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Purpose: Plain radiographic evaluation of acute shoulder trauma in adults requires a minimum of two projections, commonly the anteroposterior (AP) and lateral scapular projections, with additional projections taken for diagnosis. The aim of this retrospective study was to determine whether the addition of the apical oblique (AO) projection to the AP and lateral scapular projections increases the number and/or alters the types of abnormalities detected in the examination of acute shoulder trauma. Methods: Examinations of 56 adults who had undergone three-projection (AP, lateral scapular, AO) radiographic shoulder examination for acute trauma were allocated into two-projection (AP, lateral scapular) and three-projection cases and assessed by a radiologist. The differences in number and types of abnormalities between the two-projection and three-projection cases were quantified using the one-tailed t test and chi-square goodness-of-fit test, respectively. Results: Test-retest reliability was moderate (intra-class correlation coefficient [95%CI], 0.56 [0.15 to 0.80]) for number, and almost perfect (kappa [95%CI], 0.94 [0.85 to 1.00]) for types, of abnormalities detected. There was a significant increase in the number of abnormalities detected across all three-projection versus two-projection cases (difference in means [95%CI], 0.20 [0.01 to 0.39]) and for fractures (difference in means [95%CI], 0.30 [0.11 to 0.49]), but no difference in the types of abnormalities detected (χ2 = 4.7, p = 0.19). Conclusion: This study suggests that adding the AO projection to two-projection examination of acute shoulder trauma increases the number of abnormalities detected; this has potential implications for patient management. Further research investigating differences in types of abnormalities detected between two-projection and three-projection cases is warranted. Refereed/Peer-reviewed

Objective: To investigate relationships between the digit ratio (2D:4D) and competitive basketball performance in Australian men. Methods: Using an observational cross-sectional design a total of 221 Australian basketball players who competed in the Olympic Games, International Basketball Federation World Championships/Cup, Australian National Basketball League, Central Australian Basketball League or socially had their 2D:4Ds measured. Analysis of variance was used to assess differences in mean 2D:4Ds between men playing at different competitive standards, with relationships between 2D:4Ds and basketball game-related statistics assessed using Pearson's product moment correlations in men playing at a single competitive standard. Results: There were significant differences between competitive standards for the left 2D:4D following Bonferroni correction, but not for the right 2D:4D, with basketballers who achieved higher competitive standards tending to have lower left 2D:4Ds. No important correlations between 2D:4D and basketball game-related statistics were found, with correlations typically negligible. Conclusions: This study indicated that the 2D:4D can discriminate between basketballers competing at different standards, but not between basketballers within a single competitive standard using objective game-related statistics. Refereed/Peer-reviewed

Objective To develop sex-specific and age-specific international norms for the 20 m shuttle run test(20mSRT) in children and youth (aged 9–17 years), and to estimate the prevalence meeting the FITNESSGRAM criterion-referenced standards for healthy cardio respiratory endurance (CRE). Methods A systematic review was undertaken to identify papers explicitly reporting descriptive 20mSRT(with 1 min stages) data on children and youth since1981. Data were included on apparently healthy (free from known disease/injury) 9–17 years old. Following standardisation to a common metric and for protocol differences, pseudo data were generated using Monte Carlo simulation, with population-weighted sex-specific and age-specific normative centiles generated using the Lambda Mu and Sigma (LMS) method. Sex-related and age-related differences were expressed as per cent and standardised differences in means. The prevalence with healthy CRE was estimated using the sex-specific and age-specific FITNESSGRAM criterion-referenced standards for VO_ 2peak. Results Norms were displayed as tabulated centiles and as smoothed centile curves for the 20mSRT using 4common metrics (speed at the last completed stage,completed stages/minutes, laps and relative VO_ 2peak).The final data set included 1 142 026 children and youth from 50 countries, extracted from 177 studies.Boys consistently outperformed girls at each age group(mean difference±95% CI: 0.86±0.28 km/h or 0.79±0.20 standardised units), with the magnitude of age related increase larger for boys than for girls. A higher proportion of boys (mean±95% CI: 67±14%) had healthy CRE than girls (mean±95% CI: 54±17%), with the prevalence of healthy CRE decreasing systematically with age.Conclusions This study provides the most comprehensive and up-to-date set of international sex specific and age-specific 20mSRT norms for children and youth, which have utility for health and fitness screening, profiling, monitoring and surveillance. Refereed/Peer-reviewed

