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L-citrulline (CIT) supplementation seems to improve resistance training performance; yet, whether malate has additive ergogenic effects when combined with CIT is unknown. This randomized, double-blind, placebo-controlled crossover trial aimed to compare the acute effects of CIT versus citrulline malate (CMA) supplementation on neuromuscular performance and exertion and emotional perceptions in young, trained men and women. 43 (21 women; 24.2 ± 3.7 years) participants ingested a placebo, CIT (5.3 g of CIT), or CMA (5.3 g of CIT, 2.7 g of malate) 45 min before three experimental sessions in a counterbalanced manner. We evaluated the upper and lower limb maximal neuromuscular and ballistic performance through the two-point method and countermovement jump. Strength-endurance was assessed across three sets of 10 repetitions in the squat and bench press exercises. Exertion and emotional perceptions were evaluated before and after the assessment and during the strength-endurance assessment. CIT and CMA supplementation did not enhance maximal neuromuscular performance (all p ≥.061, η p 2 ≤.066), or ballistic strength (all p ≥.348, η p 2 ≤.025). Neither CIT nor CMA supplementation improved strength-endurance as observed in the total number of repetitions (all p ≥.590, η p 2 ≤.013), repetitions before reaching velocity loss threshold (all p ≥.623, η p 2 ≤.010), mean velocity (all p ≥.792, η p 2 ≤.004), mean velocity decline (all p ≥.293, η p 2 ≤.029), and mean velocity maintenance (all p ≥.393 η p 2 ≤.022), or exertion and emotional perceptions (both p ≥.306, η p 2 ≤.028). In conclusion, CIT and CMA supplementation may not increase the neuromuscular performance during low- to moderate-volume resistance training sessions in young, trained adults. This trial was registered at ClinicalTrials.gov (No. NCT05183893). [ABSTRACT FROM AUTHOR]

Context: The single-leg hop is based solely on performance with no measure of movement quality. The purpose of this study was to (1) develop a real-time screening tool to capture single-leg functional performance and movement quality and (2) to provide preliminary validation (criterion validity) of a trained clinician's real-time movement quality assessment with 3D kinematics. Study Design: Cross-sectional. Methods: Fifty-nine adolescent athletes volunteered (15.2 [1.1] y, 165.8 [9.2] cm, and 61.5 [13.9] kg, 51 females and 8 males). Each participant performed 3 trials of the single-leg hop on their dominant leg. A 3-dimensional inertial measurement system was used to capture knee joint kinematics. A movement quality checklist for use during a single-leg hop (movement quality single-leg hop) was developed to score biomechanical errors based on lower-extremity injury risk factors. Four criteria were developed for the checklist: (1) knee valgus, (2) foot rotation, (3) lateral trunk flexion, and (4) erect posture. An independent t test was conducted for each dependent variable (knee flexion displacement and knee abduction displacement) by each independent variable (movement category presence of (1) lateral trunk flexion, (2) knee valgus, (3) foot rotation, and (4) erect posture/sound during landing [yes or no]). The alpha level was set at α <.05 for all analyses. Results: Knee flexion displacement was significantly decreased (P <.001, mean difference 9.40 [1.88]) and knee abduction displacement was significantly increased (P <.001, mean difference 9.41 [0.47]) for those who had knee valgus documented by the clinician. In additional, for those with visually documented erect posture/sound of landing, there was a significant decrease in knee flexion displacement (P <.001, mean difference 10.13 [2.34]). Conclusion: The movement quality single-leg hop checklist has shown promising preliminary validation (criterion validity) for clinicians to assess movement quality. Increased knee abduction and decreased knee flexion are common risk factors associated with knee injuries and this clinician friendly real-time checklist may highlight individuals who are at risk of sustaining a knee injury. [ABSTRACT FROM AUTHOR]

Background: The aims of this cross-sectional study were to (a) assess actigraphy-based sleep parameters (total sample and gender differences), (b) assess differences in morphological parameters and physical function between short- versus normal-sleepers and poor- versus good-sleepers, and (c) assess the possible correlations between sleep variables and morphological and physical function parameters in older subjects. Methods: This study enrolled 42 healthy older participants (60–80 years). Participants completed the following clinical evaluations: (1) whole-body dual-energy X-ray absorptiometry to assess the appendicular skeletal muscle mass index; (2) magnetic resonance imaging acquisition to determine the cross-sectional muscle area of thigh muscles and intermuscular adipose tissue; (3) risk of fall assessment through the mini-Balance Evaluation Systems Test; (4) strength assessment: (a) chair stand test and (b) handgrip strength test; (5) sleep monitoring by actigraphy to assess total sleep time, sleep efficiency, wake after sleep onset, sleep latency, fragmentation index, mobile time, and subjective sleep quality. Results: 31.0% of subjects were short-sleepers (total sleep time < 6 hr), 19.1% were poor-sleepers (sleep efficiency < 85%), and gender differences were detected in mobile time (males: 15.8 ± 6.0 and females: 13.4 ± 6.8; p <.001) and fragmentation index (males: 35.3 ± 14.3 and females: 29.6 ± 14.6; p <.001); no significant differences were observed between groups (short- vs. normal-sleepers and poor- vs. good-sleepers) in morphological and physical function variables; correlation analysis showed that sleep latency negatively correlated with Mini-Balance Evaluation Systems Test (r = −.352; p =.022) and a positive correlation was detected between cross-sectional muscle area and mobile time (r =.349, p =.023). Conclusion: No differences were observed in morphological and function parameters between good- versus poor-sleepers, those subjects with worse sleep onset latency (i.e., longer time to fall asleep) registered higher for risk of fall. The potential role of sleep in the physiological mechanisms of muscular aging must be explored through cross-sectional cohort studies with a larger population. [ABSTRACT FROM AUTHOR]

Background: The lumbar extensor muscles (LEMs) play an important role in body posture and physical function in older adults. Because lumbar extensor strength decreases more rapidly than limb muscle strength with age, it should be evaluated to aid healthy aging. This study investigated the association between LEM strength and physical performance in community-dwelling older adults. Methods: This prospective observational cohort study of spinal sarcopenia (SarcoSpine) was conducted at a single center. One hundred and ten consecutive individuals who completed the baseline survey, including conventional sarcopenic indices, lumbar spine three-dimensional magnetic resonance imaging, isokinetic lumbar extensor strength, and physical performance tests (Short Physical Performance Battery, Berg Balance Scale, and Back Performance Scale [BPS]), were enrolled. A multivariate linear regression analysis was performed to determine the variables for evaluating their association with LEM strength. Results: Among the conventional sarcopenic indices, gait speed was significantly correlated with Short Physical Performance Battery results and Berg Balance Scale score in men and women. Handgrip strength was significantly correlated with the BPS score for both sexes. In the multivariable linear regression, age (β = −2.12, p <.01) and BPS score (β = −3.54, p =.01, R2 =.29) were independent indicators of LEM strength. Conclusions: Our findings reveal the substantial association between LEM strength and BPS score in older women. The targeted intervention aimed at improving the LEMs strength would be needed to enhance physical performance in the aging population. [ABSTRACT FROM AUTHOR]

Purpose: Although previous studies have compared strength-training adaptations between free weights (FW) and machine-guided exercises, those studies did not use a Smith machine (SM), which most closely replicates the exercises performed with FW. Thus, the aim of the present study was to investigate the chronic effects of strength-focused, velocity-based training regimens using FW versus SM. Methods: Thirty-seven sport-science students (14 female) were assigned, balanced by sex and relative strength, to either an FW or SM training group. The training program lasted 8 weeks (2 sessions/wk), and participants performed 4 sets per exercise (back squat and bench press) at 70% of their 1-repetition maximum with moderate effort levels (20%–25% velocity loss). Load–velocity profile parameters (load-axis intercept, velocity-axis intercept, and area under the load–velocity relationship line), cross-sectional areas of the vastus lateralis and pectoralis major muscles, and the number of repetitions to failure in the bench-press exercise were assessed before and after the training program. Mechanical variables were assessed using both FW and SM. Results: All variables, with the exception of back-squat velocity-axis intercept (P =.124), improved in both training groups. The changes in load-axis intercept and area under the load–velocity relationship line were more pronounced when the training and testing conditions matched. Failure in the bench-press exercise and cross-sectional areas of the vastus lateralis and pectoralis major showed comparable improvements for both training groups, while velocity-axis intercept tended to improve more in the SM group. Conclusions: The general population, unconcerned with the specificity of strength adaptations, can choose a training modality (FW or SM) based on personal preferences. [ABSTRACT FROM AUTHOR]

Purpose: This study's purpose was to investigate the midterm effects of alternative set configurations (cluster [CL] and rest redistribution [RR]) on lower- and upper-body neuromuscular capacities in female athletes. Method: Twenty team-sport female athletes were randomly assigned to a CL (n = 10) or RR (n = 10) training group. The study protocol comprised 2 pretests, 12 training sessions, and a posttest. Both groups engaged in identical exercises (squat and bench press), load intensity (75% of 1-repetition maximum), and volume (18 repetitions per exercise). The distinction between the groups lay in the total session rest time: The CL group had 23 minutes (3 sets of 6 repetitions with 30 s of intraset rest every 2 repetitions and 3 min of interset rest), whereas the RR group had 17 minutes (9 sets of 2 repetitions with 45 s of interset rest). Countermovement-jump height and load–velocity relationship variables (load-intercept, velocity-intercept, and area under the load–velocity relationship line) were assessed during the squat and bench-press exercises. Results: All dependent variables revealed greater values at posttest compared with pretest (P ≤.040; averaged Hedges g = 0.35 for CL and 0.60 for RR), but time × group interactions never reached statistical significance (P ≥.144). Likewise, the comparison of the magnitude of changes between the 2 groups revealed only trivial differences, except for a small greater change in bench-press area under the load–velocity relationship line for RRG (Hedges g = 0.40). Conclusions: RR is a more efficient strategy than CL for inducing strength gains in female athletes. [ABSTRACT FROM AUTHOR]

