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Although single-leg squats are a common dynamic balance clinical assessment, little is known about the relationship between parameters that influence squat movement and postural control performance. The objective of this study was to determine the relationships between squat parameters (speed and depth) and postural control under single task and dual task. A total of 30 healthy college students performed single-leg squats under single task and dual task with Stroop. Random-intercepts generalized linear mixed models determined the effect of squat parameters on center of pressure (CoP) parameters. For each 1-cm·s−1increase in squat speed, sway range (mediolateral: β = −0.03; anteroposterior: β = −0.05) and area (β = −0.25) decreased, whereas sway speed (mediolateral: β = 0.05; anteroposterior: β = 0.29; total: β = 0.29) increased. For each 1-cm increase in squat depth, sway range (mediolateral: β = 0.05; anteroposterior: β = 0.20) and area (β = 0.72) increased, whereas sway speed (anteroposterior: β = −0.14; total: β = −0.14) decreased. Compared with single task, the association between total and anteroposterior sway speed and squat speed was stronger under dual task. Clinicians and researchers should consider monitoring squat speed and depth when assessing dynamic balance during single-leg squats, as these parameters influence postural control, especially under dual task.

Objectives: Anterior cruciate ligament reconstruction (ACLR) remains one of the most readiness-impairing surgical conditions treated in the US Military. Greater time from the index injury to surgical management (ACLR) unnecessarily prolongs the total time of limited duty. Additionally, prolonged wait times from the index injury to ACLR may increase the patient’s likelihood of sustaining concomitant or secondary intraarticular pathologies (e.g., cartilage and meniscus damage). The optimal timing for surgical reconstruction following ACL injury is debated. The purpose of this study was to determine the impact of prolonged time from injury to surgery on medical separation within five years of primary ACLR. We hypothesized that longer durations from injury to primary ACLR would be associated with greater medical separation risk within five years following surgery. Methods: We conducted a retrospective database review using data from the Military Health System Data Repository (MDR) of primary ACLR without and with concomitant procedures (meniscus [M] and/or cartilage [C]) performed within Military Treatment Facilities (MTF) from fiscal year 2009 to and/or cartilage [C]) performed within Military Treatment Facilities (MTF) from fiscal year 2009 to 2011. At the time of the ACLR, ADSMs had to be continuously enrolled for two years prior to the surgery with no history of knee surgeries in direct care (i.e., MTFs) or purchased care to ensure a higher likelihood of the index event being a primary ACLR and not an ACLR revision. A total 2,809 active duty service members were included with primary ACLR. The MDR was queried for baseline demographic, military service, and surgical information at the time of ACLR. Duty status at the time of the ACLR and cause of separation up to five years after primary ACLR were abstracted. The time from the index injury diagnosis to the primary ACLR was calculated and grouped as follows: Acute = 0-42 days, Subacute = 43-91 days, Delayed = 92-179 days, Chronic ≥ 180 days. Kaplan-Meier survivability curves were estimated and evaluated with Log-rank. Cox Proportional Hazard Models calculated Hazard Ratios (HR) with 95% confidence intervals (95% CI) to identify time from injury to surgery, demographic, and military status factors that influenced medical separation risk for patients with primary ACLR (ACLR, ACLR+M, ACLR+C, ACLR+M+C). Results: The index surgical events were categorized by isolated ACLR (48%), ACLR+M (42%), ACLR+C (5%), and ACLR+M+C (4%). Overall, the time from diagnosis to ACLR was approximately equivalent across all time categories: Acute (19%), Subacute (31%), Delayed (23%), and Chronic (25%). The probability of medical separation 5 years following primary ACLR (ACLR, ACLR+M, ACLR+C, ACLR+M+C) was highest for the delayed [92-179 days] group (17%) and lowest for the acute [0-42 days] group (12%). Patients in the delayed group were over 51% more likely to medically separate in the 5 years following the primary ACLR than those who were treated within 42 days from injury (acute group). The difference between the acute group and subacute or chronic was not statistically significant. Those in infantry and combat support related military occupation classifications were 27% more likely to medically separate. Service members in the Army were more than 4.5 times more likely to medically separate compared to those in the Air Force. Smoking and BMI over 29 also increased the risk of medical separation within 5 years by 42% and 91%, respectively. The type of injury at the index event (ACLR, ACLR+M, ACLR+C, ACLR+M+C) did not significantly influence the likelihood of medical separation risk. Conclusion: Delay in treatment from injury to primary ACLR increases the number of limited duty days, effects medical readiness of ADSM, and military retention rates post ACLR. Specifically, when primary ACLR is delayed 3 to 6 months from injury, ADSM have a 51% increased likelihood of military medical separation risk in the 5 years following the ACLR than if they would have been treated within 41 days of injury. Early recognition of ACL tears as well as availability of surgeons and Operative Rooms (ORs) should be evaluated to determine their contribution to the delay in ACLR in the MHS.

