance metrics for each skill; linear mixed models examined whether variations changed across early childhood. There was excellent reliability among all performance metrics for each skill (all ICC> .90). Linear mixed models revealed that children's motor performance improved for two metrics of the throw, five variations of the jump, and three metrics of the hop (all p <.05). Researchers should be aware that some performance metrics from product-oriented assessments (e.g., maximum and average of three or five trials) are highly related and change, whereas others do not.

Effects of Dietary Nitrate Supplementation on Performance and Muscle Oxygenation during Resistance Exercise in Men.

The purpose of the current study was to assess the effects of acute and short-term nitrate (NO3−)-rich beetroot juice (BR) supplementation on performance outcomes and muscle oxygenation during bench press and back squat exercise. Fourteen recreationally active males were assigned in a randomized, double-blind, crossover design to supplement for 4 days in two conditions: (1) NO3−-depleted beetroot juice (PL; 0.10 mmol NO3− per day) and (2) BR (11.8 mmol NO3− per day). On days 1 and 4 of the supplementation periods, participants completed 2 sets of 2 × 70%1RM interspersed by 2 min of recovery, followed by one set of repetitions-to-failure (RTF) at 60%1RM for the determination of muscular power, velocity, and endurance. Quadriceps and pectoralis major tissue saturation index (TSI) were measured throughout exercise. Plasma [NO3−] and nitrite ([NO2−]) were higher after 1 and 4 days of supplementation with BR compared to PL (p < 0.05). Quadriceps and pectoralis major TSI were not different between conditions (p > 0.05). The number of RTF in bench press was 5% greater after acute BR ingestion compared to PL (PL: 23 ± 4 vs. BR: 24 ± 5, p < 0.05). There were no differences between BR and PL for RTF for back squat or power and velocity for back squat or bench press (p > 0.05). These data improve understanding on the ergogenic potential of BR supplementation during resistance exercise.

An Examination of Motor Competence Profiles in Preschool Children: A Latent Profile Analysis.

Purpose: Identifying profiles of preschoolers' motor competence (MC) is essential for providing accurate and targeted intervention. However, little is known regarding children's MC profiles, more specifically how skills may present in unique clusters. The purposes of the study were to explore MC profiles of U.S. children ages 3-6 years, quantify the uniqueness of these profiles, and examine differences by age, gender, race, geographic region, socioeconomic status, and Body Mass Index z-scores. Methods: Participants included children (N = 582, ngirls = 296) aged 3-6 years (Mage = 4.97, SD = .75) enrolled in one of seven early childhood education centers (Alabama, Louisiana, Ohio [× 2], South Carolina [× 2], Texas). Each child's MC was assessed with the 12 skills comprising the TGMD-2. Latent profile analysis was performed using the 12 MC skills. Results: Five profiles of MC emerged, three of which show developing MC but in varying combinations. Wald tests revealed possible MC advantages for preschool children who are older, boys, reside in an urban region, and are of higher socioeconomic status, but only for the proficient MC profile. Conclusion: By uncovering five unique latent MC profiles, professionals should consider the presentation/origins of each profile and use such knowledge to create targeted, individualized MC interventions in American preschoolers. From a research perspective, the implications of this study suggest that researchers should consider person-oriented approaches examining individual skill scores (vs. summed subscale scores) whenever possible.

The Effects of an Integrative, Universally Designed Motor Skill Intervention for Young Children With and Without Disabilities.

Many interventions feature a singular component approach to targeting children's motor competency and proficiency. Yet, little is known about the use of integrative interventions to meet the complex developmental needs of children aged 3-6 years. The purpose of this study was to examine the effects of an integrative universally designed intervention on children with and without disabilities' motor competency and proficiency. We selected children (N = 111; disability = 24; no disability = 87) to participate in either a school-based integrative motor intervention (n = 53) or a control condition (n = 58). Children in the integrative motor intervention both with and without disabilities showed significant improvement in motor competency and proficiency (p < .001) as compared with peers with and without disabilities in a control condition. Early childhood center directors (e.g., preschool and kindergarten) should consider implementing integrative universally designed interventions targeting multiple aspects of motor development to remediate delays in children with and without disabilities.

Perceived Motor Competence Mediates the Relationship Between Gross Motor Skills and Physical Activity in Youth With Visual Impairments.

