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Objectives

To compare the effects of the KISS ankle brace, Aircast ankle brace, and no brace condition, on functional performance measures and perceptions of stability, confidence and reassurance in people with and without chronic ankle instability.

Design

Randomised double-blinded cross-over trial.

Method

A total of 42 participants (21 uninjured and 21 with chronic ankle instability) were recruited from the general population and completed a series of functional performance tests, including side hop (seconds), Star excursion balance test reach distance, triple hop for distance (centimetres), modified T-agility test (seconds), standing and maximum vertical jump reach (centimetres), while wearing two ankle brace conditions and no brace (control). Results were recorded and analysed by a blinded investigator.

Results

There was no significant difference between conditions for average time on the side hop test (F(2,122) ​= ​0.04, P ​= ​0.96); best reach distance on SEBT in anterior (F (2,122) ​= ​0.04, P ​= ​0.96), postero-medial (F(2,122) ​= ​0.08, P ​= ​0.93) and postero-lateral (F(2,122) ​= ​0.08, P ​= ​0.92) directions; best distance performed on the triple hop (F(2,122) ​= ​0.03, P ​= ​0.97); best standing vertical jump performance (F(2,110) ​= ​0.04, P ​= ​0.97); best maximum vertical jump performance (F(2,110) ​= ​0.01, P ​= ​0.99); or best time for the modified T-agility run (F(2,122) ​= ​1.61, P ​= ​0.21).

Conclusions

Practitioners can be assured that functional and balance performances will not be impacted by wearing an ankle brace.

Background

Sleep disturbance is a highly prevalent and impactful symptom experienced by those adversely affected by primary brain tumours. Despite this, there is a lack of literature exploring appropriate options for the management of sleep disturbance in these populations. As such, more holistic and patient-centred approaches to address sleep disturbance are needed. Exercise presents itself as a viable option for managing sleep disturbances given its numerous health benefits, minimal costs, and acceptability, though the feasibility of its use in the context of primary brain tumours is unknown.

Methods

Primary brain tumour survivors and their caregivers will enrol and participate in a supervised, eight-week exercise intervention delivered by telehealth. Feasibility will be assessed using predetermined study metrics, including eligibility, recruitment. and assessment completion rates. Acceptability will be assessed using retention to intervention rates, session attendance, and participant satisfaction. Sleep will be assessed both objectively, using ring sleep trackers, and subjectively, using questionnaires.

Conclusion

This study will be the first to explore the feasibility and acceptability of exercise for the management of sleep disturbance in primary brain tumour survivors and their caregivers. If successful, this protocol will contribute to the development and implementation of appropriate strategies to manage sleep disturbance in these populations.

Background

Ankle braces can be used in the treatment and prevention of lateral ankle sprains. However, there is a limited understanding and consensus about which type of brace should be used, for how long, and when to stop using ankle braces.

Objective

To review the clinical recommendations made in guidelines or position statements for the use of ankle braces.

Design

Scoping review.

Methods

Ten electronic databases and Google were searched. Guidelines and/or position statements about treatment and/or prevention of lateral ankle sprains or chronic ankle instability were included if derived from a peer-reviewed source or from an official national or international professional group, society or association, and made recommendations on the use ankle braces. Recommendations for brace use and cessation were extracted, collated, reviewed, and presented in tabular format.

Results

Eleven guidelines and two position statements were included. All recommended ankle braces for the treatment of grade I and II ankle sprains and prevention of recurring sprains. Inconsistencies were present for; grade III sprains, the classification and definitions for brace types, the level of restriction ankle braces provide, how long ankle braces should be worn, and indicators for cessation of use.

Conclusion

Ankle braces are recommended for prevention of recurring sprains and the treatment of grade I and II sprains. Further information is needed on the duration or indicators for cessation of ankle brace use. A standardised classification and definitions used for the type of brace, and the level of restriction ankle braces provide is also warranted.

Background

In breast cancer survivors at risk for lymphedema, variation in lymphatic function and arm volume has been observed related to a bout of exercise, with potential for prediction of breast cancer-related arm lymphedema (BCRaL). This novel, exploratory study examined the acute lymphatic response to resistance exercise and later development of BCRaL in women at high risk for BCRaL.

Methods

One year after participation in a cross-over trial evaluating the acute lymphatic response to upper-extremity resistance exercise (low-and heavy-load), participants were assessed for BCRaL (n ​= ​16). The response to exercise was assessed before and after (post, 24- and 72-hrs) each exercise bout as extracellular fluid (L-Dex; bioimpedance spectroscopy (BIS)), interarm volume % difference (IVD; Dual-energy x-ray absorptiometry (DXA)) and symptoms (Numeric rating scale, 0–10 (NRS)). BCRaL at follow-up was defined as presence of one objective indicator (L-Dex >10, change ≥+6.5, IVD >5%) plus one objective or subjective indicator (interarm symptom ≥1 or visual inspection). Descriptive statistics were used to compare the acute response between participants with and without BCRaL at follow-up.

Results

No trends indicating a similar acute response to exercise was observed in participants who later developed BCRaL (n ​= ​5). There were no observable differences in acute lymphatic response between participants that developed BCRaL and those who did not, both at an individual and group level.

