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The purpose of this study was to examine the physical activity behaviors and campus recreation use of students enrolled in a summer transition (high school to university) program. The physical activity behaviors and socio-demographic characteristics of summer transition program students from a large Northeastern United States university were collected via an online survey. Descriptive statistics were computed, and disparities between genders were examined using independent samples t-tests. Women participated in less aerobic and muscle-strengthening activity compared to men ( p

Non-heterosexual women tend to report lower physical activity and poorer mental health than their heterosexual counterparts. The purpose of this study was to examine differences in mental health (stress and depression) and physical activity among female college students by sexual orientation. Students self-reported socio-demographic characteristics, physical activity, perceived stress, and depressive symptoms via an online survey. Correlations, independent samples t-tests, and multiple regression analyses were used to examine relationships between perceived stress, depressive symptoms, physical activity, and sexual orientation. Most participants (n = 1072, 20.0 ± 1.5 years) identified as heterosexual (90.1%), non-Hispanic White (73%), and in their fourth semester or higher. Perceived stress and depressive symptoms differed significantly between heterosexual and non-heterosexual women, but physical activity participation did not. Higher participation in vigorous physical activity and strength training predicted both lower depressive symptoms and lower perceived stress while controlling for sexual orientation. For both heterosexual and non-heterosexual sexual women, depressive symptoms had a positive relationship with perceived stress, and a negative relationship to strength training. Depressive symptoms also had negative correlations with vigorous physical activity among heterosexual women. Findings indicate non-heterosexual women experience greater perceived stress and depressive symptoms, and these mental health issues can have multi-level implications. Greater vigorous physical activity and strength training were associated with lower perceived stress and depression regardless of sexual orientation. Administrators and health promoters should consider ways to promote these forms of physical activity among non-heterosexual women. Further research is needed on the potential barriers impacting engagement in physical activity.

Background: The COVID-19 pandemic created significant disruptions for college students, impacting health and physical activity (PA). Changes to the PA environment presented many challenges for students. Purpose: To examine the influence of the physical and social environment on PA participation for college students during the onset of COVID-19 restrictions. Methods: This cross-sectional, mixed methods survey used an online questionnaire during the onset of COVID-19 restrictions with a volunteer sample of college students at a large university in the United States. Participants self-reported their demographics, PA level and environment for PA, and responded to an open-ended question about their PA participation during the pandemic. Correlations and independent samples t -tests examined relationships between PA and the environment. Qualitative data were scanned to identify overarching themes. Results : Participants ( n = 395) were predominantly Non-Hispanic White and female. The neighborhood environment and access to PA equipment were associated with PA for both men and women. Major qualitative themes highlighted the role of the physical environment and PA. Participating in PA with friends and family was positively associated with PA for both men and women as well. Conclusions: This study provides insight on the importance of the social and built environment for encouraging and supporting PA among college students during the COVID-19 pandemic which may provide insight for distance education as higher education evolves.

To examine how health behaviors and outcomes differ based on restful nights of sleep among college students.This is a cross-sectional study.The study was conducted in a large, northeastern United States university.The participants include college students (n = 4376), the majority of whom were women (59.2%) and non-Hispanic white (76.1%).Students completed an online survey, self-reporting sex, height, weight, cumulative grade point average (GPA), physical activity (PA), fruit and vegetable consumption (FVC), substance use, and depressive symptoms, along with nights of restful sleep. Participants were grouped into those who had frequent (≥4 nights/week) or infrequent (4 nights/week) nights of restful sleep. Analyses included independent sample t-tests, chi-square tests for independence, and logistic regression analyses to compute odds ratios.Parametric analyses indicated a significant, although unmeaningful, association between frequent restful sleep and PA and GPA, but not body mass index or FVC. Nonparametric analyses indicated a positive association between frequent restful sleep and the absence of depressive symptoms. Odds ratios revealed a positive association between the absence of depressive symptoms and GPA with frequent restful sleep.Findings indicate that restful sleep is associated with the absence of depressive symptoms and higher GPA among college students. Further research is required to examine the relationship, particularly directionality, between the amount of sleep and health behaviors and outcomes. Future researchers should consider using better measures of mental health, dietary quality, and objective measures of sleep and PA were possible. College administrators and health professionals should consider ways in which they can educate students about the benefits of sleep to mental health and academic performance.