Objectives Determine the association between performance on the double-leg squat (DLS) and single-leg squat (SLS) and prospective injury incidence in athletes. Design Prospective cohort study. Setting National Collegiate Athletic Association (NCAA) Division I university. Participants 111 incoming NCAA Division I athletes from 10 varsity sports teams. Main outcome measures Performance on the DLS and SLS were assessed as “poor” or “non-poor.” Lower extremity (LE) injury data for the following year were extracted from electronic medical records. Multivariate Poisson regression was used to compare the incidence of LE injuries in athletes with poor versus non-poor performance on the DLS and SLS. Results The final models for the DLS and SLS were adjusted for sex and LE injury history and yielded an incidence rate ratio (IRR) of 1.33 (95% CI: 0.80 2.22) for the DLS and 1.62 (95% CI: 0.98, 2.66) for the SLS when comparing poor to non-poor movers. Conclusions Athletes with poor LE movement quality assessed on the DLS or SLS had greater incidence of LE injury than those with non-poor movement quality. This is the first study to demonstrate an association between performance on the double-leg squat and single-leg squat and injury risk in NCAA athletes.

AB Dynamic postural control deficits and disrupted cortical pathways have been reported to persist beyond an athlete's return to activity after concussion, potentially increasing the risk of acute lower extremity musculoskeletal injury. Purpose: This study aimed to investigate acute lower extremity musculoskeletal injury rates before and after concussion in athletes with concussion and their matched control. Methods: College athletes with concussion (n = 44; age, 20.0 +/- 1.2 yr) were physician-diagnosed. Nonconcussed college athletes (n = 58; age, 20.5 +/- 1.3 yr) were matched to individuals with concussion. Acute lower extremity musculoskeletal injury data were collected for 2 yr (+/-1 yr of the diagnosed concussion) using electronic medical records. Control participants' 2-yr window for exposure and musculoskeletal injury data were anchored to their match's concussion injury date. Pre- and postconcussion musculoskeletal injury rates were calculated for 90-, 180-, and 365-d periods for both study cohorts. Risk ratios were calculated to determine differences within and between groups for all periods. Results: Within 1 yr after concussion, the group with concussion was 1.97 (95% confidence interval (CI), 1.19-3.28; P = 0.01) times more likely to have experienced an acute lower extremity musculoskeletal injury after concussion than before concussion and 1.64 times (95% CI, 1.07-2.51; P = 0.02) more likely to have experienced an acute lower extremity musculoskeletal injury after concussion than their matched nonconcussed cohort over the same period. Up to 180 d after concussion, the group with concussion was 2.02 (95% CI, 1.08-3.78; P = 0.02) times more likely to have experienced an acute lower extremity musculoskeletal injury after concussion than before concussion. Conclusions: Previous literature has identified dynamic postural control deficits along with increased motor evoked potential latency and decreased amplitude after concussion, suggesting that the brain may be unable to effectively coordinate movement. Our findings underscore the need to explore functional movement and dynamic postural control assessments in postconcussion injury assessment protocols.

Francia, Bd. 39 (2012)

Unmanned aerial systems (UASs), known colloquially as drones, constitute a rapidly growing market, with sales that tripled in the 12 months ending in April 2016.[1][1] These drones are being used innovatively for photography, racing, security, and architecture, and their use will soon include

