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Item A Path Analysis Model Examining Parent Perception, Dieting, and Food Behaviors on BMI Among Predominately Hispanic Families with Preschool Children(North Dakota State University, 2022) Quiroz, AliciaChildren and adults continue to suffer from obesity, which poses a great public health threat. This research focused on protective factors for its prevention. Parent’s perception of a healthy child’s body size, parent dieting, child dieting, and food behaviors influence on Hispanic preschool children’s weight (assessed by BMI z-scores and raw BMI) was examined in 534 mother-child dyads. A hypothesized model was constructed and tested through a secondary analysis of baseline data collected in fall 2018 from the South Texas Early Prevention Study Project. All data except BMI, were collected via self-administered questionnaires completed by the parents (or guardians). Path analysis was conducted to identify relationships. The conceptual model consisted of various simple and mediated models (i.e., the age model, the perception model, the parent model, and the child model). Inside each of these models, several paths were found to be statistically significant. Within the parent-mediated model, perception of a healthy child’s body size and parent’s dieting had a statistically significant effect on raw BMI. Within the full model, age, parent’s dieting, and child’s dieting had the greatest effects on child’s BMI z-score. As a result, children whose mothers were currently dieting are significantly more likely to diet and gain weight. This effect increased with age. Mothers are crucial to the development of children, and a great deal of research has confirmed this. Perceptions of weight, shape, and appearance are sociocultural values passed on by mothers. Therefore, it is critical to ensure that parents have healthy behaviors not only for themselves but for the sake of their children. As the population of Hispanics increases in the United States, it is important to continue to examine this area in this population.Item An Investigation of Physical Activity and Cardiorespiratory Fitness in Career Firefighters(North Dakota State University, 2018) Barry, Allison MichelleFirefighters are responsible for protecting citizens as well as the infrastructure of cities across the United States. In order to safely protect and perform on-duty tasks, firefighters must be capable of performing physiologically demanding skills. Emerging evidence has led to heightened concern for firefighters’ increased obesity levels and decreased physical activity (PA). Formal exercise and PA research specific to firefighters is lacking. More specifically, there is a lack of literature using accelerometers to objectively measure PA. There is more evidence, however, to demonstrate firefighters have a high prevalence of obesity surpassing the general population. Not only are firefighters overweight and inactive, but also they are not aerobically fit to adequately perform their job-specific tasks. Purpose: To examine the relationship of PA and obesity to cardiorespiratory fitness (CRF). Methods: Firefighters (n=29) wore an accelerometer for eight consecutive on- and off-duty days. The accelerometer was worn on the right hip and tracked sedentary activity, light physical activity (LPA), moderate physical activity (MPA), vigorous physical activity (VPA), and moderate-to-vigorous physical activity (MPVA). Additionally, each participant completed a stage-graded exercise test with submaximal square-wave verification bout to determine maximal oxygen uptake (VO2max). A stepwise linear regression model was conducted using physical activity intensity, body mass index (BMI), and waist circumference (WC) as predictor variables for CRF. Results: According to the World Health Organization BMI categorization, none were normal weight, 20 were overweight, and 9 were obese. Firefighters spent roughly 61% of their waking hours in sedentary activity, 35.4% in LPA, and only 3.6% in MVPA. The two linear regression models were used to investigate whether PA intensity, step count, physical activity rating scale, BMI, or WC were more predictive of VO2max. VPA was predictive of VO2max (F(1,27) = 7.89, R2 = 0.23, p <0.01). Additionally, when BMI and WC were added, only WC was predictive of VO2max (F(1,27) = 11.76, R2 = 0.30, p<0.01). Conclusion: It is imperative fire departments emphasize the importance of cultivating an environment where improved health and wellness is essential for firefighters to adequately perform their physiologically demanding