Reliability and Validity of a Smartphone Device and Clinical Tools for Thoracic Spine Mobility Assessments.

Quantifying thoracic spine mobility with reliable and valid tools is a challenge for clinicians in practice. The aim of this study is to determine the reliability and validity of a smartphone device, bubble inclinometer and universal goniometer to quantify the static kyphotic curve and active range of motion of the thoracic spine. A total of 17 participants (mean age = 23.7 ± 2.3 years) underwent repeated measurements with three raters, on three separate days performing the lumbar-locked trunk rotation, standing full extension, standing full flexion, standing relaxed curve and seated trunk rotation assessments. Mostly "Good" to "Excellent" intra-rater (ICC ranging from 0.624 to 0.981) and inter-reliability (ICC ranging from 0.671 to 0.968) was achieved with the smartphone and clinical tools. "Excellent" validity (ICC ranging from 0.903 to 0.947) with the smartphone was achieved during lumbar-locked trunk rotation and standing relaxed curve assessment. "Good" validity (ICC ranging from 0.836 to 0.867) of the smartphone was achieved during the seated trunk rotation. The Samsung s9+ smartphone with the iSetSquare mobile application is a reliable and valid tool to use for clinical assessments assessing thoracic spine mobility.

Are habitually barefoot children compelled to wear ill-fitting school shoes? A cross-sectional study.

BACKGROUND: Research shows that ill-fitting shoes can negatively impact the development of the pediatric foot, in a very direct manner. The primary aim of the study was to determine if the dimensions of available prescribed school shoes fit the foot dimensions of habitually barefoot South African children and adolescents. METHODS: A cross-sectional observational study was conducted where static standing foot measurements of children and adolescents from urban and rural schools were obtained with a mobile caliper. The maximum heel-toe-length and foot width with an added 10 mm toe- and width fit allowance to each participant, were compared to the corresponding school shoe length and shoe width available in retail. A mixed model ANOVA was used to compare foot dimensions between gender, age and side. RESULTS: Six hundred and ninety-eight school children (N = 698) (431 girls; 267 boys; average age 10.86 years, SD = 2.55) were participants. A total of seventy-seven (N = 77) black coloured prescribed school shoes currently available in retail ranging from different styles and brands were measured. Results show that, comparing the shoe length and maximum heel-toe-length of participants, as well as taking 10 mm toe allowance into account, fifty-nine percent (59%) of children wore shoes that were not the correct length. With regards to the shoe width and the added 10 mm of width fit allowance, ninety-eight percent (98%) of the shoes worn by participants were too narrow for their feet. CONCLUSIONS: Results confirmed that school shoes currently available in retail, are not suited for the habitually barefoot population studied. It is recommended that the shoe manufacturing industry should consider the shoe width of school shoes for children and adolescents in habitually barefoot populations to avoid the long-term negative effect of ill-fitting shoes on the pediatric foot.

Foot Strike Patterns Differ Between Children and Adolescents Growing up Barefoot vs. Shod.

Effects of early and permanent footwear use are not well understood. The aim of this study was to investigate the effects of habituation to footwear on foot strike patterns of children and adolescents. Healthy habitually barefoot and shod participants (aged 6-18 years) from South Africa (n=288) and Germany (n=390) performed multiple 20-m jogging and running trials with and without shoes. Each foot strike was captured using a high-speed camera to determine a rearfoot or non-rearfoot strike. The probability of a rearfoot strike in both cohorts and each age was analyzed by using a mixed-effects logistic regression adjusted for possible confounders. Habitually barefoot children showed a higher probability of using rearfoot strikes than habitually shod children (p<0.001). The probability was age-dependent and decreased in habitually barefoot children with age (ORbarefoot-jogging=0.82, 95% CI, 0.71 to 0.96, p=0.014; ORbarefoot-running=0.58, 95% CI, 0.50 to 0.67, p<0.001 and ORshod-running=0.68, 95% CI, 0.59 to 0.79, p<0.001). In habitually shod children, the probability increased significantly for shod jogging (OR=1.19, 95% CI, 1.05 to 1.35, p=0.006). To conclude, foot strike patterns of children are influenced by habituation to footwear. Younger habitually barefoot children show higher rates of rearfoot strikes for shod and barefoot running, and it converges in later adolescence.

Recovery-Stress States of Professional Ballet Dancers During Different Phases of a Ballet Season.

