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Background. Passive mobilization of shoulder region joints, often in conjunction with other treatment modalities, is used for the treatment of people with shoulder pain and minimal movement restriction. However, there is only limited evidence supporting the efficacy of this treatment modality. Objective. The purpose of this study was to determine whether passive mobilization of shoulder region joints adds treatment benefit over exercise and advice alone for people with shoulder pain and minimal movement restriction. Design. This was a randomized controlled clinical trial with short-, medium- and longer-term follow-up. Setting. The study was conducted in a metropolitan teaching hospital. Patients. Ninety-eight patients with shoulder pain of local mechanical origin and minimal shoulder movement restriction were randomly allocated to either a control group (n=51) or an experimental group (n=47). Intervention. Participants in both groups received advice and exercises designed to restore neuromuscular control at the shoulder. In addition, participants in the experimental group received passive mobilization specifically applied to shoulder region joints. Measurements. Outcome measurements of shoulder pain and functional impairment, self-rated change in symptoms, and painful shoulder range of motion were obtained at 1, 3, and 6 months after entry into the trial. All data were analyzed using the intention-to-treat principle by repeated-measures analyses of covariance. Results. No statistically significant differences were detected in any of the outcome measurements between the control and experimental groups at short-, medium-, or longer-term follow-up. Limitations. Therapists and participants were not blinded to the treatment allocation. Conclusion. This randomized controlled clinical trial does not provide evidence that the addition of passive mobilization, applied to shoulder region joints, to exercise and advice is more effective than exercise and advice alone in the treatment of people with shoulder pain and minimal movement restriction., Shoulder pain is a common complaint, with the prevalence ranging from 20% to 33% in the adult population. (1-4) It has been reported that shoulder pain is the third most [...]

Davies, TB, Halaki, M, Orr, R, Mitchell, L, Helms, ER, Clarke, J, and Hackett, DA. Effect of set structure on upper-body muscular hypertrophy and performance in recreationally trained men and women. J Strength Cond Res36(8): 2176–2185, 2022—This study explored the effect of volume-equated traditional-set and cluster-set structures on muscular hypertrophy and performance after high-load resistance training manipulating the bench press exercise. Twenty-one recreationally trained subjects (12 men and 9 women) performed a 3-week familiarization phase and were then randomized into one of two 8-week upper-body and lower-body split programs occurring over 3 and then progressing to 4 sessions per week. Subjects performed 4 sets of 5 repetitions at 85% one repetition maximum (1RM) using a traditional-set structure (TRAD, n= 10), which involved 5 minutes of interset rest only, or a cluster-set structure, which included 30-second inter-repetition rest and 3 minutes of interset rest (CLUS, n= 11). A 1RM bench press, repetitions to failure at 70% 1RM, regional muscle thickness, and dual-energy x-ray absorptiometry were used to estimate changes in muscular strength, local muscular endurance, regional muscular hypertrophy, and body composition, respectively. Velocity loss was assessed using a linear position transducer at the intervention midpoint. TRAD demonstrated a significantly greater velocity loss magnitude (g= 1.50) and muscle thickness of the proximal pectoralis major (g= −0.34) compared with CLUS. There were no significant differences between groups for the remaining outcomes, although a small effect size favoring TRAD was observed for the middle region of the pectoralis major (g= −0.25). It seems that the greater velocity losses during sets observed in traditional-set compared with cluster-set structures may promote superior muscular hypertrophy within specific regions of the pectoralis major in recreationally trained subjects.

