<p> The population of older adults in the United States is rapidly increasing. Falls are a major health concern among the older adult population, and there is an increasing need for more theory-driven fall risk reduction programs that are multifactorial, effective, and inexpensive. The Stay Well At Home (SWAH) program was a 16-week, in-home multifactorial fall risk reduction program that was implemented by trained lay facilitators. The development of this intervention was guided by the Health Action Process Approach (HAPA). The purpose of this study was to qualitatively examine the efficacy of SWAH program as a multifactorial program, to determine its effectiveness as a HAPA-guided intervention, and also to inform further program development of the SWAH program. Semi-structured interviews were conducted with a sample of SWAH recipients (<i>N</i>=15) at the conclusion of the 8-week in-home phase of the program. The purpose of the interviews was to learn about participant experiences with the program and changes they may have observed in themselves. All interviews were recorded, transcribed verbatim, and then thematically analyzed. Themes were also related back to HAPA constructs. The major themes reported by SWAH recipients included an overall increase in fall protective behaviors (100%) as well as improvement in gait (80%), balance (73%), and physical performance (53%). Recipients also responded positively to the SWAH program content and structure. Common barriers for SWAH recipients were health and motivation barriers (73%) and taking the time to exercise (67%). Analysis of the main themes in this study suggest that SWAH was effective at implementing the HAPA model with the exception of successfully implementing action planning activities. The SWAH program was perceived by the interviewed participants as effective in reducing overall fall risk and was fairly successful as a HAPA-guided intervention. Further, it was well received and viewed as beneficial by many SWAH recipients. </p>

<p> While body image disturbances continue to be seen in individuals living in Western society, research has shown that both weight loss and exercise participation can decrease body image disturbance in both men and women. The purpose of the study was to examine the effect of a weight management clinic on body perception of obese individuals. Thirty nine participants were a part of a three-month weight management program with caloric restrictive diets and weekly exercise recommendations. The 34-item Multidimensional Body Self Relation Questionnaire, Body Assessment Scale and Social Physique Anxiety Questionnaire were administered at baseline and 12 weeks. All physiological measurements were conducted at baseline and 12 weeks. Based on participant&rsquo;s weight loss, they were divided into two groups: weight loss and no weight loss. A 2 (baseline, 12 week) X 2 (weight loss achieved, weight loss not achieved) repeated measures ANOVA was conducted with difference between ideal and current body position as the dependent variable to examine the relationship between weight loss and body perception. A 2 (baseline, 12 week) X 2 (weight loss achieved, weight loss not achieved) repeated measures ANOVA with social physique anxiety as the dependent variable was conducted to examine the relationship between weight loss goal achieved and body perception. A 2 (baseline, 12 week) X 2 (weight loss achieved, weight loss not achieved) repeated measures ANOVA with the MBRSQ-AS subscales as the dependent variable was conducted to examine the relationship between weight loss goal achieved and body perception. A Pearson correlation was run to predict weight loss from the MBSRQ-AS subscales, SPA and BAS. The results of this study indicate that there was a significant difference in body perception from baseline to 12 weeks, regardless of weight loss achieved by participants. Additionally, there was no correlation between weight loss and body perception variables.</p>

Reaches to remembered target locations often result in different endpoint precision when compared to reaches to actual (seen) targets. Interestingly, errors are observed whether the reach to the remembered location is performed in an environment with or without allocentric cues (visual cues from the environment) available. People tend to point below remembered target locations in the dark relative to normal room lighting while seated, standing, and reaching with a step. In this study we questioned the effect of gravitational influences on upper extremity reaching and pointing accuracy in dark and illuminated environments. We hypothesized that alterations in body orientation would alter endpoint reaches to final remembered target locations differently for the two visual conditions. Young healthy adults were asked to produce reaching movement in SUPINE and UPRIGHT body orientations or straight arm pointing movements in UPRIGHT and INVERTED body orientations to real and remembered target locations. Three targets directly in front of the midline were presented at shoulder level and shoulder level ±30 cm. Prior to movement participants anchored their gaze on the displayed target before pointing to its real or remembered location. Targets in remembered trials were removed or covered before pointing in normal room lighting (LIGHT) or complete darkness (DARK). At least 6 trials were performed to each target in each body orientation, starting arm position, and visual condition. Endpoint errors, displacement, peak velocity, and movement time were calculated for each participant and compared across target level, body orientation, and visual condition for each starting arm position using repeated measures ANOVAs. In the DARK participants often produced errors corresponding to less displacement and the undershooting of remembered target locations as compared to LIGHT and REAL visual conditions. Control of smaller movement amplitudes observed in darkness primarily with greater movement excursions occurred regardless of muscle activation or body orientation. The present study revealed that the effects of the gravitational pull for endpoint precision in darkness are minimal at best, thus cannot explain the differences in endpoint accuracy between visual conditions.

