Low-impact Activities Research Articles

A Review of Swimming Cues and Tips for Physical Education

Swimming is a low-impact activity that causes little stress on joints so it can be done for a lifetime. Many teachers may wish to teach swimming but do not have cues or ideas for doing so. This article reviews swimming cues, relays and equipment that can help a physical education teacher include a swimming unit in their curriculum. Certification and adaptation for some disabilities are also mentioned.

Assessment of Nutritional Status of Regular Adolescent Swimmers (13-18 Years)

Physical activity and good nutrition plays a pivotal role in maintaining good health. Swimming is a low impact activity and a good workout which confers physical and mental health benefits. It was hypothesized that the nutrient intake and nutritional status of the adolescent swimmers (experimental group) will be different from the nonswimmers (control group). The BMI will be different from non-swimmers (control group). The study was undertaken with an aim to assess the nutritional status of regular swimmers and non-swimmers in the age group of 13-18 years. Assessment of somatic status and nutrient intake were the objectives. A sample consisting of swimmers (N=80) including 40 male swimmers and 40 female swimmers was selected along with the control group containing 30 male swimmers and 30 female non-swimmers (N=60). Irrespective of their status as swimmers or non-swimmers, the mean nutrient intake in both the groups was significantly less than their RDA (carbohydrates, proteins, fats, calcium, iron, vitamin D, vitamin C.). The BMI of the swimmers was less compared to the non-swimmers but within the normal range in case of both the boys and girls. However, the Mid Arm Circumference which depicts the muscle mass was higher among the swimmers. The study revealed that there was no significant difference in the nutrient intake of both the groups irrespective of the competitive sport. Even though nutrient intake is not meeting the RDA, the Mid Arm Circumference is good indicator depicting the importance of physicalactivity. Even though the nutritional knowledge was good in both the groups, their nutrient intake shows they not practising the same. Most of the swimmers were found to be non-vegetarians following a meal pattern of 4 meals per day, while most of the non-swimmers were found to be vegetarians and ova-vegetarians following a 3 meal pattern per day. A habit of skipping meals was found in adolescent boys (swimmers and non-swimmers). The water consumption was found to be more than 5 litres per day among the swimmers as against the non-swimmers who were consuming less than 3 litres per day.

‘Keeping your body and mind active’: an ethnographic study of aspirations for healthy ageing

ObjectiveTo describe and explore perceptions, practices and motivations for active living in later life.DesignQualitative study with semistructured interviews and ‘semistructured’ participant observations of participant-selected activities, such as exercise classes, private...

Sports Physical Therapy Section Poster Presentations (Abstracts SPO1–SPO119)

Sports Physical Therapy Section Poster Presentations (Abstracts SPO1–SPO119)

Locally Invasive Fungal Lung Disease and Exercise-Induced Pulmonary Hemorrhage: A Deadly Interplay of Cavitary Aspergilloma Kinetics and Capillary Hemodynamics

