Practical and Clinical Approaches Using Pacing to Improve Selfregulation in Special Populations such as Children and People with Mental Health or Learning Disabilities.

For special populations such as people with a mental health issue or learning disability, a disconnect between the ability to accurately monitor and regulate exercise behaviour can lead to reduced levels of physical activity, which, in turn, is associated with additional physical or mental health problems. Activity pacing is a strategy used in clinical settings to address issues of pain amelioration, while self-pacing research is now well addressed in sport and exercise science literature. It has been proposed recently that these overlapping areas of investigation collectively support the development of self-regulatory, lifestyle exercise skills across broad population groups. Activity pacing appears to have substantial application in numerous development and rehabilitation settings and, therefore, the purpose of this short communication is to articulate how an activity pacing approach could be utilized among population groups in whom self-regulatory skills may require development. This paper provides specific examples of exercise practice across 2 discrete populations: children, and people with mental health and learning difficulties. In these cases, homeostatic regulatory processes may either be altered, or the individual may require extrinsic support to appropriately self-regulate exercise performance. A support-based exercise environment or approach such as programmatic activity (lifestyle) pacing would be beneficial to facilitate supervised and education-based self-regulation until such time as fully self-regulated exercise is feasible.

A Path Analysis of Adolescent Athletes' Perceived Stress Reactivity, Competition Appraisals, Emotions, Coping, and Performance Satisfaction.

This study examined a path analysis of adolescent athletes' individual differences in perceived stress reactivity, competition appraisals, emotions, coping, and performance satisfaction. The study aimed to extend an analysis by Nicholls et al. (2012) and further validate the use of the Perceived Stress Reactivity Scale for Adolescent Athletes (PSRS-AA). Adolescent athletes (N = 229, M age = 18.55, SD = 2.40) completed the PSRS-AA followed by a measure of competition appraisals less than 1 h before a competitive event. Within an hour after the competitive event, participants completed a retrospective assessment of emotions, coping strategies, and subjective performance. A path analysis revealed that perceived stress reactivity had direct and indirect effects on the appraisal of higher stressor intensity, lower perceived control, higher perceived threat, negative emotions, and maladaptive coping. Increased threat, positive and negative emotions, and maladaptive coping were associated with performance satisfaction. However, task-orientated coping was not associated with performance satisfaction. The present study enhances and refines the validity of the PSRS-AA for assessing adolescent athletes' perceived stress reactivity. Further strengths and weaknesses of the present study are discussed, along with recommendations for practitioners aiming to support adolescent athletes with high levels of stress reactivity.

Validating a Self-Report Measure of Student Athletes' Perceived Stress Reactivity: Associations With Heart-Rate Variability and Stress Appraisals.

Student athletes experience multiple stressors relating to both their sporting and academic commitments. Individual differences play a significant role in how well student athletes cope with the demands they face. When assessing individual differences in stress reactivity, there are a lack of valid alternatives to costly and time-consuming lab-based physiological methods (e.g., cortisol sampling, cardiac variables). This paper aims to further validate a self-report measure of adolescent athletes' individual differences in perceived stress reactivity, by comparing to a psycho-physiological measure of emotion regulation (heart-rate variability) assessed during a socially evaluated cold pressor test. 30 student athletes and 31 student non-athletes completed a measure of perceived stress reactivity and took part in the socially evaluated cold pressor test while their heart-rate variability was assessed, along with their self-reported appraisals of stress, pain, and unpleasantness experienced during the procedure. Controlling for gender and athleticism, individual differences in perceived stress reactivity showed no associations with tonic or phasic levels of heart-rate variability. However, perceived stress reactivity was associated with levels of self-reported stress, pain, and unpleasantness experienced during the socially evaluated cold pressor test. These findings therefore suggest that perceived stress reactivity is associated with cognitive responses to stress (i.e., stress appraisals). However, further research is needed to confirm its relationship with physiological measures and responses. This further adds to the understanding of perceived stress reactivity, and validity of the perceived stress reactivity scale for adolescent athletes.

