Hawai'i's Opportunity for Active Living Advancement (HO'ALA): addressing childhood obesity through safe routes to school.

Increasing active transportation to and from school may reduce childhood obesity rates in Hawai'i. A community partnership was formed to address this issue in Hawai'i's Opportunity for Active Living Advancement (HO'ALA), a quasi-experimental study of active transportation in Hawai'i County. The purpose of this study was to determine baseline rates for active transportation rates to and from school and to track changes related to macro-level (statewide) policy, locally-based Safe Routes to School (SRTS) programs and bicycle and pedestrian planning initiatives expected to improve the safety, comfort and ease of walking and bicycling to and from school. Measures included parent surveys, student travel tallies, traffic counts and safety observations. Assessments of the walking and biking environment around each school were made using the Pedestrian Environment Data Scan. Complete Streets and SRTS policy implementation was tracked through the activities of a state transportation-led Task Force and an advocacy-led coalition, respectively. Planning initiatives were tracked through citizen-based advisory committees. Thirteen volunteer schools participated as the intervention (n=8) or comparison (n=5) schools. The majority of students were Asian, Native Hawaiian, and Pacific Islander in schools located in under-resourced communities. Overall, few children walked or biked to school. The majority of children were driven to and from school by their parents. With the influence of HO'ALA staff members, two intervention schools were obligated SRTS project funding from the state, schools were identified as key areas in the pedestrian master plan, and one intervention school was slated for a bike plan priority project. As the SRTS programs are implemented in the next phase of the project, post-test data will be collected to ascertain if changes in active transportation rates occur.

Ironman triathletes: MRI assessment of the shoulder.

OBJECTIVE: The objective of this paper was to demonstrate the prevalence of shoulder magnetic resonance imaging (MRI) abnormalities, including abnormal bone marrow signal at the acromioclavicular (AC) joint in symptomatic and asymptomatic Ironman Triathletes. MATERIALS AND METHODS: The shoulders of 23 Ironman Triathletes, seven asymptomatic (group I) and 16 symptomatic (group II), were studied by MRI. A separate, non-triathlete group was evaluated specifically for AC joint marrow signal abnormalities to compare with the Ironman Triathletes. RESULTS: Partial thickness tears of the rotator cuff, rotator cuff tendinopathy, and AC joint arthrosis were common findings in both groups of triathletes. Tendinopathy was the only finding that was more prevalent in the symptomatic group, but this was not a statistically significant difference (p = 0.35). There were no tears of the glenoid labrum seen in group I or II subjects. Of note is that 71% (5/7) of group I subjects and 62% (10/16) of group II subjects had increased signal changes in the marrow of the AC joint (p = 0.68). The comparison group showed a lower prevalence (35%, p = 0.06) of this finding. CONCLUSIONS: No statistically significant difference was found among the findings for group 1, group 2, or the comparison group, although the difference between the comparison group and Ironman Triathletes approached statistical significance when evaluating for AC joint abnormal signal. Shoulder MRI of Ironman Triathletes should be interpreted with an appreciation of the commonly seen findings in asymptomatic subjects.

Knees of Ironman triathletes: magnetic resonance imaging assessment of older (>35 years old) competitors.

PURPOSE: To use magnetic resonance imaging (MRI) to evaluate the knees of older (>35 years old), competitive Ironman triathletes to determine the prevalence of abnormal findings. MATERIALS AND METHODS: The knees of 29 Ironman triathletes (20 men, 9 women; age range, 35-66 years old) were studied by MRI. The findings were analyzed collectively and categorized into group I (N = 13), subjects without prior knee injuries and symptoms, and group II (N = 16), subjects with prior knee injuries and/or current symptoms. RESULTS: Ten percent of the knees had ligamentous abnormalities, but the prevalence was not statistically different comparing group I to group II. Fifty-five percent had abnormal menisci. The overall prevalence of abnormal menisci was significantly higher in group II (69%) than in group I (38%, P < 0.05). Cartilage abnormalities were found in 21% of the triathletes with a higher prevalence in group II (31%) than in group I (8%, P < 0.05). Twenty-one percent (6/29) of the knees had bone contusions, with a higher prevalence in group II (31%) than in group I (8%, P < 0.05). CONCLUSION: In general, the spectrum of abnormal MRI findings of the knee was no greater than age-related changes previously reported for other athletic populations and nonathletes. These results have important implications for the diagnostic use of MRI of the knee in this high-endurance, athletic population.