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1.
Scand J Med Sci Sports ; 31(10): 1932-1940, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34189782

RESUMO

The inherent hydrodynamic resistance force, or passive drag, of a swimmer directly influences how they move through the water. For swimmers with physical impairments, the strength of association between passive drag and swimming performance is unknown. Knowledge on this factor could improve the World Para Swimming classification process. This study established the relationship between passive drag and 100 m freestyle race performance in Para swimmers with physical impairments. Using a cross-sectional study design, an electrical-mechanical towing device was used to measure passive drag force in 132 international-level Para swimmers. There was a strong, negative correlation between normalized passive drag force and 100 m freestyle race speed in the combined participant cohort (ρ = -0.77, p < 0.001). Type of physical impairment was found to affect the relationship between passive drag and 100 m freestyle race speed when included in linear regression (R2  = 0.65, χ2  = 11.5, p = 0.025). These findings contribute to the body of evidence that passive drag can provide an objective assessment of activity limitation in Para swimmers with physical impairments. The effect of physical impairment type on the relationship between passive drag and swimming performance should be accounted for in Para swimming classification.


Assuntos
Desempenho Atlético/fisiologia , Esportes para Pessoas com Deficiência/classificação , Esportes para Pessoas com Deficiência/fisiologia , Natação/fisiologia , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
2.
J Sports Sci ; 39(sup1): 62-72, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34092196

RESUMO

The current protocol for classifying Para swimmers with hypertonia, ataxia and athetosis involves a physical assessment where the individual's ability to coordinate their limbs is scored by subjective clinical judgment. The lack of objective measurement renders the current test unsuitable for evidence-based classification. This study evaluated a revised version of the Para swimming assessment for motor coordination, incorporating practical, objective measures of movement smoothness, rhythm error and accuracy. Nineteen Para athletes with hypertonia and 19 non-disabled participants performed 30 s trials of bilateral alternating shoulder flexion-extension at 30 bpm and 120 bpm. Accelerometry was used to quantify movement smoothness; rhythm error and accuracy were obtained from video. Para athletes presented significantly less smooth movement and higher rhythm error than the non-disabled participants (p < 0.05). Random forest algorithm successfully classified 89% of participants with hypertonia during out-of-bag predictions. The most important predictors in classifying participants were movement smoothness at both movement speeds, and rhythm error at 120 bpm. Our results suggest objective measures of movement smoothness and rhythm error included in the current motor coordination test protocols can be used to infer impairment in Para swimmers with hypertonia. Further research is merited to establish the relationship of these measures with swimming performance.


Assuntos
Paralisia Cerebral/fisiopatologia , Hipertonia Muscular/fisiopatologia , Desempenho Psicomotor/fisiologia , Esportes para Pessoas com Deficiência/fisiologia , Natação/fisiologia , Acelerometria , Adulto , Algoritmos , Ataxia/fisiopatologia , Atetose/fisiopatologia , Desempenho Atlético/fisiologia , Fenômenos Biomecânicos/fisiologia , Feminino , Humanos , Masculino , Movimento/fisiologia , Hipertonia Muscular/classificação , Paratletas/classificação , Desempenho Físico Funcional , Amplitude de Movimento Articular/fisiologia , Ombro/fisiologia , Esportes para Pessoas com Deficiência/classificação , Natação/classificação , Gravação em Vídeo , Adulto Jovem
3.
BMC Sports Sci Med Rehabil ; 13(1): 63, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34088361

