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Background: This systematic review and meta-analysis quantified the effect of acute exercise mode on arterial stiffness and wave reflection measures including carotid-femoral pulse wave velocity (cf-PWV), augmentation index (AIx), and heart rate corrected AIx (AIx75).Methods: Using standardized terms, database searches from inception until 2017 identified 45 studies. Eligible studies included acute aerobic and/or resistance exercise in healthy adults, pre- and post-intervention measurements or change values, and described their study design. Data from included studies were analyzed and reported in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. Meta-analytical data were reported via forest plots using absolute differences with 95% confidence intervals with the random effects model accounting for between-study heterogeneity. Reporting bias was assessed via funnel plots and, individual studies were evaluated for bias using the Cochrane Collaboration's tool for assessing risk of bias. A modified PEDro Scale was applied to appraise methodological concerns inherent to included studies.Results: Acute aerobic exercise failed to change cf-PWV (mean difference: 0.00 ms−1 [95% confidence interval: −0.11, 0.11], p = 0.96), significantly reduced AIx (−4.54% [−7.05, −2.04], p = 0.0004) and significantly increased AIx75 (3.58% [0.56, 6.61], p = 0.02). Contrastingly, acute resistance exercise significantly increased cf-PWV (0.42 ms−1 [0.17, 0.66], p = 0.0008), did not change AIx (1.63% [−3.83, 7.09], p = 0.56), and significantly increased AIx75 (15.02% [8.71, 21.33], p < 0.00001). Significant heterogeneity was evident within all comparisons except cf-PWV following resistance exercise, and several methodological concerns including low applicability of exercise protocols and lack of control intervention were identified.Conclusions: Distinct arterial stiffness and wave reflection responses were identified following acute exercise with overall increases in both cf-PWV and AIx75 following resistance exercise potentially arising fromcardiovascular and non-cardiovascular factors that likely differ from those following aerobic exercise. Future studies should address identified methodological limitations to enhance interpretation and applicability of arterial stiffness and wave reflection indices to exercise and health.

Postactivation potentiation (PAP) mechanisms and responses have a long scientific history. However, to this day there is still controversy regarding the mechanisms underlying enhanced performance after a conditioning activity. More recently, the term postactivation performance enhancement (PAPE) has been proposed with differing associated mechanisms and protocols than with PAP. However, these 2 terms (PAP and PAPE) may not adequately describe all specific potentiation responses and mechanisms and can also be complementary, in some cases. Purpose: This commentary presents and discusses the similarities and differences between PAP and PAPE and, subsequently, elaborates on a new taxonomy for better describing performance potentiation in sport settings. Conclusion: The elaborated taxonomy proposes the formula “Post-[CONDITIONING ACTIVITY] [VERIFICATION TEST] potentiation in [POPULATION].” This taxonomy would avoid erroneous identification of isolated physiological attributes and provide individualization and better applicability of conditioning protocols in sport settings.

Background Both athletes and recreational exercisers often perform relatively high volumes of aerobic and strength training simultaneously. However, the compatibility of these two distinct training modes remains unclear. Objective This systematic review assessed the compatibility of concurrent aerobic and strength training compared with strength training alone, in terms of adaptations in muscle function (maximal and explosive strength) and muscle mass. Subgroup analyses were conducted to examine the influence of training modality, training type, exercise order, training frequency, age, and training status. Methods A systematic literature search was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed/MEDLINE, ISI Web of Science, Embase, CINAHL, SPORTDiscus, and Scopus were systematically searched (12 August 2020, updated on 15 March 2021). Eligibility criteria were as follows. Population: healthy adults of any sex and age; Intervention: supervised concurrent aerobic and strength training for at least 4 weeks; Comparison: identical strength training prescription, with no aerobic training; Outcome: maximal strength, explosive strength, and muscle hypertrophy. Results A total of 43 studies were included. The estimated standardised mean differences (SMD) based on the random-effects model were − 0.06 (95% confidence interval [CI] − 0.20 to 0.09; p = 0.446), − 0.28 (95% CI − 0.48 to − 0.08; p = 0.007), and − 0.01 (95% CI − 0.16 to 0.18; p = 0.919) for maximal strength, explosive strength, and muscle hypertrophy, respectively. Attenuation of explosive strength was more pronounced when concurrent training was performed within the same session (p = 0.043) than when sessions were separated by at least 3 h (p > 0.05). No significant effects were found for the other moderators, i.e. type of aerobic training (cycling vs. running), frequency of concurrent training (> 5 vs. < 5 weekly sessions), training status (untrained vs. active), and mean age (< 40 vs. > 40 years). Conclusion Concurrent aerobic and strength training does not compromise muscle hypertrophy and maximal strength development. However, explosive strength gains may be attenuated, especially when aerobic and strength training are performed in the same session. These results appeared to be independent of the type of aerobic training, frequency of concurrent training, training status, and age. PROSPERO: CRD42020203777.

IntroductionImpairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning.ObjectiveTo conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults.MethodsA systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria.ResultsThirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity.ConclusionsThe overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments.