SESSION TITLE: Chest Infections II: Student Resident Case Report Posters SESSION TYPE: Student/Resident Case Report Poster PRESENTED ON: Tuesday, October 27, 2015 at 01:30 PM - 02:30 PM INTRODUCTION: Aspergilloma is an opportunistic fungal disease which typically forms in cavitary lung. We report the case of an enlarging aspergilloma in an immunocompromised patient with pulmonary hemorrhage precipitated by strenuous cardiopulmonary exercise. CASE PRESENTATION: A 58-year old female presented to our emergency department in February 2015 with hemoptysis. She underwent a multi-stage treadmill cardiac stress test seven days earlier to evaluate exertional dyspnea, achieving a heart rate of 143 and a peak blood pressure of 175/100. She subsequently coughed several teaspoons of blood streaked sputum for the next week. Prior to admission she ran vigorously at her gym triggering large-volume hemoptysis (130-150ml), prompting hospital admission. Her past medical history included fully treated pulmonary tuberculosis with residual localized cystic bronchiectasis in right upper lobe with a suspected aspergilloma and Crohn's disease in remission on azathioprine and mesalamine. On arrival her blood pressure was 162/86, pulse 72, afebrile with a resting SpO2 of 100% on air. Examination was significant for coarse breath sounds in the right upper chest. Labs revealed a hemoglobin of 14.5g/dl, WBC 6,600/nL, platelets 223,000/nL, INR 0.9 and PTT 20secs. Initial CT imaging demonstrated an enlarged lobulated right apical cavity containing a soft tissue mass, which had increased in size from 19.6mm to 22.4mm over 4 months. The patient was treated with piperacillin-tazobactam for an infectious exacerbation of bronchiectasis and her blood pressure was tightly controlled with beta-blockade. Her hemoptysis ceased by hospital day 4 without need for blood transfusion or endovascular intervention. Azathioprine was discontinued and voriconazole was initiated to minimize the risk of local fungal invasion. She was counselled on the importance of blood pressure control and advised to change her exercise routine from running to a low impact activity such as cycling to minimize aspergilloma movement and prevent shearing forces within the cavity. DISCUSSION: Aspergillomas confer significant morbidity to predisposed individuals with potential for life-threatening hemoptysis. Immunosuppression may facilitate local invasion of hyphae into the adjacent lung parenchyma. The delicate granulation tissue lining the cavity is probably susceptible to pendulous forces of the aspergilloma during high impact exercise such as running and jumping resulting in capillary rupture and bleeding1. CONCLUSIONS: There is little guidance on what lifestyle modification is appropriate for patients with aspergillomas. Providers should consider the exercise tolerance of each patient, their immune status and size of the aspergilloma before recommending a type and intensity of exercise that can safely be undertaken. Reference #1: Corrin, B. (2011). Pathology of the Lungs. Churchill Livingstone/Elsevier DISCLOSURE: The following authors have nothing to disclose: Haider Ali, Erika Diaz-Narvaez, Armando Cuesta, Schantal Polanco, Chang Shim, Virginia Chung No Product/Research Disclosure Information

Assessment of recreational harvesting of the trigonal clam Tivela mactroides: Socioeconomic aspects and environmental perception

Although it is one of the major threats to sandy beach ecosystems, the impact of harvesting on marine invertebrates is poorly understood, especially considering that recreational harvesting is practiced with little or no management on beaches worldwide. Current management strategies not only target economically valuable resources and focus on biological aspects of harvested populations, but they also tend to neglect socioeconomic information such as the profile, behavior, consumption characteristics of harvesters and their perception of threats to their activities, all of which are little studied. This study evaluated the social aspects of harvesting of the clam Tivela mactroides, based on semi-structured interviews carried out at Caraguatatuba Bay, São Paulo, Brazil, during two sampling periods between 2003 and 2008. This cultural activity has continued for decades, with the continual entry of new harvesters, and the harvesters’ profile and methods varied little over time. Clammers do not depend economically on the resource, use clams mainly for family consumption, harvest them with low frequency, prefer free time periods (for subsistence) and invest little in developing more-efficient harvesting strategies, such as criteria for selecting the harvesting area and more-efficient tools. The clammers showed little awareness of the problems related to harvesting of T. mactroides and the risks associated with its consumption, despite local threats such as episodes of poor water quality and oil spills. Changes in stock abundance did not affect the socioeconomic profile or collecting behavior of clammers, and there was no evidence that harvesting pressure affects fluctuations in the clam stock. An alternate ecosystem-based management approach could include improvement of environmental quality, to guarantee food security for low-income families and food safety for all consumers, instead of traditionally employed resource-based restrictive practices, since clam collecting in Caraguatatuba Bay is a low-impact socio-cultural activity. These findings emphasize that managers of subsistence and recreational activities should not focus only on the potential environmental problems caused by exploitation, but may also benefit from understanding the harvesters, harvesting procedure and consumption estimates, as well as the sociocultural role of and threats to these activities.

Walking is a Feasible Physical Activity for People with Rheumatoid Arthritis: A Feasibility Randomized Controlled Trial.

