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The KinaTrax markerless motion capture system, used extensively in the analysis of baseball pitching and hitting, is currently being adapted for use in clinical biomechanics. In clinical and laboratory environments, repeatability is inherent to the quality of any diagnostic tool. The KinaTrax system was assessed on within- and between-session reliability for gait kinematic and spatiotemporal parameters in healthy adults. Nine subjects contributed five trials per session over three sessions to yield 135 unique trials. Each trial was comprised of a single bilateral gait cycle. Ten spatiotemporal parameters for each session were calculated and compared using the intraclass correlation coefficient (ICC), Standard Error of the Measurement (SEM), and minimal detectable change (MDC). In addition, seven kinematic waveforms were assessed from each session and compared using the coefficient of multiple determination (CMD). ICCs for between-session spatiotemporal parameters were lowest for left step time (0.896) and left cadence (0.894). SEMs were 0.018 (s) and 3.593 (steps/min) while MDCs were 0.050 (s) and 9.958 (steps/min). Between-session average CMDs for joint angles were large (0.969) in the sagittal plane, medium (0.554) in the frontal plane, and medium (0.327) in the transverse plane while average CMDs for segment angles were large (0.860), large (0.651), and medium (0.561), respectively. KinaTrax markerless motion capture system provides reliable spatiotemporal measures within and between sessions accompanied by reliable kinematic measures in the sagittal and frontal plane. Considerable strides are necessary to improve methodological comparisons, however, markerless motion capture poses a reliable application for gait analysis within healthy individuals., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Schoenwether et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Abstract: Calaway, C, Walls, K, Levitt, H, Caplan, J, Mann, B, Martinez, K, Gastaldo, R, Haq, I, and Signorile, JF. Velocity-based-training frequency impacts changes in muscle morphology, neuromuscular performance, and functional capability in persons with Parkinson's disease. J Strength Cond Res 39(1): 99-106, 2025-Velocity-based training (VBT) positively impacts muscle morphology and performance in persons with Parkinson's disease (PD); however, optimal training frequencies for VBT in patients with PD remain undetermined. Changes in ultrasound-determined muscle thickness (MT) and echo intensity (EI)-derived muscle quality of the rectus femoris (RF) and vastus lateralis (VL), neuromuscular performance, and functional capacity were examined following 2 VBT frequencies (2-3 d·wk -1 ) using 30% velocity loss thresholds for 12 weeks. Neuromuscular performance was assessed using computerized pneumatic resistance machines. For each variable, 2 (time) × 2 (group) repeated-measures analyses of variance (ANOVA) were used to determine significant main effects and interactions. Significant time effects were seen for MT and EI of all muscles ( p < 0.05). Muscle thickness improvements included right VL (RVL) (0.171 ± 0.065 cm; p = 0.019), left VL (LVL) (0.214 ± 0.101 cm; p = 0.049), right RF (RRF) (0.194 ± 0.077 cm; p = 0.023), and left RF (LRF) (0.318 ± 0.109 cm; p = 0.010). For EI, improvements occurred in RVL (-18.688 ± 3.600; p = <0.001), LVL (-10.959 ± 4.894; p = 0.040), RRF (-9.516 ± 3.537; p = 0.016), and LRF (-9.018 ± 3.444; p = 0.019). Time effects were seen for leg-press 1-repetition maximum and peak power ( p < 0.01) and habitual walking speed ( p = 0.022), with a group by time interaction for maximal gait speed favoring the 3 d·wk -1 condition (∆0.15 m·s -1 , p = 0.002). The results indicate that VBT at 2 or 3 d·wk -1 can significantly improve muscle morphology, neuromuscular performance, and functional capability in patients with PD; however, improvements in maximal gait speed require 3 d·wk -1 . These findings provide flexibility when developing exercise prescriptions for patients with PD., (Copyright © 2024 National Strength and Conditioning Association.)

Aim: The Nordic hamstring curl appears effective in reducing the incidence of injury in physically active young adults, likely through its capacity as an eccentric exercise to increase muscle stiffness. Although eccentric exercises have been shown to increase muscle stiffness, medium- and long-term Nordic hamstring curl training programs have not demonstrated an effect on muscle stiffness. This study examined the acute effects of a single session of Nordic hamstring curls on the stiffness of the biceps femoris, semitendinosus, and semimembranosus muscles using ultrasound shear wave elastography, an accepted method for measuring passive muscle stiffness., Material and Methods: Twenty physically active adults (ages 19-27 years) were randomly assigned to either the Nordic hamstring curl group ( n = 10) or the control group ( n = 10). Shear wave elastography was performed on the dominant kicking leg for both groups. The exact location of the probe was marked to ensure the same area was assessed during post-testing. Both groups performed a 5-minute cycle ergometer warm-up followed by three 30-second standing static stretches. The Nordic hamstring curl group then performed three sets of six repetitions of the eccentric phase of the Nordic hamstring curl with 1-minute rest intervals between sets. All subjects then rested for five minutes before shear wave elastography was performed., Results: Repeated measures ANOVA revealed no significant main effects or interactions for the biceps femoris or semitendinosus ( p >0.05). However, analysis of the semimembranosus was inconclusive due to variability of measurement values., Conclusions: These results are in agreement with findings indicating that long- and short-term Nordic hamstring curl training has no impact on hamstring stiffness, although the effects of Nordic hamstring curl on reducing the probability of hamstring injury are still valid., Competing Interests: Information about the conflict of interest The authors do not report any financial or personal connections with other persons or organizations which might negatively affect the contents of this publication and/or claim authorship rights to this publication., (© 2024 Rubén Cámara-Calmaestra et al., published by Sciendo.)

Objective: This study sought to evaluate the feasibility, acceptability, and preliminary efficacy of the Happy Older Latinos are Active (HOLA) health promotion intervention in a group of older Latinos who were at risk for developing major depressive disorder or generalized anxiety disorder., Method: Sixty older Latinos age 60+ with subthreshold depression or anxiety were randomized to receive either HOLA (n = 30) or enhanced psychoeducation through fotonovela control ( n = 30). The primary outcomes of interest were feasibility, acceptability, and reduction in depression and anxiety symptom severity. Outcome measures were administered at baseline and at the end of the intervention., Results: Within a year, the enrollment target was met with < 5% of eligible participants refusing randomization. The randomization scheme produced equal numbers of participants randomized to each condition. Four participants (6.7%; HOLA = 1; control = 3) were lost to follow-up, 69% of the HOLA sessions were attended, and participants reported high satisfaction with the intervention. Finally, compared with control, a significant proportion of participants in HOLA experienced a clinically significant reduction in their anxiety symptoms (60% vs. 26.7%)., Conclusions: Findings highlight the feasibility, acceptability, and significant impact the HOLA intervention can have in reducing psychological distress because it is responsive, respectful, and specific to the needs of older Latinos. Furthermore, using a community health worker to deliver a health promotion intervention to prevent common mental disorders in older Latinos is an innovative approach for reducing disease burden in a population living with high disparities in accessing and engaging in mental health services. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Despite quadriceps weakness in individuals after quadriceps tendon anterior cruciate ligament reconstruction (QT-ACLR), and its association with knee joint mechanics, no studies have addressed gait mechanics in both partial-thickness (PT-Q) and full-thickness (FT-Q) options for QT-ACLR., Objective: To assess gait mechanics across a QT-ACLR cohort. We hypothesized that QT-ACLR would show changes in knee joint mechanics compared to control participants (CON) and nonoperated limbs. Additionally, we hypothesized that FT-Q operated limbs would show greater changes compared to PT-Q and CON., Design: Retrospective cohort study., Setting: University-affiliated sports medicine institute., Participants: Sixteen patients who underwent QT-ACLR (7 FT-Q: Age (years) = 28.6 ± 7.3, post-op (months) = 23.5 ± 10.7, 9 PT-Q: Age = 25.2 ± 4.3, post-op = 24.4 ± 11.7) were recruited and compared to 11 CON (age = 23.4 ± 4.8)., Intervention: Participants underwent gait testing with force plate integrated motion capture., Main Outcome Measures: Mixed repeated-measures analyses of covariance, adjusted for gait speed, were used to determine significant main effects or interactions in peak knee flexion angle, sagittal knee range of motion, peak internal knee extension moment (KEM), and peak internal knee flexion moment., Results: When measured an average of 2 years after surgery, no main effect for limb or limb by depth interaction were detected. A significant effect by group was observed for peak KEM (p = .03, η 2  = .27) and peak knee flexion angle (p = .04, η 2  = .24) in the loading response phase. FT-Q (p = .02) and PT-Q (p = .03) showed lower KEM compared to the CON group in both limbs. The FT-Q group showed lower peak knee flexion angle compared to the CON group (p = .01)., Conclusions: Knee joint symmetry may be recovered 2 years following QT-ACLR, but lower KEM compared to CON for both graft options and lower peak knee flexion angle than CON for the FT-Q group may indicate a need for further investigation in QT-ACLR., (© 2024 The Author(s). PM&R published by Wiley Periodicals LLC on behalf of American Academy of Physical Medicine and Rehabilitation.)