Background: Preexercise caffeine intake has proven to exert ergogenic effects on cycling performance. However, whether these benefits are also observed under fatigue conditions remains largely unexplored. We aimed to assess the effect of caffeine ingested during prolonged cycling on subsequent time-trial performance in trained cyclists. Methods: The study followed a triple-blinded, randomized, placebo-controlled cross-over design. Eleven well-trained junior cyclists (17 ± 1 years) performed a field-based 8-min time trial under "fresh" conditions (i.e., after their usual warm-up) or after two work-matched steady-state cycling sessions (total energy expenditure∼20 kJ/kg and ∼100 min duration). During the latter sessions, participants consumed caffeine (3 mg/kg) or a placebo ∼60 min before the time trial. We assessed power output, heart rate, and rating of perceived exertion during the time trial and mood state (Brunel Mood Scale) before and after each session. Results: No significant condition effect was found for the mean power output attained during the time trial (365 ± 25, 369 ± 31, and 364 32 W for "fresh," caffeine, and placebo condition, respectively; p =.669). Similar results were found for the mean heart rate (p =.100) and rating of perceived exertion (p = 1.000) during the time trial and for the different mood domains (all p >.1). Conclusions: Caffeine intake during prolonged exercise seems to exert no ergogenic effects on subsequent time-trial performance in junior cyclists. Future studies should determine whether significant effects can be found with larger caffeine doses or after greater fatigue levels. [ABSTRACT FROM AUTHOR]

Purpose: To compare the acute effects on mechanical, metabolic, neuromuscular, and muscle contractile responses to different velocity-loss (VL) thresholds (20% and 40%) under distinct blood-flow conditions (free [FF] vs restricted [BFR]) in full squat (SQ). Methods: Twenty strength-trained men performed 4 SQ protocols with 60% 1-repetition maximum that differed in the VL within the set and in the blood-flow condition (FF20: FF with 20% VL; FF40: FF with 40% VL; BFR20: BFR with 20% VL; and BFR40: BFR with 40% VL). The level of BFR was 50% of the arterial occlusion pressure. Before and after the SQ protocols, the following tests were performed: (1) tensiomyography, (2) blood lactate, (3) countermovement jump, (4) maximal voluntary isometric SQ contraction, and (5) performance with the load that elicited a 1 m·s−1 at baseline measurements in SQ. Results: No "BFR × VL" interactions were observed. BFR protocols resulted in fewer repetitions and lower increases in lactate concentration than FF protocols. The 40% VL protocols completed more repetitions but resulted in lower mechanical performance and electromyography median frequency during the exercise than the 20% VL protocols. At postexercise, the 40% VL protocols also experienced greater blood lactate concentrations, higher alterations in tensiomyography-derived variables, and accentuated impairments in SQ and countermovement-jump performances. The 20% VL protocols showed an increased electromyography median frequency at postexercise maximal voluntary isometric contraction. Conclusions: Despite BFR-accelerated fatigue development during exercise, a given VL magnitude induced similar impairments in the distinct performance indicators assessed, regardless of the blood-flow condition. [ABSTRACT FROM AUTHOR]

Purpose: To investigate differences between females and males at lactate thresholds 1 (LT1) and 2 (LT2). Methods: Twenty-four female and twenty male participants performed an incremental cycle-ergometer test until exhaustion, where LT1 and LT2 were determined in each volunteer. Results: Power output at LT1 and LT2 was lower in females than in males (P <.001). In addition, power output relative to peak power was higher in females at LT1 and LT2 (P <.001). However, heart rate was higher in females than males at LT1 and LT2 (P =.008). Furthermore, the heart rate relative to maximal heart rate was higher in females compared with males at LT1 and LT2 (P =.002). Conclusion: Females and males may be in a different metabolic situation at the same percentage of maximum. This study helps to reduce sex bias in science, and future guidelines should consider establishing exercise prescription recommendations according to sex. Clinical Trial: NCT06104150. [ABSTRACT FROM AUTHOR]

Physical activity levels during skilled nursing facility (SNF) rehabilitation fall far below what is needed for successful community living and to prevent adverse events. This feasibility study's purpose was to evaluate the feasibility, acceptability, and preliminary effectiveness of an intervention designed to improve physical activity in patients admitted to SNFs for short-term rehabilitation. High-Intensity Rehabilitation plus Mobility combined a high-intensity (i.e., high weight, low repetition), progressive (increasing in difficulty over time), and functional resistance rehabilitation intervention with a behavioral economics-based physical activity program. The behavioral economics component included five mobility sessions/week with structured goal setting, gamification, and loss aversion (the idea that people are more likely to change a behavior in response to a potential loss over a potential gain). SNF physical therapists, occupational therapists, and a mobility coach implemented the High-Intensity Rehabilitation plus Mobility protocol with older Veterans (n = 18) from a single SNF. Participants demonstrated high adherence to the mobility protocol and were highly satisfied with their rehabilitation. Treatment fidelity scores for clinicians were ≥95%. We did not observe a hypothesized 40% improvement in step counts or time spent upright. However, High-Intensity Rehabilitation plus Mobility participants made clinically important improvements in short physical performance battery scores and gait speed from admission to discharge that were qualitatively similar to or slightly higher than historical cohorts from the same SNF that had received usual care or high-intensity rehabilitation alone. These results suggest a structured physical activity program can be feasibly combined with high-intensity rehabilitation for SNF residents following a hospital stay. [ABSTRACT FROM AUTHOR]

Purpose: The popularity of fencing and intense sports competition has burdened adolescents with excessive training, harming their immature bodies. Traditional training methods fail to provide timely movement corrections and personalized plans, leading to ineffective exercises. This paper aims to use artificial intelligence technology to reduce ineffective exercises and alleviate the training burden. Methods: We propose an action recognition algorithm based on the characteristics of adolescent athletes. This algorithm uses multimodal input data to comprehensively extract action information. Each modality is processed by the same network structure, utilizing attention mechanisms and adaptive graph structures. A multibranch feature fusion method is used to determine the final action category. Results: We gathered the fencing footwork data set 2.0. Our model achieved 93.3% accuracy, with the highest precision at 95.8% and the highest F1-Score at 94.5% across all categories. It effectively recognized actions of adolescents with different heights and speeds, outperforming traditional methods. Conclusion: Our artificial intelligence-based training solution improves training efficiency and reduces the training burden on adolescents. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to explore the interday reliability of mechanical variables obtained from the horizontal and vertical force–velocity (FV) profiles in adolescent female basketball players. If found to be reliable, the associations between FV parameters (theoretical maximal force, velocity, and power), squat jump (SJ) height, 30-m sprint, and change of direction (COD) times were evaluated. Methods: After familiarization, SJ against incremental loads, 30-m sprint, and 505-COD tests were obtained twice in 36 adolescent female basketball players (age = 15.4 [1.2] y). Results: Reliability for vertical FV parameters was unacceptable, whereas 505-COD times and FV horizontal parameters (except for theoretical maximal power) showed a moderate to high reliability. 505-COD time was correlated with FV horizontal parameters (range: r = −.821, −.451), and a large association was observed with both SJ height (r = −.678, −.600) and 30-m sprint time (r =.813,.858). Conclusions: Due to low levels of strength, our athletes were not adequately prepared to obtain a reliable vertical FV profile. Practitioners can expect acceptable reliability of the horizontal FV profile. Given the association between COD performance and SJ height and 30-m sprint time, we encouraged practitioners with limited equipment at their disposal to use COD and/or 30-m sprint tests. [ABSTRACT FROM AUTHOR]

Little is known about physical activity (PA) and sedentary behavior (SB) among nursing home residents although PA is known as a health promoter. This study examined PA, SB, and their predictors among nursing home residents (n = 63). Dependent variables were accelerometry-based PA and SB. Predictor variables included in a path analysis were age, sex, body mass index, Barthel Index, cognitive status (Mini-Mental State Examination), physical performance (hand grip strength and habitual walking speed), and well-being (World Health Organization-5 well-being index). PA was very low (M steps per day = 2,433) and SB was high (M percentage of sedentary time = 89.4%). PA was significantly predicted by age (β = −0.27, p =.008), body mass index (β = −0.29, p =.002), Barthel Index (β = 0.24, p =.040), and hand grip strength (β = 0.30, p =.048). SB was significantly predicted by body mass index (β = 0.27, p =.008) and Barthel Index (β = −0.30, p =.012). Results might be helpful for everyday practice to identify individuals at high risk for low PA and high SB. [ABSTRACT FROM AUTHOR]

