Srdjan Lemez

Rheumatic diseases significantly impact global healthcare through disability, lost productivity, and reduced quality of life, making them an important focus for researchers. As physiological changes associated with aging decrease bone mineral density, rheumatic diseases further elevate fracture risk in older adults. Resistance training has been shown to counteract age-related declines through increases in muscle, strength, and bone mineral density, demonstrating its potential for mitigating bone mineral density loss. This systematic review examines the effectiveness of resistance training interventions in maintaining or improving bone mineral density in older adults with rheumatic diseases, an issue of relevance given impaired skeletal integrity linked to these diseases. Articles were included if written in English, published after December 31, 1999, and in peer-reviewed journals with full-text, examined adults aged 65 years and above with diagnosed rheumatic disease, and used prospective longitudinal resistance training interventions on bone mineral density outcomes. Through the Web of Science Core Collection, SPORTDiscus (EBSCOhost), PubMed, ScienceDirect, and Wiley Online Library databases, the search yielded 17 eligible studies, of which 12 were deemed high-quality using the PEDro scale. Results were organized into four themes: (1) Resistance training alone on bone mineral density, (2) Combining resistance training with supplement intake, (3) Pairing resistance training with other exercises, and (4) How resistance training influences balance and fall risk. While most studies showed that resistance training positively impacts bone health, interpretations are limited as supplements or additional exercises were often combined with resistance training. Resistance training interventions appear to be well tolerated in older individuals and generally have a positive impact on bone health. Nevertheless, we propose that future research should focus more on longitudinal resistance training-only interventions to isolate the specific effects of resistance training on bone mineral density, in addition to prioritizing high-quality randomized controlled trials to strengthen the evidence base.

Students need to be properly prepared by their education to work respectfully and effectively with diverse populations and in diverse environments. Our purpose is twofold: (i) to provide a thorough description of the curriculum redesign process for an undergraduate kinesiology and health promotion (KHP) program, and (ii) to use our experience to provide more general recommendations to other departments and universities undergoing curricular redesign. The catalyst for this redesign was the conversion from a quarter-system to a semester-system and the opportunities for improvement identified through that process. The redesign was guided by a newly created departmental strategic plan, faculty professional development trainings, student feedback, faculty hirings and their areas of expertise, and industry demands. Diversity, equity, and inclusion (DEI) was mindfully embedded into the curriculum to reflect the department-, college-, and university-level core value of inclusivity. The redesign allows prospective KHP students to complete several courses that address DEI themes, in addition to the courses that build their technical competencies. Providing foundational exposure to DEI concepts through the undergraduate curriculum can better prepare students to work in diverse settings. As such, this report provides other programs with a framework to follow to make curriculum more DEI centric for their students.

Occupational therapists can currently enter clinical practice with either a master’s or clinical doctorate-level degree, as mandated by the American Occupational Therapy Association (AOTA); however, the single vs. dual points of entry remains a topic of debate among practitioners and stakeholders. This systematic review addresses the question of whether existing knowledge around this topic provides defensible policy decision making. As such, the overarching objective was to expound on this current issue in education by aggregating existing literature and synthesizing data related to entry mandates to practice occupational therapy (OT). From 20 May to 20 June 2021, a systematic search of three electronic scientific databases (Web of Science, PubMed, and Sports Medicine and Education Index) and the Google Scholar database was performed. Following the 2020 PRSIMA guidelines, a total of 15 articles met our established inclusion criteria, which included: (1) publication date from 1 January 2008 or later; (2) North American OT programs only; (3) articles that specifically focused on OT and entry-level degree requirements; and (4) articles published in English. Bias was assessed using risk level categorizations recommended by Cochran Collaboration. Participants across the articles included in this review (N = 1749) ranged from OT practitioners and assistants, program directors, and supervisors, to current students, graduates, and faculty. Results were categorized into two central themes related to each side of the debate, and findings indicated that a majority of the participants support maintaining two entry points into the profession, despite compelling arguments having been made for both sides. The authors acknowledge the presence of several limitations in the included studies and advocate that more evidence-based research focusing on objective measures, rather than commentaries and opinions, of clinical performance outcomes between the two OT degree groups is needed to ensure that patient needs continue to be effectively addressed and policy decision making is justifiable.

