Effects of tapering on performance in endurance athletes: A systematic review and meta-analysis.

OBJECTIVE: To assess the responses to taper in endurance athletes using meta-analysis. METHODS: Systematic searches were conducted in China National Knowledge Infrastructure, PubMed, Web of Science, SPORTDiscus, and EMBASE databases. Standardized mean difference (SMD) and 95% confidence interval (CI) of outcome measures were calculated as effect sizes. RESULTS: 14 studies were included in this meta-analysis. Significant improvements were found between pre- and post-tapering in time-trial (TT) performance (SMD = -0.45; P < 0.05) and time to exhaustion (TTE) performance (SMD = 1.28; P < 0.05). However, There were no improvements in maximal oxygen consumption ([Formula: see text]) and economy of movement (EM) (P > 0.05) between pre- and post-tapering. Further subgroup analysis showed that tapering combined with pre-taper overload training had a more significant effect on TT performance than conventional tapering (P < 0.05). A tapering strategy that reduced training volume by 41-60%, maintained training intensity and frequency, lasted ≤7 days, 8-14 days, or 15-21 days, used a progressive or step taper could significantly improve TT performance (P < 0.05). CONCLUSIONS: The tapering applied in conjunction with pre-taper overload training seems to be more conducive to maximize performance gains. Current evidence suggests that a ≤21-day taper, in which training volume is progressively reduced by 41-60% without changing training intensity or frequency, is an effective tapering strategy.

Relationship Between Shoulder Pain and Joint Reaction Forces and Muscle Moments During 2 Speeds of Wheelchair Propulsion.

The purpose of this study was to determine shoulder joint reaction forces and muscle moments during 2 speeds (1.3 and 2.2 m/s) of wheelchair propulsion and to investigate the relationship between joints reaction forces, muscle moments, and shoulder pain. The measurements were obtained from 20 manual wheelchair users. A JR3 6-channel load sensor (±1% error) and a Qualisys system were used to record 3-dimensional pushrim kinetics and kinematics. A 3-dimensional inverse dynamic model was generated to compute joint kinetics. The results demonstrated significant differences in shoulder joint forces and moments (P < .01) between the 2 speeds of wheelchair propulsion. The greatest peak shoulder joint forces during the drive phase were anterior directed (Fy, 184.69 N), and the greatest joint moment was the shoulder flexion direction (flexion moment, 35.79 N·m) at 2.2 m/s. All the shoulder joint reaction forces and flexion moment were significantly (P < .05) related to shoulder pain index. The forces combined in superior and anterior direction found at the shoulder joint may contribute to the compression of subacromial structure and predispose manual wheelchair users to potential rotator cuff impingement syndrome.

Wheelchair Tai Chi Ball Exercise for Improving Neuromuscular Functions of Older Adults With Disability.

The purposes of this perspective article were to summarize Wheelchair or Seated Tai Chi studies related to neuromuscular functions of older adults with disability; to describe the development of Wheelchair Tai Chi Ball (WTCB) exercise - a concept to combine mind-body exercise with strength training; and to propose a new Telehealth WTCB exercise for improving neuromuscular functions of old adults with spinal cord injury (SCI) and disability. With reference to neuromuscular functions, WTC intervention may have positive effects on simple reaction time, range of motion at the shoulder and trunk, static and dynamic sitting balance, handgrip strength, vagal activity, and sympathetic activity among older adults with disability. The developed WTCB intervention is a feasible and safe exercise which combines the mind-body exercise and strength conditioning into one exercise which possesses aerobic, stretching and strength trainings and may facilitate neuromuscular functions of older adults with disability. The proposed Telehealth WTCB 12 forms (TWTCB12) exercise with a "Moving Shadow" method in the telehealth may enable the learner to superimpose learner's image on an expert's demonstrating model to enhance the learning and practice effects. Since wheelchair users will learn and practice TWTCB12 movements in a seated position or sitting on a wheelchair the "Moving shadow" method on Zoom would provide an ideal telehealth learning and practice environment for the wheelchair users to learn and practice TWTCB12 exercise from home more feasible and user friendly.