Validation of a multidirectional locomotive dual-task paradigm to evaluate task-related differences in event-related electro-cortical activity.

A fundamental aspect of everyday function is the ability to simultaneously execute both cognitive and motor tasks. The ability to perform such tasks is commonly assessed using a dual-task paradigm that has the capacity to manipulate both cognitive and motor components of an action. Dual-task performance provides an opportunity to obtain an insight into how cognitive and motor function are affected during natural tasks (e.g., locomotion). The following study aimed to determine the effectiveness of using a goal-directed multidirectional locomotor task to measure differences in task-related (tasks of increasing difficulty) electro-cortical activity. In the single-task condition participants walked around a grid-based track, performing directional changes at each intersection in response to a sensory stimulus. In the dual-task condition participants performed the same primary task while performing a simultaneous memory recall task. Behavioural differences in trial completion time and electro-cortical activity were identified in relation to the posterior N2 and P3 component mean amplitudes. The results showed that, while performing a higher-level cognitive task during walking (dual-task), interference arises in a shared system that influences neural mechanisms involved in attention and selection for action, and later cognitive processes recruited in working memory and cognitive control. This study extends previous work and shows that performing a more complex cognitive task while walking, elicits interference effects sensitive to higher-level cognitive processes, and takes the next step towards measurement of electro-cortical activity within naturalistic environments.

Goal Orientation and the Presence of Competitors Influence Cycling Performance.

Introduction: The aim of this study was to investigate time-trial (TT) performance in the presence of one competitor and in a group with competitors of various abilities. Methods: In a randomized order, 24 participants performed a 5-km cycling TT individually (IND), with one similarly matched participant (1v1), and in a group of four participants (GRP). For the GRP session, two pairs of matched participants from the 1v1 session were used. Pairs were selected so that TT duration was considered either inferior (INF) or superior (SUP) compared to the other pair of participants. Results: Overall, TT duration (P = 0.86, ηp2 < 0.01) was not different between conditions, while heart rate (HR) was significantly greater in GRP compared to IND (P < 0.01, ηp2 = 0.16). For INF, a large effect size for both mean power (P = 0.07, ηp2 = 0.15) and HR (P = 0.05, ηp2 = 0.16), indicates greatest effort in GRP. Pacing behavior was affected by competition but similar in 1v1 and GRP for SUP, while large effect sizes indicate an increased power output in the initial 750-m for INF in GRP. Additionally, for INF, there was a significant correlation with ego orientation for an increase in TT duration between the GRP session and both the IND (r = 0.43, P = 0.04) and 1v1 (r = 0.54, P = 0.01) sessions. Conclusion: For INF participants, intensity was increased when competing in GRP. Yet, the presence of the SUP competitors resulted in lesser performance improvements for ego oriented INF participants. These findings demonstrate that consideration should be given to the ability of competitors in a group setting to provide adequate motivation.

Type D personality, stress, coping and performance on a novel sport task.

We investigated (1) the relationship between Type D personality, stress intensity appraisal of a self-selected stressor, coping, and perceived coping effectiveness and (2) the relationship between Type D personality and performance. In study one, 482 athletes completed the Type D personality questionnaire (DS14), stress thermometer and MCOPE in relation to a recently experienced sport stressor. Type D was associated with increased levels of perceived stress and selection of coping strategies (more emotion and avoidance coping) as well as perceptions of their effectiveness. In study two, 32 participants completed a rugby league circuit task and were assessed on pre-performance anxiety, post-performance affect and coping. Type D was associated with poorer performance (reduced distance; more errors), decreases in pre-performance self-confidence and more use of maladaptive resignation/withdrawal coping. Findings suggest that Type D is associated with maladaptive coping and reduced performance. Type D individuals would benefit from interventions related to mood modification or enhancing interpersonal functioning.

