Evaluating the Validity of Tests to Predict Sprint and Change of Direction Speed in Para-Athletes With Brain Impairments.

Maximum running speed is a performance determinant in para-athletics and cerebral palsy football. Sixty international para-athletes with brain impairments completed five activity-limitation tests (standing broad jump, four bounds for distance, split jumps, 10-m speed skip, and running in place) and two criterion tests (40-m sprint and modified agility test). The same three tests (standing broad jump, four bounds for distance, and 10-m speed skip) that correlated with running performance in nondisabled runners (.67 < r < -.82; p < .05; 75% of variance) also correlated in para-athletes with brain impairments (.41 < r < -.62; p < .01; 55% of variance). Standing broad jump, four bounds for distance, split jumps, and running in place also correlated with change-of-direction speed (.43 < r < -.63; p < .01; 58% of variance). Results indicate that methods of classification for para-athletics with nondisabled runners are also valid with para-athletes with brain impairments, and new sport-specific relationships were found for assessing the performance of rapid and short sprints toward different directions, specific of a team para-sport like cerebral palsy football.

Perceptions and beliefs of community-based fitness professionals working with people with disability: a qualitative study.

PURPOSE: There are many benefits of sport and exercise however people with disability experience barriers to participation including negative interactions with fitness professionals. To understand this barrier further, this study explored the perceptions of community-based fitness professionals working with people with disability. MATERIALS AND METHODS: Thirteen fitness professionals took part in one semi-structured interview. Data were analysed inductively using an interpretive description approach. RESULTS: Theme 1, "Understanding your client's individual needs" highlighted the requirement for fitness professionals to be flexible to the needs of their clients. Theme 2 "You have to have a little bit of the knack" discussed the importance of maintaining a mutually respectful relationship, and the skills required to achieve this. Theme 3 "It needs to be a team approach" called for greater interprofessional collaboration with health professionals. Theme 4 "The barriers of gym culture" explored the negative stigma placed on people with disability in relation to sport and exercise. Theme 5 "Change is needed" highlighted changes required within the fitness industry to better support people with disability. CONCLUSION: To facilitate inclusive service delivery, changes are required within the supports and resources available to fitness professionals thereby allowing them to cater to their diversifying client population.

Physical activity is widely acknowledged as crucial to the health and wellbeing of people with disability, with focus being placed on creating inclusive community-based physical activity opportunities rather than disability specific programs alone.Community-based fitness professionals could provide important support towards enhancing inclusive physical activity participation for people with disability.Community-based fitness professionals experience many personal and professional benefits from working with people with disability, although, also experience challenges.To continue to work towards inclusion, community-based fitness professionals require further educational and funding support facilitating them to deliver safe and effective services to people with disability.

Effectiveness of physical activity interventions on undergraduate students' mental health: systematic review and meta-analysis.

This systematic review and meta-analysis assessed the effectiveness of physical activity interventions on undergraduate students' mental health. Seven databases were searched and a total of 59 studies were included. Studies with a comparable control group were meta-analysed, and remaining studies were narratively synthesized. The included studies scored very low GRADE and had a high risk of bias. Meta-analyses indicated physical activity interventions are effective in reducing symptoms of anxiety (n = 20, standardized mean difference (SMD) = -0.88, 95% CI [-1.23, -0.52]), depression (n = 14, SMD = -0.73, 95% CI [-1.00, -0.47]) and stress (n = 10, SMD = -0.61, 95% CI [-0.94, -0.28]); however, there was considerable heterogeneity (anxiety, I2 = 90.29%; depression I2 = 49.66%; stress I2 = 86.97%). The narrative synthesis had mixed findings. Only five studies reported being informed by a behavioural change theory and only 30 reported intervention fidelity. Our review provides evidence supporting the potential of physical activity interventions in enhancing the mental health of undergraduate students. More robust intervention design and implementation are required to better understand the effectiveness of PA interventions on mental health outcomes.

The power of Para sport: the effect of performance-focused swimming training on motor function in adolescents with cerebral palsy and high support needs (GMFCS IV) - a single-case experimental design with 30-month follow-up.