Children with visual impairments typically demonstrate lower levels of motor competence, physical activity, and perceived motor competence compared to their peers without visual impairments. Stodden and colleagues purport that perceived motor competence mediates the relationship between motor competence and physical activity for youth without visual impairments. Purpose: The purpose of this study was to test whether perceived motor competence mediates the relationship between motor competence and physical activity for youth with visual impairments. Methods: Participants (N = 138; boys = 81, girls = 57) were age 9-18 years (Mage = 13.37, SD = 2.34) with visual impairments. Participants completed the Test of Gross Motor Development-3, the Test of Perceived Physical Competence-VI, and the Physical Activity Questionnaire. Results: Locomotor skills predicted perceived motor competence, which predicted physical activity. Perceived motor competence showed a mediation effect on the path from locomotor skills to physical activity. There was no significant relationship between locomotor skills and physical activity. Conclusion: The results from this study provide initial evidence to support the hypothesis proposed by Stodden and colleagues. These data provide a rationale to include both perceived and actual motor competence within targeted intervention strategies to increase physical activity behaviors for youth with visual impairments. Future research should consider following participants longitudinally to test the roles of perceived and actual motor competence as factors supporting positive developmental trajectories for health.

Standing Long Jump Performance in Youth with Visual Impairments: A Multidimensional Examination.

Muscular fitness, an important marker of health in youth, includes explosive strength, which can be assessed using the standing long jump (SLJ). Little is known concerning the SLJ in populations with disabilities such as youth with visual impairments (VI) who trend with decreased health- and performance-related outcomes. The purposes of this study were to investigate multidimensional SLJ performance outcomes in youth with VI (i.e., descriptives and percentages of occurrence) and to explore associations among such variables and known factors of interest (e.g., age) using robust linear bivariate regressions. This study was a secondary analysis from data collected in 2018 (N = 61, Mage = 12.98 years, SD = 2.21). SLJ performance was investigated using a multidimensional focus (e.g., distance, Test of Gross Motor Development-3 horizontal jump, landing developmental sequences, landing joint displacement, and stabilization after landing). In general, SLJ performance was substandard in youth with VI. Most SLJ assessment scores were predictive of other SLJ assessment scores. Few hypothesized variables of interest (e.g., multimorbidity) were predictive of SLJ performance. Youth with VI who match the characteristics of the current sample may have decreased explosive strength/muscular fitness and, worryingly, their SLJ performance may not be influenced by expected factors (e.g., age). Implications and explanations for these results are discussed.

The Brief Form of the Test of Gross Motor Development-3 for Individuals with Visual Impairments.

Children with visual impairments (VI) tend to struggle with their fundamental motor skills (FMS), and these difficulties often persist across the lifespan, requiring frequent assessment. The Test of Gross Motor Development (TGMD) shows robust psychometric properties for children with VI. The TGMD, which includes 13 skills, is time-consuming to administer and score, warranting the need to explore brief versions. Therefore, the purpose of this study was to explore the psychometric properties of three, six-skill versions of the TGMD-3 with children with VI. Children (n = 302; Boys = 58%, Girls = 42%; Mage = 13.00, SD = 2.50 years) with VI (B1 = 27%, B2 = 20%, B3 = 38%, B4 = 15%) participated in this study. We examined three different models using confirmatory factor analyses on the relationships between the motor skills and latent traits across the models. Scores from all three brief versions had acceptable global fit. Although further research should be conducted, practitioners can adopt a brief version of the TGMD to assess children with VI.

Changes in joint kinematics and dynamic postural stability with free and restricted arm movements in children.

BACKGROUND: Arm movements make a substantial and functionally relevant contribution to quiet standing and dynamic balance tasks. The impact of restricted arm movements on balance control is particularly important for children as their postural control system is not fully matured. RESEARCH QUESTION: This study investigated the effects of arm movements on lower body joint kinematics and dynamic postural stability during anterior and lateral dynamic movements in children. METHODS: Eighteen boys (age, 10.1 ± 1.6 years) completed an anterior and a lateral jump-landing task under two different verbally conveyed instructions of arm position; (1) arms placed flat across the chest touching the contralateral shoulder (i.e., restricted arm movement) and (2) arm movement without restriction. Lower body joint kinematics were recorded and used to calculate mean joint position, joint range of motion (ROM) and joint movement variability. RESULTS: Restricting arm movements resulted in a reduction of joint movement variability and joint ROM of the pelvis during the lateral jump (p <0.05), but increased joint movement variability and joint ROM of the pelvis during the anterior jump (p <0.05). SIGNIFICANCE: The reduced joint movement variability and joint ROM with restricted arm movements during the lateral jump may represent a potential compensatory 'stiffenin strategy', whilst the increase during the anterior jump suggest an exploratory strategy. These novel findings highlight that it is important for children to be introduced to different dynamic task constraints so that they can learn to control and organise the motor system degrees of freedom appropriately.

Longitudinal Locomotor Competence and Body Mass Index Across Self-Reported Gender and Vision Level for Youth With Visual Impairments: A 3-Year Investigation.