RESUMO

BACKGROUND: There is limited information on the physique attributes of female netball players from the highest playing standards and the typical body composition changes that occur with training and competition in these athletes. The purpose of this study was to examine the body composition of professional female netball players and changes that occur within and between national premier netball seasons. METHODS: Dual-energy X-ray absorptiometry (DXA) assessments were conducted in 20 female netball players (age = 26.5 [4.7] years, body mass = 77.3 [9.7] kg, stature = 182.7 [9.5] cm) contracted to a Suncorp Super Netball team. Total body lean mass, fat mass, bone mass and bone mineral density were derived for 127 assessments collected over three seasons. Linear mixed effects modelling was used to examine changes in body composition measures within and between seasons. RESULTS: Goal circle players were heavier (12.3 [3.5] kg, p < 0.001, g = 1.51) and taller (15.0 [2.7] cm, p < 0.001, g = 2.30) than midcourt players, and midcourt players had greater lean mass (3.1 [1.6] %, p = 0.07, g = 0.85) and less fat mass (-3.3 [1.7] %, p = 0.06, g = -0.84) than goal circle players when values were normalised to body mass. Players achieved increases in lean mass (2,191 [263] g, p < 0.01, g = 0.45) and decreases in fat mass (-835 [351] g, p = 0.09, g = -0.16) following a preseason preparation period. There were no changes in lean mass (-394 [295] g, p = 0.54, g = 0.07) or fat mass (102 [389] g, p = 0.99, g = 0.04) from the start to the end of the 14-week competition period. CONCLUSIONS: Professional female netball players achieve small changes in lean mass and fat mass during preseason preparation and maintain their physique over the competitive season. The results of this study can inform practitioners on the training content necessary to promote or maintain desired body composition changes in these athletes.

4.
Scand J Med Sci Sports ; 31(4): 925-935, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33345411

RESUMO

This study is the first to provide information on the age-related trajectories of performance in Para swimmers with physical, vision and intellectual impairment. Race times from long-course swim meets between 2009 and 2019 were obtained for Para swimmers with an eligible impairment. A subset of 10 661 times from 411 Para swimmers were included in linear mixed effects modelling to establish the relationship between age and performance expressed relative to personal best time and world record time. The main findings were: (a) age has the most noticeable influence on performance between the ages of 12-20 years before performances stabilize and peak in the early to late twenties, (b) women have faster times relative to personal best and world record time than men during early adolescence and their performances stabilize, peak and decline at younger ages, and (c) Para swimmers from different sport classes show varying age-related trajectories in performance after maturation and when training-related factors are more likely to explain competitive swim performance. The results of this study can guide talent identification and development of Para swimmers at various stages of their career and help to inform decision-making on the allocation of sport class and sport class status in Para swimming classification.


Assuntos
Desempenho Atlético , Comportamento Competitivo , Esportes para Pessoas com Deficiência , Natação , Adolescente , Adulto , Fatores Etários , Criança , Humanos , Estudos Retrospectivos , Adulto Jovem
5.
Int J Sports Physiol Perform ; 15(6): 816-824, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32131047

RESUMO

The assessment of swimming propulsion should be a cornerstone of Paralympic swimming classification. However, current methods do not objectively account for this component. PURPOSE: To evaluate the swimming propulsion of swimmers with and without physical impairment using a 30-second maximal fully tethered freestyle swim test. METHODS: Tethered forces were recorded during maximal fully tethered swimming in 80 competitive swimmers with (n = 70) and without (n = 10) physical impairment. The relationships between absolute and normalized tether forces and maximal freestyle swim speed were established using general additive models. RESULTS: Para swimmers with physical impairment had lower absolute and normalized tether forces than able-bodied swimmers, and there were moderate positive correlations found between tether forces and sport class (τ = .52-.55, P < .001). There was a nonlinear relationship between tether force and maximal freestyle swim speed in the participant cohort (adjusted R2 = .78-.80, P < .001). Para swimmers with limb deficiency showed stronger relationships between tether force and maximal freestyle swim speed (adjusted R2 = .78-.82, P < .001) than did Para swimmers with hypertonia (adjusted R2 = .54-.73, P < .001) and impaired muscle power (adjusted R2 = .61-.70, P < .001). CONCLUSIONS: Physical impairments affect Para swimmers' tether forces during maximal fully tethered freestyle swimming, explaining a significant proportion of their activity limitation. It is recommended that maximal fully tethered swimming be included in Paralympic swimming classification as an objective assessment of swimming propulsion.


