Faculty of Kinesiology and Recreation Management Scholarly Works

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Promoting family functioning through physical activity: a randomized trial to evaluate the “All in the Family” program
(BMC, 2025-08-12) Lee, Alfred S. Y.; Blanchard, Chris M.; Beauchamp, Mark R.; Carson, Valerie; Madigan, Sheri; Strachan, Shaelyn; Vanderloo, Leigh M.; Streight, Evangeline; Courtnall, Sandy; Rhodes, Ryan E.
Background: Effective family functioning, such as communication, family organization, and family cohesion, is essential for family well-being and child development. Promoting family physical activity (PA) through shared activities offers a promising strategy for enhancing family dynamics. Developing a strong parenting PA identity (e.g., seeing oneself as a parent who supports their child’s PA) and a family social identity around PA (e.g., perceiving the family as an active unit) may further strengthen motivation and commitment to engaging in PA. This study aims to evaluate the efficacy of three family PA interventions: (1) PA education alone; (2) PA education + PA parenting self-regulation skills; and (3) PA education + PA parenting self-regulation skills + PA parenting identity. The primary outcome is family cohesion, a key dimension of family functioning. Secondary objectives include examining the effects of these interventions on (1) family-functioning dimensions of flexibility and organization, (2) child PA levels and parent–child co-participation in PA, (3) parental PA support and its potential antecedents (i.e., parental support constructs derived from the Multi-Process Action Control Framework, and parent-perceived family PA social identity), and (4) exploring potential moderating effects of seasonal variation, child and parent characteristics, intervention adherence, and PA type. Methods: The three-armed, single-blind randomized controlled trial compares the efficacy of the three interventions over a 6-month period. Families are eligible if they have a child between the ages of 6 and 12 who is not meeting the Canadian 24-Hour Movement Guidelines for Children and Youth. Participants are randomly assigned to one of the three intervention groups. Family functioning, child PA and parent–child co-participation in PA, parental PA support, family PA social identity, and related constructs (e.g., perceived capability and opportunity, behavioral regulation, and habit) are assessed at baseline, 6 weeks, 3 months, and 6 months post-intervention. Recruitment methods include social media, recruitment poster drops, and community-based promotion. Trial registration: ClinicalTrials.gov NCT06098716. Registered on October of 2023, updated on August 2024.
Access status: Open Access ,
Contextual factors related to aging determine force-based manipulation dosage: a prospective cross-sectional study
(BMC, 2025-05-21) Maiers, Michele J.; Sundin, Alexander R.; Oster, Ryan J.; Kreul, Steven; Malone, Quinn; Passmore, Steven R.
Abstract Background Contextual factors influence clinicians’ delivery of force-based manipulation (FBM), like spinal manipulative therapy (SMT). It is particularly important to discern how contextual factors interact with therapeutic forces delivered to an older adult population, to minimize risk and identify ideal dosage. This study aimed to determine whether contextual factors pertaining to aging result in the modulation of kinetic and kinematic parameters used by experienced clinicians when delivering SMT. Methods Participants were randomly presented with a series of 12 AI-generated patient vignettes, featuring both visual and auditory content and representing varying age-related contextual factors. Factors included chronological (35-, 65- and 85-year-old), pathological (“healthy” vs degenerative spine), and felt (perceived as “young” vs. “old”) age. Participants delivered SMT to a human analogue manikin based on each vignette, presented six times in randomized order. Kinetic and kinematic parameters were collected and analyzed for differences between “young” and “old” contextual factors of age, using a 3-way repeated measures ANOVA model. Results Sixteen licensed chiropractors (8 female, 8 male) participated, with an average age of 45.4 (SD = 9.7, range 34–64) years and 18.3 (SD = 10.8, range 5–39) years of experience. A main effect in peak force was found for both chronological (F(2,30) = 26.18; p <.001, ηp2 = 0.636) and pathological age (F(1,15) = 11.58; p =.004, ηp2 = 0.436), following a stepwise progression of decreased force with increased age and with pathology. No statistically significant differences were found in peak force based on felt age, or in time to peak force for any factor. A main effect was found for chronological age with peak acceleration (F(2,20) = 9.50; p <.001, ηp2 = 0.487) and peak velocity (F(2,20) = 7.20; p =.004, ηp2 = 0.419), but not for pathological or felt age. There was a significant difference in time to peak velocity for felt age (F(1,10) = 12.23; p =.006, ηp2 = 0.550), with a shorter time to peak velocity in response to vignettes with older felt age. Conclusion Contextual factors of aging modulated certain kinetic and kinematic characteristics when delivering SMT. This provides evidence that practitioners differentially discern aspects of aging to inform how they deliver FBM dosage. Future research is needed to identify ideal kinetic and kinematic characteristics based on considerations of aging.
