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Aviva Zeev

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Krishna Prasad Miyapuram

Indian Institute of Technology Gandhinagar

David Pierre Leibovitz

Carleton University

Kansas State University

Omar-fauzee Mohd Sofian

UPM - Universiti Putra Malaysia

Appalachian State University

University of California, Irvine

Angelica Kaufmann

Università degli Studi di Milano - State University of Milan (Italy)

Evangelos Bebetsos

Democritus University of Thrace

Leiden University

Mark A Schmuckler

University of Toronto

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Papers by Aviva Zeev

Achilles Tendon and Patellar Tendon Structure in Combat Soldiers Following Prevention Exercises

Military Medicine, 2022

Introduction Military training that increases physical stress on musculoskeletal morphology also ... more Introduction Military training that increases physical stress on musculoskeletal morphology also increases the risk of orthopedic injuries. Somatosensory prevention programs that reduce stress and improve functionality could be beneficial for better organization of tendon structure. The aim of this study was to investigate the impact of a somatosensory prevention exercise on the tendon structure (percentage of echo-type fibers; A-P and M-L diameters and cross-sectional area) of the Achilles tendon and patellar tendon among combat soldiers. Materials and Methods These tendons of male Infantry soldiers aged 18-21 were screened before and after a 14-week training course. The intervention group, who performed preventative exercises, included 108 soldiers (BMI = 23.85 ± 2.76), while the control group, who participated in the same military course without these exercises, included 98 soldiers (BMI = 24.26 ± 4.03). Ultrasound scanning for tendon structure included percent of echo-type I-IV ...

Achilles Tendon Tissue Structure in Children with Overweight and Children with Obesity

Physical & Occupational Therapy In Pediatrics, 2019

Aim: To investigate differences in Achilles tendon structure between children with overweight/obe... more Aim: To investigate differences in Achilles tendon structure between children with overweight/obesity and children with normal weight. Methods: Twenty-two children with obesity, 10 children with overweight, and 44 children with normal weight participated in the study. BMI% was calculated. The Achilles tendon was examined using ultrasound tissue characterization (UTC) imaging to capture a three-dimensional structure of four echo-type fibers and a cross-sectional area. Results: A significantly higher percentile of echo-types II, a lower percentile of echo-types III and IV, and a lower cross-sectional area were found for children with normal weight compared with children with overweight/obesity (p < .05). Following a piecewise linear regression model according to tendon structure, a BMI percentile of 75% was found to be the most accurate cutoff point of the children into the "unaffected" (BMI% <75%) and "affected" tendon structure groups (BMI% ! 75%), as the children with BMI%!75% already had an Achilles tendon structure similar to that of the children with overweight/obesity. Conclusions: Tendon integrity as examined with UTC differs between children with obesity and children with normal weight. Children with a BMI percentile of !75 already demonstrate a different tendon structure pattern compared with children with BMI percentile of <75. This may put children with obesity at a greater risk of injury and should be addressed when applying an exercise program for children with overweight/obesity.

The Influence of a 14-Week Infantry Commanders Courses on the Achilles Tendon and Patellar Tendon Structure

Military Medicine, 2021

Introduction Alternated tendon structure may raise stress to the musculoskeletal structures and m... more Introduction Alternated tendon structure may raise stress to the musculoskeletal structures and may increase the potential for overuse injury. Screening the tendon structure of soldiers pre- and post-participation in a strenuous combat course is essential. The aim of the present study was to investigate the influence of a 14-week infantry commanders courses on the Achilles tendon (AT) structure and patellar tendon (PT) structure in combat soldiers. Materials and Methods Ninety-eight participants from an infantry commanders course were screened pre- and post-course for the AT and PT structures, using ultrasonographic tissue characterizaton (UTC) imaging to capture a 3D structure of four echo-type fibers (I-IV). Results In both tendons, the mean relative frequency of echo-type I fibers significantly decreased from pre- to post-testing, with a significant increase in the relative frequency of echo-types II, III, and IV fibers. In the AT, 60.2% of the subjects showed positive difference...

Adherence to physical activity recommendations and the influence of socio-demographic correlates – a population-based cross-sectional study

BMC Public Health, 2008

Background: Current physical activity guidelines acknowledge the importance of total health enhan... more Background: Current physical activity guidelines acknowledge the importance of total health enhancing physical activity (HEPA) compared to leisure time physical activity or exercise alone. Assessing total HEPA may result in different levels of adherence to these as well as the strength and/or direction of associations observed between total HEPA and socio-demographic correlates. The aim of this study was to estimate the proportion of the population adhering to the recommendation of at least 30 minutes of HEPA on most days, and to examine the influences of socio-demographic correlates on reaching this recommendation. Methods: Swedish adults aged 18-74 years (n = 1470) were categorized, based on population data obtained using the IPAQ, into low, moderately and highly physically active categories. Independent associations between the physical activity categories and socio-demographic correlates were studied using a multinomial logistic regression. Results: Of the subjects, 63% (95% CI: 60.5-65.4) adhered to the HEPA recommendation. Most likely to reach the highly physical active category were those aged < 35 years (OR = 1.8; 95% CI: 1.1-3.3), living in small towns (OR = 1.8; 95% CI: 1.1-2.7) and villages (OR = 2.4; 95% CI: 1.6-3.7), having a BMI between 25.0-29.9 kg/m 2 (OR = 2.7; 95% CI: 1.4-5.3) having a BMI < 25 kg/m 2 (OR = 2.5; 95% CI: 1.3-4.9), or having very good (OR = 2.1; 95% CI: 1.3-3.3) or excellent self-perceived health (OR = 4.1; 95% CI: 2.4-6.8). Less likely to reach the high category were women (OR = 0.6; 95% CI: 0.5-0.9) and those with a university degree (OR = 0.5; 95% CI: 0.3-0.9). Similar, but less pronounced associations were observed for the moderate group. Gender-specific patterns were also observed. Conclusion: Almost two-thirds of the Swedish adult population adhered to the physical activity recommendation. Due to a large diversity in levels of physical activity among population subgroups, social-ecological approaches to physical activity promotion may be warranted.

