bibliography for physical education project

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In This Article Expand or collapse the "in this article" section Physical Education

Introduction, general overviews.

Outcomes of Participation in Physical Education
Research Overview
Spectrum of Teaching Styles
Teaching Games for Understanding
Teaching Personal and Social Responsibility
Sport Education
Cooperative Learning
Merged Instructional Models
Teacher Socialization in Physical Education
Student Voice in Physical Education
Professional Development in Physical Education
Neoliberal Influences on Physical Education
Physical Education Futures
External Providers of Physical Education
Adapted Physical Education

Other Subject Areas

Forthcoming articles expand or collapse the "forthcoming articles" section.

English as an International Language for Academic Publishing
Girls' Education in the Developing World
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Physical Education by Barrie Gordon LAST REVIEWED: 27 July 2016 LAST MODIFIED: 27 July 2016 DOI: 10.1093/obo/9780199756810-0149

The use of physical activity as a means of educating youth is not a new phenomenon. It was a central part of the educational process for many indigenous cultures and for societies such as the Spartans, who used physical activity as a major means of socializing their citizens. In more recent times it has been incorporated into schools to develop “good character” and as a means of addressing concerns around the fitness of young boys to serve in the military. Over the years, physical education has become more educationally focused and its emphasis has continued to change. From the original drill through Swedish gymnastics to the modern-day focus on sport and games, the learning area has continued to evolve. This evolution has been largely driven by changing societal priorities and as such will continue into the future. While the content has steadily changed once the term physical education was established, it has remained consistent within schools. At the university level, however, there have been variations in terminology with terms such as kinesiology and sport pedagogy becoming popular. For the purposes of this bibliography, physical education (PE) is the term that has been used throughout.

A number of trends have occurred within the field of research in PE. The first is the examination of PE’s role in what has been termed public health. Sallis, et al. 1997 , which overviews the impact of a two-year PE program, is a good example of this approach. Aligned with PE in public health has been a body of research around the impact of PE on academic outcomes. Trudeau and Shephard 2008 , an overview of this literature, offers a summary of many key studies. A second trend within PE has been the development of “instructional models,” which have gained popularity in many countries. Arguably the most influential of these is Sport Education (see Models of Practice and Harvey, et al. 2014 , in this section), which was developed by Darryl Seidentop from the Ohio State University in the 1990s. Others include Cooperative Learning (see Models of Practice and Dyson and Grineski 2001 , in this section); Teaching Personal and Social Responsibility (see Models of Practice and Gordon 2010 , in this section); and Teaching Games for Understanding (see Models of Practice and Bunker and Thorpe 1982 , in this section) and its various derivatives (see Models of Practice ). A number of scholars have taken a critical lens to the teaching and learning in PE ( Tinning, et al. 1993 ), a perspective that has challenged many of the assumptions taken for granted that have been prevalent in PE and society in general.

Bunker, D., and R. Thorpe. 1982. A model for the teaching of games in the secondary school. Bulletin of Physical Education 18.1: 5–8.

Introduces Bunker and Thorpe’s reconceptualizing of the way that games could be taught, and what would be learned, in PE. It introduces the philosophy of Teaching Games for Understanding (TGfU) (see Models of Practice ) in an article that has had a significant influence on PE. For teachers and scholars, this is an interesting insight into where it all began.

Dyson, B., and S. Grineski. 2001. Using cooperative learning structures in physical education. Journal of Physical Education, Recreation and Dance 72.2: 28–31.

DOI: 10.1080/07303084.2001.10605831

This heavily cited article has been published with PE practitioners as the target audience. It offers clear guidance for teachers wishing to implement cooperative learning into their teaching. It will be particularly useful for teachers interested in practical suggestions of ways of incorporating cooperative learning into their teaching practice.

Gordon, B. 2010. An examination of the Responsibility Model in a New Zealand physical education programme. Journal of Teaching in Physical Education 29.1: 21–37.

Reports on a quasi-experimental study of four New Zealand PE classes. The result showed that that Teaching Personal and Social Responsibility (TPSR) could be successfully implemented in a regular classroom with positive results in classroom relationships and for the teaching and learning that occurred. There was limited support for transfer to other areas of students’ lives.

Harvey, S., D. Kirk, and M. O’Donovan. 2014. Sport Education as a pedagogical application for ethical development in physical education and youth sport. Sport, Education and Society 19.1: 41–62.

DOI: 10.1080/13573322.2011.624594

The development of ethical behavior is generally considered to be part of the Sport Education model. The authors examine the research and find little evidence of improved ethical behavior due to engagement in Sport Education. They conclude by presenting four specific approaches that can be implemented to help ethical development.

Sallis, J., T. McKenzie, J. Alcaraz, B. Kolody, N. Faucette, and M. Hovell. 1997. The effects of a 2-year physical education program (SPARK) on physical activity and fitness in elementary school students: Sport, play and active recreation for kids. American Journal of Public Health 87.8: 1328–1334.

DOI: 10.2105/AJPH.87.8.1328

This heavily cited study was one of the first that looked at PE through the lens of public health benefits. This was a large quasi-experimental design-based study involving seven schools and 955 students over two years. The result shows increased activity levels and fitness in the specialist- and teacher-led classes.

Tinning, R., D. Kirk, and J. Evans. 1993. Learning to teach physical education . Erskineville, Australia: Prentice Hall.

The critical focus of the text challenges many of the assumptions taken for granted that are associated with teaching PE. It examines such topics as the relationship between sport and PE; the nature of quality teaching in PE; and the relationship between fitness, health, and PE.

Trudeau, F., and R. Shephard. 2008. Physical education, school physical activity, school sports and academic performance. International Journal of Behavioral Nutrition and Physical Activity 5:10.

DOI: 10.1186/1479-5868-5-10

Offers an extensive overview of the literature examining the relationship between school PE, school physical activity, and sport and academic performance. The article looks at a range of methodological approaches, including quasi-experimental longitudinal and cross-sectional studies. Succinct summaries are offered of many of the key studies.

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Mr. Wedan's Physical Education Blog

Where passion finds purpose, annotated bibliography.

1) France, T. J., Moosbrugger, M., & Brockmeyer, G. (2011). Increasing the value of physical education in schools and communities. Journal of Physical Education, Recreation & Dance (JOPERD), 82 (7), 48.

France and Moosbrugger are professors in the School of Health at Springfield College in Massachusetts. This article highlights the marginalization of physical education programs in schools and in society. The authors highlight several key innovations that have enhanced the status/value of physical education including: new curriculum models, creation of physical standards, and university-based teacher induction programs. However, despite these recent contributions, the authors believe that more needs to be done in order for children and adolescents to value physical education. Possible solutions may include collaboration between those working in recreation, exercise science, and human services.

“Although the innovations that have been described demonstrate that progress ahs been made to address issues that have contributed to marginalization, physical education still lacks value and status in schools, communities, and general society” (France & Moosbrugger, 2011, p. 49).

2) Nakamura, P. M., Teixeira, I. P., Papini, C. B., Lemos, N. d., Nazario, M. E. S., & Kokubun, E. (2013). Physical education in schools, sport activity and total physical activity in adolescents. Revista Brasileira De Cineantropometria & Desempenho Humano, 15 (5)

The 2013 study conducted by Nakamura et al. was designed to “…investigate the association between the practice of physical education in schools and sports activities with the practice of total physical activity of adolescents” (p. 517). In this cross-sectional study the authors observed 467 high school participants: all students were around 15 years old and were nearly split evenly between boys and girls. In the end the study discovered two things. First, the girls had lower involvement in physical activity than the boys; second, the boys who did not participate in physical education or sports were less likely to be physically active compared to the boys who participated in these activities. This study helps re-enforce the notion that health and wellness is a lifestyle choice; if students are to be physically healthy, participating in physical education is a key component for their long-term wellbeing.

“The practice of [physical activity], in adolescence, is associated with the weight loss, the improvement in metabolic parameters, lowering blood pressure and insulin resistance, as well as the psychological well-being, the predisposition to maintain [physical activity] during adulthood, the decreased risk for cardiovascular disease and, consequently, an increase in life expectancy” (Nakamura et al., 2013, p. 518).

3) Richardson, K. P. (2011). Physical education teacher education: Creating a foundation to increase the status of physical education in schools. Journal of Physical Education, Recreation & Dance (JOPERD), 82 (7), 45.