Purpose: Maximal speed is an important physical-fitness attribute for female Australian footballers. The effects of sprint training, maximal strength, and technical training have been reported in laboratory studies. However, no study has determined the combined effect and relative contribution of these training modalities on maximal speed adaptation in situ. Therefore, the aim of this study was to determine the training factors affecting maximal speed adaptation during a preseason in subelite female Australian Rules footballers. Methods: Maximal speed during field training, predicted 1-repetition maximum (1RM) for box squat and hip thrust, and sprint biomechanics were assessed during early and late preseason (∼9 wk apart) in 15 female subelite Australian Rules Football players (age 20 [3] y). On-field training volume and intensity (total distance, high-speed running, very-high-speed running, and maximal speed) were determined using a Global Positioning System. A multivariate regression model was used to determine the factors associated with changes in maximal speed across the preseason. Results: The preseason training program had a small effect on maximal speed and large to very large effects on strength and sprint biomechanics. The multivariate regression with the greatest fit (P <.001, R2 =.939) included change in estimated 1RM box squat (β = −0.63), total distance per week (β = −0.55), and change in hip projection (β = 0.16) as factors. Multivariate regression of biomechanical factors (P =.044, R2 =.717) and maximal strength factors (P =.003, R2 =.676) were also significant. Conclusion: The development of maximal speed across a preseason is dependent on (1) total distance per week, (2) maximal strength adaptation, and (3) sprint technique adaptation in female subelite Australian rules football players. [ABSTRACT FROM AUTHOR]

Purpose: Performing back squats with elastic bands has been widely used in resistance training. Although research demonstrated greater training effects obtained from adding elastic bands to the back squat, little is known regarding the optimal elastic resistance and how it affects neuromuscular performance. This study aimed to compare the force, velocity, power, and muscle activity during back squats with different contributions of elastic resistance. Methods: Thirteen basketball players performed 3 repetitions of the back squat at 85% of 1-repetition maximum across 4 conditions: (1) total load from free weight and (2) 20%, (3) 30%, and (4) 40% of the total load from elastic band and the remaining load from free weight. The eccentric and concentric phases of the back squat were divided into upper, middle, and bottom phases. Results: In the eccentric phase, mean velocity progressively increased with increasing elastic resistance, and muscle activity of the vastus medialis and rectus femoris significantly increased with the largest elastic resistance in the upper phase (P ≤.036). In the concentric phase, mean power (P ≤.021) and rate of force development (P ≤.002) significantly increased with increasing elastic resistance. Furthermore, muscle activity of the vastus lateralis and vastus medialis significantly improved with the largest elastic resistance in the upper phases (P ≤.021). Conclusion: Velocity, power, rate of force development, and selective muscle activity increased as the elastic resistance increased in different phases during the back-squat exercise. [ABSTRACT FROM AUTHOR]

Context: High secondary injury rates after orthopedic surgeries have motivated concern toward the construct validity of return-to-sport test batteries, as it is evident that common strength and functional assessments fail to elicit pertinent behaviors like visual search and reactive decision making. This study aimed to establish the test–retest reliability of 2 reactive agility tasks and evaluate the impact of visual perturbation on physical performance. Methods: Fourteen physically active individuals completed 2 agility tasks with reaction time (ie, 4 corner agility), working memory, and pathfinding (ie, color recall) components. Participants completed both tasks 4 times in 2 sessions scheduled 7 days apart. Outcomes included performance metrics of reaction time, time to target, number of targets, and total time assessed with reactive training timing gates. To assess test–retest reliability, we used intraclass correlation coefficients (ICCs), standard error of measurement (SEM), and minimal detectable change (MDC). Stroboscopic goggles induced visual perturbation during the fourth trial of each task. To assess the effect of visual perturbation, we used paired t tests and calculated performance costs. Results: The 4-corner agility task demonstrated excellent reliability with respect to reaction time (ICC3,1 =.907, SEM = 0.13, MDC = 0.35 s); time to light (ICC3,1 =.935, SEM = 0.07, MDC = 0.18 s); and number of lights (ICC3,1 =.800, SEM = 0.24, MDC = 0.66 lights). The color recall task demonstrated good-to-excellent test–retest reliability for time to lights (ICC3,1 =.818–.953, SEM = 0.07–0.27, MDC = 0.19–0.74 s); test time (ICC3,1 =.969, SEM = 5.43, MDC = 15.04 s); and errors (ICC3,1 =.882, SEM = 0.19, MDC = 0.53 errors). Visual perturbation resulted in increased time to target (P =.022–.011), number of targets (P =.039), and total test time (P =.013) representing moderate magnitude degradation of performance (d = 0.55–0.87, performance costs = 5%–12%). Conclusions: Both tasks demonstrated acceptable test–retest reliability. Performance degraded on both tasks with the presence of visual perturbation. These results suggest standardized reactive agility tasks are reliable and could be developed as components of dynamic RTS testing. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed the reliability and load–velocity profiles of 3 different landmine-punch-throw variations (seated without trunk rotation, seated with trunk rotation, and standing whole body) with different loads (20, 22.5, and 25.0 kg), all with the dominant hand and nondominant hand. Methods: In a quasi-randomized order, 14 boxers (24.1 [4.3] y, 72.6 [10.1] kg) performed 3 repetitions of each variation with their dominant hand and their nondominant hand, with maximal effort and 3 minutes of interset rest. Peak velocity was measured via the GymAware Power Tool (Kinetic Performance Technologies). The interclass correlation coefficients and their 95% CIs were used to determine the intrasession reliability of each variation × load × hand combination. Additionally, a 2 (hand) × 3 (variation) repeated-measures analysis of variance assessed the load–velocity profile slope, and a 3 (variation) × 2 (hand) × 3 (load) repeated-measures analysis of variance assessed the peak velocity of each variation. Results: Most variations were highly reliable (intraclass correlation coefficient >.91), with the nondominant hand being as reliable or more reliable than the dominant hand. Very strong linear relationships were observed for the group average for each variation (R2 ≥.96). However, there was no variation × hand interaction for the slope, and there was no main effect for variation or hand. Additionally, there was no interaction for the peak velocity, but there were main effects for variation, hand, and load (P <.01). Conclusion: Each variation was reliable and can be used to create upper-body ballistic unilateral load–velocity profiles. However, as with other research on load–velocity profile, individual data allowed for more accurate profiling than group average data. [ABSTRACT FROM AUTHOR]

Purpose: Successful participation in taekwondo (TKD) requires athletes to possess quick decision-making abilities and demonstrate technical proficiency during competition. Dehydration, occurring during both training and competition, is widely recognized to have various negative effects. Methods: This study investigated the impact of different levels of dehydration on cognitive function, as measured by the Vienna Test System, and the specific performance of kicking techniques among TKD athletes. Using a randomized crossover design, 12 participants were involved in the study. Before and after 1 hour of training at 80% of maximal heart rate, participants were weighed and provided urine samples. All participants were randomly assigned to 3 different hydration conditions: the euhydrated (EUH) group had unrestricted access to fluid consumption, while the hypohydrated (HYP) and severely HYP (S-HYP) groups experienced reductions of 2.0% and 4.0% of their initial body weight, respectively. Results: The EUH group exhibited better reaction speed in reaction-time test-form S1 than the HYP and S-HYP groups. Notably, the EUH group demonstrated a significantly higher success rate in the front-side kick (EUH 98%, HYP 90%, S-HYP 88%; P <.05). However, the success rates of back roundhouse kick and free head kick were similar among the 3 statuses. Furthermore, postexercise heart rates were found to be significantly higher in the HYP and S-HYP groups compared with the EUH group. Conclusions: This study provides insight into the negative effects of dehydration on cognitive function and TKD-specific performance. It is recommended that TKD athletes maintain optimal hydration levels during training and competition to ensure optimal performance. [ABSTRACT FROM AUTHOR]

Altering baseball pitching mechanics affects both performance and the risk of injury. The purpose of this study is to investigate the relationships of shoulder external over internal rotation ratio (SEIR) and other shoulder rotational properties during physical exam and biomechanics of pitching for 177 collegiate baseball pitchers. The shoulder range of motion was quantitatively measured using a custom-made wireless device. Pitching motion data were collected at 240 Hz, and a custom program was created to calculate the throwing arm motion and loading during baseball pitching. Linear regression and analysis of variance tests were performed to investigate the relationships between the shoulder physical exam outcomes and throwing arm biomechanics. SEIR had significant correlations with shoulder horizontal adduction angle at foot contact, maximum shoulder external rotation angle, maximum shoulder linear velocity, and elbow angle at ball release. SEIR groups had significant differences in shoulder proximal force, adduction torque, internal rotation torque, and horizontal adduction torque, and in elbow medial force and varus torque. Glenohumeral internal rotation deficit and total rotational motion deficit had no relationships with throwing arm motions or joint loadings. Shoulder health should be monitored to improve understanding of pitching mechanics in collegiate baseball pitchers. [ABSTRACT FROM AUTHOR]

Purpose: To explore the association of the load–velocity (L-V) relationship variables and ability to maintain maximal mechanical performance during the prone bench-pull exercise with sprint swimming performance and in-water forces. Methods: Eleven competitive adult male swimmers (50-m front crawl World Aquatics points: 488 [66], performance level 4) performed 1 experimental session. The L-V relationship variables (L0 [ie, maximal theoretical load at 0 velocity]; v0 [ie, maximal theoretical velocity at 0 load], and Aline [ie, area under the L-V relationship]) and maximal mechanical maintenance capacity were assessed at the beginning of the session. Afterward, sprint swimming performance and in-water force production were tested through a 50-m front-crawl all-out trial and 15-s fully-tethered swimming, respectively. Results: Only v0 presented high positive associations with 50-m time and swimming kinematics (r >.532; P <.046). The L0, v0, and Aline showed very high positive associations with the in-water forces during tethered swimming (r >.523; P <.049). However, the ability to maintain maximal mechanical performance, assessed by the mean velocity decline during the prone bench pull, was only significantly correlated with stroke rate (r = −.647; P =.016) and stroke index (r =.614; P =.022). Conclusions: These findings indicate that maximal neuromuscular capacities, especially v0, have a stronger correlation with swimming performance and in-water force production than the ability to maintain maximal mechanical performance in level 4 swimmers. [ABSTRACT FROM AUTHOR]

