Kinesiology Commons^™

Effects Of Oxidative Damage During Ruesi Dadton Exercise In Mild Cognitive Impairment: A Randomized Controlled Trial, Phaksachiphon Khanthong, Ananya Dechakhamphu, Kusuma Sriyakul, Aungkana Krajarng, Chuntida Kamalashiran, Parunkul Tungsukruthai

International Journal of Exercise Science

International Journal of Exercise Science 15(3): 1528-1537, 2022. This study aimed to investigate the effect of biomarkers of oxidative stress (OS) in 8-isoprostane (8-iso) and 8-hydroxy-2'–deoxyguanosine (8-OH-dG) on mild cognitive impairment (MCI) during a 12-week Ruesi Dadton (RD) exercise. A total of 274 enrolled participants were classified into blocks based on age and formal educational years, and randomly assigned into two groups: RD and control (CON). The participants’ cognitive functions were tested using Mini-Mental State Examination and Montreal Cognitive Assessment (MoCA) scores to screen for MCI. Urine samples of approximately 30 mL were collected from both groups pre- and post-intervention. …

Neuromuscular Fatigability Associated With Different Pacing Strategies During An Ultra-Endurance Pull-Up Task: A Case Study, Jenny Zhang, Arash Khassetarash, Guillaume Y. Millet, Saied J. Aboodarda

International Journal of Exercise Science

International Journal of Exercise Science 15(3): 1514-1527, 2022. While neuromuscular fatigability has been previously characterized after running and cycling, no study has investigated an ultra-endurance upper body task. In preparation for a world record attempt, three pacing strategies to perform 1980 pull-ups in 6 hrs were compared during independent sessions: fast pace, long recovery (FL), fast pace, multiple short recoveries (FMS), and slow pace, no recovery (SN). Elbow flexion maximal voluntary contraction (MVC) force, grip strength, peripheral fatigue, and biceps brachii electromyography were quantified every 330 pull-ups and during recovery, alongside heart rate, perceived effort, and arm muscle pain. In …

Is There A Relationship Between Foot Reaction Time And Ankle Frontal Plane Torque In Female Soccer Athletes: A Pilot Study., Maggie Feehan, Andrew Shim, Guilherme M. Cesar, Amy Burggraff

International Journal of Exercise Science

International Journal of Exercise Science 15(1): 1506-1513, 2022. The purpose of this study was to determine if a relationship existed between foot reaction time and ankle frontal plane peak torque in female soccer athletes. A one-shot case study design was selected for this investigation. Seventeen female college athletes volunteered to participate. Right and left foot reaction time measurements were assessed using 3x4 switch mats interfaced with a precise timing counter. Participants stood in front of the mat with eyes closed and responded to the auditory stimulus by touching the mat as fast as possible with their foot. Two trials were …

The Triple Step In Recreational Swing Dancers: A Kinematic Analysis, Meredith D. Wells, Feng Yang

International Journal of Exercise Science

International Journal of Exercise Science 15(1): 1492-1505, 2022. Swing dancing is gaining popularity, yet our biomechanical understanding of swing dance remains poor, creating barriers to the development of training protocols and evaluation of performances. This study aimed to determine whether dancing with or without a partner affects the lower extremity kinematics of the triple step, and if the kinematics differ among the three steps of the dance element. Eight recreational swing dancers completed three sets of rightward triple steps with and without a partner. The angles in the sagittal, frontal and transverse planes were determined for bilateral lower limb joints …

The Effect Of Neuropriming And Focus Of Attention On Amateur Standing Long Jump Performance, Alexandra Mazza, Victoria Cimo, Kevin A. Valenzuela, Will Wu

International Journal of Exercise Science

International Journal of Exercise Science 15(1): 1472-1480, 2022. Non-invasive brain stimulation has been prominent in recent neurophysiology research. The use of brain stimulation has not been examined in combination with the focus of attention paradigm, an established motor control tool. Therefore, the purpose of this study was to examine the effects of both brain stimulation and focus of attention on the outcome performance, peak force, lower extremity joint kinematics, and projection angle of a standing long jump. Forty-one participants were assigned to either the brain stimulation group or placebo group via a counterbalance design based on leg length and jump …