Aims: i) to compare 30-s sit-to-stand (STS) test repetitions and power between older adults with and without Parkinson's disease (PD) and ii) to evaluate the relationship of STS repetitions and power with functional measures in older people with PD., Methods: STS repetitions and power (Alcazar's equation) during the 30-s STS test were assessed in forty-six age- and sex-matched older adults with and without PD. Functional measures included habitual (HGS) and maximum gait speed (MGS), timed-up-and-go (TUG) test and the Mini-Balance Evaluation System Test (Mini-BEST). PD-specific tests were as follows: the motor subscale of the Unified Parkinson's Disease Rating Scale (UPDRS-III), quality of life [Parkinson's Disease Questionnaire (PDQ-39)], perceived freezing of gait (FOG questionnaire), and fear of falling [Falls Efficacy Scale (FES)]. T scores, repeated measures ANOVA and linear regression analyses were used., Results: T scores for older adults with PD were - 2.7 ± 4.5 for STS repetitions, -5.2 ± 4.2 for absolute STS power, and - 3.1 ± 4.6 for relative STS power compared to older adults without PD. T scores for absolute STS power were lower than T scores for STS repetitions (p < 0.001) and relative STS power (p < 0.001). Both absolute and relative STS power and STS repetitions showed similar correlations with functional measures (r = 0.44 to 0.59; both p < 0.05). Relative STS power (r = -0.55; p < 0.05) and STS repetitions (r = -0.47 to -0.55; p < 0.05) but not absolute STS power were correlated to PD-specific tests., Conclusions: STS repetitions and power values estimated through the 30-s STS test were lower in older people with PD than without PD. Overall, STS power measures were similarly associated with functional performance as STS repetitions, indicating these power equations can be implemented when assessing lower extremity function in older people with PD., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The purpose of this work was to provide a simple method to determine reactive strength during the 6-meter timed hop test (6mTH) and evaluate its association with isokinetic peak torque in patients following anterior cruciate ligament reconstruction (ACLR). Twenty-nine ACLR patients who were at least four months from surgery were included in this analysis. Participants were brought into the laboratory on one occasion to complete functional testing. Quadriceps and hamstring isokinetic testing was completed bilaterally at 60, 180, and 300 deg∙s-1, using extension peak torque from each speed as the outcome measure. The 6mTH was completed bilaterally using a marker-based motion capture system, and reactive strength ratio (RSR) was calculated from the vertical velocity of the pelvis during the test. An adjustment in RSR was made using the velocity of the 6mTH test to account for different strategies employed across participants. Repeated measures correlations were used to determine associations among isokinetic and hop testing variables. A two-way mixed analysis of variance was used to determine differences in isokinetic and hop testing variables between operated and non-operated legs and across male and female participants. Moderate positive associations were found between RSR (and adjusted RSR) and isokinetic peak torque at all speeds (r = .527 to .577). Mean comparisons showed significant main effects for leg and sex. Patients showed significant deficits in their operated versus non-operated legs in all isokinetic and hop testing variables, yet only isokinetic peak torque and timed hop time showed significant differences across male and female groups. Preliminary results are promising but further development is needed to validate other accessible technologies available to calculate reactive strength during functional testing after ACLR. Pending these developments, the effects of movement strategies, demographics, and levels of participation on RSR can then be explored to translate this simple method to clinical environments., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ripic et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Purpose: The aim of this study was to examine the impact of an 8-week high-speed circuit resistance training program (HSCT) on choriocapillaris density (CCD) in healthy older adults., Methods: Eighteen cognitively normal older adults were enrolled and randomly assigned to either the HSCT or the control group (CON). The HSCT group was comprised of 11 participants who trained three times a week for eight weeks, while the CON group consisted of 7 participants who did not engage in formal training. Optical coherence tomography angiography (OCTA) was employed to image both eyes of each subject at baseline and at the 8-week follow-up. The choriocapillaris density (CCD) of 2.5 mm in diameter centered on the fovea was measured., Results: The average age of the HSCT group was 70.3 ± 5.7 years, which was not different from the CON group (average age: 71.6 ± 5.2 years, p  = 0.62). There were no significant changes in CCD between baseline and the 8-week follow-up in either the HSCT or the CON group-specifically, the baseline CCD in the HSCT group was 63.3% ± 5% (Mean ± SD), which did not differ significantly from the 8-week follow-up after HSCT training (64.7% ± 4%, p  = 0.19). Likewise, there was no significant difference in CCD between baseline and the 8-week follow-up in the CON group (63.3% ± 3% and 62.7% ± 5%, respectively, p  = 0.66)., Conclusion: CCD appeared to remain stable after 8 weeks of HSCT in healthy older individuals, possibly due to autoregulation. Further research with extended training may be necessary to verify these findings.

Abstract: Calaway, CC, Martinez, KJ, Calzada Bichili, AR, Caplan, JH, Milgrim, WP, Mann, JB, Haq, I, and Signorile, JF. Velocity-based training affects function, strength, and power in persons with Parkinson's disease. J Strength Cond Res XX(X): 000-000, 2024-Velocity-based training (VBT) is commonly associated with high-level athletes. No study has examined the effects of VBT on performance in persons with Parkinson's disease (PD). The objective of the study was to compare the effects of 10 and 30% velocity-loss threshold protocols on changes in functional performance, strength, and power in persons with PD after 12 weeks of supervised VBT, 3 days per week. Twenty-one subjects with PD (72.9 ± 5.9 y) were randomly assigned to the 10% or 30% velocity-loss threshold group and performed the 6-m walk test at habitual and maximal gait speed (6MWTMax), the 5 time sit-to-stand test (5 × STS), 1 repetition maximum (1RM), and peak power (PP) testing for the chest press (CP) and leg press (LP) exercise. A mixed ANOVA with significance was set a priori at 0.05 revealed that significant time effects were seen for the 6MWT at maximal speed (MDiff ± SD = 0.22 ± 0.04 m·s-1, p < 0.001), 5-time sit-to-stand time (-1.48 ± 0.45 seconds, p = 0.005) and power (75.5 ± 22.7 W, p = 0.005), 1RM for CP (5.1 ± 1.1 kg, p < 0.001) and LP (12.6 ± 3.7 kg, p = 0.005), and LP-PP (43.6 ± 13.2 W, p = 0.006). Secondary analyses revealed time effects for the load at which PP was achieved for the CP exercise. A Wilcoxon signed-rank test revealed no significant differences in the percentage of 1RM at which PP was achieved for either condition. Results indicate that VBT is an effective training modality for improving functional capacity, strength, and power in persons with PD; however, shifts in force-velocity relationships were not evidenced., (Copyright © 2024 National Strength and Conditioning Association.)

Abstract: Calaway, C, Mishra, S, Parrino, R, Martinez, KJ, Mann, JB, and Signorile, JF. Velocity-based training affects the load-velocity relationship in leg press and chest press for older persons. J Strength Cond Res 38(6): 1136-1143, 2024-This study examined the impact of 3 months of velocity-based training (VBT) on chest press (CP) and leg press (LP) maximal strength (1 repetition maximum [1RM]), peak power (PP), and percentage load where PP was achieved (%1RMPP) in older adults. Twenty-nine subjects were assigned to either a velocity-deficit (VD) group or a force-deficit (FD) group for each exercise depending on their load-velocity (LV) curves. Changes in load were determined by the ability to maintain either 90% (VD) or 70% (FD) of their PP during training. Subjects' powers were tested before and after the training intervention at loads between 40 and 80%1RM. Separate 2 (group) × 2 (time) ANOVA was used to examine changes in each variable by group for each exercise. Wilcoxon signed-rank tests were used to determine whether significant changes in %1RMPP for each exercise and group. For chest press 1 repetition maximum, there were no significant main effects or interaction. Significant main effects for time were observed for leg press 1 repetition maximum ( p < 0 .001, η2 = 0.547) and chest press peak power ( p = 0.009, η2 = 0.243). For LPPP, there were no significant main effects or interactions. For %1RMPP, CP median scores revealed no significant changes for either group. Significant declines in %1RMPP were observed for leg press velocity-deficit and leg press force-deficit ( p < 0.03) groups. Velocity-based training was effective at improving 1RM, PP, and shifting %1RMPP in the LP groups. These results have implications for targeting power improvements at specific areas of the LV curve. Health care providers and trainers should consider these findings when constructing exercise programs to counter age-related declines in older adults., (Copyright © 2024 National Strength and Conditioning Association.)

Abstract: Parrino, RL, Martinez, KJ, Konlian, JA, Conti, JM, and Signorile, JF. Leg press and chest press power normative values by half decade in older women. J Strength Cond Res 38(5): 991-998, 2024-Neuromuscular power is essential for the performance of most activities of daily living and the maintenance of functional independence throughout the aging process. Power declines rapidly in later life; however, this decline may be reduced or delayed with early detection and intervention. Therefore, this study provides leg press and chest press power normative values for older women. Women's power data for this analysis included 229 participants, 60-90 years of age. Power testing was conducted on Keiser A420 pneumatic leg press and chest press machines following a standardized protocol. Data were stratified into half-decade age groups and analyzed using a 1-way ANOVA. Descriptive statistics and quartile rankings are reported, and significant differences between age groups are outlined. There were significant differences in absolute and relative leg press peak power between the age groups ( p < 0.05). However, there were no significant differences in absolute or relative chest press peak power between the age groups. This research established normative values and quartile rankings for leg press and chest press power in older women 60-90 years of age, allowing comparative evaluations with patients and subjects by clinicians and researchers, respectively. These values should improve exercise interventions designed to improve power production by providing assessments of subjects' current status and allowing comprehensive monitoring of progress., (Copyright © 2023 National Strength and Conditioning Association.)