Purpose: Monitoring performance athletes' training responses can be efficiently completed at competitive events. This study aimed to explore the changes in swimming, countermovement-jump (CMJ), and pull-up (PU) performance following training across a competitive phase, as well as immediately before and after each race. Methods: Fourteen well-trained male sprint/middle-distance swimmers (height 179 [7] cm, mass 70 [8] kg, age 18 [2] y), from 3 regional training groups, completed CMJ and PU tests before and after the national competitions in October and May, when race performance was also assessed. Results: Swimming race performance was significantly improved from before the national competitions in October to after the national competitions in May (1.8% [3.2%], P =.044, d = 0.60, moderate effect). Although there were no significant changes in PU velocity, CMJ performance significantly improved from before the national competitions in October to after the national competitions in May (mean difference 2.29 cm, P =.004, d = 3.52) and showed before-to-after race decreases (mean difference −1.64 cm, P =.04, d = 2.28). Conclusion: Swimming performance and CMJ performance improved as the season progressed, although these improvements were not directly correlated. PU performance did not appear to be sensitive to training or race-induced fatigue, in contrast to CMJ, in this group of male swimmers. [ABSTRACT FROM AUTHOR]

This study investigated the impact of multimorbidity patterns on physical activity and capacity outcomes over the course of a year-long exercise intervention, and on physical activity 1 year later. Participants were 314 physically inactive community-dwelling men and women aged 70–85 years, with no contraindications for exercise at baseline. Physical activity was self-reported. Physical capacity measurements included five-time chair-stand time, 6-minute walking distance, and maximal isometric knee-extension strength. The intervention included supervised and home-based strength, balance, and walking exercises. Multimorbidity patterns comprised physician-diagnosed chronic disease conditions as a predictor cluster and body mass index as a measure of obesity. Multimorbidity patterns explained 0%–12% of baseline variance and 0%–3% of the change in outcomes. The magnitude and direction of the impact of unique conditions varied by outcome, time point, and sex. Multimorbid older adults with no contraindications for exercise may benefit from multimodal physical training. [ABSTRACT FROM AUTHOR]

This study aimed to compare community-dwelling older adults' physical activity (PA) during the COVID-19 restrictions in 2020 to their PA levels 2 years before and investigate associations between earlier physical performance and PA levels over the follow-up. Participants' (n = 809, initial age 75–85 years) self-reported PA was assessed at baseline in 2017–2018 and May/June 2020 as total weekly minutes of walking and vigorous PA. Physical performance was assessed at baseline using the maximal handgrip strength and Short Physical Performance Battery tests. During the first wave of the COVID-19 pandemic, a median change in total weekly minutes of walking and vigorous PA among all participants was + 20.0 (interquartile range: −60.0 to 120.0, p <.001) min per week compared with 2 years earlier. Higher baseline Short Physical Performance Battery total scores were associated with higher total weekly minutes of walking and vigorous PA over the follow-up in men and women, and better handgrip strength in women. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the preliminary effects of movement pattern training (MoveTrain) versus strengthening/flexibility (standard) treatment on hip and pelvic biomechanics in patients with chronic hip-related groin pain. This is a secondary analysis of data collected during a pilot randomized clinical trial. Thirty patients with hip pain, between the ages of 15 and 40 years, were randomized to MoveTrain or standard. Both groups completed 10 treatment sessions over 12 weeks along with a daily home exercise program. Three-dimensional motion analysis was used to collect kinematic and kinetic data of the pelvis and hip during a single-leg squat task at pretreatment and immediately posttreatment. Compared with the standard group, the MoveTrain group demonstrated smaller hip adduction angles (P =.006) and smaller hip external adduction moments (P =.008) at posttreatment. The desired changes to hip joint biomechanics, as found in this study, may require specificity in training that could allow health care professionals to better customize the rehabilitation of patients with hip pain. These findings can also be applied to the design and implementation of future clinical trials to strengthen our understanding of the long-term implications of different rehabilitation techniques for patients with hip pain. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effects of unilateral flywheel training (FT), using a rotational conical pulley, including multidirectional movements with either preplanned or random unanticipated/unexpected executions on functional performance in football players. Methods: A total of 32 young male football players were randomly assigned to an FT program including preplanned unilateral multidirectional movements (PTG, n = 11), an FT executing the same unilateral movements through random (ie, right or left leg) unanticipated (ie, verbal or visual cue) or unexpected (ie, moment where the cue was provided) situations (UTG, n = 11), or a control group (n = 10) that followed their football training routine. FT consisted of 1 set × 5–12 repetitions of 4 exercises performed once a week for 10 weeks. Intermittent endurance performance, repeated unilateral and bilateral jumping ability, change-of-direction (COD) ability, linear sprint velocity, preplanned repeated-sprint ability (RSA), and uncertainty RSA (RSA-RANDOM) were assessed preintervention and postintervention. Results: Significant improvements were found in RSA-RANDOM performance (P <.05, effect size [ES] range: UTG [1.83–2.16], PTG [0.69–0.73]) and COD (P <.05, ES: UTG = 1.34, PTG = 0.98]) in both training groups. Furthermore, significant improvements were also found in intermittent endurance performance (P =.016, ES = 0.37) and sprinting (P =.006, ES = 0.45) in UTG. No changes in any variable were found in the control group. No significant between-groups differences (P >.05) were reported between UTG and PTG, while differences were observed to the control group in unilateral jumping ability, COD, and RSA-RANDOM for UTG, and in RSA-RANDOM for PTG. Conclusions: A 10-week unilateral FT improved RSA-RANDOM and COD ability in youth football players, so both preplanned and unexpected situations should be included on strength training. [ABSTRACT FROM AUTHOR]

Objective: To rate athletes' functional ability and return to sport (RTS) success at the end of their individual, formal, medically prescribed rehabilitation after anterior anterior cruciate ligament (ACL) reconstruction. Methods: In our prospective multicenter cohort study, 88 (42 females) adults aged 18-35 years after acute unilateral ACL rupture and subsequent hamstring grafting were included. All patients were prospectively monitored during their rehabilitation and RTS process until the end of their formal rehabilitation and RTS release. As outcome measures, functional hop and jump tests (front hop, balance hops, and drop jump screening test) and self-report outcomes (Knee Injury and Osteoarthritis Outcome Score, ACL-RTS after injury) were assessed. Literature-based cut-off values were selected to rate each performance as fulfilled or not. Results: At 7.5 months (SD 2.3 months) after surgery, the percentage of participants meeting the functional thresholds ranged from 4% (Knee Injury and Osteoarthritis Outcome Score SPORT) and over 44% (ACL-RTS after injury sum score) to 59% (Knee Injury and Osteoarthritis Outcome Score activities of all daily living) in the self-report and from 29% (Balance side hop) to 69% (normalized knee separation distance) in performance testing. Only 4% fulfilled all the cut-offs, while 45% returned to the same type and level of sport. Participants who successfully returned to their previous sport (type and level) were more likely to be "over-cut-off-performers." Conclusions: The low share of the athletes who fulfilled the functional RTS criteria highlights the importance of continuing the rehabilitation measures after the formal completion to assess the need for and success of, inter alia, secondary-preventive therapies. [ABSTRACT FROM AUTHOR]

Prior studies have explored the relationship between knee valgus and musculoskeletal variables to formulate injury prevention programs, primarily for females. Nonetheless, there is insufficient evidence pertaining to professional male soccer players. Here, the aim was to test the correlation of lateral trunk inclination, hip adduction, hip internal rotation, ankle dorsiflexion range of motion, and hip isometric strength with knee valgus during the single-leg vertical jump test. Twenty-four professional male soccer players performed a single-leg vertical hop test, hip strength assessments, and an ankle dorsiflexion range of motion test. A motion analysis system was employed for kinematic analysis. Maximal isometric hip strength and ankle dorsiflexion range of motion were tested using a handheld dynamometer and a digital inclinometer, respectively. The correlation of peak knee valgus with peak lateral trunk inclination was.43 during the landing phase (P =.04) and with peak hip internal rotation was −.68 (P <.001). For knee valgus angular displacement, only peak lateral trunk inclination presented a moderate positive correlation (r =.40, P =.05). This study showed that trunk and hip kinematics are associated with knee valgus, which could consequently lead to increased knee overload in male professional soccer players following a unilateral vertical landing test. [ABSTRACT FROM AUTHOR]

The purpose of this investigation was (1) to test the effect of movement restriction of the free leg during unilateral vertical jump on performance and power output comparing 2 different jump techniques: flexed (Classic technique) and straight (FC Luzern technique) free leg, and (2) to test the correlation between performance and power output obtained using these 2 techniques. Twenty elite soccer players performed squat (SJ) and countermovement (CMJ) jumps on each leg. The jump height and peak power output were compared between the 2 techniques for both legs. The jump height and peak power were significantly higher for the classic test for SJ and CMJ (P <.001) with no side effects or interactions. The angular range of motion of the free leg was higher for the Classic test than for the FC Lucerne test (P <.001), with no difference in the angular range of motion of the trunk. A moderate correlation was found between the 2 techniques on peak power (SJ: r =.626; CMJ: r =.649) and jump height (SJ: r =.742; CMJ: r =.891). Consequently, FC Lucerne technique, limiting the contribution of the free leg, is more appropriate to assess lower limb strength capacities during unilateral jump test. [ABSTRACT FROM AUTHOR]

