Joseph F. Signorile’s research while affiliated with University of Miami and other places

Background/Objectives Older Latino persons with HIV (OLPWH) experience early-onset cognitive decline due to specific factors associated with accelerated aging as well as more established risk factors like depression, anxiety, and sedentary behavior. Yet, few behavioral interventions to improve OLPWH’s psychological and cognitive health have been assessed. Thus, this pilot study evaluated the feasibility, acceptability, and preliminary intervention effects of the Happy Older Latinos are Active (HOLA) physical activity health promotion intervention on cognition and mental health among this underserved population. Research Design/Methods Thirty OLPWH (Age: M=61.7 years, SD=6.00 years 40% female, 46.7% less than high-school education) enrolled in a pilot single-arm selective prevention intervention trial evaluating changes in psychological and neurocognitive outcomes at two timepoints (baseline and post intervention). Participants were asked at the end of the study to offer qualitative feedback on their acceptance of and interest in the intervention. Results: Within 7-months, enrollment targets were met (<5% of eligible participants refusing participation) and lost-to-follow up was minimal (10%). Participants attended an average of 54% of sessions and reported a high degree of satisfaction with the intervention via the Client-Satisfaction-Questionnaire-8 (M=30.5, SD=2.2). Significant improvements in cognitive (delayed recall [aRR=1.16], working memory [aRR=0.79], verbal fluency [aRR=1.09]) and psychological (depression [aRR=0.63], and anxiety severity [aRR=0.73]) domains were observed when controlling for age, gender, and education. Discussion/Implications Results indicate that HOLA is an innovative and promising health promotion program that is uniquely tailored to address the multiple cognitive and psychological concerns affecting OLPWH in a non-stigmatizing and culturally acceptable manner.

Purpose: The goal of this study was to assess the changes in choriocapillaris perfusion density (CCD) after 24 weeks of structured high-speed circuit resistance training (HSCT) in healthy older adults. Methods: A total of 30 healthy, cognitively normal adults, 60 years old and above, were recruited for the study. The participants were randomized to either the HSCT group (n = 15) or the control group (CON, n = 15). The HSCT group trained 3 times a week on non-consecutive days for 24 weeks, while the CON group did not perform formal training. Optical coherence tomography angiography (OCTA) was used to image both eyes of each study participant at baseline and 24-week follow-up. The follow-up session was completed within 3 days of the last exercise session for the HSCT group. The CCD was measured within a 2.5-mm in diameter centered on the fovea. Results: There were no significant differences in CCD between baseline and 24-week follow-up in either the HSCT group or the CON group. In the HSCT group, the CCD was 62.6 ± 6.1% (mean ± SD) at baseline and 63.7 ± 6.1% at the 24-week follow-up (p = 0.21). In the CON group, the CCD was 62.8 ± 5.6% at baseline and 63.8 ± 4.9% at 24 weeks (p = 0.18). Conclusion: CCD was unchanged after a 24-week high-speed circuit resistance training in healthy older individuals, suggesting possible regulatory maintenance of choroidal blood flow. Further research with multiple age cohorts may be necessary to corroborate these findings.

The KinaTrax markerless motion capture system, used extensively in the analysis of baseball pitching and hitting, is currently being adapted for use in clinical biomechanics. In clinical and laboratory environments, repeatability is inherent to the quality of any diagnostic tool. The KinaTrax system was assessed on within- and between-session reliability for gait kinematic and spatiotemporal parameters in healthy adults. Nine subjects contributed five trials per session over three sessions to yield 135 unique trials. Each trial was comprised of a single bilateral gait cycle. Ten spatiotemporal parameters for each session were calculated and compared using the intraclass correlation coefficient (ICC), Standard Error of the Measurement (SEM), and minimal detectable change (MDC). In addition, seven kinematic waveforms were assessed from each session and compared using the coefficient of multiple determination (CMD). ICCs for between-session spatiotemporal parameters were lowest for left step time (0.896) and left cadence (0.894). SEMs were 0.018 (s) and 3.593 (steps/min) while MDCs were 0.050 (s) and 9.958 (steps/min). Between-session average CMDs for joint angles were large (0.969) in the sagittal plane, medium (0.554) in the frontal plane, and medium (0.327) in the transverse plane while average CMDs for segment angles were large (0.860), large (0.651), and medium (0.561), respectively. KinaTrax markerless motion capture system provides reliable spatiotemporal measures within and between sessions accompanied by reliable kinematic measures in the sagittal and frontal plane. Considerable strides are necessary to improve methodological comparisons, however, markerless motion capture poses a reliable application for gait analysis within healthy individuals.