Assuntos
Desempenho Atlético/fisiologia , Teste de Esforço/métodos , Esportes para Pessoas com Deficiência/fisiologia , Natação/fisiologia , Adulto , Desempenho Atlético/classificação , Estudos Transversais , Feminino , Humanos , Masculino , Esportes para Pessoas com Deficiência/classificação , Natação/classificação , Adulto Jovem
6.
J Sports Sci ; 38(8): 839-847, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32138613

RESUMO

Swimmers with limb deficiency are a core population within Para Swimming, accordingly this study examined the contribution of limb segments to race performance in these swimmers. Data were obtained for 174 male Para swimmers with limb deficiency. Ensemble partial least squares regression showed accurate predictions when using relative limb segment lengths to estimate Para swimmers' personal best race performances. The contribution of limb segments to performance in swim events was estimated using these regression models. The analysis found swim stroke and event distance to influence the contributions of limb segments to performance. For freestyle swim events, these changes were primarily due to the increased importance of the hand, and decreased importance of the foot and shank, as the distance of the event increased. When comparing swim strokes, higher importance of the thigh and shank in the 100 m breaststroke compared with other swim strokes confirms the separate SB class. Varied contributions of the hand, upper arm and foot suggest that freestyle could also be separated from backstroke and butterfly events to promote fairer classification. This study shows that swim stroke and event distance influence the activity limitation of Para swimmers with limb deficiency suggesting classification should account for these factors.


Assuntos
Desempenho Atlético/fisiologia , Extremidade Inferior/fisiopatologia , Esportes para Pessoas com Deficiência/fisiologia , Natação/fisiologia , Extremidade Superior/fisiopatologia , Comportamento Competitivo/fisiologia , Humanos , Masculino , Esportes para Pessoas com Deficiência/classificação , Natação/classificação
7.
Med Sci Sports Exerc ; 52(7): 1576-1584, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32032236

RESUMO

INTRODUCTION: Paralympic classification should provide athletes with an equitable starting point for competition by minimizing the impact their impairment has on the outcome of the event. As swimming is an event conducted in water, the ability to overcome drag (active and passive) is an important performance determinant. It is plausible that the ability to do this is affected by the type and severity of the physical impairment, but the current World Para Swimming classification system does not objectively account for this component. The aim of this study was to quantify active and passive drag in Para swimmers and evaluate the strength of association between these measures and type of physical impairment, swimming performance, and sport class. METHODS: Seventy-two highly trained Para swimmers from sport classes S1 to S10 and 14 highly trained nondisabled swimmers were towed by a motorized winch while the towing force was recorded. Passive drag was measured with the arms held by the side; active drag was determined during freestyle swimming using an assisted towing method. RESULTS: Active and passive drag were higher in Para swimmers with central motor and neuromuscular impairments than for nondisabled swimmers and were associated with severity of swim-specific impairment (sport class) and maximal freestyle performance in these swimmers (r = -0.40 to -0.50, P ≤ 0.02). Para swimmers with anthropometric impairments showed similar active and passive drag to nondisabled swimmers, and between swimmers from different sport classes. CONCLUSIONS: Para swimmers with central motor and neuromuscular impairments are predisposed to high active drag during freestyle swimming that impacts on their performance. It is recommended that drag measures be considered in revised classification for these swimmers, but not for those with anthropometric impairments.


Assuntos
Desempenho Atlético/fisiologia , Esportes para Pessoas com Deficiência/classificação , Esportes para Pessoas com Deficiência/fisiologia , Natação/classificação , Natação/fisiologia , Adulto , Antropometria , Comportamento Competitivo/fisiologia , Feminino , Humanos , Hidrodinâmica , Masculino , Índices de Gravidade do Trauma , Adulto Jovem
8.
J Aging Phys Act ; 27(3): 398-405, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30300065

RESUMO

This study examined the effect of water immersion on trunk and lower limb kinematics during squat exercises in older participants. A total of 24 active older adults (71.4 ± 5.4 years) performed squats and split squats on land and while partially submerged in water. Inertial sensors (100 Hz) were used to record trunk and lower body kinematics. Water immersion increased the squat depth (squat: p = .028, d = 0.63 and split squat: p = .005, d = 0.83) and reduced the trunk flexion range (squat: p = .006, d = 0.76 and split squat: p < .001, d = 1.35) during both exercises. In addition, water immersion increased the hip range of motion during the split squat (p = .002, d = 0.94). Waveform analyses also indicated differences in the timing of the movements. These results showed that water-based exercise generates a different exercise outcome and appears to provide an alternative option for older adults, enabling exercisers to perform these tasks in a manner not possible on land.