The Effect of a Functional Strength Training Intervention on Movement Quality and Physical Fitness in Adolescents.

This study compared a 12 week Functional Strength Training (FST) program on functional movement and physical performance to typical physical education (PE) classes for middle school (MS) and high school (HS) students. We randomly assigned 266 participants (M age = 14.35, SD = 0.57 years; M height = 164.82, SD = 6.13 cm; M mass = 55.09, SD = 12.19 kg; M BMI = 20.11, SD = 3.54 kg/m2) into an FST or control group. The FST group trained in flexibility and stability, functional movement patterns, and health-related functional strength. The control group continued regular physical education (PE) classes. Each group trained three-times/week in 45 minute sessions for 12 weeks. Outcome measures included the Functional Movement Screen protocol and seven physical performance tests, assessed every four weeks over a 12 week period. We employed a mixed model ANOVA with Bonferroni post-hoc tests to examine differences between and within groups. Compared to the control group, the FST group significantly (p < 0.01) improved Functional Movement Screen total scores (25.7%), curl-ups (70.4%), pull-ups (281.6%), and flexibility (83.6%). We suggest including the FST program in the MS and HS PE curriculum.

Effects of wheelchair Tai Chi ball exercise on physical and mental health and functional abilities among elderly with physical disability.

The purpose of this study was to examine the effect of a 12-week Wheelchair Tai Chi Ball (WTCB) intervention, a combination of mind-body exercise with strength training, on physical and mental health and functional abilities among elderly with disability. Twenty-six elderly persons participated in the study, nine WTCB group participants and ten control group participants completed the study. The WTCB group practised WTCB12 twice/week for one hour each time. The control group did their daily routine without WTCB intervention. The outcomes measures were: Pain Self-Efficacy Questionnaire (PSEQ), SF-36v2 for physical and mental health, heart rate, blood pressure, range of motion and muscle strength of the dominant arm at the shoulder, elbow and wrist joints. The Mixed Model ANOVA was employed to examine the differences between and within the two groups using pre-test and post-test scores. The results demonstrated the WTCB group had significant improvements on PSEQ, general physical health and had positive effects on maintaining muscle strength at the shoulder, elbow and wrist joints as compared to the control group. The WTCB12 exercise had positive effects on self-efficacy for pain management, general physical health, and maintain upper extremity muscle strength and is a feasible exercise for elderly with disability.

The effect of Qigong-based therapy on patients with Parkinson's disease: a systematic review and meta-analysis.

OBJECTIVE: This study was to evaluate the effects of Qigong on clinical motor symptoms, walking ability, and balance of patients with Parkinson's disease. DATA SOURCES: Seven electronic databases (MEDLINE, Web of Science, CINAHL, SportDiscus, Scopus, China National Knowledge Infrastructure, and Wanfang Database) were searched from inception to June 28, 2020. METHODS: Two reviewers independently selected and extracted the data from studies with randomized controlled trial, and effect sizes were calculated by employing random-effect models with 95% confidential interval (CI). We used Physiotherapy Evidence Database scale to evaluate the quality of included studies. RESULTS: A total of seven studies with 325 participants (180 males and 145 females) were included in this meta-analysis. Results of this meta-analysis showed that Qigong had significantly positive effects on motor symptoms (SMD = 0.59, 95% CI [0.24, 0.93]), walking ability (SMD = 0.78, 95% CI [0.10, 1.47]), and balance (SMD = 0.72, 95% CI [0.23, 1.20]) in patients with Parkinson's disease. Subgroup analysis showed Qigong exercise had significant difference on improving motor symptoms and walking ability compared to passive control (P < 0.01), and no significant difference compared to active control. Subgroup analysis of Qigong exercise revealed a significant difference on balance compared to both active and passive control (P < 0.05). In addition, meta-regression result indicated that the effect of Qigong exercise on motor symptoms was influenced by age. CONCLUSION: The findings from current meta-analysis supported Qigong exercise as a beneficial alternative therapy may contribute to increasing motor function, walking ability, and balance for patients with Parkinson's disease.