OBJECTIVE: This study aims to evaluate the effect of a performance-focused swimming programme on motor function in previously untrained adolescents with cerebral palsy and high support needs (CPHSN) and to determine whether the motor decline typical of adolescents with CPHSN occurred in these swimmers. METHODS: A Multiple-Baseline, Single-Case Experimental Design (MB-SCED) study comprising five phases and a 30-month follow-up was conducted. Participants were two males and one female, all aged 15 years, untrained and with CPHSN. The intervention was a 46-month swimming training programme, focused exclusively on improving performance. Outcomes were swim performance (velocity); training load (rating of perceived exertion min/week; swim distance/week) and Gross Motor Function Measure-66-Item Set (GMFM-66). MB-SCED data were analysed using interrupted time-series simulation analysis. Motor function over 46 months was modelled (generalised additive model) using GMFM-66 scores and compared with a model of predicted motor decline. RESULTS: Improvements in GMFM-66 scores in response to training were significant (p<0.001), and two periods of training withdrawal each resulted in significant motor decline (p≤0.001). Participant motor function remained above baseline levels for the study duration, and, importantly, participants did not experience the motor decline typical of other adolescents with CPHSN. Weekly training volumes were also commensurate with WHO recommended physical activity levels. CONCLUSIONS: Results suggest that adolescents with CPHSN who meet physical activity guidelines through participation in competitive swimming may prevent motor decline. However, this population is clinically complex, and in order to permit safe, effective participation in competitive sport, priority should be placed on the development of programmes delivered by skilled multiprofessional teams. TRIAL REGISTRATION NUMBER: ACTRN12616000326493.

Data from four consecutive cohorts of students in Australia (2019-2022) show the impact of the COVID-19 pandemic on domestic and international university students' mental health.

INTRODUCTION: COVID-19 and related travel and social restrictions caused significant stress for university students in Australia and globally. Learning quickly moved online and many students (particularly international students) were separated from social and economic support. This study examined the impact of the pandemic from pre-pandemic (2019) to the COVID-19 Omicron wave (2022) on domestic and international students' mental health. METHODS: Participants were 1540 students (72% females, 28% international) in four first-year cohorts (2019, 2020, 2021, 2022). We screened for mental health concerns (% positive) and symptom scores for depression, anxiety and somatic distress using the PsyCheck, and general wellbeing using the Warwick-Edinburgh Mental Well-being scale. RESULTS: From pre-COVID (2019) to the first wave of COVID-19 (2020), the proportion of students screening positive for mental health problems rose in both domestic students (66-76%) and international students (46-67%). Depression symptoms and wellbeing were worse in 2020 than in 2019, 2021 and 2022. Anxiety symptoms increased from 2019 to 2020 and continued to rise in 2021 and 2022. Somatic symptoms did not show an effect of cohort. Contrary to expectations, domestic students reported higher distress and lower wellbeing than international students across cohorts. CONCLUSION: The pandemic was associated with a marked increase in psychological distress in first-year university students, not all of which settled with the easing of restrictions. Post-pandemic recovery in the Australian university sector must include university-wide access to mental health information and support for incoming students.

Behavioural outcomes of interprofessional education within clinical settings for health professional students: A systematic literature review.

Interprofessional education facilitates collaborative practice, which promotes high-quality patient care and patient safety. Interprofessional education (IPE) experiences within clinical settings provide an opportunity for the development of interprofessional collaborative practice competence. The aim of this systematic review was to review the literature evaluating interprofessional education for health professional students within clinical settings and summarize the behavioral outcomes. Databases searched were PubMed, Embase, Scopus, Web of Science, Taylor & Francis Online, ERIC and PsycINFO. Full-text articles were independently screened by two reviewers and included if agreed. Outcomes were analyzed using Kirkpatrick's model modified for IPE. Studies with behavioral change outcomes were analyzed and synthesized using narrative methods. Included studies provided evidence that IPE experiences in clinical settings can enable students to develop and integrate interprofessional collaborative practice competencies, across diverse types of settings. Key tasks enabling students to achieve these learning outcomes included synchronous patient consultations, collaborative development of integrative health-care plans outside of patient consultations, and participation in socialization with health-care teams. There were limitations in the methodological design of the included studies, with limited use of comparator groups and validated tools, high usage of self-report data and serious risk of bias identified across all quantitative included studies. In conclusion, high-quality research designed to measure the construct of behavioral change is lacking. Such research could further investigate the key tasks in IPE experiences in clinical settings that are necessary for students to develop the range of required collaborative practice competencies and integrate these. This could provide clarification regarding if and how this could be achieved across different types of clinical placements.