Access status: Open Access ,
Assessing the readiness and feasibility to implement a model of care for spine disorders and related disability in Cross Lake, an Indigenous community in northern Manitoba, Canada: a research protocol
(BMC, 2025-03-13) Bussières, André; Passmore, Steven; Kopansky-Giles, Deborah; Tavares, Patricia; Ward, Jennifer; Ladwig, Jacqueline; Glazebrook, Cheryl; Mior, Silvano; Atkinson-Graham, Melissa; Moss, Jean; Robak, Nicole; Broeckelmann, Elena; Monias, David A.; Mckay, Donnie Z.; Hamilton, Helga; Scott, Muriel; Smolinski, Randall; Hurwitz, Eric L.; Woolf, Anthony D.; Johnson, Michael; Fowler-Woods, Melinda J.; Haldeman, Scott
Abstract Background Since the 1990s, spine disorders have remained the leading cause of global disability, disproportionately affecting economically marginalized individuals, rural populations, women, and older people. Back pain related disability is projected to increase the most in remote regions where lifestyle and work are increasingly sedentary, yet resources and access to comprehensive healthcare is generally limited. To help tackle this worldwide health problem, World Spine Care Canada, and the Global Spine Care Initiative (GSCI) launched a four-phase project aiming to address the profound gap between evidence-based spine care and routine care delivered to people with spine symptoms or concerns in communities that are medically underserved. Phase 1 conclusions and recommendations led to the development of a model of care that included a triaging system and spine care pathways that could be implemented and scaled in underserved communities around the world. Methods The current research protocol describes a site-specific customization and pre-implementation study (Phase 2), as well as a feasibility study (Phase 3) to be conducted in Cross Lake, an Indigenous community in northern Manitoba, Canada. Design: Observational pre-post design using a participatory mixed-methods approach. Relationship building with the community established through regular site visits will enable pre- and post-implementation data collection about the model of spine care and provisionally selected implementation strategies using a community health survey, chart reviews, qualitative interviews, and adoption surveys with key partners at the meso (community leaders) and micro (clinicians, patients, community residents) levels. Recruitment started in March 2023 and will end in March 2026. Surveys will be analyzed descriptively and interviews thematically. Findings will inform co-tailoring of implementation support strategies with project partners prior to evaluating the feasibility of the new spine care program. Discussion Knowledge generated from this study will provide essential guidance for scaling up, sustainability and impact (Phase 4) in other northern Canada regions and sites around the globe. It is hoped that implementing the GSCI model of care in Cross Lake will help to reduce the burden of spine problems and related healthcare costs for the local community, and serve as a scalable model for programs in other settings.
Access status: Open Access ,
The effectiveness of new urban trail infrastructure on physical activity and active transportation: a systematic review and meta-analysis of natural experiments
(BMC, 2025-03-27) Fast, Isaak; Nashed, Christie; Lotscher, Jack; Askin, Nicole; De Visser, Hannah S.; McGavock, Jonathan
Background Cities in Western countries are investing billions of dollars in new cycling infrastructure (urban trails) to support active transportation (AT) and leisure-type physical activity (PA). Little empirical evidence exists on the effectiveness of urban trails on changes in AT or PA. Design and methods We searched CINAHL, OVID, SPORTDiscus, Transport Research International Documentation (TRID), Web of Science Core Collection and Google Scholar for articles published from 2010 to 2023. We included controlled experimental studies that reported PA, AT or trail counts as outcome measures before and after construction of an urban trail. A modified risk of bias tool was employed to assess the methodological quality of each selected study (Prospero ID: CRD42023438891). Results Three independent reviewers screened abstracts from 3936 articles identified in the original search and identified 24 articles that met inclusion criteria: 11 studies (n = 11,464) that measured changes in PA, 8 studies (n = 92,001) that measured changes in cycling traffic and 5 studies (n = 4,958,203) that measured changes in rates of AT/cycling. Meta-analysis revealed that new trails increased PA levels among individuals in proximity to one, compared to those living in control areas (SMD = 0.12; 95% CI: 0.04, 0.20; I2 = 73%; n = 11,464). This effect was marginally stronger when data were restricted to individuals living in closest proximity to trails (SMD = 0.14; 96% CI: 0.06 to 0.25, I2 = 74%; n = 8234). Meta-analyses were not possible for measures of AT and cycling counts. All studies were at high risk of bias due to a failure to adhere to reporting guidelines for quasi-experimental studies. Conclusions There is limited but intriguing evidence that the addition of protected urban trails increases daily PA for individuals living in neighbourhoods that receive them. The strength of this evidence could be enhanced with the application of and adherence to principles of causal inference and increased diversity of individuals included in study designs.
Access status: Open Access ,
“We are an active family”: a randomized trial protocol to evaluate a family-system social identity intervention to promote child physical activity
(BMC, 2024-09-27) Streight, Evangeline; Beauchamp, Mark R.; Smith, Kurt J.; Blanchard, Chris M.; Carson, Valerie; Strachan, Shaelyn; Vanderloo, Leigh M.; Courtnall, Sandy; Rhodes, Ryan E.