College students’ experiences and attitudes toward physical activity counseling (PAC) from health care professionals were examined using an online survey. Few students had received PAC from health care professionals in the past 24 months. Most reported receiving useful information that they used, but few were referred to health and fitness professionals. Thus, there is considerable room for improvement with respect to the quality and quantity of PAC provided to students. Nurse practitioners, who are often the first health care professional with whom students interact, hold great potential to address this need.

Objective: Examine differences in physical activity (PA) constraints experienced as freshmen among college upperclassmen based on sex, race/ethnicity, adiposity, and fitness. Participants and metho...

Examine the prevalence of body weight perception discordance, and its relationship with physical activity and mental health among college women.Data were collected from a convenience sample of female undergraduates enrolled in general education health and wellness courses at a large, northeastern United States university (Though most women had accurate weight status perceptions (A relatively large minority of women demonstrated discordant weight status perceptions, which were associated with adverse mental health outcomes. Colleges should consider improving healthy weight status perception education among women to improve mental health.

Background: Investigating the impact of the COVID-19 pandemic on both physical activity (PA) and mental health is important to demonstrate the need for interventions. This study examined the apparent impact of the pandemic on college students’ PA, perceived stress, and depressive symptoms. Methods: From 2015 through 2020, data were collected at the beginning and end of the spring semester at a large Northeastern US university via an online survey assessing student demographics, PA, perceived stress, and depressive symptoms. Mixed ANOVA examined differences in PA and mental health changes over the spring semester between “normal” and COVID-19 circumstances. Two-way ANOVA examined the interaction between circumstance and changes in PA in relation to changes in mental health. Results: Participants (n = 1019) were predominately women and non-Hispanic white. There was a significant decline in PA and an increase in perceived stress under COVID-19, but not normal, circumstances and a significant increase in depressive symptoms under COVID-19, but not normal, circumstances among women. Conclusions: A significant decline in PA and mental health among college students occurred under COVID-19 circumstances, and PA did not appear to protect against deterioration in mental health. Proactive and innovative policies, programs, and practices to promote student health and well-being must be explored immediately.

The purpose of this study was to examine changes in health behaviors and outcomes of higher education (college) students following graduation. Undergraduate students (n = 206) enrolled at a large, northeastern United States university in general education health and wellness courses were assessed pre and post-graduation. Participants self-reported their demographics, physical activity behaviors, dietary behaviors, sleep, and stress pre and post-graduation via an online survey. Paired sample t-tests examined changes health behaviors pre and post-graduation. Following graduation, fruit and vegetable consumption increased significantly, moderate physical activity declined significantly, and both vigorous physical activity and energy expenditure, as well as weight remained stable. There was a significant reduction in stress, for men but not women, and, an increase in restful nights of sleep among women but not men. College students tended to maintain the seemingly healthy lifestyles they had as students during the period immediately following graduation. Findings highlight the value of general health and wellness courses within college given vigorous physical activity and energy expenditure did not decline following graduation.