Familiarization Protocol Influences Reproducibility of 20-km Cycling Time-Trial Performance in Novice Participants.

Introduction: Exercise performance is reproducible in experienced athletes; however, less trained participants exhibit greater variability in performance and pacing. To reduce variability, it is common practice to complete a familiarization prior to experimental testing. However, there are no clear guidelines for familiarizing novice participants to a cycling time-trial (TT), and research findings from novice populations may still be influenced by learning effects. Accordingly, the aims of this study were to establish the variability between TTs after administering differing familiarization protocols (duration or type) and to establish the number of familiarization trials required to limit variability over multiple trials. Methods: Thirty recreationally active participants, with no prior experience of a TT, performed a 20-km cycling TT on five separate occasions, after completing either a full (FF, 20-km TT, n = 10), a half (HF, 10-km TT, n = 10) or an equipment familiarization (EF, 5-min cycling, n = 10). Results: Variability of TT duration across five TTs was the lowest after completing FF (P = 0.69, η p2 = 0.05) compared to HF (P = 0.08, η p2 = 0.26) and EF (P = 0.07, η p2 = 0.21). In the FF group after TT2, the effect size for changes in TT duration was small (d < 0.49). There were large differences between later TTs in HF (d = 1.02, TT3-TT4) and EF (d = 1.12, TT4-TT5). The variability in mean power output profiles between trials was lowest within FF, with a similar pacing profile reproduced between TT3-TT5. Discussion: Familiarization of the exercise protocol influenced reproducibility of pacing and performance over multiple, maximal TTs, with best results obtained after a full experience of the exercise compared to HF and EF. The difference of TT1 to later TTs indicates that one familiarization is not adequate in reducing the variability of performance for novice participants. After the FF and an additional TT, performance changes between TTs were small, however, a reproducible pacing profile was not developed until after the FF and two additional TTs. These findings indicate that a minimum of three full familiarizations are necessary for novice participants to limit systematic error before experimental testing.

No Influence of Transcutaneous Electrical Nerve Stimulation on Exercise-Induced Pain and 5-Km Cycling Time-Trial Performance.

Introduction: Afferent information from exercising muscle contributes to the sensation of exercise-induced muscle pain. Transcutaneous electrical nerve stimulation (TENS) delivers low-voltage electrical currents to the skin, inhibiting nociceptive afferent information. The use of TENS in reducing perceptions of exercise-induced pain has not yet been fully explored. This study aimed to investigate the effect of TENS on exercise-induced muscle pain, pacing strategy, and performance during a 5-km cycling time trial (TT). Methods: On three separate occasions, in a single-blind, randomized, and cross-over design, 13 recreationally active participants underwent a 30-min TENS protocol, before performing a 5-km cycling TT. TENS was applied to the quadriceps prior to exercise under the following conditions; control (CONT), placebo with sham TENS application (PLAC), and an experimental condition with TENS application (TENS). Quadriceps fatigue was assessed with magnetic femoral nerve stimulation assessing changes in potentiated quadriceps twitch force at baseline, pre and post exercise. Subjective scores of exertion, affect and pain were taken every 1-km. Results: During TTs, application of TENS did not influence pain perceptions (P = 0.68, [Formula: see text] = 0.03). There was no significant change in mean power (P = 0.16, [Formula: see text] = 0.16) or TT duration (P = 0.17, [Formula: see text] = 0.14), although effect sizes were large for these two variables. Changes in power output were not significant but showed moderate effect sizes at 500-m ([Formula: see text] = 0.10) and 750-m ([Formula: see text] = 0.10). Muscle recruitment as inferred by electromyography data was not significant, but showed large effect sizes at 250-m ([Formula: see text] = 0.16), 500-m ([Formula: see text] = 0.15), and 750-m ([Formula: see text] = 0.14). This indicates a possible effect for TENS influencing performance up to 1-km. Discussion: These findings do not support the use of TENS to improve 5-km TT performance.