Convergent Validity Of The Short Recovery And Stress Scale In Collegiate Weightlifters, Alec R. Perkins, S. Kyle Travis, Satoshi Miziguchi, Michael Stone, Kevin Breuel, Michael Kellmann, Caleb Bazyler

International Journal of Exercise Science

International Journal of Exercise Science 15(6): 1457-1471, 2022. The purpose of this study was to determine whether changes in collegiate weightlifters’ external training load, biochemical markers, and jumping performance correlate to changes in items of the Short Recovery and Stress Scale (SRSS) throughout four microcycles. Twelve well-trained weightlifters (8 males, 4 females; age 24.30 ± 4.36 yr; height 170.28 ± 7.09 cm; body mass 81.73 ± 17.00 kg) with at least one year of competition experience participated in the study. Measurements included hydration, SRSS, biochemical analysis of blood (cortisol [C], creatine kinase [CK]), and unloaded and loaded squat jumps (SJ), …

A Pilot, Virtual Exercise Intervention Improves Health And Fitness During The Covid-19 Pandemic, Alexander H.K. Montoye, Makenzie J. Rajewski, Drew A. Marshall, Sylvia E. Neph, Karin A. Pfeiffer

International Journal of Exercise Science

International Journal of Exercise Science 15(7): 1395-1417, 2022. Physical activity levels are low in individuals with chronic disease (e.g., obesity) and have worsened during the COVID-19 pandemic. Purpose: Our pilot study tested a virtual exercise intervention for rural-dwelling adults with chronic disease from January-April 2021 for changes in mental health, physical fitness, and physical activity and for intervention fidelity. Methods: Participants (n = 8 [7 female]; age = 57.5 ± 13.8 years, body mass index = 38.2 ± 8.0 kg/m²) completed an exercise intervention led virtually by collegiate health science majors. Participants attended two 60-minute sessions/week for …

Changes In Fitness-Fatness Index Following A Personalized, Community-Based Exercise Program In Physically Inactive Adults: A Randomised Controlled Trial, Abbey M. Jones, Lance C. Dalleck, Ryan M. Weatherwax, Joyce S. Ramos

International Journal of Exercise Science

International Journal of Exercise Science 15(4): 1418-1429, 2022. Fitness-fatness index (FFI) is used to identify those at high risk of developing type 2 diabetes and cardiovascular events. It is measured as the ratio between an individual’s cardiorespiratory fitness (CRF) and waist-to-height ratio. Studies suggest that CRF and waist-to-height ratio are modifiable and can be improved by exercise. However, there is limited evidence surrounding a personalized approach to exercise prescription. This study investigated the impact of a 12-week personalized exercise program on FFI among sedentary individuals. It was hypothesized that the intervention would be effective in improving FFI in this cohort. …

Exercise Based Cancer Rehabilitation Program Improves Phase Angle In Breast Cancer Survivors, Trevor Short, Cheri Teranishi-Hashimoto, Paulette Yamada

International Journal of Exercise Science

International Journal of Exercise Science 15(3): 1444-1456, 2022. Phase angle (PhA) is an index of cell membrane integrity and prognostic indicator of survival and quality of life in cancer survivors. The efficacy of exercise-based cancer rehabilitation programs (ExCR) on PhA is unknown. To assess the effect of ExCR on PhA in breast cancer survivors. Fifty-nine female breast cancer survivors (61 ± 9 years) were referred to the ExCR by their oncologist and participated in one-on-one exercise-based training for 90 minutes, 3 times a week, for 12 weeks. Training sessions included 45 minutes of resistance training at intensities between 40-85% of …

Functional Benefits Of Hard Martial Arts For Older Adults: A Scoping Review, Ian Miller, Mike Climstein, Luke Del Vecchio