Assuntos
Teste de Esforço/métodos , Exercício Físico/fisiologia , Água , Idoso , Idoso de 80 Anos ou mais , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Postura , Amplitude de Movimento Articular
9.
J Sci Med Sport ; 22(5): 526-531, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30503355

RESUMO

OBJECTIVES: The International Paralympic Committee has mandated that International Sport Federations develop sport-specific classification systems that are evidence-based. This study examined the predictive and convergent validity of instrumented tapping tasks to classify motor coordination impairments in Para swimming. DESIGN: Cross-sectional. METHODS: Thirty non-disabled participants and twenty-one Para swimmers with brain injury completed several instrumented tapping tasks as an assessment of upper and lower limb motor coordination. Para swimmers also completed a maximal freestyle swim to obtain a performance measure. The predictive and convergent validity of instrumented tapping tasks was examined by establishing differences in test measures between participants with and without brain injury and defining the strength of association between test measures and maximal freestyle swim speed in Para swimmers, respectively. RESULTS: Random forest successfully classified 96% of participants with and without brain injury using test measures derived from instrumented tapping tasks. Most test measures had moderate to high correlations (r=0.54 to 0.72; p<0.01) with maximal freestyle swim speed and collectively explained up to 72% of the variance in maximal freestyle swim performance in Para swimmers with brain injury. CONCLUSIONS: The results of this study evidence the predictive and convergent validity of instrumented tapping tasks to classify motor coordination impairments in Para swimmers with brain injury. These tests can be included in revised Para swimming classification to improve the objectivity and transparency in determining athlete eligibility and sport class for these Para athletes.


Assuntos
Ataxia/diagnóstico , Lesões Encefálicas/fisiopatologia , Pessoas com Deficiência , Natação , Adolescente , Adulto , Ataxia/fisiopatologia , Atletas , Estudos Transversais , Feminino , Humanos , Masculino , Esportes para Pessoas com Deficiência , Adulto Jovem
10.
Spine J ; 19(2): e19-e27, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-24370272

RESUMO

BACKGROUND CONTEXT: Most spine patient-reported outcome measures are divided into neck and back subregions. This prevents their use in the assessment of the whole spine. By contrast, whole-spine patient-reported outcome measures assess the spine from cervical to lumbar as a single kinetic chain. However, existing whole-spine patient-reported outcomes have been critiqued for clinimetric limitations, including concerns with practicality. PURPOSE: To develop the Spine Functional Index (SFI) as a new whole-spine patient-reported outcome measure that addressed the limitations of existing whole-spine questionnaires; and to determine the SFI's clinimetric and practical characteristics concurrently with a recognized criterion, the Functional Rating Index (FRI). STUDY DESIGN: Observational cohort study within 10 physical therapy outpatient clinics. PATIENT SAMPLE: Spine-injured patients were recruited from a convenience sample referred by a medical practitioner to physical therapy. A pilot study (n=52, 57% female, age 47.6±17.5 years) followed by the main study (n=203, 48% female, age 41.0±17.8 years) that had an average symptom duration of less than 5 weeks. OUTCOME MEASURES: Spine Functional Index, FRI, and Numerical Rating Scale (NRS). METHODS: The SFI was developed through three stages: 1) item generation, 2) item reduction with an expert panel and patient focus group, and 3) pilot field testing to provide provisional clinimetric properties and sample size requirements and to determine suitability for a larger study. Participants completed the SFI, FRI, and NRS every 2 weeks for 6 weeks, then every 4 weeks until discharge or study completion at 6 months. Responses were assessed to provide individual psychometric and practical characteristics for both patient-reported outcomes, with the overall performance evaluated by the Measurement of Outcome Measures and Bot clinimetric assessment scales. RESULTS: The SFI demonstrated a high criterion validity with the FRI (Pearson r=0.87, 95% confidence interval [CI]), equivalent internal consistency (α=0.91), and a single-factor structure. The SFI and FRI demonstrated suitable reliability (intraclass correlation coefficient2,1=0.97:0.95), responsiveness (standardized response mean=1.81:1.68), minimal detectable change with 90% CI (6.4%:9.7%), Flesch scale reading ease (64%:47%), and user errors (1.5%:5.3%). The clinimetric performance was higher for the SFI on the Measurement of Outcome Measures (96%:64%) and on the Bot scale (100%:75%). CONCLUSIONS: The SFI demonstrated sound clinimetric properties with lower response errors, efficient completion and scoring, and improved responsiveness and overall clinimetric performance compared with the FRI. These results indicated that the SFI was suitable for functional outcome measurement of the whole spine in both the research and clinical settings.