Purpose: To determine the changes in retinal microvascular density after a 24-week high-speed circuit resistance training program (HSCT) in healthy older adults., Methods: Thirty healthy older adults were recruited and randomly assigned to either a training group (HSCT) or a non-training (CON) group. Fifteen subjects (age 73.3 ± 7.76 yrs) in the HSCT group exercised three times per week on non-consecutive days for 24 weeks. Fifteen subjects in the CON group (age 72.2 ± 6.04 yrs) did not have formal physical training. Both eyes of each subject were imaged using optical coherence tomography angiography (OCTA) at baseline and at the 24-week follow-up. The vessel densities of the retinal vascular network (RVN), superficial vascular plexus (SVP), and deep vascular plexus (DVP) were measured., Results: There were no demographic differences between the study groups. There were significant decreases in the retinal vessel densities of RVN, SVP and DVP in the HSCT group (P < 0.05). However, there were no significant changes in all three vascular measurements in the CON group (P > 0.05), although the changes showed a decreasing trend. The decreased vessel densities were doubled in the HSCT group in comparison to the CON group. However, the differences between groups did not reach a significant level (P > 0.05)., Conclusions: This is the first study to reveal the decreased retinal vessel densities as a possible imaging marker for the beneficial effects of the 24-week HSCT program in older adults., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Both partial- and full-thickness quadriceps tendon (QT) graft harvests are used for anterior cruciate ligament reconstruction (ACLR)., Purpose: To evaluate the impact of QT graft harvest depth (full or partial thickness) on electromechanical delay (EMD), peak torque (PT), and rate of torque development (RTD) after ACLR., Study Design: Controlled laboratory study., Methods: A total of 26 patients who underwent either partial-thickness (n = 14) or full-thickness (n = 12) autograft QT ACLR were recruited between June and November 2021 (>1 year before participation). Patients performed isokinetic knee extension testing with surface electromyography of the quadriceps muscles. Mixed repeated-measures analysis of variance with least significant difference post hoc testing was used to determine significant differences (mean difference [MD] ± SE) or interactions for all variables., Results: A significant speed×depth interaction was seen for the vastus medialis ( P = .005). Pairwise analyses showed significantly longer EMD for the partial-thickness graft than the full-thickness graft (MD ± SE, 19.92 ± 6.33 ms; P = .006). In the partial-thickness graft, the EMD was significantly longer at 90 deg/s versus 180 deg/s (MD ± SE, 19.11 ± 3.95 ms; P < .001) and 300 deg/s (MD ± SE, 16.43 ± 5.30 ms; P = .006). For PT, the full-thickness graft had a significantly lower PT on the operated versus nonoperated side at all speeds (MD ± SE: 90 deg/s, -57.0 ± 10.5 N·m, P < .001; 180 deg/s, -26.0 ± 10.2 N·m, P = .020; 300 deg/s, -20.3 ± 8.9 N·m, P = .034). For RTD, the full-thickness graft showed significantly Slower RTD for the operated versus nonoperated side at all time points (MD ± SD: RTD 0-25 (0-25% of the range of motion), -131.3 ± 50.9 N·m/s, P = .018; RTD 25-50 , -197.0 ± 72.5 N·m/s, P = .014; RTD 50-75 , -113.3 ± 39.8 N·m/s, P = .013; RTD 75-100 , -149.4 ± 35.9 N·m/s, P < .001)., Conclusion: Compared with partial-thickness QT, full-thickness QT showed a shorter vastus medialis EMD at higher loading, and therefore greater stiffness, as well as slower RTD and lower PT across all testing speeds., Clinical Relevance: The impact of full-thickness QT autograft on EMD and neuromuscular performance should be considered for ACLR., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: M.G.B. has received education payments from Southern Edge Orthopaedics, consulting fees from Arthrex and LifeNet Health, nonconsulting fees from Arthrex, and hospitality payments from Smith & Nephew. L.D.K. has received education payments from Southern Edge Orthopaedics, nonconsulting fees from Arthrex, and royalties from Arthrex and Smith & Nephew. T.M.B. has received consulting fees from Bioventus and hospitality payments from GE Healthcare. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2023.)

Vision-based methods using RGB inputs for human pose estimation have grown in recent years but have undergone limited testing in clinical and biomechanics research areas like gait analysis. The purpose of the present study was to compare lower extremity kinematics during overground gait between a traditional marker-based approach and a commercial multi-view markerless system in a sample of subjects including young adults, older adults, and adults diagnosed with Parkinson's disease. A convenience sample of 35 adults between the age of 18-85 years were included in this study, yielding a total of 114 trials and 228 gait cycles that were compared between systems. A total of 30 time normalized waveforms, including three-dimensional joint centers, segment angles, and joint angles were compared between systems using root mean-squared error (RMSE), range of motion difference (ΔROM), Pearson correlation coefficients (r), and interclass correlation coefficients (ICC). RMSEs for joint center positions were less than 28 mm in all joints with correlations indicating good to excellent agreement. RMSEs for segment and joint angles were in range of previous results, with highest agreement between systems in the sagittal plane. ΔROM differences were within reference values that characterize clinical groups like Parkinson's disease, stroke, or knee osteoarthritis. Further improvements in pelvis tracking, markerless keypoint model definitions, and standardization of comparison study protocols are needed. Nevertheless, markerless solutions seem promising toward unrestricted motion analysis in biomechanics research and clinical settings., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Video-based motion analysis systems are emerging in the biomechanics research community, yet there is limited exploration of kinetics prediction using RGB-markerless kinematics and musculoskeletal modeling. This project aimed to provide ground reaction force (GRF) and ground reaction moment (GRM) predictions during over-ground gait by introducing RGB-markerless kinematics into a musculoskeletal modeling framework. Full-body markerless kinematic inputs and musculoskeletal modeling were used to obtain GRF and GRM predictions which were compared to measured force plate values. The markerless-driven predictions yielded average root mean-squared error (RMSE) in the stance phase of 0.035 ± 0.009 N∙BW -1 , 0.070 ± 0.014 N∙BW -1 , and 0.155 ± 0.041 N∙BW -1 in the mediolateral (ML), anteroposterior (AP), and vertical (V) GRFs. This was accompanied by moderate to high correlations and interclass correlation coefficients (ICC) indicating moderate to good agreement between measured and predicted values (95% Confidence Inervals: ML = [0.479, 0.717], AP = [0.714, 0.856], V = [0.803, 0.905]). For ground reaction moments (GRM), average RMSE was 0.029 ± 0.013 Nm∙BWH -1 , 0.014 ± 0.005 Nm∙BWH -1 , and 0.005 ± 0.002 Nm∙BWH -1 in the sagittal, frontal, and transverse planes. Pearson correlations and ICCs indicated poor agreement between systems for GRMs (95% Confidence Intervals: Sagittal = [0.314, 0.608], Frontal = [0.006, 0.373], Transverse = [0.269, 0.570]). Currently, RMSE is larger than target thresholds set from studies using Kinect, inertial, or marker-based kinematic drivers; but methodological considerations highlighted in this work may help guide follow-up iterations. At this point, further use in research or clinical practice is cautioned until methodological considerations are addressed, although results are promising at this point., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Markerless motion capture methods are continuously in development to target limitations encountered in marker-, sensor-, or depth-based systems. Previous evaluation of the KinaTrax markerless system was limited by differences in model definitions, gait event methods, and a homogenous subject sample. The purpose of this work was to evaluate the accuracy of spatiotemporal parameters in the markerless system with an updated markerless model, coordinate- and velocity-based gait events, and subjects representing young adult, older adult, and Parkinson's disease groups. Fifty-seven subjects and 216 trials were included in this analysis. Interclass correlation coefficients showed excellent agreement between the markerless system and a marker-based reference system for all spatial parameters. Temporal variables were similar, except swing time which showed good agreement. Concordance correlation coefficients were similar with all but swing time showing moderate to almost perfect concordance. Bland-Altman bias and limits of agreement (LOA) were small and improved from previous evaluations. Parameters showed similar agreement across coordinate- and velocity-based gait methods with the latter showing generally smaller LOAs. Improvements in spatiotemporal parameters in the present evaluation was due to inclusion of keypoints at the calcanei in the markerless model. Consistency in the calcanei keypoints relative to heel marker placements may improve results further. Similar to previous work, LOAs are within boundaries to detect differences in clinical groups. Results support the use of the markerless system for estimation of spatiotemporal parameters across age and clinical groups, but caution should be taken when generalizing findings due to remaining error in kinematic gait event methods., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: To determine the retinal capillary function (RCF, the efficiency of blood flow transferring in the capillary network) and its relation to cognitive function in healthy older people without known cognitive impairment following an 8-week high-speed circuit resistance training program (HSCT)., Methods: Eleven subjects in the HSCT group and 7 age-matched nontraining controls (CON) were recruited. The HSCT group trained 3 times per week for 8 weeks, whereas CON performed no formal training. One eye of each subject from both groups was imaged at baseline and 8-week follow-up. Retinal blood flow (RBF) was measured using a retinal function imager, and retinal capillary density (RCD, expressed as fractal dimension Dbox) was measured using optical coherence tomography angiography. RCF was defined as the ratio of RBF to RCD. Cognitive function was assessed during both visits using the NIH Toolbox Fluid Cognition Battery., Results: RCF was 2.07 ± 0.64 nL⋅s -1 ·Dbox -1 (mean ± SD) at baseline, and significantly increased to 2.59 ± 0.54 nL⋅s -1 ·Dbox -1 after training ( P = 0.0003) in the HSCT group, reflecting an increase of 25%. The changes of RBF were not related to the changes of RCD in the HSCT group (r = -0.18, P = 0.59). There was no significant change of RCF in the CON group ( P = 0.58). In the HSCT group, the Pattern Comparison Processing Speed Test and Fluid Cognition Composite Score were significantly increased after HSCT ( P = 0.01). Furthermore, the changes in Flanker Inhibitory Control and Attention Test (FLNK) were positively correlated to increases in RCF (r = 0.77, P = 0.005)., Conclusions: This is the first prospective study to demonstrate that the increased RCF after HSCT was related to improved cognition in cognitively normal older adults., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 by North American Neuro-Ophthalmology Society.)

Abstract: Ly, A, Strand, KL, Courtney, KJ, Barry, SS, Liscano, JA, Trebotich, TL, Martin-Diala, C, Martin, E, and Signorile, JF. Reliability of gallon-jug shelf-transfer test power equations in older women. J Strength Cond Res 37(5): 1124-1130, 2023-This study examined the test-retest reliability of the gallon-jug shelf-transfer (GJST) test as a measure of upper-body functional power in older women. Although the validity of the predictive equations for power during the GJST test has been established, for the test to be viable in either a laboratory or clinical environment, between-day and within-day reliability must be established. Thirty-four independently living older women (mean ± SD : 75.0 ± 6.4 years) performed 2 sets of 3 repetitions of the GJST test on 2 days separated by at least 48 hours. Using the established predictive equations, the values for peak power and average power were then computed. Statistical analyses to assess reliability included intraclass correlation coefficient, coefficient of variation (CV), SEM , minimal detectable change (MDC), and Cronbach's α values. Furthermore, Bland-Altman plots evaluated the agreement between the tests. Intraclass correlation coefficient (>0.91, p < 0 001), CV (<8.1%), SEM (<5.94 W), MDC (<14 W), and Cronbach's α (>0.95) indicated excellent reliability. The lines of equality for all Bland-Altman plots fell within the 95% confidence interval of the mean difference, implying that there were no significant differences between tests. Furthermore, bias values were small (<11.15 W), and the limits of agreement (LOA) were within an acceptable range. Based on our statistical analyses, the GJST test is a highly reliable assessment for determining object transfer power for healthy older women., (Copyright © 2022 National Strength and Conditioning Association.)

