Gregory S. Kolt

The Mechanisms of Massage and Effects on Performance, Muscle Recovery and Injury Prevention

AbstractMany coaches, athletes and sports medicine personnel hold the belief, based on observations and experiences, that massage can provide several benefits to the body such as increased blood flow, reduced muscle tension and neurological excitability, and an increased sense of well-being. Massage can produce mechanical pressure, which is expected to increase muscle compliance resulting in increased range of joint motion, decreased passive stiffness and decreased active stiffness (biomechanical mechanisms). Mechanical pressure might help to increase blood flow by increasing the arteriolar pressure, as well as increasing muscle temperature from rubbing. Depending on the massage technique, mechanical pressure on the muscle is expected to increase or decrease neural excitability as measured by the Hoffman reflex (neurological mechanisms). Changes in parasympathetic activity (as measured by heart rate, blood pressure and heart rate variability) and hormonal levels (as measured by cortisol levels) following massage result in a relaxation response (physiological mechanisms). A reduction in anxiety and an improvement in mood state also cause relaxation (psychological mechanisms) after massage. Therefore, these benefits of massage are expected to help athletes by enhancing performance and reducing injury risk. However, limited research has investigated the effects of pre-exercise massage on performance and injury prevention.Massage between events is widely investigated because it is believed that massage might help to enhance recovery and prepare athletes for the next event. Unfortunately, very little scientific data has supported this claim. The majority of research on psychological effects of massage has concluded that massage produces positive effects on recovery (psychological mechanisms). Post-exercise massage has been shown to reduce the severity of muscle soreness but massage has no effects on muscle functional loss. Notwithstanding the belief that massage has benefits for athletes, the effects of different types of massage (e.g. petrissage, effleurage, friction) or the appropriate timing of massage (pre-exercise vs post-exercise) on performance, recovery from injury, or as an injury prevention method are not clear. Explanations are lacking, as the mechanisms of each massage technique have not been widely investigated. Therefore, this article discusses the possible mechanisms of massage and provides a discussion of the limited evidence of massage on performance, recovery and muscle injury prevention. The limitations of previous research are described and further research is recommended.

Physical activity in preschoolers: understanding prevalence and measurement issues.

Accurate physical activity quantification in preschoolers is essential to establish physical activity prevalence, dose-response relationships between activity and health outcomes, and intervention effectiveness. To date, best practice approaches for physical activity measurement in preschool-aged children have been relatively understudied. This article provides a review of physical activity measurement tools for preschoolers, an overview of measurement of preschoolers’ physical activity, and directions for further research. Electronic and manual literature searches were used to identify 49 studies that measured young children’s physical activity, and 32 studies that assessed the validity and/or reliability of physical activity measures with preschool-aged children. While no prevalence data exist, measurement studies indicate that preschool children exhibit low levels of vigorous activity and high levels of inactivity, boys are more active than girls, and activity patterns tend to be sporadic and omnidirectional. As such, measures capable of capturing differing activity intensities in very short timeframes and over multiple planes are likely to have the most utility with this population. Accelerometers are well suited for this purpose, and a number of models have been used to objectively quantify preschoolers’ physical activity. Only one model of pedometer has been investigated for validity with preschool-aged children, showing equivocal results. Direct observation of physical activity can provide detailed contextual information on preschoolers’ physical activity, but is subjective and impractical for understanding daily physical activity. Proxy-report questionnaires are unlikely to be useful for determining actual physical activity levels of young children, and instead may be useful for identifying potential correlates of activity. Establishing validity is challenging due to the absence of a precise physical activity measure, or ‘criterion’, for young children. Both energy expenditure (EE) and direct observation have been considered criterion measures in the literature; however, EE is influenced by multiple variables, so its use as a physical activity ‘criterion’ is not ideal. Also, direct observation is inherently subjective, and coding protocols may result in failure to capture intermittent activity, thereby limiting its utility as a physical activity criterion. Accordingly, these issues must be taken into account where EE or direct observation are used to validate physical activity instruments. A combination of objective monitoring and direct observation may provide the best standard for the assessment of physical activity measurement tools. Ideally, the convergent validity of various physical activity tools should be investigated to determine the level of agreement between currently available measures. The correlational approaches commonly employed in the assessment of physical activity measures do not reveal this relationship, and can conceal potential bias of either measure.