tasks.Item External Ankle Supports Alter Kinematics and Kinetics during Drop-Jump Landing and Forward-Jump Landing Tasks(North Dakota State University, 2014) Okamatsu, HidefusaThis research project was designed to understand the influence of excessively restricting ankle range of motion (ROM) on knee injuries, especially non-contact anterior cruciate ligament (ACL) tear. Participating in physical activity without injuries is important to maintain physically active life style and well-being. To prevent ankle injuries, external ankle supports (EAS) are widely used in sport settings by limiting frontal plane ankle ROM; however, the EAS also restricts sagittal plane ankle ROM that could increase the risk of non-contact ACL injury by intensifying the medial knee displacement (MKD) and ground reaction force (GRF). In this research, the effects of external ankle supports (EAS) on landing mechanics were investigated among 19 physically active college-aged females. Two research manuscripts report the results of this research project. The first manuscript investigated the effect of EAS on landing kinematics and kinetics during a drop-jump landing task. The results demonstrated the use of EAS altered the ankle displacement, total MKD, and vertical GRF; however, no relationship was observed between isokinetic plantar flexor strength and landing mechanics. The second manuscript compared the effect of EAS on landing kinematics and kinetics between drop-jump landing and forward-jump landing tasks. The result exhibited the use of EAS similarly affect ankle displacement, knee displacement, peak MKD in drop-jump landing and forward-jump landing tasks. However, the landing tasks affected the posterior GRF differently, and the EAS altered vertical GRF differently in the two landing tasks. Overall, excessively restricted ankle ROM changed the landing kinematics and kinetics, especially MKD and GRF during landing tasks. Our findings indicate that healthcare professionals should use EAS with care because the overly limited ankle ROM could increase the risk of non-contact knee injuries by increased MKD and GRF. Future research should include an examination of the effect of EAS on the magnitude of ACL strain, an assessment of the strength of the other muscles, an evaluation of the muscular activation during a landing task. These studies help understand the landing techniques and strength training to reduce the risk of non-contact ACL tear among physically active population.Item Changes in Physical Activity and Quality of Life of Cancer Survivors Participating in a Group Exercise Program(North Dakota State University, 2017) Greterman, SarahAlthough cancer survival rates are improving, cancer treatment is often associated with adverse biopsychosocial symptoms, including increased risk of anxiety, depression, and social isolation, and reduced physical fitness and quality of life (QOL) (Courneya, 2003; Howlader, et al., 2012; Rajotte, et al., 2012). Since the early 1990’s, interest in the potential benefits of participation in exercise on the well-being of cancer survivors has been growing (Pinto & Floyd, 2007). Although physical activity (PA) has shown to improve physical functioning and QOL many adverse biopsychosocial effects often impact one’s ability to engage in regular PA, and challenges overall well-being. (Knobf, Musanti, & Dorward, 2007). To overcome some of these barriers, the LIVESTRONG® Foundation partnered with numerous YMCA’s establishing a structured 12-week post-treatment group exercise program for cancer survivors. The purpose of this study was to evaluate changes in PA and QOL among cancer survivors participating in a LIVESTRONG® at the YMCA group-exercise program. Subjects (N=47) participating in a program in Fargo, North Dakota, between July 2011 and August 2014, were grouped into cohorts based on their monthly start date. PA was monitored using the SenseWear armband activity monitor and QOL was assessed using the FACT-G. Both PA and QOL were evaluated at three different time points: end of week 1, week 6, and week 12. Overall, results indicated participants engaged in more than 4 hours of PA each day, with more than 40 minutes of moderate-vigorous PA per day. Furthermore, significant declines in sedentary activity were observed from week 1 to week 6 and week 6 to week 12, based on wear time. In addition, participants started the program with relatively high QOL. All areas of QOL improved, with the most significant improvements correlated with physical well-being. Although it was difficult to determine exact cause and effect relationships