Purpose: To investigate performance progression from early-junior to peak performance age and compare variety in race distances and swimming strokes between swimmers of various performance levels. Methods: Using a longitudinal data analysis and between-groups comparisons 306,165 annual best times of male swimmers (N = 3897) were used to establish a ranking based on annual best times at peak performance age. Individual performance trajectories were retrospectively analyzed to compare distance and stroke variety. Performances of world-class finalists and international- and national-class swimmers (swimming points: 886 [30], 793 [28], and 698 [28], respectively) were compared across 5 age groups—13–14, 15–16, 17–18, 19–20, and 21+ years—using a 2-way analysis of variance with repeated measures. Results: World-class finalists are not significantly faster than international-class swimmers up to the 17- to 18-year age group (F2|774 = 65, P <.001, η p 2 =.14) but specialize in short- or long-distance races at a younger age. World-class breaststroke finalists show faster breaststroke times compared to their performance in other swimming strokes from an early age (P <.05), while world-class freestyle and individual medley finalists show less significant differences to their performance in other swimming strokes. Conclusions: While federation officials should aim for late talent selection, that is, not before the 17- to 18-year age group, coaches should aim to identify swimmers' preferred race distances early on. However, the required stroke variety seems to be specific for each swimming stroke. Breaststroke swimmers could aim for early and strong specialization, while freestyle and individual medley swimmers could maintain large and very large stroke variety, respectively. [ABSTRACT FROM AUTHOR]

Despite a strong body of evidence supporting benefits of exercise to reduce severity of motor symptoms of Parkinson's Disease (PD) over time, research on the immediate impact of exercise as an adjunctive therapy for nonpharmacologic management of motor symptoms and mobility performance in people with PD is limited. The purpose of this study was to examine immediate effects of a single bout of high-cadence cycling on motor symptoms of PD and performance-based outcomes. Twenty individuals with idiopathic PD participated in a pretest/posttest study investigating immediate impacts of a single high-cadence cycling session on performance-based outcomes across multiple domains of motor function, mobility, and balance. Outcomes were analyzed based on time since last dose of levodopa/carbidopa medication. Immediate improvements were observed in motor symptoms of PD with significant improvements in performance across multiple balance systems, dynamic gait, and upper-extremity coordination following a cycling intervention. [ABSTRACT FROM AUTHOR]

Adequate body composition is essential for health, function, and independence in older adults. However, standard body composition assessments require complex and costly modalities, limiting their use for early detection of body composition changes and periodic follow-up. This study explored the ability of three practical measures—handgrip strength, five times sit-to-stand test, and upper limb loading during seated push-up test (ULL-SPUT)—to determine body composition in 109 older adults with and without sarcopenia. Participants (average age 76 years) were cross-sectionally measured for outcomes of the study. The ULL-SPUT and handgrip strength, but not the five times sit-to-stand test, significantly correlated with body composition (rs, r =.297–.827, p <.01). The ULL-SPUT, in combination with demographic data, could determine body composition up to 82%. Therefore, the ULL-SPUT may be a practical preliminary measure to identify older adults for whom standard body composition assessments and follow-up would prove timely and beneficial. [ABSTRACT FROM AUTHOR]

Objective: This study aims to systematically validate the reliability and applicability of Iliac Tilt (IT) as a parameter for sagittal balance assessment, explore its relationship with traditional parameters such as Pelvic Tilt (PT) and Pubic-Sacral Angle (PSA), and analyze its performance across different stages of skeletal development. Methods: A retrospective study was conducted with 118 healthy pediatric participants. Full-length sagittal radiographs were obtained using the advanced EOS imaging system, and relevant sagittal plane parameters were measured using standardized methods. Participants were grouped based on Risser staging, and statistical analyses, including one-way analysis of variance (ANOVA), Pearson correlation analysis, and linear regression, were performed. Results: Iliac Tilt (IT) was significantly negatively correlated with Pelvic Tilt (PT) (r = -0.761, p < 0.001) and significantly positively correlated with Pubic-Sacral Angle (PSA) (r = 0.814, p < 0.001). Linear regression analysis revealed that IT was a significant predictor of both PT and PSA, with R² values of 0.736 and 0.717, respectively. Additionally, across different Risser stages, IT demonstrated high stability, while PSA and T1 Slope-Pelvic Incidence (T1SPI) showed significant changes with staging. Conclusion: As a novel parameter, Iliac Tilt (IT) demonstrates high reliability and broad applicability in reflecting posterior pelvic tilt and sagittal spinal balance. Compared to traditional parameters, IT offers a simpler measurement process, making it suitable for complex cases with limited imaging quality. It provides an efficient evaluation tool for clinical and research applications. Highlights: Introduction of a Novel Parameter: This study systematically validates Iliac Tilt (IT) as a new and reliable parameter for assessing sagittal spinal balance in adolescents, demonstrating its broad applicability. Strong Correlations Identified: IT shows a significant negative correlation with Pelvic Tilt (PT) (r = -0.761) and a significant positive correlation with Pubic-Sacral Angle (PSA) (r = 0.814), highlighting its effectiveness in reflecting pelvic and spinal alignment. Stability Across Developmental Stages: IT remains highly stable across different Risser stages of skeletal development, unlike traditional parameters such as PSA and T1 Slope-Pelvic Incidence (T1SPI), which vary significantly with skeletal maturity. Clinical Advantages: Compared to traditional sagittal parameters, IT offers a simpler and more reliable measurement process by requiring only unilateral iliac imaging, making it suitable for complex cases with limited imaging quality or special anatomical structures. Foundation for Future Research: The findings establish IT as a valuable tool for clinical and research applications in spinal health assessment, recommending further studies to explore its applicability in diverse age groups and pathological conditions. [ABSTRACT FROM AUTHOR]

Autistic individuals often exhibit motor atypicalities, which may relate to difficulties in social communication. This study utilized a smart tablet activity to computationally characterize motor control by testing adherence to the two-thirds power law (2/3 PL), which captures a systematic covariation between velocity and curvature in motor execution and governs many forms of human movement. Children aged 4–8 years old participated in this study, including 24 autistic children and 33 typically developing children. Participants drew and traced ellipses on an iPad. We extracted data from finger movements on the screen, and computed adherence to the 2/3 PL and other kinematic metrics. Measures of cognitive and motor functioning were also collected. In comparison to the typically developing group, the autistic group demonstrated greater velocity modulation between curved and straight sections of movement, increased levels of acceleration and jerk, and greater intra- and inter-individual variability across several kinematic variables. Further, significant motor control development was observed in typically developing children, but not in those with autism. This study is the first to examine motor control adherence to the 2/3 PL in autistic children, revealing overall diminished motor control. Less smooth, more varied movement and an indication of developmental stasis in autistic children were observed. This study offers a novel tool for computational characterization of the autism motor signature in children's development, demonstrating how smart tablet technology enables accessible assessment of children's motor performance in an objective, quantifiable and scalable manner. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the measurement properties of activity monitoring for a rehabilitation (AMoR) platform for step counting, time spent in sedentary behavior, and postural changes during activities of daily living (ADLs) in a simulated home environment. Methods: Twenty-one individuals in the post-stroke chronic phase used the AMoR platform during an ADL protocol and were monitored by a video camera. Spearman's correlation coefficient, mean absolute percent error (MAPE), intraclass correlation coefficient (ICC), and Bland–Altman plot analyses were used to estimate the validity and reliability between the AMoR platform and the video for step counting, time spent sitting/lying, and postural changes from sit-to-stand (SI-ST) and sit-to-stand (ST-SI). Results: Validity of the platform was observed with very high correlation values for step counting (rs = 0.998) and time spent sitting/lying (rs = 0.992) and high correlation for postural change of SI-ST (rs = 0.850) and ST-SI (rs = 0.851) when compared to the video. An error percentage above 5% was observed only for the SI-ST postural change (7.13%). The ICC values show excellent agreement for step counting (ICC3, k = 0.999) and time spent sitting/lying (ICC3, k = 0.992), and good agreement for SI-ST (ICC3, k = 0.859) and ST-SI (ICC3, k = 0.936) postural change. Values of the differences for step counting, sitting/lying time, and postural change were within the limits of agreement according to the analysis of the Bland–Altman graph. Conclusion: The AMoR platform presented validity and reliability for step counting, time spent sitting/lying, and identification of SI-ST and ST-SI postural changes during tests in a simulated environment in post-stroke individuals. [ABSTRACT FROM AUTHOR]