Approximately 20 million Americans are suffering Peripheral Neuropathy (PN). It is estimated that the prevalence of all-cause PN is about 2.4% in the entire adult population, whereas over 8-10% in the population segment over the age of 55 (Martyn & Hughes, 1997). Peripheral Neuropathy leads to a high risk of falling, resulting from the deficits of postural control caused by the impaired peripheral nerves, especially the degenerative somatosensory system. To date, there is no effective medical treatment for the disease but pain managements. The deficits of postural control decrease the life quality of this population. The degeneration of peripheral nerves reduces sensory inputs from the somatosensory system to central nervous system via spinal reflexive loop, which should provide valuable real-time information for balance correction. Therefore, it is necessary to investigate how PN affects the somatosensory system regarding postural control. Besides that, people with PN may develop a compensatory mechanism which could be reinforced by exercise training, ultimately to improve balance and mobility in their daily life. The neuroplasticity may occur within somatosensory system by relying on relative intact sensory resources. Hence, unveiling the compensatory mechanism in people with PN may help in understanding (a) essential sensations or function of peripheral nerves to postural control, (b) effective strategy of physical treatments for people with PN, and (c) task-dependent sensory information requirements. Therefore, this dissertation discussed the roles of foot sole sensation, ankle proprioception, and stretch reflex on balance as well as gait among people with PN. Furthermore, the discussion of the coupling between small and large afferent reflexive loops may spot the compensatory mechanism in people with PN.

Background/Purpose: Parents introduce children to youth sport and can increase a childs level of enjoyment in the sport. However, parents can also place too much pressure on the child, which can lead to increased pre-competition anxiety and decreased performance (Bois, Lalanne, & Delforge, 2008; Scanlan & Lewthwaite, 1984). The purpose of this study was to examine the relationships among perceived and desired parental pressure, pre-competition state anxiety, subsequent performance, and intention to continue the sport in youth swimmers ages 9-18. Method: A sample of 43 swimmers (17 male, 26 female; M=12.8±2.6 years) on a United States Swimming (USS) sanctioned club team in a mid-sized Southern city participated in this study. These swimmers completed the directive behavior scale of the Parental Involvement in Sport Questionnaire (PISQ) in the days preceding a swim meet. Variables analyzed in the PISQ include perceived pressure, desired pressure and the discrepancy between perceived and desired pressure for each parent. Immediately before the swimmers first race of this meet, each athlete completed the Competitive State Anxiety Inventory-2 Modified for Children (CSAI-2C); the swimmers performance from this first race was compared to the previous personal best of the athlete to develop a performance time-ratio. After the meet concluded, each swimmer declared his or her intention to continue swimming past this year. Analysis/Results: Bivariate correlations and regressions were run to analyze the questionnaires. Discrepancy of fathers pressure (b=0.277, p=. 021) and self-confidence (b=-.374, p=. 004) were significant predictors of cognitive anxiety in a regression analysis. In separate regression analyses, cognitive anxiety predicted intention to continue (b =-.066, p=. 036); the more cognitive anxiety a swimmer experiences, the less likely that swimmer will intend to continue swimming and age was the only significant predictor of performance (b=.012, p<.001). Conclusions: Results indicate the importance of working with parents to learn appropriate supportive behaviors when interacting with their children in sport settings and working with parents and coaches to develop programs to reduce cognitive anxiety in children participating in sport.

Leadership in the United States Army is essential for successful completion of domestic and international missions. Reserve Officer Training Corps (ROTC) programs are used to effectively develop leadership skills within the Army. Physical training (PT) is a mandatory component in ROTC, used to improve physical ability and prepare cadets for the rigors of the big Army environment. Resiliency and selfless service development are seen as critical elements of leadership, yet little is known about the formal and informal experiences in ROTC PT that facilitate or hinder resiliency and selfless service during early career preparation. The overall purpose of this dissertation was to provide insight into the development of cadets resiliency and selfless service in the context of PT. Two qualitative studies were used to address these issues. The purpose of the first study was to investigate resiliency development in an ROTC PT context. The Army recognizes five dimensions of resiliency, which maximize solders fortitude and mental toughness. Failure, challenge, and support played significant roles in cadets development of resiliency dimensions. Lack of support and organization were the greatest contributors to lack of resiliency throughout the battalion. Overall, ROTC PT improved specific dimensions of resiliency in effort to produce successful leaders in the United States Army. The purpose of the second qualitative study was to investigate selfless service development in an ROTC PT context using Identity Fusion Theory- used in situations where individuals are willing to make significant personal sacrifices on behalf of a group. Results underscored how cadets identity became increasingly fused with the ROTC organization through exposure to emotionally charged experiences. Fighting for a high placement on the Order of Merit List facilitated peer competition, which both increased potential for identity fusion and negative self-centric influences on selfless service. Furthermore, results indicated that assigned leadership roles throughout the program were also critical in evolving a cadets brain from self-centric to Army-centric (i.e. selfless behavior). Overall, results provided insight into resiliency and selfless service development among United States Army ROTC cadets in PT. Implications for cadre and other leaders as well as suggestions for future research are included.