Exercise has been recognized as important in the management of rheumatoid arthritis (RA). Walking is a low-cost and low-impact activity, requiring little supervision. It requires no specialist training, is suited to a variety of environments and is inherently a clinically meaningful measure of independence. The aim of the present study was to determine whether a designed walking programme for people with RA successfully facilitated regular physical activity in participants, without detriment to pain levels. Thirty-three people with RA were recruited from Dunedin Hospital rheumatology outpatient clinics and enrolled in a walking randomized controlled trial (RCT) feasibility study. Participants were randomly allocated to the walking intervention (n = 11) or control (n = 22) groups. Control participants received a nutrition education session, and the walking intervention group received instructions on a walking route with three loops, to be completed 3-4 times per week. The walking route shape was designed so that the length of the walk could be tailored by participants. Both groups were assessed at baseline and six weeks later. The primary outcome measures were feasibility, acceptability and safety. The principal secondary outcome was change in walking speed after the intervention. Additional outcome measures were a step-up test, activity limitations (on the Health Assessment Questionnaire), global well-being (on the European Quality of Life Questionnaire), self-efficacy for managing arthritis symptoms, self-efficacy for physical activity, daily pedometer readings and a daily visual analogue scale for pain. Participants successfully completed the walk for the suggested frequency, indicating feasibility and acceptability. There were no reported adverse effects of participation and the walking intervention group did not have higher daily pain levels than the control group, indicating safety. The walking intervention group showed a pattern of improvements in self-efficacy and global well-being; no changes in these outcomes were noted in the control group. No outcome measure showed statistically significant between-group differences. Walking appears to be a feasible, acceptable and safe intervention for people with RA. These findings inform the design and power requirements of larger trials of structured walking interventions. Copyright © 2015 John Wiley & Sons, Ltd.

Recreational Sports Activities After Calcaneal Fractures and Subsequent Subtalar Joint Arthrodesis

Subtalar joint arthrodesis is a common treatment for the management of hindfoot pathologic entities. Despite pain reduction, hindfoot stiffness is a common concern of active patients, who wish to continue or start exercising for fitness. The purpose of the present retrospective observational clinical study was to assess the rate and type of recreational sports activities in patients before and after subtalar joint arthrodesis and to correlate the clinical outcome and the level of sports activities. In 33 patients (22 males, 11 females) treated with subtalar joint arthrodesis, the pre- and postoperative participation in sports and recreational activities was evaluated. The American Orthopaedic Foot and Ankle Society hindfoot scale score, 36-item Short Form Health Survey, and a visual analog scale for pain were used as clinical outcome measures. The weekly session number, session time, and interval to activity recovery after surgery were registered. Patients with a subtalar joint arthrodesis returned to a satisfactory level of activity postoperatively. The sports participation almost reached levels similar to those preoperatively but with a shift from high- to low-impact activities.

Indication of visitor trampling impacts on intertidal seagrass beds in a New Zealand marine reserve

Marine Protected Areas (MPAs) are recognised as an important tool for protecting sensitive habitats and ecosystems from anthropogenic impacts. Despite this protection, many of these areas are open to non-extractive or consumptive visitor activities, which often receive little regulation. This paper examines the effects of low-impact visitor activities on Zostera marina seagrass beds within the Te Angiangi Marine Reserve, New Zealand. Seagrass cover (shoot count and blade length) was compared between an area that received high levels of visitor use and an analogous, relatively-unused area within the marine reserve. The high-use area had significantly lower seagrass cover than the control site, with a gradient of increasing impact observed closer to the beach and at the edge of a high-use swimming area. These impacts reflect estimated visitor use patterns in the area and highlight the need for additional management strategies that consider the potential impacts of seemingly ‘low-impact’ visitor activities on sensitive habitats within no-take MPAs.

Anterior Closing Wedge Tibial Osteotomy for Failed Anterior Cruciate Ligament Reconstruction

The success rate for achieving knee stability in primary anterior cruciate ligament (ACL) reconstruction is high; however, the results of revision reconstruction are less satisfactory. Sagittal plane malalignment is an uncommon predisposing factor for failure because excessive posterior tibial slope increases stress on the ACL graft. In carefully selected patients, tibial slope correction is an essential adjunctive procedure to achieve a stable knee. We present a case report outlining the surgical technique for correction of sagittal plane imbalance by a slope-decreasing anterior closing wedge tibial osteotomy combined with a second-stage revision ACL reconstruction. At 2 years following surgery, our patient had a stable knee and returned to low-impact athletic activity without symptoms. Further investigation is needed to refine the indications for this procedure in the setting of failed ACL reconstruction.