Objectives To provide sex- and age-specific normative values for health-related fitness of 9–17-year-old Australians. Methods A systematic literature search was undertaken to identify peer-reviewed studies reporting health-related fitness data on Australian children since 1985—the year of the last national fitness survey. Only data on reasonably representative samples of apparently healthy (free from known disease or injury) 9–17-year-old Australians, who were tested using field tests of health-related fitness, were included. Both raw and pseudo data (generated using Monte Carlo simulation) were combined with sex- and age-specific normative centile values generated using the Lambda Mu and Sigma (LMS) method. Sex- and age-related differences were expressed as standardised effect sizes. Results Normative values were displayed as tabulated percentiles and as smoothed centile curves for nine health-related fitness tests based on a dataset comprising 85347 test performances. Boys typically scored higher than girls on cardiovascular endurance, muscular strength, muscular endurance, speed and power tests, but lower on the flexibility test. The magnitude of the age-related changes was generally larger for boys than for girls, especially during the teenage years. Conclusion This study provides the most up-to-date sex- and age-specific normative centile values for the health-related fitness of Australian children that can be used as benchmark values for health and fitness screening and surveillance systems. Refereed/Peer-reviewed

Mechanography during the vertical jump may enhance screening and determining mechanistic causes underlying physical performance changes. Utility of jump mechanography for evaluation is limited by scant test-retest reliability data on force-time variables. This study examined the test-retest reliability of eight jump execution variables assessed from mechanography. Thirty-two women (mean±SD: age 20.8 ± 1.3 yr) and 16 men (age 22.1 ± 1.9 yr) attended a familiarization session and two testing sessions, all one week apart. Participants performed two variations of the squat jump with squat depth self-selected and controlled using a goniometer to 80º knee flexion. Test-retest reliability was quantified as the systematic error (using effect size between jumps), random error (using coefficients of variation), and test-retest correlations (using intra-class correlation coefficients). Overall, jump execution variables demonstrated acceptable reliability, evidenced by small systematic errors (mean±95%CI: 0.2 ± 0.07), moderate random errors (mean±95%CI: 17.8 ± 3.7%), and very strong test-retest correlations (range: 0.73–0.97). Differences in random errors between controlled and self-selected protocols were negligible (mean±95%CI: 1.3 ± 2.3%). Jump execution variables demonstrated acceptable reliability, with no meaningful differences between the controlled and self-selected jump protocols. To simplify testing, a self-selected jump protocol can be used to assess force-time variables with negligible impact on measurement error. Refereed/Peer-reviewed

Background Digit ratio (2D:4D), a measure of prenatal testosterone exposure, is weakly-to-moderately associated with increased physical performance, although the evidence is far stronger for males than females. Objective To examine the relationship between 2D:4D and measured on-water rowing performance in young females competing at the Australian Rowing Championships. Methods Using an observational, cross-sectional design, female rowers (n = 69, aged 12–30 years) who competed in single sculls events at the Australian Rowing Championships in 2007 and 2008 had numerous physical and digital anthropometric measurements taken, including 2D:4D measurements. Relationships between 2D:4Ds and race times were examined using Pearson's correlations, partial correlations and multiple regression. Partial Least Squares regression analysis determined the strength of the 2D:4D as a predictor of race time relative to 78 body dimensions plus age. Results Overall, weak to strong positive correlations between 2D:4D and race time were found; that is, females with smaller 2D:4Ds had faster race times than females with larger 2D:4Ds. Relationships were weak to moderate for all females (r = 0.29–0.32), moderate-to-strong for senior rowers (aged ≥20 years; r = 0.42–0.55), and weak for junior rowers (aged