Background and Purpose Graduated rotation exercises performed with the arm by the side are commonly used to improve rotator cuff (RC) muscle function. The aim of this study was to compare the pattern of recruitment of the RC muscles with that of other shoulder muscles that rotate the shoulder joint during these exercises. Subjects The nondominant shoulders of 15 subjects who were healthy were tested. Methods Activity in the infraspinatus, supraspinatus, subscapularis, latissimus dorsi, pectoralis major, and posterior deltoid muscles was recorded. Low-, medium-, and high-intensity rotation exercises were performed with a pulley system. Results As the intensity of both internal and external rotation exercises increased, activity increased in a systematic manner in all muscles capable of producing rotation torque during concentric and eccentric contractions. Discussion and Conclusion The results indicate that, in people who are healthy, the motor strategy used to deal with increasing rotation resistance with the arm in a pendant position is to gradually increase activity in all shoulder rotation torque-generating muscles., The shoulder (glenohumeral) joint has a high degree of mobility to enable the hand to perform a multitude of varied tasks. (1-3) To maintain shoulder joint stability without compromising mobility, [...]

The article discusses the impact of different textiles on sleep quality and thermal comfort. It explains that bedding plays a crucial role in maintaining a comfortable temperature for sleep and that the right textiles can regulate body temperature and wick away moisture. Cotton and wool are highlighted as effective insulators and breathable fabrics, while linen provides less insulation but is suitable for keeping cool in summer. Polyester, on the other hand, is not naturally breathable and can trap sweat. The article suggests that the choice of bedding is highly individual and recommends experimenting with different textiles to find what works best. However, it also acknowledges that other factors, such as body size, climate, and bedroom temperature, can affect sleep quality. The article concludes by advising readers to seek more information from the Sleep Health Foundation if they are experiencing sleep difficulties. [Extracted from the article]

Background/aimsHigh-intensity power training has been shown to be effective in improving muscular capabilities, functional performance and health-related quality of life in populations with physical impairments. However, the effectiveness of high-intensity power training in people with Charcot–Marie–Tooth disease remains uncertain. This case series investigated the effects of high-intensity power training on muscle performance, function and health-related quality of life in middle-aged women with Charcot-Marie-Tooth disease.MethodsFour women (age 51–58 years) with Charcot–Marie–Tooth disease type 1A participated in 8 weeks of supervised high-intensity power training.ResultsAll participants improved strength of the right hip abductors (46.7–109.7%) and left hip abductors (27.3–128.6%), maximal gait speed (2.3–9.1%), static balance (0.7–4.9%), tandem walk (−3.3 to −58.5%), and mental component scores on the Short Form 36 Health Status Survey (0.8–27.6%). Adherence to high-intensity power training was 100% and only one minor adverse event related to the intervention was reported.ConclusionsAlthough promising, larger controlled studies are indicated to confirm the safety and efficacy of high-intensity progressive resistance and power training in this cohort.

Uterine artery embolisation (UAE) is regarded as a safe and effective treatment for symptomatic uterine fibroids and/or adenomyosis. Dose reduction during UAE is critical for this reproductive‐age patient population to minimise the risks of radiation‐induced effects. The aim of this study was to identify the predictors of radiation dose which can be controlled and optimised for patients during UAE. A total of 150 patients between June 2018 and August 2019 were included in this study. Demographic and clinical information such as age, body mass index (BMI), total number of fibroids, total fibroid volume, total uterus volume and dosimetric measurements on Dose Area Product (DAP), Air Kerma (AK) and fluoroscopy time were recorded. Total digital subtraction angiography (DSA), total conventional roadmap (CRM), total last‐image hold (LIH) and total fluoroscopy were calculated from the dose report. Multiple linear regression analysis was used to identify the independent predictor variables of total dose (DAP) using a regression model. Total DSA, total CRM and total LIH were identified as the determinants of dose for UAE (P< 0.05) and together accounted for 95.2% of the variance. This study identified the key imaging predictors of dose for UAE. Total DSA, total CRM and total LIH were shown to have a greater impact on the outcome DAP compared to other demographic or dosimetric measurements. Optimisation of these predictors during future UAE procedures can facilitate radiation dose reduction to the pelvis and reproductive organs. The predictors of patient radiation dose have been identified for the interventional radiology procedure known as uterine artery embolisation (UAE). A regression model entered and identified total digital subtraction angiography (DSA), total conventional roadmap (CRM) and total last‐image hold (LIH) as the determinants of dose over demographic and other angiographic variables. Control of these dose predictors can potentially minimise radiation dose exposure to this reproductive‐age patient population. Dose optimisation can be attained to reduce the risks of tissue effects and/or stochastic effects associated with irradiating the pelvis region.

