Sports Medicine Bulletin
Mar. 18, 2014

Active Voice: Physical Activity — A Vital Health Measure
By Leonard A. Kaminsky, Ph.D., FACSM
Active Voice is a column by experts in science, medicine and allied health. The viewpoints expressed do not necessarily reflect positions or policies of ACSM.

Lenny Kaminsky is a professor of exercise science at the Ball State University Human Performance Laboratory. He is the coordinator of the master’s degree program in Clinical Exercise Physiology and Director of the Adult Physical Fitness Program. His research interests center on the unique roles of physical activity, exercise, and physical fitness in the prevention and rehabilitation of chronic disease. He presently chairs an American Heart Association (AHA) Advisory Board, charged with establishing a national cardiorespiratory fitness registry.

This commentary provides an overview of the importance of physical activity assessment, as outlined in an AHA Scientific Statement, which published in late 2013 and developed by a writing group that Dr. Kaminsky co-chaired with Dr. Scott Strath.

Although great strides have been made in treatment of cardiovascular diseases (CVD), these diseases are still responsible for one in every three deaths in the United States. Prevention of CVD, therefore, is being re-emphasized as major goal by many organizations, including the American Heart Association (AHA) and the Centers for Disease Control and Prevention (2020 Impact Goals). A key component of this preventative strategy is to assess CVD risk factors. Although clinicians and allied health professionals do an excellent job of assessing five of the six modifiable CVD risk factors (smoking status, blood pressure, cholesterol, diabetes, and obesity), assessment of physical activity status is seldom performed.

One of the primary reasons for lack of physical activity assessment in the healthcare setting is the wide range of different methods that exist, with no clear understanding which would be the best choice. However, a 2013 Scientific Statement by the AHA now provides clinicians and researchers with an excellent resource to understand physical activity assessment and guide their selection of an appropriate method. Although the purpose of this AHA report was not to provide a comprehensive review of physical activity assessment, it does an excellent job of overviewing related key concepts. These concepts include explaining the four dimensions of physical activity (frequency, intensity, time, and type) and the four physical activity domains (occupational, domestic, transportation, and leisure time). Additionally, it describes the approaches to quantifying physical activity, including the elements of total energy expenditure (kilocalories), metabolic equivalents (METs), or time spent in different intensity levels. The difference between absolute (external work requirement) and relative (compared to the individual’s maximal capacity) intensity also is discussed and explained related to assessment of physical activity. More

Summit on Developing the Healthy Youth Athlete: The Public Health Challenge and Opportunity Tackles Top Issues Facing Youth Sports

ACSM — with a large and extraordinary array of partner organizations, including ESPN Wide World of Sports; the Aspen Institute; the President's Council on Fitness, Sports & Nutrition; the National Youth Sports Health & Safety Institute; the National Council of Youth Sports; and many more — hosted a thought-leading and action-leading summit on "Developing the Healthy Youth Athlete: the Public Health Challenge and Opportunity," Feb. 11-12 at Lake Buena Vista, Fla. The conference blended research and science with real-life examples and community best practices to provide innovative insights and understanding of the hot topics in youth athletics. The summit was only the beginning of an ongoing initiative, but below are some key takeaway messages from the event:

Youth sports are powerfully important at all levels of society with a vast array of complementary benefits for individuals, communities, and countries, but need fundamental change to make them even safer, healthier, more enjoyable, and playing a greater beneficial role for people as youth and throughout the lifespan.

A robust agenda of nationally and internationally prominent speakers and panels called for new approaches to youth sports, and came with solutions as well as a collective call to action. The summit led to a process of thinking anew about youth sports, an exercise in reimagining that takes the current best of youth sports, which is considerable, along with steps that are pressing needs and attractive opportunities for progress.

So, for a moment, let's imagine a new world where every kid between the ages of 6 and 17 has the opportunity to play organized sports — a world where:


Policy Corner: FASEB, Allies Push for NIH Appropriations

Research funding is at stake as the White House and Congress wrangle over the federal budget for FY2015. Jennifer Zeitzer summarizes the process and issues in the following update from FASEB (Federation of American Societies for Experimental Biology), of which ACSM is a member society.

Obama Budget Released; FY 2015 Appropriations Process Underway; Research Champions Seek $32 Billion for NIH

Last week, President Barack Obama released his fiscal year (FY) 2015 budget proposal, requesting an additional $56 billion above the FY 2015 discretionary spending level of $1.014 trillion agreed upon by House Budget Committee Chairman Paul Ryan (R-WI) and Senate Budget Committee Chairwoman Patty Murray (D-WA) in December. Although Obama offset the additional spending with other cuts and changes in the tax code, both Republicans and Democrats on Capitol Hill quickly threw cold water on the proposal.

House Appropriations Committee Chairman Hal Rogers (R-KY) issued a press release expressing his extreme disappointment that the Obama proposal “blatantly disregards the budget limits for fiscal year 2015,” and emphatically stated that the Committee will abide by the spending limit agreed to in the Ryan-Murray budget deal. Senate Appropriations Committee Chairwoman Barbara Mikulski (D-MD) also released a statement pledging that her Committee would adhere to the spending caps in the Ryan-Murray deal.