In her article, Richardson entertains the concept that in order to increase the status of physical education in schools we must first address issues related to physical education teacher education (PETE). Richardson believes that a redesign in physical education will help decrease the stigmatization of physical education and help elevate students’ learning. Programs for teachers may include, “…an integrated clinical curriculum, student learning at the center of teacher effectiveness, partnerships between universities and public schools, and mentoring and support for new teachers as an extension of pre-service teacher education” (Richardson, 2011, p. 47). The ideas presented in this article help reinforce the current plans to revise the BC curriculum for physical education; by redesigning the course content, we can work to make physical education a more practical and enjoyable subject that students will appreciate into their adult life.

“Although the program foci have shifted, PETE continues to struggle to produce teachers who can achieve the espoused outcomes of physical education in schools, which is a primary problem in the marginalization of physical education” (Richardson, 2011, p. 45).

4) Bushman, B. A. (2014). Kids and physical activity — who, what, why, and how. ACSM’s Health & Fitness Journal, 18 (5), 5-10. doi:10.1249/FIT.0000000000000063

Barbara Bushman, the author of the article, is a clinical exercise specialist and professor at Missouri State University. In this piece she seeks to provide answers as to why physical activity, and physical education, is so critically important a lifelong pursuit of healthy living. Bushman recommends age-appropriate physical activity for everyone; this includes infants and older adults! This article proves significant in that it clearly articulates the idea that health is a continuum: it is a lifetime endeavor and must be taken seriously in order to maximize our wellbeing. In the context of high school physical education it is important for students to understand the health choices they make when they are young can have lasting effects on their bodies well into adulthood.

“Through collaboration among families, schools, and communities, physical activity habits in the youth can serve as a foundation for continued physical activity into adulthood” (Bushman, 2011, p. 10).

5) Washington, R. (2009). Physical education in schools helps reduce future cardiovascular risk. Circulation, 120 (22), 2168-2169. doi:10.1161/CIRCULATIONAHA.109.906115

This article examines how properly executed physical education programs in schools can help reduce students’ risks of developing cardiovascular disease later on in life. Washington, the author, observes that over the course of several decades, childhood obesity rates have steadily increased; he believe that by the mid 2010’s, every 1 in 4 children in the United States will be obese. In order to better understand health and wellness in younger populations, Washington discusses the results of a German study in which the participants (all grade 6 students) engaged in physical education classes and had their blood lipid profiles tested to indicate if there was a future risk of developing cardiovascular disease. The results of the study did indeed support the notion that daily physical activity does in fact play an important role in regulating atherosclerosis (plaque in blood vessels) and reducing the risk of heath problems later in life. This is of particular importance for high school physical education students in that it helps them develop good health habits that will have tremendous carry-over to their future wellbeing.

“However, the obesity epidemic in youth is, in a sense, the perfect storm” (Washington, 2009, p. 2168).

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Journal articles on the topic "Physical education":

Kayihan Erbas, Mustafa. "Determination of physical education teachers' educational beliefs." International Journal of Academic Research 5, no. 5 (October 15, 2013): 386–92. http://dx.doi.org/10.7813/2075-4124.2013/5-5/b.60.

Yuldashov, Ikromjon. "PHYSICAL EDUCATION IN HIGHER EDUCATION INSTITUTIONS." European International Journal of Multidisciplinary Research and Management Studies 02, no. 04 (April 1, 2022): 52–57. http://dx.doi.org/10.55640/eijmrms-02-04-12.

Kumar, Pradeep, and Vijendra Singh. "Comparative Self-Concept Study of Physical Education and Non-Physical Education Students." International Journal of Physical Education & Sports Sciences 7, no. 13 (July 1, 2014): 0. http://dx.doi.org/10.29070/7/56005.

Kumar, Pradeep. "Relative Study of Stress In Physical Education and Non-Physical Education Students." International Journal of Physical Education & Sports Sciences 7, no. 13 (January 1, 2015): 0. http://dx.doi.org/10.29070/7/56010.

Kumar, Pradeep. "Study of Social Adjustment In Physical Education and Non-Physical Education Students." International Journal of Physical Education & Sports Sciences 8, no. 15 (July 1, 2015): 0. http://dx.doi.org/10.29070/8/56017.

Bahadirovna, Khamraeva Zukhro. "PEDAGOGICAL CATEGORIES OF PHYSICAL EXERCISES IN PHYSICAL EDUCATION CLASSES TAUGHT IN HIGHER EDUCATIONAL INSTITUTIONS." International Journal of Pedagogics 03, no. 04 (April 1, 2023): 71–75. http://dx.doi.org/10.37547/ijp/volume03issue04-13.

Ilxomjonovich, Ikromov Isomiddin, Yusupov Toir Tolanovich, and Haitbayeva Barnohon Baxodirovna. "Physical Education In The Structure Of Professional Education." American Journal of Social Science and Education Innovations 03, no. 03 (March 26, 2021): 226–29. http://dx.doi.org/10.37547/tajssei/volume03issue03-31.

O.S., Jumanov. "MODERN APPROACHES TO THE ORGANIZATION OF PHYSICAL EDUCATION IN EDUCATIONAL INSTITUTIONS." CURRENT RESEARCH JOURNAL OF PEDAGOGICS 02, no. 10 (October 1, 2021): 113–17. http://dx.doi.org/10.37547/pedagogics-crjp-02-10-22.

Richardson, Karen Pagnano. "Physical Education Teacher Education." Journal of Physical Education, Recreation & Dance 82, no. 7 (September 2011): 45–56. http://dx.doi.org/10.1080/07303084.2011.10598658.

Mahammatov, Abdumannon, Azam Abdurakhimov, and Mingjigit Kholbekov. "Combination Of Music And Physical Education." American Journal of Social Science and Education Innovations 03, no. 03 (March 6, 2021): 6–15. http://dx.doi.org/10.37547/volume03issue03-02.

Books on the topic "Physical education":

Kidd, Bruce. Physical education . Toronto: Guidance Centre, Ontario Institute for Studies in Education, 1993.

Birmingham (England). Education Department., ed. Physical education. Birmingham: Birmingham City Council, Education Department, 1996.

Barbieri, Maggie. Physical education . New York: Minotaur Books, 2011.

J, Eccles D., and North Western Counties Physical Education Association., eds. Physical education workbooks . (U.K.): (s.l.), 1989.

Fletcher, Tim, Déirdre Ní Chróinín, Douglas Gleddie, and Stephanie Beni, eds. Meaningful Physical Education . Abingdon, Oxon ; New York, NY : Routledge, 2021. | Series: Routledge focus on sport pedagogy: Routledge, 2021. http://dx.doi.org/10.4324/9781003035091.

Webster, D. E. GCSE physical education . London: Letts Educational, 1997.

Mosston, Muska. Teaching physical education . 3rd ed. Columbus: Merrill Pub. Co., 1986.

1902-, Seaton Don Cash, ed. Physical education handbook . 8th ed. Englewood Cliffs, N.J: Prentice Hall, 1992.

Mosston, Muska. Teaching physical education . 4th ed. New York: Macmillan, 1994.

Mosston, Muska. Teaching physical education . 5th ed. San Francisco, CA: B. Cummings, 2002.

Book chapters on the topic "Physical education":

Connolly, Maureen. "Physical Education." In Contributions to Phenomenology , 534–37. Dordrecht: Springer Netherlands, 1997. http://dx.doi.org/10.1007/978-94-017-5344-9_120.

Kelly, Luke E., Martin E. Block, and Andrew M. Colombo-Dougovito. "Physical Education." In Handbook of Special Education , 586–605. Second Edition. | New York : Routledge, 2017. | “First edition published by Routledge 2011”—T.p. verso.: Routledge, 2017. http://dx.doi.org/10.4324/9781315517698-45.

Jess, Mike, and Malcolm Thorburn. "Physical Education." In The SAGE Handbook of Curriculum, Pedagogy and Assessment: Two Volume Set , 441–55. 1 Oliver's Yard, 55 City Road London EC1Y 1SP: SAGE Publications Ltd, 2016. http://dx.doi.org/10.4135/9781473921405.n28.

Penney, Dawn, and Andrew Jones. "Physical Education Studies." In Digital Representations of Student Performance for Assessment , 169–95. Rotterdam: SensePublishers, 2013. http://dx.doi.org/10.1007/978-94-6209-341-6_7.

Goldfield, Raymond. "Physical Education, Teaching." In Encyclopedia of Cross-Cultural School Psychology , 729–31. Boston, MA: Springer US, 2010. http://dx.doi.org/10.1007/978-0-387-71799-9_314.