Wear Testing of Moderate Activities of Daily Living Using In Vivo Measured Knee Joint Loading

Resumption of daily living activities is a basic expectation for patients provided with total knee replacements. However, there is a lack of knowledge regarding the impact of different activities on the wear performance. In this study the wear performance under application of different daily activities has been analyzed. In vivo load data for walking, walking downstairs/upstairs, sitting down/standing up, and cycling (50 W & 120 W) has been standardized for wear testing. Wear testing of each activity was carried out on a knee wear simulator. Additionally, ISO walking was tested for reasons of comparison. Wear was assessed gravimetrically and wear particles were analyzed. In vivo walking produced the highest overall wear rates, which were determined to be three times higher than ISO walking. Moderate wear rates were determined for walking upstairs and downstairs. Low wear rates were determined for standing up/sitting down and cycling at power levels of 50 W and 120 W. The largest wear particles were observed for cycling. Walking based on in vivo data has been shown to be the most wear-relevant activity. Highly demanding activities (stair climbing) produced considerably less wear. Taking into account the expected number of loads, low-impact activities like cycling may have a greater impact on articular wear than highly demanding activities.

Sport and activity restrictions following total ankle replacement: A survey of orthopaedic foot and ankle specialists.

Despite an increasing utilization of total ankle replacement, surgeons have little guidance with regards to physical activity and sport participation recommendations following the procedure. Orthopaedic foot and ankle specialists were surveyed as to the activity and sports restrictions they place on their patients following ankle replacement. Fifty sports and activities were included and the results were used to derive a set of consensus recommendations. Of the 1063 surgeons that were sent the survey, 173 responded, yielding a response rate of 16.3%. In general, surgeons were comfortable with aerobic or low impact sports and activities. Boot immobilized sports represented a grey area with the determination of whether or not to allow them based largely on the prior experience of the patient. High impact, cutting and jumping sports and activities were largely discouraged. Young age, high BMI and poor bone quality led surgeons to be more restrictive. These consensus recommendations serve as a useful guideline for surgeons and help patients set appropriate expectations for the procedure.

Swimming Breaststroke after Total Hip Replacement; Are We Sending the Correct Message

There are approximately 80,000 total hip replacements (THR) carried out annually in the UK. Patients are encouraged to carry out low-impact activities to strengthen muscles and improve bone quality. Swimming is a low impact activity and is frequently encouraged as part of a post-operative regime. However, swimming breast stroke is generally not encouraged. The aim of this study is to explore the information given to patients regarding swimming (especially breaststroke) following THR. Additionally to review the literature/surgeon experience on dislocation rates following swimming breaststroke. We conducted a survey of 640 health care professionals and 215 THR patients to see the desires, capabilities and advice given regarding swimming following THR. We also reviewed the literature on dislocated THR following swimming breaststroke. 100% of hip arthroplasty consultants would advise patients to swim breaststroke, compared to 18% of other health care professionals. No healthcare professionals have seen a case of dislocated THR following swimming breaststroke, and there are no reported cases in the literature. Conflicting information is given to patients on swimming following THR. With no reported cases in the literature, we recommend patients to swim breaststroke following THR, in order to help rehabilitate soft tissue tension and function, therefore improving hip stability.

Traditional Knowledge in the History of Coastal Resource Management in Costa Maya

Traditional knowledge is based on a daily social dimension. It involves the existence of social and intergenerational relations that are directly associated with the environment. In addition, we can only understand local lore by analyzing it through its historic aspect. Therefore, we must think knowledge as a space-time schema to observe it as a social process shared and transmitted. Hence, our purpose lies on exploring the concept of traditional knowledge in the management of coastal resources in one of the micro regions of the Mexican Caribbean. We analyze the life histories of women and men of three main communities of the area known as Costa Maya (Mexican Caribbean in Quintana Roo): Xcalak, Mahuahual and Punta Herrero. We should point out that this paper is founded on a larger research conducted in Quintana Roo, Mexico. Although natural resource management does not imply sustainable processes neither environmental low impact activities, we believe that through this anthropological approach a set of the possibilities of human-environment interaction may be enable.