Abstract Background Regular engagement in moderate-to-vigorous physical activity (MVPA) during childhood yields a myriad of health benefits, and contributes to sustained MVPA behaviors into adulthood. Given the influence of parents on shaping their child’s MVPA behaviour, the family system represents a viable target for intervention. The purpose of this study is to compare the effects of two intervention conditions designed to increase child MVPA: (1) A standard education + planning intervention providing information about benefits, action planning, and coping planning; and (2) An augmented physical activity education + planning intervention that includes the components of the standard intervention, as well as a focus on family identity promotion and developing as an active member of the family. Methods A two-arm parallel single-blinded randomized trial will compare the two conditions over 6 months. Eligible families have at least one child aged 6–12 years who is not meeting the physical activity recommendations within the Canadian 24-Hour Movement Guidelines (i.e.,<60 min/day of MVPA). Intervention materials targeting family identity promotion will be delivered online via zoom following baseline assessment, with booster sessions at 6-weeks and 3-months. Child MVPA will be measured by wGT3X-BT Actigraph accelerometry at baseline, 6-weeks, 3-months, and 6-months as the primary outcome. At these same time points, parent cognition (e.g., attitudes, perceived control, behavioral regulation, habit, identity) and support behaviours, and parent-child co-activity will be assessed via questionnaire as secondary outcomes. Child-health fitness measures will be also administered through fitness testing at baseline and 6-months as secondary outcomes. Finally, upon completion of the trial’s 6-month measures, a follow-up end-of-trial interview will be conducted with parents to examine parents’ experiences with the intervention. Results So far, 30 families have been enrolled from the Southern Vancouver Island and Vancouver Lower Mainland area. Recruitment will be continuing through 2026 with a target of 148 families. Discussion This study will contribute to the understanding of effective strategies to increase child physical activity by comparing two intervention approaches. Both provide parents with education on physical activity benefits, action planning, and coping planning supports. However, one intervention also incorporates components focused on promoting an active family identity and involving all family members in physical activity together. The findings from this study have the potential to inform the design and implementation of public health initiatives aimed at improving physical activity participation in children and guide the development of more effective interventions that leverage the crucial role of parents and the family system in shaping children’s physical activity behaviors. Trial Registration The clinical trial registration ID is NCT05794789. This trial was registered with clinicaltrials.gov on March 2nd, 2023, with the last updated release on September 28th, 2023.
Access status: Open Access ,
Views and perspectives toward implementing the Global Spine Care Initiative (GSCI) model of care, and related spine care program by the people in Cross Lake, Northern Manitoba, Canada: a qualitative study using the Theoretical Domain Framework (TDF)
(BMC, 2024-09-17) Robak, Nicole; Broeckelmann, Elena; Mior, Silvano; Atkinson-Graham, Melissa; Ward, Jennifer; Scott, Muriel; Passmore, Steven; Kopansky-Giles, Deborah; Tavares, Patricia; Moss, Jean; Ladwig, Jacqueline; Glazebrook, Cheryl; Monias, David; Hamilton, Helga; McKay, Donnie; Smolinski, Randall; Haldeman, Scott; Bussières, André
Abstract Background Back pain is very common and a leading cause of disability worldwide. Due to health care system inequalities, Indigenous communities have a disproportionately higher prevalence of injury and acute and chronic diseases compared to the general Canadian population. Indigenous communities, particularly in northern Canada, have limited access to evidence-based spine care. Strategies established in collaboration with Indigenous peoples are needed to address unmet healthcare needs, including spine care (chiropractic and movement program) services. This study aimed to understand the views and perspectives of Cross Lake community leaders and clinicians working at Cross Lake Nursing Station (CLNS) in northern Manitoba regarding the implementation of the Global Spine Care Initiative (GSCI) model of spine care (MoC) and related implementation strategies. Method A qualitative exploratory design using an interpretivist paradigm was used. Twenty community partners were invited to participate in semi-structured interviews underpinned by the Theoretical Domains Framework (TDF) adapted to capture pertinent information. Data were analyzed deductively and inductively, and the interpretation of findings were explored in consultation with community members and partners. Results Community leaders (n = 9) and physicians, nurses, and allied health workers (n = 11) emphasized: 1) the importance of contextualizing the MoC (triaging and care pathway) and proposed new services through in-person community engagement; 2) the need and desire for local non-pharmacological spine care approaches; and 3) streamlining patient triage and CLNS workflow. Recommendations for the streamlining included reducing managerial/administrative duties, educating new incoming clinicians, incorporating follow-up appointments for spine pain patients, and establishing an electronic medical record system along with a patient portal. Suggestions regarding how to sustain the new spine care services included providing transportation, protecting allocated clinic space, resolving insurance coverage discrepancies, addressing misconceptions about chiropractic care, instilling the value of physical activity for self-care and pain relief, and a short-term (30-day) incentivised movement program which considers a variety of movement options and offers a social component after each session. Conclusion Community partners were favorable to the inclusion of a refined GSCI MoC. Adapting the TDF to unique Indigenous needs may help understand how best to implement the MoC in communities with similar needs.