Self-determined motivation in rehabilitating professional rugby union players.

BACKGROUND: The aim of the present study was to explore the views of professional rugby union players during the early rehabilitation, late rehabilitation and return to play stages, following anterior cruciate ligament (ACL) injury. METHODS: A qualitative dominant, mixed methodological approach was utilized with five players who had suffered an ACL injury requiring reconstructive surgery. A longitudinal approach, concurrent with each player's rehabilitation, consisting of twice monthly interviews, a self-report diary and three established questionnaires (MOS-Social Support Survey, Sherbourne & Stewart, 1991; Sport Climate Questionnaire, Deci & Ryan, n.d.; Injury Rehabilitation Questionnaire, Deci & Ryan, n.d.) were completed. RESULTS: Theoretical thematic analysis was conducted on three distinct phases (Early Limited Participation phase, 10 higher order themes; Late Limited Rehabilitation phase, 11 higher order themes; and Return to Play phase, 9 higher order themes) and coded relating to autonomy, competence and relatedness. CONCLUSIONS: The findings suggest that increased autonomy and control assist emotional and behavioral responses during rehabilitation and return to play, while development of competence increases self-confidence.

Cycling in the Absence of Task-Related Feedback: Effects on Pacing and Performance.

INTRODUCTION: To achieve personal goals in exercise task completion, exercisers have to regulate, distribute, and manage their effort. In endurance sports, it has become very commonplace for athletes to consult task-related feedback on external devices to do so. The aim of the present study was to explore the importance of the presence of this information by examining the influence of the absence of commonly available task-related feedback on effort distribution and performance in experienced endurance athletes. METHODS: A 20-km cycling time trial was performed. Twenty Participants from a homogenous cyclist population were appointed to a group that did not receive any feedback (NoF), or a group that could consult task-related feedback (i.e., speed, heart rate, power output, cadence, elapsed time, and elapsed distance) continuously during their trial (FF). RESULTS: The distribution of power output (PO) differed between groups. Most evident is the spurt at the end of the trial of FF, which was not incorporated by NoF. Nevertheless, no between-group differences were found in performance time (FF: 28.86 ± 3.68 vs. NoF: 30.95 ± 2.77 min) and mean PO controlled by body mass (FF: 3.61 ± 0.60 vs. NoF: 3.43 ± 0.38 W/kg). Also, no differences in rating of perceived exertion scores were found. CONCLUSION: The current study provides a first indication that prior knowledge of task demands together with reliance on bodily and environmental information can be sufficient for experienced athletes to come to comparable time trial performances. This questions the necessity of the presence of in-race instantaneous task-related feedback via external devices for maximizing performance. Moreover, it seems that different pacing strategies emerge depending on sources of information available to experienced athletes.

Effect of a non-dieting lifestyle randomised control trial on psychological well-being and weight management in morbidly obese pre-menopausal women.

OBJECTIVE: This study examined the effects of a non-dieting lifestyle intervention approach for morbidly obese women designed in the framework of the self-determination theory (SDT) and Health at Every Size on weight maintenance and psychological functioning. PARTICIPANTS AND DESIGN: Predominantly white (97%), morbidly obese (BMI ≥ 35 kg m(-2) with at least one co-morbid condition or a BMI ≥ 40 kg m(-2)) pre-menopausal women (N=62), aged between 24 and 55 years were initially randomly assigned to 12 weeks of lifestyle intervention (IIG) or delayed start control group (DSCG). The program consisted of 3 months intensive lifestyle intervention followed by 9 month maintenance phase. The DSCG group commenced the program after 3 months. RESULTS AND CONCLUSIONS: Initially, the IIG showed a significant decrease in body weight (baseline to end of the RCT phase) compared with a significant increase in the DSCG group. However, no significant changes in weight status were evident in either group at 12 months compared with baseline. The 3-month intensive intervention resulted in significantly improved psychological functioning in both groups, which were maintained at 12 months. The study provides additional support for a non-dieting, theory-based, lifestyle approach to weight management and psychological well-being among morbidly obese females.