Context: Although an association between concussion and musculoskeletal injury has been described in collegiate and professional athletes, no researchers have investigated an association in younger athletes. Objective: To determine if concussion in high school athletes increased the risk for lower extremity musculoskeletal injury after return to activity. Design: Observational cohort study. Setting: One hundred ninety-six high schools across 26 states. Patients or Other Participants: We used data from the National Athletic Treatment, Injury and Outcomes Network surveillance system. Athletic trainers provided information about sport-related concussions and musculoskeletal injuries in athletes in 27 sports, along with missed activity time due to these injuries. Main Outcome Measure(s): Three general estimating equations were modeled to predict the odds of sustaining (1) any lower extremity injury, (2) a time-loss lower extremity injury, or (3) a non–time-loss lower extremity injury after concussion. Predictors were the total number of previous injuries, number of previous concussions, number of previous lower extremity injuries, number of previous upper extremity injuries, and sport contact classification. Results: The initial dataset contained data from 18 216 athletes (females = 39%, n = 6887) and 46 217 injuries. Lower extremity injuries accounted for most injuries (56.3%), and concussions for 4.3% of total injuries. For every previous concussion, the odds of sustaining a subsequent time-loss lower extremity injury increased 34% (odds ratio [OR] = 1.34; 95% confidence interval [CI] = 1.13, 1.60). The number of previous concussions had no effect on the odds of sustaining any subsequent lower extremity injury (OR = 0.97; 95% CI = 0.89, 1.05) or a non–time-loss injury (OR = 1.01; 95% CI = 0.92, 1.10). Conclusions: Among high school athletes, concussion increased the odds of sustaining subsequent time-loss lower extremity injuries but not non–time-loss injuries. By definition, time-loss injuries may be considered more severe than non–time-loss injuries. The exact mechanism underlying the increased risk of lower extremity injury after concussion remains elusive and should be further explored in future research.

Context: The Landing Error Scoring System (LESS) can be used to identify individuals with an elevated risk of lower extremity injury. The limitation of the LESS is that raters identify movement errors from video replay, which is time-consuming and, therefore, may limit its use by clinicians. A markerless motion-capture system may be capable of automating LESS scoring, thereby removing this obstacle. Objective: To determine the reliability of an automated markerless motion-capture system for scoring the LESS. Design: Cross-sectional study. Setting: United States Military Academy. Patients or Other Participants: A total of 57 healthy, physically active individuals (47 men, 10 women; age = 18.6 ± 0.6 years, height = 174.5 ± 6.7 cm, mass = 75.9 ± 9.2 kg). Main Outcome Measure(s): Participants completed 3 jump-landing trials that were recorded by standard video cameras and a depth camera. Their movement quality was evaluated by expert LESS raters (standard video recording) using the LESS rubric and by software that automates LESS scoring (depth-camera data). We recorded an error for a LESS item if it was present on at least 2 of 3 jump-landing trials. We calculated κ statistics, prevalence- and bias-adjusted κ (PABAK) statistics, and percentage agreement for each LESS item. Interrater reliability was evaluated between the 2 expert rater scores and between a consensus expert score and the markerless motion-capture system score. Results: We observed reliability between the 2 expert LESS raters (average κ = 0.45 ± 0.35, average PABAK = 0.67 ± 0.34; percentage agreement = 0.83 ± 0.17). The markerless motion-capture system had similar reliability with consensus expert scores (average κ = 0.48 ± 0.40, average PABAK = 0.71 ± 0.27; percentage agreement = 0.85 ± 0.14). However, reliability was poor for 5 LESS items in both LESS score comparisons. Conclusions: A markerless motion-capture system had the same level of reliability as expert LESS raters, suggesting that an automated system can accurately assess movement. Therefore, clinicians can use the markerless motion-capture system to reliably score the LESS without being limited by the time requirements of manual LESS scoring.

OBJECTIVES To examine (a) generalization of the effectiveness of prolonged exposure (PE) therapy for posttraumatic stress disorder (PTSD) in improving postconcussive symptoms (PCSs) and other outcomes in military service members and Veterans (VA) with histories of mild to severe traumatic brain injury (TBI), and (b) factors associated with PCS reduction. SETTING VA polytrauma medical center. PARTICIPANTS Consecutive referrals for PTSD treatment of Active Duty (n = 17) or Veterans (n = 27) diagnosed with PTSD and TBI (N = 44). MAIN OUTCOME MEASURES Neurobehavioral Symptom Inventory, Key Behaviors Change Inventory, Self-Efficacy for Symptom Management, Posttraumatic Stress Disorder Checklist, and Beck Depression Inventory, 2nd edition. DESIGN Post hoc analysis of archival clinical effectiveness program evaluation data. INTERVENTIONS PE for PTSD. RESULTS There were significant improvements on all outcome measures with large effect sizes (Cohen's d ranging from 0.68 to 2.02). Improvement on PCS (Cohen's d = 1.21) was associated with lower levels of VA service-connected disability and PE treatment completion. CONCLUSION PE treatment-related improvements for participants with comorbid PTSD and TBI generalize from PTSD outcomes to PCS and other TBI-related outcomes. Positive outcomes were independent of TBI severity, treatment setting, or Veteran status, but dependent upon PE treatment completion and lower levels of VA service-connected disability.