Background Active travel (AT), that is walking or biking for transport, is one way in which individuals can accumulate physical activity to benefit their physical and mental health. The purpose of this study was to examine the contribution of AT to physical activity among college students. Methods Data were collected from students enrolled in general health and wellness courses at a large university in the northeast of the United States using an online survey distributed via email. Participants self-reported their demographics (age, sex, race/ethnicity, and residence location) as well as their physical activity using the Global Physical Activity Questionnaire. Weekly metabolic equivalent minutes (weekly MET-minutes) were calculated for moderate physical activity (MPA), vigorous physical activity (VPA) and AT. Participants were categorized as moderately and highly physically active based on whether they met the criteria of ≥600 and ≥1500 weekly MET-minutes from MPA and VPA respectively both before and after adjusting for weekly AT MET-minutes. Results Analyses were conducted on 3714 students, who had a mean age of 21.0±1.5 years, and the majority of whom were women (57.8%), non-Hispanic white (77.2%), and resided off campus (79.5%). Adjusting for weekly AT MET-minutes resulted in a significant decrease in the number of students classified as moderately and highly physically active. Odds ratios revealed that sex, but not race, significantly predicted the likelihood of students no longer being both moderately and highly physically active after adjusting for AT. Women were more than 40% more likely to no longer meet both criteria compared to men after controlling for age, race, and residence location. Conclusions Findings suggest that AT contributes considerably to college students’ physical activity, particularly among women. Findings reinforce the importance of facilitating and promoting AT among college students and considering socio-demographic characteristics when making such efforts.

Exercise is Medicine™ (EiM) on campus targets physical activity (PA) participation on college campuses. Limited research has addressed how PA initiatives can be operationalized on college campuses. Purpose To describe the implementation of EiM on a large U.S. university campus and present preliminary outcomes on participation and awareness. Methods EiM week was implemented on a large university campus. Exercise stations were set-up at campus locations to encourage brief bouts of PA and educate about the benefits of PA. Evaluation included observations of participation, surveys, and intercept surveys to assess awareness and reach. Results EiM week was implemented during Fall 2013. Exercise stations elicited 1771 exercise bouts from participants. Surveys indicated widespread reach across the university (13 of 17 colleges); most students (50.8%) became aware of the EiM campaign by passing by the exercise stations. Campus intercept surveys 1-week post-event indicated 54% students had heard about EiM, of which 39% had heard/seen the event through messages encouraging exercise. Conclusion The current study was successful in engaging a large, diverse population on a college campus. Lessons learned from the development, implementation, and evaluation of EiM on campus activities provide insight for university campuses looking to target student health and PA participation.

Aerobic physical activity and muscle-strengthening activities are beneficial to both physical and mental health, though disparities in these behaviors exist based on social determinants. The purpose of this study was to examine differences in college students' aerobic physical activity and muscle-strengthening activities based on gender, race, and sexual orientation. Undergraduates enrolled in general education health and wellness courses at a large northeastern University in the United States responded to an online survey in August 2018 that assessed their demographics and physical activity behaviors. Differences in physical activity behaviors based on social determinants were examined using independent-samples t-tests and chi-square tests for independence. Less than half (40.3%) of participants (n = 606) met both aerobic physical activity and muscle-strengthening recommendations. No differences were found in physical activity based on sexual orientation. However, significantly more non-Hispanic white participants met aerobic physical activity (74.4% vs. 63.8%) and muscle-strengthening recommendations (47.2% vs. 37.6%); and, men reported significantly greater vigorous physical activity (p = .034, η2 = 0.01) and participation in muscle-strengthening activities (p

Background Active travel (AT); walking and biking for transportation; has many health, environmental and economic benefits, yet rates of participation remain low in the US. During college years AT participation is typically higher than in older adulthood, but it is unknown how this behavior tracks into later life stages. Therefore this study examined AT participation before and after graduation from college. Methods: A volunteer sample of college students participated in an online baseline survey with follow-ups at regular intervals, up to, and including, post-graduation. The survey assessed participant demographics, AT participation (dichotomized as high/low AT), physical activity (PA) participation, and post-graduation work details (hours worked, sit time at work, distance to work), and health outcomes (body mass index, stress, depression,). Separate logistic regression models predicted AT status according to pre/post-graduation factors and significant factors were examined simultaneously in a multivariate logistic model. Results: Students (n = 204) were predominately female (n = 122, 60.7%) and Non-Hispanic White (n = 166, 83%). The high post-graduation AT group reported 324.73 ± 193.10 min of AT/week versus those in the low AT group (24.69 ± 41.81; p