Cross-sectional. An epidemiological study describing leisure time physical activities (LTPA) and the associations of barriers, sociodemographic and injury characteristics to moderate-vigorous aerobic exercise participation among individuals with spinal cord injury (SCI) in a developing Southeast Asian country. SCI community in Malaysia. The study sample consisted of 70 participants with SCI. Questionnaires were distributed containing an abbreviated Physical Activity Scale for Individuals with Physical Disabilities (items 2–6) and the Barriers to Exercise Scale using a 5-tier Likert format. Statistical analyses were χ2tests, odds ratios, and binary forward stepwise logistic regression to assess the association and to predict factors related to participation in moderate-vigorous intensity aerobic exercise (items 4 and 5). Seventy-three percent of the study sample did not participate in any form of moderate or vigorous LTPA. The top three barriers to undertaking LTPA (strongly agree and agree descriptors) were expensive exercise equipment (54%), pain (37%) and inaccessible facilities (36%). Participants over the age of 35 years, ethnicity, health concerns, perceiving exercise as difficult and indicating lack of transport were significantly different (p< 0.05) between participation and non-participation in moderate-vigorous aerobic exercise type of LTPA. Age, ethnicity, indicated health concerns and lack of transport were the significant predictors in likelihood of participating in moderate-vigorous LTPA (p< 0.1). The issues raised depicted barriers within the intrapersonal (health concerns, exercising is too difficult, pain while exercising, age more than 35), interpersonal (different ethnicity), community (expensive exercise equipment), and policy levels (lack of or poor access to transportation, inaccessible facilities) that prevent LTPA participation.

To report on the reliability and validity of a Diet Quality Index (DQI) to assess preschoolers dietary patterns using a short food frequency questionnaire (sFFQ) and 3-day food records (3d-FR). Seventy-seven preschool carers/parents completed a telephone interview on preschoolers (2–5-year olds) dietary habits in metropolitan Sydney. Agreement in scores was assessed using intraclass correlation (ICC) and paired t-tests for repeated sFFQ–DQI scores and Bland–Altman methods and paired t-tests for sFFQ–DQI and 3d-FR–DQI scores. Mean-total sFFQ–DQI ICC scores was high = 0.89, 95% CI (0.81, 0.93). There was weak agreement between sFFQ–DQI and 3d-FR–DQI scores (r= 0.36, p< 0.01). The 3d-FR–DQI scores were positively associated with carbohydrate, folate, ß-carotene, magnesium, calcium, protein, total fat and negatively associated with sugar, starch, niacin, vitamin C, phosphorus, polyunsaturated fat, and monounsaturated fat. The sFFQ–DQI demonstrated good reliability but weak validity. Associations between nutrients and 3d-FR–DQI scores indicate promising usability and warrants further investigation. Further research is needed to establish its validity in accurately scoring children’s diet quality using sFFQ compared to 3d-FR before the tool can be implemented for use in population settings.

AimTo investigate the relationship between training volume and soft tissue injury incidence, and characterise soft tissue injury in rugby union players.DesignA systematic search of electronic databases was performed. The search strategy combined terms covering: training volume and injury, and rugby union, and players of all levels.Data sourcesMedline, SPORTDiscus, Web of Science, Embase, PubMed.Eligibility criteria for selecting studiesStudies were included if they reported: male rugby union players, a clear definition of a rugby union injury, the amount of training volume undertaken by participants, and epidemiological data for soft-tissue injuries including the number or incidence.Results15 studies were eligible for inclusion. Overall match and training injury incidence ranged from 3.3 to 218.0 injuries/1000 player match hours and 0.1–6.1 injuries/1000 player training hours, respectively. Muscle and tendon as well as joint (non-bone) and ligament injuries were the most frequently occurring injuries. The lower limb was the most prevalent injury location. Injury incidence was higher in professional rugby union players than non-professional players. Contact events were responsible for the greatest injury incidence. For non-contact mechanisms, running was responsible for the highest injury incidence. Inconsistent injury definitions hindered reliable comparison of injury data. The lack of reporting training volumes in hours per player per week limited the ability to investigate associations between training volume and injury incidence.ConclusionsA higher level of play may result in higher match injury incidence. Muscle and tendon injuries were the most common type of soft tissue injury, while the lower limb was the most common location of injury in rugby union players, and running was responsible for the highest injury incidence during non-contact events.