Influence of Tai Chi on Self-Efficacy, Quality of Life, and Fatigue Among Patients With Cancer Receiving Chemotherapy: A Pilot Study Brief.

Purpose: While exercise is an effective intervention used to minimize side effects associated with chemotherapy, tai chi (TC) exercise for persons actively receiving chemotherapy remains understudied. The purposes of this study were to (a) evaluate the effects of TC on self-efficacy, quality of life (QOL), and cancer-related fatigue (CRF) and (b) understand the experience and perceived benefits of patients taking chemotherapy involved in a TC program. Design: An explanatory sequential mixed methods study with a dominant qualitative strand was used to explore the differences between an intervention group participating in TC (n = 3) and a nonexercising, wait-listed comparison group (n = 3). Method: Following 8-weeks of TC classes, a focus group was conducted with the intervention group. Pretest/posttest scores for CRF, self-efficacy, and QOL were analyzed using t tests to compare the means between and within groups. Thematic analysis was used to interpret transcripts. Quantitative and qualitative results were compared to determine congruence between findings. Findings: Qualitative findings revealed increased mind/body strength. Quantitative scores trended toward improved CRF, self-efficacy, and QOL. Findings from the two strands supported one another. Conclusions: Tai chi is an effective and feasible exercise for individuals with cancer receiving chemotherapy. This mind-body exercise appears to provide benefits beyond improved physical functioning.

Effects of Functional Strength Training Program on Movement Quality and Fitness Performance Among Girls Aged 12-13 Years.

Liao, T, Li, L, and Wang, YT. Effects of functional strength training program on movement quality and fitness performance among girls aged 12-13 years. J Strength Cond Res 33(6): 1534-1541, 2019-The purpose of this study is to evaluate the effects of a 12-week intervention of functional strength training (FST) on movement quality and fitness performance among 12- to 13-year-old untrained girls. One hundred forty-four girls (age 12.47 ± 0.57 years) were randomly assigned to the FST group and traditional strength training (TST) group. The FST group underwent 10 functional movement corrective exercises in the first 6 weeks and 10 functional strength promotion exercises in the following 6 weeks, whereas the TST group did 10 TST exercises with progressive intensity in 12 weeks. The training was 3 times per week and 45 min per session for both groups. The subjects were tested at the beginning and at the end of the intervention on movement quality and fitness performance variables. To compare the 2 groups pretest vs. posttests, analysis of variance with mixed model analysis of variance, paired t-test and independent t-test, and 2 × 2 contingency chi-squared analysis were used. The main time-by-group interaction effect of the total score of Functional Movement Screen (FMS) showed FST group significantly better than TST group explicitly (p ≤ 0.05). Differences between groups were detected for individual components in FMS test, injury-related problem items of FMS, and fitness performance variables. Although TST group increased the muscular strength significantly (p ≤ 0.05), the FST group has significant improvements on more variables such as deep squat and trunk stability, muscular strength, flexibility, and power (p ≤ 0.05). In comparison with TST program, FST program may be more effective on the improvements of movement quality, muscular strength, flexibility, and power among untrained healthy girls aged 12-13 years, and may result in better health promotion and injury prevention as well.

Effects of Rock Climbing Exercise on Physical Fitness among College Students: A Review Article and Meta-analysis.