Access status: Open Access ,
Rediscovering Citta: Vignettes on Violence and Healing in Life and Commercial Yoga Spaces
(2023-12-31) Cumberbatch, Brett Lesley
I have spent most of my life fighting for breath. It is hard to connect and fall in love with breath, the very life force of a person’s being, when you are busy every moment of every day fighting for it. When you are this structurally vulnerable, healing is near impossible because you are constantly bombarded by violence. I am a large built six-foot Black man who spent the first three and a half decades of his life disconnected and disembodied. I felt purposely separated from myself. Numb for the sake of survival, sober, but inebriated with disassociation just to make it through the day. This is an intentional and well-calibrated consequence of structural racism. I obviously did not know this as a child. Maybe I knew deep down inside, however like many young Black men I could not adequately put words to the emotional location of my experience. One thing I remember being confident enough to affirm (I was around the age of five), I did not feel “well” and things around me did not feel “sincere.”
Access status: Open Access ,
Database quality assessment in research in paramedicine: a scoping review
(BMC, 2023-11-11) McDonald, Neil; Little, Nicola; Kriellaars, Dean Johannes.; Doupe, Malcolm B.; Giesbrecht, Gordon; Pryce, Rob T.
Background Research in paramedicine faces challenges in developing research capacity, including access to high-quality data. A variety of unique factors in the paramedic work environment influence data quality. In other fields of healthcare, data quality assessment (DQA) frameworks provide common methods of quality assessment as well as standards of transparent reporting. No similar DQA frameworks exist for paramedicine, and practices related to DQA are sporadically reported. This scoping review aims to describe the range, extent, and nature of DQA practices within research in paramedicine. Methods This review followed a registered and published protocol. In consultation with a professional librarian, a search strategy was developed and applied to MEDLINE (National Library of Medicine), EMBASE (Elsevier), Scopus (Elsevier), and CINAHL (EBSCO) to identify studies published from 2011 through 2021 that assess paramedic data quality as a stated goal. Studies that reported quantitative results of DQA using data that relate primarily to the paramedic practice environment were included. Protocols, commentaries, and similar study types were excluded. Title/abstract screening was conducted by two reviewers; full-text screening was conducted by two, with a third participating to resolve disagreements. Data were extracted using a piloted data-charting form. Results Searching yielded 10,105 unique articles. After title and abstract screening, 199 remained for full-text review; 97 were included in the analysis. Included studies varied widely in many characteristics. Majorities were conducted in the United States (51%), assessed data containing between 100 and 9,999 records (61%), or assessed one of three topic areas: data, trauma, or out-of-hospital cardiac arrest (61%). All data-quality domains assessed could be grouped under 5 summary domains: completeness, linkage, accuracy, reliability, and representativeness. Conclusions There are few common standards in terms of variables, domains, methods, or quality thresholds for DQA in paramedic research. Terminology used to describe quality domains varied among included studies and frequently overlapped. The included studies showed no evidence of assessing some domains and emerging topics seen in other areas of healthcare. Research in paramedicine would benefit from a standardized framework for DQA that allows for local variation while establishing common methods, terminology, and reporting standards.
Access status: Open Access ,
Neuromuscular activity of the lower-extremities during running, landing and changing-of-direction movements in individuals with anterior cruciate ligament reconstruction: a review of electromyographic studies
(BioMed Central (BMC), 2023-04-14) Georgoulis, Jim D.; Melissaridou, Dimitra; Patras, Kostas; Megaloikonomos, Panayiotis D.; Trikoupis, Ioannis; Savvidou, Olga D.; Papagelopoulos, Panayiotis J.
Abstract Purpose Running, jumping/landing and cutting/change of direction (CoD) are critical components of return to sport (RTS) following anterior cruciate ligament reconstruction (ACLR), however the electromyographic (EMG) activity patterns of the operated leg during the execution of these tasks are not clear. Methods A systematic review was conducted to retrieve EMG studies during running, jumping/landing and cutting/(CoD) in ACLR patients. MEDLINE, PubMed, SPORTDiscus and Web of Science databases were searched from 2000 to May, 2022 using a combination of keywords and their variations: “anterior cruciate ligament reconstruction” OR “ACLR”, “electromyography” OR “EMG”, “running”, “jumping” OR “landing”, “cutting” OR “change-of-direction” OR “CoD”. The search identified studies comparing EMG data during running, landing and cutting/(CoD) between the involved limb and contralateral or control limbs. Risk of bias was assessed and quantitative analyses using effect sizes were performed. Results Thirty two studies met the inclusion criteria. Seventy five percent (24/32) of the studies reported altered EMG activity pattern of the ACLR leg during running, jumping/landing and cutting/(CoD) when compared with either the healthy control leg or the contra-lateral leg. Twelve studies showed decreased, delayed or earlier onset and delayed peak in quadriceps EMG activity with small to large effect sizes and 9 studies showed increased, delayed or earlier onset and delayed peak in hamstrings EMG activity with small to large effect sizes. Four studies showed a “hamstrings-dominant” strategy i.e. decreased quadriceps coupled with increased hamstrings EMG activity in both running and jumping/landing irrespective of graft type. One study reported that on the grounds of decreased quadriceps activity, lower hamstrings EMG activity was predictive of ipsilateral re-injury in ACLR patients. Conclusion This systematic review of Level III evidence showed that the ACLR leg displays decreased quadriceps or increased hamstrings EMG activity or both despite RTS. Simultaneous decreased quadriceps and increased hamstrings EMG activity was shown for both running and jumping/landing. From a clinical perspective this “hamstrings dominant” strategy can serve as a protective mechanism against graft re-injury. Level of evidence III.
