Musculoskeletal performance assessment is critical in the analysis of physical training programs in order to prioritize goals for decreasing injury risk and focusing performance goals. Abdominal endurance as part of this analysis is often assessed with techniques that have validity that has been debated in literature. The purpose of this study was to develop normative sex- and athlete-specific percentiles for a trunk stabilization and muscular endurance by using a prone forearm plank test in college-aged students. A second purpose of this study was to investigate the effect of habitual physical activity and the reason for test termination. There were 471 participants (means ± SE; males: n = 194, age 20.4 ± 0.2 years, body height 179.4 ± 0.5 cm, body mass 81.1 ± 1.2 kg; females: n = 277, age 20.2 ± 0.2 years, body height 165.7 ± 0.4 cm, body mass 63.9 ± 0.7 kg) who performed this test to volitional or technique failure. Males produced significantly higher test durations than females (means ± SD; 124 ± 72 seconds vs. 83 ± 63 seconds) and athletes produced significantly longer test durations than non-athletes (123 ± 69 s vs. 83 ± 63 s) but no interaction effects were seen in the variables of sex and athletic status. The activity level was found to have a threshold of influence (>3 times/week) on abdominal endurance that is dose-specific where greater than 5 times/week showed the greatest influence. The fatigue of the abdominals was the termination reason producing the lowest test duration and there was no sex effect on reason for test termination. These normative percentiles for abdominal endurance suggest that the abdominal plank test can now be used as an alternative to other abdominal assessments in college students, but further investigation is warranted prior to confirmation and generalization to other populations.

IntroductionCancer pathogenesis and resulting treatment may lead to bone loss and poor skeletal health in survivorship. The purpose of this investigation was to evaluate the influence of 26 weeks of combined aerobic and resistance-training (CART) exercise on bone mineral density (BMD) in a multi-racial sample of female cancer survivors.MethodsTwenty-six female cancer survivors volunteered to undergo CART for 1 h/day, 3 days/week, for 26 weeks. The Improving Physical Activity After Cancer Treatment (IMPAACT) Program involves supervised group exercise sessions including 20 min of cardiorespiratory training, 25 min of circuit-style resistance-training, and 15 min of abdominal exercises and stretching. BMD at the spine, hip, and whole body was assessed using dual-energy X-ray absorptiometry (DXA) before and after the intervention. Serum markers of bone metabolism (procollagen-type I N-terminal propeptide, P1NP, and C-terminal telopeptides, CTX) were measured at baseline, 13 weeks, and at study completion.ResultsEighteen participants, with the average age of 63.0 ± 10.3 years, completed the program. Mean duration since completion of cancer treatment was 6.2 ± 10.6 years. Paired t-tests revealed significant improvements in BMD of the spine (0.971 ± 0.218 g/cm2 vs. 0.995 ± 0.218 g/cm2, p = 0.012), hip (0.860 ± 0.184 g/cm2 vs. 0.875 ± 0.191 g/cm2, p = 0.048), and whole body (1.002 ± 0.153 g/cm2 vs. 1.022 ± 0.159 g/cm2, p = 0.002). P1NP declined 22% at 13 weeks and 28% at 26 weeks in comparison to baseline (p < 0.01) while CTX showed a non-significant decrease of 8% and 18% respectively.ConclusionsWe report significant improvements in BMD at the spine, hip, and whole body for female cancer survivors who completed 26 weeks of CART. This investigation demonstrates the possible effectiveness of CART at improving bone health and reducing risk of osteoporosis for women who have completed cancer treatment. The IMPAACT Program appears to be a safe and feasible way for women to improve health after cancer treatment.

Cancer survivors often experience poor post-treatment musculoskeletal health. This study examined the feasibility of combined aerobic and resistant training (CART) for improving strength, skeletal health and balance. Cancer survivors (n = 24) were identified by convenience sampling in Los Angeles County with 11 survivors consenting to 13 weeks of CART. Pre- and post-intervention assessments of bone mineral density (BMD), strength, flexibility and biomarker analysis were performed. Paired t-test analysis suggested increases in lower and upper body strength. The average T-score for BMD at the femoral neck improved from -1.46 to -1.36 and whole body BMD improved from -1.65 to -1.55. From baseline to follow-up, participants also displayed decreases in sway velocity on the eyes open (7%) and eyes closed (27%) conditions. Improvement in lower body strength was associated with increases in lean body mass (LBM) (r = 0.721) and an inverse association was observed between sway velocity and LBM (r = 0.838). Age and time since last treatment were related with biomarkers of anabolic growth (IGF-1, IGFbp-3) and bone (DPD, BAP). In summary, observed physiological changes were consistent with functional improvements, suggesting that isometric and dynamic exercise prescription may reduce the risk for falls and fall-related fractures among survivors.

The objective of this study was to determine the relative risk and reported symptoms of concussions in 11- to 13-year-old, female soccer players. For this, a survey to compare the reported incidence of concussion in age-matched female soccer players to nonsoccer players was performed. The survey included 342 girls between the ages of 11 and 13: 195 were involved in an organized soccer team and 147 were not involved in organized soccer but were allowed to participate in any other sport or activity. A total of 94 of the 195 soccer players, or 48%, reported at least one symptom consistent with a concussion. The most prevalent symptom for these girls was headache (84%). A total of 34 of the 147 nonsoccer players, or 23%, reported at least one symptom consistent with a concussion in the previous six months. These results determined that the relative risk of probable concussions among 11- to 13-year-old, female soccer players is 2.09 (p < .001, α = .05, CI = 95%). This demonstrates that the relative risk of probable concussions in young female soccer players is significantly higher than in a control group of nonsoccer players of the same sex and age.

The objective of this case study was to identify the signs and symptoms of concussion and post-concussive syndrome in a collegiate, female basketball player, as well as her progress to becoming symptom free. The patient, a previously healthy, 21-year-old with no previous head injuries, experienced a concussion and continued to participate in her sport. Even though the athlete knew the risks of playing while symptomatic, she did not report her symptoms, and continued playing until the season ended. This case highlights that even when patients know the risks, they may be willing to overlook them to continue playing and it emphasizes the importance of further education. In addition, it shows that even when following recommended guidelines, and with normal neurocognitive testing, symptoms may come back upon return to play.