Eustress, distress and interpretation in ocupational stress

We examine the concepts of stress, distress, and eustress and develop three tenets that are used to relate these concepts to three major theories or models of occupational stress. Selyes concept of eustress or “good stress” appears to be largely ignored in the literature, while the Yerkes Dodson Law is illustrated as a model for management practice. We suggest that the meaning assigned to the word stress has shifted from Selyes original formulation, and that this shift, in conjunction with the use of the Yerkes Dodson Law leads to inappropriate management of stress in organizations. We conclude that the concept that some stress is good and enhances performance should be rejected in favour of more useful and accurate concepts.

Physical activity in culturally and linguistically diverse migrant groups to western society: a review of barriers, enablers and experiences.

A close examination of epidemiological data reveals burdens of disease particular to culturally and linguistically diverse (CALD) migrants, as these individuals adjust to both culture and modernization gaps. Despite the increased risk of hypertension, diabetes mellitus, overweight/obesity and cardiovascular disease, individuals from CALD groups are less likely to be proactive in accessing healthcare or undertaking preventative measures to ensure optimal health outcomes. The purpose of this paper is to review literature that outlines the barriers, challenges and enablers of physical activity in CALD groups who have recently migrated to Western society, and to identify key strategies to increase physical activity participation for these individuals. Electronic and manual literature searches were used to identify 57 publications that met the inclusion criteria. Findings from the review indicate that migration to Western societies has a detrimental effect on the health status and health behaviours of CALD groups as they assimilate to their new surroundings, explore different cultures and customs, and embrace a new way of life. In particular, there is evidence that physical inactivity is common in migrant CALD groups, and is a key contributing risk factor to chronic disease for these individuals. Challenges and barriers that limit physical activity participation in CALD groups include: cultural and religious beliefs, issues with social relationships, socioeconomic challenges, environmental barriers, and perceptions of health and injury. Strategies that may assist with overcoming these challenges and barriers consist of the need for cultural sensitivity, the provision of education sessions addressing health behaviours, encouraging participation of individuals from the same culture, exploration of employment situational variables, and the implementation of ‘Health Action Zones’ in CALD communities. This information will inform and support the development of culturally appropriate programmes designed to positively influence the physical activity behaviours of individuals from CALD populations.

Effect of telephone counseling on physical activity for low-active older people in primary care: a randomized, controlled trial.

OBJECTIVES: To assess the long‐term effectiveness of a telephone counseling intervention on physical activity and health‐related quality of life in low‐active older adults recruited through their primary care physician.

Home-based activity program for older people with depressive symptoms: DeLLITE--a randomized controlled trial.

PURPOSE We wanted to assess the effectiveness of a home-based physical activity program, the Depression in Late Life Intervention Trial of Exercise (DeLLITE), in improving function, quality of life, and mood in older people with depressive symptoms. METHODS We undertook a randomized controlled trial involving 193 people aged 75 years and older with depressive symptoms at enrollment who were recruited from primary health care practices in Auckland, New Zealand. Participants received either an individualized physical activity program or social visits to control for the contact time of the activity intervention delivered over 6 months. Primary outcome measures were function, a short physical performance battery comprising balance and mobility, and the Nottingham Extended Activities of Daily Living scale. Secondary outcome measures were quality of life, the Medical Outcomes Study 36-item short form, mood, Geriatric Depression Scale (GDS-15), physical activity, Auckland Heart Study Physical Activity Questionnaire, and self-report of falls. Repeated measures analyses tested the differential impact on outcomes over 12 months’ follow-up. RESULTS The mean age of the participants was 81 years, and 59% were women. All participants scored in the at–risk category on the depression screen, 53% had a Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases, Tenth Revision diagnosis of major depression or scored more than 4 on the GDS-15 at baseline, indicating moderate or severe depression. Almost all participants, 187 (97%), completed the trial. Overall there were no differences in the impact of the 2 interventions on outcomes. Mood and mental health related quality of life improved for both groups. CONCLUSION The DeLLITE activity program improved mood and quality of life for older people with depressive symptoms as much as the effect of social visits. Future social and activity interventions should be tested against a true usual care control.

Eustress, distress and their interpretation in primary and secondary occupational stress management interventions: which way first?

Purpose – To develop an argument for the retention of secondary approaches to stress management (those that focus on the individual within the organization) as first interventions, prior to the employment of primary approaches (those that focus on the organizations processes and structures). This is based on a reconsideration of eustress versus distress and a review of current empirical evidence on the effectiveness of stress management interventions.Design/methodology/approach – Major empirical studies and reviews are critically reviewed and placed within a theoretical framework derived from both early and more recent work in the field.Findings – There is little empirical evidence on which to base recommendations for organization‐based stress management interventions as first or sole approaches and therefore the value of these as first or sole approaches is questioned. Instead secondary, individual‐focused, approaches are recommended as first‐line interventions prior to the adoption of organization‐base...