Macrae, Eilidh. "Physical Education Experiences." In Palgrave Studies in Sport and Politics , 39–80. London: Palgrave Macmillan UK, 2016. http://dx.doi.org/10.1057/978-1-137-58319-2_2.

Østerlie, Ove, Chad Killian, and Julia Sargent. "‘Global’ Physical Education." In Flipped Learning in Physical Education , 9–17. London: Routledge, 2022. http://dx.doi.org/10.4324/9781003203377-3.

Jess, Mike, Paul McMillan, and Nicola Carse. "Primary Physical Education." In An Introduction to Primary Physical Education , 39–52. 2nd ed. London: Routledge, 2021. http://dx.doi.org/10.4324/9781003257783-5.

Kwok, Hui Min. "Inclusive Physical Education." In CPD for Teaching and Learning in Physical Education , 86–109. London: Routledge, 2022. http://dx.doi.org/10.4324/9781003171973-7.

Howells, Kristy. "Physical Education and Health Education." In Inspiring Primary Learners , 133–50. Abingdon, Oxon; New York, NY: Routledge, 2021.: Routledge, 2021. http://dx.doi.org/10.4324/9780429024597-10.

Reports on the topic "Physical education":

Azevedo, Eugénia, Rui Araújo, and Isabel Mesquita. The Development of Reflective Skills in Physical Education Teacher Education: a systematic review . INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, March 2021. http://dx.doi.org/10.37766/inplasy2021.3.0079.

Iglesias, Damián, and Javier Fernandez-Rio. Cooperative learning in physical education: A systematic review . INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, July 2022. http://dx.doi.org/10.37766/inplasy2022.7.0093.

Cawley, John, Chad Meyerhoefer, and David Newhouse. The Impact of State Physical Education Requirements on Youth Physical Activity and Overweight . Cambridge, MA: National Bureau of Economic Research, June 2005. http://dx.doi.org/10.3386/w11411.

Zhang, Junlong, Lixia Bao, Mohd Nasiruddin Nasnoor Mohd Nasiruddin, Mohd Ashraff Mohd Mohd Anuar, and Gege Yao. Effects of Sports Education Model on Students' Attitudes Towards Physical Education Learning: A Systematic Review . INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, October 2022. http://dx.doi.org/10.37766/inplasy2022.10.0040.

Kuznetsova, Lyudmila. DEVELOPMENT OF CULTURE OF HEALTH AND PHYSICAL EDUCATION OF STUDENTS IS A PRIORITY GOAL OF EDUCATION SYSTEM . Federal State Budgetary Educational Establishment of Higher Vocational Education "Povolzhskaya State Academy of Physical Culture, Sports and Tourism" Naberezhnye Chelny, December 2013. http://dx.doi.org/10.14526/41_2013_13.

Cawley, John, David Frisvold, and Chad Meyerhoefer. The Impact of Physical Education on Obesity among Elementary School Children . Cambridge, MA: National Bureau of Economic Research, August 2012. http://dx.doi.org/10.3386/w18341.

Zimmer, Zachary, Albert Hermalin, and Hui-Sheng Lin. Whose education counts? The impact of grown children's education on the physical functioning of their parents in Taiwan . Population Council, 2001. http://dx.doi.org/10.31899/pgy6.1048.

GAO, YONGQI. The Influence of Workshop Method on Students’ Physical Education Achievement: A Systematic Review . INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, February 2023. http://dx.doi.org/10.37766/inplasy2023.2.0012.

Dix, Katherine, Syeda Kashfee Ahmed, Toby Carslake, and Shani Sniedze-Gregory. Evidence of impact underpinning Life Education Programs . Life Education Australia, September 2021. http://dx.doi.org/10.37517/978-1-74286-643-7.

Guo, Qi, and Shamsulariffin Samsudin. The Relationship between Perceived Teacher Support and Student Engagement in Physical Education: A Systematic Review . INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, May 2022. http://dx.doi.org/10.37766/inplasy2022.5.0143.

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How to format your references using the Physical Education and Sport Pedagogy citation style

This is a short guide how to format citations and the bibliography in a manuscript for Physical Education and Sport Pedagogy. For a complete guide how to prepare your manuscript refer to the journal's instructions to authors .

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Journal articles

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Not all journals organize their published articles in volumes and issues, so these fields are optional. Some electronic journals do not provide a page range, but instead list an article identifier. In a case like this it's safe to use the article identifier instead of the page range.

Books and book chapters

Here are examples of references for authored and edited books as well as book chapters.

Sometimes references to web sites should appear directly in the text rather than in the bibliography. Refer to the Instructions to authors for Physical Education and Sport Pedagogy .

This example shows the general structure used for government reports, technical reports, and scientific reports. If you can't locate the report number then it might be better to cite the report as a book. For reports it is usually not individual people that are credited as authors, but a governmental department or agency like "U. S. Food and Drug Administration" or "National Cancer Institute".

Theses and dissertations

Theses including Ph.D. dissertations, Master's theses or Bachelor theses follow the basic format outlined below.

News paper articles

Unlike scholarly journals, news papers do not usually have a volume and issue number. Instead, the full date and page number is required for a correct reference.

In-text citations

References should be cited in the text by name and year in parentheses :

Here are examples of in-text citations with multiple authors:

Two authors: (Balskus and Jacobsen 2007)
Three authors: (Bennett, Brandon, and Nutman 2007)
4 or more authors: (Zhang et al. 2014)
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Roundtable on Obesity Solutions; Food and Nutrition Board; Institute of Medicine. Physical Activity: Moving Toward Obesity Solutions: Workshop Summary. Washington (DC): National Academies Press (US); 2015 Nov 10.

Physical Activity: Moving Toward Obesity Solutions: Workshop Summary.