To enable dynamic regulation of muscle mass and myofiber repair following injury, a satellite cell precursor population exists to supply additional nuclei. Activated satellite cells express many genes and associated proteins necessary for maturation and incorporation into the damaged fiber. There is little knowledge about the response of these markers following whole-body resistance exercise training. We investigated the impact of 12 weeks of progressive whole-body resistance training on the expression of MRFs, PAX7, NCAM, and FA1, incorporating both acute and chronic resistance exercise components. Ten young recreationally active males (21.2 ± 3.5 years) performed 12 weeks of whole-body resistance training at 70-85% of their predetermined one-repetition maximum (1RM). At the initiation and completion of the training period, muscular strength was assessed by RM and dynamometer testing, and vastus lateralis samples were obtained prior to and 3 h following an acute resistance exercise test (both whole-body and isometric exercises). Increased mRNA expression of PAX7 (threefold), NCAM (threefold), MYF5 (threefold), MYOD (threefold) and MYOGENIN (twofold) was observed 3 h after the acute resistance exercise test, both pre and post training. Similarly, PAX7 (11-fold) and FA1 (twofold) protein abundance increased after acute exercise, while resting NCAM (eight fold) and FA1 (threefold) protein abundance increased following 12 weeks of resistance training. It is possible that these molecular changes are primarily due to the preceding exercise bout, and are not modified by long-term or whole-body exercise training. Refereed/Peer-reviewed

Objectives This study quantified differences in body shape of people differing in body mass index (BMI), using three-dimensional (3D) scan-extracted segmental body volumes. Methods Eight segmental volumes were measured on 340 young adults (169 males and 171 females) aged 18–30 years, using the Vitus Smart 3D whole body scanner. Body volumes were also expressed as a ratio of the sex-specific mean volume (segmental or whole body) and compared to BMI using simple linear regression, multiple-segment-linear regression and Lowess curves. Results While all segmental volumes increased significantly as BMI increased, the BMI-related patterns of increase varied among different body segments. For example, pelvis and abdomen volumes increased at a significantly greater rate than whole body volume, with the rates of increase greatest in the overweight and obese. Conclusions Body shape changes due to variations in body volume could have important implications in a range of fields that currently use 1D anthropometric measurements that do not capture body shape differences in the same detail. Am. J. Hum. Biol. 26:156–163, 2014. © 2013 Wiley Periodicals, Inc.

Background/aim: Resistance training is an exercise modality at which overweight and obese adolescents can excel and which can therefore positively affect their psychological well-being. The aim of this study was to determine the effect of a 6-month resistance training intervention on the self-concept strength and body composition of overweight and obese adolescent males.Methods: 56 overweight and obese males aged 13-17 years were randomly allocated to an Intervention (n=30) or Control (n=26) group. Primary ( psychological) and secondary (strength and body composition) outcomes were assessed at baseline as well as at 3 (halfway through the intervention), 6 (immediately post intervention) and 12 months follow-up. Random effects mixed modelling was used to determine the effects of the intervention. Results: Statistically significant differences between the Intervention and Control groups were observed at 3-month and 6-month assessments for exercise self efficacy, resistance training confidence and self-esteem. Large increases in strength for the Intervention group, relative to Controls, were also observed with no substantial changes in body composition shown for either group. Values for all variables returned to baseline following completion of the programme.Conclusions: A 6-month resistance training intervention can positively affect the self-concept and strength of overweight and obese adolescent boys. Refereed/Peer-reviewed