BACKGROUND: The aim of this study was to systematically determine the effects of rock climbing on College Students' physical fitness by means of Meta-analysis. METHODS: Studies investigated the possible fitness benefits of rock climbing were identified through a computerized search of six electronic databases: China National Knowledge Infrastructure, China Science Periodical Database, PubMed, Web of Science, SPORTDiscus and PsycINFO. Effects of rock climbing exercise intervention trials ≥4 wk, published in English and Chinese between Jan 1996 and May 2016, including between subject and within subject designs, were reviewed. Nine studies were included in this meta-analysis. Ten selected variables in this meta-analysis were: Body fat percentage, VO2max, Heart rate, Handgrip strength, Lower limb pedaling power, Vertical Jump, Push-Ups, Pull-Ups, Sit-Ups, and Sit-and-reach. The effect sizes of these ten variables were calculated (P<0.05) and forest plots along with effective sizes were presented. RESULTS: Rock climbing can significantly improve Handgrip strength, Lower limb pedaling power, Vertical Jump, Push-Ups, Pull-Ups, Sit-Ups and Sit-and-reach (P<0.01), and significantly increase VO2max (P<0.05), however, rock climbing did not show significant improvement on Heart rate and Body fat percentage. CONCLUSION: As a newly popular physical exercise, rock climbing has a significantly positive impact on the physical fitness among college students. Rock climbing may be more effective if the college students engage in it for a longer term.

Traditional Chinese Mind and Body Exercises for Promoting Balance Ability of Old Adults: A Systematic Review and Meta-Analysis.

The purpose of this study was to provide a quantitative evaluation of the effectiveness of traditional Chinese mind and body exercises in promoting balance ability for old adults. The eligible studies were extensively searched from electronic databases (Medline, CINAHL, SportDicus, and Web of Science) until 10 May 2016. Reference lists of relevant publications were screened for future hits. The trials used randomized controlled approaches to compare the effects of traditional Chinese mind and body exercise (TCMBE) on balance ability of old adults that were included. The synthesized results of Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and static balance with 95% confidence intervals were counted under a random-effects model. Ten studies were selected based on the inclusion criteria, and a total of 1,798 participants were involved in this review. The results of the meta-analysis showed that TCMBE had no significant improvement on BBS and TUG, but the BBS and TUG could be obviously improved by prolonging the intervention time. In addition, the results showed that TCMBE could significantly improve the static balance compared to control group. In conclusion, old adults who practiced TCMBE with the time not less than 150 minutes per week for more than 15 weeks could promote the balance ability.

Effects of wheelchair Tai Chi on physical and mental health among elderly with disability.

A 12-week Wheelchair Tai Chi 10 Form (WTC10) intervention was conducted among elderly with disability to examine the effect of this WTC10 intervention on selected physical and mental health variables. Thirteen (age 87.23 ± 6.71) in the WTC10 intervention group and 15 (age 89.73 ± 6.31) in the control group completed the study. Independent t-tests and paired t-tests were employed to examine the differences between groups and within groups, respectively, at pretest and post-test. The WTC10 intervention group showed significant improvements in systolic and diastolic blood pressure, shoulder external rotation, left trunk rotation and total trunk rotation after the intervention. A 12-week WTC10 intervention had positive effects on blood pressure, range of motion at the shoulder and trunk, physical activity, and mental health among the elderly with disability. WTC10 is a feasible and safe exercise for the elderly with disability.

Immediate video feedback on ramp, wheelie, and curb wheelchair skill training for persons with spinal cord injury.

We hypothesized that the effects of immediate video feedback (IVF) on training ramp, wheelie, and curb wheelchair skills for persons with spinal cord injury (SCI) would be equivalent to or better than the traditional wheelchair skill training. Participants were manual wheelchair users with recent SCI (thoracic 1-lumbar 1) who were matched (9 pairs) on motor function level, age, and sex and randomly assigned to a control group (conventional training) or an experimental group (IVF training). Participants learned three wheelchair skills and then went through the wheelchair skill competency test, retention test, and transfer test. Paired t-tests were used to examine the differences in training time (minutes), spotter intervention needed (counts), and successful rate in performance between the two groups. A 2 (groups) x 3 (skills) x 3 (tests) repeated-measures analysis of variance and Bonferroni adjustment test were used to examine differences between groups on wheelchair skills and tests. No differences were found between two groups in training times (minutes) on three wheelchair skills (experimental vs control: ramp 14.92 +/- 5.80 vs 11.69 +/- 7.85; wheelie 17.79 +/- 6.03 vs 19.92 +/- 13.42; and curb 38.35 +/-23.01 vs 48.59 +/- 15.21). This study demonstrated that IVF for training manual wheelchair skills may produce similar results as the conventional training and may be an alternative training method for wheelchair skills.

