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The intervention is acceptable, practical and improves delivery of very brief advice on physical activity by nurses to cancer patients in the short-term. Both face-to-face and online delivery should be considered.

Shoulder pain is a common musculoskeletal complaint that is difficult to treat because of the biomechanical complexity of the shoulder region, the interplay between mobility and stability, and the vital role played by the shoulder in moving, positioning, and providing stability for hand function. Despite advances in biomechanics and pain science, there is still much to learn about how impairments influence shoulder function and health. One impairment, posterior shoulder tightness (PST), is often noted in individuals with shoulder pain and consequently has generated much discussion and debate in recent years. Range-of-motion shifts and deficits are the clinical indicators of PST, with 3 tissue alterations potentially contributing to these modifications: (1) increased humeral retrotorsion (retroversion), (2) reduced posterior glenohumeral joint capsule extensibility, and (3) reduced posterior shoulder muscle/tendon extensibility. The significance of each alteration for shoulder function and the interaction among them remain unclear. It is also unknown if, or to what extent, these impairments can be resolved through interventions. This raises a clinically relevant and straightforward question: when PST is present, should we treat or not treat? In this Viewpoint, we will debate this question and propose that physical therapy interventions have the potential to improve only 1 of the 3 tissue alterations contributing to PST. J Orthop Sports Phys Ther 2018;48(3):133-136. doi:10.2519/jospt.2018.0605.

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Background: Although posterior shoulder tightness (PST) has been associated with shoulder pathology and altered glenohumeral joint kinematics, uncertainty remains regarding its cause and definition. To understand the efficacy of treatments for PST, it must be possible to identify people with PST for the purposes of research and clinical decision-making. Clinical tests for PST must demonstrate acceptable levels of measurement reliability in order to identify the condition and to evaluate the response to intervention. There is currently a lack of research describing intersession reliability for measures of PST. The aim of this study was to quantify the inter-session reliability for three clinical tests used to identify PST over a 6-10 week interval. Methods: A convenience sample of 26 asymptomatic adult participants (52 shoulders) were recruited from a university setting over a five-month duration. Participants attended the human movement laboratory for measurement of glenohumeral joint internal rotation, horizontal adduction and low flexion on two occasions separated by an interval of 6-10 weeks. Intra-class correlation coefficients were calculated from the mean square values derived from the within-subject, single factor (repeated measures) ANOVA. Test-retest measurement stability was evaluated by calculating the standard error of measurement and the minimum detectable change for each measurement. Results: All 3 tests demonstrated good intersession intra-rater reliability (0.86-0.88), and the standard error of measurement (95%) were 7.3°for glenohumeral horizontal adduction, 9.4°for internal rotation, and 6.9°for low flexion. The minimum detectable change for glenohumeral horizontal adduction was 10.2°, internal rotation was 13.3°, and low flexion was 9.7°. Conclusion: In this population of people without symptoms, the 3 measures of PST all demonstrated acceptable inter-session reliability. The standard error of measurement and minimum detectable change results can be used to determine if a change in measures of PST are due to measurement error or an actual change over time.

By 2013, fantasy sports leagues (and games) were entered into and played by more than an estimated 32-million people (Dwyer, 2013) across American and Canada, and produced a projected economic impact of $3.1-billion dollars annually (Fantasy Sports Trade Association, 2012). This work seeks to explain both the historical growth and cultural transitions of in-home sport gaming in the United States as well as the technological evolution that drove the appeal of modern 'fantasy sports' and continued enhancement of professional league avidity by developing stronger brand allegiances for leagues such as Major League Baseball (MLB) or the National Football League (NFL). From a historical standpoint, the term 'Fantasy League' didn't garner popularity until the 1980s, but the concept of fantasy sports gaming can be traced back to the mid-1860s with a simple wooden tabletop contraption that simulated outcome elements of a baseball game (Cooper, 1995). Over the next 150 years, technological and social developments in the areas of in-home recreation and networked gaming have caused fantasy sports to reshape sports media coverage, sports marketing (particularly of sports data), fan avidity, technology engagement and general sport discussion. The impact of these fan-based developments might prove significant and increasingly leagues like the NFL have been forced to ask whether the at-home experience of following professional football (including the owning and managing of fantasy football league teams) is reaching a point where it could replace attending NFL games in person. A sea-change such as that (decreases in NFL game attendance, failure to sell out NFL games, etc.) would potentially threaten lucrative team and league sponsorships, stadium merchandise and concessions (food, beverage, parking, etc.) and possibly even TV network broadcast contracts (by way of diminished ratings and advertising demand).

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