Loneliness is associated with an increased risk of sedentary life in older Israelis

Aging & Mental Health, 2013

Objectives: Both loneliness and insufficient physical activity are common in old age. This study ... more Objectives: Both loneliness and insufficient physical activity are common in old age. This study investigated the association between loneliness and adherence to recommended guidelines of physical activity in a national sample of Israelis, and examined whether loneliness was a riskfactor for insufficient physical activity independent of other variables. Methods: A random sample of 1663 (799 men) older adults aged 65+ reported their physical activity routine, and based on official guidelines were categorized as sufficiently active, insufficiently active, and inactive. In addition, they were divided into lonely or not lonely based on a single question from the Center for Epidemiologic Studies Depression Scale. Results: Chi-square analyses indicated that loneliness, but not living alone, were inversely related to level of physical activity in both genders. Based on multinomial stepwise logistic regressions body mass index, being religious versus secular, self-rated health, and education were associated with engaging in physical activity in men (Cox & Snell R 2 = 0.202). Lonelinesscontributed significantly to explaining the level of participation in physical activity beyond these variables in women, but not in men (Cox & Snell R 2 = 0.197). Conclusions: Loneliness is associated with an increasing risk of inactivity in advanced age in women. Further research inquiring into whether loneliness is the cause of reduced physical activity or whether physical activity acts as a protective factor against loneliness is needed. Developing and implementing tailored intervention programs that encourage social interaction in combination with a physical activity program are recommended.

Level of physical activity and anthropometric characteristics in old age—results from a national health survey

European Review of Aging and Physical Activity, 2014

Advanced age is associated with degenerative changes in body composition. There is evidence sugge... more Advanced age is associated with degenerative changes in body composition. There is evidence suggesting that changes may vary upon differences in lifestyle, environment, or gender. Physical activity engagement is considered an important component of lifestyle definition. There are suggestions that engaging in physical activity might alleviate degenerative body compositional changes. The objective is to assess the relationship between adherence to recommended guidelines of physical activity and anthropometric parameters in Israeli older adults. Anthropometric measures, including height, weight, and waist circumference, were taken, and BMI was calculated, from a random sample of 1,663 elderly adults (799 men and 864 women), aged 74.31 (±6.05) years old. Participants reported their physical activity habits and, based on official guidelines recommendations, they were divided into sufficiently active, insufficiently active, and inactive groups. One-way ANOVA (level of physical activity) for both genders was conducted for each anthropometric variable. In both genders, an association between level of physical activity and weight, waist circumference, and BMI was found, with lower values among the sufficiently active. In addition, a relationship between level of physical activity and height was indicated among women, implying that the more active women were taller than the less active. In addition to the already known health benefits of physical activity in old age, it is possible that adherence to recommended guidelines of physical activity is associated with favorable anthropometric characteristics.

Active and Healthy Lifestyle – Nationwide Programs in Israeli Schools

Health Promotion International

The World Health Organization (WHO) announced the &amp;amp;amp;amp;#39;Global School Health I... more The World Health Organization (WHO) announced the &amp;amp;amp;amp;#39;Global School Health Initiative&amp;amp;amp;amp;#39; in 1995 following recommendations formulated in the Ottawa Charter for Health Promotion. Hence, the aims of the present study were to describe the various programs for nurturing an active and healthy lifestyle implemented during 2011-12 in schools in Israel, and to identify variables that may explain the success versus lack of success in implementing these programs. Participants were a nationwide representative sample of 126 school principals from six supervisory districts of the Ministry of Education, including six sectors, from the elementary, junior-high and senior-high school levels. Semi-structured telephone interviews were recorded and processed using the ATLAS.ti software for qualitative analysis. Physical education teachers, sciences teachers and social coordinators led the programs&amp;amp;amp;amp;#39; implementation. The programs included four main activities domains: health, physical education, nutrition and sustainability. Three types of program implementation were observed: leading principles, teaching methods, and external programs. Parents were involved mostly in elementary schools. Evidence of program integration into school life was presented by changes in children&amp;amp;amp;amp;#39;s behaviors, whereas difficulties stemmed from lack of budget and teaching hours. Science and physical education lessons constituted the anchor for the programs. The schools needed a committed leader to help conduct and maintain the program. Thus, the role of the school principal was to initiate the idea of developing a program, encourage its implementation, select a leader for the program, and then, most importantly, to reinforce the teachers&amp;amp;amp;amp;#39; enthusiasm.

Longitudinal Study Evaluating Postural Balance of Young Athletes

Perceptual and motor skills, 2016

Repeated anaerobic conditions during athletic performance may cause general and local fatigue tha... more Repeated anaerobic conditions during athletic performance may cause general and local fatigue that result in postural balance deficit. Evidence suggests that improved postural balance during athletic training may decrease the risk for fallings and traumatic injuries among athletes. Twenty athletes (12 girls, 8 boys) and 20 controls (12 girls, 8 boys) ages 10-15 years participated in the current study. All athletes were active in an 8-month physical activity program, 3 times per week for 90 min., specific to basketball, soccer, or athletic training. The control children participated in physical education at school only, with no involvement in organized extracurricular sports. All participants were evaluated for postural balance in three assessments over one year (at 4-mo intervals); the Interactive Balance System machine (Tetrax device) was used to assess balance at three test times (pre-, post-, and 10 min) after a session of a repeated sprint anaerobic test, consisting of 12 × 20 m...