The Effects of Vibration on the Gait Pattern and Vibration Perception Threshold of Children With Idiopathic Toe Walking.

The effectiveness of idiopathic toe walking treatments is not conclusive. The study investigated the use of vibration as a therapeutic/treatment method for children with idiopathic toe walking. Fifteen children with idiopathic toe walking and 15 typically developing children, aged 4 to 10 years, completed the study. The study included a barefoot gait examination and a vibration perception threshold test before and after standing on a whole body vibration machine for 60 seconds. Temporal-spatial parameters were recorded along with HR32, a calculation designed to distinguish on aspects of the toe-walking pattern. No significant gait pattern differences were found between children with idiopathic toe walking and typically developing children after one bout of vibration intervention. HR32 was found to be a means to identify the toe-walking pattern (P < .001). Hypersensitivity to vibration of children with idiopathic toe walking was not found in the current study (P = .921).

PNI Biomarkers and Health Outcomes in College Women.

Sleep disturbance has been found to trigger a stress response with a subsequent activation of the psychoneuroimmunological (PNI) pathway associated with adverse health outcomes. This study aimed to assess the association among selected PNI biomarkers, sleep disturbances, and adverse health outcomes (depressive symptoms, physical symptoms). A stratified, quota sample (14 poor sleepers and 15 good sleepers) was drawn from a pool of healthy college women from a larger scale of study. The participants reported their sleep, stress, depressive, and physical symptoms. Wrist actigraphy was used to collect objective sleep data, and the Enzyme-Linked ImmunoSorbent Assay was used to assess PNI biomarkers. Poor sleep quality, higher stress perception, elevated serum serotonin, and lower serum interleukin-10 explained 75.3% of the variances for the depressive symptoms. Poor sleep quality along with delayed peak activity rhythms accounted 31.4% of the physical symptoms. High serotonin and tumor necrosis factor-α were the significant predictors for poor sleep efficiency, and serotonin was the single significant predictor for poor daytime functioning. Stress and sleep disturbances negatively impact the health of college women and should be as part of regular check-ups on campus. PNI effects on health outcomes should be further explored. Educational materials in the areas of sleep hygiene, health impacts from sleep disturbances, and strategies to maintain synchronized circadian rhythms should be mandatorily included in the college curriculum.

Custom-molded foot-orthosis intervention and multisegment medial foot kinematics during walking.

CONTEXT: Foot-orthosis (FO) intervention to prevent and treat numerous lower extremity injuries is widely accepted clinically. However, the results of quantitative gait analyses have been equivocal. The foot models used, participants receiving intervention, and orthoses used might contribute to the variability. OBJECTIVE: To investigate the effect of a custom-molded FO intervention on multisegment medial foot kinematics during walking in participants with low-mobile foot posture. DESIGN: Crossover study. SETTING: University biomechanics and ergonomics laboratory. PATIENTS OR OTHER PARTICIPANTS: Sixteen participants with low-mobile foot posture (7 men, 9 women) were assigned randomly to 1 of 2 FO groups. INTERVENTION(S): After a 2-week period to break in the FOs, individuals participated in a gait analysis that consisted of 5 successful walking trials (1.3 to 1.4 m/s) during no-FO and FO conditions. MAIN OUTCOME MEASURE(S): Three-dimensional displacements during 4 subphases of stance (loading response, midstance, terminal stance, preswing) were computed for each multisegment foot model articulation. RESULTS: Repeated-measures analyses of variance (ANOVAs) revealed that rearfoot complex dorsiflexion displacement during midstance was greater in the FO than the no-FO condition (F(1,14) = 5.24, P = .04, partial η(2) = 0.27). Terminal stance repeated-measures ANOVA results revealed insert-by-insert condition interactions for the first metatarsophalangeal joint complex (F(1,14) = 7.87, P = .01, partial η(2) = 0.36). However, additional follow-up analysis did not reveal differences between the no-FO and FO conditions for the balanced traditional orthosis (F(1,14) = 4.32, P = .08, partial η(2) = 0.38) or full-contact orthosis (F(1,14) = 4.10, P = .08, partial η(2) = 0.37). CONCLUSIONS: Greater rearfoot complex dorsiflexion during midstance associated with FO intervention may represent improved foot kinematics in people with low-mobile foot postures. Furthermore, FO intervention might partially correct dysfunctional kinematic patterns associated with low-mobile foot postures.

