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There is a growing need for physical education teachers to integrate different types of fitness activities into their lessons in order to provide opportunities for all students to learn and practice a variety of movement skills that will enhance their physical fitness and support free-time physical activity. An increased focus on age-appropriate interventions that enhance muscle strength and motor skills is particularly important for overweight youth who may not have developed competence and confidence in their physical abilities to engage in aerobic games and sport activities. FUNdamental Integrative Training, or FIT, incorporates a variety of strength and conditioning exercises into a well-designed lesson that enhances the health- and skill-related components of physical fitness. Youth who participate in FIT will be more likely to participate in games, activities, and sports as an ongoing lifestyle choice. This article provides a fresh approach for incorporating FIT into elementary-school physical education curricula.

Context: Despite the popularity of jump-landing tasks being used to identify injury risk factors, minimal data currently exist examining differences in knee kinematics during commonly used bilateral jumping tasks. This is especially the case for rebounding-based protocols involving young athletes. Objective: To compare the frontal plane projection angles (FPPAs) during the drop vertical jump (DVJ) and tuck jump assessment (TJA) in a cohort of elite male youth soccer players of varying maturity status. Methods: A total of 57 male youth soccer players from an English championship soccer club participated in this study. Participants performed 3 trials of the DVJ and TJA, during which movement was recorded with 2-dimensional video cameras. FPPA for both right (FPPA-r) and left (FPPA-l) legs, with values <180° indicative of medial knee displacement. Results: On a whole-group level, FPPA-r (172.7° [7.4°] vs 177.2° [11.7°]; P <.05; effect size [ES] = 0.46) and FPPA-l (173.4° [7.3°] vs 179.2° [11.0°]; P <.05; ES = 0.62) were significantly greater for both limbs in the TJA compared with the DVJ; however, these differences were less consistent when grouped by maturity status. FPPA-r during the TJA was significantly and moderately greater in the circa-peak height velocity (PHV) group compared with the post-PHV cohorts (169.4° [6.4°] vs 175.3° [7.8°]; P <.05; ES = 0.49). Whole-group data showed moderate relationships for FPPA-r and FPPA-l between the TJA and DVJ; however, stronger relationships were shown in circa- and post-PHV players compared with the pre-PHV cohort. Conclusions: Considering that the TJA exposed players to a larger FPPA and was sensitive to between-group differences in FPPA-r, the TJA could be viewed as a more suitable screen for identifying FPPA in young male soccer players. [ABSTRACT FROM AUTHOR]

Purpose: To determine the differences in muscle architecture of the lower limb in pre-peak height velocity (PHV), circa-PHV, and post-PHV boys. Method: Muscle architecture variables from both the gastrocnemius medialis (GM) and vastus lateralis (VL) were derived from ultrasonographic images in 126 school-aged boys. One-way analysis of variance using Bonferroni post hoc comparisons was employed to determine between-group differences, and effect sizes were calculated to establish the magnitude of these differences. Results: All muscle architecture variables showed significant small to large increases from pre-PHV to post-PHV, excluding GM fascicle length (d = 0.59–1.39; P <.05). More discrete between-group differences were evident as GM and VL muscle thickness, and physiological thickness significantly increased between pre-PHV and circa-PHV (d > 0.57; P <.05); however, only the VL muscle thickness and physiological thickness increased from circa-PHV to post-PHV (d = 0.68; P <.05). The post-PHV group also showed larger GM pennation angles than the circa-PHV group (d = 0.59; P <.05). Conclusion: The combined results showed that maturation is associated with changes in muscle morphology. These data quantify that the maturity-related changes in muscle architecture variables provide a reference to differentiate between training-induced adaptations versus changes associated with normal growth and maturation. [ABSTRACT FROM AUTHOR]