In dance, the goals of actions are not always clearly defined. Investigations into the perceived quality of dance actions and their relation to biomechanical motion should give insight into the performance of dance actions and their goals. The purpose of this review was to explore and document current literature concerning dance perception and its relation to the biomechanics of motion. Seven studies were included in the review. The study results showed systematic differences between expert, non-expert, and novice dancers in biomechanical and perceptual measures, both of which also varied according to the actions expressed in dance. Biomechanical and perceptual variables were found to be correlated in all the studies in the review. Significant relations were observed between kinematic variables such as amplitude, speed, and variability of movement, and perceptual measures of beauty and performance quality. However, in general, there were no clear trends in these relations. Instead, the evidence suggests that perceptual ratings of dance may be specific to both the task (the skill of the particular action) and the context (the music and staging). The results also suggest that the human perceptual system is sensitive to skillful movements and neuromuscular coordination. Since the value perceived by audiences appears to be related to dance action goals and the coordination of dance elements, practitioners could place a priority on development and execution of those factors.

IMPORTANCE: Disease severity of childhood Charcot-Marie-Tooth disease (CMT) has not been extensively characterized, either within or between types of CMT to date. OBJECTIVE: To assess the variability of disease severity in a large cohort of children and adolescents with CMT. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional study was conducted among 520 children and adolescents aged 3 to 20 years at 8 universities and hospitals involved in the Inherited Neuropathies Consortium between August 6, 2009, and July 31, 2014, in Australia, Italy, the United Kingdom, and the United States. Data analysis was conducted from August 1, 2014, to December 1, 2015. MAIN OUTCOMES AND MEASURES: Scores on the Charcot-Marie-Tooth Disease Pediatric Scale (CMTPedS), a well-validated unidimensional clinical outcome measure to assess disease severity. This instrument includes 11 items assessing fine and gross motor function, sensation, and balance to produce a total score ranging from 0 (unaffected) to 44 (severely affected). RESULTS: Among the 520 participants (274 males) aged 3 to 20 years, CMT type 1A (CMT1A) was the most prevalent type (252 [48.5%]), followed by CMT2A (31 [6.0%]), CMT1B (15 [2.9%]), CMT4C (13 [2.5%]), and CMTX1 (10 [1.9%]). Disease severity ranged from 1 to 44 points on the CMTPedS (mean [SD], 21.5 [8.9]), with ankle dorsiflexion strength and functional hand dexterity test being most affected. Participants with CMT1B (mean [SD] CMTPedS score, 24.0 [7.4]), CMT2A (29.7 [7.1]), and CMT4C (29.8 [8.6]) were more severely affected than those with CMT1A (18.9 [7.7]) and CMTX1 (males: 15.3 [7.7]; females: 13.0 [3.6]) (P &lt; .05). Scores on the CMTPedS tended to worsen principally during childhood (ages, 3-10 years) for participants with CMT4C and CMTX1 and predominantly during adolescence for those with CMT1B and CMT2A (ages, 11-20 years), while CMT1A worsened consistently throughout childhood and adolescence. For individual items, participants with CMT4C recorded more affected functional dexterity test scores than did those with all other types of CMT (P &lt; .05). Participants with CMT1A and CMTX1 performed significantly better on the 9-hole peg test and balance test than did those with all other types of CMT (P &lt; .05). Participants with CMT2A had the weakest grip strength (P &lt; .05), while those with CMT2A and CMT4C exhibited the weakest ankle plantarflexion and dorsiflexion strength, as well as the lowest long jump and 6-minute walk test distances (P &lt; .05). Multiple regression modeling identified increasing age (r = 0.356, β = 0.617, P &lt; .001) height (r = 0.251, β = 0.309, P = .002), self-reported foot pain (r = 0.162, β = .114, P = .009), and self-reported hand weakness (r = 0.243, β = 0.203, P &lt; .001) as independent predictors of disease severity. CONCLUSIONS AND RELEVANCE: These results highlight the phenotypic variability within CMT genotypes and mutation-specific manifestations between types. This study has identified distinct functional limitations and self-reported impairments to target in future therapeutic trials.