Hardcopy Version at National Academies Press
Adeigbe RT, Ramirez AG. Physical activity in Latino communities. Institute of Medicine commentary; 2015. [August 11, 2015]. http://nam .edu/wp-content /uploads/2015/06/PAandLatinos.pdf .
Anderson LH, Martinson BC, Crain AL, Pronk NP, Whitebird RR, O'Connor PJ, Fine LJ. Health care charges associated with physical inactivity, overweight, and obesity. Preventing Chronic Disease. 2005; 2 (4):A09. [ PMC free article : PMC1435706 ] [ PubMed : 16164813 ]
Babey SH, Brown ER, Hastert TA. Access to safe parks helps increase physical activity among teenagers. Policy Brief/UCLA Center for Health Policy Research. 2005;(PB2005-10):1–6. [ PubMed : 16397964 ]
Barkin SL, Poe E. Systematic exposure to recreation center increases uses by Latino families with young children. Childhood Obesity. 2012; 8 (2):116–123. [ PMC free article : PMC3660074 ] [ PubMed : 22799511 ]
Barkin SL, Gesell S, Poe E, Escarfuller J, Tempesti T. Culturally tailored, family-centered, behavioral obesity intervention for Latino-American preschoolers. Pediatrics. 2012; 130 (3):445–456. [ PMC free article : PMC4074623 ] [ PubMed : 22869834 ]
Barnidge EK, Radvanyi C, Duggan K, Motton F, Wiggs I, Baker EA, Brownson RC. Understanding and addressing barriers to implementation of environmental and policy interventions to support physical activity and healthy eating in rural communities. Journal of Rural Health. 2013; 29 (1):97–105. [ PMC free article : PMC4760835 ] [ PubMed : 23289660 ]
Barros RM, Silver EJ, Stein RE. School recess and group classroom behavior. Pediatrics. 2009; 123 (2):431–436. [ PubMed : 19171606 ]
Bassett DR, Fitzhugh EC, Heath GW, Erwin PC, Frederick GM, Wolff DL, Welch WA, Stout AB. American Journal of Preventive Medicine. 2013; 44 (2):108–113. [ PubMed : 23332325 ]
Beets MW. Policies and standards for promoting physical activity in after-school programs: A research brief. Princeton, NJ: Robert Wood Johnson Foundation; 2012.
Beets MW, Rooney L, Tilley F, Beighle A, Webster C. Evaluation of policies to promote physical activity in afterschool programs: Are we meeting current benchmarks? Preventive Medicine. 2010; 51 (3-4):299–301. [ PubMed : 20637796 ]
Belcher BR, Berrigan D, Dodd KW, Emken BA, Chou CP, Spruijt-Metz D. Physical activity in U.S. youth: Effect of race/ethnicity, age, gender, and weight status. Medicine & Science in Sport & Exercise. 2010; 42 (12):2211–2221. [ PMC free article : PMC3242154 ] [ PubMed : 21084930 ]
Bergouignan A, Rudwill F, Simon C, Blanc S. Physical inactivity as the culprit of metabolic inflexibility: Evidence from bed-rest studies. Journal of Applied Physiology. 2011; 111 (4):1201–1210. [ PubMed : 21836047 ]
Blair SN, Kohl HW III, Paffenbarger RS Jr., Clark DG, Cooper KH, Gibbons LW. Physical fitness and all-cause mortality. A prospective study of healthy men and women. Journal of the American Medical Association. 1989; 262 (17):2395–2401. [ PubMed : 2795824 ]
Bouchard C. Childhood obesity: Are genetic differences involved? The American Journal of Clinical Nutrition. 2009; 89 (5):1494S–1501S. [ PMC free article : PMC2677002 ] [ PubMed : 19261728 ]
Britton KA, Lee IM, Wang L, Gaziano JM, Manson JE, Buring JE, Sesso HD. Physical activity and the risk of becoming overweight or obese in middle-aged and older women. Obesity. 2012; 20 (5):1096–1103. [ PMC free article : PMC3359055 ] [ PubMed : 22193920 ]
Bruins J, Jörg F, Bruggeman R, Slooff C, Corpeleijn E, Pijnenborg M. The effects of lifestyle interventions on (long-term) weight management, cardiometabolic risk and depressive symptoms in people with psychotic disorders: A meta-analysis. PLoS ONE. 2014; 9 (12):e112276. [ PMC free article : PMC4256304 ] [ PubMed : 25474313 ]
Buman MP, Winter SJ, Baker C, Hekler EB, Otten JJ, King AC. Neighborhood Eating and Activity Advocacy Teams (NEAAT): Engaging older adults in policy activities to improve food and physical environments. Translational Behavioral Medicine. 2012; 2 (2):249–253. [ PMC free article : PMC3717885 ] [ PubMed : 24073118 ]
Carlson JA, Sallis JF, Chriqui JF, Schneider L, McDermid LC, Agron P. State policies about physical activity minutes in physical education or during school. The Journal of School Health. 2013; 83 (3):150–156. [ PubMed : 23343315 ]
CDC (Centers for Disease Control and Prevention). Overweight and obesity among people with disabilities. 2010. [August 28, 2015]. http://www .cdc.gov/ncbddd /disabilityandhealth /documents/obesityFactsheet2010.pdf .
CDC. Comprehensive school physical activity programs: A guide for schools. Atlanta, GA: U.S. Department of Health and Human Services; 2013.
Centola D. An experimental study of homophily in the adoption of health behavior. Science. 2011; 334 (6060):1269–1272. [ PubMed : 22144624 ]
Chang VW, Lauderdale DS. Income disparities in body mass index and obesity in the United States, 1971-2002. Archives of Internal Medicine. 2005; 165 (18):2122–2128. [ PubMed : 16217002 ]
Chen AY, Kim SE, Houtrow AJ, Newacheck PW. Prevalence of obesity among children with chronic conditions. Obesity. 2010; 18 (1):210–213. [ PubMed : 19521350 ]
Chen YT, Fredericson M, Matheson G, Phillips E. Exercise is medicine. Current Physical Medicine and Rehabilitation Reports. 2013; 1 :48–56.
Chriqui JF. Physical activity policy implementation and impact: A multisectoral review. Washington, DC: Apr 14-15, 2015. (Presentation at the IOM Roundtable on Obesity Solutions workshop).
Chriqui JF, Taber DR, Slater SJ, Turner L, Lowrey KM, Chaloupka FJ. The impact of state Safe Routes to School-related laws on active travel to school policies and practices in U.S. elementary schools. Health Place. 2012; 18 (1):8–15. [ PubMed : 22243902 ]
Chriqui JF, Eyler A, Carnoske C, Slater S. State and district policy influences on district-wide elementary and middle school physical education practices. Journal of Public Health Management and Practice. 2013; 19 (Suppl. 1):S41–S48. [ PubMed : 23529054 ]
Church TS, Thomas DM, Tudor-Locke C, Katzmarzyk PT, Earnest CP, Rodarte RQ, Martin CK, Blair SN, Bouchard C. Trends over 5 decades in U.S. occupation-related physical activity and their associations with obesity. PLoS ONE. 2011; 6 (5):e19657. [ PMC free article : PMC3102055 ] [ PubMed : 21647427 ]
Crespo NC, Sallis JF, Conway TL, Saelens BE, Frank LD. Worksite physical activity policies and environments in relation to employee physical activity. American Journal of Health Promotion. 2011; 25 (4):264–271. [ PubMed : 21361812 ]
Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, Murray CJ, Ezzati M. The preventable causes of death in the United States: Comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Medicine. 2009; 6 (4):e1000058. [ PMC free article : PMC2667673 ] [ PubMed : 19399161 ]
Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine. 2002; 346 :393–403. [ PMC free article : PMC1370926 ] [ PubMed : 11832527 ]
Diabetes Prevention Program Research Group. Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, Brenneman AT, Brown-Friday JO, Goldberg R, Venditti E, Nathan DM. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009; 374 (9702):1677–1686. [ PMC free article : PMC3135022 ] [ PubMed : 19878986 ]
DiPietro L. Physical activity in older people. Institute of Medicine commentary; 2015. [August 11, 2015]. http://nam .edu/wp-content /uploads/2015/06/PAandolderpeople .
Dodson EA, Lovegreen SL, Elliott MB, Haire-Joshu D, Brownson RC. Worksite policies and environments supporting physical activity in midwestern communities. American Journal of Health Promotion. 2008; 23 (1):51–55. [ PMC free article : PMC3973737 ] [ PubMed : 18785375 ]
Donnelly JE, Smith BK. Is exercise effective for weight loss with ad-libitum diet? Energy balance, compensation, and gender differences. Exercise Sport Science Reviews. 2005; 33 (4):169–174. [ PubMed : 16239833 ]
Donnelly JE, Hill JO, Jacobsen DJ, Potteiger J, Sullivan DK, Johnson SL, Heelan K, Hise M, Fennessey PV, Sonko B, Sharp T, Jakicic JM, Blair SN, Tran ZV, Mayo M, Gibson C, Washburn RA. Effects of a 16-month randomized controlled exercise trial on body weight and composition in young, overweight men and women. Archives of Internal Medicine. 2003; 163 (11):1343–1350. [ PubMed : 12796071 ]
Dugdill L, Brettle A, Hulme C, McCluskey S, Long AF. Workplace physical activity interventions: A systematic review. International Journal of Workplace Health Management. 2008; 1 (1):20–40.
Eaglehouse YL, Kramer MK, Rockette-Wagner B, Arena VC, Kriska AM. Evaluation of physical activity reporting in community Diabetes Prevention Program lifestyle intervention efforts: A systematic review. Preventive Medicine. 2015; 77 :191–199. [ PubMed : 26051204 ]
Edmunds S, Hurst L, Harvey K. Physical activity barriers in the workplace: An exploration of factors contributing to non-participation in a U.K. workplace physical activity intervention. International Journal of Workplace Health Management. 2013; 6 (3):227–240.
Egan B, Zierath JR. Exercise metabolism and the molecular regulation of skeletal muscle adaptation. Cell Metabolism. 2013; 17 (2):162–184. [ PubMed : 23395166 ]
Ekelund U, Brage S, Besson H, Sharp S, Wareham NJ. Time spent being sedentary and weight gain in healthy adults: Reverse or bidirectional causality? American Journal of Clinical Nutrition. 2008; 88 (3):612–617. [ PubMed : 18779275 ]
Ekelund U, Besson H, Luan J, May AM, Sharp SJ, Brage S, Travier N, Agudo A, Slimani N, Rinaldi S, Jenab M, Norat T, Mouw T, Rohrmann S, Kaaks R, Bergmann MM, Boeing H, Clavel-Chapelon F, Boutron-Ruault MC, Overvad K, Jakobsen MU, Johnsen NF, Halkjaer J, Gonzalez CA, Rodriguez L, Sanchez MJ, Arriola L, Barricarte A, Navarro C, Key TJ, Spencer EA, Orfanos P, Naska A, Trichopoulou A, Manjer J, Lund E, Palli D, Pala V, Vineis P, Mattiello A, Tumino R, Bueno-de-Mesquita HB, van den Berg SW, Odysseos AD, Riboli E, Wareham NJ, Peeters PH. Physical activity and gain in abdominal adiposity and body weight: Prospective cohort study in 288,498 men and women. American Journal of Clinical Nutrition. 2011; 93 (4):826–835. [ PubMed : 21346093 ]
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ORIGINAL RESEARCH article

This article is part of the research topic.