relative to participation in the LIVESTRONG® at the YMCA group exercise program, the fact that participants met the minimum ACSM PA recommendations at each time point, expressed a significant decline in sedentary activity, and displayed improvements in QOL is promising.Item Life Skills at a Tribal College: Effects of a Culturally Relevant Educational Intervention on College Retention & Self-efficacy for Healthy Choices among American Indian Tribal College Students(North Dakota State University, 2016) Keith, Jill FabriciusAmerican Indians and Alaskan Natives (AIAN) have the lowest rates of college retention and graduation in the U.S. Additionally, AIAN face health disparities including higher rates of obesity/overweight and Type 2 diabetes. The study purpose was to explore the effects of a culturally relevant life skills curriculum delivered in a family-style environment on self-efficacy, healthy choices, and college retention in tribal college students over four separate semesters. A non-experimental cohort design using mixed methods (quantitative and qualitative) was utilized for the study. Participants in the study (full study completion, n=9; initial participants, n=26) were purposively sampled newly enrolled, academically under-prepared tribal college students. Participant demographics included various tribal affiliations, ages, and number of dependents. Research instruments included pre- and post-questionnaires and pre- and post-telephone interviews. General self-efficacy did not increase significantly, nutrition knowledge increased but not significantly, and nutrition attitudes and beliefs were not different between pre- and post-intervention. Dietary analysis reflected improved intake of healthy choices, however none of the participants met dietary recommendations for any food group. Eating behaviors such as eating in front of the TV decreased. Retention of students within-semester was lower among participants than overall students at the tribal college. However, semester-to-semester retention rates of Life Skills at a Tribal College participants who completed the course were significantly higher than those participants who did not complete the course and significantly higher than overall semester-to-semester retention rates at the tribal college. Qualitative analysis revealed a variety of barriers and strategies for making healthy food choices. Addressing self-efficacy and perception of capabilities regarding making healthy food choices can help AIAN students feel more capable of success and impact the quality of their diet. However, challenges remain to college retention and improving dietary intake to meet recommendations.Item Using Electronic Handgrip Dynamometry to Determine Human Performance in Master's Aged Cyclists and Triathletes(North Dakota State University, 2022) Klawitter, LukusPurpose: This dissertation study sought to examine the correlations of maximal handgrip strength (HGS), rate of HGS force development, and HGS fatigability on lean body mass, peak power, functional threshold power, and aerobic capacity in master’s aged cyclists and triathletes. Methods: A cross-sectional design was utilized and the analytic sample included n=31 master’s aged cyclists and triathletes (age: 49.1±10.4 years). Achievement motivation was self-reported with a Situational Motivation Scale Questionnaire. A stationary bicycle trainer and metabolic cart was used to evaluate peak power and aerobic capacity with standardized protocols. Whole body bioelectrical impedance measured lean body mass. An electronic handgrip dynamometer examined maximal HGS, rate of HGS force development, and HGS fatigability. Results: Maximal HGS was moderately correlated with peak power (r=0.46; p<0.01), lean body mass was moderately correlated with peak power (r=0.48; p<0.01) and negligibly correlated with aerobic capacity (r=0.37; p=0.04). Rate of HGS force development was also moderately correlated with peak power (r=0.36; p=0.04). Maximal HGS was moderately correlated with rate of HGS force development (r=0.63; p<0.01). Moreover, after ranking the measures, maximal HGS was moderately correlated with peak power (r=0.40; p=0.02) and lean body mass was moderately correlated with peak power (r=0.50; p<0.01). Conclusions: The findings from this dissertation study suggests that maximal HGS and rate of HGS force development share a signal with peak power in master’s aged cyclists and triathletes. Further, increased lean body mass is related to greater peak power. Maximal HGS and rate of HGS force development show promise for being utilized in a single