Time cost associated with sports participation for athletes with high support needs: a time-motion analysis of tasks required for para swimming.

Objectives: People with cerebral palsy and high support needs (CP&HSN) are profoundly inactive but also under-represented in studies evaluating physical activity interventions. Reasons for their exclusion have not been evaluated. We hypothesised that CP&HSN would be associated with high time costs of preparatory activities (eg, getting dressed/undressed), possibly contributing to low participation and under-representation. Accordingly, this pilot study aimed to: (1) evaluate whether the time required for preparatory activities was extremely different (≥3 SD) between swimmers with and without CP&HSN; and (2) provide a qualitative indication of the preparatory tasks undertaken by swimmers with CP&HSN. Methods: Each of three experienced (5 years) para swimmers with CP&HSN and 20 non-disabled swimmers were timed entering and then exiting the pool on three occasions. Mean entry and exit time for each para swimmer was compared with the group mean for non-disabled swimmers, and differences of greater than 3.0 SD were considered extreme. A qualitative description of the tasks completed by the para swimmers was recorded. Results: The differences in time costs between para and non-disabled swimmers met the criterion of extreme. Pool entry times for para swimmers were 8-13 times greater (Effect size = 4.1-8.7). Pool exit times were 6-10 times greater (ES=7.0-9.5). 90% of tasks completed by para swimmers required personal assistance or wheeled mobility. Conclusions: This pilot study suggests that, compared with non-disabled swimmers, time costs for preparation to commence or depart training are extremely high for swimmers with CP&HSN. Further research is required to evaluate the veracity of these findings.

Altered countermovement jump force profile and muscle-tendon unit kinematics following combined ballistic training.

Combined heavy- and light-load ballistic training is often employed in high-performance sport to improve athletic performance and is accompanied by adaptations in muscle architecture. However, little is known about how training affects muscle-tendon unit (MTU) kinematics during the execution of a sport-specific skill (e.g., jumping), which could improve our understanding of how training improves athletic performance. The aim of this study was to investigate vastus lateralis (VL) MTU kinematics during a countermovement jump (CMJ) following combined ballistic training. Eighteen young, healthy males completed a 10-week program consisting of weightlifting derivatives, plyometrics, and ballistic tasks under a range of loads. Ultrasonography of VL and force plate measurements during a CMJ were taken at baseline, mid-test, and post-test. The training program improved CMJ height by 11 ± 13%. During the CMJ, VL's MTU and series elastic element (SEE) length changes and velocities increased from baseline to post-test, but VL's fascicle length change and velocity did not significantly change. It is speculated that altered lower limb coordination and increased force output of the lower limb muscles during the CMJ allowed more energy to be stored within VL's SEE. This may have contributed to enhanced VL MTU work during the propulsion phase and an improved CMJ performance following combined ballistic training.

Study protocol for Running for health (Run4Health CP): a multicentre, assessor-blinded randomised controlled trial of 12 weeks of two times weekly Frame Running training versus usual care to improve cardiovascular health risk factors in children and youth with cerebral palsy.

