Objectives: The purpose of this study was to describe the reliability and validity of measurements of cervical retraction strength obtained with a hand held dynamometer (HHD) from healthy adults. Background: Impaired neck muscle strength is related to neck pain, abnormal posture, and various cervical pathologies. While sophisticated devices to objectively measure neck strength exist, many are not practicable in typical orthopedic practices or have questionable validity and reliability. Methods: Forty participants were included in the analysis of neck strength using isometric testing with an HHD fixed in a cradle on a table top. The highest neck retraction force recorded in Newtons (N) for each participant, was used for data analysis. Results: Both intratester and intertester reliability were excellent as judged by intraclass correlation coefficients (ICCs) (.885-.974) and minimal detectable change (MDC) (21.1 to 47.6 N). Validity was confirmed on the basis of expected gender and age differences (ie, men were stronger than women and younger participants were stronger than older participants). Conclusion: Fixed HHD is a reliable and valid tool for measuring isometric neck retraction strength in ostensibly healthy adults. Its value in the assessment of individuals with neck pathology awaits further examination.

Purpose: To statistically evaluate the internal and external load metrics in different types of lacrosse drills. Methods: A total of 25 Division I collegiate female lacrosse players wore a heart rate monitor and a global positioning system during preseason training sessions. Seven measures determined training load, 2 internal measures and 5 external measures, across 5 different types of drills: stickwork, small-sided games, individual skills, conditioning, and team drills. Principal component analysis was used to determine which internal and external load variables were most associated with each drill type. Results: Stickwork extracted 2 principal components, explaining 45% and 17% of the variance. Small-sided games extracted 1 principal component, explaining 51% of the variance. Individual skills extracted 2 components, explaining 39% and 22% of the variance. Conditioning extracted 2 components, explaining 44% and 24% of the variance. Team drills extracted 2 components, explaining 52% and 18% of the variance. Conclusions: In 4 out of 5 training modes, the inclusion of both internal and external training-load measures was necessary to accurately decipher training load. For most drills, the first component is related to measures of external load, and the second component described the balance between internal and external load measures. Small-sided games extracted only external measures including the following: accelerations, total distance, and average speed. These results show that a combination of internal and external load measures is required to determine training load during certain training modes. This information can help coaches make decisions about desired training load for practice sessions.

BACKGROUND: Knee osteoarthritis (OA) is common among older adults and associated with impaired knee strength. OBJECTIVE: Describe isokinetic testing procedures and clinimetric findings associated with the testing of knee strength in the presence of knee OA. METHODS: Relevant articles were identified by an electronic search of PubMed using the search string "isokinet * AND knee osteoarthritis." RESULTS: One-hundred and twenty-nine relevant articles were found. The articles support the validity and reliability of isokinetic strength testing for patients with knee OA. The responsiveness to various therapeutic interventions has been reported. CONCLUSIONS: Isokinetic dynamometry is a valid and reliable measure of muscle strength in knee OA.

Objective: To assess current literature focused on the influence of functional training with blood flow restriction (BFR) on muscular adaptation in adults below the age of 65 years. Methods: A systematic literature search was performed with the following databases: PubMed, CINAHL Complete EBSCOhost, and ScienceDirect. Two researchers filtered the articles according to the criteria and quality, supported by the Consolidated Standards of Reporting Trials (CONSORT) tool. Studies were limited to those with participants with a mean age between18 and 65 years. Articles were peer-reviewed, available in English, and utilized either multi-joint resistance exercises or functional exercise as the intervention. Results: The search yielded 16 studies on uninjured, older adult, injured and athletic subjects. Regardless of the population, the studies tended to favor BFR training for improvements of strength, but this was highly dependent on cuff pressure and training load. Conclusions: Current literature suggests that BFR with functional and or multi-joint strength training is successful in improving strength, hypertrophy, function and in pain reduction. Favorable results with functional BFR included procedures using relative and well-controlled occlusion pressure. More research is necessary to understand the effect of BFR on self-reported outcomes and hypertrophy in athletic and older adults.

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Background: Despite the known benefits of physical activity (PA), most of the population in the United States fails to meet minimum recommended levels, and this lack of activity is believed to affect their health and well-being. Objective: The purpose of this study was to compare lifestyle behaviors of exercise and sleep in low, moderate, and high performers for maximal aerobic capacity (VO2max) and hand-grip strength (GS). Methods: Participants (n = 107, 19-62 years old) performed physical fitness assessments: estimated VO2max through submaximal cycle ergometry, and GS. Physical activity (PA) and sleep were assessed via self-reported questionnaires: physical activity as a vital sign (PAVS) and the Pittsburgh Sleep Quality Index (PSQI). Participants were categorized according to age and gender-specific normative values as low, medium, and high performer (LP, MP, and HP). Group characteristics were compared for each ranked variable using Kruskall-Wallis tests. Results: PAVS scores revealed 66.3% (n=68) of participants met minimum PA of 150 min/week (221.6 ± 177.8). According to VO2max performance groups, the LP group was taller, heavier, had higher diastolic blood pressure, and had a larger waist circumference than MP or HP (p =.000-.029), with moderate and high effect sizes. When categorized by relative GS, the LP group was heavier and had larger waist and hip circumferences than the HP group (p =.003-.011), all with high effect sizes. Conclusion: Despite high levels of self-report PA in this cohort, this did not translate to better cardiorespiratory fitness or muscular strength. Participants met PA guidelines but achieved suboptimal scores for VO2max and GS signifying elevated risk of mortality. The incongruity between PA levels and fitness classification suggest that lifestyle habits may not be a suitable surrogate for objective measurement of fitness.

concentrations were determined using ELISA. Heart rate (HR), gastrointestinal temperature (Tgi), physiological strain index (PSI) and changes in blood biomarkers were assessed using 2-way ANOVA and paired Student's t-test with p<0.05 as statistically significant. RESULTS: Participants observed similar baseline Tgi (37.0 ± 0.2ºC; p=0.910) and HR (69 ± 7 bpm; p=0.469). After ingestion at rest, Tgi was lower in ICE (36.5 ± 0.2ºC) compared to AMB (36.9 ± 0.2ºC, p<0.001). Tgi was similar post-FDE (ICE:38.4 ± 0.4ºC, AMB: 38.6 ± 0.3ºC; p=0.196) and post-ECT (both 39.5 ± 0.5ºC; p=0.976). PSI for FDE (ICE: 5.6 ± 0.6, AMB: 5.5 ± 0.7; p=0.652) and ECT (ICE: 6.8 ± 1.0, AMB: 6.9 ± 1.0; p=0.668) were also similar. ECT run times for ICE (48 ± 13 min) and AMB (45 ± 13 min; p=0.142) did not differ. Serum cortisol concentrations were similar at baseline (5.1 ± 2.7 ug/dL, p=0.840) and post-FDE (4.4 ± 3.1 ug/dL, p=0.804). Post-ECT serum cortisol concentrations were lower in ICE (7.8 ± 2.5 ug/dL) than AMB (9.7 ± 3.1 ug/dL, p=0.03). Serum concentrations of i-FABP, LPS and IL-6 were similar at baseline, post-FDE and post-ECT (p>0.05). CONCLUSION: Ice slurry ingestion before and during exercise reduces serum cortisol levels via mechanisms independent from the physiological strain incurred during exercise.