Fundamental Movement Skills Are More than Run, Throw and Catch: The Role of Stability Skills.

INTRODUCTION: In motor development literature fundamental movement skills are divided into three constructs: locomotive, object control and stability skills. Most fundamental movement skills research has focused on children's competency in locomotor and object control skills. The first aim of this study was to validate a test battery to assess the construct of stability skills, in children aged 6 to 10 (M age = 8.2, SD = 1.2). Secondly we assessed how the stability skills construct fitted into a model of fundamental movement skill. METHOD: The Delphi method was used to select the stability skill battery. Confirmatory factor analysis (CFA) was used to assess if the skills loaded onto the same construct and a new model of FMS was developed using structural equation modelling. RESULTS: Three postural control tasks were selected (the log roll, rock and back support) because they had good face and content validity. These skills also demonstrated good predictive validity with gymnasts scoring significantly better than children without gymnastic training and children from a high SES school performing better than those from a mid and low SES schools and the mid SES children scored better than the low SES children (all p < .05). Inter rater reliability tests were excellent for all three skills (ICC = 0.81, 0.87, 0.87) as was test re-test reliability (ICC 0.87-0.95). CFA provided good construct validity, and structural equation modelling revealed stability skills to be an independent factor in an overall FMS model which included locomotor (r = .88), object control (r = .76) and stability skills (r = .81). DISCUSSION: This study provides a rationale for the inclusion of stability skills in FMS assessment. The stability skills could be used alongside other FMS assessment tools to provide a holistic assessment of children's fundamental movement skills.

Examination of the suitability of collecting in event cognitive processes using Think Aloud protocol in golf.

Two studies examined the use of Think Aloud (TA) protocol as a means for collecting data of cognitive processes during performance in golf. In Study 1, TA was employed to examine if different verbalisation (Level 2 or Level 3 TA) instructions influence performance of high and low skilled golfers. Participants performed 30 putts using TA at either Levels 2, 3, or no verbalization condition. Although Level 3 verbalization produced a higher volume of verbal data than Level 2, TA at either Level 2 or 3 did not impair putting performance compared to no verbalization. Study 2 examined the congruence between data collected via TA at Level 3 and cued retrospective recall of cognitive processes during golf performance. Experienced golfers performed six holes of golf whilst engaging in Level 3 TA. After performance, three semi-structured retrospective interviews were conducted (10 min after performance, 24 h after performance and 48 h after performance). A comparison of the themes identified large discrepancies between the information reported during TA and at interview, with only 38-41% similarity in variables reported to influence decision making on each hole. Both studies suggest TA is a valuable method for recording cognitive processes of individuals during task performance. TA provides richer verbal data regarding decisions than cued retrospective recall, and TA does not negatively impact performance.

The role of depressive symptomatology in peri- and post-menopause.

OBJECTIVES: There is evidence that menopausal symptoms manifested at peri-menopause occur less frequently when compared to the symptoms experienced at post-menopause. The aim of this study was to investigate this and to test the hypothesis that depressive symptomatology mediates the relationship between menopausal stage and symptom frequency. METHODS: This cross-sectional study included 213 women (M age=52 years), of whom 125 were peri- and 88 post-menopausal. Measures comprised the Center for Epidemiologic Studies-Depression scale (CES-D) and the Women's Health Questionnaire (WHQ) vasomotor symptoms and somatic symptoms subscales. RESULTS: Multiple mediated regression analyses provided evidence that somatic symptoms and vasomotor symptoms were less frequent at post- compared to peri-menopause, and that these differences were mediated by depressive symptomatology. Multivariate effect sizes ranged from small to moderate, and univariate effect sizes were uniformly small with wide confidence intervals. CONCLUSIONS: The frequency of vasomotor and somatic symptoms appears to increase with depressed affect. The management of symptoms could include interventions of a psychotherapeutic nature, which may offset this effect, particularly in women for whom depressive symptoms are a feature of the climacteric syndrome. The extent to which depression and the climacteric syndrome may be causally related to one another remains unclear and longitudinal research should further examine the mechanisms of this association.