International Journal of Exercise Science

International Journal of Exercise Science 15(3): 1430-1443, 2022. The present scoping review focused upon the functional benefits of hard martial arts training for older adults. The AXIS Critical Appraisal Tool was used to appraise all studies included in the review. A systematic literature search identified 265 papers via electronic database and ten papers from additional sources. Of these, six studies featuring 240 participants were included in the final scoping review. Of the included studies, three were randomized control trials and three were comparative studies with concurrent controls. The available studies outlined improvements in functional fitness parameters for older adults participating …

The Association Of Field Test Outcomes With Peak Oxygen Uptake In Patients With Cystic Fibrosis: A Systematic Review, Natália E. Campos, Fernanda M. Vendrusculo, Gisele A. Da Costa, Ingrid S. De Almeida, Nicolas A. Becker, Márcio V F Donadio

International Journal of Exercise Science

International Journal of Exercise Science 15(3): 1381-1394, 2022. The purpose of the study was to evaluate the association of field test outcomes with peak oxygen uptake (VO₂peak) in patients with cystic fibrosis (CF) and to describe the main prediction equations available. Data searches were performed in five databases (Pubmed, Embase, LILACs, Scopus and Web of Science) and also in the reference lists of articles included. The following inclusion criteria were used: studies including individuals with CF, presenting both a field test and a cardiopulmonary exercise testing (CPET), and describing a predictive equation or coefficient of correlation/determination. Case studies, …

Comparison Of Spine–Pelvis Kinematics Variability During Sit-To-Stand And Stand-To-Sit In People With & Without Chronic Low Back Pain: A Vector Coding And Statistical Parametric Mapping Approach, Narges Jangjoo, Elham Alijanpour, Saeid Khodabakhsh, Seyed Sadredin Shojaedin, Roozbeh Naemi

Rehabilitation Sciences Faculty Publications

There is evidence in the literature to suggest that low back pain may change spine–pelvis coordination during activities of daily living. This study aimed to compare the variability of the spine– pelvis coordination during sit-to-stand in people with and without LBP. Ten healthy individuals with a history of LBP and ten individuals without history of LBP participated in this study. Three-dimensional kinematic data of the upper trunk (UT), lower trunk (LT), lower back (LB), and pelvis segments during sit-to-stand and stand-to-sit were recorded using a multi-segmental spine and pelvis models using a motion capture system. The coordination patterns and the …

Four Weeks Of Hericium Erinaceus Supplementation Does Not Impact Markers Of Metabolic Flexibility Or Cognition, Corey Grozier, Victor Alves, Lauren Killen, Eric O'Neal, Jeffrey Simpson, Hunter Waldman

International Journal of Exercise Science

International Journal of Exercise Science 15(2): 1366-1380, 2022. Hericium erinaceus (HE), also known as Lion’s Mane mushroom, has been found to enhance cognition and metabolic flexibility in various animal models. To date however, only four studies exist in humans and none have evaluated the effects of HE on markers of metabolic flexibility or cognitive performance. A single-blind, placebo controlled, parallel-longitudinal study was used to determine the effects of HE on markers of metabolic flexibility and cognition. Twenty-four participants completed a graded exercise test on a cycle ergometer to analyze substrate oxidation rates and markers of cardiorespiratory fitness. Additionally, two dual-task …

Variables Associated With High School Shot Put Performance, Rebecca Caughey, Camille Thomas

International Journal of Exercise Science

International Journal of Exercise Science 15(6): 1357-1365, 2022. This study determined the relationship between high school athletes' maximal strength, jumping, and sprinting with shot put performance. High school athletes (n = 9; 16.9 ± 1 years; 110.4 ± 10.8 kg; 183.73 ± 9.33 cm) performed the broad jump, 1RM squat, 1RM bench, 40-yard dash with 10-yd split, and shot put. Strong positive correlations between shot put performance and broad jump (r = 0.89), 1RM squat (r = 0.90), and 1RM bench press (r = 0.87), and a strong negative correlation between shot put performance and 40-yd …