Background: Patients who are discharged from the intensive care unit (ICU; termed ICU survivors) often experience persistent physical impairment., Objective: The aim of this study was to explore the effects of a self-managed, music-guided exercise intervention on physical outcomes and adherence rates among ICU survivors., Methods: A randomized controlled design was used. Following ICU discharge, participants admitted to the ICU for at least 5 days were randomly assigned to a music group ( n = 13) or an active control group ( n = 13). Activity counts were measured using an Actiwatch, and the physical health score was measured using the Patient-Reported Outcomes Measurement Information System global health subscale. Adherence to exercise was documented daily. Independent t -tests were used for data analysis., Results: Data were analyzed for 26 participants. The mean age was 62.8 ± 13.8 years, 53.8% were male, 65.4% were White, and mean Acute Physiology and Chronic Health Evaluation severity of illness score was 59 ± 23.4. Global health physical scores were significantly higher in the music group than in the active control group. Although not significantly different, music group participants tended to be more active and had higher physical activity and adherence rates compared to those in the active control group., Conclusion: A self-managed, music-guided exercise intervention demonstrated positive benefits on physical outcomes. Future clinical trials with a larger sample size should be conducted to examine the effects of this tailored, cost-effective, innovative, self-managed exercise intervention among ICU survivors., Competing Interests: The authors have no conflicts of interest to report., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Strand, KL, Ly, AS, Barry, SS, Liscano, JA, Trebotich, TL, Martin-Diala, C, Martin, E, and Signorile, JF. Validity and reliability of the seated medicine ball throw as a measure of upper body power in older women. J Strength Cond Res 37(4): 902-908, 2023-In women, aging is associated with diminishing upper body power, which may increase the risk of falls and fall-related injury; however, the validity and reliability of clinical tests to evaluate upper body power need to be confirmed. The seated medicine ball throw (SMBT) is an upper body performance test used to monitor muscle function among older individuals. The purpose of this study was to evaluate the validity and test-retest reliability of the SMBT in older women. Thirty-five women (age = 75.15 ± 6.39 years) participated in this study. Subjects performed SMBT trials using common ball masses (SMBT 4lb and SMBT 3kg ) over 3 sessions. Familiarization with the SMBT and chest press 1 repetition maximum (CP 1RM ) was provided on the first day. On day 2, subjects repeated the tests, but data were recorded. On day 3, SMBT was retested followed by an evaluation of chest press peak power (CP PP ) values at 30-80% of CP 1RM . Significant correlations ( p ≤ 0.05) were found between the CP PP and SMBT 4lb ( r = 0.775, p < 0.001) and SMBT 3kg ( r = 0.734, p < 0.001), and SMBT distance showed expected declines with age ( r = -0.724 to -0.626, p < 0.001), demonstrating its validity. High reliability between testing days was found, and Bland-Altman plots showed few points that fell outside the limits of agreement. In conclusion, the SMBT is a valid and highly reliable tool that can be used by health professionals to monitor deficits in upper body muscular power to improve treatment protocols in older women., (Copyright © 2022 National Strength and Conditioning Association.)

Background: Anterior cruciate ligament reconstruction (ACLR) using the quadriceps tendon is an increasingly popular technique. Both partial-thickness quadriceps tendon (PT-Q) and full-thickness quadriceps tendon (FT-Q) graft depths are employed., Hypothesis/purpose: This study was designed to assess isokinetic peak torque, average power, and total work during knee extension in patients with FT-Q or PT-Q grafts for ACLR. We hypothesized that both groups would show lower isokinetic values for the operated side, with greater deficits in the FT-Q group than in the PT-Q group., Study Design: Cohort study; Level of evidence, 3., Methods: A total of 26 patients who underwent ACLR with either an FT-Q or PT-Q graft were recruited between June 2021 and November 2021. Patients underwent isokinetic knee extension testing at > 1 year after surgery. Mixed repeated-measures analysis of covariance with least square difference post hoc testing was used to determine significant differences or interactions for all variables., Results: Peak torque was significantly lower for the operated limb than the nonoperated limb in the FT-Q group (mean difference [MD] ± standard error [SE], -38.6 ± 8.3 Nċm [95% CI, -55.7 to -21.5 Nċm]; P < .001; d = 0.90) but not in the PT-Q group (MD ± SE, -7.3 ± 7.7 Nċm [95% CI, -23.2 to 8.5 Nċm]; P = .348; d = 0.20). Similarly, average power for the operated limb was lower than that for the nonoperated limb in the FT-Q group (MD ± SE, -53.6 ± 13.4 W [95% CI, -81.3 to -26.9 W]; P < .001; d = 0.88) but not in the PT-Q group (MD ± SE, -4.1 ± 12.4 W [95% CI, -29.8 to 21.5 W]; P = .742; d = 0.07), and total work was lower for the operated limb compared with the nonoperated limb in the FT-Q group (MD ± SE, -118.2 ± 27.1 J [95% CI, -174.3 to -62.2 J]; P < .001; d = 0.96) but not in the PT-Q group (MD ± SE, -18.3 ± 25.1 J [95% CI, -70.2 to 33.6 J]; P = .472; d = 0.15)., Conclusion: The FT-Q group showed significant deficits in the operated limb compared with the nonoperated limb for all isokinetic variables. In contrast, no significant differences were found between the nonoperated and operated limbs for the PT-Q group.

Gait analysis is used in research and clinical environments; yet several limitations exist in current methodologies. Markerless systems, utilizing high-speed video and artificial intelligence, eliminate most limitations encountered in marker-, depth-, or inertial sensor-based systems; however, further development is needed to improve their utility and accessibility in practice. Spatiotemporal parameters from 22 young adults were estimated during over-ground gait. Nine parameters were calculated using events determined from force plate information combined with foot segment tracking and from motion of the foot relative to the sacrum using marker-based and markerless tracking. Two-way mixed effects, single measurement, absolute agreement and relative consistency interclass correlation coefficients, Bland-Altman bias and limits of agreement, and Lin's concordance correlations were used to examine the validity of parameters from markerless tracking compared to parameters calculated from gait event methods using force plates and marker-based tracking. Gait speed, stride length, step length, cycle time, and step time from the markerless system all showed strong agreement with the force plate method. Other markerless-determined parameters were not as accurate. Differences in stride width are attributable to inconsistencies in foot segment definitions between models; while differences in stance time, swing time, and double limb support time were influenced by gait event methods. Mean differences in gait parameters were smaller than meaningful clinical differences in Parkinson's disease patients and within ranges of reference values for elderly subjects. Further studies are needed to determine the validity across other patient groups, but results support the continued development of markerless systems for over-ground gait analysis., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Given the aging of the population worldwide, to learn the underlying age-related biological phenomena is important to improve the understanding of the ageing process. Neurodegeneration is an age-associated progressive deterioration of the neuron. Retinal neurodegeneration during aging, such as the reduction in thickness of the retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) measured by optical coherence tomography (OCT), has been reported, but no studies have provided their specific alteration patterns with age. Therefore, this study is to provide visualization of the evolution of various tomographic intraretinal layer thicknesses during aging and to document age-related changes in focal thickness., Methods: A total 194 healthy subjects were included in this cross-sectional study. The subjects were divided into four age groups: G1, <35 years; G2, 35-49 years; G3, 50-64 years; and G4 ≥65 years. One eye of each subject was imaged using a custom-built ultrahigh-resolution optical coherence tomography (UHR-OCT). Volumetric data centered on the fovea were segmented to obtain the thickness maps of six intraretinal layers, including the macular retinal nerve fiber layer (mRNFL) and GCIPL., Results: There were alterations visualized in thickness maps in these intraretinal layers. The GCIPL showed a thickness reduction localized in the inner annulus in elder subjects (G4). Within the inner annulus, the most profound alteration in G4, an oval zone (length 0.76 mm and width 0.52 mm), appeared to be in the inferior sector about 0.61 mm below the fovea, named "A zone". The average thickness reduction of the A zone was 14.4 µm in the elderly group (G4). Age was significantly related to the GCIPL thickness of the inner annulus (ρ =-0.48; P<0.001) and of the A zone (ρ =-0.39, P<0.001)., Conclusions: This is the first study to apply UHR-OCT for visualizing the age-related alteration of intraretinal layers in a general population. The most profound change of the optic nerve fiber is an oval-like focal thinning in GCIPL, which occurred in the inferior sector within the inner annulus and was strongly related to increased age., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-21-860/coif). The authors have no conflicts of interest to declare., (2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

The incidence of anterior cruciate ligament injury and reconstruction (ACLR) may set the stage for the development of early onset osteoarthritis in these patients. Development of accessible quantitative motion capture methodologies for recurrent monitoring of knee joint loading during daily activities following ACLR is necessary. This study aimed to compare lower extremity kinetics between ACLR affected limbs, ACLR unaffected limbs, and dominant limbs of healthy control subjects during over-ground gait and stair ascent using a single depth sensor-driven musculoskeletal modeling approach. No meaningful differences were found between groups during over-ground gait in any kinetic variables. When subjected to a stair ascent task, both ACLR limbs showed greater hip extension and internal rotation moments compared to control subjects at approximately 72-79% stance. This was coincident with greater knee flexion moments in both ALCR limbs compared to control. The absence of differences during over-ground gait but presence of compensatory strategies during stair ascent, suggests task dependent recovery in this cohort who were tested at least 1-year following surgery. Importantly, this was determined using a portable low-cost motion capture method which may be attractive to professionals in sports medicine for recurrent monitoring following ACLR., (Copyright © 2022 IPEM. Published by Elsevier Ltd. All rights reserved.)