Physical Culture for Mental Health

Effects of physical activity on subjective well-being: the mediating role of social support and self-efficacy Provisionally Accepted

1 Zhaoqing University, China

The final, formatted version of the article will be published soon.

Objective: Subjective well-being is an essential component of college students' mental health, and the purpose of this study was to investigate the relationship between physical activity and subjective wellbeing among college students and to examine the mediating role of social support and self-efficacy between the physical activity and subjective well-being.This study utilized a cross-sectional design with a stratified whole group sample of 989 college students (Mage = 19.65 years, SD = 1.1) from three universities in Guangdong Province, China, and used the Physical Activity Scale, Subjective Well-Being Scale, Social Support Scale, and Self-Efficacy Scale for data collection. In this study, SPSS 26.0 was used for descriptive statistical analysis and correlation analysis of the collected data. Harman's one-way method was used to test for common method bias.(1) Physical activity, subjective well-being, social support and self-efficacy were significantly correlated with each other. Among them, physical activity was significantly and positively correlated with subjective well-being (r= 0.36), physical activity directly predicted subjective well-being (β = 0.125, t = 3.992, p < 0.01). ( 2) Physical activity positively predicted social support (β = 0.386, t = 12.505, p < 0.01) and self-efficacy (β = 0.358, t = 11.793, p < 0.01), social support significantly positively predicted subjective well-being (β = 0.332, t = 11.370, p < 0.01) and self-efficacy (β = 0.254, t = 8.744, p < 0.01), self-efficacy significantly and positively predicted subjective well-being (β = 0.255, t = 8.251, p < 0.01). (3) Not only did social support and self-efficacy play an independent mediating role between physical activity and subjective well-being, but social support and self-efficacy played a chain mediating role between physical activity and subjective well-being.This study enriched the theoretical guidance for physical activity in promoting college students' subjective well-being. In the practical teaching of promoting college students' subjective well-being, in addition to paying attention to stimulating physical activity, special attention should be paid to the promotion of social support and self-efficacy.

Keywords: physical activity, social support, self-efficacy, Subjective well-being, Mediating role, crosssectional design

Received: 29 Dec 2023; Accepted: 14 May 2024.

Copyright: © 2024 Guo, Fu and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mx. Huaying Fu, Zhaoqing University, Zhaoqing, Guangdong Province, China

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Published: 11 May 2024

Occupational tasks associated with shoulder pain and upper extremity disability: a cross-sectional study in the Johnston County Osteoarthritis Project

Elizabeth L. Yanik 1 ,
Carolina Alvarez 2 ,
Rebecca J. Cleveland 2 ,
Amanda E. Nelson 2 &
Yvonne M. Golightly 2 , 3

BMC Musculoskeletal Disorders volume 25 , Article number: 374 ( 2024 ) Cite this article

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Shoulder pain is a leading cause of disability. Occupations requiring high upper extremity demands may put workers at greater risk of shoulder injury and resulting pain. We examined associations of occupation with shoulder pain and upper extremity disability in the Johnston County Osteoarthritis Project.

Work industry and occupational tasks for the longest job held were collected from participants. At follow-up ranging from 4–10 years later, participants were asked about shoulder symptoms (pain, aching, or stiffness occurring most days of 1 month in the last year) and given a 9-item, modified Disabilities Arm Shoulder and Hand (DASH) questionnaire to categorize disability from 0–4 (none-worst). Logistic regression and cumulative logit regression models were used to estimate associations with prevalent shoulder symptoms and with worse disability category, respectively. Models were adjusted for cohort, age, sex, race, education and time to follow-up. Sex- and race-stratified associations were evaluated.

Among 1560 included participants, mean age was 62 years (standard deviation ± 9 years); 32% were men, and 31% were Black. Compared to the managerial/professional industry, higher odds of both shoulder symptoms and worse upper extremity disability were seen for most industrial groups with physically demanding jobs, particularly the service industry. Work that often or always required lifting/moving > 10 lbs. was associated with higher odds of shoulder symptoms. Work that sometimes or always required heavy work while standing was associated with higher odds of shoulder symptoms, and this association was stronger among men and White workers.

Physically demanding occupations were associated with increased occurrence of shoulder pain and disability. Mitigating specific physical work demands may reduce shoulder-related disability.

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Introduction

Shoulder injury and resulting pain is a leading cause of disability, with shoulder osteoarthritis (OA) and rotator cuff disease being two of the most frequent causes of shoulder disability. In the US, over 90,000 occupational shoulder injuries occur annually, with shoulder injuries leading to a higher median number of days away from work than any other body part (2015 median = 23 days) ( 1 ). Occupations that require high upper extremity demands may put individuals at greater risk of mechanical stresses and may be a key risk factor for shoulder disability.

Studies in European populations have shown that occupational upper extremity loads are associated with shoulder symptoms and risk of shoulder disorders [ 2 , 3 , 4 , 5 ]. A general population cohort of 883 people in Finland demonstrated associations of repetitive movements, lifting heavy loads, and working in awkward positions with chronic shoulder disorders [ 2 ]. In a study of over 30,000 people in Denmark, high occupational shoulder load was associated with significantly higher risk of surgery for subacromial impingement syndrome [ 3 ]. Few such studies have been conducted in the United States, where workers may be even more strongly impacted by physical work exposures due to weaker workplace protections as evidenced by higher rates of workplace accidents [ 6 ]. Additionally, some analyses have led to inconsistent findings across populations, such as the evaluation of differences in the effects of occupational exposures by sex [ 2 , 7 ].

We utilized data from the Johnston County Osteoarthritis Project (JoCoOA), a community-based prospective cohort in a mostly rural county in North Carolina that collected data on occupational exposures and measures of shoulder symptoms and upper extremity disability. A prior cross-sectional analysis of JoCoOA demonstrated that 26% of participants reported shoulder symptoms, but associations with occupational demands were not investigated [ 8 ]. JoCoOA captures a racially diverse population, as the cohort was developed to have adequate sample sizes to allow evaluation of differences in osteoarthritis development and progression by race. In the United States, physically-demanding jobs are more likely to be done by non-white workers [ 9 ], making it imperative to demonstrate that the occupational risks identified in primarily white, European populations generalize to non-white workers.

In the current study, we aimed to determine if occupation industry or occupational tasks involving the upper extremities are associated with prevalent shoulder symptoms or upper extremity disability. We also aimed to determine whether associations differed by race or sex.

Materials and methods

Study population.

JoCoOA is a community-based prospective cohort originally established to study knee and hip OA among men and women who identified as Black or White. Participants were recruited from the noninstitutionalized population of adults 45 years of age and older residing in Johnston County, North Carolina. Further details on recruitment methods and sampling strategies have been reported previously [ 10 ]. An initial round of enrollment occurred between 1991 and 1997 during which baseline information was collected through home interviews. For these participants a first follow-up visit (T1) was conducted between 1999 and 2004 during which occupational information was collected (N = 1733). New participants were enrolled in the cohort in 2003–2004 with the same occupational information collected at enrollment (N = 1015). The second round of recruitment aimed to enrich the sample for individuals who were Black and younger. We refer to this second group of enrolled participants as the enrichment cohort. A second follow-up visit (T2) was conducted during 2006–2010 at which information on shoulder symptoms and upper extremity disability were collected (Fig. 1 ).

Timeline of enrollment and study visits in the Johnston County Osteoarthritis Project

The study population for the present analysis included participants who completed both T1 and T2 follow-up visits (N = 1697). From this population, we excluded: 1) participants who did not respond to any of the questions about occupation at T1, 2) participants who did not respond to questions about shoulder symptoms or upper extremity disability, and 3) a small fraction of participants missing information on BMI or education (other demographic information was complete). With this population, we conducted a cross-sectional analysis of associations between occupational measures and shoulder disability measures.