Assuntos
Medição da Dor/métodos , Medidas de Resultados Relatados pelo Paciente , Doenças da Coluna Vertebral/patologia , Coluna Vertebral/patologia , Adulto , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor/normas , Psicometria/métodos , Psicometria/normas , Reprodutibilidade dos Testes , Inquéritos e Questionários/normas
11.
J Sports Sci ; 37(4): 404-413, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30058953

RESUMO

This study examined the validity of isometric strength tests for evidence-based classification in Para swimming. Thirty non-disabled participants and forty-two Para swimmers with physical impairment completed an isometric strength test battery designed to explain activity limitation in the freestyle discipline. Measures pertaining to dominant and non-dominant limb strength and symmetry were derived from four strength tests that were found to be reliable in a cohort of non-disabled participants (ICC = 0.85-0.97; CV = 6.4-9.1%). Para swimmers had lower scores in strength tests compared with non-disabled participants (d = 0.14-1.00) and the strength test battery successfully classified 95% of Para swimmers with physical impairment using random forest algorithm. Most of the strength measures had low to moderate correlations (r = 0.32 to 0.53; p ≤ 0.05) with maximal freestyle swim speed in Para swimmers. Although, fewer correlations were found when Para swimmers with hypertonia or impaired muscle power were analysed independently, highlighting the impairment-specific nature of activity limitation in Para swimming. Collectively, the strength test battery has utility in Para swimming classification to infer loss of strength in Para swimmers, guide minimum eligibility criteria, and to define the impact that strength impairment has on Para swimming performance.


Assuntos
Desempenho Atlético/fisiologia , Avaliação da Deficiência , Teste de Esforço , Força Muscular , Esportes para Pessoas com Deficiência/fisiologia , Natação/fisiologia , Adulto , Atletas/classificação , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Adulto Jovem
12.
Phys Ther Sport ; 32: 34-41, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29730533

RESUMO

OBJECTIVES: To evaluate the reliability of swimming-specific range of movement tests developed in order to permit evidenced-based classification in the sport of para swimming. DESIGN: Test-retest intra- and inter-examiner reliability. SETTING: International Swimming training camps and university exercise science departments. PARTICIPANTS: 42 non-disabled participants (mean age 23.2 years) and 24 Para swimmers (mean age 28.5 years). MAIN OUTCOME MEASURES: Intra- and inter-examiner reliability of a battery of novel active range of motion tests. RESULTS: Good to excellent intra-examiner reliability was found for the majority (32/34) of tests in non-disabled participants (ICC = 0.85-0.98). SEM values ranged from 1.18° to 6.11°. Similarly, good to excellent inter-examiner reliability was found for the majority (35/42) of tests in non-disabled participants (ICC = 0.85-0.98). SEM values range from 0.73° to 6.52°. Para swimmers exhibited significantly reduced range of motion compared to non-disabled participants. CONCLUSIONS: The large majority of ROM tests included in this novel battery were reliable both within and between examiners in non-disabled participants. The tests were found to differentiate between non-disabled participants and Para swimmers with hypertonia or impaired muscle power.