Background: The relationship between 24-hour (24-h) movement guidelines and frailty remains unclear. We aimed to investigate the associations between meeting 24-h movement guidelines and frailty and to conduct secondary analyses by age, gender, and ethnicity. Methods: In this study, we extracted data from the National Health and Nutrition Examination Survey (2007–2018) database. A total of 5,726 participants (50.25 ± 0.31 years) were included in this analysis, representing 38,240,356 noninstitutionalized U.S. individuals. Three 24-h movement behaviors, namely, physical activity, sedentary behavior (SB), and sleep, were self-reported using the standardized questionnaires. The 49-item frailty index was used to measure frailty. Multivariable logistic regression models and trend tests were used to examine the associations between meeting 24-h movement guidelines and frailty. Sensitivity analyses were also conducted to ensure the robustness of our results. Results: The total age-adjusted prevalence of frailty was 30.5%. In the fully adjusted model, compared with not meeting any of the 24-h movement guidelines, the adjusted odds ratios (AORs) of frailty were 0.786 (95% CI: 0.545, 1.133), 1.161 (95% CI: 0.787, 1.711), and 0.915 (95% CI: 0.616, 1.358) for participants meeting only moderate to vigorous physical activity (MVPA), only SB, and only sleep guidelines, respectively, but no statistically significant differences were observed (all P values > 0.05). Participants who met the SB + sleep guidelines (AOR = 0.613, 95% CI: 0.423, 0.887), MVPA + sleep guidelines (AOR = 0.389, 95% CI: 0.255, 0.593), and MVPA + SB guidelines (AOR = 0.555, 95% CI: 0.383, 0.806) presented a significantly lower risk of frailty by 39%, 61%, and 45%, respectively. Meeting all 3 guidelines (AOR = 0.377, 95% CI: 0.264, 0.539) and meeting 2 guidelines (AOR = 0.527, 95% CI: 0.377, 0.736) were associated with a lower risk of frailty (P value < 0.001), showing a linear trend (P for trend < 0.001). The strength of these associations varied somewhat by age, gender, and ethnicity. Conclusions: Significant associations between the 24-h movement guidelines and frailty were observed among U.S. adults. Future studies are warranted to examine the causality and trajectory of these associations. [ABSTRACT FROM AUTHOR]

Background: Mobilization with Movement (MWM) is an examination and management approach for correcting the intra-articular translational and rotational movements to facilitate the active physiological movement. The study aimed to determine the effects of MWM on Total Knee Arthroplasty (TKA) using a randomized controlled trial (RCT) design. Methods: The trial is registered (ISRCTN ref: 13,028,992). A blinded examiner assessed patients at pre-surgical (before TKA), post-surgical (at 3-weeks post-TKA), 6-weeks and 6-months post-TKA. Participants were randomly assigned to receive MWM (six sessions, between 3 and 6 weeks post-TKA) plus standard rehabilitation (intervention group) or standard rehabilitation alone (control group) of outpatient rehabilitation including range of motion and strengthening exercises, cycling, gait and stair training. Outcome measures were range of motion (goniometer), pain (visual analogue scales), physical function (Timed Up and Go (TUG)), a 15-m walk test, and health status (Western Ontario and McMaster (WOMAC) Osteoarthritis Index). Change in outcome measures from post-surgical to 6 weeks and 6 months post-TKA were compared between groups. The primary outcome was change in knee flexion range of motion at 6 weeks. Results: 84 women scheduled for TKA were randomly allocated to intervention (n = 42) or control (n = 42); mean ± (SD) age 65.1 ± 7.4 and 66.8 ± 8.9 years, respectively. The intervention group demonstrated significantly greater increase in knee flexion at both 6 weeks (median (IQR) + 10.000 (20.000) compared with + 2.500 (6.250) in the control group) and 6 months (+ 12.500 (15.000) and + 5.000 (10.000) respectively) (both p < 0.05). There were no differences between groups in secondary outcomes. Conclusion: Introducing MWM for TKA rehabilitation has greater benefits for women post-TKA in increasing knee joint flexion range of motion than the standard rehabilitation programs in the short and medium-term. This evidence-based approach offers a promising adjunctive intervention for optimizing recovery and rehabilitation process following TKA in women. Clinicians should consider including MWM approach in post-TKA rehabilitation programs. Level of Evidence: I [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to translate the Fear of Falling Avoidance Behavior Questionnaire (FFABQ) into Traditional Chinese (FFABQ-TC) and to evaluate the psychometric properties of FFABQ-TC in Taiwanese adults. Methods: We translated and culturally adapted the FFABQ into Traditional Chinese, ensuring linguistic accuracy and cultural relevance. A total of 230 Taiwanese community-dwelling adults participated in the study. Test-retest reliability was assessed in 30 participants, while 200 participants were included in the validity analysis. Known-groups validity was investigated by comparing the FFABQ-TC scores between fallers and non-fallers. Convergent validity was examined by correlating FFABQ-TC scores with Activities-specific Balance Confidence Scale (ABC), Geriatric Fear of Falling Measure (GFFM), and Timed-Up-and-Go (TUG) test. Results: The FFABQ-TC demonstrated excellent test-retest reliability (Intraclass Correlation Coefficient = 0.884) and excellent internal consistency (Cronbach's alpha = 0.930). Known-groups analysis revealed that FFABQ-TC significantly differentiated between fallers and non-fallers. Convergent validity was examined and showed significant correlations of FFABQ-TC with the ABC, the GFFM, and TUG. Conclusion: The psychometric properties of FFABQ-TC was established in Taiwanese adults for assessing FOF-related avoidance behaviors. The translated and adapted FFABQ-TC is a reliable and valid clinical tool for evaluating fall risk in this population. IMPLICATION FOR REHABILITATION: The current evidence supports the reliability and validity of the Traditional Chinese version of the Fear of Falling Avoidance Behavior Questionnaire (FFABQ-TC) in Taiwanese community-dwelling adults. FFABQ-TC is recommended as a reliable measurement to determine fall risk in clinical and research settings. [ABSTRACT FROM AUTHOR]

Background: Motion can exacerbate headache during a migraine attack, potentially leading to avoidance of routine physical activity. Advances in wrist-worn actigraphy facilitate objectively analyzing how headache episodes affect physical activity in everyday settings. The primary hypothesis was hypoactivity during daytime headache events. Secondary hypotheses are hypoactivity during the prodromal and postdromal hours closest to the headache event. Methods: During a 90-day prospective observational study, participants diagnosed with migraine wore an actigraphy device on their non-dominant wrist during daily life and work, while also logging migraine-related data in a dedicated smartphone application. There were no restrictions on use of acute and preventive headache treatments. Data from the wrist-worn accelerometer were used to (i) calculate activity energy expenditure, and (ii) predict types of human activities. These metrics were used to compare daytime prodromal, ictal, and postdromal phases of headache events with time-matched intervals during non-headache periods. Results: A significant reduction in daytime physical activity was observed during the ictal phase of headache attacks, as evidenced by decreases in both activity energy expenditure and human activity recognition prediction metrics. A reduction in movement was also observed during evening hours (18:00–24:00) on headache days. However, no significant physical activity changes were noted in the prodromal and postdromal phases. Reduced physical activity was more pronounced during the ictal phase when acute treatments were ineffective. Conclusions: This study is the first to examine the impact of headache on physical activity levels during daytime headache events by assessing changes in daily activities and activity energy expenditure in individuals with migraine, within their habitual environments and without restrictions on acute medication use. Our findings confirm reduced movement during the ictal phase of migraine attacks, supporting the primary hypothesis. Wrist-worn actigraphy further indicated that this reduction is more pronounced when patients experience movement sensitivity. Evening hypoactivity is also observed on headache days. Furthermore, attacks with ineffective acute treatment or moderate-to-high intensity were associated with more pronounced reductions in movement. In contrast, our data did not support the secondary hypothesis that physical activity would decrease during daytime prodromal and postdromal periods. Trial registration: NCT04983186 (www.ClinicalTrials.gov). [ABSTRACT FROM AUTHOR]

Background: Enhancing youth's physical fitness levels during childhood and adolescence through prior training programs can significantly optimize their athletic performance. The integrative neuromuscular training (INT) model is designed to improve neuromuscular function and prevent athletic injuries, and is superior to the traditional physical training method. This systematic review and meta-analysis aims to compare the effects of INT versus traditional physical fitness training (PT) on physical performance-related outcomes in young athletes. Methods: Six online databases (PubMed, MEDLINE, Embase, SPORTDiscus, Web of Science, PsycINFO) searched from inception through 15 January 2024. Meta-analysis was performed when data were available from two or more trials. Physical performance-related outcomes were analyzed using standardized mean differences (SMDs) and mean differences (MDs) with 95% confidence intervals (CIs). The certainty of evidence and quality of the included studies were rated using the GRADE scale and the revised Cochrane risk-of-bias tool respectively. Results: Seventeen randomized controlled trials with 649 young athletes were included in the systematic review. Of those, 1 study showed a low risk of bias, 1 showed a high risk, and 15 showed some concerns. Compared to the PT group, INT significantly improved dynamic balance (MD = 7.29%, 95%CI 3.31 to 11.28, p < 0.001, I2 = 64.7%), static balance (SMD = −0.54, 95%CI −0.84 to −0.24, p < 0.001, I2 = 0.0%), jumping performance (SMD = 0.53, 95%CI 0.32 to 0.73, p < 0.001, I2 = 0.0%), sprinting capacity (SMD = −0.76, 95%CI −1.13 to −0.39, p < 0.001, I2 = 57.6%) and maximal strength (SMD = 1.01, 95%CI 0.35 to 1.67, p = 0.002, I2 = 81.9%%). No significant between-group differences were identified for agility and flexibility. Conclusion: Our findings suggest that INT has the potential to be an effective training method to improve physical performance in young athletes. Moreover, further research is needed to determine the effects and associated doses for young athletes of different age groups. Key Points: Integrated neuromuscular training (INT) significantly improves balance, lower-body explosive power, and maximal strength in young athletes compared to traditional physical fitness training. INT interventions show significant enhancements in agility and flexibility after sensitivity analysis, indicating their potential for comprehensive physical performance improvements. Subgroup analysis suggests that longer interventions (over 12 weeks) and higher training frequencies (triweekly) show a trend towards greater improvements in young athletes' physical performance, despite not reaching statistical significance. [ABSTRACT FROM AUTHOR]