Youth with visual impairments are more likely to be overweight than peers without visual impairments and often struggle with their locomotor skills. Locomotor development can combat unhealthy body weight statuses by supporting physical activity behaviors. There are no longitudinal investigations concerning the locomotor skill and body mass index (BMI) developmental trajectories of youth with visual impairments. The purpose of this study was to examine the 3-year developmental trajectory of the locomotor skills and BMI of youth with visual impairments including differential effects of self-reported gender and degree of vision. Participants (N = 34, Mage = 11.75 years, 47% female) showed severely delayed and arrested locomotor development with increases in BMI across 3 years regardless of self-reported gender or degree of vision. Participants failed to breech a proficiency barrier of motor competence to combat against increases in BMI across time. Additional longitudinal inquiries are needed.

The Effects of Ecologically Valid Intervention Strategies on the Locomotor Skills of Children With Visual Impairments.

Children with visual impairments often exhibit difficulties with locomotor skills (e.g., the ability to move one's body from one place to another), warranting the need for ecologically valid interventions with conditions that attempt to match the real world in a variety of settings. Parents and physical education teachers are the ones choosing to provide movement opportunities for children with visual impairments and must be included in any ecologically valid intervention strategy. This was a descriptive-analytic study. To support the greatest diversity in settings, the authors recruited 94 participants (blind = 44 and low vision = 50; Mage = 13.01 years, SD = 3.26) from schools for the deaf and blind in the United States (teacher led, n = 17) or Latvia (teacher led, n = 57), through an online LISTSERV throughout the United States (parent led, n = 10), and a control subgroup (n = 10). At the pretest, no participant's motor development met age expectations. Children with visual impairments from multiple locations and cultures significantly improved compared with controls who did not. Results were most favorable when the physical educator was the interventionist. However, further research is needed to replicate these findings.

A Systematic Review and Qualitative Synthesis Resulting in a Typology of Elementary Classroom Movement Integration Interventions.

BACKGROUND/OBJECTIVE: Movement integration (MI) involves infusing physical activity into normal classroom time. A wide range of MI interventions have succeeded in increasing children's participation in physical activity. However, no previous research has attempted to unpack the various MI intervention approaches. Therefore, this study aimed to systematically review, qualitatively analyze, and develop a typology of MI interventions conducted in primary/elementary school settings. SUBJECTS/METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to identify published MI interventions. Irrelevant records were removed first by title, then by abstract, and finally by full texts of articles, resulting in 72 studies being retained for qualitative analysis. A deductive approach, using previous MI research as an a priori analytic framework, alongside inductive techniques were used to analyze the data. RESULTS: Four types of MI interventions were identified and labeled based on their design: student-driven, teacher-driven, researcher-teacher collaboration, and researcher-driven. Each type was further refined based on the MI strategies (movement breaks, active lessons, other: opening activity, transitions, reward, awareness), the level of intrapersonal and institutional support (training, resources), and the delivery (dose, intensity, type, fidelity). Nearly half of the interventions were researcher-driven, which may undermine the sustainability of MI as a routine practice by teachers in schools. An imbalance is evident on the MI strategies, with transitions, opening and awareness activities, and rewards being limitedly studied. Delivery should be further examined with a strong focus on reporting fidelity. CONCLUSIONS: There are distinct approaches that are most often employed to promote the use of MI and these approaches may often lack a minimum standard for reporting MI intervention details. This typology may be useful to effectively translate the evidence into practice in real-life settings to better understand and study MI interventions.

Motor Competence Levels and Developmental Delay in Early Childhood: A Multicenter Cross-Sectional Study Conducted in the USA.

BACKGROUND AND OBJECTIVES: Developmental delay in motor competence may limit a child's ability to successfully participate in structured and informal learning/social opportunities that are critical to holistic development. Current motor competence levels in the USA are relatively unknown. The purposes of this study were to explore motor competence levels of US children aged 3-6 years, report percentages of children demonstrating developmental delay, and investigate both within and across childcare site predictors of motor competence, including sex, race, geographic region, socioeconomic status, and body mass index percentile classification. Potential implications from results could lead to a greater awareness of the number of children with developmental delay, the impetus for evidence-based interventions, and the creation of consistent qualification standards for all children so that those who need services are not missed. METHODS: Participants included children (N = 580, 296 girls) aged 3-6 years (Mage = 4.97, standard deviation = 0.75) from a multi-state sample. Motor competence was assessed using the Test of Gross Motor Development, Second Edition and the 25th and 5th percentiles were identified as developmental delay-related cutoffs. RESULTS: For both Test of Gross Motor Development, Second Edition subscales, approximately 77% of the entire sample qualified as at risk for developmental delay (≤ 25th percentile), while 30%  of the entire sample were at or below 5th percentile. All groups (e.g., sex, race, socioeconomic status) were prone to developmental delay. Raw object control scores differed by sex. CONCLUSIONS: Developmental delay in motor competence is an emerging epidemic that needs to be systematically acknowledged and addressed in the USA. By shifting norms based upon current data, there may be a lower standard of "typical development" that may have profound effects on factors that support long-term health.