Overweight and obese children and adolescents face many physical and psychosocial hardships. Resistance training is a modality of exercise which allows this at-risk group to excel and therefore has the potential to positively affect not only their physical but also psychosocial health.To systematically review and meta-analyse the peer-reviewed literature to determine the effect of resistance training on the strength, body composition and psychosocial status of overweight and/or obese children and/or adolescents.Relevant databases (MEDLINE, Embase, Scopus, Web of Science, SPORTDiscus, CINAHL, PsycINFO, Cochrane library, ProQuest) were searched up to and including 30 January 2013.Included studies (n = 40, from the 2,247 identified) were randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs) and uncontrolled trials (UCTs) which had run an exercise intervention, with a resistance training component, for overweight and/or obese children and/or adolescents, and which had examined the effect of resistance training on either strength, body composition or psychosocial outcomes.Studies were initially critically appraised for risk of bias by the lead author, following which both co-authors critically appraised five randomly selected studies to assess reliability.Randomised controlled trials and NRCTs were analysed separately from UCTs. To determine the overall intervention effect for each outcome variable for each study design group, standardised mean differences were calculated with each individual study/data set weighted by the inverse of the pooled variance. The overall intervention effect reported for RCTs and NRCTs was relative to the control group whereas the effect reported for UCTs shows an overall post-intervention effect. Subgroup analyses, which determined whether the overall intervention effect was influenced by intervention type, training volume, age, sex, risk of bias or study design (for RCT/NRCT group only), were run using the same summary measure. Typically, resistance training had very small to small effects on body composition and moderate to large effects on strength in favour of the intervention. However, the magnitude and direction of the effect of resistance training on psychological outcomes are still unclear given the limited number of studies which looked at psychosocial outcomes and the inconclusive results shown by this review. Uncontrolled trials typically showed larger intervention effects than RCTs and NRCTs; however, these results may be greatly influenced by maturational changes rather than the intervention itself.The included studies employed a number of different exercise intervention types (e.g. resistance training, resistance plus aerobic training etc.) that ranged from 6 to 52 weeks in duration. Studies also employed a number of different methodologies to assess similar outcome measures (e.g. dual energy X-ray absorptiometry versus skinfolds to assess body composition; one-repetition maximum testing versus hand grip strength to assess strength). However, by completing subgroup analyses and using a standardised summary measure these limitations have been accounted for.While the effect of resistance training on the body composition and strength of overweight and obese children and adolescents is clear, given the paucity of conclusive data more studies are needed to fully understand the effect of resistance training on the psychosocial status of this population.

Objective: Digit ratio (2D:4D) is a negative correlate of sports performance, although this relationship may be weak in open-skill sports such as basketball. The primary aim was to quantify relationships between 2D:4D and game-related statistics in semi-professional female basketball players. The secondary aim was to quantify the differences in mean 2D:4Ds between players based on their position in the starting lineup. Methods: Using a cross-sectional design, 64 female basketball players who competed in the South Australian Premier League were measured in-season for height, mass, and 2D:4D, with game-related statistics collected end-season. Partial correlations (adjusted for age and body mass index) were used to quantify relationships between right and left 2D:4Ds and game-related statistics. Unpaired t-tests were used to quantify differences in mean 2D:4Ds between starting and reserve players. Results: 2D:4D was a substantial negative correlate of blocks, rebounds, and field-goal percentage; meaning, females with lower 2D:4Ds were generally better defensively as they recorded more blocks and rebounds, and were more efficient scorers, irrespective of their age and body size. Mean 2D:4D differed by position in the starting lineup, as females with lower 2D:4Ds were more likely to be in the starting lineup. Conclusions: This study found evidence that 2D:4D was a correlate of performance in an open-skill sport. Female players with lower digit ratios tended to perform better in several aspects of basketball, especially defensively, and were more likely to be starters, suggesting they are the best players on the team in their positions. These results probably reflect the organizational benefits of prenatal testosterone. Refereed/Peer-reviewed

Refereed/Peer-reviewed

The Active Healthy Kids Global Alliance organized the concurrent preparation of Report Cards on the physical activity of children and youth in 38 countries from 6 continents (representing 60% of the world's population). Nine common indicators were used (Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behavior, Family and Peers, School, Community and the Built Environment, and Government Strategies and Investments), and all Report Cards were generated through a harmonized development process and a standardized grading framework (from A = excellent, to F = failing). The 38 Report Cards were presented at the International Congress on Physical Activity and Public Health in Bangkok, Thailand on November 16, 2016. The consolidated findings are summarized in the form of a Global Matrix demonstrating substantial variation in grades both within and across countries. Countries that lead in certain indicators often lag in others. Average grades for both Overall Physical Activity and Sedentary Behavior around the world are D (low/poor). In contrast, the average grade for indicators related to supports for physical activity was C. Lower-income countries generally had better grades on Overall Physical Activity, Active Transportation, and Sedentary Behaviors compared with higher-income countries, yet worse grades for supports from Family and Peers, Community and the Built Environment, and Government Strategies and Investments. Average grades for all indicators combined were highest (best) in Denmark, Slovenia, and the Netherlands. Many surveillance and research gaps were apparent, especially for the Active Play and Family and Peers indicators. International cooperation and cross-fertilization is encouraged to address existing challenges, understand underlying determinants, conceive innovative solutions, and mitigate the global childhood inactivity crisis. The paradox of higher physical activity and lower sedentary behavior in countries reporting poorer infrastructure, and lower physical activity and higher sedentary behavior in countries reporting better infrastructure, suggests that autonomy to play, travel, or chore requirements and/or fewer attractive sedentary pursuits, rather than infrastructure and structured activities, may facilitate higher levels of physical activity.