Context: Verbal and tactile feedback (VTF) during rehabilitation exercises can increase muscle activation, thus improving the therapeutic benefits. However, it is unclear which feedback method elicits the greatest electromyographic (EMG) amplitude. Objective: To determine if the addition of tactile to verbal feedback (VF) increases EMG amplitude of selected shoulder musculature during scapular plane elevation (Ys), shoulder horizontal abduction with external rotation (Ts), and scapular retraction with external rotation (Ws). Design: Repeated-measures cross-over design. Setting: Biomechanics laboratory. Participants: A total of 30 physically active adults volunteered for this study—age = 20.23 (1.25) years; height = 1.71 (0.073) m; and mass = 70.11 (15.14) kg. Interventions: Electromyography of the serratus anterior; upper, middle, and lower trapezii; and anterior and posterior deltoids was recorded during Ys, Ts, and Ws with VTF and VF alone during separate testing sessions. Participants completed baseline trials without feedback, then received VTF and VF across 2 counterbalanced sessions. Main Outcome Measures: Difference scores were calculated between prefeedback and postfeedback interventions, and the difference score between baseline measurements was used as a control. One-way analysis of variance of the difference scores was used to evaluate the influence of VTF and VF on EMG amplitude during Ys, Ts, and Ws. Results: There was a significant difference between conditions for EMG amplitude of the middle trapezius (F2,28 = 4.09, P = .02) and serratus anterior (F2,28 = 3.91, P = .03) during Ys, the middle trapezius (F2,28 = 7.82, P = .001) during Ws, and the upper (F2,28 = 3.61, P = .03) and middle trapezii (F2,28 = 5.81, P = .01) during Ts. Post hoc testing revealed that both feedback conditions elicited greater EMG amplitude compared with no feedback, but there were no significant differences between the feedback conditions. Conclusions: The addition of tactile feedback to VF does not increase EMG amplitude compared with VF alone. This study indicates that feedback, regardless of type, is more beneficial than providing no feedback, for increasing EMG amplitude.

Introduction Shoulder instability is one of the most common pathologies seen by the orthopedic sports medicine surgeon. With a uniquely young, high-demand patient population in the U.S. Military, the incidence of shoulder instability is remarkably more common than the civilian population. As such, military orthopedic surgeons and sports medicine and shoulder specialists have developed a unique understanding and experience of shoulder instability. The historical advances of shoulder instability in the military have been instrumental in understanding the epidemiology, evaluation, pathology, treatment of first-time shoulder subluxations and dislocations, operative and non-operative treatment options, arthroscopic and open stabilization methods, management of the in-season athlete, treatment of combined and circumferential labral pathology, and associated pathology. Methods The purpose of this article is to chronicle the experience of military orthopedic surgeons in treating shoulder instability. We discuss how this unique experience has led to a better understanding of the epidemiology and pathology of this condition and how we have adapted our clinical practice to improve patient outcomes. Results The historical contribution of U.S. Military orthopedics to the understanding of shoulder instability has been monumental. This article reviews the evolution of shoulder instability treatment and the understanding as it has evolved in the U.S. Military. It further elaborates on our understanding of the epidemiology of shoulder instability in the U.S. Military, with attention given to our incidence of 1.69 per 1000 person-years, approximately 20 times higher incidence than the general population. We discuss known risk factors for dislocation that contribute to this incidence, which are specific to military service. We address pathologic changes seen following a first-time instability event, including an analysis of labral injury and the role of these pathologic changes in recurrent instability. We also review our results from arthroscopic evaluation of first-time dislocations and compare the pathologic changes with those following a first-time subluxation. Evaluation of treatment outcomes is discussed, comparing operative and non-operative results as well as open and arthroscopic stabilization in the U.S. Military population and contact/collision athletes. Finally, we address how these results drive our current treatment algorithm. Discussion and conclusion The physical demands of military service result in a high rate of shoulder instability relative to the general population. For years military orthopedic surgeons have sought to better understand this pathology and learn how to optimally manage it so as to reduce this heavy burden of disease. This article discusses our experience with treating shoulder instability, provides an overview of the lessons learned, and provides a historical perspective for the evolution of shoulder instability understanding in the U.S. Military.