Transcuneiform Crush Injury: A Case Report

Introduction: Transcuneiform fracture patterns without dislocations are uncommon. In a review of the literature, numerous case reports describe cuneiform fracture-dislocations involving either the transmetatarsal or midtarsal joint complexes due to direct trauma; however, an isolated transcuneiform fracture pattern without dislocation has not been reported. Methods: We present a rare injury of the foot: an isolated transcuneiform fracture without associated dislocation of the tarsometatarsal joint or midtarsal joint complex. Case: A 29 year old active duty Army male sustained direct blunt trauma to his foot when a 20 ton trailer fell onto it. His initial presentation prompted protected weight bearing after a clinical exam revealed soft tissue injury and tenderness to palpation about the dorsum of his midfoot. Due to persistent symptoms, he was referred to a musculoskeletal specialist. Radiographs and computed tomography (CT) images demonstrated a minimally displaced comminuted transcuneiform fracture involving the medial and intermediate cuneiforms without evidence of dislocation or subluxation. Treatment consisted of non-weight bearing cast immobilization with crutches for ten weeks before being transitioned into a weight bearing control ankle motion (CAM) boot. Radiographic evidence of healing was documented at 4 weeks by callus formation at the first metatarsal and medial cuneiform. The patient returned to low impact activity by 10 month follow-up without surgical intervention. Discussion and Conclusions: Blunt trauma to the midfoot can result in isolated or complex fracture patterns without the typical fracture-dislocation following high mechanism trauma. Appropriate clinical suspicion and careful physical examination can facilitate timely diagnosis and treatment. Minimally displaced transcuneifom fracture patterns without associated midfoot dislocation injuries can be treated nonoperatively with protected weight bearing, close radiographic and clinical follow up, and gradual advancement to activity with acceptable clinical outcomes.

Development of an Activity Card Sort for Australian adults aged 18-64 years.

The Activity Card Sort (ACS) is an interview-based, client-centred tool that measures the activity engagement of older adults aged 65 years and above. The tool consists of photos which clients are asked to sort into categories to reflect their previous and current level of engagement. The activities that older adults engage in may differ to that of younger adults and there is a need to explore the development of an ACS Australia for adults aged 18-64 years. The Delphi survey method as applied by previous ACS development was used in this study. Purposeful and snowball sampling were employed to recruit participants between the ages of 18 and 64 years who were Australian citizens or residents. Demographic information was obtained via a questionnaire. There were two stages in the study. The first Delphi survey generated, selected and finalised activities and the second Delphi survey generated, selected and finalised categories. Australian citizens and residents were involved in the development of the activities (n = 61) and categories (n = 65). The final tool includes 85 activities sorted into three broad categories representing personal care, daily life and home maintenance; rest and relaxation; and high and low impact activities. This study has resulted in the development of a preliminary version of an ACS for adults aged 18-64 years. Further work is required to determine the psychometric properties of the tool.

Return to sports, recreational activity and patient-reported outcomes after lateral unicompartmental knee arthroplasty.

As the indication for unicompartmental knee arthroplasty (UKA) in recent years has been extended to young and more active patients, the expectations concerning the postoperative level of activity are high. The aim of the following study was to survey the activity level and the health-related quality of life of patients following lateral UKA. Forty-five patients were surveyed to determine their sporting and recreational activities at a mean follow-up of 3 years (range 2.0-4.3 years) after lateral UKA. We also assessed health-related quality of life of our patients at the time of the survey by use of the SF-36 Health Survey. Before the onset of the first restricting symptoms, 42 of 45 (93 %) patients were active in at least one sport compared to 43 of 45 (96 %) patients after surgery resulting in a return to activity rate of 98 %. Within 3 months, 56 % returned to their activities after surgery and 78 % within 6 months. The mean postoperative UCLA score was 6.7 (±1.5). Two-thirds of the patients reached a high activity level (UCLA ≥7). Most common activities after surgery were biking, hiking and long walks. While high-impact activities showed a significant decrease, low-impact activities showed a significant increase. The main reason for a decrease in patients' level of activity was precaution. There are no statistically significant differences in the postoperative scores of our patients and those of a matched healthy reference population in the SF-36 scores. The results of the present study demonstrate that a vast majority (98 %) of our patients independent to age or gender returned to sports and recreational activity after lateral UKA. Two-thirds of the patients reached a high activity level. Activities patients were most participating in were low- or mid-impact, whereas high-impact activities were mostly given up. Further follow-up is necessary to assess the effect of activity on implant fixation and wear. Retrospective case series, Level IV.