ObjectiveThe objective of this study was to evaluate effects of a self-managed music-guided exercise intervention on muscle strength among intensive care unit (ICU) survivors. Methods We used a two-arm randomized-controlled trial. Following ICU discharge, eligible participants were assigned to one of two groups: music group ( n = 13) or active control group ( n = 13). The music group was taught to self-manage upper and lower extremity exercise movements by listening to an individualized music-guided playlist twice daily for 5 days. The active control group was provided an exercise brochure and advised to perform the same exercises at the same intervals. Dynamometers were used to measure muscle strength. T-tests and Weighted GEE models were used for testing the intervention effect between groups. Results Twenty-six subjects were enrolled. The mean age was 62.8 ( SD = 13.8), 53.8% were male, 65.4% were Caucasian, and the mean APACHE severity of illness score was 59 ( SD = 23.4). Reasons for ICU admission were mainly cardiac and medical. The music group showed significant improvements in handgrip, plantar flexion, leg extension, elbow flexion, and shoulder adduction strengths on left and right sides. Additionally, left and right leg extensor and left plantar flexor strengths showed significant post-differences, and small to moderately large effect sizes, between the music group and control group. Conclusion These findings suggest that a music-guided exercise intervention has the potential to improve muscle strength in ICU survivors and prevent further post-ICU deterioration in ICU survivors. Future trials should build upon these preliminary findings.

Abstract: Mann, JB, Mayhew, JL, Dos Santos, ML, Dawes, JJ, and Signorile, JF. Momentum, rather than velocity, is a more effective measure of improvements in Division IA football player performance. J Strength Cond Res 36(2): 551-557, 2022-Speed, or the time to complete straight runs or agility drills, is commonly used to assess performance in collegiate American football players. However, it is common for players' speeds to plateau by the second year of eligibility, whereas their body masses continue to increase. The purpose of this study was to track change in speed, body mass, and momentum (body mass · velocity), across Division 1 football players' 4-year careers (n = 512). Complete data were derived for the 40-yd sprint (n = 82), the proagility shuttle (n = 73), and the L drill (n = 73) from the same NCAA Division 1 team over a 15-year period. Significant changes were seen for velocity between year 1 and the next 3 playing years (p < 0.05), with no differences between years 2 and 4, whereas body mass increased significantly across all playing years (p < 0.05). Further momentum increased across all years for all tests (p < 0.0001). These results indicate the importance of including changes in body mass when evaluating performances during sprints and change of direction drills. Our results also suggest that using sprint or agility drill times to evaluate playing potential across football players' collegiate careers may be ineffective and can provide players with a false and disheartening picture of their improvements across their careers. Momentum, which incorporates training-induced increases in both speed and body mass, would be a more relevant and supportive measure of players' improvements. In addition, the simple computation of this variable, using existing speed and body mass data, may be an important addition to the National Football League combine as a measure of playing potential in the professional game., (Copyright © 2021 National Strength and Conditioning Association.)

Objectives: This study aimed i) to compare relative sit-to-stand power (STS rel ) values yielded by the different equations reported in the literature; ii) to examine the associations between STS rel , derived from the equations, and age, sex, frailty and habitual gait speed (HGS); and iii) to compare the ability of the different STS rel equations to detect frailty and low HGS in older adults., Methods: 1568 participants (>65 years) were included. STS rel was calculated according to four validated equations. Frailty was assessed using the Frailty Trait Scale and HGS as the time to complete 3 m. ANOVA tests, regression analyses and receiver operator characteristic curves were used., Results: There were significant differences among the STS rel values yielded by all the equations, which were higher in men compared to women and negatively associated with age (r = -0.21 to -0.37). STS rel was positively and negative associated to HGS and frailty, respectively, in both men (r = 0.29 to 0.36 and r = -0.18 to -0.45) and women (r = 0.23 to 0.45 and r = -0.09 to -0.57) regardless of the equation used. Area under the curve values varied between 0.68 and 0.80 for Alcazar's, 0.67-0.80 for Ruiz-Cárdenas's, 0.51-0.65 for Smith's, and 0.68-0.80 for Takai's equations. Low STS rel indicated an increased probability of having both low HGS and frailty (OR [95%CI] = 1.6 to 4.5 [1.21 to 5.79]) for all equations with the exception of Smith's equations for frailty in women., Conclusions: All the equations presented adequate criterion validity, however, the Alcazar's equation showed the highest level of clinical relevance according to its ability to identify older people with frailty and low HGS., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Accurate determinations of individuals' one-repetition maximum (1RM) are critical when evaluating the effectiveness of an exercise intervention involving progressive resistance training (RT). Traditional ("bottom-up"; BT) testing methods involve progressions from low to maximal loads and are commonly used in clinical and laboratory environments. Concerns about the reliability of BT testing in certain populations suggest a different technique may be more effective. Purpose : To compare the reliability and effectiveness of traditional 1RM testing to a novel technique (TDT) involving progressive load reductions and a starting intensity equal to 130% of exercisers' estimated 1RM. Method : 70 healthy adults (age = 45.03 ± 25.64 y) with diverse RT experience were randomized into a reliability testing trial (RTT; n = 33) or an optimal method trial (OMT; n = 37). Subjects in the RTT performed either TDT or BT on 3 occasions separated by ≥ 72 hours, while subjects in the OMT performed each method once in random order on separate days. Results : No significant differences in percent coefficient of variation were observed between BT and TDT for either exercise used in the study (pneumatic seated chest press: Hedge's g = 0.25, p = .49; pneumatic recumbent leg press: Hedge's g = 0.12, p = .74). TDT was not found to produce significantly higher 1RM values than BT in any group. Conclusion : TDT does not appear to facilitate more reliable 1RM estimates than BT. Further research is needed to determine the stability of these findings across levels of exercisers' age, sex, and previous RT experience.

Abstract: Infante, MA, Harrell, GM, Strand, KL, Parrino, RL, and Signorile, JF. One repetition maximum test-retest reliability and safety using Keiser pneumatic resistance training machines with older women. J Strength Cond Res 35(12): 3513-3517, 2021-Chest press (CP) and leg press (LP) are the most common exercises used to assess strength in older persons; therefore, the reliability of these tests is critical to clinicians and researchers. Because women comprise the highest proportion of the older population, this study examined the test-retest reliability of Keiser A420 pneumatic machines during CP and LP 1 repetition maximum (1RM) testing in 23 older women on 2 separate occasions, trial 1 (T1) and trial 2 (T2), at least 72 hours apart. Significance was set at <0.05. CP1RM and LP1RM showed excellent test-retest reliability (intraclass correlation coefficient = 0.974, 0.972, respectively, p < 0.001) and low coefficients of variation (CP1RM = 5.28%; LP1RM = 6.32%). Standard error of measurement for CP1RM (0.97 kg) was lower than that of LP1RM (6.36 kg). The minimal detectable change (MDC) for the CP1RM and LP1RM was 2.69 and 17.63 kg, respectively. Bland-Altman plots revealed only 1 point outside of the 95% CI for comparison of T1 and T2 for either exercise, there was little systematic error across average values, both lines of equality fell within the limits of agreement (LOA), and the bias between T1 and T2 for both exercises was below 5% of the average 1RM. By contrast, the LOA for CP1RM and LP1RM are somewhat wide because they both exceeded their computed MDC values. Given the excellent test-retest reliability of the Keiser A420 pneumatic CP and LP machines with older women, clinicians and researchers can confidently and safely use these machines for 1RM testing after proper familiarization., (Copyright © 2021 National Strength and Conditioning Association.)

Background: Quadriceps tendon (QT) autografts are increasingly popular for anterior cruciate ligament reconstruction (ACLR). However, no study has compared QT autografts with bone-patellar tendon-bone (BTB) autografts regarding the electromechanical delay (EMD), the peak torque (PT), and the rate of force development (RFD) in the superficial quadriceps muscles (rectus femoris [RF], vastus medialis [VM], and vastus lateralis [VL])., Hypotheses: We hypothesized (1) there would be a significantly lower PT, lower RFD, and longer quadriceps EMD of the operative limb for the QT versus the BTB autograft; (2) the PT, the RFD, and the quadriceps EMD of the operative limb would be significantly depressed compared with those of the nonoperative limb, regardless of the surgical technique; and (3) there would be greater increases in the RF EMD than in the VM or the VL EMD., Study Design: Cohort study; Level of evidence, 3., Methods: A total of 34 patients (age, 18-40 years), who had undergone ACLR (QT, n = 17; BTB, n = 17) at least 1 year before testing and performed 3 perceived maximal effort isometric tests, which were time synchronized with surface electromyography (EMG) on their operative and nonoperative limbs, were included in this study. EMD, PT, and RFD data were analyzed using a 2 (limb) × 2 (graft) × 3 (repetition) mixed repeated-measures analysis of variance., Results: The EMD, the PT, and the RFD were not significantly affected by graft choice. For the VL, a significant repetition × graft × limb interaction was detected for the VL EMD ( P = .027; ηp = 0.075), with repetition 3 having longer EMD than repetition 2 (mean difference [MD], 16 milliseconds; P = .039). For the RF EMD, there was a significant repetition × limb interaction ( P = .027; ηp = 0.074), with repetition 3 being significantly longer on the operative versus the nonoperative limb (MD, 24 milliseconds; P = .004). Further, the operative limb EMD was significantly longer for repetition 3 versus repetition 2 (MD, 17 milliseconds; P = .042). For the PT, there was a significant effect for repetition ( P = .003; ηp = 0.114), with repetition 1 being significantly higher than both repetitions 2 (MD, 8.52 N·m; P = .001) and 3 (MD, 7.79 N·m; P = .031). For the RFD, significant limb ( P = .034; ηp = 0.092) and repetition ( P = .010; ηp = 0.093) effects were seen, with the nonoperative limb being significantly faster than the operative limb (MD, 23.7 N·m/s; P = .034) and repetition 1 being significantly slower than repetitions 2 (MD, -20.46 N·m/s; P = .039) or 3 (MD, -29.85 N·m/s; P = .002)., Conclusion: The EMD, the PT, and the RFD were not significantly affected by graft type when comparing QT and BTB autografts for ACLR; however, all neuromuscular variables were affected regardless of the QT or the BTB harvest., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: M.G.B. has received education payments and consulting fees from Arthrex and hospitality payments from Smith & Nephew. T.M.B. has received hospitality payments from GE Healthcare. L.D.K. has received education payments and speaking fees from Arthrex and royalties from Smith & Nephew. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2021.)