With the use of three-dimensional whole body scanning technology, this study compared the 'traditional' anthropometric model [one-dimensional (1D) measurements] to a 'new' model [1D, two-dimensional (2D), and three-dimensional (3D) measurements] to determine: (1) which model predicted more of the variance in self-reported best 2000-m ergometry rowing performance; and (2) what were the best anthropometric predictors of ergometry performance, for junior rowers competing at the 2007 and 2008 Australian Rowing Championships. Each rower (257 females, 16.3 ± 1.4 years and 243 males, 16.6 ± 1.5 years) completed a performance and demographic questionnaire, had their mass, standing and sitting height physically measured and were landmarked and scanned using the Vitus Smart® 3D whole body scanner. Absolute and proportional anthropometric measurements were extracted from the scan files. Partial least squares regression analysis, with anthropometric measurements and age as predictor variables and self-reported best 2000-m ergometer time as the response variable, was used to first compare the two models and then to determine the best performance predictors. The variance explained by each model was similar for both male [76.1% (new) vs. 73.5% (traditional)] and female [72.3% (new) vs. 68.6% (traditional)] rowers. Overall, absolute rather than proportional measurements, and 2D and 3D rather than 1D measurements, were the best predictors of rowing ergometry performance, with whole body volume and surface area, standing height, mass and leg length the strongest individual predictors. Refereed/Peer-reviewed

Measurements of whole body surface area (WBSA) have important applications in numerous fields including biological anthropology, clinical medicine, biomechanics, and sports science. Currently, WBSA is most often estimated using predictive equations due to the complex and time consuming methods required for direct measurement. The main aim of this study was to identify whether there were significant and meaningful differences between WBSA measurements taken using a whole body three-dimensional (3D) scanner (criterion measure) and the estimates derived from each WBSA equation identified from a systematic review. The study also aimed to determine whether differences varied according to body mass index (BMI), sex, or athletic status. Fifteen WBSA equations were compared with direct measurements taken on 1,714 young adult subjects, aged 18–30 years, using the Vitus Smart 3D whole body scanner, including 1,452 subjects (753 males, 699 females) from the general Australian population and 262 rowers (148 males, 114 females). Mixed-design analysis of variances determined significant differences and accuracy was quantified using Bland-Altman analysis and effect sizes. Thirteen of the 15 equations overestimated WBSA. With a few exceptions, equations were accurate with a low-systematic error (bias 2%) and low-random error (standard deviation of the differences 1.5–3.0%). However, BMI did have a substantial impact with the accuracy of some WBSA equations varying between the four BMI categories. The Shuter and Aslani: Eur J Appl Physiol 82 (2000) 250-254 equation was identified as the most accurate equation and should be used for Western populations 18–30 years of age. Care must be taken when deciding which equation to use when estimating WBSA. Refereed/Peer-reviewed

The aim of this study was to quantify the anthropometric differences between elite senior Australian rowers and the Australian adult population using three-dimensional (3D) whole-body scanning. The dimensions of senior rowers competing at the 2007-2008 Australian Rowing Championships were compared with those of an age-matched sample of Australian adults. Mass, height, and sitting height were measured before the participants underwent a 3D whole-body scan, with lengths, breadths, girths, cross-sectional and surface areas, and volumes extracted from each scan. Differences in means and variability between the two groups were expressed as standardized effect sizes and ratios of coefficients of variation. Heavyweight rowers were generally much larger than the general population in absolute size, with 3D dimensions and height and mass showing the largest effects. In contrast, lightweight rowers were generally similar or smaller in absolute and proportional size. The dimensions of rowers, especially the lightweights, were also generally less variable than those of the general population. The greatest differences between elite rowers and the general population were seen in dimensions that could not be captured without 3D scanning, such as segmental volumes and cross-sectional areas.