protocol as a correlate for peak power when exhaustive testing is not possible, and maintaining lean mass is also advised for human performance in older endurance athletes.Item Interval Training Methods to Increase Performance Markers and Load Carriage in Tactical Professionals(North Dakota State University, 2019) Dicks, Nathan D.Load carriage is an inherent part of the military and other tactical occupations (e.g., law enforcement, firefighters). Variation in load carriage ranges from 7-60 kg and can increase energy expenditure as well as lead to higher injury risk. Various novel training methods such as low-intensity interval training (LIT) in combination with blood flow restriction (BFR) as well as high-intensity interval training (HIT) aim at enhancing critical velocity (CV), aerobic fitness, and load carriage performance. Two investigations identified the feasibility of LIT with BFR and the use of HIT to increase performance and load carriage. Methods: Twelve male participants (21.8 +/- 1.5 yrs) underwent LIT with (BFR-LOAD) and without BFR (LOAD) loaded with 15% of their body mass to compare the acute metabolic and perceptual responses. Next, twenty adult participants (male = 15, female = 5) (age = 21.8 +/- 1.5 yrs) completed 4-weeks of HIT (2 d⋅wk-1) to compare aerobic fitness and load carriage task performance. Results: Metabolic responses (VO2) were elevated 7% during BFR-LOAD (p = .001) compared with BFR familiarization and LOAD Condition. There were significant increases with CV (p = .005) and velocity at VO2max (vVO2max) (p = .037), but there was no statistical difference between the groups. There were load carriage performance improvements for the 3200 m task (p < .001) with a decrease of 9.8% in completion times. Conclusion: There was an increased metabolic response during the BFR-LOAD condition. Thus, there is a potential for BFR to limit the use of load carriage for individuals engaging in rehabilitation and reconditioning programs due to injury. Furthermore, four weeks of 2 d⋅wk-1 HIT was appropriate to see improvements in with aerobic measures of CV and vVO2max as well as improvements in the load carriage task performances. LIT and HIT methods warrant continued research to increase aerobic fitness and load carriage performance.Item Strategies for the Reduction of Adipose Tissue and Retention of Muscle Mass in Overweight Individuals(North Dakota State University, 2020) Kotarsky, Christopher JosephPurpose: The purpose of this study was to determine whether time-restricted feeding (TRF) was an effective dietary strategy for reducing fat mass and preserving fat-free mass while evaluating potential changes in cardiometabolic biomarkers, hormones, muscle performance, and energy and macronutrient intake after eight weeks of aerobic exercise and resistance training in overweight and obese adults. Methods: This study was a randomized, controlled trial. Sedentary, overweight and obese adults (mean ± SD; age: 44.48 ± 7.28 years; BMI: 29.61 ± 2.62 kg/m2; females: 85.71%; males: 14.29%) were randomly assigned to a TRF or normal feeding (NF) dietary strategy group. The TRF group consumed all calories between 1200 and 2000 hours, whereas the NF group ate their typical diet. All groups completed eight weeks of aerobic exercise and supervised resistance training. Body composition, muscle performance, energy and macronutrient intake, physical activity, and physiological variables were assessed week zero and week nine. Results: A total of 21 participants completed the study (NF: n = 10; TRF: n = 11). A mild energy restriction was seen for the TRF (~300 kcal/day, 14.0%) and NF (~250 kcal/d, 11.0%) groups between baseline and week seven. Losses of total body mass were significantly greater for TRF (3.3%) relative to NF (0.2%), of which TRF had significantly greater losses of fat mass (9.0%) compared to NF (3.3%) despite similar reductions in energy intake. Lean mass increased across the intervention for both TRF (0.6%) and NF (1.9%), with no group differences. Conclusion: These data support the use of TRF and concurrent exercise training as a short-term dietary strategy for reducing fat mass and preserving lean mass in overweight and obese adults.Item Barriers and Strategies to Optimize Diabetes Management in Emerging Adults with Type 1 Diabetes(North Dakota State University, 2021) Sawyer, Bailee CatherineEmerging adults aged 18 – 30 years with type 1 diabetes (T1DM) make unique lifestyle choices that can create complications for disease management. The objective of this study was to identify barriers and strategies for management of