Effects of walking speed on asymmetry and bilateral coordination of gait

Gait & Posture, 2013

The mechanisms regulating the bilateral coordination of gait in humans are largely unknown. Our o... more The mechanisms regulating the bilateral coordination of gait in humans are largely unknown. Our objective was to study how bilateral coordination changes as a result of gait speed modifications during over ground walking. 15 young adults wore force sensitive insoles that measured vertical forces used to determine the timing of the gait cycle events under three walking conditions (i.e., usual-walking, fast and slow). Ground reaction force impact (GRFI) associated with heel-strikes was also quantified, representing the potential contribution of sensory feedback to the regulation of gait. Gait asymmetry (GA) was quantified based on the differences between right and left swing times and the bilateral coordination of gait was assessed using the phase coordination index (PCI), a metric that quantifies the consistency and accuracy of the anti-phase stepping pattern. GA was preserved in the three different gait speeds. PCI was higher (reduced coordination) in the slow gait condition, compared to usual-walking (3.51% vs. 2.47%, respectively, p=0.002), but was not significantly affected in the fast condition. GRFI values were lower in the slow walking as compared to usual-walking and higher in the fast walking condition (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Stepwise regression revealed that slow gait related changes in PCI were not associated with the slow gait related changes in GRFI. The present findings suggest that left-right anti-phase stepping is similar in normal and fast walking, but altered during slow walking. This behavior might reflect a relative increase in attention resources required to regulate a slow gait speed, consistent with the possibility that cortical function and supraspinal input influences the bilateral coordination of gait.

Injuries in female dancers aged 8 to 16 years

Journal of athletic training

Most studies of injured dancers have been carried out on professional adult dancers; data on youn... more Most studies of injured dancers have been carried out on professional adult dancers; data on young, nonprofessional injured dancers are sparse. To identify the types of injuries sustained by recreational dancers and to examine their association with age, joint range of motion, body structure, age at menarche, presence of anatomic anomalies, and physical burden (i.e., practice hours en pointe). Descriptive epidemiology study. The Israel Performing Arts Medicine Center, Tel Aviv. A total of 569 injured female dancers, aged 8 to 16 years. Dependent variables were 61 types of current injuries that were later classified into 4 major categories: knee injuries, foot and ankle tendinopathy, back injuries, and other injuries. Independent variables were age, joint range of motion, body size and shape, age at menarche, anatomic anomalies, and dance discipline (e.g., hours of practice per week en pointe). At least 1 previous injury had been sustained by 42.4% of the dancers. The most common inj...

Adolescents' physical activity habits - results from a national health survey

Child: Care, Health and Development, 2013

The MABAT Youth National Health and Nutrition Survey was conducted in Israel by the Ministry of... more The MABAT Youth National Health and Nutrition Survey was conducted in Israel by the Ministry of Health and the Center for Disease Control. This article presents results of physical activity (PA) habits in Israel, in relation to recommendations by world health organizations. Participants were 6274 adolescents, grades 7-12, enrolled in a cross-sectional, representative, school-based survey. Sufficient level of PA was defined as any moderate and vigorous level of PA that adds up daily to 60 min/day. Light PA was considered to be an insufficient level of PA. Only 10.5% of the participants reported performing sufficient PA. Large gender differences were found, with 17.7% of boys versus only 4.6% of girls meeting the guidelines. Results highlight the need to develop programmes for school children in Israel to promote PA. Such programmes have been initiated in many countries that have a large percentage of adolescents with a sedentary lifestyle.

Posturography Characteristics of Obese Children with and Without Associated Disorders 1

Perceptual and Motor Skills, 2013

A group of 59 obese children ages 6–12 years were interviewed for current medical diagnoses (e.g.... more A group of 59 obese children ages 6–12 years were interviewed for current medical diagnoses (e.g., Attention Deficit Hyperactivity Disorder- ADHD, and clumsiness) and later were examined posturographically for balance and stability. General stability of all the obese children deviated significantly from norms. 32.2% of the obese children had a pattern of balance that could indicate orthopedic problems. Obese children with ADHD or perceived clumsiness had significantly worse balance and postural performance compared to other obese children. Balance and posture among obese children without suspicion of problems were similar to non-obese controls. In conclusion, obese children with associated disorders (such as ADHD and perceived clumsiness) manifested disturbance in balance control. Thus, physical activity interventions for these children should include safety measures to decrease the chances of falling and subsequent injury.

Motivation dimensions for running a marathon: A new model emerging from the Motivation of Marathon Scale (MOMS)

Journal of Sport and Health Science, 2015

The aim of this study was to test and expand the Motivation of Marathoners Scale (MOMS) model (Ma... more The aim of this study was to test and expand the Motivation of Marathoners Scale (MOMS) model (Masters et al., 1993). The MOMS questionnaire was distributed to 306 male and female marathon runners (age range: 20-77 years) with experience in marathon running (range: 1-44 runs). A confirmatory factor analysis (CFA) revealed that the original model failed to fit the data. Hence, exploratory factor analysis (EFA) was performed to test the best factorial solution for the current data, and a subsequent CFA was performed on the revised factorial structure. Then, a series of EFAs using maximum likelihood factor extraction method were performed. The best structure solution for model-data fit resulted in 11 factors: psychological coping-emotional-related coping, psychological coping-everyday-life management, life meaning, self-esteem, recognition, affiliation, weight concerns, general health orientation-reduced disease prevalence and longevity, general health orientation-keep fit, competition, and personal goal achievement. This study provides a sound and solid framework for studying motivation for physically demanding tasks such as marathon runs, and needs to be similarly applied and tested in studies incorporating physical tasks which vary in mental demands.