As part of the physical education program at the United States Military Academy, all cadets complete a movement training course designed to develop skills and improve performance in military-related physical tasks as well as obstacle navigation. The purpose of this study was to determine if completion of this course would also result in changes in jump-landing technique that reduce the risk of anterior cruciate ligament (ACL) injury. Analysis of landing mechanics on a two-footed jump landing from a height of 30 cm with a three-dimensional motion capture system synchronized with two force plates revealed both positive and negative changes. Video assessment using the Landing Error Scoring System (LESS) revealed an overall improved landing technique (p=.001) when compared to baseline assessments. The studied military movement course appears to elicit mixed but overall improved lower extremity jump-landing mechanics associated with risk for ACL injury.

The goal of this study was to evaluate physical examination findings in a healthy cohort and determine potential correlations with a history of shoulder instability. A cross-sectional analysis was performed using the baseline data for an ongoing prospective cohort study to examine the risk factors for shoulder instability. A complete history of shoulder instability events was obtained, and a blinded physical examination was performed. The cohort comprised 711 patients (627 men, 84 women) with a mean age of 18.8 years. A total of 100 patients had a history of shoulder instability. Patients with a history of instability were more likely to have increased posterior translation ( P =.010), positive apprehension sign ( P =.003), positive relocation sign ( P =.007), and sulcus sign ( P =.017).

Background: Relative to dislocations, glenohumeral subluxation events have received little attention in the literature, despite a high incidence in young athletes. The pathoanatomy of first-time, traumatic, anterior subluxation events has not been defined, to our knowledge. Methods: As part of a prospective evaluation of all cases of shoulder instability sustained during one academic year in a closed cohort of military academy cadets, a total of thirty-eight first-time, traumatic, anterior glenohumeral subluxation events were documented. Clinical subluxation events were defined as incomplete instability events that did not require a manual reduction maneuver. Twenty-seven of those events were evaluated with plain radiographs and magnetic resonance imaging within two weeks after the injury and constitute the cohort studied. Magnetic resonance imaging studies were independently evaluated by a musculoskeletal radiologist blinded to the clinical history. Arthroscopic findings were available for the fourteen patients who underwent arthroscopic surgery. Results: Of the twenty-seven patients who sustained a first-time, traumatic, anterior subluxation, twenty-two were male and five were female, and their mean age was twenty years. Plain radiographs revealed three osseous Bankart lesions and two Hill-Sachs lesions. Magnetic resonance imaging revealed a Bankart lesion in twenty-six of the twenty-seven patients and a Hill-Sachs lesion in twenty-five of the twenty-seven patients. Of the fourteen patients who underwent surgery, thirteen had a Bankart lesion noted during the procedure. Of the thirteen patients who chose nonoperative management, four experienced recurrent instability. Two of the thirteen patients left the academy for nonmedical reasons and were lost to follow-up. The remaining seven patients continued on active-duty service and had not sought care for a recurrent instability event at the time of writing. Conclusions: First-time, traumatic, anterior subluxation events result in a high rate of labral and Hill-Sachs lesions. These findings suggest that clinical subluxation events encompass a broad spectrum of incomplete events, including complete separations of the articular surfaces with spontaneous reduction. A high index of suspicion for this injury in young athletes is warranted, and magnetic resonance imaging may reveal a high rate of pathologic changes, suggesting that a complete, transient luxation of the glenohumeral joint has occurred.