Occupational exposures

Occupational information was self-reported via an interviewer-administered questionnaire [ 11 ]. Participants were only asked to provide occupational information if they reported having held a job outside of the home/farm for pay for more than one year. Participants were asked to report information about the longest job they had held during their life. For this job they were asked the job title and the frequency of performance of various tasks, including lifting/carrying/moving objects weighing > 10 lbs and heavy work while standing. Job titles were categorized into six industrial groups based on the 1990 Census of Population and Housing Alphabetical Index of Industries and Occupations: managerial and professional; technical, sales, and administrative support; service; farming, forestry, and fishing; precision production, craft, and repair; and operators, fabricators, and laborers [ 12 ]. In our analyses, jobs in the managerial and professional industry were used as the referent group. For occupational tasks, participants were asked to rate the frequency on a 5-point scale: 0 = never, 1 = seldom, 2 = sometimes, 3 = often, and 4 = always. In stratified analyses, occupational exposure categories were condensed due to decreased statistical power. Specifically, the frequency of lifting/carrying/moving tasks was condensed into three categories (never/seldom, sometimes, and often/always), the frequency of heavy work while standing was condensed into two categories (never/seldom and sometimes/often/always), and occupational industries were condensed into two categories: physical work (service; farming, forestry, and fishing; precision production, craft, and repair; and operators, fabricators, and laborers) and non-physical work (managerial and professional, and technical, sales, and administrative support).

At the T2 time point, several outcome measures relevant to shoulder disability were collected. Participants were asked whether they had pain, aching, or stiffness (PAS) in the left (or right) shoulder on most days of any one month in the last year. If a participant answered “Yes” to this question for either the left or right shoulder they were counted as someone with prevalent shoulder symptoms. Additionally, they were asked to rate their shoulder symptoms as mild, moderate, or severe. A modified 9-item Disabilities Arm Shoulder and Hand (DASH) questionnaire was administered to assess upper extremity disability on a scale from 0 (no disability) to 100 (worst disability) [ 13 ]. These scores were further classified into five categories of disability (0, 1–25, 26–50, 51–75, 76–100). Finally, a back scratch test was used to assess shoulder function [ 14 ]. Participants were asked to reach over the right shoulder with the right hand while reaching with the left hand up the middle of the back to attempt to touch their fingers together. This measure was categorized into six categories: fingers touching or overlapping, measurable distance between extended middle fingers (1-14 cm, 15-21 cm, 22-29 cm, 30 + cm) or unable to perform the test. This test was then repeated on the opposite side with the left hand reaching over the left shoulder. The worst measure from the two sides was used for analyses.

Other measurements

Other relevant variables collected by JoCoOA included self-reported sex (male/female), race (Black/White), and education (less than high school education/at least a high school education). Age was calculated based on self-reported birthdate. Height and weight were measured at both T1 and T2 follow-up visits allowing assessment of BMI and changes in BMI between follow-up time points. Data also included record of whether each participant was part of the original recruitment cohort, or the enrichment cohort.

Statistical analysis

Descriptive statistics were calculated for the study population including demographic characteristics, distribution of occupational industries, and frequency of upper extremity occupational tasks. For evaluating associations of occupation industry and occupational tasks with prevalent shoulder symptoms, logistic regression models were used to calculate odds ratios and 95% confidence intervals as measures of association. For evaluating associations of occupation industry and occupational tasks with upper extremity disability, cumulative logit regression models, under the proportional odds (PO) assumption, were used to estimate associations with worse modified-DASH category and worse back scratch test category [ 15 , 16 ]. The assumption of PO for these two polytomous outcomes was assessed using the Score test and, if significant at a 0.05 level, a partial PO model was assessed by testing for unequal slopes or effects across the number of levels of outcome, for each of the explanatory variables. If any of the contrast tests for a given variable was significant at 0.05, then that variable produced unequal slopes or effects for each level of outcome, otherwise the variable produced a proportional effect for worse outcome. For modified-DASH category a multinomial, partial PO model with cumulative logit regression was used, accounting for unequal slopes for covariates when indicated. For the back scratch test no evidence of violation of the PO assumption was found with the score test and a PO model was used with cumulative logit regression. All models were adjusted for age, sex, race, education, enrollment cohort, and time between follow-up visits T1 and T2. Primary analyses did not adjust for BMI as occupation may indirectly influence musculoskeletal problems through effects on obesity. Sensitivity analyses were run with adjustment for BMI to evaluate associations of occupational exposures independent of obesity. Associations stratified by sex and race, and corresponding interaction terms, were also calculated to evaluate effect measure modification. Interaction terms with a p-value < 0.10 were considered evidence of effect measure modification. For analyses of interaction terms, sensitivity analyses were run in which models additionally adjusted for length of time participants reported being employed in their ‘longest job held’, as differences in length of employment by sex or race might drive differences in associations.

Ethics approval and informed consent

All participants completed informed consent forms. The Institutional Review Board at the University of North Carolina, Chapel Hill has continuously approved JoCoOA.

Population selection and descriptive statistics

Out of 1625 JoCoOA participants that attended both T1 and T2 follow-up visits, 38 (2.3%) did not have data available on shoulder symptoms or the modified-DASH measure (Fig. 2 ). An additional 15 participants did not report any occupational information, and 12 were missing information on either BMI or education. After all exclusions, 1560 participants (96% of participants with T1 and T2 visits) remained for inclusion in the final analytic population with an average of 6.5 years between T1 and T2 visits (range = 4–10 years).

Flow chart of exclusion criteria applied to Johnston County Osteoarthritis Project participants to identify the analytic study population

In this population, 32% were men, 31% were Black, and the mean age at T1 visit was 62 years (standard deviation = 9 years) (Table 1 ). Among the 1487 people with information on occupational industry, 48% were in physical work industries (service; farming, forestry, and fishing; precision production, craft, and repair; and operators, fabricators, and laborers) (Table 1 ). Among the 1555 people reporting job requirements for lifting, carrying, or moving objects weighing > 10 lbs, 28% reported jobs that often required these tasks and 15% reported jobs that always required these tasks. Among the 1446 participants reporting job requirements for heavy work while standing, 7% reported jobs that often required these tasks and 3% reported jobs that always required these tasks.

At the T2 follow-up visit, 24% of people reported shoulder PAS on most days for at least one month during the last year (Table 2 ). Among these 379 people, 3% reported severe symptoms, 11% reported moderate symptoms, and 10% reported mild symptoms. The median modified-DASH score was 2.78, representing minimal upper extremity disability. When DASH scores were categorized into five levels of disability, 1% of people reported the worst category of disability (unable to perform tasks, scores > 75), 6% reported severe difficulty performing tasks (scores > 50 and ≤ 75), and 15% reported moderate difficulty performing tasks (scores > 25 and ≤ 50). For the back scratch test, 5% of people had fingers touching or overlapping on at least one side, while 14% of people were unable to perform the test (Table 2 ). Among the 1350 people able to perform the back scratch test, the mean distance between fingers was 22 cm (standard deviation = 11.7 cm).

Occupational exposure associations with measures of shoulder disability

Compared to workers in the managerial and professional industry, workers in both the operators/fabricators/laborers industry and service industry had statistically significantly worse outcomes for all measures of shoulder disability. Operators, fabricators, and laborers had 68% higher odds of reporting shoulder PAS, 71% higher odds of having a worse category of upper extremity disability as measured by the modified DASH score, and 137% higher odds of having a back scratch test measure in a worse category (Table 3 ). Service industry workers had 96% higher odds of reporting shoulder PAS, 123% higher odds of having a worse category of upper extremity disability as measured by the modified DASH score, and 127% higher odds of having a back scratch test measure in a worse category. Shoulder disability measures were also consistently worse in workers in the precision, production, craft, and repair industry, though the only statistically significant association was with worse back scratch test category (odds ratio [OR] = 1.68, 95%CI = 1.20–2.34).

People with jobs that often or always required lifting/carrying/moving > 10 lb. objects had significantly higher odds of reporting shoulder PAS compared to people with jobs that never required lifting/carrying/moving > 10 lb. objects (ORs of 1.83 for ‘Always’ and 1.86 for ‘Often’, Table 3 ). People with jobs that often or always required listing/carrying/moving > 10 lb. objects also had worse modified-DASH scores and worse performance on the back scratch test, though these associations did not reach statistical significance. Jobs that seldom required lifting/carrying/moving > 10 lb. objects were not associated with any increases in shoulder disability outcomes.

