Bench Press Range-of-Motion and Velocity-based Repetition Control: Effects on Ballistic Push-up Performance in Males.

The purpose of this study was to investigate whether the ballistic push-up (BPU) is responsive to post-activation performance enhancement (PAPE) after a bench press conditioning exercise using velocity-based repetition control. Additionally, we aimed to evaluate the effects of range of motion (ROM) conditions on subsequent BPU performance. In a randomized crossover design, 18 males performed two conditions (full ROM and self-selected partial ROM) of bench press at 80% of their 1RM until mean concentric velocity dropped 10%. Each participant performed two pre- and six post-test BPUs to assess the PAPE effect. Paired sample t-tests assessed bench press performance measures. Multiple two-way repeated measures ANOVAs assessed differences in flight time, impulse, and peak power for the pre- and post-test BPUs. No significant differences existed between ROM conditions for total repetitions, volume load, or peak velocity. Compared to partial ROM, full ROM showed greater displacement (0.42 ± 0.05 vs. 0.34 ± 0.05 m), work (331.99 ± 67.72 vs. 270.92 ± 61.42 J), and mean velocity (0.46 ± 0.09 vs. 0.44 ± 0.08 m/s). Neither bench press ROM condition enhanced the BPU and were detrimental in some cases. Several time points showed partial ROM (flight time: 2 min post, impulse: 12 min post, peak power: 12 min post) significantly greater than full ROM, possibly indicating less fatigue accumulation. The BPU may require a different stimulus or may not be practical for PAPE effects in college-aged males. Partial ROM can be an alternative that achieves similar peak velocities while requiring less overall work.

Learning From Consumers of Mandated Sex-Offending Programs: "It's Not Treatment, I Wish It Was."

The purpose of this qualitative study was to explore clients' perceptions of sex-offending treatment. The sample included 291 people required to register as sex offenders in the U.S. who answered an open-ended question in an online survey asking them to describe their positive and negative experiences in mandated treatment. Using qualitative analysis, three overarching themes (with several subthemes) were identified: (1) positive and (2) negative treatment experiences and (3) the affiliation between the criminal justice system and clinical services. Experiences in sex offending treatment were viewed as positive when clients had opportunities to learn about themselves, experience group cohesion, build a positive alliance with a caring therapist, learn tools and skills for emotional health, explore the roots of offense behavior, and create healthy life plans to reduce risk for re-offending. Negative themes emerged when treatments were viewed as coercive, confrontational, or demeaning; when therapists seemed inexperienced or unqualified; and when seemingly outdated or unscientific methods were emphasized without explanation or dialogue. The entanglement between court-mandated treatment providers and the criminal justice system led to concerns about confidentiality, conflicts of interest, and role ambiguity. Drawing upon literature related to therapeutic alliance, trauma-informed care, and Risk-Need-Responsivity models, we offer suggestions for integrating client feedback to improve treatment responsivity and prevent re-offending.

Prevalence and Trends of Weakness Among Middle-Aged and Older Adults in the United States.

ABSTRACT: McGrath, R, FitzSimmons, S, Andrew, S, Black, K, Bradley, A, Christensen, BK, Collins, K, Klawitter, L, Kieser, J, Langford, M, Orr, M, and Hackney, KJ. Prevalence and trends of weakness among middle-aged and older adults in the United States. J Strength Cond Res 37(12): 2484-2490, 2023-Muscle weakness, which is often determined with low handgrip strength (HGS), is associated with several adverse health conditions; however, the prevalence and trends of weakness in the United States is not well-understood. We sought to estimate the prevalence and trends of weakness in Americans aged at least 50 years. The total unweighted analytic sample included 22,895 Americans from the 2006-2016 waves of the Health and Retirement Study. Handgrip strength was measured with a handgrip dynamometer. Men with weakness were below at least one of the absolute or normalized (body mass, body mass index) cut points: <35.5 kg, <0.45 kg/kg, <1.05 kg/kg/m 2 . The presence of any weakness in women was also identified as being below one of the absolute or normalized HGS cut points: <20.0 kg, <0.34 kg/kg, or <0.79 kg/kg/m 2 . There was an increasing trend in the prevalence of any weakness over time ( p < 0.001). The prevalence of weakness was 45.1% (95% confidence interval [CI]: 44.0-46.0) in the 2006-2008 waves and 52.6% (CI: 51.5-53.7) in the 2014-2016 waves. Weakness prevalence was higher for older (≥65 years) Americans (64.2%; CI: 62.8-65.5) compared with middle-aged (50-64 years) Americans (42.2%; CI: 40.6-43.8) in the 2014-2016 waves. Moreover, the prevalence of weakness in the 2014-2016 waves was generally higher in women (54.5%; CI: 53.1-55.9) than in men (50.4%; CI: 48.7-52.0). Differences existed in weakness prevalence across races and ethnicities. The findings from our investigation suggest that the prevalence of weakness is overall pronounced and increasing in Americans. Efforts for mitigating and better operationalizing weakness will elevate in importance as our older American population grows.