T1DM in young adults (YA). A non-experimental, causal-comparative, observational cross-sectional study using both quantitative and qualitative methods was utilized for the study. In May 2020, YA with T1DM (n = 115; mean age diagnosed 14 ± 7.23) aged 18 – 30 years (64% in age group 25 – 30 years) were recruited to complete the Managing Diabetes in Young Adults Survey. Participant self-reported biomarkers and demographics. The survey included: T1DM management questions from the Diabetes Empowerment Scale (DES), the Diabetes Self-Management Questionnaire (DSMQ), the Diabetes Eating Problems Survey – Revised (DEPS-R), and select questions from the Centers for Disease Control Youth Risk Behavior Surveillance System (YRBSS). Qualitative methods included a telephone interview. From the survey, ‘good’ glycemic control (GC) was associated with higher DSMQ overall scores (p = 0.0003) and the DSMQ glucose management subscale (p = 0.0027) compared to ‘medium’ and ‘poor’ GC. Participants with ‘good’ GC were observed to have higher eating disorder/disordered eating risk (DEPS-R score 20) than the ‘medium’ GC group (mean 28.60 ± 6.86 vs. mean 22.17 ± 2.56, p = 0.0320). Participants who drank more alcohol per session and per week were more likely to adjust dietary intake and insulin dosage: (F (1,114) = 9.52, R^2=0.0770,p=0.0026), (F (1,114) = 5.14, R^2=0.0431,p= 0.0253). There was a weak negative association observed from the Spearman correlation coefficient (-0.0755; 95% CI -0.2665, 0.1154) for ‘good’ GC and those who are at risk for low blood glucose during physical activity. Qualitative examination exposed various barriers and strategies for T1DM management. From the survey participants, 21 volunteered for the telephone interview (female = 19, male = 2) (diagnosed age: mean 15.00 ± 8.00). Barrier themes included physiology, environment, and insurance and subthemes, mental health, lack of social support and weather. Strategy themes included medical technology, social support, and physical activity; and strategy subthemes, supplies, compliance, social media and accountability.Item Appraising Anterior Cruciate Ligament Injury Risk: Single-Legged Jump-Landing Dynamic Postural Stability(North Dakota State University, 2022) Bond, ColinAppraising anterior cruciate ligament (ACL) injury risk is of great interest to the orthopedic and sports medicine professional. Due to the high prevalence of non-contact ACL injuries, professionals have sought to identify intrinsic and modifiable neuromuscular and biomechanical risk factors to aid in the design of injury risk screens that have the discriminatory capacity to stratify ACL injury risk and the efficiency to be implemented at-scale. Prospective studies have revealed that poor dynamic postural stability (DPS), quantified as time to stabilization (TTS), following a backwards single-legged jump-landing (BSLJL) and poor hip external rotation and abduction strength relative to body weight, quantified using a handheld dynamometer, are two risk factors for ACL injury. The purposes of this study were to assess the effects of repeated BSLJL on within-session motor learning as quantified by DPS, evaluate the reliability of DPS, and determine the relation between DPS, hip strength, and fatigue. Twenty-seven recreationally active college-aged adults (24.0 ± 2.8 y, 1.73 ± 0.08 m, 75. ± 14.0 kg) were enrolled in this semi-randomized, cross-over study. During visit one, subjects completed 10 BSLJL trials per leg without familiarization and had their hip external rotation and abduction strength measured. During visits two through four, subjects complete two fatigue sessions and one control session in a randomized order. During these sessions, subjects completed two sets of three BSLJL trials per leg separate by either a seated rest in a chair (control) or a short-term functional fatigue protocol (fatigue). DPS was quantified as TTS and the dynamic postural stability index (DPSI). To appropriately familiarize a subject to the BSLJL, results suggest that a minimum of six familiarization trials per leg are required to sufficiently reduce the motor learning effect. Results also indicate that TTS reliability is poor after 10 trials per leg whereas DPSI reliability is good after just two trials per leg and excellent after just six trials per leg. Finally, results indicate that following completion of a fatigue protocol, there are decrements in TTS, but not in DPSI. Further, greater hip abduction strength is associated with better DPSI when rested and fatigued, but not TTS.
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