Psychological functioning and adherence to the recommended dose of physical activity in later life: results from a national health survey

by Tal Shimony, Sima Zach, R. Goldsmith, and Aviva Zeev

International Psychogeriatrics, 2012

Background: Official health organizations have established the dose of physical activity needed f... more Background: Official health organizations have established the dose of physical activity needed for preserving both physical and psychological health in old age. The objective of this study was to explore whether adherence to the recommended criterion of physical activity accounted for better psychological functioning in older adults in Israel.

Reasons attributed to omitting exercising: A population‐based study

by Gershon Tenenbaum and Aviva Zeev

International Journal of Sport and Exercise Psychology, 2008

... YAEL NETZ1, AVIVA ZEEV1, MICHAL ARNON1, AND GERSHON TENENBAUM2 ... 1999; Owen &amp;amp; B... more ... YAEL NETZ1, AVIVA ZEEV1, MICHAL ARNON1, AND GERSHON TENENBAUM2 ... 1999; Owen &amp;amp; Bauman, 1992), and in women (Ainsworth, 2000; Hall, 1998; Johnson, Corrigan, Dubert, &amp;amp; Gramling, 1990; Yoshida, Allison, &amp;amp; Osborn, 1988; Zhu, Timm, &amp;amp; Ainsworth, 2001). ...

Low back pain: Reliability of a set of pain measurement tools

Jacob T, Baras M, Zeev A, Epstein L. Low back pain: reliability of a set of pain measurement tool... more

A Longitudinal, Community-Based Study of Low Back Pain Outcomes

Spine, 2004

To assess the report of low back pain (LBP) over 1 year and its predictors in individuals reporti... more To assess the report of low back pain (LBP) over 1 year and its predictors in individuals reporting symptoms during an initial cross-sectional survey. A longitudinal community-based study. The natural history of LBP is poorly understood. Different studies report various rates of persistent and recurrent symptoms as well as different predictors of outcomes. Subjects from a single town in Israel reporting low back pain during the previous month were followed up after 2 and 12 months. The primary outcome was experiencing LBP and the secondary outcomes were pain and functional status as measured by the Roland &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Morris Disability questionnaire and Pain Symptoms Frequency and Bothersomeness Indexes. More than three fourths reported LBP (different levels of severity) after 2 and 12 months. This group did not show an improvement in pain measures. Baseline pain characteristics and perception of general health were predictors of both primary and secondary outcomes. Work satisfaction and experiencing a negative event during the past months were also predictors of the secondary outcomes. In this community-based study, LBP symptoms after 1 year are common and symptoms of those experiencing LBP at follow up do not improve over time. Predictors of experiencing LBP and of LBP symptoms after 1 year included baseline pain characteristics and psychosocial factors.

Morphological characteristics of the young scoliotic dancer

Physical Therapy in Sport, 2013

Background: The literature lacks important data about the relationship between scoliosis and grow... more Background: The literature lacks important data about the relationship between scoliosis and growth process, scoliosis and intensive exercise, scoliosis and morphological characteristics, and scoliosis and injuries, among young dancers. Objective: The aims of the present study were to determine the extent to which dance experience, body structure, anatomical anomalies and injuries are associated with scoliosis, and to identify variables able to discriminate between scoliotic and non-scoliotic female dancers at time of screening. Design: Cross-sectional cohort study. Methods: One thousand two hundred and eighty-eight non-professional female dancers, aged 8e16 years, were screened for the current study. We determined their morphometrical profile (height, weight, BMI), dance discipline (as hours of practice per week), manifestation of anatomical anomalies, and existing injuries. All dancers were clinically examined for presence of scoliosis. Results: Three hundred and seven of the 1288 dancers (23.8%) were diagnosed as having scoliosis. Dance experience and body structure were similar for dancers with or without scoliosis. Scoliotic dancers presented a significantly higher prevalence of anatomical anomalies (such as genu varum, and hallux valgus). Back injuries were more common among scoliotic dancers compared to non-scoliotic dancers. Conclusion: Screening and identifying the young scoliotic dancers prior to their advancing to higher levels of exercise is recommended. The scoliotic dancers should realize that there might be a connection between the presence of scoliosis and increased incidence of anatomical anomalies and back pain, hence, it should be suggested they seek help with an adequate assessment and exercise rehabilitation program.

Physical Activities and Low Back Pain: A Community-Based Study

Medicine & Science in Sports & Exercise, 2004

Very little is known about the relationship between physical activity and low back pain (LBP) in ... more Very little is known about the relationship between physical activity and low back pain (LBP) in general populations. This study aimed to evaluate the relationship between different dimensions of physical activity and LBP among all adults of a defined community. A cross-sectional survey addressed all adults aged 22-70 of a single town. Inhabitants were asked to complete a self-administered questionnaire regarding physical activities, LBP, and related characteristics. The Beacke Physical Activity Questionnaire evaluated physical activity, and the Modified Roland and Morris Disability Questionnaire, a pain severity scale, and the Pain Symptoms Frequency and Bothersomeness Indices evaluated LBP. High occupational activity demands contributed to increased LBP prevalence, and, conversely, high sporting activity participation contributed to a decline in all LBP measures. Subjects free of LBP and subjects who participate in sporting activities are more likely not to smoke and not to participate in high occupational activity demands. Type of sporting activity was not associated with LBP prevalence or severity. Different dimensions of physical activity yield different relationships to LBP. There are several shared characteristics of those participating in sport on a regular basis and those free of LBP. Both groups present a healthier lifestyle. Although LBP was less frequent among those who participate in sporting activities, participating in sporting activities did not contribute independently to a lower prevalence of LBP. However, once LBP was established, participating in sporting activities contributed indirectly to its severity.