For the past half-century, the Paralympic Games has continued to grow, evident through increased participation, media recognition, and rising research focus in Para sport. While the competitive pool of athletes has increased, athlete development models have stayed relatively the same. Currently, coaches rely mainly on experiential knowledge, informal communication with colleagues, and theory transferred from able-bodied contexts as main resources to support development for themselves and their athletes. The purpose of this paper was to introduce Newell’s constraint-led model and its multidimensional spectrum and practical scope to address the complexities of athlete development. The model consists of three overarching constraint categories (i.e., individual, task, and environment) along with proposed additional sub-categories to capture nuances associated in Para sport in order to provide additional context to coaches regarding athlete development. Utilizing this theoretical framework, we present a holistic approach for coaches and practitioners to consider while addressing athletes’ short- and long-term developmental plans. This approach highlights the interactions among factors from a wide range of categories that indirectly and directly impact one another and ultimately influence athletes’ developmental processes. It is important to consider the dynamic interaction of constraints over various timescales during development and identify underlying issues to improve athlete experience and maximize developmental opportunities. Coaches and practitioners can use the proposed framework as a guide to key factors to consider for their cohort of athletes. This approach provides a context-specific approach that considers unique factors associated with athletes and their environment.

To date, research has examined the physiological determinants of performance in standardized CrossFit^® (CF) workouts but not without the influence of CF familiarity. Therefore, the purpose of this present study was to examine the predictive value of aerobic fitness, body composition, and total body strength on performance of two standardized CF workouts in CF-naïve participants. Twenty-two recreationally trained individuals (males = 13, females = 9) underwent assessments of peak oxygen consumption (VO₂ peak), ventilatory thresholds, body composition, and one repetition maximum tests for the back squat, deadlift, and overhead press in which the sum equaled the CF Total. Participants also performed two CF workouts: a scaled version of the CF Open workout 19.1 and a modified version of the CF Benchmark workout Fran to determine scores based on total repetitions completed and time-to-completion, respectively. Simple Pearson’s r correlations were used to determine the relationships between CF performance variables (19.1 and modified Fran) and the independent variables. A forward stepwise multiple linear regression analysis was performed and significant variables that survived the regression analysis were used to create a predictive model of CF performance. Absolute VO₂ peak was a significant predictor of 19.1 performance, explaining 39% of its variance (adjusted R² = 0.39, p = 0.002). For modified Fran, CF Total was a significant predictor and explained 33% of the variance in performance (adjusted R² = 0.33, p = 0.005). These results suggest, without any influence of CF familiarity or experience, that performance in these two CF workouts could be predicted by distinct laboratory-based measurements of fitness.

The road to professional baseball illustrates the complexity, variability and non-linearity of athlete development, as players may be drafted from various high school, 2 year, or 4 year programs and then placed into extensive minor league systems. The purpose of this study was to identify the different pathways to Major League Baseball (MLB) and explore their influence on career success. Performance and developmental data of 2,291 American-born MLB players who debuted between 1990 and 2010 were collected using baseball-reference.com. Three performance indicators, career games played (GP), age of debut, and wins above replacement (WAR; player’s total contributions in wins), were coupled with high school, post-secondary, and Minor League Baseball (MiLB) data. Analyses revealed 17 descriptively different pathways to MLB, which were grouped into three main streams based on the last institution attended before entrance into professional baseball. Overall, 63% of the athletes started their career directly after attending a 4 year higher education institution, 23% after high school, and 14% directly after attending a 2 year institution. Interestingly, 78% of the athletes did not sign or were not selected as high school draft picks. Position players drafted or signed from high school debuted in MLB younger (M = 23.99) and averaged significantly more MiLB GP (M = 909.13) than those drafted or signed from a 2 year (M = 25.67 and 834.41 GP) or 4 year institution (M = 25.95 and 752.33 GP). Pitchers signed or drafted from high school also debuted in MLB younger and played more MiLB games, as well as played in more MLB games than players from a 2 year or 4 year institution, F(8, 3,082) = 31.96, p ≤ 0.001. No significant differences of WAR were noted in position players or pitchers. Perhaps pitchers who are drafted from high school are afforded more opportunities to succeed, which may be indicative of sunk cost effects. This is conceivable as these players had the highest average GP but did not accrue a higher WAR. Future research may benefit from the consideration of post-secondary and/or high school statistics in combination with draft selection data, which may have important implications for improving talent identification accuracy.