AimsThe results of kinematic total knee arthroplasty (KTKA) have been reported in terms of limb and component alignment parameters but not in terms of gap laxities and differentials. In kinematic alignment (KA), balance should reflect the asymmetrical balance of the normal knee, not the classic rectangular flexion and extension gaps sought with gap-balanced mechanical axis total knee arthroplasty (MATKA). This paper aims to address the following questions: 1) what factors determine coronal joint congruence as measured on standing radiographs?; 2) is flexion gap asymmetry produced with KA?; 3) does lateral flexion gap laxity affect outcomes?; 4) is lateral flexion gap laxity associated with lateral extension gap laxity?; and 5) can consistent ligament balance be produced without releases?Patients and MethodsA total of 192 KTKAs completed by a single surgeon using a computer-assisted technique were followed for a mean of 3.5 years (2 to 5). There were 116 male patients (60%) and 76 female patients (40%) with a mean age of 65 years (48 to 88). Outcome measures included intraoperative gap laxity measurements and component positions, as well as joint angles from postoperative three-foot standing radiographs. Patient-reported outcome measures (PROMs) were analyzed in terms of alignment and balance: EuroQol (EQ)-5D visual analogue scale (VAS), Knee Injury and Osteoarthritis Outcome Score (KOOS), KOOS Joint Replacement (JR), and Oxford Knee Score (OKS).ResultsPostoperative limb alignment did not affect outcomes. The standing hip-knee-ankle (HKA) angle was the sole positive predictor of the joint line convergence angle (JLCA) (p < 0.001). Increasing lateral flexion gap laxity was consistently associated with better outcomes. Lateral flexion gap laxity did not correlate with HKA angle, the JLCA, or lateral extension gap laxity. Minor releases were required in one third of cases.ConclusionThe standing HKA angle is the primary determinant of the JLCA in KTKA. A rectangular flexion gap is produced in only 11% of cases. Lateral flexion gap laxity is consistently associated with better outcomes and does not affect balance in extension. Minor releases are sometimes required as well, particularly in limbs with larger preoperative deformities. Cite this article: Bone Joint J 2019;101-B:331–339.

A single bout of resistance training induces residual fatigue, which may impair performance during subsequent endurance training if inadequate recovery is allowed. From a concurrent training standpoint, such carry-over effects of fatigue from a resistance training session may impair the quality of a subsequent endurance training session for several hours to days with inadequate recovery. The proposed mechanisms of this phenomenon include: (1) impaired neural recruitment patterns; (2) reduced movement efficiency due to alteration in kinematics during endurance exercise and increased energy expenditure; (3) increased muscle soreness; and (4) reduced muscle glycogen. If endurance training quality is consistently compromised during the course of a specific concurrent training program, optimal endurance development may be limited. Whilst the link between acute responses of training and subsequent training adaptation has not been fully established, there is some evidence suggesting that cumulative effects of fatigue may contribute to limiting optimal endurance development. Thus, the current review will (1) explore cross-sectional studies that have reported impaired endurance performance following a single, or multiple bouts, of resistance training; (2) identify the potential impact of fatigue on chronic endurance development; (3) describe the implications of fatigue on the quality of endurance training sessions during concurrent training, and (4) explain the mechanisms contributing to resistance training-induced attenuation on endurance performance from neurological, biomechanical and metabolic standpoints. Increasing the awareness of resistance training-induced fatigue may encourage coaches to consider modulating concurrent training variables (e.g., order of training mode, between-mode recovery period, training intensity, etc.) to limit the carry-over effects of fatigue from resistance to endurance training sessions.

This study examined the acute effect of strength and endurance training sequence on running economy (RE) at 70% and 90% ventilatory threshold (VT) and on running time to exhaustion (TTE) at 110% VT the following day. Fourteen trained and moderately trained male runners performed strength training prior to running sessions (SR) and running prior to strength training sessions (RS) with each mode of training session separated by 6 h. RE tests were conducted at baseline (Base-RE) and the day following each sequence to examine cost of running (CR), TTE, and lower extremity kinematics. Maximal isometric knee extensor torque was measured prior to and following each training session and the RE tests. Results showed that CR at 70% and 90% VT for SR-RE (0.76 ± 0.10 and 0.77 ± 0.07 mL·kg(-0.75)·m(-1)) was significantly greater than Base-RE (0.72 ± 0.10 and 0.70 ± 0.11 mL·kg(-0.75)·m(-1)) and RS-RE (0.73 ± 0.09 and 0.72 ± 0.09 mL·kg(-0.75)·m(-1)) (P < 0.05). TTE was significantly less for SR-RE (237.8 ± 67.4 s) and RS-RE (275.3 ± 68.0 s) compared with Base-RE (335.4 ± 92.1 s) (P < 0.01). The torque during the SR sequence was significantly reduced for every time point following the strength training session (P < 0.05). However, no significant differences were found in torque following the running session (P > 0.05), although it was significantly reduced following the strength training session (P < 0.05) during the RS sequence. These findings show that running performance is impaired to a greater degree the day following the SR sequence compared with the RS sequence.