Assuntos
Artrometria Articular , Pessoas com Deficiência , Amplitude de Movimento Articular , Natação/fisiologia , Adulto , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Natação/classificação , Adulto Jovem
13.
Phys Med Rehabil Clin N Am ; 29(2): 333-346, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29627092

RESUMO

Swimming is one of the inaugural sports within the Olympic and Paralympic Games, the key difference between the Olympic and Paralympic games being the classification system. The aim of this study was to investigate how effective the current classification system creates clearly differentiated Paralympic competition classes, based on performance time for all swimming strokes and events. Based on the performance characteristics of swimmers within the current classification system, the relationship between impairment and swimming performance is inconsistent, potentially disadvantaging some athletes. Appropriate sports medicine tests are required for the development of an evidence-based swimming classification system.


Assuntos
Atletas , Pessoas com Deficiência , Natação , Atletas/classificação , Desempenho Atlético , Pessoas com Deficiência/classificação , Humanos , Natação/classificação , Natação/fisiologia
14.
Prosthet Orthot Int ; 42(3): 318-327, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29119860

RESUMO

BACKGROUND: In principle, lower limb bone-anchored prostheses could alleviate expenditure associated with typical socket manufacturing and residuum treatments due to socket-suspended prostheses. OBJECTIVE: This study reports (a) the incremental costs and (b) heath gain as well as (c) cost-effectiveness of bone-anchored prostheses compared to socket-suspended prostheses. STUDY DESIGN: Retrospective individual case-controlled observations and systematic review. METHODS: Actual costs were extracted from financial records and completed by typical costs when needed over 6-year time horizon for a cohort of 16 individuals. Health gains corresponding to quality-adjusted life-year were calculated using health-related quality-of-life data presented in the literature. RESULTS: The provision of bone-anchored prostheses costed 21% ± 41% more but increased quality-adjusted life-years by 17% ± 5% compared to socket-suspended prostheses. The incremental cost-effectiveness ratio ranged between -$25,700 per quality-adjusted life-year and $53,500 per quality-adjusted life-year with indicative incremental cost-effectiveness ratio of approximately $17,000 per quality-adjusted life-year. Bone-anchored prosthesis was cost-saving and cost-effective for 19% and 88% of the participants, respectively. CONCLUSION: This study indicated that bone-anchored prostheses might be an acceptable alternative to socket-suspended prostheses at least from a prosthetic care perspective in Australian context. Altogether, this initial evidence-based economic evaluation provided a working approach for decision makers responsible for policies around care of individuals with lower limb amputation worldwide. Clinical relevance For the first time, this study provided evidence-based health economic benefits of lower limb bone-anchored prostheses compared to typical socket-suspended prostheses from a prosthetic care perspective that is essential to clinicians and decision makers responsible for policies.


Assuntos
Amputados/reabilitação , Membros Artificiais/economia , Análise Custo-Benefício , Osseointegração/fisiologia , Ajuste de Prótese/economia , Âncoras de Sutura/economia , Adulto , Idoso , Amputação/métodos , Estudos de Casos e Controles , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese/economia , Ajuste de Prótese/métodos , Queensland , Estudos Retrospectivos
15.
Disabil Rehabil ; 40(17): 2093-2097, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-28475409