Extrinsic and intrinsic risk factors associated with injuries in young dancers aged 8–16 years

by Youssef Masharawi and Aviva Zeev

Journal of Sports Sciences, 2012

Achilles Tendon and Patellar Tendon Structure in Combat Soldiers Following Prevention Exercises

Military Medicine, 2022

Introduction Military training that increases physical stress on musculoskeletal morphology also ... more Introduction Military training that increases physical stress on musculoskeletal morphology also increases the risk of orthopedic injuries. Somatosensory prevention programs that reduce stress and improve functionality could be beneficial for better organization of tendon structure. The aim of this study was to investigate the impact of a somatosensory prevention exercise on the tendon structure (percentage of echo-type fibers; A-P and M-L diameters and cross-sectional area) of the Achilles tendon and patellar tendon among combat soldiers. Materials and Methods These tendons of male Infantry soldiers aged 18-21 were screened before and after a 14-week training course. The intervention group, who performed preventative exercises, included 108 soldiers (BMI = 23.85 ± 2.76), while the control group, who participated in the same military course without these exercises, included 98 soldiers (BMI = 24.26 ± 4.03). Ultrasound scanning for tendon structure included percent of echo-type I-IV ...

Achilles Tendon Tissue Structure in Children with Overweight and Children with Obesity

Physical & Occupational Therapy In Pediatrics, 2019

Aim: To investigate differences in Achilles tendon structure between children with overweight/obe... more Aim: To investigate differences in Achilles tendon structure between children with overweight/obesity and children with normal weight. Methods: Twenty-two children with obesity, 10 children with overweight, and 44 children with normal weight participated in the study. BMI% was calculated. The Achilles tendon was examined using ultrasound tissue characterization (UTC) imaging to capture a three-dimensional structure of four echo-type fibers and a cross-sectional area. Results: A significantly higher percentile of echo-types II, a lower percentile of echo-types III and IV, and a lower cross-sectional area were found for children with normal weight compared with children with overweight/obesity (p < .05). Following a piecewise linear regression model according to tendon structure, a BMI percentile of 75% was found to be the most accurate cutoff point of the children into the "unaffected" (BMI% <75%) and "affected" tendon structure groups (BMI% ! 75%), as the children with BMI%!75% already had an Achilles tendon structure similar to that of the children with overweight/obesity. Conclusions: Tendon integrity as examined with UTC differs between children with obesity and children with normal weight. Children with a BMI percentile of !75 already demonstrate a different tendon structure pattern compared with children with BMI percentile of <75. This may put children with obesity at a greater risk of injury and should be addressed when applying an exercise program for children with overweight/obesity.

The Influence of a 14-Week Infantry Commanders Courses on the Achilles Tendon and Patellar Tendon Structure

Military Medicine, 2021

Introduction Alternated tendon structure may raise stress to the musculoskeletal structures and m... more Introduction Alternated tendon structure may raise stress to the musculoskeletal structures and may increase the potential for overuse injury. Screening the tendon structure of soldiers pre- and post-participation in a strenuous combat course is essential. The aim of the present study was to investigate the influence of a 14-week infantry commanders courses on the Achilles tendon (AT) structure and patellar tendon (PT) structure in combat soldiers. Materials and Methods Ninety-eight participants from an infantry commanders course were screened pre- and post-course for the AT and PT structures, using ultrasonographic tissue characterizaton (UTC) imaging to capture a 3D structure of four echo-type fibers (I-IV). Results In both tendons, the mean relative frequency of echo-type I fibers significantly decreased from pre- to post-testing, with a significant increase in the relative frequency of echo-types II, III, and IV fibers. In the AT, 60.2% of the subjects showed positive difference...

Adherence to physical activity recommendations and the influence of socio-demographic correlates – a population-based cross-sectional study

BMC Public Health, 2008

Background: Current physical activity guidelines acknowledge the importance of total health enhan... more Background: Current physical activity guidelines acknowledge the importance of total health enhancing physical activity (HEPA) compared to leisure time physical activity or exercise alone. Assessing total HEPA may result in different levels of adherence to these as well as the strength and/or direction of associations observed between total HEPA and socio-demographic correlates. The aim of this study was to estimate the proportion of the population adhering to the recommendation of at least 30 minutes of HEPA on most days, and to examine the influences of socio-demographic correlates on reaching this recommendation. Methods: Swedish adults aged 18-74 years (n = 1470) were categorized, based on population data obtained using the IPAQ, into low, moderately and highly physically active categories. Independent associations between the physical activity categories and socio-demographic correlates were studied using a multinomial logistic regression. Results: Of the subjects, 63% (95% CI: 60.5-65.4) adhered to the HEPA recommendation. Most likely to reach the highly physical active category were those aged < 35 years (OR = 1.8; 95% CI: 1.1-3.3), living in small towns (OR = 1.8; 95% CI: 1.1-2.7) and villages (OR = 2.4; 95% CI: 1.6-3.7), having a BMI between 25.0-29.9 kg/m 2 (OR = 2.7; 95% CI: 1.4-5.3) having a BMI < 25 kg/m 2 (OR = 2.5; 95% CI: 1.3-4.9), or having very good (OR = 2.1; 95% CI: 1.3-3.3) or excellent self-perceived health (OR = 4.1; 95% CI: 2.4-6.8). Less likely to reach the high category were women (OR = 0.6; 95% CI: 0.5-0.9) and those with a university degree (OR = 0.5; 95% CI: 0.3-0.9). Similar, but less pronounced associations were observed for the moderate group. Gender-specific patterns were also observed. Conclusion: Almost two-thirds of the Swedish adult population adhered to the physical activity recommendation. Due to a large diversity in levels of physical activity among population subgroups, social-ecological approaches to physical activity promotion may be warranted.