Access status: Open Access ,
Relative age effects on speed trials in Brazilian athletics
(BMC, 2023-02-11) Barboza-Neto, Rui; Nobari, Hadi; Aidar, Felipe J.; Almeida-Neto, Paulo F.; Silva, Ana F.; Medeiros, Radamés M. V.; Clemente, Filipe M.; de Queiros, Victor S.; de Matos, Dihogo G.; da Silva, Luiz F.; Badicu, Georgian; Dantas, Paulo M. S.; de Araújo Tinôco Cabral, Breno G.
Background Relative age effect (RAE) is a concept related to the possible advantage that older athletes would have over younger ones within the same category. Although many studies have approached this subject in individual sports, there are few clippings by events within the sport. More detailed analyses are necessary for a better understanding of how RAE behaves in sports, especially in athletics, the subject of this study. The objective of this study was to analyze the RAE on speed in track and field events as a whole, separating the flat races from the hurdles races. Methods The Brazilian Ranking of Brazilian Athletics Confederation was used for data analysis, and the sample was composed of the 50 best-placed marks in the ranking of speed events in athletics in the categories Under(U)-16 and U-18 (female and male). Statistical analysis was calculated by chi-square, and the effect size was checked by Cramer’s V. Likelihood-ratio test (L-Ratio) assessed the probability of the RAE occurring in the total sample and by age groups. Results In the total sample the results pointed to the emergence of RAE in males in both categories (U-16: p < 0.001; V: 0.13; L-Ratio: 3.64, U-18: p < 0.001; V: 0.13; L-Ratio: 3.80), whereas in females no such effect was found in any category (U-16: p = 0.6; V: 0.09; L-Ratio: 0.09, U-18: p = 0.6; V: 0.07; L-Ratio: 0.12). When the results were separated by type of event, there was only a RAE in the shallow event in the U-18 female category (p = 0.3; V: 0.11; L-Ratio: 8.72). Conclusion The results allow us to conclude that there is a RAE in the speed trials of Brazilian athletics in the U16 and U18 categories for men, while this effect appears only in the shallow trials of the U18 category for women, indicating that the RAE has incidence when there is more participation and competition in the sport.
Access status: Open Access ,
Force–velocity relationship in Paralympic powerlifting: two or multiple-point methods to determine a maximum repetition
(2022-08-24) Aidar, Felipe J.; Brito, Ciro J.; de Matos, Dihogo G.; de Oliveira, Levy A. S.; de Souza, Rapahel F.; de Almeida-Neto, Paulo F.; de Araújo Tinoco Cabral, Breno G.; Neiva, Henrique P.; Neto, Frederico R.; Reis, Victor M.; Marinho, Daniel A.; Marques, Mário C.; Clemente, Filipe M.; Nobari, Hadi
Abstract Background Due to the absence of evidence in the literature on Paralympic Powerlifting the present study investigated various methods to assess bench press maximum repetition and the way each method influences the measurement of minimum velocity limit (MVT), load at zero velocity (LD0), and force–velocity (FV). Objective To evaluate the precision of the multi-point method using proximal loads (40, 50, 60, 70, 80, and 90% of one repetition maximum; 1RM) compared to the four-point method (50, 60, 70, and 80% of 1RM) and the two-point method using distant loads (40 and 80% and 50 and 80% of 1RM) in in the MVT, LD0, and FV, in bench press performed by Paralympic Powerlifters (PP). Methods To accomplish this, 15 male elite PP athletes participated in the study (age: 27.7 ± 5.7 years; BM: 74.0 ± 19.5 kg). All participants performed an adapted bench press test (free weight) with 6 loads (40, 50, 60, 70, 80, and 90% 1RM), 4 loads (50, 60, 70, and 80% 1RM), and 2 loads (40–80% and 50–80% 1RM). The 1RM predictions were made by MVT, LD0, and FV. Results The main results indicated that the multiple (4 and 6) pointsmethod provides good results in the MVT (R2 = 0.482), the LD0 (R2 = 0.614), and the FV (R2 = 0.508). The two-point method (50–80%) showed a higher mean in MVT [1268.2 ± 502.0 N; ICC95% 0.76 (0.31–0.92)], in LD0 [1504.1 ± 597.3 N; 0.63 (0.17–0.86)], and in FV [1479.2 ± 636.0 N; 0.60 (0.10–0.86)]. Conclusion The multiple-point method (4 and 6 points) and the two-point method (40–80%) using the MVT, LD0, and FV all showed a good ability to predict bench press 1RM in PP.
