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Introduction: It has been shown that 45%–85% of patients with anterior cruciate ligament reconstruction (ACLR) will have early-onset arthritis within 10–12 years following surgery. Over the past two decades, the amount of literature regarding ACLR, gait maladaptations after ACLR and their potential link to early-onset arthritis, and rehabilitation techniques has grown exponentially; however, long-term patient outcomes remain modest. Methods: To evaluate current clinicians' attitudes, perspectives, and clinical practice approach for rehabilitation of patients following ACLR, a survey questionnaire was designed using the Delphi technique. Results: Of the 263 respondents, 84.4% (n = 226) reported that they believed gait training to be "Very" or "Extremely Important." However, only 35.7% (n = 94) reported objectively measuring gait during ACLR rehabilitation. Of the total respondents, only 6.8% (n = 18) assessed gait during rehabilitation using two-dimensional or three-dimensional motion capture technologies. Discussion: Our results suggest that while gait evaluation was perceived as important, most respondents did not objectively measure gait metrics as a clinical outcome during ACLR rehabilitation. These findings provide a prospective rehabilitation target to potentially mitigate a known risk factor of early-onset arthritis (gait maladaptations) in individuals following ACLR. [ABSTRACT FROM AUTHOR]

Purpose: Walking net V ˙ O2 tends to increase with advancing age; however, factors contributing to this relationship have not been widely described. The implications of such findings could inform targeted strategies to promote independent mobility in older adults. Herein, we evaluated the relationship between net V ˙ O2 and age at two submaximal workloads while exploring potential moderators of this relationship. Methods: Secondary analyses were performed on 35 older (65 ± 3 years) women who completed a battery of physical assessments including fixed-speed, non-graded and graded (+ 2.5%) treadmill walking with indirect calorimetry to determine net V ˙ O2. Maximal oxygen uptake ( V ˙ O2max), knee extensor maximal isometric voluntary contraction (MVC), peak rate of torque development (RTD), and plantar flexor range-of-motion (PFROM) were also measured. Results: Bivariate correlations showed non-graded (r = 0.403, p = 0.017) and graded (r = 0.413, p = 0.014) net V ˙ O2 were positively related to age. Notably, these relationships strengthened after adjusting for V ˙ O2max. Regression modeling showed age, RTD:MVC ratio (composite of muscle performance), and PFROM together explained 49% and 34% of the variance in non-graded and graded net V ˙ O2, respectively. Further analyses suggested knee extensor MVC moderates the relationship between non-graded net V ˙ O2 and age, accounting for 9% of the variance [ΔR2 = 0.090, F (1,31) = 4.13, p = 0.05]. Conclusion: These data support the premise that, in older women, walking net V ˙ O2 rises with advancing age, and additionally, the RTD:MVC ratio and PFROM are independent correlates of non-graded net V ˙ O2. Exercise interventions with a high degree of training specificity including explosive, velocity-based elements may promote independent mobility in older women. [ABSTRACT FROM AUTHOR]

Objective: To determine if estimates of functional muscle strength from a novel progressive lateral-step-up test (LSUT) are feasible, reliable, and related to physical activity in children with cerebral palsy (CP). Design: Cross-sectional; test-retest reliability Subjects/Patients: Children with CP and typically developing control children (n = 45/group). Methods: An LSUT with 10, 15, and 20 cm step heights was completed. It was repeated 4 weeks later in 20 children with CP. A composite score of LSUT was calculated based on the step height and number of repetitions completed. Physical activity was assessed using monitors worn on the ankle and hip. Results: Only 4 (13%) of the children with CP were unable to complete a lateral step-up repetition without assistance. All children were able to complete at least 1 repetition with assistance, though more than twice as many children with CP required assistance at 15 and 20 cm step heights than at the 10 cm step height (p < 0.01). Children with CP had 59 to 63% lower LSUT performance, 37% lower physical activity assessed at the ankle, and 22% lower physical activity assessed at the hip than controls (all p < 0.01). The intra-class correlation coefficient ranged from 0.91 to 0.96 for LSUT performance at the different step heights and was 0.97 for the composite score. All LSUT performance measures were positively related to ankle physical activity in children with CP (r range = 0.43 to 0.47, all p < 0.01). Only performance at 20 cm and the composite score were positively related to hip physical activity (r = 0.33 and 0.31, respectively, both p < 0.05). The relationship between the LSUT performance and physical activity at both the ankle and hip increased when age and sex were statistically controlled (model r range = 0.55 to 0.60, all p < 0.001). Conclusion: Estimates of functional muscle strength from a novel progressive LSUT are feasible, reliable, and positively related to physical activity in children with CP. [ABSTRACT FROM AUTHOR]

The authors examined sex-specific relationships between fat mass index (FMI), android/gynoid (A/G) fat ratio, relative skeletal muscle mass index, and Bone-Specific Physical Activity Questionnaire derived bone-loading scores (BLSs) in middle-aged and older adults (men, n = 27; women, n = 33; age = 55–75 years). The FMI, A/G fat ratio, and relative skeletal muscle mass index were estimated by dual-energy X-ray absorptiometry. The Bone-Specific Physical Activity Questionnaire was used to assess: (a) BLSpast (age 1 until 12 months before the study visit), (b) BLScurrent (last 12 months), and (c) BLStotal (average of [a] and [b]) scores. Separate multiple linear regression analysis of (a) age, FMI, and relative skeletal muscle mass index and (b) age, height, and A/G fat ratio versus BLS revealed that FMI and A/G fat ratio were negatively associated with BLSpast and BLStotal (p <.05) in women only. Adiposity and, specifically, central adiposity is negatively related to bone-loading physical activity in middle-aged and older women. [ABSTRACT FROM AUTHOR]