Ballet dancers are exposed to chronic high training and performance demands that are associated with overtraining syndrome and injury. Balancing high training loads with recovery to reduce the risk of negative training adaptations is critical. Moreover, the recovery-stress states of professional ballet dancers during training phases of a season are largely unknown. Professional dancers (n = 27) from one classical ballet company in South Africa were monitored for two 8-week phases of a ballet season. A recovery-stress questionnaire for Athletes (RESTQ-76 Sport) was completed weekly during the rehearsal phase (P1) and the performance phase (P2), which took place at the start and the end of the ballet season, respectively. Comparisons were calculated between phases, sexes, and levels of performance with a mixed-model ANOVA and between demographic variables with a one-way ANOVA. The performance phase was signified by lower total recovery (TR, p < 0.01) and higher total stress (TS, p < 0.01) for the group. Female dancers had significantly lower recovery scores than male dancers during P2 (p < 0.01). No differences between levels of performance were found. Subscales previously associated with overreaching and injury were identified in certain groups during P2. In conclusion, P2 was a critical period where dancers, especially females, experienced high stress and low recovery. This could increase the risk for injury and negative training adaptations.

Effect of six-week traditional resistance and functional training on functional performance in female netball players.

BACKGROUND: Improving the quality of functional movements in athletes generally requires additional training targeting specific functional deficiencies. However, well-rounded, traditional strength and conditioning program should also improve player's movement quality. Therefore, the primary aim of this study was to compare the effect of two different six-week interventions on the functional score of female netball players. METHODS: In a randomized controlled study, players were divided into control and intervention group. Both groups completed identical six-week strength and conditioning program, with the intervention group also completing additional corrective exercises three sessions per week during the same period. RESULTS: The FMS® score was significantly higher in the intervention group after 6-week program (f = 9.85, p = 0.004). However, the differences in total score may be attributed mainly to differences between groups in active straight leg raise (p = 0.004) and trunk stability push-up test (p = 0.02), as other individual tests demonstrated similar time and group effect. CONCLUSION: These results indicate that although FMS® based intervention may improve overall functional movement score, the athletes in both groups have demonstrated similar improvements in most of the individual tests. Hence, a well-rounded strength and conditioning program incorporating athlete-specific exercises based on limitations identified in the functional movement screen, may result in a balanced training strategy and reduce the need for supplementary functional training sessions.

Positional In-Match Running Demands of University Rugby Players in South Africa.

The implementation of the Varsity Cup rugby competition among South African universities has sparked interest in university rugby cultures around the country. The Varsity Cup has established itself as one of the most important rugby competitions for full-time students. The development of specific conditioning programs for rugby players requires a thorough understanding of the game and the unique demands of playing positions. Therefore, the study aimed to investigate the in-match running demands of South African university rugby players by using GPS during match play for primary and secondary positional groups. Rugby players (n = 40) from two universities were assessed during match play (n = 17) over a competitive season by using GPS. Players were grouped into two primary positional groups, forwards (n = 22) and backs (n = 18), and five secondary positional groups, tight forwards (n = 14), loose forwards (n = 8), half backs (n = 5), inside backs (n = 6), and outside backs (n = 7). The GPS analysis provided the following match-play movements: total distance, high-speed meters, maximum velocity, match intensity, the number of accelerations and decelerations, and velocity zone. Halfbacks recorded the highest total distance (6620.9 ± 784.4 m; p = 0.02) and match intensity (77.7 ± 11.6 m/min; p = 0.01). Outside backs recorded the highest maximum velocity (8.385 ± 1.242 m/s; p = 0.00). Loose forwards registered the highest number of accelerations (385.5 ± 122.1) and decelerations (378.7 ± 108.1). Backs and their specific subgroups play at and within high velocity thresholds, significantly higher (p = 0.01) than that of the forwards. Forwards tend to be involved in a higher amount of accelerations and decelerations during match play, suggesting that forward play is at close quarters to the opposition. During university rugby matches, the backs covered greater distances and speeds than the forwards, whereas the forwards achieved more accelerations and decelerations than backs. Results from the study can assist Varsity Cup strength and conditioning coaches to prepare players for the position-specific demands of the competition.

Sleep-Related Issues for Recovery and Performance in Athletes.