Diabetes management in older adults who fall: a study amongst older adults presenting to the emergency department.

INTRODUCTION: Type 2 diabetes mellitus (T2D) is associated with poor health outcomes whilst tight glycaemic targets are questionable in those aged over 70 years with increased frailty. Our aim was to examine whether people with T2D admitted to hospital with a fall, were more likely to have greater frailty, increased mortality and co-morbidity burden, or risk factors for falls than people without T2D, and whether these differences were associated with medications used for the treatment of T2D. METHODS: The Older Persons Assessment Service (OPAS) is a local emergency department (ED) service, which accepts patients on frailty criteria. The OPAS accepts patients primarily aged over 70 years who present with frailty and geriatric syndromes such as falls, with retrieval from the ED department directly to the service from triage. The OPAS databank was analysed for people with T2D admitted with a fall between June 2020-September 2022. We examined clinical outcomes relating to medication, age, Charlson co-morbidity index (CCI) and clinical frailty score (CFS). RESULTS: 1081 patients were included: 294 (27.2%) with T2D and a mean HbA1c of 53.9 (± 15.8) mmol/mol [7.1%]. People with T2D had a similar mean CFS and age compared to those without T2D, but higher mean CCI (7.0 ± 2.2 vs 5.9 ± 2.1, p < 0.001). Of those people with T2D, 175 (59.5%) and 240 (81.6%) had a HbA1c ≤ 53 mmol/mol [7.0%] and ≤ 64 mmol/mol [8.0%], respectively. In total, 48 (16.3%) people with T2D were identified to have a capillary blood glucose below 4.0 mmol/L on admission to the ED. At 12 months' follow-up, 831 (76.9%) patients were alive and 250 (23.1%) had died. People with T2D treated with insulin and/or gliclazide had a greater 1-year mortality (36.6% vs 23.6%, p < 0.05), greater frequency of hypoglycaemia (35.4% vs 11.8%, p < 0.001), and greater HbA1c (65.5 ± 17.2 mmol/mol [8.2] vs 48.9 ± 12.1 mmol/mol [6.6%]) compared to those who used other agents. Logistic regression confirmed a diagnosis of T2D was associated with 1-year mortality, but mortality was not significantly associated with hypoglycaemic-inducing agents. People with T2D were not more likely to live in deprived areas. CONCLUSIONS: A diagnosis of T2D is associated with greater 1-year mortality, and may be influenced by use of hypoglycaemia-inducing diabetes medications. Clinician awareness can support de-prescribing for patients with frailty and HbA1c < 64 mmol/mol.

The Association Between Handgrip Strength Asymmetry Severity and Future Morbidity Accumulation: Results from the Health and Retirement Study.

Analyzing the severity of handgrip strength (HGS) asymmetry in aging populations may help to screen for morbidities and add utility to handgrip dynamometer testing. Our study sought to determine the relationships between HGS asymmetry severity and future accumulating morbidities in older Americans. Secondary analyses from the 2006-2016 waves of the Health and Retirement Study included 18,506 adults ≥ 50 years old. The highest recorded HGS values from each hand were used to calculate HGS asymmetry ratio (non-dominant HGS/dominant HGS). If the HGS asymmetry ratio < 1.0, it was inversed to make all asymmetry ratios ≥ 1.0. Participants were categorized into groups based on the severity of their HGS asymmetry ratio: 1) 0.0% - 10.0%, 2) 10.1% - 20.0%, 3) 20.1% - 30.0%, and 4) > 30.0%. Healthcare provider-diagnosed morbidities (hypertension, diabetes, cancer, chronic lung disease, cardiovascular disease, stroke, arthritis, and psychiatric problems) were self-reported. Covariate-adjusted ordinal generalized estimating equations evaluated the relationships between HGS asymmetry severity on future accumulating morbidities. Results showed 8,936 (48.3%) participants had HGS asymmetry 0.0%-10.0%, 6,105 (33.0%) participants had HGS asymmetry 10.1%-20.0%, 2,411 (13.0%) participants had HGS asymmetry 20.1%-30.0%, and 1,054 (5.7%) participants had HGS asymmetry > 30.0%. Overall, every 10% increase in HGS asymmetry was associated with a 1.17 (CI: 1.05, 1.32) greater odds of future morbidity accumulation. Additionally, asymmetry between 10.1% - 20.0%, 20.1% - 30.0%, and > 30.0% was associated with a 1.10 (CI: 1.05, 1.15), 1.11 (CI: 1.04, 1.18), and 1.20 (CI: 1.09, 1.33) greater odds for morbidity accumulation during aging. These findings suggest that severe functional asymmetries may elevate the odds for accumulating morbidities.