Relationship between Type-D personality, physical activity behaviour and climacteric symptoms.

BACKGROUND: A number of factors have been identified which might influence the variation observed in climacteric symptoms in peri- and post-menopausal women. We examined the role of the distressed or Type-D personality and mode of physical activity or exercise on the climacteric symptoms experienced by peri- or post-menopausal women. METHODS: 213 Women (M age 52.2 years, SD = 5.9), 58% classified as peri- and 42% as post-menopausal completed a questionnaire pack consisting of demographic questions, the DS14 (Type-D personality), Kaiser Physical Activity Survey (assessing household care giving, occupational, active living and sport and exercise index) and the Greene Climacteric Scale (Psychological, somatic/physical, vasomotor and sexual symptoms). RESULTS: Type-D personality and increased levels of household care-giving physical activity were both associated with increased bothersomness for all four climacteric factors. Increased levels of sport and exercise participation on the other hand resulted in less psychological, somatic/physical and sexual functioning problems whereas the active living index was inversely related to somatic/physical climacteric symptoms. Finally, lower income was associated with more psychological and somatic/physical symptoms and being peri-menopausal resulted in more vasomotor symptoms. CONCLUSIONS: The results suggest that mode of physical activity is an important moderator in alleviating climacteric symptoms. In addition, our results support previous findings in that Type-D personality is associated with negative health outcomes. In particular menopausal women with Type-D personality would benefit from interventions (coping, mindfulness training) and regular sport and exercise participation to reduce climacteric symptomology.

Evidence for Skill Level Differences in the Thought Processes of Golfers During High and Low Pressure Situations.

Two studies examined differences in the cognition of golfers with differing levels of expertise in high and low pressure situations. In study 1, six high skill and six low skill golfers performed six holes of golf, while verbalizing their thoughts using Think Aloud (TA) protocol. Higher skilled golfers' cognitive processes centered more on planning in comparison to lower skilled golfers. Study 2 investigated whether thought processes of golfers changed in response to competitive pressure. Eight high skill and eight moderate skilled golfers, completed a practice round and a competition round whilst verbalizing thoughts using TA. To create pressure in the competition condition, participants were instructed that monetary prizes would be awarded to the top three performers and scores of all golfers would be published in a league table in the club house. When performing under competitive pressure, it was found that higher skilled golfers were more likely to verbalize technical rules compared to practice conditions, especially during putting performance. This shift in cognition toward more technical aspects of motor performance was strongly related to scores on the Decision Specific Reinvestment Scale, suggesting individuals with a higher propensity for reinvestment show the largest changes in cognition under pressure. From a practical perspective, TA can aid a player, coach or sport psychologist by allowing thought processes to be identified and investigate a performer's thoughts when faced with the pressure of a competition.

Do children emotionally rehearse about their body image?

This study examined the association between propensity for emotional rehearsal, body image self-perception and weight status in Chinese Hong Kong pre-adolescents. Children 8-12 years of age (n = 278) completed measurement of body mass index, body image and emotional rehearsal. Multinomial regression analyses revealed that body mass index was positively associated with body image dissatisfaction and a significant predictor of body size estimation. However, only body size underestimation was associated with lower rehearsal tendencies. The prevalence of body image dissatisfaction and body size estimation was also reported for this population. Future research is suggested for greater understanding of emotional coping in body image dissatisfaction in young children.

Longitudinal kinematic and kinetic adaptations to obstacle crossing in recent lower limb amputees.