There is increasing evidence that the aerobic fitness performance of children is declining, at least in developed countries. To see if there was evidence of similar trends in a non-Western country, this study analysed data on 6-18-year-old Koreans tested between 1968 and 2000 using distance runs ranging from 600 to 1200 m. All existing data on the results of children's aerobic fitness tests in Korea were collated. In addition to six individual studies, very large datasets were available from the Korean Ministries of Education, and the Ministry of Culture and Tourism. Data on a total of 22,127,265 6-18-year-old children were available in the form of group means and standard deviations. Data were collated for each age x sex x test group, and performances were expressed as percentages of the fitted values for the year 1992 to standardise across tests, ages and sexes. All age x sex x test groups were then combined, and curves were fitted using weighted regression. A two-linear segment model best described the pattern of change (r = 0.83, p < 0.001). There was a relatively slow decline (0.26 % per year) in the aerobic performance of Korean children between 1968 and 1984. After 1984, however, there was a steep decline in performance, averaging 0.80 % per year. The rate of decline was greater in boys, younger children and children from outside the capital Seoul. Changes in running performance showed a similar pattern to changes in estimated body mass index. Compared to other countries, there has been a sharp decline in Korean children's performance on tests of aerobic fitness, which has been concurrent with increases in estimated body mass index.

Background:Australia has joined a growing number of nations that have evaluated the physical activity and sedentary behavior status of their children. Australia received a “D minus” in the first Active Healthy Kids Australia Physical Activity Report Card.Methods:An expert subgroup of the Australian Report Card Research Working Group iteratively reviewed available evidence to answer 3 questions: (a) What are the main sedentary behaviors of children? (b) What are the potential mechanisms for sedentary behavior to impact child health and development? and (c) What are the effects of different types of sedentary behaviors on child health and development?Results:Neither sedentary time nor screen time is a homogeneous activity likely to result in homogenous effects. There are several mechanisms by which various sedentary behaviors may positively or negatively affect cardiometabolic, neuromusculoskeletal, and psychosocial health, though the strength of evidence varies. National surveillance systems and mechanistic, longitudinal, and experimental studies are needed for Australia and other nations to improve their grade.Conclusions:Despite limitations, available evidence is sufficiently convincing that the total exposure and pattern of exposure to sedentary behaviors are critical to the healthy growth, development, and wellbeing of children. Nations therefore need strategies to address these common behaviors.

Aim: To quantify the global changes in anaerobic fitness (operationalized as power and speed test performance) of children and adolescents. Methods: Following an extensive review of the literature, 32 studies examining secular changes in power and speed test performance of children and adolescents were analysed. Performance changes were calculated at the country × age × sex × test level using weighted least-squares regression, and were expressed as a percentage of the weighted mean value for all data points in the regression. Negative values indicated performance declines, and positive values indicated improvements. Results: Changes in power (n=20 802 925) and speed (n=28 320 308) test performance were calculated for 6–19 year olds from 27 countries and five geographical regions, for the period 1958–2003. Overall, power and speed test performances improved at +0.03% and +0.04% per annum, respectively. Performance changes were remarkably similar for boys and girls, and children and adolescents, and somewhat similar for different geographical regions, and high and low income economies. The pattern of change was reasonably consistent over time. Conclusion: The relative stability in anaerobic fitness test performances in recent decades could be due to the negating effects of increases in fat mass and fat-free mass on anaerobic performance.

Secular changes in anaerobic fitness test performance in healthy 6- to 17-year-old Australasians were examined by meta-analysis of 232,564 power- and speed-test performances between 1960 and 2002. Overall, power-test performance improved at a rate of +0.05% [95% confidence interval (CI) = +0.01% to +0.09%] per annum, and speed at +0.04% (CI = +0.02% to +0.06%) per annum. Results indicate that anaerobic-fitness-test performances have remained relatively stable in Australasian children and adolescents in recent decades.