The rugby union scrum comprises of two distinct phases; the engagement and second shove. The engagement phase is achieved through the interlocking of opposition forward packs through front row players of each team. The current study analysed professional and amateur front row forwards for horizontal force production. EMG patterns and muscular activation were compared between groups during two distinct time points of the engagement phase, pre engagement to first contact and first contact to maximum horizontal force to determine their effects, if any on horizontal force production. Isokinetic strength data was collected from all players to investigate any relationship this had to horizontal force production during the engagement phase. Body mass was found to be significantly different between playing groups. Maximum horizontal force during the engagement phase was significantly different between groups, with professional players generating more than both amateur groups. EMG analysis presented no significant differences between groups for muscular activation patterns. Peak muscular activation for all recorded muscles was achieved prior to first contact. A significant correlation was found between muscular activation and max horizontal force for professional players only. Junior players were found to have a significant negative correlation between isokinetic strength and max horizontal force production.

During isometric shoulder adduction in normal subjects, do the rotator cuff muscles activate more than other shoulder muscles? Are the activation patterns influenced by shoulder abduction angle or load?

Background: Following recent reforms by the Australian Government to the Medicare Benefits Schedule, people living with a diagnosed eating disorder (ED) in Australia have greater access to dietetic services. However, new graduate dietitians anecdotally lack confidence to provide appropriate interventions to support patients with an ED. Therefore, this cross-sectional study aims to explore the perceived confidence, and educational and professional development needs of student dietitians and new graduate dietitians in the area of EDs. Methods: An online survey with 17 questions was designed, consisting of a combination of discrete (yes/no) questions, free text, ordered scales and 5-point Likert scales. Student dietitians, and first- and second- year graduates (n= 1456) were approached via email as potential participants, from the professional organisation Dietitians Australia member list. Survey data was analysed using descriptive statistics and odds ratios. Results: In total, 150 surveys were completed, with a response rate of 10.3%. Respondents reported a lack of confidence in managing patients with an ED and implementing ED treatment approaches (81 and 95%, respectively). However, participants previously exposed to patients with an ED, such as anorexia nervosa, were 4.7 times (95% CI 1.72, 12.97) more likely to be confident compared to those not exposed to patients with an ED. The majority of respondents (37%) stated they would seek assistance from other dietitians, and develop their skills via online webinars (27%) and workshops (25%). Conclusions: This survey identified that final year dietetics students and new graduate dietitians perceive lower levels of confidence to practice in the area of EDs. The desire for further ED-specific training and education was reported.

Patients hospitalised with anorexia nervosa require nutrition support as part of their treatment, whilst refeeding complications are prevented. Of particular concern, is the reintroduction of carbohydrate to malnourished patients, which has been proposed to cause a surge in insulin levels and disturbance in electrolytes, particularly a decrease in blood phosphate levels. This double-blinded randomised controlled trial measured the occurrence of low phosphate blood levels and other refeeding complications, in adolescent and young adult patients hospitalised with anorexia nervosa. These patients were provided either a lower carbohydrate/high fat feed (28% carbohydrate, 56% fat) or a standard enteral feed (54% carbohydrate, 29% fat). Fewer patients in the lower carbohydrate/high fat feed group (5/14) than standard feed group (9/10) developed a low phosphate level. There was no significant difference in weight gain, number of days to reach medical stability, occurrence of hypoglycaemia, or hospital length of stay.