BACKGROUND: Obstacle crossing is an important activity of daily living, necessary to avoid tripping or falling, although it is not fully understood how transtibial amputees adapt to performing this activity of daily living following discharge from rehabilitation. OBJECTIVES: The objective of this study was to investigate the longitudinal adaptations in obstacle crossing in transtibial amputees post-discharge from rehabilitation. STUDY DESIGN: Longitudinal repeated measures. METHODS: Seven unilateral transtibial amputees crossed an obstacle 0.1m high positioned along a walkway while kinematic and kinetic data were recorded at 1, 3 and 6 months post-discharge. RESULTS: At 6 months post-discharge, walking velocity had increased (0.17 m.s(-1)) with most participants self-selecting an intact lead limb preference. During swing phase, peak knee flexion (p = 0.03) and peak knee power absorption (K4; p = 0.01) were greater with an intact versus affected lead limb preference. Having crossed the obstacle, intact limb peak ankle power generation in pre-swing (A2; p = 0.01) and knee power absorption (K3; p = 0.05) during stance phase were greater when compared to the affected limb. CONCLUSIONS: Obstacle crossing improved, although a greater reliance on intact limb function was highlighted. Results suggested that further improvements to locomotor performance may be obtained by increasing affected limb knee range of motion and concentric and eccentric strength of the knee extensors and flexors. CLINICAL RELEVANCE: The novel objective data from this study establish an understanding of how recent transtibial amputees adapt to performing obstacle crossing following discharge from rehabilitation. This allows for evidence-based clinical interventions to be developed, aimed at optimising biomechanical function, thus improving overall locomotor performance and perhaps subsequent quality of life.

Understanding the contexts of adolescent female participation in sport and physical activity.

PURPOSE: Participation in physical activity (PA) is reported to decline in adolescence, particularly for girls. However, we do not know if this decline in PA is consistent across modes and settings or whether there are transfers of participation between modes and settings. Nor do we understand the changes in specific types of PA or the interaction between types of participation and different modes/settings. This study investigated contexts of PA participation for female adolescents at two life transition points. METHOD: A survey of 489 Year 7 and 243 Year 11 adolescent girls was conducted, incorporating a measure of overall PA level and participation rates in seven modes/settings and in specific types of sport and PA. RESULTS: Less than half of the respondents met or exceeded the recommended level of moderate or vigorous PA--60 min or more--on the previous day, and there was no statistically significant difference in the proportions in Years 7 and 11 (39.5% vs. 45.9%; p > .05). However, older adolescents shifted their participation away from organized, competitive modes and settings toward nonorganized and noncompetitive modes and settings and individual types of PA. CONCLUSIONS: An understanding of the changes in PA modes and settings identified here can inform the planning of policies and implementation of programs for the promotion of PA by adolescent girls.

Temporal adaptations in generic and population-specific quality of life and falls efficacy in men with recent lower-limb amputations.

This study examined the longitudinal changes in generic health-related quality of life (QOL), prosthesis-related QOL, falls efficacy, and walking speed in men with lower-limb amputations up to 6 months following discharge from rehabilitation. Seven male unilateral transtibial amputees completed the Medical Outcomes Study 36-Item Short Form Health Survey, the Prosthesis Evaluation Questionnaire, and the Modified Falls Efficacy Scale at 1, 3, and 6 months postdischarge from rehabilitation. Walking speed was also recorded to objectively assess participants' mobility. Health-related QOL measures displayed increases, resulting in large effect sizes though not reaching statistical significance. Prosthesis-related QOL measures indicated that scales relating to the participants' prostheses improved and the support of significant others was the most positively scored variable. Walking speed increased by 0.12 m/s, although it was not significantly related to indices of QOL or falls efficacy. Falls efficacy did not improve significantly during the study period, although it was strongly related to QOL (p < 0.05). These results provide a novel insight into how QOL and falls efficacy develop in people with lower-limb amputations, alongside changes in mobility, after discharge from rehabilitation. Further improvements in physical health following discharge may be required to elicit subsequent increases in overall QOL and concurrent improvements in falls efficacy.