The development of the field of sport expertise over the past 20 years has been remarkable, and our understanding of the varying factors affecting athlete development and motor skill acquisition has expanded considerably. Recently, there has been a push toward more sophisticated research designs to continue the advancement of our understanding of sport expertise. Even in a population of performers at the highest levels of performance and competition (e.g., participants in professional sports or those who compete at Olympic Games), there are those with obvious superiority compared to others in the cohort, such as those who win “most valuable player” awards or who are elected to the Hall of Fame. This paper builds a case that athletes who reach this level of achievement possess a more advanced level of skill than those at the elite or expert stage and we refer to this stage of development as “eminence.” This paper explores the notion of eminence and provides converging forms of evidence for the division between expertise and eminence. Moreover, it explores the implications of this division for the further examination of skill acquisition across the lifespan.

Comprehensive investigations into the mortality outcomes of elite athletes can assist in decoding risk factors for premature mortality and provide avenues for exploring human health through engagement in sport. As such, the purpose of this study was to comprehensively examine lifespan trends of athletes from the 4 major sports in North America: Major League Baseball (MLB), National Basketball Association (NBA), National Football League (NFL), and National Hockey League (NHL). We hypothesized that proportional death rates would be similar across the 4 sports, when standardizing the data by debut years. Overall, 17 523 of 50 515 (34.7%) athletes were deceased as of the respective data collection cutoff date for their sport, with MLB players having the highest risk of imminent mortality. Professional basketball players generally had the highest relative proportion of death when standardizing data by debut year, although NHL and NFL players who debuted after 2005 had the highest proportion of death. In addition, a 1‐year increase in career length significantly decreased the risk of death (HR: 0.982, 95% CI: 0.978‐0.985), even after adjusting for sport type (HR: 0.977, 95% CI: 0.974‐0.980). Meaningful significance should be considered given the historical and unique nature of the sample. Nevertheless, investigating risk of death differences through different occupational and biological variables can help highlight aversive trends to lifespan that permeate throughout high‐performance athlete populations.

While empirical evidence suggests that elite athletes have superior lifespan outcomes relative to the general population, less is known regarding their causes of death. The purpose of this study was to critically examine the mortality outcomes of deceased National Basketball Association and American Basketball Association players. Death data were collected from publicly available sources until 11 December 2015, and causes of death were categorized using the International Classification of Diseases, Tenth Revision (ICD). Mortality was measured through: i) cause-specific crude death rates (CDR), ii) estimates of death rates per athlete-year (AY), and iii) binary and multinomial regression analyses. We identified 514 causes of death from 787 deceased players (M = 68.1 y ± 16.0) from 16 different ICD groups, 432 of which were from natural causes. Findings showed similar leading causes of death and CDRs to sex- and race-matched controls, higher death rate differences per AY within time-dependent variables (i.e., birth decade, race, and height), and a higher likelihood of dying below the median age of death for black and taller players, although this was highly confounded by birth decade. More complete knowledge of mortality outcomes would provide broad public health applications and disarm harmful stereotypes of elite athlete health.

While factors such as genetics may mediate the relationship between height and mortality, evidence suggests that larger body size may be an important risk indicator of reduced lifespan longevity in particular. This study critically examined this relationship in professional basketball players. We examined living and deceased players who have played in the National Basketball Association (debut between 1946–2010) and/or the American Basketball Association (1967–1976) using descriptive and Kaplan-Meier and Cox regression analyses. The cut-off date for death data collection was December 11, 2015. Overall, 3,901 living and deceased players were identified and had a mean height of 197.78 cm (± 9.29, Range: 160.02–231.14), and of those, 787 former players were identified as deceased with a mean height of 193.88 cm (± 8.83, Range: 167.6–228.6). Descriptive findings indicated that the tallest players (top 5%) died younger than the shortest players (bottom 5%) in all but one birth decade (1941–1950). Similarly, survival analyses showed a significant relationship between height and lifespan longevity when both dichotomizing [χ² (1) = 13.04, p < .05] and trichotomizing [χ² (2) = 18.05, p < .05] the predictor variable height per birth decade, where taller players had a significantly higher mortality risk compared to shorter players through median (HR: 1.30, 95% CI: 1.13–1.50, p < .05) and trichotomized tertile split (HR: 1.40, 95% CI: 1.18–1.68, p <. 05; tallest 33.3% compared to shortest 33.3%) analyses. The uniqueness of examining the height-longevity hypothesis in this relatively homogeneous sub-population should be considered when interpreting these results. Further understanding of the potential risks of early mortality can help generate discourse regarding potential at-risk cohorts of the athlete population.