The body of research that reports the relevance of sleep in high-performance sports is growing steadily. While the identification of sleep cycles and diagnosis of sleep disorders are limited to lab-based assessment via polysomnography, the development of activity-based devices estimating sleep patterns provides greater insight into the sleep behavior of athletes in ecological settings. Generally, small sleep quantity and/or poor quality appears to exist in many athletic populations, although this may be related to training and competition context. Typical sleep-affecting factors are the scheduling of training sessions and competitions, as well as impaired sleep onset as a result of increased arousal prior to competition or due to the use of electronic devices before bedtime. Further challenges are travel demands, which may be accompanied by jet-lag symptoms and disruption of sleep habits. Promotion of sleep may be approached via behavioral strategies such as sleep hygiene, extending nighttime sleep, or daytime napping. Pharmacological interventions should be limited to clinically induced treatments, as evidence among healthy and athletic populations is lacking. To optimize and manage sleep in athletes, it is recommended to implement routine sleep monitoring on an individual basis.

The influence of biological maturity on motor performance among habitually barefoot versus habitually shod adolescents.

Biological maturation is associated with physiological changes which in turn affect motor performance. No study has assessed the association between growing up habitually shod versus habitually barefoot and motor performance in the context of maturation, so this approach is unique. The purpose of this study was to examine the influence of biological maturity on motor performance dependent on the participants' footwear habits. Sixty-five German habitually shod (mean age 13.28 ± 0.83 years) and fifty-five South African habitually barefoot (mean age 13.38 ± 0.87 years) participants were included. Dynamic postural control was determined via backward balancing, explosive strength by standing long jump and sprinting performance based on a 20-m sprinting test. All tests were performed barefoot and shod. Biological maturation was calculated by using the maturity offset value. Linear mixed models were used to analyse interactions between the maturity offset value, footwear habits and motor performance. Throughout maturation, there was a significant difference between habitually barefoot and habitually shod balance performance (P = 0.001). Maturation led to balance improvements in habitually barefoot adolescents, but not in habitually shod adolescents. No such differences could be observed for standing long jump and 20-m sprint performance. Maturity offset was a significant predictor for jumping and sprinting performances (P < 0.001), independent of being habitually barefoot or habitually shod. Better performances could be observed in more mature subjects. Biological maturation seems to be a relevant predictor for motor performance characteristics for the jumping and sprinting performance in adolescents.

Motor Skills of Children and Adolescents Are Influenced by Growing up Barefoot or Shod.

Background: The objective of this study was to evaluate the association between growing up barefoot or shod and the development of motor performance during childhood and adolescence. Methods: Habitual barefoot and shod children and adolescents between 6 and 18 years were recruited in South Africa and Germany. Participants completed balance, standing long jump and 20 m sprint tests in barefoot and shod conditions. Outcomes were analyzed in separate mixed-effects linear regressions for three age groups according to stages of development (6-10, 11-14, and 15-18 years). All models were adjusted for confounders: sex, ethnicity, BMI, PAQ score and order of tests (barefoot vs. shod). Results: Three hundred and eight-five habitually barefoot and 425 habitually shod children participated. Significant age by footwear effects were found for the jump (p = 0.032) and sprint test (p = 0.041). Habitually barefoot children aged 6-10 years scored higher in the balance test (p = 0.015) and standing long jump (p = 0.005) whereas habitually shod children sprinted faster (p < 0.001). Faster sprint times were found for habitually shod participants between 11 and 14 years (p < 0.001). Habitually barefoot adolescents between 15 and 18 years of age showed a greater long jump distance (p < 0.001) but slower sprint times (p = 0.014) than shod adolescents. Conclusions: The results emphasize the importance of footwear habits for the development of motor skills during childhood and adolescence. Regular physical activities without footwear may be beneficial for the development of jumping and balance skills, especially in the age of 6 to 10 years.

Recovery and Performance in Sport: Consensus Statement.

The relationship between recovery and fatigue and its impact on performance has attracted the interest of sport science for many years. An adequate balance between stress (training and competition load, other life demands) and recovery is essential for athletes to achieve continuous high-level performance. Research has focused on the examination of physiological and psychological recovery strategies to compensate external and internal training and competition loads. A systematic monitoring of recovery and the subsequent implementation of recovery routines aims at maximizing performance and preventing negative developments such as underrecovery, nonfunctional overreaching, the overtraining syndrome, injuries, or illnesses. Due to the inter- and intraindividual variability of responses to training, competition, and recovery strategies, a diverse set of expertise is required to address the multifaceted phenomena of recovery, performance, and their interactions to transfer knowledge from sport science to sport practice. For this purpose, a symposium on Recovery and Performance was organized at the Technical University Munich Science and Study Center Raitenhaslach (Germany) in September 2016. Various international experts from many disciplines and research areas gathered to discuss and share their knowledge of recovery for performance enhancement in a variety of settings. The results of this meeting are outlined in this consensus statement that provides central definitions, theoretical frameworks, and practical implications as a synopsis of the current knowledge of recovery and performance. While our understanding of the complex relationship between recovery and performance has significantly increased through research, some important issues for future investigations are also elaborated.