Context: Laboratory-based biomechanical analyses of sport-relevant movements such as landing and cutting have classically been used to quantify kinematic and kinetic factors in the context of injury risk, which are then used to inform targeted interventions designed to improve risky movement patterns during sport. However, the noncontextual nature of standard assessments presents challenges for assessing sport-relevant skill transfer. Objective: To examine injury-risk biomechanical differences exhibited by athletes during a jump-landing task performed as part of both a standard biomechanical assessment and a simulated, sport-specific virtual reality (VR)-based assessment. Design: Observational study. Setting: Medical center laboratory. Participants: Twenty-two female adolescent soccer athletes (age = 16.0 [1.4] y, height = 165.6 [4.9] cm, and weight = 60.2 [11.4] kg). Interventions: The landing performance was analyzed for a drop vertical jump task and a VR-based, soccer-specific corner-kick scenario in which the athletes were required to jump to head a virtual soccer ball and land. Main OutcomeMeasures: Hip, knee, and ankle joint kinematic differences in the frontal and sagittal planes. Results: Athletes exhibited reduced hip and ankle flexion, hip abduction, and frontal plane ankle excursion during landing in realistic sport scenario compared with the standard drop vertical jump task. Conclusion: VR-based assessments can provide a sport-specific context in which to assess biomechanical deficits that predispose athletes for lower-extremity injury and offer a promising approach to better evaluate skill transfer to sport that can guide future injury prevention efforts. [ABSTRACT FROM AUTHOR]

Biomechanical analysis can effectively identify factors associated with task performance and injury risk, but often does not account for the interaction among the components that underlie task execution. Uncontrolled manifold (UCM) analyses were applied to data from 38 female, adolescent athletes performing single-leg drop landings and were used to differentiate successful and unsuccessful task performance by examining the frontal plane joint variance within the UCM (VUCM) that stabilized the horizontal center of mass position (VUCM) and within the orthogonal subspace (VORT). The UCM revealed stronger coordination, indicated by the VUCM/VORT ratio, in the successful condition. This may inform future research examining reduced motor coordination in failed movement tasks and its relation to injury risk and allow for targeted interventions that consider coordination processes rather than joint-specific outcomes. [ABSTRACT FROM AUTHOR]

Visual biofeedback has been shown to facilitate injury-resistant movement acquisition in adolescent athletes. Visual biofeedback is typically thought to foster implicit learning by stimulating athletes to focus attention externally (on movement outcome). However, biofeedback may also induce explicit learning if the athlete uses the visual information to consciously guide movement execution (via an internal focus). To determine the degree to which athletes reported statements indicating implicit or explicit motor learning after engaging in a visual biofeedback intervention. Prospective cohort study. Three-dimensional motion-analysis laboratory. Twenty-five adolescent female soccer athletes (age = 15.0 ± 1.5 years, height = 165.7 ± 5.9 cm, mass = 59.4 ± 10.6 kg). Standard 6-week neuromuscular training intervention (three 90-minute sessions/wk), with added visual biofeedback sessions (2 sessions/wk). For the biofeedback training, participants performed squatting and jumping movements while interacting with a visual rectangular stimulus that mapped key parameters associated with injury risk. After the last biofeedback session in each week, participants answered open-ended questions to probe learning strategies. Responses to the open-ended questions were categorized as externally focused (ie, on movement outcome, suggestive of implicit learning), internally focused (ie, on movement itself, suggestive of explicit learning), mixed focus, or other. A total of 171 open-ended responses were collected. Most of the responses that could be categorized (39.2%) were externally focused (41.8%), followed by mixed (38.8%) and internally focused (19.4%). The frequency of externally focused statements increased from week 1 (18%) to week 6 (50%). Although most statements were externally focused (suggesting implicit learning), the relatively large proportion of internal- and mixed-focus statements suggested that many athletes also engaged in explicit motor learning, especially in early practice sessions. Therefore, biofeedback may affect motor learning through a mixture of implicit and explicit learning. [ABSTRACT FROM AUTHOR]

Although the benefits of regular physical activity are widely acknowledged, recent findings indicate that a growing number of youth are not as active as they should be. The impact of a sedentary lifestyle during childhood on lifelong pathological processes and associated health care costs have created a need for immediate action to manage, if not prevent, unhealthy behaviors during this vulnerable period of life. The concept of identifying children with exercise deficit disorder early in life and prescribing effective interventions to prevent the cascade of adverse health outcomes later in life is needed to raise public awareness, focus on primary prevention, and impact the collective behaviors of health care providers and public health agencies. School nurses are in a unique position to take advantage of well-child visits as an ideal opportunity to assess physical activity habits and encourage daily participation in play, recess, sports, planned exercise, and physical education.