Loneliness is associated with an increased risk of sedentary life in older Israelis

Aging & Mental Health, 2013

Objectives: Both loneliness and insufficient physical activity are common in old age. This study ... more Objectives: Both loneliness and insufficient physical activity are common in old age. This study investigated the association between loneliness and adherence to recommended guidelines of physical activity in a national sample of Israelis, and examined whether loneliness was a riskfactor for insufficient physical activity independent of other variables. Methods: A random sample of 1663 (799 men) older adults aged 65+ reported their physical activity routine, and based on official guidelines were categorized as sufficiently active, insufficiently active, and inactive. In addition, they were divided into lonely or not lonely based on a single question from the Center for Epidemiologic Studies Depression Scale. Results: Chi-square analyses indicated that loneliness, but not living alone, were inversely related to level of physical activity in both genders. Based on multinomial stepwise logistic regressions body mass index, being religious versus secular, self-rated health, and education were associated with engaging in physical activity in men (Cox & Snell R 2 = 0.202). Lonelinesscontributed significantly to explaining the level of participation in physical activity beyond these variables in women, but not in men (Cox & Snell R 2 = 0.197). Conclusions: Loneliness is associated with an increasing risk of inactivity in advanced age in women. Further research inquiring into whether loneliness is the cause of reduced physical activity or whether physical activity acts as a protective factor against loneliness is needed. Developing and implementing tailored intervention programs that encourage social interaction in combination with a physical activity program are recommended.

Level of physical activity and anthropometric characteristics in old age—results from a national health survey

European Review of Aging and Physical Activity, 2014

Advanced age is associated with degenerative changes in body composition. There is evidence sugge... more Advanced age is associated with degenerative changes in body composition. There is evidence suggesting that changes may vary upon differences in lifestyle, environment, or gender. Physical activity engagement is considered an important component of lifestyle definition. There are suggestions that engaging in physical activity might alleviate degenerative body compositional changes. The objective is to assess the relationship between adherence to recommended guidelines of physical activity and anthropometric parameters in Israeli older adults. Anthropometric measures, including height, weight, and waist circumference, were taken, and BMI was calculated, from a random sample of 1,663 elderly adults (799 men and 864 women), aged 74.31 (±6.05) years old. Participants reported their physical activity habits and, based on official guidelines recommendations, they were divided into sufficiently active, insufficiently active, and inactive groups. One-way ANOVA (level of physical activity) for both genders was conducted for each anthropometric variable. In both genders, an association between level of physical activity and weight, waist circumference, and BMI was found, with lower values among the sufficiently active. In addition, a relationship between level of physical activity and height was indicated among women, implying that the more active women were taller than the less active. In addition to the already known health benefits of physical activity in old age, it is possible that adherence to recommended guidelines of physical activity is associated with favorable anthropometric characteristics.

Active and Healthy Lifestyle – Nationwide Programs in Israeli Schools

Health Promotion International

The World Health Organization (WHO) announced the &amp;amp;amp;amp;#39;Global School Health I... more The World Health Organization (WHO) announced the &amp;amp;amp;amp;#39;Global School Health Initiative&amp;amp;amp;amp;#39; in 1995 following recommendations formulated in the Ottawa Charter for Health Promotion. Hence, the aims of the present study were to describe the various programs for nurturing an active and healthy lifestyle implemented during 2011-12 in schools in Israel, and to identify variables that may explain the success versus lack of success in implementing these programs. Participants were a nationwide representative sample of 126 school principals from six supervisory districts of the Ministry of Education, including six sectors, from the elementary, junior-high and senior-high school levels. Semi-structured telephone interviews were recorded and processed using the ATLAS.ti software for qualitative analysis. Physical education teachers, sciences teachers and social coordinators led the programs&amp;amp;amp;amp;#39; implementation. The programs included four main activities domains: health, physical education, nutrition and sustainability. Three types of program implementation were observed: leading principles, teaching methods, and external programs. Parents were involved mostly in elementary schools. Evidence of program integration into school life was presented by changes in children&amp;amp;amp;amp;#39;s behaviors, whereas difficulties stemmed from lack of budget and teaching hours. Science and physical education lessons constituted the anchor for the programs. The schools needed a committed leader to help conduct and maintain the program. Thus, the role of the school principal was to initiate the idea of developing a program, encourage its implementation, select a leader for the program, and then, most importantly, to reinforce the teachers&amp;amp;amp;amp;#39; enthusiasm.

Longitudinal Study Evaluating Postural Balance of Young Athletes

Perceptual and motor skills, 2016

Repeated anaerobic conditions during athletic performance may cause general and local fatigue tha... more Repeated anaerobic conditions during athletic performance may cause general and local fatigue that result in postural balance deficit. Evidence suggests that improved postural balance during athletic training may decrease the risk for fallings and traumatic injuries among athletes. Twenty athletes (12 girls, 8 boys) and 20 controls (12 girls, 8 boys) ages 10-15 years participated in the current study. All athletes were active in an 8-month physical activity program, 3 times per week for 90 min., specific to basketball, soccer, or athletic training. The control children participated in physical education at school only, with no involvement in organized extracurricular sports. All participants were evaluated for postural balance in three assessments over one year (at 4-mo intervals); the Interactive Balance System machine (Tetrax device) was used to assess balance at three test times (pre-, post-, and 10 min) after a session of a repeated sprint anaerobic test, consisting of 12 × 20 m...