Objective: This study investigates the interplay between muscle strength, information processing speed, EEG-specific biomarkers, and cognitive function in elderly individuals with cognitive impairments, emphasizing the mediating roles of information processing speed and EEG-specific biomarkers. Method: A cross-sectional study design was employed to recruit 151 elderly participants. The participants underwent grip strength and 30-s sit-to-stand tests to assess muscle strength, completed the Trail Making Test part A (TMT-A) and the Symbol Digit Modality Test (SDMT) to evaluate information processing speed, and utilized the Montreal Cognitive Assessment (MOCA) to gauge cognitive function. Additionally, EEG signals were recorded for 5 min to capture neural activity. Results: The difference in information processing speed among elderly individuals with varying degrees of cognitive impairment was statistically significant (p < 0.001). A significant negative correlation was observed between the MoCA score and the time consumption of TMT-A (r = −0.402, p < 0.01), and a significant positive correlation was found between the MoCA score and the SDMT score (r = 0.609, p < 0.01). Grip strength was negatively correlated with the time consumption of TMT-A (r = −0.336, p < 0.01) and positively correlated with the SDMT score (r = 0.336, p < 0.01). A significant negative correlation was found between the 30-s sit-to-stand test and the time consumption of TMT-A (r = −0.273, p < 0.01), and a significant positive correlation was observed between the 30-s sit-to-stand test and the SDMT score (r = 0.372, p < 0.01). Additionally, we observed that the α1 power value indicators were significantly correlated with the MoCA score, the time consumption of TMT-A, and the SDMT score (all p < 0.01). The α1 power values at F7 + F8 and T5 + T6 were identified as sensitive EEG indicators for muscle strength and information processing speed. The EEG-specific indicators (B = 0.019, 95% CI: 0.003, 0.047) and information processing speed (B = 0.137, 95% CI: 0.096, 0.292) were found to partially mediate the relationship between grip strength and MoCA scores, with information processing speed exerting a stronger mediating effect. Conclusion: Specific patterns were observed in the EEG of elderly individuals with cognitive impairments, which could objectively assess the risk of cognitive decline in this population. Muscle strength, information processing speed, and EEG-specific biomarkers were closely associated with cognitive function in elderly individuals. The potential pathway of interaction—muscle strength → EEG-specific biomarkers → information processing speed → cognitive function—provides valuable insights into advancing the field of cognitive research in the elderly. [ABSTRACT FROM AUTHOR]

Background: Iron deposition has been observed in Parkinsonism and is emerging as a diagnostic marker for movement disorders. Brain functional network disruption has also been detected in parkinsonism, and is believed to be accountable for specific symptoms in parkinsonism. However, how iron deposition influences brain network remains to be elucidated. Methods: We recruited 16 Parkinson's disease (PD), 8 multiple system atrophy (MSA) and 7 progressive supranuclear palsy (PSP) patients. T1-weighted, susceptibility weighted images and resting-state functional MRI (rs-fMRI) were acquired. Quantitative susceptibility mapping (QSM) analysis was performed to quantify iron deposition in substantia nigra, putamen and dentate nucleus. Cerebellar network, sensorimotor network, default mode network and language networks were segregated using independent analysis. Network and iron deposition status were evaluated in relation to diagnostic groups, motor and non-motor symptoms. The relationship between quantitative iron deposition and brain network status was further interrogated. To further validate the findings, 13 healthy controls and 37 PD patients who had available T1 and rs-fMRI scans were selected from Parkinson's progression markers initiative (PPMI) database, and network analysis was performed. Results: In local cohort, compared to PD, MSA patients showed greater iron deposition in putamen, while PSP patients had greater iron deposition in caudate nucleus and thalamus. Cerebellar and language networks showed significant difference across diagnostic groups, while default mode network and sensorimotor network did not. MSA patients had significantly impaired cerebellar network and language networks compared to PD patients. Cerebellar network was positively associated with motor symptom scores while language network was positively associated with MoCA scores in the patients. Iron deposition was negatively associated with both networks' activity in the patients. In PPMI cohort, impairment was found in both cerebellar and language networks in PD. Cerebellar and language networks correlated with motor and cognitive impairment, respectively. Conclusion: Cerebellar network and language networks are differently influenced in MSA, PD and PSP, which can serve as potential diagnostic marker. Impairment of cerebellar network and language network are associated with motor symptoms and cognitive impairment, respectively. Moreover, dysfunction of the networks is associated with iron deposition in deep nuclei (SN, DN, Putamen). [ABSTRACT FROM AUTHOR]

Background Pain is common in people with dementia in general hospitals. This can be difficult to identify. Objectives To evaluate the psychometric properties of PainChek electronic pain assessment tool. Design Cross-sectional psychometric study. Setting Six medical care of older people wards from two general hospitals in greater London, UK. Subjects 63 people with clinical diagnosis of dementia: mean 84 years (SD 6.7), 59% female, 69% living in their own homes, 64% white British, 77% moderate/severe dementia. Method Psychometric evaluation of PainChek, a point-of-care electronic pain assessment tool combining artificial intelligence, facial analysis and smartphone technology. From a total of 216 assessments, we tested PainChek's inter-rater reliability (IRR) (Cohen's kappa), internal consistency (Cronbach's alpha) and concurrent validity (Pearson's coefficient) between PainChek and Pain Assessment in Advanced Dementia (PAINAD) scores at rest and post-movement [95% confidence interval (95% CI) where appropriate]. We assessed convergent validity with Symptom Management–End of Life in Dementia scale (SM-EOLD) (Pearson's coefficient) and discriminant validity (rest vs post-movement). Results IRR was 0.714 (95% CI 0.562 to 0.81) (rest) and 0.817 (95% CI 0.692 to 0.894) (post-movement). Internal consistency was 0.755 (rest) and 0.833 (post-movement). Concurrent validity with PAINAD was 0.528 (95% CI 0.317 to 0.690) (rest) and 0.787 (0.604 to 0.891) (post-movement). Convergent validity with SM-EOLD was −0.555 (95% CI −0.726 to −0.318) (rest) and −0.5644 (95% CI −0.733 to −0.331) (post-movement). Discriminant validity was significant. Conclusions PainChek is a valid and reliable pain assessment tool for people with dementia in general hospitals. Further consideration will be needed for implementation into this setting. [ABSTRACT FROM AUTHOR]

Objective To investigate the effectiveness of formula nutrition supplementation (mainly containing glucosamine sulphate, chondroitin sulphate and rhizoma drynariae) plus supervised exercise versus exercise alone for the treatment of knee osteoarthritis (OA). Methods This was a double-blinded, single-centre, randomised, placebo-controlled trial. The study recruited 65 participants (40–75 years) with knee OA. Participants were randomly allocated to nutrition supplementation plus exercise (N + E) group or placebo plus exercise (P + E) group. The intervention lasted for 6 months. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Secondary outcomes included physical function and performance scores, lower extremity strength and serum biomarkers. Results Among the 65 randomised patients, 56 (86%) completed the trial. At 3 months, more participants in the N + E group than in the P + E group achieved minimum clinically important difference (MCID) in WOMAC total score (19/30 [63.3%] vs 8/26 [30.8%]; P  < .01). At 6 months, more participants in the N + E group than in the P + E group achieved MCID in WOMAC stiffness score (19/30 [63.3%] vs 10/26 [38.5%]; P  < .05). Meanwhile, at 6 months the decreased percentages of WOMAC stiffness score in the N + E group was greater than in the P + E group (P  < .05). The flexor peak torque at 120°/s and 180°/s in the N + E group were significantly higher than those in the P + E group at 3 months (P  < .05). Moreover, compared with baseline, improvements in the WOMAC overall and pain score, visual analogue scale pain and 30-second chair stand test were observed in both groups at 6 months. However, these indicators in the N + E group were improved as early as 3 months (P  < .05). Conclusions The improvement effects of nutrition supplementation plus exercise were superior to those of exercise alone, and the improvement occurred earlier. Nutrition supplementation plus exercise would be a more efficient strategy for knee OA. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the efficacy of adding radial extracorporeal shockwave therapy or sham to exercise for people with insertional Achilles tendinopathy. Design: A two-armed, parallel-group, explanatory, single-centre, randomised controlled trial within a superiority framework. Setting: Private clinic. Participants: People diagnosed with insertional Achilles tendinopathy who were over 18 years old with a symptom duration of greater than 3 months. Intervention: A total of 76 people were randomly assigned (one-to-one ratio) to receive three sessions of radial extracorporeal shockwave therapy or sham to the affected side (or most affected side if bilateral). All participants received identical education and exercise. Outcome measures: The primary outcome was the Victorian Institute of Sports Assessment – Achilles questionnaire. Measures were recorded at baseline, 6 weeks and 12 weeks. Results: At 12 weeks, the questionnaire data were available for 37 people (96%) in the radial extracorporeal shockwave therapy group and 36 people (95%) in the sham group. For the primary outcome, we found no evidence for between-group differences at 6 (3, 95% confidence interval −4.6–10.5) or 12 weeks (4.6, 95% confidence interval −2.5–11.6). There was also no evidence for a between-group difference for any secondary outcome measures at either 6 or 12 weeks (p >.05). No serious adverse events were reported. Conclusion: The addition of radial extracorporeal shockwave therapy to exercise and education did not lead to improvements in pain, function or other outcomes compared to sham at 6 or 12 weeks among people with insertional Achilles tendinopathy. ANZCTR Reg No: ACTRN12620000035921 [ABSTRACT FROM AUTHOR]