Analysis of Total and Segmental Body Composition Relative to Fitness Performance Measures in Law Enforcement Recruits.

Law enforcement agencies often test the fitness performance and body composition of incoming recruits. This study investigated the relationships between whole and segmental body composition, and fitness tests in law enforcement recruits. A retrospective analysis of 72 male and 11 female recruits was performed. Bioelectrical impedance analysis (BIA) variables were: lean mass (LM), upper-extremity lean mass (UELM), trunk LM, lower-extremity lean mass (LELM), fat mass (FM), upper-extremity fat mass (UEFM), trunk FM, and lower-extremity fat mass (LEFM). Fitness tests included: vertical jump (VJ), peak anaerobic power (PAPw), 75-yard pursuit run (75PR), push-ups, sit-ups, 2-kg medicine ball throw (MBT), and the multi-stage fitness test (MSFT). Partial correlations and ANCOVAs between quartiles assessed relationships between body composition and performance. Significant moderate-to-large relationships were found; LM, UELM, trunk LM, LELM all related to PAPw (r = 0.500-0.558) and MBT (r = 0.494-0.526). FM, UEFM, trunk FM, LEFM all related to VJ (r = -0.481 to -0.493), 75PR (r = 0.533-0.557), push-ups (r = -0.484 to -0.503), sit-ups (r = -0.435 to -0.449), and MSFT (r = -0.371 to -0.423). The highest LM quartile (4) had superior PAPw and MBT than LM quartiles 1-3. Higher FM quartiles performed poorer in VJ, push-ups, and sit-ups. The 75PR quartiles 2, 3, and 4 were slower than quartile 1, and MSFT quartile 4 completed less shuttles. Total and segmental measures of LM and FM shared the same relationships; lower FM and higher LM related to better performance. Monitoring body composition could help guide training to optimize performance.

Differences in Muscle Activity and Kinetics Between the Goblet Squat and Landmine Squat in Men and Women.

ABSTRACT: Collins, KS, Klawitter, LA, Waldera, RW, Mahoney, SJ, and Christensen, BK. Differences in muscle activity and kinetics between the goblet squat and landmine squat in men and women. J Strength Cond Res 35(10): 2661-2668, 2021-Squat exercise variations are widely used and extensively researched. However, little information exists on the goblet squat (GBS) and landmine squat (LMS) and differences between men and women. This study investigated the differences in muscle activity and kinetics between the GBS and the LMS in 16 men and 16 women. Five repetitions of each squat type were performed loaded at 30% of their body mass. Vertical and anteroposterior ground reaction forces for the eccentric and concentric phases and peak vertical force were recorded with a force plate. Electromyographic (EMG) signals were recorded for the vastus medialis (VM), vastus lateralis (VL), semitendinosus (ST), and biceps femoris (BF). Normalized mean EMG values and ground reaction forces were analyzed with repeated measures analysis of variance (p < 0.05). Significant main effects for squat condition and sex were found. The LMS reduced activity in the quadriceps (VM and VL) muscles and vertical forces, while increasing posterior horizontal forces. In the LMS, men showed decreased ST activity, whereas women had decreased BF activity. Women exhibited greater quadriceps activity in both the GBS and LMS and greater ST in the LMS. Women also produced greater eccentric vertical force in both the GBS and LMS and less posterior horizontal forces in the LMS. The LMS may be useful to balance hamstring to quadriceps activity, increase horizontal loading, and reduce vertical loading. Conversely, the GBS can better target quadriceps activity and increase vertical loading. Sex differences should be considered for training programs that include the GBS and LMS.

Handgrip Strength Asymmetry and Weakness are Differentially Associated with Functional Limitations in Older Americans.