Metabolic inflexibility is an emerging physiological marker indicative of metabolic dysfunction and associated with type 2 diabetes (T2D) and obesity. Exercise is a potent stimulus to improve metabolic health, however, not much is known about the acute effects of exercise on metabolic flexibility (METFLEX). The purpose of this dissertation was study the time-course of diet and exercise and its effects on METFLEX. Three studies were conducted to investigate molecular and clinical aspects of diet and exercise and how these stimuli may alter the metabolic response to fuel. The first study was conducted on obesity-prone, Osborne-Mendel (OM) and obesity-resistant S5B/Pl (S5B) rats. This experiment investigated inherent differences in EE, metabolic rate, METFLEX and skeletal muscle markers of metabolism, lipid storage and lipid oxidation between OM and S5B, as well as HFD-induced strain differences in these parameters. The consumption of a HFD in S5B rats increased metabolic rate and EE and decreased metabolic rate and EE in OM rats. These strain differences were not due to the differences in activity or food intake. These results suggest that HFD-induced differences in metabolic rate and EE may be mediated by HFD-induced differences in pAMPK and PPARγ expression and lipid accumulation in the gastrocnemius muscle of OM and S5B rats. The second study was designed to investigate the effect of acute aerobic exercise at an intensity that maximizes the rate of fat oxidation (FATMAX) on glucose tolerance, insulin action, and metabolic flexibility (METFLEX) compared to acute aerobic exercise at the onset of blood lactate accumulation (OBLA) resulting in greater carbohydrate (CHO) oxidation. OBLA exercise appears to have deleterious effects on oral glucose tolerance and metabolic flexibility acutely, however, FM exercise does not confer improved METFLEX. These results suggest that predominate substrate utilization does not promote improved glucose tolerance and metabolic flexibility in young overweight men. The third and final study of this dissertation was designed to investigate the immediate and extended of a single bout of high intensity interval exercise (HIIE) on METFLEX and mitochondrial function. Participants were recruited with a family history (FmHx) of T2D (n=8) and without a family history of T2D (n=8). The extended effects (48 hours) work via the reduction fat oxidation by increasing resting fat oxidation rate and improving the suppression of fat oxidation in response to a mixed meal.

<p> Regular physical activity (PA) in childhood and adolescence improves strength and endurance, helps build healthy bones and muscles, helps control weight, reduces anxiety and stress, increases self-esteem, and may improve blood pressure and cholesterol levels. The American College of Sports Medicine (ACSM) shows PA trends among adolescents (defined as 13&ndash;18 yrs.) decrease such that the majority of adolescents are not participating in sufficient activity to meet recommended guidelines. Cardiovascular Disease (CVD) risk factors that are present in adolescence have a tendency to track into adulthood. Youth who are overweight tend to have a higher prevalence of CVD risk factors than their normal weight peers. </p><p> Rural adolescents may not be engaging in PA as often as their urban counterparts due to barriers of their rural lifestyle. Many rural communities are characterized by vast distances, low socioeconomic status, transportation challenges, and low public funding levels for facilities, programs, and other public amenities. Rural residency, especially in the southern U.S. has been associated with low levels of PA. The rural population is very unique in that they have specific barriers to PA. These may be social, financial, transportation, personal (i.e. lack of time, resources, caregiver responsibilities) or environmental factors (i.e., transportation, inadequate programs, lack of facilities). </p><p> The purpose of this study was to extend previous findings by surveying a large sample of rural Alabama adolescents regarding barriers to PA and surveying parents and school administrators in this regard as well. Also, this study evaluated the effect that age, race/ethnicity, gender, and SES have on barriers to PA. This study did indeed demonstrate several demographic differences concerning barriers to PA. Additionally, it demonstrated several differences between students, parents, and administrators regarding perceived barriers to PA. Finally, this study provided additional data concerning common barriers to PA reported in the literature. Gender and SES differences were found to be the two covariates that were barriers to exercise and PA in rural West Alabama adolescents.</p>