The study aimed to determine the acute effects of subtetanic neuromuscular electrical stimulation (NMES) combined with active recovery between sprint exercises on blood lactate accumulation, sprint performance, and muscle fatigue. Sixteen healthy young individuals [23(4) years, 10 males] underwent a 1-min rest followed by sprint interval training consisting of four 15-sec maximal sprint exercises with three 5-min active cycling sessions. Participants engaged in voluntary cycling at 40% of peak oxygen consumption, with or without NMES (VOLES or VOL; interventions). Blood lactate concentration ([La]b) was assessed at the end of the rest and each intervention periods. Mean power was assessed during each sprint exercise session. Maximum voluntary contraction (MVC) of the knee extensor was measured before and after sprint interval training to evaluate muscle fatigue. The [La]b was significantly higher in VOLES than in VOL (main effect, P=0.037). Mean power did not differ between conditions (main effect and interaction, P>0.050). MVC after sprint interval exercise was significantly lower in VOLES than in VOL (interaction, P<0.001). Subtetanic NMES combined with voluntary cycling enhanced blood lactate accumulation and induced greater voluntary fatigue but resulted in similar peripheral muscle fatigue and sprint exercise performance compared with voluntary cycling without NMES. [ABSTRACT FROM AUTHOR]

Ginsenosides, active compounds derived from Panax ginseng, exhibit promising potential in enhancing physical performance. This study investigates the impact of UG0712 (UG), a novel ginsenoside compound, on endurance capacity, body weight, organ weights, blood parameters, and specific transcriptomic changes in liver and muscle tissues using a C57BL/6N mouse model. The mice received UGs orally at three doses: UG50 (50 mg/kg), UG100 (100 mg/kg), and UG200 (200 mg/kg) for a specified duration. Endurance capacity, physiological parameters, and transcriptome signatures in liver and muscle tissues were assessed. UG administration significantly improved time to exhaustion, with UG50 and UG200 showing substantial enhancements. Body and organ weights exhibited no notable differences, suggesting a lack of adverse effects. Biochemical markers, except for decreased creatine kinase levels in the UG100 group, showed no significant variations. Transcriptome analysis revealed limited group separation and dose-dependent patterns. The UG100 group displayed significant enrichment in lipid metabolism and muscle-related terms. Identified dose-dependent improvements in endurance capacity highlight UGs' potential as supplements. The absence of adverse effects on body and organ weights, along with positive effects on biochemical markers, supports their safety. Despite limited dose-dependent patterns in transcriptomic analyses, the UG100 group showcased significant enrichment in pathways related to muscle and lipid metabolism. These findings offer valuable insights for athletes and aging individuals seeking to enhance physical performance, warranting further exploration into UG effects' on molecular mechanisms. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to provide evidence for the interpretation of the projected frontal area (PFA) during front crawl. To achieve this goal, we developed a method for calculating the PFA of each body segment using digital human technology and compared the pressure drag under two calculation conditions: a combination of the PFA with and without accounting for the horizontal velocity of each body segment. Methods: Twelve competitive male swimmers performed a 15-m front crawl at 1.20 m·s−1. The three-dimensional positions of the reflective markers attached to the swimmer's body were recorded using an underwater motion-capture system. Based on the body shape of each swimmer obtained from the photogenic body scanner, individual digital human body models were created with the color of the model's vertices divided into eight body segments. The time series of the volumetric swimming motion was reconstructed using inverse kinematics. The PFA of each body segment was then calculated by the automatic processing of a series of parallel frontal images. The pressure drag index, defined as the value excluding the drag coefficient while simultaneously considering the PFA and the horizontal velocity, was calculated under two conditions: the static condition (accounting for only the PFA of each body segment) and the dynamic condition (accounting for the PFA and horizontal velocity of each body segment). Results: Notably, the pressure drag index was higher under the static condition than under the dynamic condition for the humerus, ulna, and hand segments (P < 0.001). Conclusions: The results obtained using our methodology indicate that the PFA of the upper limb segments overestimates their contribution to pressure drag during front crawl under the static condition. [ABSTRACT FROM AUTHOR]

Purpose: This study compared the effects of off- and on-bike resistance training (RT) on endurance cycling performance as well as muscle strength, power, and structure. Methods: Well-trained male cyclists were randomly assigned to incorporate two sessions/week of off-bike (full squats, n = 12) or on-bike (all-out efforts performed against very high resistances and thus at very low cadences, n = 12) RT during 10 wk, with all RT-related variables (number of sessions, sets, and repetitions, duration of recovery periods, and relative loads [70% of one-repetition maximum]) matched between the two groups. A third, control group (n = 13), did not receive any RT stimulus, but all groups completed a cycling training regime of the same volume and intensity. Outcomes included maximum oxygen uptake (V̇O2max), off-bike muscle strength (full squat) and on-bike ("pedaling") muscle strength, and peak power capacity (Wingate test), dual-energy X-ray absorptiometry-determined body composition (muscle/fat mass), and muscle structure (cross-sectional area, pennation angle). Results: No significant within/between-group effect was found for V̇O2max. Both the off-bike (mean Δ = 2.6%–5.8%) and on-bike (4.5%–7.3%) RT groups increased squat and pedaling-specific strength parameters after the intervention compared with the control group (−5.8% to –3.9%) (P < 0.05) with no significant differences between them. The two RT groups also increased Wingate performance (4.1% and 4.3%, respectively, vs –4.9% in the control group, P ≤ 0.018), with similar results for muscle cross-sectional area (2.5% and 2.2%, vs –2.3% in the control group, P ≤ 0.008). No significant within/between-group effect was found for body composition. Conclusions: The new proposed on-bike RT could be an effective alternative to conventional off-bike RT training for improving overall and pedaling-specific muscle strength, power, and muscle mass. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine associations between clinical measures (self-reported and clinician administered) and subsequent injury rates in the year after concussion return to play (RTP) among adolescent athletes. Methods: We performed a prospective, longitudinal study of adolescents ages 13–18 yr. Each participant was initially assessed within 21 d of concussion and again within 5 d of receiving RTP clearance from their physician. Participants completed self-report measures: the Pittsburgh Sleep Quality Index and Tampa Scale of Kinesiophobia, and clinician-administered measures: single- and dual-task tandem gait and reaction time (RT; simple and clinical) assessments. They then completed monthly surveys for a year after RTP, which assessed exposure to injury (sport participation) and subsequent injuries (musculoskeletal or concussions) sustained. We used Poisson regression models to calculate injury rate ratios with the number of subsequent injuries sustained as the outcome, adjusted for RTP clearance time and competitive exposures for each measure. Results: Forty-one participants were included (age = 15.5 ± 1.3 yr, 56% female, 9.6 ± 4.6 d postconcussion; 38.0 ± 31.5 d to RTP). A higher injury rate per athletic exposure was observed for simple RT ≥ 505 ms versus <505 ms (injury rate ratio = 2.96, 95% confidence interval = 1.41-6.60, P = 0.005). Injury rates did not significantly differ by Pittsburgh Sleep Quality Index or Tampa Scale of Kinesiophobia scores, single/dual-task tandem gait time, or clinical RT. Conclusions: Simple RT may be one risk factor that is associated with higher rates of subsequent injury after adolescent concussion. A simple RT measure incorporated into a comprehensive concussion RTP assessment may identify some individuals at higher risk of subsequent injury in the year after concussion, although further research is needed to better understand this relationship. [ABSTRACT FROM AUTHOR]

Background: Approximately 40% of college/university students have overweight/obesity; physical activity and sleep play a role. To address these interrelated behaviors, Canada recently released 24-Hour Movement Guidelines. This study aimed to determine (1) the percent of students with overweight/obesity meeting Canadian 24-Hour Movement Guidelines, (2) whether health behaviors differ by demographics, and (3) whether meeting guidelines is associated with BMI. Methods: University students 18–35 years (n = 459) enrolled in a randomized controlled weight management trial completed 1 week of ActiGraph measured activity, self-reported sleep duration, researcher-measured height/weight, and demographics at baseline. ANOVA and t-tests determined differences in student demographics and BMI among those meeting vs not meeting each guideline. Results: Of the analytic sample (n = 403), 341 (84.6%) met the MVPA guideline, 284 (70.5%) met the LIPA guideline, 236 (58.6%) met the sleep guideline, 62 (15.4%) met the sedentary time guideline, and 34 (8.4%) met all guidelines. Students meeting MVPA (30.8±4.3 vs 32.5±4.5, P =.008) or sleep (30.7±4.4 vs 31.6±4.3, P =.04) guidelines had significantly lower BMIs compared to those not meeting each guideline. Percent of students meeting sleep (P =.039) or all guidelines (P =.012) differed by race/ethnicity. Conclusion: Meeting MVPA/sleep guidelines is associated with lower BMI; these behaviors are important targets for future weight management programs. [ABSTRACT FROM AUTHOR]