People with jobs that sometimes or always required heavy work while standing had significantly higher odds of reporting shoulder PAS compared to people with jobs that never required heavy work while standing (ORs of 2.86 for ‘Always’ and 1.80 for ‘Sometimes’ Table 3 ). People with jobs that ‘Sometimes’ required heavy work while standing also had significantly worse modified-DASH scores and worse performance on the back scratch test compared to people with jobs that never required heavy work while standing (modified-DASH OR = 1.39, 95%CI = 1.03–1.89; back scratch test OR = 1.37, 95%CI = 1.03–1.81). Jobs that ‘Always’ required heavy work while standing were associated with even higher odds of worse modified-DASH scores and back scratch test performance, but these associations were not statistically significant as these estimates were less precise (modified-DASH OR = 1.49, 95%CI = 0.79–2.81; back scratch test OR = 1.74, 95%CI = 0.97–3.11). Jobs that seldom required heavy work while standing were not associated with any increases in shoulder disability outcomes.

Results were similar in sensitivity analysis that additionally adjusted for BMI at the T1 time point and for change in BMI from the T1 to T2 time points (Table 4 ).

Associations stratified by sex and race

Employment in a physical work industry was associated with worse shoulder disability for both men and women across all outcome measures (Table 5 ). Interaction terms between sex and occupational industry did not indicate effect measure modification. Jobs that ‘often/always’ required lifting/carrying/moving > 10 lb. objects and jobs that sometimes/often/always required heavy work while standing were significantly associated with higher odds of shoulder PAS in both men and women. While the magnitude of the associations was larger in men, interaction terms did not indicate effect modification. Jobs that often/always required lifting/carrying/moving > 10 lb. objects and jobs that sometimes/often/always required heavy work while standing were significantly associated with higher odds of worse modified-DASH score category among men, but not women. This corresponded with a significant interaction between sex and frequency of heavy work while standing (interaction p-value = 0.06). However, the interaction term for sex and frequency of lifting/carrying/moving was not significant (interaction p-value = 0.34). For the back scratch test, no interactions with sex were identified.

Employment in a physical work industry was associated with worse shoulder disability for both Black and White participants across all outcome measures (Table 6 ), and interaction terms did not indicate effect measure modification. Similarly, no significant interactions were observed between race and job requirements for lifting/carrying/moving > 10 lb. objects, but the magnitude of associations did differ. For instance, among White participants, jobs that ‘sometimes’ or ‘often/always’ required lifting/carrying/moving > 10 lb. objects were associated with 52% higher odds and 96% higher odds of shoulder PAS, respectively, when compared to people in jobs that ‘never/rarely’ required those tasks. Among Black participants, no association was observed with jobs that ‘sometimes’ required lifting/carrying/moving > 10 lb. objects (OR = 0.99), while jobs that ‘often/always’ required lifting/carrying/moving > 10 lb. objects were only associated with 61% higher odds of shoulder PAS. Conversely, for the modified-DASH measure, jobs that ‘often/always’ required lifting/carrying/moving > 10 lb. objects had a stronger association with higher odds among Black participants than White participants (Table 6 ). Jobs that sometimes/often/always required heavy work while standing were significantly associated with higher odds of shoulder PAS in White participants, but not among Black participants. This corresponded with a significant interaction between race and frequency of heavy work while standing (interaction p-value = 0.05). For the back scratch test, no interactions with race were identified.

Results were similar in sensitivity analyses that additionally adjusted for the length of employment for “longest job held” with the same statistically significant interaction terms identified.

Function of the upper extremities, and specifically the shoulder, is essential to daily activities in both the home and the workplace. Occupational burdens are likely key contributors to the development of shoulder injuries and pathology that leads to pain and disability. In the JoCoOA, we found that compared to people employed in the managerial/professional industry, people in industries with physically demanding jobs had higher odds of both shoulder symptoms and worse upper extremity disability, particularly the service industry and operators, fabricators, and laborers. When examining specific occupational requirements, jobs that often or always required lifting/moving > 10 lb. objects and jobs that required heavy work while standing were associated with higher odds of shoulder symptoms. The association between heavy work while standing and shoulder symptoms was stronger among men and White workers. But overall, physically demanding occupations were associated with higher prevalence of shoulder pain and disability across populations, regardless of race or sex.

Consistent with our results, several European studies have shown that occupational upper extremity loads are associated with risk of shoulder pain and shoulder disorders broadly [ 2 , 3 , 4 , 17 , 18 , 19 ]. Recently, studies have started to identify occupational risk factors for specific shoulder disorders [ 20 , 21 , 22 ]. This includes work from our research team showing a doubling of risk for rotator cuff disease surgery with long-term exposure to physical work exposures in the UK [ 20 ]. In Denmark, an investigation of the relationships between cumulative occupational shoulder exposures and different diagnoses related to shoulder impingement surgery found particularly strong associations for patients with osteoarthritis diagnoses, including a doubling of risk for workers for long-term exposure to tasks requiring upper arm-elevation or repetitive shoulder movements [ 22 ]. A couple US studies have also provided preliminary evidence of associations between physical work exposures and shoulder disorders, though these studies had limited statistical power due to small sample sizes (case Ns of 55 and 18) [ 23 , 24 ].

Some studies have also evaluated sex-specific associations with mixed results. Another study by the Danish research group reported no differences in sex-specific associations of occupational exposures on subacromial impingement surgery [ 7 ]. But an earlier Finnish study demonstrated differences by sex in the associations of specific occupational tasks with chronic shoulder disorders [ 2 ]. For instance, lifting heavy loads had a stronger association with shoulder disorders among women, while repetitive movements had a stronger association with shoulder disorders among men [ 2 ]. In our study, the only significant difference in sex-stratified results was the association of heavy work while standing with shoulder function, which was significantly stronger in men. Differences in these associations may be due to the limited specificity of this measure. While we accounted for differences in length of time employed in the jobs reported, there may also be differences in the specific physical tasks being done. For instance, men may be doing more strenuous or more repetitive heavy work on average.

As prior large studies of the relationship between occupational exposures and risk of shoulder symptoms and disability have been conducted in European populations, these populations have all been predominantly White. And the few existing US occupational studies of shoulder disorders did not have sufficient sample sizes for evaluating associations by race [ 23 , 24 ]. By contrast, the JoCoOA population was recruited in the United States with a population-based sampling design that provided a large, diverse, representative sample of a mostly rural region of North Carolina in which > 30% of the population was Black. This allowed sufficient statistical power to estimate and compare race-stratified associations, which have not been evaluated in prior studies. In our study, most associations did not differ by race, but we did observe a stronger association between heavy work while standing and shoulder symptoms in White than Black participants. Similar to the effect measure modification observed by sex, these results may be explained by differences in the type of heavy work conducted. Of note, a prior JoCoOA study demonstrated that shoulder symptoms did not differ by sex or race overall [ 8 ], so differences in the relative odds do not appear to be driven by differences in the baseline prevalence between groups.

There were several limitations to this study. First, occupational measures were self-reported and it is possible that those who experienced upper extremity pain or disability may have over-reported the frequency of physical tasks at work. However, a prior study comparing self-reported upper extremity exposures to direct observation did not demonstrate such a bias among people with musculoskeletal symptoms [ 25 ]. Furthermore, it is less likely that occupational industry would be reported differentially based on symptoms or disability. We also did not have measures of shoulder-specific occupational exposures, such as arm elevation, which could be more strongly associated with shoulder disability than the general measures of lifting/moving objects and heavy work. Second, shoulder disability measures were only available at a single time point, so we could not evaluate incident disability or whether symptoms or function worsened over time while employed in a physically demanding job. Relatedly, if some participants had endured chronic shoulder symptoms for many years prior to our occupational assessment, this may have reduced the likelihood that they remained in a physically demanding job. If such a bias is present, then the true effects of occupational exposures on shoulder disability may be even stronger than the associations reported here. JoCoOA participants also did not have clinical examinations of their shoulders and so we cannot identify associations with particular shoulder injuries or pathologies. Prior evidence indicates that occupational shoulder demands may influence a myriad of shoulder disorders, including tendonitis, rotator cuff tears, and osteoarthritis [ 20 , 22 ]. Finally, as we did not have lifetime occupational histories we could not evaluate the cumulative impact of occupational exposures over time, and some differences in effects by sex and race may be driven by differences in total years of exposure. Given the older age of our study population, most participants have likely had numerous jobs over time.

In conclusion, we found that having a job in a physical work industry, or a job that specifically requires physically demanding tasks is associated with increased occurrence of shoulder pain and disability. While some associations differed by race or sex, significant associations between physical work and shoulder disability measures were observed across all populations that were examined. Mitigating specific physical work demands may reduce shoulder-related disability. Future prospective studies that capture more detailed occupational exposures along with follow-up for incident shoulder pain and disability will be key to informing appropriate mitigation measures. For example, devices such as exoskeletons are being developed to reduce biomechanical loading on the shoulder joint [ 26 ]. Evaluation of interventions such as these will be important to determine ways to reduce shoulder disability in the future.

