Effects of Multicomponent Injury Prevention Programs on Children and Adolescents' Fundamental Movement Skills: A Systematic Review With Meta-Analyses.

OBJECTIVE: Fundamental movement skills (FMS) are essential to participate in physical activity. Understanding the effects of multicomponent injury prevention programs (MIPP) on FMS may help promote safe physical activity. Our objective was to synthesize the evidence on the effects of MIPP on biomechanical outcomes and neuromuscular performance measured on children and adolescents while performing FMS. DATA SOURCE: We searched PubMed, SPORTDiscus, Web of Science, and SCOPUS. STUDY INCLUSION AND EXCLUSION CRITERIA: We included peer-reviewed randomized controlled trials, published in English, that analyzed the effects of MIPP on biomechanics and neuromuscular performance of FMS in participants under 18 years of age. DATA EXTRACTION: Two reviewers screened the articles, assessed the quality of the evidence using the Physiotherapy Evidence Database (PEDro) scale, and synthesized the data. DATA SYNTHESIS: We conducted meta-analyses and reported the characteristics, outcomes, and risk of bias of studies. RESULTS: We included 27 articles that reported data from 1,427 participants. Positive effects on FMS were reported in 23 of the 27 included articles. Vertical Jump, running speed, acceleration, and dynamic balance presented positive-significant pooled effect sizes. Dribbling and horizontal jump presented non-significant pooled effect sizes. CONCLUSION: MIPP can positively affect FMS in children and adolescents in sports-related settings. Lack of participant compliance and implementation fidelity may affect MIPP effectiveness. Including MIPP in physical literacy interventions, physical education classes, and organized physical activity may lead to functional adaptations that help promote safe physical activity.

Effects of balance status and age on muscle activation while walking under divided attention.

We examined the role of attention during different phases of the gait cycle by using a dual-task paradigm. Younger and older adults performed a self-paced treadmill walking task, a semantic judgment task, and both tasks simultaneously. We recorded vocal reaction time for the judgment task, and we recorded muscle activity by the use of electromyography. We derived dual-task costs from difference scores (single vs dual task). Our analysis of the judgment task showed that both groups responded more quickly during dual-task conditions than during single-task conditions. In five of eight muscle groups, stance-phase muscle activity decreased significantly from dual to single task. For older adults, individuals with poor balance increased their muscle activity during dual-task performance. These results suggest that, during moderately demanding walking and cognitive performance, poor balancers can compensate successfully for their motoric vulnerability.

Influence of back support conditions on the apparent mass of seated occupants under horizontal vibration.

The response characteristics of seated human subjects exposed to fore-aft (x-axis) and lateral (y-axis) vibration are investigated through measurements of dynamic interactions between the seated body and the seat pan, and the upper body and the seat backrest. The experiments involved: (i) three different back support conditions (no back support, and upper body supported against a vertical and an inclined backrest); (ii) three different seat pan heights (425, 390 and 350 mm); and three different magnitudes (0.25, 0.5 and 1.0 m/s2 rms acceleration) of band limited random excitations in the 0.5-10 Hz frequency range, applied independently along the fore-aft and lateral directions in an uncoupled manner. The body force responses, measured at the seat pan and the backrest along the direction of motion, are applied to characterize the total body apparent mass (APMS) reflected on the seat pan, and those of the upper body reflected on the backrest. Unlike the widely reported responses of seated occupants under vertical vibration, the responses to horizontal vibration show strong effect of excitation magnitude. The large displacements at lower frequencies cause considerable rotations of the upper body, and the knees and ankles, particularly when seated without a back support, which encouraged the occupants to continually shift larger portion of the body weight towards their feet. This together with the strong dependence on the excitation magnitude resulted in considerable inter-subject variability of the data. The addition of a back support causes stiffening of the body to limit the low frequency rocking motion of the upper body under x-axis motion, while considerable dynamic interactions with the backrest occur. The mean apparent mass (APMS) responses measured at the seat pan and the backrest suggest strong contributions due to the back support condition, and the direction and magnitude of horizontal vibration, while the role of seat height is important only in the vicinity of the resonant frequencies. In the absence of a back support, the seat pan responses predominate at a lower frequency (near 0.7 Hz) under both directions of motion, while two secondary peaks in the magnitude also occur at relatively higher frequencies. The addition of back support causes the seat pan response to converge mostly to a single primary peak, resulting in a single-degree-of-freedom like behavior, with peak occurring in the 2.7-5.4 Hz range under x-axis, and 0.9-2.1 Hz range under y-axis motions, depending upon the excitation magnitude and the back support condition. This can be attributed to the stiffening of the body in the presence of the constraints imposed by the backrest. A relaxed posture with an inclined backrest, however, causes a softening effect, when compared to an erect posture with a vertical backrest. The backrest, however, serves as another source of vibration to the seated occupant, which tends to cause considerably higher magnitude responses. The considerable magnitudes of the apparent mass response measured at the seat back under fore-aft motions suggest strong interactions with the backrest. Such interactions along the side-to-side motions, however, are relatively small. The results suggest that the biodynamic characterization of seated occupants exposed to horizontal vibration requires appropriate considerations of the interactions with the backrest.