INTRODUCTION: Children and youth with moderate-severe (Gross Motor Function Classification System (GMFCS) levels II-V) cerebral palsy (CP) participate less frequently in physical activities compared with peers without CP and have elevated risk of cardiorespiratory morbidity and mortality in adulthood. Frame Running (RaceRunning) is a new athletics discipline that is an accessible option for physical activity participation for people with moderate-severe CP. There is no high-quality evidence for the effect of Frame Running on cardiovascular disease in children and young people with CP. The primary aim of this study is to conduct a randomised controlled trial of the effect of 12 weeks of Frame Running training on risk factors for cardiovascular disease. METHODS AND NALYSIS: Sixty-two children and youth with CP (age 8-20 years) in GMFCS levels II-V will be recruited across four sites and randomised to receive either 12 weeks of Frame Running training two times weekly for 60 min, or usual care. Outcomes will be measured at baseline, immediately postintervention (primary endpoint) and 12 weeks later for retention of training effects. The primary outcome is cardiorespiratory fitness as measured by distance covered on Six Minute RaceRunner Test with 1 min heart rate recovery. Other outcomes include blood pressure, objectively measured physical activity, body mass index, waist circumference, percentage body fat, gross motor function capacity, community participation, feasibility, tolerability and safety. Adverse events will be monitored, and participants and their caregivers will be interviewed to discern their experiences of participation in Frame Running. ETHICS AND DISSEMINATION: The Children's Health Queensland Hospital and Health Service and the University of Queensland Human Research Ethics Committees have approved this study. Results will be disseminated in peer-reviewed journals and scientific conferences; through professional and athletic organisations; and to people with CP and their families. TRIAL REGISTRATION NUMBER: ACTRN12621000317897; Australian New Zealand Clinical Trials Registry number.

Effects of the Off-Season on Muscular Power in Professional Rugby League.

PURPOSE: Periods away from training and competition are necessary for physical and mental restoration in sport. There is limited research investigating changes to physical qualities in rugby league following prolonged breaks. This study aimed to evaluate the effects of the off-season on muscular power in rugby league. In addition, this study aimed to determine whether the type and volume of training players chose to complete had any relationship to feelings of restoration and/or readiness to return to training. METHODS: Twenty professional rugby league players participated in this study. Lower-body muscular power was evaluated using a countermovement jump prior to the off-season and at the recommencement of training. Players completed a questionnaire to identify training and activities completed during the break and to assess feelings of restoration and readiness to commence training. Linear regression was used to estimate the effects of the number of days off on muscular power. One-way repeated-measures analysis of variance was conducted to examine differences in lower-body power throughout the study. Spearman rank order correlation was calculated to determine the relationship between off-season activities and feelings of restoration and readiness. RESULTS: Peak velocity and peak force significantly increased following the off-season break. There were significant relationships between mental restoration and upper-body resistance training, as well as physical restoration and full-body resistance training. CONCLUSIONS: The off-season has a positive effect on a player's ability to generate muscular power. Coaches may want to encourage players to complete resistance training sessions with the aim simply to maintain training load and potentially help players to feel rested.

Predicting Rugby League Tackle Outcomes Using Strength and Power Principal Components.

PURPOSE: Tackling is a fundamental skill in collision sports such as rugby league. Given the complexity of tackling and multitude of strength and power variables available for analysis, this study aimed to predict tackle outcomes in professional rugby league based on strength and power principal components (PCs). METHODS: Twenty-eight rugby league players participated in this study. Maximal strength was assessed via 1 repetition maximum on the back squat, bench press, and bench pull. Lower-body vertical and horizontal power were evaluated using a countermovement jump and standing broad jump. A postmatch analysis of 5 National Rugby League matches was conducted to examine tackling outcomes. PC analysis was performed on the strength and power assessments. The first PCs were retained in each analysis, and a series of Spearman rank-order correlations were conducted between the tackle outcomes and the retained PCs. The PCs significantly related to tackle outcomes were included in the multiple regression analyses to estimate their effect on tackle outcomes. RESULTS: Strength PC was a significant predictor of play-the-ball speed in attack, accounting for 54% of the variance. Countermovement jump PC was a significant predictor of postcontact meters, explaining 19% of the variance. CONCLUSIONS: These findings demonstrate that a range of tackle outcomes may be predicted from strength and power components. The coaching staff may choose to develop programs and testing designed to focus on these components, which may further develop players' tackle outcomes during competition.

The Relationship Between Match Tackle Outcomes and Muscular Strength and Power in Professional Rugby League.