Access status: Open Access ,
A pilot and feasibility study of a randomized clinical trial testing a self-compassion intervention aimed to increase physical activity behaviour among people with prediabetes
(2022-05-27) Signore, Alana K.; Jung, Mary E.; Semenchuk, Brittany; Kullman, Sasha M.; Tefft, Olivia; Webber, Sandra; Ferguson, Leah J.; Kowalski, Kent; Fortier, Michelle; McGavock, Jon; Ahmed, Rashid; Orr, Marion; Strachan, Shaelyn
Abstract Background Seventy-five per cent of individuals with prediabetes will eventually be diagnosed with type 2 diabetes. Physical activity is a cornerstone in reducing type 2 diabetes risk but can be a challenging behaviour to adopt for those living with prediabetes. Individuals with prediabetes experience difficult emotions associated with being at risk for a chronic disease, which can undermine self-regulation. Self-compassion enhances self-regulation because it mitigates difficult emotions and promotes adaptive coping. We performed a pilot randomized controlled trial to determine the feasibility and acceptability of a self-compassion informed intervention to increase physical activity for persons with prediabetes. Methods This explanatory mixed methods study tested the feasibility and acceptability of a two-arm, randomized, single-blind, actively controlled, 6-week online intervention. Using a 1:1 allocation ratio, participants (identified as people with prediabetes, low physical activity, and low self-compassion) were randomized to a self-compassion (Mage = 60.22 years) or control condition (Mage = 56.13 years). All participants received behaviour change education (e.g. SMART goals, action-coping planning) and either other health knowledge (control condition: e.g. sleep, benefits of water) or self-compassion training (intervention condition: practising mindfulness, writing a letter to themselves offering the same support that they would offer to a friend). The primary outcome was to determine the feasibility and acceptability of the trial. To be considered feasible, our outcomes needed to meet or surpass our pre-determined criteria (e.g. time for group formation: 14–20 participants per month). Feasibility was assessed by examining the recruitment rates, retention, adherence, fidelity, and capacity. Semi-structured interviews were conducted with participants to determine trial acceptability. As a secondary purpose, we examined the means on key study variables (secondary and exploratory variables; see Table 1) at all planned time points (baseline, intervention-end, 6- and 12-week follow-up) to identify if they are suitable to include in the efficacy trial (see Additional Table 3). Results Eighteen participants were screened and randomized to one of two conditions. Retention, instructor fidelity, safety, capacity, adherence to most of the study aspects, and acceptability by participants and facilitators all met the criteria for feasibility. Recruitment rate, process time, and adherence to home practice were below our criteria, and we offer ways to address these shortcomings for the efficacy trial. Conclusion The results from this study suggest that it should be feasible to deliver our intervention while highlighting the alterations to components that may be altered when delivering the efficacy trial. We outline our changes which should improve and enhance the feasibility and acceptability of our planned intervention. Funding for this study was from the Canadian Institutes of Health Research (CIHR). Trial registration ClinicalTrials.gov, NCT04402710 . Registered on 09 April 2020.
Access status: Open Access ,
Transgender Eligibility Policy in Sport: Science, Ethics, and Evidence
(Parnassos Press, 2017) Teetzel, Sarah
In response to cases of high-profile athletes’ sex being called into question, prior to the 2012 London Olympic Games, the International Association of Athletics Federations (IAAF) updated its policy addressing the conditions under which athletes are eligible to compete in the women’s sport category. The IAAF’s policy, which stipulated the eligibility conditions that transgender athletes, as well as athletes with disorders of sex development (DSD) and hyperandrogenism, must meet to participate in high-performance sport, was subsequently endorsed by the International Olympic Committee (IOC), and remained in effect until 2015 when the Court of Arbitration for Sport (CAS) ordered the immediate suspension of the policy. The decision rendered mixed reactions, with some dissenting voices echoing American athlete Summer Pierson’s (2011) view that “it is a privilege to compete, and in order to enjoy such a privilege, the sacrifice of certain rights is required” (323). To engage in moral evaluation of the policy, more information is needed about how the rules in force apply to and impact athletes. To gain new knowledge about athletes’ views of the sex verification regulations, athletes who identify as a trans and high-performance female athletes were invited to participate in semi-structured, in-depth interviews about their understanding of, and reactions to, rules governing sex verification in sport. Athletes, such as Pierson, who speak openly about their concerns regarding rule changes that promote inclusive sport have faced criticism and charges of intolerance, and may fear losing sponsorship opportunities for speaking their minds (Ljungqvist & Genel, 2005). For example, MMA fighter Ronda Roussey received negative publicity after questioning whether trans women MMA fighters compete at an advantage compared to athletes identified as female at birth (Samano, 2013). In discussing the results from this study, this presentation analyzes athletes’ public and private experiences supporting and challenging sex verification rules mandated by sport governing bodies, such as the IOC, IAAF, and CAS. The philosophy of sport literature is quite silent on the extent that athletes’ views should shape policymaking on contentious ethical issues. The perspectives of the people impacted most (that is, the athletes) certainly need to be included in the dialogue; however, the extent that their perspectives should be privileged over other views remains unclear. Thus, this chapter focuses on the impact of athletes’ voices in determining the moral acceptability of rule changes in sport.