How does ankle-foot orthosis stiffness affect gait in patients with lower limb salvage?

Ankle-foot orthoses (AFOs) are commonly prescribed during rehabilitation after limb salvage. AFO stiffness is selected to help mitigate gait deficiencies. A new custom dynamic AFO, the Intrepid Dynamic Exoskeletal Orthosis (IDEO), is available to injured service members but prescription guidelines are limited. In this study we ask (1) does dynamic AFO stiffness affect gait parameters such as joint angles, moments, and powers; and (2) can a given dynamic AFO stiffness normalize gait mechanics to noninjured control subjects? Thirteen patients with lower limb salvage (ankle arthrodesis, neuropathy, foot/ankle reconstruction, etc) after major lower extremity trauma and 13 control subjects who had no lower extremity trauma and wore no orthosis underwent gait analysis at a standardized speed. Patients wore their custom IDEO with posterior struts of three different stiffnesses: nominal (clinically prescribed stiffness), compliant (20% less stiff), and stiff (20% stiffer). Joint angles, moments, powers, and ground reaction forces were compared across the varying stiffnesses of the orthoses tested and between the patient and control groups. An increase in AFO compliance resulted in 20% to 26% less knee flexion relative to the nominal (p = 0.003) and stiff (p = 0.001) conditions, respectively. Ankle range of motion and power generation were, on average, 56% (p < 0.001) and 63% (p < 0.001), respectively, less than controls as a result of the relatively fixed ankle position. Patients with limb salvage readily adapted to different dynamic AFO stiffnesses and demonstrated few biomechanical differences among conditions during walking. None of the stiffness conditions normalized gait to controls. The general lack of differences across a 40% range of strut stiffness suggests that orthotists do not need to invest large amounts of time identifying optimal device stiffness for patients who use dynamic AFOs for low-impact activities such as walking. However, choosing a stiffer strut may more readily translate to higher-impact activities and offer less chance of mechanical failure.

Unravelling the impact of anthropogenic pressure on plant communities in Mediterranean temporary ponds

Identifying the respective role of environmental, landscape and management factors in explaining the patterns in community composition is an important goal in ecology. Using a set of 32 temporary ponds in northern Morocco we studied the respective importance of local (within the pond) and regional (density of ponds in landscape) factors and the impacts of different land uses on the plant species assemblages, separating pond and terrestrial species. The main hypotheses tested were that (1) species assemblages respond to both local and regional environmental factors, (2) anthropogenic pressure has a negative influence on the number of pond species, and that (3) human activities differ in their impact on pond biodiversity. The results showed that (1) local factors explain most of the variation in plant community composition, and (2) land use impacts the communities through changing local environmental conditions, leading to a loss of typical pond species. Aside from recreation, all other activities (grazing, drainage, agriculture and partial urbanisation) significantly reduced the number of pond species. The conservation strategy for rare pond species should focus on maintaining networks of oligotrophic ponds, while allowing only low-impact activities.

ECONOMIC AND MARKET VIABILITY OF SCIENTIFIC ECOTOURISM RELATED TO THE JAGUAR IN A VÁRZEA AREA IN CENTRAL AMAZONIA

Ecotourism can be an efficient strategy to generate income for local communities and conservation. Scientific tourism is defined under the same premises as ecotourism, but its objectives are focused on research. In this study, the creation of a package tour for jaguar-related scientific ecotourism in the Mamiraua Sustainable Development Reserve (MSDR) was proposed. The objectives were to analyze the economic and market viability for this package through a cash flow analysis for 18 different scenarios. Questionnaires were sent to two groups titled technical-scientific and ecotourism. Nine scenarios had the same daily rate for the 10 year period, and the other nine had daily rates increase annually in accordance with the mean IPCA for the previous three years. For each scenario, the Net Present Value (NPV) was calculated. Ninety-two questionnaires were returned: 47 from the technical-scientific group, and 45 from the ecotourism group. Jaguar-related scientific ecotourism activities should be related to scientific research, contemplation, and culture, and not just focused on the species. Ecotourists also value low-impact activities, information, and benefits to the communities and to research. For the economically viable scenarios, sharing of profits with the communities and with research was proposed.