<p> Introduction: Gait impairments, notably reduced knee flexion angle and external knee flexion moment, are common following anterior cruciate ligament reconstruction (ACLR) and may contribute to reinjury or future osteoarthritis development. Recently, plantar cutaneous sensation deficits have been reported following ACLR. It is likely that these sensory deficits influence gait and may represent a mechanism through which gait can be improved. </p><p> Objective: To examine the efficacy of two sensory interventions, plantar massage and textured insoles, at altering plantar sensation and improving gait in patients after ACLR. </p><p> Methods: Fourteen recreationally active adults with a history of ACLR participated in this study. Participants completed two testing sessions, each of which consisted of a baseline gait and plantar cutaneous sensation analysis, followed by completion of an intervention (massage or textured insole), and repeated gait and plantar cutaneous sensation assessment. Gait analysis was completed via 3D motion capture synchronized with force plate data collection while participants walked at standard gait speed (1.4 m/s &plusmn; 5%). Sagittal and frontal plane knee joint biomechanics were extracted from gait analysis using a standard inverse dynamics approach. Plantar cutaneous sensation analysis was conducted with Semmes Weinstein Monofilaments (SWM) with a 4-2-1 stepping algorithm at the plantar aspect of the head of the first metatarsal, base of the fifth metatarsal, and the medial and lateral malleoli. The plantar massage intervention consisted of a single, five-minute massage targeting the entire plantar surface of both feet, combining effleurage and petrissage techniques. For the textured insoles intervention, the participant was given textured insoles made from coarse grit sandpaper to place into his or her neutral athletic shoes to be worn during gait analysis. Gait data were analyzed using limb X time X condition repeated measures ANOVAs. T-tests were utilized to make all <i>post hoc</i> comparisons. Plantar cutaneous sensation data were analyzed via Wilcoxon Signed Rank tests to compare differences between limbs, conditions, and time. Effect sizes were calculated using Cohen&rsquo;s d. Statistical analysis was performed using SPSS (v. 21, IBM SPSS, IBM Corp, Armonk, NY) and Microsoft Excel (v. 2011, Microsoft Corp., Redmond, WA). Alpha was set <i>a priori</i> at <i>P</i>&lt; 0.05. </p><p> Results: There was a significant limb x condition interaction for sagittal plane knee rotation <i>Post hoc</i> analyses revealed no differences between limbs or conditions (<i>P</i>>0.05). There was a significant main effect of limb for knee frontal plane rotation, suggesting the ACLR limb was more abducted during walking than the contralateral limb (<i>P</i>=0.028) regardless of time or condition. No significant interactions or main effects were observed for knee joint moments. There were no statistically significant differences between pre-massage and pre-textured insoles sessions within limbs pre-intervention. Comparing sensation between limbs prior to massage, the 5^th metatarsal (<i>P</i>=0.016), medial malleolus (<i>P</i>=0.028), and lateral malleolus (<i> P</i>=0.046) demonstrated poorer sensation in the ACLR compared to the contralateral limb. Prior to receiving the textured insoles, participants demonstrated differences in sensation over the 5^th metatarsal (<i>P</i>=0.031), with the ACLR limb having worse sensation. Massage improved sensation over the 1^st metatarsal head (<i>P </i>=0.026), base of the 5^th metatarsal (<i>P</i>=0.039), medial malleolus (<i>P</i>=0.035), and lateral malleolus (<i> P</i>=0.043) in the ACLR limb. No changes in sensation occurred as a result of massage in the contralateral limb. Following textured insoles application, sensation improved over the 1^st metatarsal (<i>P</i>=0.027), 5^th metatarsal (<i>P</i>=0.011), and medial malleolus (<i>P</i>=0.007) of the ACLR limb. No changes in sensation were observed as a result of textured insoles in the contralateral limb. </p><p> Conclusions: Plantar massage and textured insoles improved plantar cutaneous sensation in the involved limb following ACLR. Both somatosensory interventions had minimal effects on gait biomechanics. Further investigation of other sensory interventions such as visual-spatial targeted interventions, should be implemented to improve gait biomechanics following ACLR.</p>

<p> The purpose of this study was to compare trunk muscle activity during common Pilates exercises performed at different angles of support. Nineteen college aged students volunteered as participants and performed 2 exercises (modified teaser and high plank) on three different surface inclinations. Muscle activity of the abdominals and back extensors on the right side of the body were recorded using surface electrodes and were expressed as a percent of the individual muscles maximum contraction (MVIC) recorded during data collection. These values were compared using 1-way repeated measures ANOVAs. During the high plank, the altered surface inclination changed the abdominal activity. During the modified teaser differences were seen between all muscles when comparing activity on the incline surface to the decline surface. The results of this study suggest that trunk muscle activity can be altered by modifying the surface angle.</p>