Objective: This study sought to evaluate the feasibility, acceptability, and preliminary efficacy of the Happy Older Latinos are Active (HOLA) health promotion intervention in a group of older Latinos who were at risk for developing major depressive disorder or generalized anxiety disorder. Method: Sixty older Latinos age 60+ with subthreshold depression or anxiety were randomized to receive either HOLA (n = 30) or enhanced psychoeducation through fotonovela control (n = 30). The primary outcomes of interest were feasibility, acceptability, and reduction in depression and anxiety symptom severity. Outcome measures were administered at baseline and at the end of the intervention. Results: Within a year, the enrollment target was met with <5% of eligible participants refusing randomization. The randomization scheme produced equal numbers of participants randomized to each condition. Four participants (6.7%; HOLA = 1; control = 3) were lost to follow-up, 69% of the HOLA sessions were attended, and participants reported high satisfaction with the intervention. Finally, compared with control, a significant proportion of participants in HOLA experienced a clinically significant reduction in their anxiety symptoms (60% vs. 26.7%). Conclusions: Findings highlight the feasibility, acceptability, and significant impact the HOLA intervention can have in reducing psychological distress because it is responsive, respectful, and specific to the needs of older Latinos. Furthermore, using a community health worker to deliver a health promotion intervention to prevent common mental disorders in older Latinos is an innovative approach for reducing disease burden in a population living with high disparities in accessing and engaging in mental health services.

Background Despite quadriceps weakness in individuals after quadriceps tendon anterior cruciate ligament reconstruction (QT‐ACLR), and its association with knee joint mechanics, no studies have addressed gait mechanics in both partial‐thickness (PT‐Q) and full‐thickness (FT‐Q) options for QT‐ACLR. Objective To assess gait mechanics across a QT‐ACLR cohort. We hypothesized that QT‐ACLR would show changes in knee joint mechanics compared to control participants (CON) and nonoperated limbs. Additionally, we hypothesized that FT‐Q operated limbs would show greater changes compared to PT‐Q and CON. Design Retrospective cohort study. Setting University‐affiliated sports medicine institute. Participants Sixteen patients who underwent QT‐ACLR (7 FT‐Q: Age (years) = 28.6 ± 7.3, post‐op (months) = 23.5 ± 10.7, 9 PT‐Q: Age = 25.2 ± 4.3, post‐op = 24.4 ± 11.7) were recruited and compared to 11 CON (age = 23.4 ± 4.8). Intervention Participants underwent gait testing with force plate integrated motion capture. Main Outcome Measures Mixed repeated‐measures analyses of covariance, adjusted for gait speed, were used to determine significant main effects or interactions in peak knee flexion angle, sagittal knee range of motion, peak internal knee extension moment (KEM), and peak internal knee flexion moment. Results When measured an average of 2 years after surgery, no main effect for limb or limb by depth interaction were detected. A significant effect by group was observed for peak KEM ( p = .03, η ² = .27) and peak knee flexion angle ( p = .04, η ² = .24) in the loading response phase. FT‐Q ( p = .02) and PT‐Q (p = .03) showed lower KEM compared to the CON group in both limbs. The FT‐Q group showed lower peak knee flexion angle compared to the CON group ( p = .01). Conclusions Knee joint symmetry may be recovered 2 years following QT‐ACLR, but lower KEM compared to CON for both graft options and lower peak knee flexion angle than CON for the FT‐Q group may indicate a need for further investigation in QT‐ACLR.

Aim: The Nordic hamstring curl appears effective in reducing the incidence of injury in physically active young adults, likely through its capacity as an eccentric exercise to increase muscle stiffness. Although eccen- tric exercises have been shown to increase muscle stiffness, medium- and long-term Nordic hamstring curl training programs have not demonstrated an effect on muscle stiffness. This study examined the acute ef- fects of a single session of Nordic hamstring curls on the stiffness of the biceps femoris, semitendinosus, and semimembranosus muscles using ultrasound shear wave elastography, an accepted method for measuring passive muscle stiffness. Material and methods: Twenty physically active adults (ages 19–27 years) were ran- domly assigned to either the Nordic hamstring curl group (n = 10) or the control group (n = 10). Shear wave elastography was performed on the dominant kicking leg for both groups. The exact location of the probe was marked to ensure the same area was assessed during post-testing. Both groups performed a 5-minute cycle ergometer warm-up followed by three 30-second standing static stretches. The Nordic hamstring curl group then performed three sets of six repetitions of the eccentric phase of the Nordic hamstring curl with 1-minute rest intervals between sets. All subjects then rested for five minutes before shear wave elastography was performed. Results: Repeated measures ANOVA revealed no significant main effects or interactions for the biceps femoris or semitendinosus (p >0.05). However, analysis of the semimembranosus was incon- clusive due to variability of measurement values. Conclusions: These results are in agreement with findings indicating that long- and short-term Nordic hamstring curl training has no impact on hamstring stiffness, although the effects of Nordic hamstring curl on reducing the probability of hamstring injury are still valid.