Effects of walking speed on asymmetry and bilateral coordination of gait

Gait & Posture, 2013

The mechanisms regulating the bilateral coordination of gait in humans are largely unknown. Our o... more The mechanisms regulating the bilateral coordination of gait in humans are largely unknown. Our objective was to study how bilateral coordination changes as a result of gait speed modifications during over ground walking. 15 young adults wore force sensitive insoles that measured vertical forces used to determine the timing of the gait cycle events under three walking conditions (i.e., usual-walking, fast and slow). Ground reaction force impact (GRFI) associated with heel-strikes was also quantified, representing the potential contribution of sensory feedback to the regulation of gait. Gait asymmetry (GA) was quantified based on the differences between right and left swing times and the bilateral coordination of gait was assessed using the phase coordination index (PCI), a metric that quantifies the consistency and accuracy of the anti-phase stepping pattern. GA was preserved in the three different gait speeds. PCI was higher (reduced coordination) in the slow gait condition, compared to usual-walking (3.51% vs. 2.47%, respectively, p=0.002), but was not significantly affected in the fast condition. GRFI values were lower in the slow walking as compared to usual-walking and higher in the fast walking condition (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Stepwise regression revealed that slow gait related changes in PCI were not associated with the slow gait related changes in GRFI. The present findings suggest that left-right anti-phase stepping is similar in normal and fast walking, but altered during slow walking. This behavior might reflect a relative increase in attention resources required to regulate a slow gait speed, consistent with the possibility that cortical function and supraspinal input influences the bilateral coordination of gait.

Injuries in female dancers aged 8 to 16 years

Journal of athletic training

Most studies of injured dancers have been carried out on professional adult dancers; data on youn... more Most studies of injured dancers have been carried out on professional adult dancers; data on young, nonprofessional injured dancers are sparse. To identify the types of injuries sustained by recreational dancers and to examine their association with age, joint range of motion, body structure, age at menarche, presence of anatomic anomalies, and physical burden (i.e., practice hours en pointe). Descriptive epidemiology study. The Israel Performing Arts Medicine Center, Tel Aviv. A total of 569 injured female dancers, aged 8 to 16 years. Dependent variables were 61 types of current injuries that were later classified into 4 major categories: knee injuries, foot and ankle tendinopathy, back injuries, and other injuries. Independent variables were age, joint range of motion, body size and shape, age at menarche, anatomic anomalies, and dance discipline (e.g., hours of practice per week en pointe). At least 1 previous injury had been sustained by 42.4% of the dancers. The most common inj...

Adolescents' physical activity habits - results from a national health survey

Child: Care, Health and Development, 2013

The MABAT Youth National Health and Nutrition Survey was conducted in Israel by the Ministry of... more The MABAT Youth National Health and Nutrition Survey was conducted in Israel by the Ministry of Health and the Center for Disease Control. This article presents results of physical activity (PA) habits in Israel, in relation to recommendations by world health organizations. Participants were 6274 adolescents, grades 7-12, enrolled in a cross-sectional, representative, school-based survey. Sufficient level of PA was defined as any moderate and vigorous level of PA that adds up daily to 60 min/day. Light PA was considered to be an insufficient level of PA. Only 10.5% of the participants reported performing sufficient PA. Large gender differences were found, with 17.7% of boys versus only 4.6% of girls meeting the guidelines. Results highlight the need to develop programmes for school children in Israel to promote PA. Such programmes have been initiated in many countries that have a large percentage of adolescents with a sedentary lifestyle.

Posturography Characteristics of Obese Children with and Without Associated Disorders 1

Perceptual and Motor Skills, 2013

A group of 59 obese children ages 6–12 years were interviewed for current medical diagnoses (e.g.... more A group of 59 obese children ages 6–12 years were interviewed for current medical diagnoses (e.g., Attention Deficit Hyperactivity Disorder- ADHD, and clumsiness) and later were examined posturographically for balance and stability. General stability of all the obese children deviated significantly from norms. 32.2% of the obese children had a pattern of balance that could indicate orthopedic problems. Obese children with ADHD or perceived clumsiness had significantly worse balance and postural performance compared to other obese children. Balance and posture among obese children without suspicion of problems were similar to non-obese controls. In conclusion, obese children with associated disorders (such as ADHD and perceived clumsiness) manifested disturbance in balance control. Thus, physical activity interventions for these children should include safety measures to decrease the chances of falling and subsequent injury.

Motivation dimensions for running a marathon: A new model emerging from the Motivation of Marathon Scale (MOMS)

Journal of Sport and Health Science, 2015

The aim of this study was to test and expand the Motivation of Marathoners Scale (MOMS) model (Ma... more The aim of this study was to test and expand the Motivation of Marathoners Scale (MOMS) model (Masters et al., 1993). The MOMS questionnaire was distributed to 306 male and female marathon runners (age range: 20-77 years) with experience in marathon running (range: 1-44 runs). A confirmatory factor analysis (CFA) revealed that the original model failed to fit the data. Hence, exploratory factor analysis (EFA) was performed to test the best factorial solution for the current data, and a subsequent CFA was performed on the revised factorial structure. Then, a series of EFAs using maximum likelihood factor extraction method were performed. The best structure solution for model-data fit resulted in 11 factors: psychological coping-emotional-related coping, psychological coping-everyday-life management, life meaning, self-esteem, recognition, affiliation, weight concerns, general health orientation-reduced disease prevalence and longevity, general health orientation-keep fit, competition, and personal goal achievement. This study provides a sound and solid framework for studying motivation for physically demanding tasks such as marathon runs, and needs to be similarly applied and tested in studies incorporating physical tasks which vary in mental demands.