Correction to: Motor Competence Levels and Developmental Delay in Early Childhood: A Multicenter Cross-Sectional Study Conducted in the USA.

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Predictors of Physical Activity for Preschool Children With and Without Disabilities From Socioeconomically Disadvantaged Settings.

The purpose of this study was to examine differences in motor competence, perceived motor competence (PMC), body mass index, and physical activity (PA) and to assess factors that predict PA behaviors of preschool children with and without disabilities. A total of 59 children with (n = 28) and without (n = 31) disabilities participated in the study. Results revealed that children with disabilities had significantly greater amounts of PA than peers without disabilities. There were no significant differences for motor competence, PMC, and body mass index for children with or without a disability. Although age and body mass index were controlled, both disability and PMC significantly predicted PA. Future intervention studies should consider maintaining high levels of PMC, as it is a significant predictor of PA.

Correlates of physical activity among children with visual impairments.

BACKGROUND: Children with visual impairments (VI) often reveal higher levels of sedentary time and lower levels of fundamental motor skills (FMS), health-related fitness (HRF) and physical activity (PA) than peers without visual impairments. Extrapolating correlates of HRF and PA are important to develop targeted intervention strategies aimed at improving health- and movement-based outcomes. OBJECTIVE: The purpose of this study was to examine associations among FMS (divided into locomotor and object control skills), HRF, and home- and sport-camp based PA measures in children with VI. METHODS: Children with VI (N = 66; 9-18 years) completed PA, HRF (including cardio-respiratory fitness, muscular strength and endurance), and FMS measures during a seven-day period. Partial and zero-order correlations, which included controlling for age, degree of VI, and BMI z-score were performed. RESULTS: When controlling for vision, age, and BMI z-score, home-based self-report PA moderately correlated with camp-based accelerometer data (p < .001); home-based and camp-based PA associated with object control and locomotor subscales (p < .001); object control and locomotor skills were the most influential factors above and beyond vision associating with both PA measures. Cardiorespiratory fitness and grip strength were significantly associated with both object control and locomotor skills (p < .001). CONCLUSIONS: Future intervention strategies that target increasing PA and HRF levels for children with VI should consider focusing upon both object control and locomotor skill development.

Head, Toes, Knees, SKIP! Improving Preschool Children's Executive Function Through a Motor Competence Intervention.

Executive function skills play a critical role in school readiness for young children and can be improved through targeted intervention. However, children in preschool often experience deficits in multiple developmental domains. Thus, there is a need for integrated interventions that target multiple domains in concert. This study tested whether a proven gross motor skill intervention, Successful Kinesthetic Instruction for Preschoolers (SKIP), also improves preschoolers' executive function. Participants were randomly assigned to either intervention (n = 50) or control (n = 57) conditions. Prior to intervention, executive function and gross motor skills were tested. Intervention occurred for 6 weeks with 30-min sessions twice weekly (dose = 360 min). At posttest, participants in the SKIP condition showed significantly better gross motor and executive function skills than control participants. Results are the first to document the effectiveness of the SKIP intervention in also improving children's executive function.

Dynamic Postural Control in Children: Do the Arms Lend the Legs a Helping Hand?

There is growing empirical evidence lending support to the existence of an "upper body strategy" to extend the ankle and hip strategies in maintaining upright postural stability among adults. Both postural stability and arm movement functions are still developing in children. Therefore, enquiry concerning arm contribution to postural stability among children is needed. This proof of concept study seeks to determine whether the arms play a functionally relevant role in dynamic postural control among children. Twenty-nine children (girls, n = 15; age, 10.6 ± 0.5 years; height, 1.48 ± 0.08 m; mass, 42.8 ± 11.4 kg; BMI, 19.2 ± 3.7 kg/m2) completed three dynamic balance tests; (1) Y Balance test®, (2) timed balance beam walking test, (3) transition from dynamic to static balance using the dynamic postural stability index (DPSI). Each test was performed with free and restricted arm movement. Restricting arm movements elicited a marked degradation in the Y Balance reach distance (all directions, P ≤ 0.001, d = -0.85 to -1.13) and timed balance beam walking test (P ≤ 0.001, d = 1.01), while the DPSI was the only metric that was not different between free and restricted arm movements (P = 0.335, d = -0.08). This study provides direct evidence that the arms play a functionally relevant role in dynamic balance performance among children. These findings may provide the impetus to develop training interventions to improve the use of the arms in activities of daily living.