ABSTRACT: Redman, KJ, Wade, L, Whitley, R, Connick, MJ, Kelly, VG, and Beckman, EM. The relationship between match tackle outcomes and muscular strength and power in professional rugby league. J Strength Cond Res 36(10): 2853-2861, 2022-Tackling is a fundamental skill in collision sports, such as rugby league. Match success is largely dependent on a player's ability to complete tackles and tolerate physical collisions. High levels of strength and power are key physical qualities necessary for effective tackling because players are required to generate large forces while pushing and pulling their opponents. The aim of this study was to examine the relationship between tackle outcomes and strength and power qualities in professional rugby league. Fourteen rugby league players participated in this study. Maximal strength was assessed through 1 repetition maximum on the back squat, bench press, and bench pull. Lower-body vertical and horizontal powers were evaluated using a countermovement jump and standing broad jump (SBJ), respectively. Upper-body power was assessed on a plyometric push-up (PPU). Postmatch analysis of 5 National Rugby League matches was conducted to examine tackling outcomes. A series of Spearman's rank-order correlations were used to assess the relationship among match tackle outcomes and strength and power variables. Significant associations were observed between play-the-ball speed and SBJ peak power (rs = -0.74, p = 0.003), postcontact metres and PPU peak power (rs = 0.77, p = 0.002), losing the play-the-ball contest in defence with SBJ distance (rs = 0.70, p = 0.006), and ineffective tackles with PPU concentric impulse (rs = 0.70, p = 0.007). These results suggest the development and maintenance of full-body power to enhance the likelihood of positive tackle outcomes during professional rugby league match-play.

How Do Music Activities Affect Health and Well-Being? A Scoping Review of Studies Examining Psychosocial Mechanisms.

Background: This scoping review analyzed research about how music activities may affect participants' health and well-being. Primary outcomes were measures of health (including symptoms and health behaviors) and well-being. Secondary measures included a range of psychosocial processes such as arousal, mood, social connection, physical activation or relaxation, cognitive functions, and identity. Diverse music activities were considered: receptive and intentional music listening; sharing music; instrument playing; group singing; lyrics and rapping; movement and dance; and songwriting, composition, and improvisation. Methods: Nine databases were searched with terms related to the eight music activities and the psychosocial variables of interest. Sixty-three papers met selection criteria, representing 6,975 participants of all ages, nationalities, and contexts. Results: Receptive and intentional music listening were found to reduce pain through changes in physiological arousal in some studies but not others. Shared music listening (e.g., concerts or radio programs) enhanced social connections and mood in older adults and in hospital patients. Music listening and carer singing decreased agitation and improved posture, movement, and well-being of people with dementia. Group singing supported cognitive health and well-being of older adults and those with mental health problems, lung disease, stroke, and dementia through its effects on cognitive functions, mood, and social connections. Playing a musical instrument was associated with improved cognitive health and well-being in school students, older adults, and people with mild brain injuries via effects on motor, cognitive and social processes. Dance and movement with music programs were associated with improved health and well-being in people with dementia, women with postnatal depression, and sedentary women with obesity through various cognitive, physical, and social processes. Rapping, songwriting, and composition helped the well-being of marginalized people through effects on social and cultural inclusion and connection, self-esteem and empowerment. Discussion: Music activities offer a rich and underutilized resource for health and well-being to participants of diverse ages, backgrounds, and settings. The review provides preliminary evidence that particular music activities may be recommended for specific psychosocial purposes and for specific health conditions.

Establishing the reliability of instrumented trunk impairment assessment methods to enable evidence-based classification in Para swimming.