Context: Dynamic balance deficits have been described postconcussion, even after athletes return to play. Lower extremity (LE) musculoskeletal injury rates increase for up to 1 year after concussion, but the long-term musculoskeletal implications of concussion are unclear. Objective: To (1) examine the association of concussion and LE injury histories with osteoarthritis (OA) prevalence in retired National Football League players and (2) examine the association of concussion and LE injury histories with OA prevalence in those ≤55 years of age. Design: Case-control study. Setting: Survey. Patients or Other Participants: We administered the Health Survey of Retired National Football League Players, which collects information about demographics, OA, LE injury, and concussion history. Main Outcome Measure(s): Twelve discrete categories were created based on concussion and LE injury history, ranging from 0 concussions and 0 LE injuries (referent group) to 3+ concussions and 2+ LE injuries. Binomial regression analysis modeled lifetime OA prevalence. Covariates were body mass index, age at the time of the survey, and total years playing professional football. Results: Complete data were available for 2696 participants. Lifetime OA prevalence was smallest in the referent group (21.1%) and largest in the 3+ concussion and 2+ LE group (50.6%; 2.5 times the referent; 95% confidence interval [CI] = 2.1, 3.1). Participants in all concussion groups (1, 2, 3+) who reported a history of 0 LE injuries had a greater OA prevalence than the referent group. When participants were stratified by age, the ≤55 years of age, 3+ concussions, and 2+ LE injuries group prevalence ratio (3.6; 95% CI = 2.7, 5.2) was larger than that of the >55 years of age, 3+ concussions, and 2+ LE injuries group (1.8; 95% CI = 1.3, 2.4) compared with the respective referent groups. Conclusions: Concussion with or without a history of LE injury may be an important moderator of OA. Future researchers should seek to better understand the mechanisms that influence the association among concussion, LE injury, and OA.

Background: Ankle sprains are among the most common injuries experienced by collegiate athletes. The type of ankle sprain is rarely differentiated in epidemiological studies. This differentiation is necessary, as each ankle sprain type has a unique injury mechanism and recovery period. High ankle sprains commonly result in long recovery periods. Thus, a further examination of the epidemiology of high ankle sprains is warranted. Purpose: To describe the epidemiology of high ankle sprains in National Collegiate Athletic Association (NCAA) sports during the 2009/2010-2014/2015 academic years. Study Design: Descriptive epidemiology study. Methods: NCAA Injury Surveillance Program high ankle sprain data and athlete-exposures (AEs) from 25 sports were evaluated. Certified athletic trainers recorded sport-related injury, event, and AE data during team-sanctioned events. High ankle sprain injury rates per 10,000 AEs were calculated. Percentage distributions were calculated for the amount of time lost from sport and percentage of recurrent injuries. Injury rate ratios (RRs) and 95% CIs compared injury rates by event type, participation restriction time, and sex. 95% CIs not containing 1.00 were considered statistically significant. Results: The overall high ankle sprain injury rate was 1.00 per 10,000 AEs. Overall, 56.7% of high ankle sprain injuries occurred during competitions, and 9.8% of high ankle sprain injuries were recurrent. Men’s football (2.42/10,000 AEs), wrestling (2.11/10,000 AEs), and ice hockey (1.19/10,000 AEs) had the highest high ankle sprain injury rates. In sex-comparable sports, men had higher injury rates (RR, 1.77; 95% CI, 1.28-2.44). Player contact was the most common injury mechanism (60.4%), and 69.0% of injuries resulted in ≥1 day of participation restriction, with 47.1% resulting in ≥7 days of participation restriction and 15.8% resulting in >21 days of participation restriction. Conclusion: High ankle sprains resulted in significant participation restriction time from sport participation. The majority of high ankle sprain injuries resulted from player contact and were observed in contact/collision sports. The large proportion of high ankle sprains resulting from player contact, specifically in male contact sports, is worthy of further investigation. Clinical Relevance: The enhanced understanding of the epidemiology of high ankle sprains provided in our study will aid clinicians in developing targeted injury prevention strategies to mitigate the negative consequences of these injuries.