Following the release of the President’s FY 2015 budget, the Appropriations Committees immediately proceeded with hearings on the individual agency spending requests. The majority of the hearings on the science agency budgets will take place over the next few weeks, with Agriculture Secretary Tom Vilsack scheduled to appear before the House Appropriations Committee on March 14. On March 25, the House Labor, Health and Human Services (LHHS) Appropriations Subcommittee will hold a “Public Witness” hearing to receive testimony from organizations and individuals on behalf of the National Institutes of Health (NIH) and other agencies funded by that panel. The Federation of American Societies for Experimental Biology (FASEB) has requested to testify at that hearing. NIH Director Francis Collins, MD, PhD, is also expected to discuss the agency’s budget with the House LHHS Subcommittee later this month.


ACSM to Participate in Concussion Summit May 2

In its continuing leadership with and engagement on sports concussion, ACSM is involved the 8th Annual National Summit on Sports Concussion: Sports and Concussion Outcomes, which will be held May 2 in Los Angeles.

Following a morning plenary session, participants will follow their choice of three tracks:

The summit, presented by the Sports Concussion Institute, takes place at the Marriott Hotel LAX. To register or for more information, please see the summit website.More

New Travel Award Available: Dr. Lisa Krivickas Clinician/Scholar Travel Award

The American College of Sports Medicine Foundation has announced a new award opportunity to fund travel expenses for one female applicant to present her scholarly work at the ACSM Annual Meeting. One $1,000 USD award will be given. ACSM's 61st Annual Meeting, 5th World Congress on Exercise is Medicine® and World Congress on the Role of Inflammation in Exercise, Health, and Disease, will take place in Orlando, Fla. from May 27 – May 31, 2014. To view requirements and apply, click here. Deadline to apply is April 1.More

View Your Health Insurance Options — ACSM-Sponsored Health Exchange

Sort out your options for health insurance coverage in one convenient place when you visit the American Health Insurance Exchange (AHiX) — available exclusively through ACSM's Member Insurance Program.

The Affordable Care Act (ACA) has broadened access to health insurance but also introduced many new choices for consumers. Through AHiX, you can find coverage in three easy steps:

Click here to enter the AHiX Exchange NOW or call toll-free 1-888-301-8706 and speak with a licensed and certified Exchange Specialist. ACT NOW to view your insurance options or call 1-888-301-8706 to speak with an Exchange Specialist.More

Optimum Performance: A Surprising Paradox Between Running and Walking
The Times-Picayune
Why don't most runners get knee osteoarthritis? This question was posed in a research paper, which appears in the March issue of Medicine & Science in Sports and Exercise — the official journal of the American College of Sports Medicine.

"Most studies on humans have concluded that long-distance running is not associated with an increased risk of knee osteoarthritis. This is not to say that runners are less at risk for knee osteoarthritis compared with non-runners. However, they do not appear to be at greater risk," noted the research.

Osteoarthritis, according to the Mayo Clinic, "is the most common form of arthritis, affecting millions of people around the world. Often called wear-and-tear arthritis, osteoarthritis occurs when the protective cartilage on the ends of your bones wears down over time. While osteoarthritis can damage any joint in your body, the disorder most commonly affects joints in your hands, neck, lower back, knees and hips."

It appears that chronic high knee loads (between surfaces within the knee) are suspected to a play a role in the initiation and development of knee osteoarthritis. Here is where the paradox between walking and running takes hold.More

New Pain Treatment Uses Ultrasound at Home
The Wall Street Journal
The Ache: Ultrasound energy is widely used by physical therapists and other clinicians to treat sports injuries and chronic pain. But because the machines are hand-held, treatment is generally limited to 15 minutes or less. Some scientists think longer treatments will be more effective.

The Claim: New wearable ultrasound devices can be used almost anywhere for four to six hours, sometimes more, at a time.

The Verdict: Several small studies show reduction in pain in the upper back, pelvis and rotator cuff, as well as increased mobility among people with arthritic knees. But the work remains preliminary and larger, more rigorous independent studies are needed to prove the devices' effectiveness, says Stephen G. Rice, a sport medicine doctor in Neptune, N.J., and a fellow of the American College of Sports Medicine. Since the machines cost about $1,000, "I wouldn't be running out to buy one," he adds.More

The Real 'Fat Burn' Zone
You see the "Fat Burn Zone" as a setting on pieces of cardio equipment, but it doesn't mean what you think.

"It's a little misleading in that sense and I think it gives the public a little bit of a false sense of security about what they're doing," says Dr. Tony Kaleth, an exercise physiologist, professor, researcher and marathoner.

The "Fat Burn Zone" — as it's listed on cardio equipment — is simply a lower intensity range where your body burns the highest percentage of fat, but not the most calories of any exercise.

"It really takes the higher intensity exercise to burn more calories," says Kaleth. High intensity exercise takes you to maximum effort very quickly, for example, Crossfit with its explosive moves, or basketball with its sprints and physical drives. Running can also be high intensity when the pace is swift and difficult to sustain.

"There are numerous variations of programs that incorporate both strength and aerobic training into one workout–like Insanity or P90X," says Kaleth. "These programs typically involve alternating muscle group exercises with little rest between sets."More