Backward compared to forward over ground gait retraining have additional benefits for gait in individuals with mild to moderate Parkinson's disease: A randomized controlled trial.

Over ground gait retraining in the reverse direction has shown to be beneficial for neurological rehabilitation, but has not yet been investigated in Parkinson's disease (PD). Backwards walking (BW) might be a useful training alternative to improve PD gait and possibly reduce fall risk during complex multi-directional daily activities. The primary aim was to compare the effect of an eight-week forward (FWG) and backwards (BWG) gait retraining program on gait parameters in PD individuals. Twenty-nine participants (aged 71.0±8.8years; UPDRS-III 38.1±12.3; H&Y 2.7±0.5) were randomly assigned to either the control (FWG; n=14) or experimental group (BWG; n=15). Baseline measures included disease severity (UPDRS III), global cognition (MoCA) and depression (PHQ-9). Outcome measures were selected gait variables on the 10m-instrumented-walk-test (i10mWT) assessed before and after the interventions. Both groups improved usual gait speed (FWG: p=0.03, d=0.35; BWG: p<0.01, d=0.35) and height-normalized gait speed (FWG: p=0.04, d=0.35; BWG: p<0.01, d=0.57). Additionally, the BWG demonstrated improved cadence (p<0.01, d=0.67) and stride length (SL; p=0.02, d=0.39). Both interventions were effective to improved gait speed sufficiently to independently navigate in the community.

Growing-up (habitually) barefoot influences the development of foot and arch morphology in children and adolescents.

The development of the human foot is crucial for motor learning in children and adolescents as it ensures the basic requirements for bipedal locomotion and stable standing. Although there is an ongoing debate of the advantages and disadvantages of early and permanent footwear use, the influence of regular barefootness on foot characteristics in different stages of child development has not been extensively evaluated. A multicenter epidemiological study was conducted to compare the foot morphology between habitually barefoot children and adolescents (N = 810) to age-, sex- and ethnicity-matched counterparts that are used to wearing shoes. While controlling for confounders, we found that habitual footwear use has significant effects on foot-related outcomes in all age groups, such as a reduction in foot arch and hallux angles. The results indicate an impact of habitual footwear use on the development of the feet of children and adolescents. Therefore, growing up barefoot or shod may play an important role for childhood foot development, implying long-term consequences for motor learning and health later in life.

The effects of being habitually barefoot on foot mechanics and motor performance in children and adolescents aged 6-18 years: study protocol for a multicenter cross-sectional study (Barefoot LIFE project).

BACKGROUND: Barefoot locomotion has evoked an increasing scientific interest with a controversial debate about benefits and limitations of barefoot and simulated barefoot walking and running. While most current knowledge comes from cross sectional laboratory studies, the evolutionary perspective suggests the importance of investigating the long-term effects. Observing habitually barefoot populations could fill the current gap of missing high quality longitudinal studies. Therefore, the study described in this design paper aims to investigate the effects of being habitually barefoot on foot mechanics and motor performance of children and adolescents. METHODS: This study has a cross-sectional, binational design and is part of the "Barefoot Locomotion for Individual Foot- and health Enhancement (Barefoot LIFE)" project. Two large cohorts (n(total) = 520) of healthy children and adolescents between 6 and 18 years of age will be included respectively in Germany and South Africa. A barefoot questionnaire will be used to determine habitually barefoot individuals. The testing will be school-based and include foot mechanical (static arch height index, dynamic arch index, foot pliability) and motor performance (coordination, speed, leg power) outcomes. Gender, BMI and level of physical activity will be considered for confounding. DISCUSSION: The strength of this study is the comparison of two large cohorts with different footwear habits to determine long-term effects of being habitually barefoot on foot mechanics and motor performance.

The 'Bunkie' test: assessing functional strength to restore function through fascia manipulation.

It has been speculated that repetitive patterns of movement will lead to specific patterns in fascia contraction, which, if it exceeds a specific limit, will lead to injury. Therapists working in the athletic environment are challenged to find ways not only to assess and measure fascia dysfunction, but also to restore functional strength by manipulating the fascia back to its neutral position. The 'Bunkie' test was developed over a period of 12 years to measure the function of the specific fascia lines in athletes. Numerous athletes from various sports were assessed and treated. Results have shown over the years that this test can be used successfully to find the cause of and treat injuries and to determine the progress of treatment in elite and recreational athletes.