BackgroundControversy remains over the most appropriate graft for anterior cruciate ligament reconstruction.HypothesisThere is no significant difference in outcomes after 4-strand hamstring and patellar tendon autograft anterior cruciate ligament reconstructions using similar fixation techniques.Study DesignRandomized controlled trial; Level of evidence, 1.MethodsBetween August 2000 and May 2003, 64 Keller Army Hospital patients with complete anterior cruciate ligament tears were randomized to hamstring (n = 32) or patellar tendon (n = 32) autograft anterior cruciate ligament reconstruction. Operative graft fixation and rehabilitative techniques were the same for both groups. Follow-up assessments included the Single Assessment Numeric Evaluation score, Lysholm score, International Knee Documentation Committee score, and Knee Injury and Osteoarthritis Outcome Score. Postoperative radiographs were analyzed for tunnel location and orientation.ResultsEleven women and 53 men were randomized. Eighty-three percent of the patients (53 of 64) had follow-up of greater than 2 years, or to the point of graft rupture or removal (average follow-up, 36 months). Four hamstring grafts (12.5%) and three patellar tendon grafts (9.4%) ( P = .71) ruptured. One deep infection in a hamstring graft patient necessitated graft removal. Forty-five of the 56 patients with intact grafts had greater than 2-year follow-up. Patients with patellar tendon grafts had greater Tegner activity scores ( P = .04). Single Assessment Numeric Evaluation scores were 88.5 (95% confidence interval: 83.1, 93.8) and 90.1 (95% confidence interval: 85.2, 96.1) for the hamstring and patellar tendon groups, respectively ( P = .53). Lysholm scores were 90.3 (95% confidence interval: 84.4, 96.1) and 90.4 (95% confidence interval: 84.5, 96.3) for the hamstring and patellar tendon groups, respectively ( P = .97). There were no significant differences in knee laxity, kneeling pain, isokinetic peak torque, International Knee Documentation Committee score, or Knee Injury and Osteoarthritis Outcome Scores. Postoperative graft rupture correlated with more horizontal tibial tunnel orientation.ConclusionHamstring and patellar tendon autografts provide similar objective, subjective, and functional outcomes when assessed at least 2 years after anterior cruciate ligament reconstruction.

Background The literature provides little information detailing the incidence of traumatic shoulder instability in young, healthy athletes. Hypothesis Shoulder instability is common in young athletes. Study Design Descriptive epidemiologic study. Methods We prospectively captured all traumatic shoulder instability events at the United States Military Academy between September 1, 2004, and May 31, 2005. Throughout this period, all new traumatic shoulder instability events were evaluated with physical examination, plain radiographs, and magnetic resonance imaging. Instability events were classified according to direction, chronicity, and type (subluxation or dislocation). Subject demographics, mechanism of injury, and sport were evaluated. Results Among 4141 students, 117 experienced new traumatic shoulder instability events during the study period; 11 experienced multiple events. The mean age of these 117 subjects was 20.0 years; 101 students were men (86.3%), and 16 were women (13.7%). The 1-year incidence proportion was 2.8%. The male incidence proportion was 2.9% and the female incidence proportion was 2.5%. Eighteen events were dislocations (15.4%), and 99 were subluxations (84.6%). Of the 99 subluxations, 45 (45.5%) were primary events, while 54 (54.5%) were recurrent. Of the 18 dislocations, 12 (66.7%) were primary events, while 6 (33.3%) were recurrent. The majority of the 117 events were anterior in nature (80.3%), while 12 (10.3%) were posterior, and 11 (9.4%) were multidirectional. Forty-four percent (43.6%) of the instability events experienced were as a result of contact injuries, while 41.0% were a result of noncontact injuries, including 9 subluxations caused by missed punches during boxing; information was unavailable for the remaining 15%. Conclusion Glenohumeral instability is a common injury in this population, with subluxations comprising 85% of instability events.