Conclusions

Findings from this exploratory study showed no evidence to suggest that the acute response to resistance exercise can predict BCRaL development.

Background

Transcranial direct current stimulation (tDCS), via an electrical current being sent through the brains motor cortex, can elicit pain reduction and improved function in people with knee osteoarthritis (OA), compared to a sham. However, it is unknown whether tDCS-induced reductions in pain can be expected in hip OA given differences between hip and knee OA phenotypes.

Methods

Two-armed (n ​= ​39 per arm), triple-blind, randomised controlled trial, with an 8-week intervention window and 8-week post-intervention follow-up assessing the efficacy of real anodal tDCS plus exercise versus sham tDCS plus exercise. Primary outcome measure is the International Hip Outcome Tool–33 (iHOT-33).

Aims

The primary objective of this randomised controlled trial is to quantify the effect of tDCS and exercise on pain, disability and quality of life in people with hip OA. Our secondary objectives include: 1) quantifying the influence of motor cortex excitability and conditioned pain modulation on treatment effects, and 2) quantifying the economic cost/benefit of tDCS for improving health-related quality of life in people with hip OA.

Analysis

Data distributions will be examined for each outcome and guide preliminary statistical between group test selections. Repeated mixed effects models will determine between-group differences for the primary outcome (iHOT-33), accounting for relevant confounders (i.e., age; sex; body mass index; radiographic severity) with relevant model assumptions examined. Secondary analysis will determine between-group differences for the other outcomes of interest (cortex excitability and conditioned pain modulation).

Implications

This randomised controlled trial investigates a novel intervention to improve pain, function and quality of life in people with hip OA.

Purpose

Examine the impact of the EXercise for Cancer to Enhance Living Well's (EXCEL) 10–12-week exercise and behaviour change support intervention on secondary effectiveness outcomes, including patient-reported outcomes, physical function, and program satisfaction.

Methods

Individuals with cancer up to 3 years post treatment with any tumour type were eligible. Outcomes were measured at baseline and immediately following the 10–12-week intervention. Patient-reported outcomes included participant characteristics, overall well-being, cognition, fatigue, symptom severity, exercise barrier self-efficacy, and program satisfaction. Physical function included shoulder flexion, 30-s sit to stand, sit and reach, 2-min step test or 6-min walk test (in-person only), and single leg balance. Wilcoxon signed-rank tests were used to assess changes in patient-reported outcomes and physical function assessments from baseline to 12-weeks.

Results

A total of 804 participants enrolled in the study in the first 2.5-years, with 699 completing the intervention. Wilcoxon signed rank tests and Rosenthal coefficients (r) showed significant (p ​< ​0.05) small improvements in well-being (r ​= ​0.10), fatigue (r ​= ​0.25), symptom severity (r ​= ​0.17), and self-efficacy (r ​= ​0.11). Significant (p ​< ​0.01) moderate to large improvements were observed for the 30-s sit to stand (r ​= ​0.54), sit and reach (left: r ​= ​0.46; right: r ​= ​0.41), 2-min step test (r ​= ​0.66), 6-min walk test (r ​= ​0.52), and single leg balance (left: r ​= ​0.32; right: r ​= ​0.34) assessments. Participants reported high satisfaction with program staff (average ​= ​4.5/5) and that the program was beneficial and enjoyable (average ​= ​4.6/5).

Conclusion

EXCEL's group-based exercise program with behaviour change support, delivered in an online supervised setting to individuals living with cancer, may improve patient-reported outcomes and physical function and is associated with high participant satisfaction.

For over 100 years there has been an academic pursuit of understanding and applying the principals of sport psychology to improve athletic performance. How is it that certain athletes do their best when it means the most while others “choke”? Meeting and exceeding the challenges that are presented can completely change the trajectory of any athlete's career. What is it that separates the good from the great and the great from the superstars? Is it motivation, preparation, determination, discipline, commitment, natural talent, physical strength, or work ethic? Maybe it is a combination of all of these characteristics. Without the right mentality everything can fall apart. In Alcoholics Anonymous, it is said, “you don't have a drinking problem – you have a thinking problem.” The evidence is quite clear that the mental game can have a substantial impact, both for the better and for the worse, on performance. In this perspectives and viewpoints, we share our own insights from our experience for athletes to obtain the ultra-mentality and maximise their athletic performance. We have attempted to take simple words to briefly explain complicated concepts.

Objectives

The Six Minute Walk Test (6MWT) assesses functional capacity. We determined the reference range distance walked, heart rate change, and breathlessness in healthy women.

Design

Prospective observational study.

Methods

100 nulliparous women aged 18–40 performed two 6MWTs, with the second performed after heart rate returned to baseline. Borg scales compared expected and true breathlessness.

Results

Reference range was 472–758 ​m, with distance mean (SD) of 615 (73.0) metres. Heart rate increase during exercise was 11 (11.8) beats per minute, recovering to baseline in 4.5 (3.9) minutes. 63 ​% of women overestimated breathlessness.

Conclusions

These data represent reference values for functional evaluation of healthy young women.