RESUMO

BACKGROUND: Physical activity has been documented as both beneficial and detrimental for individuals with multiple sclerosis (MS). The varied experience highlights challenges associated with physical activity and MS, requiring a greater understanding of the experiences of exercise for individuals with MS. OBJECTIVE: The purpose of this study was to explore how physical activity played a role in the life of a Paralympic Gold medallist. Carol was diagnosed with MS and went onto achieve the highest accolade in Paralympic sport. METHODS: Narrative inquiry, within a single-case design, explored how physical activity played a role in Carol's life. The narrative was analysed through the lens of a salutogenic framework, which explores how individuals create health despite adverse circumstances. FINDINGS: Carol's physical activity pathway explores life before and after her diagnosis, motivations to return to exercise and pathway to Paralympic Gold. Carol's experiences highlight how physical activity played a role during various stages of her life. Exercise had a significant role in Carol's life prior to diagnosis, it assisted in the management of MS and she cycled the elite level, winning a Paralympic Gold medal in para-cycling. Implications for Rehabilitation Physical activity has been reported as beneficial for multiple sclerosis management; however, there can be a fine line between the benefits and an overload that can harm. An elite athlete with multiple sclerosis maintained and sustained physical activity to the highest level in elite sport, incorporating a positive health outlook throughout different stages of her life. The case highlights how commitment and self-awareness of capabilities and limits may be useful self-management tools in increasing physical activity for individuals living with multiple sclerosis.


Assuntos
Pessoas com Deficiência , Exercício Físico , Motivação , Esclerose Múltipla , Esportes para Pessoas com Deficiência , Atletas/psicologia , Atitude Frente a Saúde , Pessoas com Deficiência/psicologia , Pessoas com Deficiência/reabilitação , Exercício Físico/fisiologia , Exercício Físico/psicologia , Feminino , Humanos , Acontecimentos que Mudam a Vida , Esclerose Múltipla/diagnóstico , Esclerose Múltipla/fisiopatologia , Esclerose Múltipla/psicologia , Esclerose Múltipla/reabilitação , Narração , Adulto Jovem
16.
Artigo em Inglês | MEDLINE | ID: mdl-29238596

RESUMO

Background: The presence of pain during movement typically results in changes in technique. However, the physical properties of water, such as flotation, means that water-based exercise may not only reduce compensatory movement patterns but also allow pain sufferers to complete exercises that they are unable to perform on land. The purpose of this study was to assess bilateral kinematics during double-leg squats and single-leg squats on land and in water in individuals with unilateral anterior knee pain. A secondary aim was to quantify bilateral asymmetry in both environments in affected and unaffected individuals using a symmetry index. Methods: Twenty individuals with unilateral knee pain and twenty healthy, matched controls performed body weight double- and single-leg squats in both environments while inertial sensors (100 Hz) recorded trunk and lower body kinematics. Repeated-measures statistics tested for environmental effects on movement depths and peak angles within the anterior knee pain group. Differences in their inter-limb symmetry in each environments was compared to the control group using analysis of variance tests. Results: Water immersion allowed for greater movement depths during both exercises (double-leg squat: +7 cm, p = 0.032, single-leg squat: +9 cm, p = 0.002) for the knee pain group. The double-leg squat was symmetrical on land but water immersion revealed asymmetries in the lower body frontal plane movements. The single-leg squat revealed decreased hip flexion and frontal plane shank motions on the affected limb in both environments. Water immersion also affected the degree of lower limb asymmetry in both groups, with differences also showing between groups. Conclusions: Individuals with anterior knee pain achieved increased squat depth during both exercises whilst in water. Kinematic differences between the affected and unaffected limbs were often increased in water. Individuals with unilateral anterior knee pain appear to utilise different kinematics in the affected and unaffected limb in both environments.

17.
Sci Rep ; 7(1): 15750, 2017 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-29146972

RESUMO

A strategy combining covalent conjugation of photosensitizers to a peptide ligand directed to the melanocortin 1 (MC1) receptor with the application of sequential LED light dosage at near-IR wavelengths was developed to achieve specific cytotoxicity to melanocytes and melanoma (MEL) with minimal collateral damage to surrounding cells such as keratinocytes (KER). The specific killing of melanotic cells by targeted photodynamic therapy (PDT) described in this study holds promise as a potentially effective adjuvant therapeutic method to control benign skin hyperpigmentation or superficial melanotic malignancy such as Lentigo Maligna Melanoma (LMM).