Physical Activity Is Related To Mental Health And Sexual Orientation Among Women In College, Ellen M. Brooks, Oliver W.A. Wilson, Lucas Elliott, Michele Duffey, Melissa Bopp

International Journal of Exercise Science

International Journal of Exercise Science 15(5): 1347-1356, 2022. Non-heterosexual women tend to report lower physical activity and poorer mental health than their heterosexual counterparts. The purpose of this study was to examine differences in mental health (stress and depression) and physical activity among female college students by sexual orientation. Students self-reported socio-demographic characteristics, physical activity, perceived stress, and depressive symptoms via an online survey. Correlations, independent samples t-tests, and multiple regression analyses were used to examine relationships between perceived stress, depressive symptoms, physical activity, and sexual orientation. Most participants (n = 1072, 20.0 ± 1.5 years) identified as heterosexual …

Impact Of Two Types Of Fitness Programs On Soldier Physical Fitness, Aaron G. Parks, William H. Murrah, Wendi H. Weimar, Paige A. Mchenry, Donald Bigham, Kkevin Giordano, Joellen M. Sefton

International Journal of Exercise Science

International Journal of Exercise Science 15(4): 1326-1346, 2022. This study compared an expert supervised, fully resourced physical training (PT) program compared to a traditional physical training PT plan on Army Officer Candidate School (OSC) soldier fitness outcomes. This retrospective cohort study compared 228 OCS soldiers (179 male [26.74±3.78 years] and 49 female [26.55±4.18 years]) in two companies for 12 weeks. One company participated in a fully resourced PT program designed by fitness experts to improve overall fitness and mobility (TAP-C). One company participated in traditional physical training designed to excel on the Army combat fitness test (ACFT, includes deadlift, power …

The Effects Of Step Aerobic Training On Muscle Power And Agility In Female Badminton Players, Charee Jansupom, Yupaporn Kanpetta, Khaothin Thawichai, Sarawut Kusump, Ashira Hiruntrakul

International Journal of Exercise Science

International Journal of Exercise Science 15(6): 1317-1325, 2022. The purpose of the study was to compare the effects of step aerobic training (SAT) on muscle power and agility in female badminton players. Twenty female badminton players were assigned to experimental groups (EG = 10) were for 30 minutes 3 days a week to perform SAT (age: 16.70 ± 1.15 yrs), and control groups (CG = 10) were regular badminton training. (age: 16.60 ± 1.17 yrs). Measures of muscle power was tested with a knee extensors (KE) and knee flexors (KF) isokinetic peak toque 180°/sec (NM) and agility was tested in …

The Reliability Of Three-Dimensional Inertial Measurement Units In Capturing Lower-Body Joint Kinematics During Single-Leg Landing Tasks, Jacob M. Thomas, Roger O. Kollock

International Journal of Exercise Science

International Journal of Exercise Science 15(1): 1306-1316, 2022. 3-D inertial measurement units (IMUs) have advantages over other types of motion capture systems, as IMUs cannot be obstructed by equipment and gear. Therefore, the purpose of this study was to assess the reliability of IMUs in measuring joint angles at the hip, knee, and ankle during two types of single-leg landings: 1) drop-landing (DL) and 2) leap-landing (LL). Nineteen subjects, both males (n = 9, 21.88 ± 1.64 yrs, 178.36 ± 9.68 cm, 185.68 ± 16.63 kg) and females (n = 11, 22.45 ± 4.32 yrs, 171.57 ± 6.55 …

Wellness Review 2022, Part 1, Martin Huecker, Brian A. Ferguson, Jacob Shreffler

Journal of Wellness

Introduction: This article represents the first of a two-part assessment of 2022 literature addressing wellness in healthcare professionals published from January 1, 2022 to June 30, 2022.