Availability of data and materials

The data that support the findings of this study are available on request from the study authors. The data are not publicly available due to privacy or ethical restrictions.

Abbreviations

Body mass index

Confidence interval

Disabilities Arm Shoulder and Hand

Johnston County Osteoarthritis Project

Osteoarthritis

Pain, aching, or stiffness

First follow-up visit

Second follow-up visit

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Acknowledgements

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ELY was funded by NIH K01-AR073318. Data for these analyses from the Johnston County Osteoarthritis Project were supported in part by cooperative agreements S043, S1734, and S3486 from the Centers for Disease Control and Prevention (CDC)/Association of Schools of Public Health; the NIAMS Multipurpose Arthritis and Musculoskeletal Disease Center grant 5-P60-AR30701; and the NIAMS Multidisciplinary Clinical Research Center grant 5-P60-AR49465.

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Carolina Alvarez, Rebecca J. Cleveland, Amanda E. Nelson & Yvonne M. Golightly

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ELY, CA, RJC, and YMG participated in the conception and design of the work. ELY, CA, RJC, AEN, and YMG participated in the acquisition, analysis, or interpretation of data for the work. ELY, CA, RJC, AEN, and YMG participated in drafting the work or revising it critically for important intellectual content. ELY, CA, RJC, AEN, and YMG gave final approval of the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Yanik, E.L., Alvarez, C., Cleveland, R.J. et al. Occupational tasks associated with shoulder pain and upper extremity disability: a cross-sectional study in the Johnston County Osteoarthritis Project. BMC Musculoskelet Disord 25 , 374 (2024). https://doi.org/10.1186/s12891-024-07487-x

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listing sources of free and low-cost materials. Digest of Physical Education, Health, and Recreation, 5315. Drexel Ave., Chicago. $1.00 per year. 10 months. Under the editorship of C. D. Giauque of George Williams College and an advisory board, this pocket size magazine reprints in condensed form approxi.
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One instructional approach popular in modern education aligning with both programs, is Project-Based Learning (PBL). This article conceptualises current PBL characteristics and its potential in PE. Specically, we explore fi how PBL has impacted student learning experiences and the limited research in PE thus far.
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Annotated Bibliography. 1) France, T. J., Moosbrugger, M., & Brockmeyer, G. (2011). Increasing the value of physical education in schools and communities. Journal of Physical Education, Recreation & Dance (JOPERD), 82 (7), 48. France and Moosbrugger are professors in the School of Health at Springfield College in Massachusetts.
Physical Education and Sport: APA Style
Citation generators and managers allow you to automatically create and manage citations. They work for APA, MLA, and other major citation styles. ... Tags: health professions, health sciences, physical education, sport. Central Michigan University Libraries, 250 East Preston Street, Mount Pleasant, MI 48859 | (989) 774-1100 | Contact Us.
Bibliography of Health and Physical Education
Bibliography of Health and Physical Education. January 2014. DOI: 10.1080/23267402.1936.10761782. Authors: Earl B. Greene. C. H. McCloy. To read the full-text of this research, you can request a ...
PDF Sport and Health Bibliography
Collins, M. (2004). Sport, physical activity and social exclusion. Journal of Sports Sciences, 22 (8), 727-740. Daley, A., and Duda, J.A. (2006). Self-determination, stage of readiness to change for exercise, and frequency of physical activity in young people. European Journal of Sport Science 6 (4), p231-244.
Bibliographies: 'Physical education'
Consult the lists of relevant articles, books, theses, conference reports, and other scholarly sources on the topic 'Physical education.'. Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style ...
Textbooks and Learning Materials in Physical Education in the
1. Introduction. In recent decades there has been a considerable advance in the general study of textbooks and didactic materials in the international context from a variety of perspectives [1,2].In particular and within the scope of the current analysis, a good deal of research regarding the study of these resources in the field of Physical Education (PE) has proliferated [].
Physical Education and Sport Pedagogy citation style ...
The easiest way is to use a reference manager: Paperpile. The citation style is built in and you can choose it in Settings > Citation Style or Paperpile > Citation Style in Google Docs. EndNote. Download the output style file. Mendeley, Zotero, Papers, and others. The style is either built in or you can download a CSL file that is supported by ...
Project-based learning and its potential in physical education: an
Notwithstanding, science, technology, engineering, arts, and math (STEAM) curriculum and Comprehensive School Physical Activity Programs (CSPAP) have proliferated in many US schools impacting most content areas, including PE. One instructional approach popular in modern education aligning with both programs, is Project-Based Learning (PBL).
A Selected Annotated Bibliography on Physical Education. Part 2 of a
A Selected Annotated Bibliography on Physical Education. Part 2 of a Series on Health, Physical Education, and Recreation. Eyler, Marvin. This is a selected bibliography of materials on physical education that were announced in the ERIC system. The citations are listed alphabetically by author. It is divided into two sections: ERIC abstracts ...
Workbooks in Physical Education: A Guide to Their Creation and Use
Workbooks in Physical Education: A Guide to Their Creation and Use. January 2011. Journal of Physical Education, Recreation & Dance 82 (1):1-60. DOI: 10.1080/07303084.2011.10598557. Authors: Elian ...
Health and Physical Education
Health and Physical Education. Preparing Educators for the Future. Search within full text. This book is no longer available to purchase from Cambridge Core. Cited by 9. Deborah Callcott, Edith Cowan University, Western Australia, Judith Miller, University of New England, Australia, Susan Wilson-Gahan, University of Southern Queensland.
Textbooks and Learning Materials in Physical Education in the ...
This paper presents a review of the research carried out internationally in recent years regarding textbooks, teaching materials, and the field of physical education. The objectives to which this article aims are as follows: To offer a compilation of current research papers published in the Scopus, Web of Science, and Dialnet databases and to provide a classification of the research lines ...
References
Slater SJ, Nicholson L, Chriqui J, Turner L, Chaloupka F. The impact of state laws and district policies on physical education and recess practices in a nationally representative sample of U.S. public elementary schools. Archives of Pediatrics and Adolescent Medicine. 2012; 166 (4):311-316. [PMC free article: PMC3523123] [PubMed: 22147763]
Physical Education project class 12
Oct 9, 2021 • Download as DOCX, PDF •. 24 likes • 77,034 views. S. SayanMandal31. physical education investigatory project for class 12 on Cricket. enjoy the content. Sports. 1 of 43. Download now.
PDF Annotated Bibliography for Health and Wellness for People with Disabilities
The bibliography is divided into five sections: General Health/Wellness, Nutrition, Physical Activity, Recreational Activities, and Stress. Most of the resources are from non-profit community groups, government agencies, or university based programs and projects that focus on the health promotion and wellness for individuals with disabilities.
Effects of physical activity on subjective well-being: the mediating
Objective: Subjective well-being is an essential component of college students' mental health, and the purpose of this study was to investigate the relationship between physical activity and subjective wellbeing among college students and to examine the mediating role of social support and self-efficacy between the physical activity and subjective well-being.This study utilized a cross ...
Annotated Football Bibliography. An Applied Project in Physical Education
This annotated bibliography was compiled to assist physical education majors, especially those having a major interest in football and football coaching. The bibliography is limited to the areas of coaching techniques and philosophy, fundamentals, offense, defense, injuries, and conditioning at the high school and college level. These broader topics are, in some cases, broken down into more ...
Annotated Football Bibliography. An Applied Project in Physical
An Applied Project in Physical Education." by W. Clemence et al. Semantic Scholar extracted view of "Annotated Football Bibliography. An Applied Project in Physical Education." ... {Annotated Football Bibliography. An Applied Project in Physical Education.}, author={William J. Clemence and James Walter Pitts}, year={1977}, url={https://api ...
Occupational tasks associated with shoulder pain and upper extremity
Background Shoulder pain is a leading cause of disability. Occupations requiring high upper extremity demands may put workers at greater risk of shoulder injury and resulting pain. We examined associations of occupation with shoulder pain and upper extremity disability in the Johnston County Osteoarthritis Project. Methods Work industry and occupational tasks for the longest job held were ...
[2405.02709] Constant Velocity Physical Warp Drive Solution
Constant Velocity Physical Warp Drive Solution. Warp drives are exotic solutions of general relativity that offer novel means of transportation. In this study, we present a solution for a constant-velocity subluminal warp drive that satisfies all of the energy conditions. The solution involves combining a stable matter shell with a shift vector ...