Facilitators and barriers to engagement in physical activity for people with multiple sclerosis: a qualitative investigation

Purpose. To explore the barriers and facilitators to engagement in physical activity from the perspective of people with multiple sclerosis (MS). Method. This study adopted a qualitative descriptive design, using semi-structured interviews. Participants were recruited through local MS Societies and one District Health Board as part of a larger study. Ten people with a definite diagnosis of MS were purposefully selected aiming for diversity on a range of characteristics. Results. A number of factors were identified that seemed to interact and work to tip the decisional balance regarding physical activity engagement for people with MS. The most prominent themes included beliefs about physical activity; related emotional responses; and the role of fatigue in the decision to take part in physical activity. One of the most striking findings was the apparent tension surrounding the decision to take part in physical activity which seemed to be related to the co-existence of conflicting beliefs. Conclusions. For people with MS, the decision to engage in physical activity (or not) is complex, fluid and individual; made more complex by the unpredictable nature of MS. Rehabilitation professionals attempting to engage people with MS in a physical activity programme should consider adopting an individualised approach to barrier management which takes into account personal beliefs and perceptions regarding physical activity engagement.

Is Neighborhood Green Space Associated With a Lower Risk of Type 2 Diabetes? Evidence From 267,072 Australians

OBJECTIVE Lifestyle interventions for type 2 diabetes mellitus (T2DM) are best positioned for success if participants live in supportive neighborhood environments. Deprived neighborhoods increase T2DM risk. Parks and other “green spaces” promote active lifestyles and therefore may reduce T2DM risk. We investigated association between neighborhood green space and the risk of T2DM in a large group of adult Australians. RESEARCH DESIGN AND METHODS Multilevel logit regression was used to fit associations between medically diagnosed T2DM and green space exposure among 267,072 participants in the 45 and Up Study. Green space data were obtained from the Australian Bureau of Statistics, and exposure was calculated using a 1‐km buffer from a participant’s place of residence. Odds ratios (ORs) were controlled for measures of demographic, cultural, health, diet, active lifestyles, socioeconomic status, and neighborhood circumstances. RESULTS The rate of T2DM was 9.1% among participants in neighborhoods with 0–20% green space, but this rate dropped to approximately 8% for participants with over 40% green space within their residential neighborhoods. The risk of T2DM was significantly lower in greener neighborhoods, controlling for demographic and cultural factors, especially among participants residing in neighborhoods with 41–60% green space land use (OR 0.87; 95% CI 0.83–0.92). This association was consistent after controlling for other explanatory variables and did not vary according to neighborhood circumstances. CONCLUSIONS People in greener surroundings have a lower risk of T2DM. Planning, promoting, and maintaining local green spaces is important in multisector initiatives for addressing the T2DM epidemic.

A review of the effectiveness of physical activity interventions for adult males

Physical inactivity is one of the main modifiable risk factors for a range of noncommunicable diseases. Of particular interest are adult males, a hard-to- reach population group for health promotion interventions. The purpose of this review is to provide a critical evaluation of the published health-related physical activity interventions that have targeted adult males.A comprehensive search of MEDLINE, CINAHL®, ScienceDirect, Web of Science, PsycINFO, the Cochrane Library, and SPORTDiscus™was conducted for intervention studies published in English, between January 1990 and August 2010. Studies including community-dwelling adult men (±18 years), or including both males and females where data on male parti- cipants could be extracted and examined, were included in this review. Studies assessing changes in levels of physical activity, physical fitness or changes in biomarkers of disease risk relevant to physical activity (e.g. body weight, waist circumference, lipids, blood pressure) were the primary focus.A total of 14 studies focusing on physical activity only and nine combined physical activity and nutrition studies were also included in this review. Ten of the 14 physical activity only studies and four of the nine combined physical activity and nutrition studies demonstrated significant increases in physical activity outcomes. Face-to-face, group-based and print-based methods were most commonly employed in these interventions. Within each mode of de- livery, a number of elements including regular feedback, access to self- monitoring tools, elements of social support, variety in activities and a degree of friendly competition, were revealed as positive inclusions for this pop- ulation group.Males are generally under-represented in health-promotion interven- tions and should therefore be targeted specifically, and while results of the included studies are encouraging, there is a lack of intervention studies tar- geting adult males. Further research into this population group is therefore required.