Purpose: We examined the associations between retinal microvascular density, cognition, and physical fitness in healthy older adults with no reported cognitive decline., Methods: Twenty cognitively normal older adults (age: 70.3 ± 4.6 years) were recruited. Both eyes of each subject were imaged using optical coherence tomography angiography. The vessel densities of the retinal vascular network (RVN), superficial vascular plexus (SVP), and deep vascular plexus (DVP) were measured. Cognitive function was assessed using the Mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA), while physical performance was evaluated using the total work during the YMCA cycle ergometer test (TW-YMCA). Spearman correlations (r s ) were computed between measures of retinal microvascular density, cognitive function, and physical performance., Results: The MoCA was significantly correlated to vessel density of SVD (r s  = 0.53, P = 0.02) but not RVN (r s  = 0.39, P = 0.09) and DVP (r s  = 0.02, P = 0.93). MoCA was not correlated with TW-YMCA (r s  = 0.05, P = 0.83). Retinal microvascular densities were not related to TW-YMCA (r s  = -0.05-0.18, P > 0.05). Additionally, MMSE was not related the retinal vessel densities (r s  = -0.10-0.21, P > 0.05) and TW-YMCA (r s  = -0.19, P = 0.41)., Conclusions: This is the first study to reveal the association between retinal vessel density and cognition as measured with MoCA in healthy older adults with no reported cognitive decline., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Evaluating muscular strength is vital to the application of effective training protocols that target quality of life and independence in older individuals. Resistance training is a valuable tool to improve functional capacity, strength, and power in this population; however, the lack of normative values for common lifts such as the leg press (LP) and chest press (CP) reduce its utility. This study developed age- and sex-specific normative strength values for older individuals. LP and CP 1-repetition maximum (1RM) values on Keiser A420 pneumatic machines were compiled from 445 older adults, ages 60-85y. Descriptive statistics and quartile rankings are reported, and two-way ANOVAs were conducted to determine differences between sex and age groups. There were significant sex x age group interactions for LP and CP. Men were significantly stronger than women across all age groups for both exercises (p < .01); however, the mean difference decreased with age. For men, no differences were seen among the 60-64 (237 ± 39 kg), 65-69 (223 ± 43 kg) and 70-74 (219 ± 50 kg) age groups; but the 60-64 group showed higher strength values than the 75-79 group (193 ± 52 kg) and all three groups contained higher strength values than the 80-85 group (172 ± 40 kg). Similarly, for relative strength, the 60-64 group (2.80 ± 0.53 kg·kgBM) surpassed values for all groups but the 65-69, and the 65-69 (2.70 ± 0.54 kg·kgBM) produced greater strength values than the 70-74 (2.45 ± 0.47 kg·kgBM), 75-79 (2.09 ± 0.37 kg·kgBM) and 80-85 (2.19 ± 0.38 kg·kgBM) groups. In contrast, no significant differences in absolute or relative strength were seen among age groups for the women. Our study establishes absolute and relative age- and sex-specific normative values for the LP1RM and CP1RM in older individuals. These values allow practitioners and researchers to interpret the results of various interventions, and evaluate their importance to evaluation of sarcopenia, injury risk, functional mobility and quality of life. Additionally, our results reveal that age-related declines in strength are prominent for male LP and CP, but not female CP or LP., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Abstract: Strand, KL, Cherup, NP, Totillo, MC, Castillo, DC, Gabor, NJ, and Signorile, JF. Periodized resistance training with and without functional training improves functional capacity, balance, and strength in Parkinson's disease. J Strength Cond Res 35(6): 1611-1619, 2021-Periodized progressive resistance training (PRT) is a common method used to improve strength in persons with Parkinson's disease (PD). Many researchers advocate the addition of functional training to optimize translation to activities of daily living; however, machine-based PRT, using both force and velocity training components, may elicit similar benefits. Thirty-five persons with PD (Hoehn and Yahr I-III) were randomized into a strength, power, and hypertrophy (SPH; n = 17) or strength, power, and functional (SP + Func; n = 18) group, training 3 times weekly for 12 weeks. Both groups performed machine-based strength and power training on days 1 and 2 each week, respectively; whereas, on day 3, SPH group performed machine-based hypertrophy training and SP + Func group performed functional training. Functional performance was tested using the timed up and go, 30-second sit-to-stand (30-s STS), gallon-jug shelf-transfer, and seated medicine ball throw (SMBT) tests. Balance (Mini-BESTest), strength, motor symptoms (UPDRS-III), quality of life, and freezing of gait (FOG) were also assessed. Repeated measures analysis of variance revealed a main effect for time (p ≤ 0.05) with significant improvements for the sample in the 30-s STS (p = 0.002), SMBT (p = 0.003), Mini-BESTest (p < 0.001), upper-body strength (p = 0.002) and lower-body strength (p < 0.001). A significant group × time interaction was seen for FOG, with SP + Func alone showing improvement (p = 0.04). Furthermore, the SPH group produced a clinically important difference for the UPDRS-III (mean difference = 4.39, p = 0.18). We conclude that both exercise strategies can be equally effective at improving functional capacity, balance, and muscular strength in individuals with PD. In addition, FOG and motor symptoms may be targeted through SP + Func and SPH, respectively. The results provide options for individualized exercise prescriptions., (Copyright © 2021 National Strength and Conditioning Association.)

Abstract: Mann, JB, Bird, M, Signorile, JF, Brechue, WF, and Mayhew, JL. Prediction of anaerobic power from standing long jump in NCAA Division IA football players. J Strength Cond Res 35(6): 1542-1546, 2021-Despite the popularity of the standing long jump (SLJ), limited research has explored the estimation of power developed during this test. The purpose of this study was to determine SLJ power from jump distance and selected anthropometric measures in NCAA Division IA football players. Height (Ht), body mass (Wt), thigh length, and lower leg length (LL) were measured in 58 players, allowing calculation of leg ratios of thigh length·Ht-1, LL·Ht-1, and TL·SL-1. Players performed 2-3 maximal familiarization trials of SLJ followed by 2 maximal jumps from a 3-dimension force plate sampling at 1,000 Hz. Standing long jump distance (intraclass correlation coefficient [ICC] = 0.944) and power (ICC = 0.926) calculated from resultant force and velocity vectors were highly reliable. Standing Ht (r = 0.40), Wt (r = 0.36), lower leg length (r = 0.43), total leg length (thigh + LLs) (r = 0.38), and best SLJ (r = 0.52) were significantly related (p < 0.05) to peak power, but none accounted for more than 27% of the common variance. Step-wise multiple regression identified SLJ and body mass as the only significant variables necessary to predict peak power (Power [W] = 32.49·SLJ [cm] + 39.69·Wt [kg] - 7,608, R = 0.86, SEE = 488 W, CV% = 9.3%). Standing long jump contributed 56.8% to the known variance, whereas Wt contributed 43.2%. Thus, a combination of SLJ and Wt can be used to effectively estimate explosive power in Division IA college football players., (Copyright © 2021 National Strength and Conditioning Association.)

Background: Alzheimer disease (AD) is a heterogeneous and multifactorial disorder with an insidious onset and slowly progressive disease course. To date, there are no effective treatments, but biomarkers for early diagnosis and monitoring of disease progression offer a promising first step in developing and testing potential interventions. Cerebral vascular imaging biomarkers to assess the contributions of vascular dysfunction to AD are strongly recommended to be integrated into the current amyloid-β (Aβ) [A], tau [T], and neurodegeneration [(N)]-the "AT(N)" biomarker system for clinical research. However, the methodology is expensive and often requires invasive procedures to document cerebral vascular dysfunction. The retina has been used as a surrogate to study cerebral vascular changes. There is growing interest in the identification of retinal microvascular changes as a safe, easily accessible, low cost, and time-efficient approach to enhancing our understanding of the vascular pathogenesis associated with AD., Evidence Acquisition: A systemic review of the literature was performed regarding retinal vascular changes in AD and its prodromal stages, focusing on functional and structural changes of large retinal vessels (vessels visible on fundus photographs) and microvasculature (precapillary arterioles, capillary, and postcapillary venules) that are invisible on fundus photographs., Results: Static and dynamic retinal microvascular alterations such as retinal arterial wall motion, blood flow rate, and microvascular network density were reported in AD, mild cognitive impairment, and even in the preclinical stages of the disease. The data are somewhat controversial and inconsistent among the articles reviewed and were obtained based on cross-sectional studies that used different patient cohorts, equipment, techniques, and analysis methods., Conclusions: Retinal microvascular alterations exist across the AD spectrum. Further large scale, within-subject longitudinal studies using standardized imaging and analytical methods may advance our knowledge concerning vascular contributions to the pathogenesis of AD., Competing Interests: The authors report no conflicts of interest., (Copyright © 2020 by North American Neuro-Ophthalmology Society.)