Access status: Open Access ,
Allyship in elite women’s sport
(Routledge, 2020) Teetzel, Sarah
Throughout 2019, retired athletes Martina Navratilova (tennis), Sharron Davies (swimming), Kelly Holmes (athletics) and Paula Radcliffe (marathon) all spoke publically about what they perceive to be the unfairness of trans women competing in women’s elite sport. These successful athletes, all with a history of growing and promoting women’s sport, were simultaneously celebrated for sharing their thoughts on a complex issue, and labelled transphobic for expressing anti-inclusive and transphobic views. Navratilova, particularly, despite her long history of fighting for inclusion and to end homophobia in sport, faced a severe backlash for expressing anti-trans rhetoric. This paper examines the concept of allyship in the context of inclusion and fairness in sport. Conceptual clarification of what allyship involves and requires precedes an examination of whether athletes should be obliged to promote inclusive sport. I argue that elite women athletes have an obligation to promote women’s sport, but not one that extends as far as a requirement to actively act as allies. To support this conclusion, I argue that: 1) past and present trans athlete eligibility rules endorsed by the IOC are problematic; 2) the typical arguments from unfairness and performance advantages fail to demonstrate why trans athletes should not be welcome to compete; but 3) a requirement of allyship requires more from women athletes than we can reasonably expect. Being mandated to act as an ally, without full commitment, does more harm than good. Athletes thus are entitled to express their views, but sports organizations should be responsible for providing education to all athletes on the science and ethics of trans athlete inclusion.
Access status: Open Access ,
Response to Lawrence DJ: the global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature
(2021-07-20) Côté, Pierre; Hartvigsen, Jan; Axén, Iben; Leboeuf-Yde, Charlotte; Corso, Melissa; Shearer, Heather; Wong, Jessica; Marchand, Andrée-Anne; Cassidy, J. D.; French, Simon; Kawchuk, Gregory N.; Mior, Silvano; Poulsen, Erik; Srbely, John; Ammendolia, Carlo; Blanchette, Marc-André; Busse, Jason W.; Bussières, André; Cancelliere, Carolina; Christensen, Henrik W.; De Carvalho, Diana; De Luca, Katie; Rose, Alister D.; Eklund, Andreas; Engel, Roger; Goncalves, Guillaume; Hebert, Jeffrey; Hincapié, Cesar A.; Hondras, Maria; Kimpton, Amanda; Lauridsen, Henrik H.; Innes, Stanley; Meyer, Anne-Laure; Newell, David; O’Neill, Søren; Pagé, Isabelle; Passmore, Steven; Perle, Stephen M.; Quon, Jeffrey; Rezai, Mana; Stupar, Maja; Swain, Michael; Vitiello, Andrew; Weber, Kenneth; Young, Kenneth J.; Yu, Hainan
Access status: Open Access ,
Modeling age-related neuromuscular changes in humans
(NRC Research Press, 2009-08) Webber, Sandra C.; Porter, Michelle M.; Gardiner, Phillip, F.
With aging, motoneurons and muscle tissue undergo significant changes, which influence function in terms of strength, mobility, and overall independence. Mathematical modeling provides a practical method of studying the relationships among recruitment, rate-coding, and force output in motor units, and may be used to predict functional neuromuscular changes related to aging. For this study, the Heckman–Binder model was used to examine changes in human quadriceps motor units. Relationships among current input, firing frequency, and force output were defined for both a younger and an older individual. Included in the model were age-related effects associated with reduced muscle contractile speed; reduced muscle-fibre number, size, and specific tension; reduced gain of the frequency–current relationship; decreased size of motoneurons; and altered motor unit remodeling. Adjustment of this model to reflect age-related changes resulted in a leftward shift of the force–frequency function, lower firing frequency for any given current injected into the motoneuron, and a reduction in maximal force output. The model suggests that older individuals are capable of reaching force levels up to approximately 50% of those attained by younger individuals, with relatively similar or even slightly lower levels of current input. This could mean that the sense of effort and the contribution of factors other than degree of effort from afferent inputs to the pool, including conscious supraspinal centres, might be different in the older adult.