A greater knee valgus angle is a risk factor for lower extremity injuries. Visually observed medial knee displacement is used as a proxy for knee valgus motion during movement assessments in an attempt to identify individuals at heightened risk for injury. The validity of medial knee displacement as an indicator of valgus motion has yet to be determined during a single-leg squat. This study compared three-dimensional knee and hip angles between participants who displayed medial knee displacement (MKD group) during a single-leg squat and those who did not (control group). Participants completed five single-leg squats. An electromagnetic motion tracking system was used to quantify peak knee and hip joint angles during the descent phase of each squat. MANOVA identified a difference between the MKD and control group kinematics. ANOVA post hoc testing revealed greater knee valgus angle in the MKD (12.86 ± 5.76) compared with the control (6.08 ± 5.23) group. There were no other differences between groups. Medial knee displacement is indicative of knee valgus motion; however, it is not indicative of greater knee or hip rotation, or hip adduction. These data indicate that clinicians can accurately identify individuals with greater knee valgus angle through visually observed medial knee displacement.

Knee valgus is a potential risk factor for lower extremity (LE) injuries. Clinical movement screenings and passive range of motion (PROM) measurements may help identify neuromuscular patterns, which contribute to knee valgus. The purpose of this study was to compare LE muscle activation and PROM between subjects who display visual medial knee displacement (MKD) during a single leg squat (SLS) and those who do not. We hypothesized that muscular activation and PROM would differ between the groups. Forty physically active adults (20 controls, 20 MKDs) participated in this study. Subjects completed 10 LE PROM assessments and performed 5 SLS trials while electromyography (EMG) data were collected from 8 LE muscles. Three separate multivariate analysis of variance were used to identify group differences in EMG data, muscle coactivation, and PROM. Results during the SLS indicated hip coactivation ratios revealed smaller gluteus medius to hip adductor (GMed:Hip Add) (p = 0.028) and gluteus maximus to hip adductor (GMax:Hip Add) coactivation ratios (p = 0.007) compared with the control group. Also, the MKD group displayed significantly less passive ankle dorsiflexion with the knee extended (p = 0.047) and flexed (p = 0.034), and greater talar glide motion (p = 0.012). The findings of this study indicate that MKD during a SLS seems to be influenced by decreased coactivation of the gluteal to the hip adductor muscles and restricted dorsiflexion. Therefore, conditioning, rehabilitation, and injury prevention programs should focus on decreasing hip adductor activity, increasing hip abductor and external rotator activity, and increasing ankle dorsiflexion in hopes to decrease the incidence of these injuries.

Emergency Departments (EDs) are important settings for routine HIV screening because they are safety nets for populations with limited access to primary care and high risk for HIV infection. However, EDs rarely perform routine HIV screening due to logistical barriers. An electronic medical record (EMR)-driven routine opt-out HIV screening program was implemented in an urban academic ED and led to rapid scale-up of screening volume and detection of unknown HIV infection. The streamlined tool, requiring 4 mouse clicks, automates screening for eligibility, facilitates documentation of consent and orders the HIV test. HIV screening increased to a monthly average of 550 tests compared to an average of 7 tests prior to program implementation. Similar EMR innovations can be leveraged in a variety of other clinical settings and for testing of other diseases to improve clinical flow and outcomes.

Combining dynamic postural control assessments and cognitive tasks may give clinicians a more accurate indication of postural control under sport-like conditions compared to single-task assessments. We examined postural control, cognitive and squatting performance of healthy individuals during static and dynamic postural control assessments in single- and dual-task paradigms. Thirty participants (female = 22, male = 8; age = 20.8 ± 1.6 years, height = 157.9 ± 13.0 cm, mass = 67.8 ± 20.6 kg) completed single-leg stance and single-leg squat assessments on a force plate individually (single-task) and concurrently (dual-task) with two cognitive assessments, a modified Stroop test and the Brooks Spatial Memory Test. Outcomes included centre of pressure speed, 95% confidence ellipse, squat depth and speed and cognitive test measures (percentage of correct answers and reaction time). Postural control performance varied between postural control assessments and testing paradigms. Participants did not squat as deep and squatted slower (P 0.001) during dual-task paradigms (≤12.69 ± 3.4 cm squat depth, ≤16.20 ± 4.6 cm · s

To assess whether sport involvement, particularly as a fan, is central enough to one's self-concept to be mentioned in obituary content, it was hypothesized that a greater proportion of men's obituaries than women's would mention the deceased individual's sport fan identification. Obituaries were randomly selected from 19 newspapers and coded for specific affiliations (e.g., military) and involvement in leisure activities (e.g., sport participation). Consistent with the hypothesis, a chi-squared analysis indicated the men's obituaries (15.2%) were significantly more likely than the women's (5.2%) to mention sport fan identification. A higher proportion of the men's obituaries (24.4%) mentioned sport participation than the women's obituaries (7.4%).