Background: Little is known about the risk factors for glenohumeral joint instability. We hypothesized that a prior history of instability would be a significant risk factor for subsequent injury. Methods: We conducted a prospective cohort study over a four-year period within a high-risk group of young athletes to address the research hypothesis. Subjects were freshmen entering the U.S. Military Academy in June of 2006. Part of the baseline assessment included documenting a prior history of glenohumeral instability on entry into the study. All subjects were followed for subsequent glenohumeral joint instability events until graduation in May of 2010. The primary outcome of interest in this study was time to glenohumeral instability event during the follow-up period. We examined injury outcomes, looking for any instability, anterior instability, and posterior instability events. Cox proportional-hazards regression models were used to analyze the data. Results: Among the 714 subjects, eight shoulders were excluded from the analyses due to prior surgical stabilization, leaving 1420 shoulders, of which 126 had a self-reported prior history of instability. There were forty-six (thirty-nine anterior and seven posterior) acute instability events documented in the cohort during the follow-up period. Subjects with a prior history of instability were over five times (p < 0.001) more likely to sustain an acute (anterior or posterior) instability event during the follow-up period. Subjects with a history of instability were also 5.6 times (p < 0.001) more likely to experience a subsequent anterior instability event and 4.6 times (p = 0.068) more likely to experience a posterior instability event during follow-up. Similar results were observed in multivariable models after controlling for the influence of demographic and baseline physical examination findings. Conclusions: Despite meeting the rigorous physical induction standards for military service, subjects with a prior history of glenohumeral joint instability were approximately five times more likely to experience a subsequent instability event, regardless of direction, within this high-risk athletic population. Level of Evidence: Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.

Background The objective of this innovative research study was to describe clinical shoulder complex range of motion (ROM) measures for a young, healthy, and physically active population. This investigation represents a cross-sectional experiment conducted at a military academy-based sports medicine center. Military cadets with no history of shoulder complex injury were assessed within two months of enrollment in the academy; 548 men (18.8 ± 1.0 yr, 75.2 ± 12.2 kg, 178.3 ± 7.4 cm) and 74 women (18.7 ± 0.9 yr, 63.2 ± 8.9 kg, 165.2 ± 6.9 cm) participated. Descriptive measures included cross-body adduction (CAD), flexion (FLX), external rotation (ER0) with the shoulder complex in adduction and elbow flexed to 90°, internal and external rotation (IR, ER) with the shoulder complex at 90° of abduction and elbow flexed to 90° as well as arc (ARC) of IR-ER using standardized clinical quantification techniques. Bilateral and sex differences were evaluated using dependent and independent t-tests, respectively. Percentiles by arm dominance and sex were also calculated for all ROM measures. Results Data were normally distributed. Active and passive ROM measures indicated significant bilateral differences (P Conclusions These original data provide descriptive measures for shoulder complex ROM excursions, assisting sports medicine practitioners in potentially identifying clinical deficiencies and functional outcomes following shoulder injury.

Context:Little is known about the relationship among sex, generalized joint hypermobility, and glenohumeral joint instability.Objective:To examine the relationship among sex, generalized joint hypermobility scores, and a history of glenohumeral joint instability within a young, physically active cohort and to describe the incidence of generalized joint hypermobility within this population.Design:Cross-sectional cohort study.Setting:United States Military Academy at West Point, New York.Patients or Other Participants:Of the 1311 members of the entering freshman class of 2010, 1050 (80%) agreed to participate.Main Outcome Measure(s):Generalized joint hypermobility was assessed using the Beighton Scale. A history of glenohumeral joint instability was identified via a baseline questionnaire.Results:Most participants (78%) had no signs of generalized joint hypermobility. Only 11 volunteers (1.5%) had Beighton Scale scores of 4 or greater. Logistic regression analysis revealed a relationship between generalized joint hypermobility and a history of glenohumeral joint instability (P = .023). When sex and race were controlled, those with a total Beighton Scale score of ≥2 were nearly 2.5 times as likely (odds ratio = 2.48, 95% confidence interval = 1.19, 5.20, P = .016) to have reported a history of glenohumeral joint instability. A relationship was observed between sex and nearly all individual Beighton Scale items. Although women had higher total Beighton Scale scores than men, sex (P = .658) and race (P = .410) were not related to a history of glenohumeral joint instability when other variables in the model were controlled.Conclusions:In these participants, generalized joint hypermobility and a history of glenohumeral joint instability were associated.