Access status: Open Access ,
Accuracy of Thresholds Based on Cadence and Lifestyle Counts per Minute to Detect Outdoor Walking in Older Adults With Mobility Limitations
(Human Kinetics, Inc., 2020-05) Webber, Sandra C.; Hahn, Francine; Lix, Lisa M.; Tittlemier, Brenda J.; Salbach, Nancy M.; Barclay, Ruth
To determine the optimal threshold, based on cadence and lifestyle counts per minute, to detect outdoor walking in mobility-limited older adults. Methods: Older adults (N = 25, median age: 77.0 years, interquartile range: 10.5) wore activity monitors during 80 outdoor walks. Walking bouts were identified manually (reference standard) and compared with identification using cadence thresholds (≥30, ≥35, ≥40, ≥45, and ≥50 steps/min) and >760 counts per minute using low frequency extension analysis. Results: Median walking bout duration was 10.5 min (interquartile range 4.8) and median outdoor walking speed was 0.70 m/s (interquartile range 0.20). Cadence thresholds of ≥30, ≥35, and ≥40 steps/min demonstrated high sensitivity (1.0, 95% confidence intervals [0.95, 1.0]) to detect walking bouts; estimates for specificity and positive predictive value were highest for ≥40 steps/min. Conclusion: A cadence threshold of ≥40 steps/min is recommended for detecting sustained outdoor walking in this population.
Access status: Open Access ,
Monitoring Mobility in Older Adults Using Global Positioning System (GPS) Watches and Accelerometers: A Feasibility Study
(Human Kinetics, Inc., 2009-10) Webber, Sandra C.; Porter, Michelle M.
This exploratory study examined the feasibility of using Garmin global positioning system (GPS) watches and ActiGraph accelerometers to monitor walking and other aspects of community mobility in older adults. After accuracy at slow walking speeds was initially determined, 20 older adults (74.4 ± 4.2 yr) wore the devices for 1 day. Steps, distances, and speeds (on foot and in vehicle) were determined. GPS data acquisition varied from 43 min to over 12 hr, with 55% of participants having more than 8 hr between initial and final data-collection points. When GPS data were acquired without interruptions, detailed mobility information was obtained regarding the timing, distances covered, and speeds reached during trips away from home. Although GPS and accelerometry technology offer promise for monitoring community mobility patterns, new GPS solutions are required that allow for data collection over an extended period of time between indoor and outdoor environments.
Access status: Open Access ,
An Evaluation of the Roadwise Review: A Mixed Methods Approach
(Traffic Injury Prevention, 2011) Porter, Michelle M.; Tuokko, Holly A.
Objective: The objective of this mixed methods study was to perform an evaluation of the Roadwise Review CD-ROM (RWR), a self-screening tool for older drivers. Methods: Ninety-six older drivers (67 to 91) used the RWR with a research assistant at two different sites, and then completed written surveys (closed and open-ended questions) immediately after the session as well as two weeks later. In addition, RWR test results by these 96 older drivers were compared to the results of the original sample that was used to establish normative data for the RWR. Results: When test scores were evaluated, almost all participants (96%) were found to have at least one impairment. The rates of impairment varied dramatically between tests from 3% (visual acuity) to 75% (visual search). Several average test scores were found to be different from the original samples upon which the normative data were derived. Several factors were found that influenced these older drivers’ scores on the various components of the RWR, although the explanatory power was very low. Participants reported that the RWR was useful, they made changes to their driving, and talked to their family and friends about driving. Participants also provided many good suggestions for improvements of this tool. Conclusions: The RWR offers promise for older drivers to self-screen their ability to drive as well as provide education on safe driving, however modifications are recommended for this tool.
Access status: Open Access ,
Speeding and Speed Modification of Older Drivers: Does Vehicle Type Make a Difference?
(2020-09) Cull, A.W.; Porter, M.M.; Nakagawa, S.; Smith, G.A.; Rapoport, M.J.; Marshall, S.C.; Bedard, M.; Tuokko, H.; Vrkljan, B.; Naglie, G.; Myers, A.M.; Mazer, B.
The purpose of this study was to examine whether vehicle type based on size (car vs. other = truck/van/SUV) had an impact on the speeding, acceleration, and braking patterns of older male and female drivers (70 years and older) from a Canadian longitudinal study. The primary hypothesis was that older adults driving larger vehicles (e.g., trucks, SUVs, or vans) would be more likely to speed than those driving cars. Participants (n = 493) had a device installed in their vehicles that recorded their everyday driving. The findings suggest that the type of vehicle driven had little or no impact on per cent of time speeding or on the braking and accelerating patterns of older drivers. Given that the propensity for exceeding the speed limit was high among these older drivers, regardless of vehicle type, future research should examine what effect this behaviour has on older-driver road safety.

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