This study examined the reliability of instrumented trunk assessment methods across two experiments to develop and improve evidence-based classification in Para swimming. Trunk coordination, range of motion (ROM), and strength were assessed in 38 non-disabled participants. Each test battery was completed on two occasions to determine inter-session reliability. Intra-session reliability was also determined in Experiment Two. Absolute agreement of two-way mixed intraclass correlation coefficients (ICC 3,1) was calculated to assess reliability. Standard errors of measurement (SEMs) were also reported to facilitate comparisons between different outcomes. Trunk coordination measures had low-to-moderate reliability (inter-session ICCs = 0.00-0.60; intra-session ICCs = 0.14-0.65) and variable SEMs (5-60%). Trunk ROM demonstrated moderate-to-excellent reliability (inter-session ICCs = 0.61-0.93; intra-session ICCs = 0.87-0.95) and good SEMs (<10%). Trunk strength measures demonstrated good-to-excellent reliability (ICCs = 0.87-0.98) and good SEMs (<10%). The strength values obtained for the load cell and hand-held dynamometer (HHD) were significantly different from each other with the HHD underestimating strength. Modifications provided in Experiment Two improved the reliability of strength and ROM assessments but did not improve coordination measures. Further research involving para swimmers is required to establish the validity of the methods.

Monitoring Prescribed and Actual Resistance Training Loads in Professional Rugby League.

ABSTRACT: Redman, KJ, Connick, MJ, Beckman, EM, and Kelly, VG. Monitoring prescribed and actual resistance training loads in professional rugby league. J Strength Cond Res 35(6): 1604-1610, 2021-Coaches devote a considerable amount of time and effort prescribing and selecting exercises to elicit training adaptations. Adherence to the prescribed resistance training load may vary for a number of reasons. The aim of this study was to quantify the difference between prescribed and actual resistance training loads in a team of professional rugby league players. Training loads were quantified using volume load and training intensity throughout a season. The competition was categorized into preseason, early competition, mid-competition, and late competition. Twenty-seven players participated in this study. Four exercises were monitored: back squat, bench press, bench pull, and clean pull. A Friedman's test was used to assess differences between prescribed and actual training loads throughout different phases of the season, for different exercises, and during different weeks in a training block. There were significantly greater differences in prescribed and actual volume loads during the mid-competition in comparison to all other phases of the season (p < 0.01). Although players adherence to prescribed training intensity was significantly greater during the preseason compared with the remainder of the season (p < 0.05), they completed significantly less prescribed training load during week 1 in comparison to week 4 within a training block (p < 0.05). The results of this study demonstrate that regular monitoring of completed resistance training loads may be of greater importance to strength and conditioning coaches to assist in examining potential progress and fatigue or allow for more accurate prescription of load to enhance adaptation throughout a season.

Does sports-specific training improve measures of impairment developed for para sport classification? A multiple-baseline, single-case experiment.

Conceptually, sports-specific training should not influence measures of impairment used to classify Para athletes. This study evaluated the extent to which measures of strength, range of movement and coordination developed for Para swimming classification changed in response to a performance-focused swimming programme. A five-phase multiple-baseline, single-case experimental research design was utilized. Three participants with cerebral palsy and high support needs completed the 64-week study, which included two 16-week performance-focused swimming training blocks. Swimming speed, isometric shoulder extension strength, shoulder flexion range of movement and upper limb coordination were monitored throughout.Interrupted Time-Series Simulation Method analysis demonstrated large, significant changes in swimming speed (m/s) during the first (d = 2.17; 95% CI 0.45-3.88; p = 0.01) and second (d = 2.59; 95% CI 1.66-3.52; p = 0.00) training blocks. In contrast, changes in strength, range of movement and coordination were predominantly trivial and non-significant. This was the first study to investigate training responsiveness of measures developed for Para sport classification. Results indicate that despite significantly improved swimming performance, impairment measures remained relatively stable, and therefore these measures of impairment may be valid for the purposes of Para swimming classification. Further research is required in elite athletes, different sports and different impairment types.

Do women runners report more pelvic floor symptoms than women in CrossFit®? A cross-sectional survey.