Background: Handgrip strength (HGS) is a convent measure of strength capacity and associated with several age-related health conditions such as functional disability. Asymmetric strength between limbs has been linked to diminished function. Therefore, both HGS asymmetry and weakness could be associated with functional disability. We examined the associations of HGS asymmetry and weakness on functional limitations in a nationally representative sample of older Americans. Methods: Data were analyzed from 2689 adults ≥ 60 years who participated in the 2011-2012 and 2013-2014 waves of the National Health and Nutrition Examination Survey. Weakness was defined as HGS < 26 kg for men and < 16 kg for women. Asymmetry was determined from the ratio of the dominant and non-dominant HGS. Those with HGS ratio 0.9-1.1 were considered as having HGS symmetry, and those outside this range had asymmetry. Results: Compared to those with symmetric HGS and were not weak, those with weakness alone, and both weakness and HGS asymmetry had 2.47 (95% confidence interval [CI]: 1.14-5.35) and 3.93 (CI: 1.18-13.07) greater odds for functional limitations, respectively. However, HGS asymmetry alone was not associated with functional limitations (odds ratio: 0.80; CI: 0.62-1.03). Conclusion: The use of HGS asymmetry in protocols could improve the prognostic value of handgrip dynamometers.

Relationships and Reliability Between a Drive Block Test and Traditional Football Performance Tests in High School Offensive Line Players.

Collins, KS, Coburn, JW, Galpin, AJ, and Lockie, RG. Relationships and reliability between a drive block test and traditional football performance tests in high school offensive line players. J Strength Cond Res 32(12): 3432-3441, 2018-The offensive line (OL) is a specialized football position responsible for blocking tasks. Little research exists on OL-specific movements and relationships to performance tests in high school players. This study investigated the reliability of the average and peak velocity (avgV, peakV) and momentum (avgM, peakM) of a drive block test (DBT) in 15 high school OL and relationships to performance tests. A linear position transducer attached to the OL waist measured the DBT from a 3-point stance into a blocking pad. Linear speed was measured by a 36.58-m sprint. Change-of-direction (COD) ability was measured by the pro-agility shuttle (first COD, second COD, and total time) and COD deficit from the first (COD deficit 1) and second COD (COD deficit 2) of the pro-agility shuttle. Vertical jump, standing broad jump (SBJ), and 1 repetition maximum (1RM) back squat were also measured. Pearson's correlations (p < 0.05) investigated relationships between the DBT and performance tests. Intraclass correlation coefficients (ICCs), dependent t-tests, and coefficient of variation (CV) assessed DBT reliability. Drive block test variables were reliable (ICC > 0.90; CV = 6.46-8.29%) and correlated with the second pro-agility shuttle COD and COD deficit 2 (r = -0.515 to -0.721). One repetition maximum back squat correlated with avgM and peakM (r = 0.551-0.582); SBJ correlated with avgV and peakV (r = 0.557-0.571). The pro-agility shuttle splits, COD deficit, and SBJ may provide useful information about DBT qualities important for high school OL. It is recommended high school OL training focus on strength, COD performance, and jumping ability to aid drive block performance.

The Relationship Between Vancomycin Trough Concentrations and AUC/MIC Ratios in Pediatric Patients: A Qualitative Systematic Review.

BACKGROUND: In adults, the area under the concentration-time curve (AUC) divided by the minimum inhibitory concentration (MIC) is associated with better clinical and bacteriological response to vancomycin in patients with methicillin-resistant Staphylococcus aureus who achieve target AUC/MIC ≥ 400. This target is often extrapolated to pediatric patients despite the lack of similar evidence. The impracticalities of calculating the AUC in practice means vancomycin trough concentrations are used to predict the AUC/MIC. OBJECTIVE: This review aimed to determine the relationship between vancomycin trough concentrations and AUC/MIC in pediatric patients. METHODS: We searched the MEDLINE and Embase databases, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials using the medical subject heading (MeSH) terms vancomycin and AUC and pediatric* or paediatric*. Articles were included if they were published in English and reported a relationship between vancomycin trough concentrations and AUC/MIC. RESULTS: Of 122 articles retrieved, 11 met the inclusion criteria. One trial reported a relationship between vancomycin trough concentrations, AUC/MIC, and clinical outcomes but was likely underpowered. Five studies found troughs 6-10 mg/l were sufficient to attain an AUC/MIC > 400 in most general hospitalized pediatric patients. One study in patients undergoing cardiothoracic surgery found a trough of 18.4 mg/l achieved an AUC/MIC > 400. Two oncology studies reported troughs ≥ 15 mg/l likely attained an AUC/MIC ≥ 400. In critical care patients: one study found a trough of 9 mg/l did not attain the AUC/MIC target; another found 7 mg/l corresponded to an AUC/MIC of 400. CONCLUSIONS: Potential vancomycin targets varied based on the population studied but, for general hospitalized pediatric patients, troughs of 6-10 mg/l are likely sufficient to achieve AUC/MIC ≥ 400. For MIC ≥ 2 mg/l, higher troughs are likely necessary to achieve an AUC/MIC ≥ 400. More research is needed to determine the relationships between vancomycin trough concentrations, AUC/MIC, and clinical outcomes.