Psychological functioning and adherence to the recommended dose of physical activity in later life: results from a national health survey

by Tal Shimony, Sima Zach, R. Goldsmith, and Aviva Zeev

International Psychogeriatrics, 2012

Background: Official health organizations have established the dose of physical activity needed f... more Background: Official health organizations have established the dose of physical activity needed for preserving both physical and psychological health in old age. The objective of this study was to explore whether adherence to the recommended criterion of physical activity accounted for better psychological functioning in older adults in Israel.

Reasons attributed to omitting exercising: A population‐based study

by Gershon Tenenbaum and Aviva Zeev

International Journal of Sport and Exercise Psychology, 2008

... YAEL NETZ1, AVIVA ZEEV1, MICHAL ARNON1, AND GERSHON TENENBAUM2 ... 1999; Owen &amp;amp; B... more ... YAEL NETZ1, AVIVA ZEEV1, MICHAL ARNON1, AND GERSHON TENENBAUM2 ... 1999; Owen &amp;amp; Bauman, 1992), and in women (Ainsworth, 2000; Hall, 1998; Johnson, Corrigan, Dubert, &amp;amp; Gramling, 1990; Yoshida, Allison, &amp;amp; Osborn, 1988; Zhu, Timm, &amp;amp; Ainsworth, 2001). ...

Low back pain: Reliability of a set of pain measurement tools

Jacob T, Baras M, Zeev A, Epstein L. Low back pain: reliability of a set of pain measurement tool... more

A Longitudinal, Community-Based Study of Low Back Pain Outcomes

Spine, 2004

To assess the report of low back pain (LBP) over 1 year and its predictors in individuals reporti... more To assess the report of low back pain (LBP) over 1 year and its predictors in individuals reporting symptoms during an initial cross-sectional survey. A longitudinal community-based study. The natural history of LBP is poorly understood. Different studies report various rates of persistent and recurrent symptoms as well as different predictors of outcomes. Subjects from a single town in Israel reporting low back pain during the previous month were followed up after 2 and 12 months. The primary outcome was experiencing LBP and the secondary outcomes were pain and functional status as measured by the Roland &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Morris Disability questionnaire and Pain Symptoms Frequency and Bothersomeness Indexes. More than three fourths reported LBP (different levels of severity) after 2 and 12 months. This group did not show an improvement in pain measures. Baseline pain characteristics and perception of general health were predictors of both primary and secondary outcomes. Work satisfaction and experiencing a negative event during the past months were also predictors of the secondary outcomes. In this community-based study, LBP symptoms after 1 year are common and symptoms of those experiencing LBP at follow up do not improve over time. Predictors of experiencing LBP and of LBP symptoms after 1 year included baseline pain characteristics and psychosocial factors.

Morphological characteristics of the young scoliotic dancer

Physical Therapy in Sport, 2013

Background: The literature lacks important data about the relationship between scoliosis and grow... more Background: The literature lacks important data about the relationship between scoliosis and growth process, scoliosis and intensive exercise, scoliosis and morphological characteristics, and scoliosis and injuries, among young dancers. Objective: The aims of the present study were to determine the extent to which dance experience, body structure, anatomical anomalies and injuries are associated with scoliosis, and to identify variables able to discriminate between scoliotic and non-scoliotic female dancers at time of screening. Design: Cross-sectional cohort study. Methods: One thousand two hundred and eighty-eight non-professional female dancers, aged 8e16 years, were screened for the current study. We determined their morphometrical profile (height, weight, BMI), dance discipline (as hours of practice per week), manifestation of anatomical anomalies, and existing injuries. All dancers were clinically examined for presence of scoliosis. Results: Three hundred and seven of the 1288 dancers (23.8%) were diagnosed as having scoliosis. Dance experience and body structure were similar for dancers with or without scoliosis. Scoliotic dancers presented a significantly higher prevalence of anatomical anomalies (such as genu varum, and hallux valgus). Back injuries were more common among scoliotic dancers compared to non-scoliotic dancers. Conclusion: Screening and identifying the young scoliotic dancers prior to their advancing to higher levels of exercise is recommended. The scoliotic dancers should realize that there might be a connection between the presence of scoliosis and increased incidence of anatomical anomalies and back pain, hence, it should be suggested they seek help with an adequate assessment and exercise rehabilitation program.

Physical Activities and Low Back Pain: A Community-Based Study

Medicine & Science in Sports & Exercise, 2004

Very little is known about the relationship between physical activity and low back pain (LBP) in ... more Very little is known about the relationship between physical activity and low back pain (LBP) in general populations. This study aimed to evaluate the relationship between different dimensions of physical activity and LBP among all adults of a defined community. A cross-sectional survey addressed all adults aged 22-70 of a single town. Inhabitants were asked to complete a self-administered questionnaire regarding physical activities, LBP, and related characteristics. The Beacke Physical Activity Questionnaire evaluated physical activity, and the Modified Roland and Morris Disability Questionnaire, a pain severity scale, and the Pain Symptoms Frequency and Bothersomeness Indices evaluated LBP. High occupational activity demands contributed to increased LBP prevalence, and, conversely, high sporting activity participation contributed to a decline in all LBP measures. Subjects free of LBP and subjects who participate in sporting activities are more likely not to smoke and not to participate in high occupational activity demands. Type of sporting activity was not associated with LBP prevalence or severity. Different dimensions of physical activity yield different relationships to LBP. There are several shared characteristics of those participating in sport on a regular basis and those free of LBP. Both groups present a healthier lifestyle. Although LBP was less frequent among those who participate in sporting activities, participating in sporting activities did not contribute independently to a lower prevalence of LBP. However, once LBP was established, participating in sporting activities contributed indirectly to its severity.

Extrinsic and intrinsic risk factors associated with injuries in young dancers aged 8–16 years

by Youssef Masharawi and Aviva Zeev

Journal of Sports Sciences, 2012