INTRODUCTION AND HYPOTHESIS: Women who perform high-impact activities might be at greater risk of pelvic floor dysfunction (PFD) than those participating in low-impact exercise; however, little is known about whether PFD is more common in one type of high-impact activity than another. The aim of this study was to compare the prevalence of PFD symptoms in women who engage in high-impact activity compared with CrossFit®-brand training (CF). METHODS: An online survey collected data from 1,379 women (521 runners, 858 CF) on exercise participation, parity, and PFD symptoms, via the Pelvic Floor Distress Inventory (PFDI-20). Specific questions from each PFDI-20 subscale further investigated symptoms of pelvic organ prolapse (POP), anal incontinence (AI), as well as stress (SUI) and urgency (UUI) urinary incontinence. RESULTS: Symptoms of POP and AI were significantly higher in runners (POP 12.7%, AI 34.0%) than in CF (POP 7.8%, p = 0.003; AI 27.7%, p = 0.014). There was no significant difference in SUI symptoms between groups (37.0% vs 41.0% respectively, p = 0.141). Vaginally parous runners reported significantly more symptoms of POP (19.0% vs 12.2%, p = 0.023), AI (39.3% vs 27.2%, p = 0.001), and UUI (36.3% vs 29.0%, p = 0.037) than CF. CONCLUSION: Women, particularly parous women, who participate in running, have a higher prevalence of POP and AI symptoms than women who participate in CF. This suggests that CrossFit®-brand training might not be more detrimental to PFD symptoms than other high-impact activity, such as running. This study does not conclude a pelvic floor health benefit of one exercise over another, but highlights that exercise options can be provided to women.

Measures of impairment applicable to the classification of Paralympic athletes competing in wheelchair sports: A systematic review of validity, reliability and associations with performance.

A fundamental aspect of classification systems in Paralympic sport is having valid and reliable measures of impairment. However, minimal consensus exists for assessing impaired strength, coordination and range of motion. This review aimed to systematically identify measures of upper body strength, coordination and range of motion impairments that meet the requirements for use in evidence-based classification systems in wheelchair sports. Three electronic databases were searched from 2003 until 31 August 2019 for studies that assessed upper body function of participants and used a measurement tool that assessed strength, coordination or range of motion. The body of evidence for each identified measure was appraised using the Grading of Recommendations Assessment, Development and Evaluation framework. Twenty-three studies were included: ten measured strength and coordination, and six measured range of motion. There was "moderate" confidence in using isometric strength for assessing strength impairment. Tapping tasks for the assessment of coordination impairment received a "low" confidence rating. All other identified measures of coordination and range of motion impairment received a "very low" confidence rating. Several potential measures were identified for assessing upper body strength, coordination and range of motion impairments. Further research is warranted to investigate their use for classification in Paralympic wheelchair sports.

Seasonal Changes in Strength and Power in Elite Rugby League: A Systematic Review and Meta-Analysis.

The ability of a rugby league player to express high levels of strength and power is crucial for success in competition. Although researchers have shown relationships between physical attributes and performance, there is a lack of information related to changes in strength and power across various phases of the season. The purpose of this review was to identify the magnitude of change in muscular strength and power during different phases of an elite rugby league season. Percentage change and effect size were calculated to evaluate the magnitude of changes in strength and power. Meta-analyses were conducted to provide pooled estimates and 95% confidence intervals. Twelve studies were included; six reported changes following pre-season training, two during the competition phase and four examined changes over multiple seasons. Pooled estimates indicated large increases in upper and lower body strength 0.81 [0.43-1.19] and 1.35 [0.79-1.91], respectively, following pre-season training. Studies incorporating predominantly heavier loads (p 80% 1 RM) in training reported greater increases in maximal strength than studies completing lighter loads. Four studies used a wave-like programming strategy to obtain large improvements in strength and power 0.91 [0.36-1.45] and 0.90 [0.22-1.57], over multiple seasons. The results of this review highlight the limited current evidence and provides a preliminary reference point for strength and conditioning coaches aiming to develop and maintain strength and power across various stages, and over multiple seasons. Importantly, the results also indicate that higher loads result in greater increases in strength than lower loads.

Interprofessional, student-led community health clinic: expanding service provision and clinical education capacity.

Student-led interprofessional health clinics offer valuable opportunities for student learning and meeting the health care needs of the community. This case study describes the operation of a new interprofessional student-led community health service over its initial 13-month period of operation. This case study also presents an overview of the service provision, student placement opportunities and focuses on the challenges associated with the service and the impact on future planning.