Purpose: To determine the retinal tissue perfusion (RTP) and its relation to cognitive function in healthy older people after an 8-week high-speed circuit resistance training program (HSCT)., Methods: Eleven subjects in the HSCT group and seven age-matched non-training controls (CON) were recruited. The HSCT group trained 3 times per week for 8 weeks, while CON performed no formal training. One eye of each subject in both groups was imaged at baseline and at an 8-week follow-up, using a Retinal Function Imager to measure retinal blood flow (RBF). Retinal tissue perfusion (RTP) was calculated as RBF divided by the corresponding tissue volume. Cognitive function was assessed during both visits using the NIH Toolbox Fluid Cognition Battery., Results: RTP was 2.99 ± 0.91 nl·s -1 ·mm -3 (mean ± SD) at baseline and significantly increased to 3.77 ± 0.86 nl·s -1 ·mm -3 after training (P < 0.001) in the HSCT group, reflecting an increase of 26%. In the HSCT group, the Pattern Comparison Processing Speed Test (PAT) and Fluid Cognition Composite Score (FCS) were significantly increased after HSCT (P = 0.01). Furthermore, the changes in Flanker Inhibitory Control and Attention Test (FLNK) were positively correlated to increases in RTP (r = 0.80, P = 0.003)., Conclusions: This is the first prospective study to demonstrate that the increased RTP after HSCT was related to improved cognition in cognitively-normal elders, indicating RTP could be an imaging marker for monitoring cognitive changes due to physical activity in the elderly., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: The effect of a peritransplant multidirectional walking intervention to target losses in physical function and quality of life (QOL) has not been investigated., Purpose: This study examined the effects of a novel multidirectional walking program on physical function and QOL in adults receiving a hematopoietic stem cell transplant (HSCT)., Methods: Thirty-five adults receiving an autologous or allogeneic HSCT were randomized to a multidirectional walking (WALK) or usual care (CONT) group. The WALK group received supervised training during hospitalization; the CONT group received usual care. Patients were assessed at admission (t0), 3 to 5 d post-HSCT (t1), and 30 d post-HSCT (t2). Physical function measures included the 6-min walk test (6MWT), the Physical Performance Test, and the Timed Up and Go test. Health-related QOL was collected using the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) questionnaire., Results: There were no significant between-group changes for physical function or QOL. However, after the intervention (t1 to t2), the WALK group showed significant improvement in aerobic capacity (6MWT, P = 0.01), physical (P < 0.01) and functional well-being (P = 0.04), and overall QOL scores (P < 0.01). The CONT group saw no significant changes in physical function or QOL. Effect sizes showed the WALK group had a larger positive effect on physical function and QOL. Minimal clinically important differences in the 6MWT and FACT-BMT were exceeded in the WALK group., Conclusion: A multidirectional walking program during the transplant period may be effective at increasing aerobic capacity and QOL for patients receiving HSCT compared with no structured exercise., (Copyright © 2020 by the American College of Sports Medicine.)

This study compared the effectiveness of two proprioceptive exercise programs for persons diagnosed with Parkinson's disease (PD). Thirty-three patients with mild to moderate PD were randomly assigned to a yoga meditation program (YoMed) or to an established proprioceptive training program (PRO). Both interventions included twice weekly sessions (45 minutes each), spanning a 12-week period. Outcome measures included: joint position sense (JPS 45 °, JPS 55 °, JPS 65 °) and joint kinesthesia (JK Flex and JK Ext ), the Tinetti Balance Assessment Tool (TIN), Falls Efficacy Scale (FES), Balance Error Scoring System (BESS), dynamic posturography (DMA and TIME) and the Timed Up-and-Go Test (TUG). Test administrators were blinded to group affiliation. Significant between-group differences favoring the YoMed group were observed for TIN ( p  = 0.01, d  = 0.77) and JK Flex ( p  = 0.05, d  = -0.72). DMA and TIME scores significantly improved for both groups, and no adverse events were reported. These findings indicate that the YoMed program is safe and effective for patients with PD. Researchers should continue to examine the clinical efficacy of mind-body techniques to improve movement control and body awareness in this population.

Background: Although stair ambulation should be included in the rehabilitation of the long-term effects of ACL injury on knee function, the assessment of kinetic parameter in the situation where stair gait can only be established using costly and cumbersome force platforms via conventional inverse dynamic analysis. Therefore, there is a need to develop a practical laboratory setup as an assessment tool of the stair gait abnormalities in lower extremity that arise from an ACL deficiency., Research Question: Can the use of a single depth sensor-driven full-body musculoskeletal gait model be considered an accurate assessment tool of the ground reaction forces (GRFs) during stair climbing for patients following ACL reconstruction (ACLR) surgery?, Methods: A total of 15 patients who underwent ACLR participated in this study. GRFs data during stair climbing was collected using a custom-built 3-step staircase with two embedded force platforms. A single depth sensor, commercially available and cost effective, was used to obtain participants' depth map information to extract the full-body skeleton information. The AnyBody TM GaitFullBody model was utilized to estimate GRFs attained by 25 artificial muscle-like actuators placed under each foot. Mean differences between the measured and estimated GRFs were compared using paired samples t-tests. The ensemble curves of the GRFs were compared between both approaches during stance phase of the gait cycle., Results: The findings of this study showed that the estimation of the GRFs produced during staircase gait using a depth sensor-driven musculoskeletal model can produce acceptable results when compared to the traditional inverse dynamics modelling approach as an alternative tool in clinical settings for individuals who had undergone ACLR., Significance: The introduced approach of full-body musculoskeletal modelling driven by a single depth sensor has the potential to be a cost-effective stair gait analysis tool for patients with ACL injury., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Purpose: To characterize the changes of retinal microvascular density and their relations to cognitive function in the healthy older people without known cognitive impairment after an 8-week high-speed circuit resistance training program (HSCT)., Methods: Twenty cognitively normal older people were recruited and randomly assigned to either the HSCT group or control group (CON). Twelve subjects (age 70.8 ± 5.8 yrs) in the HSCT group trained three times per week for 8 weeks. Eight subjects in the CON group (age 71.8 ± 4.8 yrs) did not perform formal training. Both eyes of each subject were imaged using optical coherence tomography angiography (OCTA) at baseline and at 8-week follow-up. The densities of the retinal vascular network (RVN), superficial vascular plexus (SVP), and deep vascular plexus (DVP) were measured. In addition, their cognitive functions were tested using the NIH toolbox., Results: There were significant increases in pattern comparison processing speed (PAT, P = 0.02) and fluid composite score (FCS, P = 0.005) at the follow-up in the HSCT group. Although the vessel densities did not differ between visits in either group, the variation (i.e., change) in retinal vessel density of SVP was negatively related to the changes of FCS (r = -0.54, P = 0.007) and the List Sorting Working Memory test (r = -0.43, P = 0.039) in the HSCT group., Conclusions: This is the first study to reveal that the individual response of the SVD was related to the improvement in the cognition in cognitively normal older people after HSCT., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Castillo, DC, Strand, KL, Oh, J, Eltoukhy, M, Totillo, MC, and Signorile, JF. The development of a regression model to predict object transfer power in older adults. J Strength Cond Res 34(11): 3086-3093, 2020-Declines in mechanical power affect independence in older adults; however, no practical clinical method exists to assess peak power (PP) and average power (AP) during transfer tasks in this population. Therefore, predictive models were developed and validated during performance of an existing transfer assessment, the gallon-jug shelf-transfer (GJST) test. Twenty-one independent-living older women (age = 74.8 ± 5.6) and men (age = 73.8 ± 4.5) participated in the development phase. Peak power and AP were computed using data from three-dimensional movement analyses while subjects moved five 1-gallon jugs from a low (0.59 m) to high shelf (1.43 m) as quickly as possible. Stepwise linear regression models using test duration, subject height, and age produced equations with high R values for PP (0.655-0.701; p < 0.0001) and AP (0.703-0.759; p < 0.0001). However, regression and Bland-Altman analyses showed models with declining agreement as power values increased. Therefore, analyses were repeated using a quadratic model, showing stronger predictive capacity (PP: R = 0.786; AP: R = 0.878; p < 0.0001). Validity of this model was evaluated in a second sample of 30 older women (age = 69.9 ± 4.7) and men (age = 70.7 ± 4.3). Computed GJST AP and PP were compared with power produced during dominant arm chest press and distance during the seated medicine ball throw. Generalizability of these models was also confirmed through cross-validation analyses. Our results indicate mechanical power in older adults can be accurately measured using the quadratic model, with test duration as the independent variable. This model provides a simple, safe, and inexpensive assessment tool that can be administered by clinicians to improve diagnostic and therapeutic processes in older persons.

Focal intraretinal alterations have been studied to advance our understanding of the pathology of neurodegenerative diseases. The current literature involving focal alterations in the intraretinal layers was reviewed through PubMed using the search terms "focal alteration", "region of interest", "optical coherence tomography", "glaucoma", "multiple sclerosis", "Alzheimer's disease", "Parkinson disease", "neurodegenerative diseases" and other related items. It was found that focal alterations of intraretinal layers were different in various neurodegenerative diseases. The typical focal thinning might help differentiate various ocular and cerebral diseases, track disease progression, and evaluate the outcome of clinical trials. Advanced exploration of focal intraretinal alterations will help to further validate their clinical and research utility., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.