An instrumented wheel system for measuring 3-D pushrim kinetics during racing wheelchair propulsion.

The purpose of this study was to design and validate an instrumented wheel system (IWS) that can measure 3-dimensional (3-D) pushrim forces during racing wheelchair propulsion. Linearity, precision, and percent error were determined for both static and dynamic conditions. For the static condition, the IWS demonstrated a high linearity (0.91

The effect of low-mobile foot posture on multi-segment medial foot model gait kinematics.

A number of in vitro, invasive in vivo, and non-invasive marker based multi-segment foot models (MSFMs) have reported significant motion in the articulations distal to the calcaneus during gait. Few studies, however, have applied a MSFM to the investigation of the effect of foot posture on gait kinematics. Differences in stance phase kinematics between participants with low-mobile (LMF) (n=11) versus "typical" (TYPF) (n=11) foot postures were investigated using a multi-segment medial foot model. Three-dimensional position and stance phase excursions of four functional articulations (rearfoot complex [RC], calcaneonavicular complex [CNC], medial forefoot, first metatarsophalangeal complex) were quantified using an eight optical camera motion analysis system (Vicon Motus, Vicon Motions Systems, Centennial, CO) and a custom written software program (Matlab 7.0.1, The MathWorks, Natick, MA), respectively. Excursions during four subphases of stance phase (loading response, midstance, terminal stance, pre-swing) at each of the functional articulations were compared using multivariate analyses of variance (alpha

The relationship between consistency of propulsive cycles and maximum angular velocity during wheelchair racing.

The purposes of this study were to examine the consistency of wheelchair athletes' upper-limb kinematics in consecutive propulsive cycles and to investigate the relationship between the maximum angular velocities of the upper arm and forearm and the consistency of the upper-limb kinematical pattern. Eleven elite international wheelchair racers propelled their own chairs on a roller while performing maximum speeds during wheelchair propulsion. A Qualisys motion analysis system was used to film the wheelchair propulsive cycles. Six reflective markers placed on the right shoulder, elbow, wrist joints, metacarpal, wheel axis, and wheel were automatically digitized. The deviations in cycle time, upper-arm and forearm angles, and angular velocities among these propulsive cycles were analyzed. The results demonstrated that in the consecutive cycles of wheelchair propulsion the increased maximum angular velocity may lead to increased variability in the upper-limb angular kinematics. It is speculated that this increased variability may be important for the distribution of load on different upper-extremity muscles to avoid the fatigue during wheelchair racing.

Fundamental locomotive activity time efficiency with differently positioning drive-axis wheelchairs among elders.

This study examined time efficiency in wheelchair locomotive activities among four different wheelchairs propelled by elders with arms and/or legs. Sixteen elder manual wheelchair users propelled her/his own wheelchair and three wheelchairs (the main drive-axis wheels positioning in front, middle, and rear, respectively) in the test of seven wheelchair locomotive activities of daily living. A Mixed-Model ANOVA and Bonferroni post hoc test (p < .05) were employed to determine the time efficiency among four wheelchairs and three groups. The results demonstrated better time efficiency resulted from propelling the mid drive-axis and/or rear drive-axis wheelchairs; using arms and legs simultaneously propelling wheelchairs was more time efficient than using the arms or legs only in the selected locomotive activities.