Assuntos
Melanoma/patologia , Peptídeos/farmacologia , Fotoquimioterapia , Fármacos Fotossensibilizantes/farmacologia , Animais , Proliferação de Células , Clorofila/análogos & derivados , Clorofila/química , Humanos , Ligantes , Azul de Metileno/química , Camundongos , Receptores de Melanocortina/metabolismo
18.
PLoS One ; 12(8): e0182320, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28767683

RESUMO

Aquatic exercises can be used in clinical and sporting disciplines for both rehabilitation and sports training. However, there is limited knowledge on the influence of water immersion on the kinematics of exercises commonly used in rehabilitation and fitness programs. The aim of this study was to use inertial sensors to quantify differences in kinematics and movement variability of bodyweight squats, split squats, and single-leg squats performed on dry land and whilst immersed to the level of the greater trochanter. During two separate testing sessions, 25 active healthy university students (22.3±2.9 yr.) performed ten repetitions of each exercise, whilst tri-axial inertial sensors (100 Hz) recorded their trunk and lower body kinematics. Repeated-measures statistics tested for differences in segment orientation and speed, movement variability, and waveform patterns between environments, while coefficient of variance was used to assess differences in movement variability. Between-environment differences in segment orientation and speed were portrayed by plotting the mean difference ±95% confidence intervals (CI) throughout the tasks. The results showed that the depth of the squat and split squat were unaffected by the changed environment while water immersion allowed for a deeper single leg squat. The different environments had significant effects on the sagittal plane orientations and speeds for all segments. Water immersion increased the degree of movement variability of the segments in all exercises, except for the shank in the frontal plane, which showed more variability on land. Without compromising movement depth, the aquatic environment induces more upright trunk and shank postures during squats and split squats. The aquatic environment allows for increased squat depth during the single-leg squat, and increased shank motions in the frontal plane. Our observations therefore support the use of water-based squat tasks for rehabilitation as they appear to improve the technique without compromising movement depth.


Assuntos
Exercício Físico/fisiologia , Extremidade Inferior/fisiologia , Tronco/fisiologia , Adulto , Fenômenos Biomecânicos , Meio Ambiente , Feminino , Voluntários Saudáveis , Humanos , Masculino , Água , Adulto Jovem
20.
Int J Sports Physiol Perform ; 12(7): 977-983, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27967276

RESUMO

PURPOSE: To quantify the influence of the assistive pole, seat configuration, and upper-body and trunk strength on seated-throwing performance in athletes with a spinal-cord injury (SCI). METHODS: Ten Paralympic athletes competing in wheelchair rugby, basketball, or athletics (seated throws) participated in 2 randomized sessions: seated throwing and strength tests. Participants threw a club from a custom-built throwing chair, with and without a pole. 3D kinematic data were collected (150 Hz) for both conditions using standardized and self-selected seat configurations. Dominant and nondominant grip strength were measured using a dynamometer, and upper-body and trunk strength were measured using isometric contractions against a load cell. RESULTS: Seated throwing with an assistive pole resulted in significantly higher hand speed at release than throwing without a pole (pole = 6.0 ± 1.5 m/s, no pole = 5.3 ± 1.5 m/s; P = .02). There was no significant difference in hand speed at release between standardized and self-selected seating configurations during seated throwing with or without an assistive pole. Grip strength (r = .59-.77), push/pull synergy (r = .81-.84), and trunk-flexion (r = .50-.58) strength measures showed large and significant correlations with hand speed at release during seated throwing with and without an assistive pole. CONCLUSIONS: This study has demonstrated the importance of the pole for SCI athletes in seated throwing and defined the relationship between strength and seated-throwing performance, allowing us to better understand the activity of seated throws and provide measures for assessing strength that may be valid for evidence-based classification.


Assuntos
Desempenho Atlético , Pessoas com Deficiência , Força Muscular , Postura , Equipamentos Esportivos , Esportes para Pessoas com Deficiência , Adulto , Atletas , Fenômenos Biomecânicos , Estudos Cross-Over , Feminino , Humanos , Contração Isométrica , Masculino , Esportes , Tronco , Cadeiras de Rodas , Adulto Jovem
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