Successful adaptation of gait in healthy older adults during dual-task treadmill walking.

Dual-task methods have been used to demonstrate increased prioritization of walking performance over cognition in healthy aging. This is expressed as greater dual-task costs in cognitive performance than in walking. However, other research shows that older adults can prioritize cognitive performance over walking when instructed to do so. We asked whether age-related cognitive prioritization would emerge by experimentally manipulating cognitive difficulty. Young and older adults performed mental arithmetic at two levels of difficulty, alone or while walking. Electromyography and footswitches were used to measure muscle activity and stride parameters. Under high cognitive load, older adults increased their stride time, stride length, and hamstring activity, while maintaining their cognitive performance. Young adults showed negligible dual-task costs in each domain. The older adults appeared to successfully adapt their stride in response to high cognitive demands. The results have implications for neural models of gait regulation, and age differences in task emphasis.

The Effects of Sex, Joint Angle, and the Gastrocnemius Muscle on Passive Ankle Joint Complex Stiffness.

OBJECTIVE: To assess the effects of sex, joint angle, and the gastrocnemius muscle on passive ankle joint complex stiffness (JCS). DESIGN AND SETTING: A repeated-measures design was employed using sex as a between-subjects factor and joint angle and inclusion of the gastrocnemius muscle as within-subject factors. All testing was conducted in a neuromuscular research laboratory. SUBJECTS: Twelve female and 12 male healthy, physically active subjects between the ages of 18 and 30 years volunteered for participation in this study. The dominant leg was used for testing. No subjects had a history of lower extremity musculoskeletal injury or circulatory or neurologic disorders. MEASUREMENTS: We determined passive ankle JCS by measuring resistance to passive dorsiflexion (5 degrees.s(-1)) from 23 degrees plantar flexion (PF) to 13 degrees dorsiflexion (DF). Angular position and torque data were collected from a dynamometer under 2 conditions designed to include or reduce the contribution of the gastrocnemius muscle. Separate fourth-order polynomial equations relating angular position and torque were constructed for each trial. Stiffness values (Nm.degree(-1)) were calculated at 10 degrees PF, neutral (NE), and 10 degrees DF using the slope of the line at each respective position. RESULTS: Significant condition-by-position and sex-by-position interactions and significant main effects for sex, position, and condition were revealed by a 3-way (sex-by-position, condition-by-position) analysis of variance. Post hoc analyses of the condition-by-position interaction revealed significantly higher stiffness values under the knee-straight condition compared with the knee-bent condition at both ankle NE and 10 degrees DF. Within each condition, stiffness values at each position were significantly higher as the ankle moved into DF. Post hoc analysis of the sex-by-position interaction revealed significantly higher stiffness values at 10 degrees DF in the male subjects. Post hoc analysis of the position main effect revealed that as the ankle moved into dorsiflexion, the stiffness at each position became significantly higher than at the previous position. CONCLUSIONS: The gastrocnemius contributes significantly to passive ankle JCS, thereby providing a scientific basis for clinicians incorporating stretching regimens into rehabilitation programs. Further research is warranted considering the cause and application of the sex-by-position interaction.