Background: When stable osteochondritis dissecans (OCD) lesions of the femoral condyle in a skeletally immature patient fail to heal with nonoperative methods, the standard of care treatment is condylar OCD drilling. Two primary OCD drilling techniques have been described, but no prospective studies have compared their relative effectiveness. Purpose/Hypothesis: The purpose of this study was to compare the healing and function after transarticular drilling (TAD) with that after retroarticular drilling (RAD). It was hypothesized that there would be no difference in rate or time to healing, rate or time to return to sports, patient-reported outcomes (PROs), or secondary OCD-related surgery. Study Design: Randomized controlled clinical trial; Level of evidence, 1. Methods: Skeletally immature patients with magnetic resonance imaging–confirmed stable OCD lesions of the medial femoral condyle who did not demonstrate substantial healing after a minimum of 3 months of nonoperative treatment were prospectively enrolled by 1 of 17 surgeon-investigators at 1 of 14 centers. Patients were randomized to the TAD or RAD group. Tourniquet time, fluoroscopy time, and complications were compared between the treatment groups. Postoperatively, serial radiographs were obtained every 6 weeks to assess healing, and PROs were obtained at 6 months, 12 months, and 24 months. Results: A total of 91 patients were included, consisting of 51 patients in the TAD and 40 patients in the RAD group, who were similar in age, sex distribution, and 2-year PRO response rate. Tourniquet time and fluoroscopy time were significantly shorter with TAD (mean, 38.1 minutes and 0.85 minutes, respectively) than RAD (mean, 48.2 minutes and 1.34 minutes respectively) (P =.02; P =.004). In the RAD group, chondral injury from K-wire passage into the intra-articular space was reported in 9 of 40 (22%) patients, but no associated postoperative clinical sequelae were identified in these patients. No significant differences between groups were detected in follow-up Pediatric–International Knee Documentation Committee, Lysholm, Marx Activity Scale, or Knee injury and Osteoarthritis Outcome Score Quality of Life scores. Healing parameters were superior at 6 months and 12 months in the TAD group, compared with the RAD group, and secondary OCD surgery occurred in 4% of patients who underwent TAD and 10% of patients who underwent RAD (P =.40). Patients in the TAD group returned to sports earlier than those in the RAD group (P =.049). Conclusion: TAD showed shorter operative time and fluoroscopy time and superior healing parameters at 6 and 12 months, but no differences were seen in 24-month healing parameters or PROs at all follow-up time points, when compared with RAD. Registration: NCT01754298 (ClinicalTrials.gov identifier). [ABSTRACT FROM AUTHOR]

Bilateral sensorimotor coordination is required for everyday activities, such as walking and sitting down/standing up from a chair. Sensorimotor coordination functional neuroimaging (fMRI) paradigms (e.g., stepping, cycling) increase activity in the sensorimotor cortex, supplementary motor area, insula, and cerebellum. Although these paradigms are designed to assay coordination, performance measures are rarely collected simultaneously with fMRI. Therefore, we aimed to identify neural correlates of lower extremity coordination using a bilateral, in‐phase, multi‐joint coordination task with concurrent MRI‐compatible 3D motion analysis. Seventeen female athletes (15.0 ± 1.4 years) completed a bilateral, multi‐joint lower‐extremity coordination task during brain fMRI. Interlimb coordination was quantified from kinematic data as the correlation between peak‐to‐peak knee flexion cycle time between legs. Standard preprocessing and whole‐brain analyses for task‐based fMRI were completed in FSL, controlling for total movement cycles and neuroanatomical differences, with interlimb coordination as a covariate of interest. A clusterwise multi‐comparison correction was applied at z > 3.1 and p <.05. Less interlimb coordination during the task was associated with greater activation in the posterior cingulate and precuneus (zmax = 6.41, p <.01) and the lateral occipital cortex (zmax = 7.55, p =.02). The inability to maintain interlimb coordination alongside greater activity in attention‐ and sensory‐related brain regions may indicate a failed compensatory neural strategy to execute the task. Alternatively, greater activity could be secondary to reduced afferent acuity that may be elevating central demand to maintain in‐phase lower extremity motor coordination. Future research aiming to improve sensorimotor coordination should consider interventional approaches uniquely capable of promoting adaptive neuroplasticity to enhance motor control. In the first report of a bilateral lower extremity, in‐phase, multi‐joint coordination fMRI motor paradigm with concurrent kinematics, we found that lower extremity coordination was negatively associated with neural activity in the posterior cingulate gyrus, precuneus, and lateral occipital cortex; such that poorer coordination is associated with greater activity. This alteration may indicate a failed compensatory strategy to maintain motor control or higher central demand downstream from reduced afferent acuity. [ABSTRACT FROM AUTHOR]