Wooten, SV, Cherup, N, Mazzei, N, Patel, S, Mooney, K, Rafiq, A, and Signorile, JF. Yoga breathing techniques have no impact on isokinetic and isoinertial power. J Strength Cond Res 34(2): 430-439, 2020-As an exercise discipline, yoga incorporates breathing (pranayama) and posture (asana) techniques to facilitate improvements in flexibility, strength, and meditation. Both techniques have been used to enhance muscular strength and power output. The purpose of this study was to determine the effects of various yoga breathing techniques on lower-limb power output. Thirty-two individuals (15 men and 17 women) participated in the study. All subjects performed a baseline 1 repetition maximum (1RM) on a pneumatic leg press machine and isokinetic testing on a Biodex 4 dynamometer. Participants then performed 3RM power tests at 50% of 1RM on the pneumatic leg press machine using 3 different yoga breathing techniques (Ujjayi, Bhastrika, and Kapalabhati) and normal breathing (control) across all repetitions. After power testing, participants completed an isokinetic test on the Biodex 4 dynamometer using their dominant leg. Subjects had their knee placed at a predetermined starting position (90°) and executed knee extension at 3 randomized testing speeds (60, 180, and 300°·s). The implementation of specific breathing protocols before and during the leg press produced no significant differences in power output. For isokinetic power measured at 60, 180, and 300°·s, there was a significant difference among testing speeds (η = 0.639; p < 0.0001) and a significant sex × speed interaction (η = 0.064; p < 0.0001), where men consistently demonstrated greater isoinertial power, isokinetic power, isokinetic torque, and isokinetic work than women. No other significant differences or interactions were detected. The differences between our study and others, which have concluded that adopting specific breathing techniques can enhance core stability and force production during lifting, may be attributable to the acute nature of the design, the novice participants who had insufficient time to practice the breathing techniques or testing protocols, and the use of tests that isolated specific muscle groups. Nonetheless, the current findings do not support the use of yoga breathing techniques as a method to enhance power output, whether used before or during power performance.

Background: Abnormalities in gait kinetics in patients with Parkinson's disease (PD) who have suffer from gait impairment have been noted using a conventional inverse dynamic analysis derived by marker-based motion capture system and force plate, which are typically mounted in the laboratory floor. Despite the high accuracy of this approach in tracking markers' trajectories and acquiring ground reaction forces (GRFs), its dependence on laboratory-mounted equipment restricts its potential use in wider variety of clinical applications., Research Question: Would a full-body musculoskeletal model driven by a single depth sensor data only produce comparable gait kinetic parameters, including GRFs and lower extremity joints moments, for elderly participants, both healthy and those diagnosed with PD?, Methods: Nine patients diagnosed with PD and 11 healthy age-matched control participants performed three over-ground gait trials. Full-body kinematic data were collected using a depth sensor and a musculoskeletal model have been constructed using AnyBody musculoskeletal modeling system to predict the three-dimensional GRFs and lower extremity joint moments. Predicted kinetic parameters for both PD and control groups were compared during the braking and propulsive phases of the gait cycle. In addition, ensemble curve analysis with 90% confidence intervals were constructed to compare between group differences across the stance phase of the gait cycle., Results: The findings of this study showed that the PD exhibited a significantly lower braking peak vertical GRF and propulsion peak horizontal GRF while no significant between-group differences were found in peak lower extremity joint moments. However, the PD showed significant alterations in lower extremity joint moments during the early and late phases of stance, which indicate a difference in ambulation strategy., Significance: The proposed method adopting full-body musculoskeletal model driven by a depth sensor data proves that it has the potential to be a portable and cost-effective gait analysis tool in the clinical setting., Competing Interests: Declaration of Competing Interest The authors confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced the outcome., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Introduction: Isoflavones, a chemical class of phytoestrogens found in soybeans and soy products, may have biological functions similar to estradiol. After binding with ERβ or perhaps independently of estrogen receptors, isoflavones may augment vascular endothelial relaxation, contributing to improved limb blood flow., Purpose: To determine if acute fermented soy extract supplementation influences 20-km time trial cycling performance and cardiac hemodynamics compared with a placebo., Methods: Subjects included 25 cyclists and triathletes (31 ± 8 yr, V˙O2peak: 55.1 ± 8.4 mL·kg·min). Each subject completed a V˙O2peak assessment, familiarization, and two 20-km time trials in randomized order after ingestion of a fermented soy extract supplement or placebo. The fermented soy extract consisted of 30 g powdered supplement in 16 fl. ounces of water. The placebo contained the same quantities of organic cocoa powder and water. Each trial consisted of 60 min of rest, 30 min at 55% Wpeak, and a self-paced 20-km time trial., Results: Soy supplementation elicited a faster time to 20-km completion (-0.22 ± 0.51 min; -13 s), lower average HR (-5 ± 7 bpm), and significantly greater power (7 ± 3 W) and speed (0.42 ± 0.16 km·h) during the last 5 km of the time trial compared with placebo. Analysis of the results by relative fitness level (<57 vs ≥ 57 mL⋅kg⋅min) indicated that those with a higher level of fitness reaped the largest performance improvement alongside a reduced HR (-5 ± 7 bpm)., Conclusions: Ingestion of a fermented soy extract supplement improved sprint-distance performance through improvements in both power and speed. For those with great aerobic fitness, soy supplementation may help to decrease cardiac demand alongside performance improvement.

Background: Declines in strength and power are cardinal symptoms of Parkinson's disease (PD), a progressive neuromuscular disorder. Progressive resistance training (PRT) has been shown to reduce a wide variety of PD-related motor deficits; however, no study has examined differences between the two most common RT methodologies utilized in this population, high-load, low velocity strength training (ST) and low-load, high-velocity power training (PT). The primary purpose of this study was to compare the effects of ST and PT on measures of strength, power, balance and functional movement in persons with PD., Method: Thirty-five persons with mild to moderate PD (Hoehm and Yahr Stages = 1-3; UPDRS Part III = 30.6 ± 14.0) were randomized into either a ST or PT group involving 12 weeks of supervised PRT (2 visits per week). Leg press (LP) and chest press (CP) muscular strength (1RM) and muscular peak power (PP) were assessed before and after the twelve week training period as primary outcome measures. In addition, secondary measures of balance (Berg Balance Assessment (BBA), dynamic posturography (DMA), Modified Falls Efficacy Scale (MFES)), functional movement (timed up-and-go), and quality of life (PDQ-39 summary index and Mobility subscore) were obtained at the same time points, given the impact of PD symptoms on fall probability and independence., Results: Repeated measures ANCOVA revealed significant improvements in LP 1RM (M diff  = 54.89 kg, 95% CI: 43.38, 66.40; p < .05; d = 3.38) and CP 1RM (M diff  = 7.33 kg, 95% CI: 4.75, 9.91; p < .05; d = 2.02). Additionally, significant improvements were seen in LP PP (M diff  = 112.27 W, 95% CI: 56.03, 168.51; p < .05; d = 1.42) and CP PP (M diff  = 52.1 W, 95% CI: 23.38, 80.86; p = .001; d = 1.29). No significant improvements were seen for any secondary outcome measures, however BBA scores were shown to significantly decrease following the intervention (M diff  = -1.686, 95% CI: -2.89, -0.482; p = .007 d = -0.96), although this change did not reach clinical significance (clinically meaningful change = ±4.0). In addition, the ST group demonstrated significantly poorer PDQ-39 SI scores (M diff  = 4.96, 95% CI: 0.54, 9.38; p = .029), whereas the entire sample showed significantly poorer PDQ-39 MOB scores (M diff  = 4.80, 95% CI: 0.17, 9.43; p = .043; d = 0.71)., Conclusions: Both ST and PT appear to be effective at reducing the neuromuscular deficits associated with PD; however, the use of these interventions for improving functional performance was not supported., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Progressive resistance training (RT) is one of the most effective interventions for reducing age-related deficits in muscle mass and functional capacity., Purpose: To compare four approaches to load progressions in RT for older adults to determine if an optimal method exists., Methods: Eighty-two healthy community-dwelling older adults (71.8 ± 6.2 yr) performed 11 wk of structured RT (2.5 d·wk) in treatment groups differing only by the method used to increase training loads. These included percent one repetition maximum (%1RM): standardized loads based on a percentage of the one repetition maximum (1RM); rating of perceived exertion (RPE): loads increased when perceived difficulty falls below 8/10 on the OMNI-Resistance Exercise Scale perceived exertion scale; repetition maximum (RM): loads increased when a target number of repetitions can be completed with a given load; repetitions in reserve (RiR): identical to RM except subjects must always maintain ≥1 "repetition in reserve," thus avoiding the possibility of training to temporary muscular failure., Results: Multiple analyses of covariance indicated no significant between-group differences on any strength (chest press 1RM; leg press 1RM) or functional performance outcome (usual walking speed, maximum walking speed, 8-ft timed up-and-go, gallon jug transfer test, 30 s sit-to-stand). The RPE group found the exercise to be significantly more tolerable and enjoyable than subjects in the RiR, RM, and %1RM groups., Conclusion: Given the RM, RPE, %1RM, and RiR methods appear equally effective at improving muscular strength and functional performance in an older population, we conclude that the RPE method is optimal because it is likely to be perceived as the most tolerable and enjoyable, which are two important factors determining older adults' continued participation in RT.

Background: Age-related decrements in power affect quality of life in older adults; however, no studies have determined the optimal loads that maximize power outputs using the most commonly employed lifting equipment, plate-loaded machines., Methods: Fifteen older men (69.2 ± 6.9 y) and 22 older women (68.9 ± 5.9 y) performed two sessions of strength and power testing. Individuals completed ten plate-loaded exercises to determine their maximum dynamic strengths (1RM) and peak power outputs (PP). Power was tested at 40, 50, 60, 70 and 80% 1RM using a linear position transducer. PP was expressed relative to the highest power produced (PP REL )., Results: Multi-joint exercises produced optimal load values at 50-60%1RM for leg press, 50%1RM for chest press, and 40-60%1RM for seated row, with no significant differences among loads for shoulder press. Single-joint exercise optimal loads were seen at 50-60% for hip adduction, 50-70%1RM for calf raise, 60-80%1RM for biceps curl, and 50-80%1RM for triceps extension, with no significant differences between loads for hip abduction or leg curl. No significant differences were found between sexes for any exercise., Conclusions: Different optimal load ranges are required for individual plate-loaded exercises in older persons. Specifically, multi-joint exercises demonstrated a narrow optimal load range favoring the velocity end of the load-velocity curve, while single-joint exercises produced a wider optimal load range extending into the upper limits of the load end of the curve., (Copyright © 2019 Elsevier Inc. All rights reserved.)