Methods: Three editors conducted a similar keyword search in Pubmed, also adding manually curated articles. Focusing chiefly on clinical trials and other prospective research, we settled on a final 25 significant papers focusing on wellness in medical professionals to include in this review.

Literature Review: Recent literature into HCW wellness continues to describe burnout factors and COVID-19 impact, but includes more resilience-targeting interventions and systematic reviews of trials seeking bolstering of well-being. Subsections …

Deaths In Open Water Swimming Races In Brazil From 2009 To 2019, Fabrízio Di Masi, Gabriel Costa E Silva, Danielli Braga De Mello, David Szpilman, Mike Tipton

International Journal of Exercise Science

International Journal of Exercise Science 15(6): 1295-1305, 2022. Since the inclusion in the Olympic Games (2008), open swimming races have attracted greater media attention and, therefore, have a greater number of practitioners, especially in Brazil, an extremely favorable country for this sport. However, increasing reports of fatal incidents in open water races brought the medical and scientific community to attention. The aim of this study was to review the characteristics of deaths in open waters events in Brazil from 2009 to 2019. The survey was divided into 3 steps: 1) contacting sports-related federations and companies, including swimming and triathlon federations, …

Exploring Predictive Ability Of Fitness Test Data Relative To Fire Academy Graduation In Trainees: Practical Applications For Physical Training, Robert G. Lockie, Robin (Rob) Marc Orr, Fernando Montes, Tomas Ruvalcaba, J. Jay Dawes

International Journal of Exercise Science

International Journal of Exercise Science 15(4): 1274-1294, 2022. This study investigated the predictive abilities of fitness tests relative to academy graduation in firefighter trainees. Archival fitness test data from 305 trainees were analyzed, including: Illinois agility test (IAT); push-ups; pull-ups; leg tucks; multistage fitness test; 4.54-kg backwards overhead medicine ball throw (BOMBT); 10-repetition maximum deadlift; and a 91.44-m farmers carry with 18-kg kettlebells. Within the department, trainees were allocated points for each test. Trainees were split into graduated (245 males, 16 females) or released (29 males, 15 females) groups. Independent samples t-tests and effect sizes calculated between-group fitness test differences …

Physiological Responses To Speed-Matched Running On Non-Motorized Assault Airrunner Versus Traditional Treadmills In Active Females: A Pilot Study, Noelle Morrow, Kayla Mitchell, Hannah Weighart, Diana Alonzo, Stephen Ives

International Journal of Exercise Science

International Journal of Exercise Science 15(4): 1262-1273, 2022. Treadmills are utilized as a training tool to improve aerobic fitness, but precise understanding of intensity and the corresponding physiological strain is critical for optimizing exercise prescription and associated adaptations. Running on non-motorized, curved treadmills may result in greater oxygen uptake (VO₂), increased heart rate (HR), and increased rating of perceived exertion (RPE) compared to traditional motorized treadmills. The purpose of this study was to investigate the physiological responses on non-motorized versus traditional motorized treadmills during speed-matched running. Participants were 4 college-aged, recreationally active females. HR, VO₂, respiratory …

Implementation Of High Intensity Interval Training And Autoregulatory Progressive Resistance Exercise In A Law Enforcement Training Academy, Gabriel J. Martinez, Xin Ma, Stuart A. Best, Benjamin F. Johnson, Mark Abel

International Journal of Exercise Science

International Journal of Exercise Science 15(4): 1246-1261, 2022. The purpose of this investigation was to assess the feasibility and efficacy of implementing autoregulatory progressive resistance exercise (APRE) and high intensity interval training (HIIT) methodologies to improve physical fitness and occupational physical ability in police cadets. Two law enforcement academy classes were stratified into a standard care academy training cohort (SC; n=32, m=27, f=5) and a high performance cohort (HP; n=31; m=27, f=4) that utilized APRE and HIIT methodologies during a 17-week academy training program. Demographic, internal loading parameters, anthropometric, fitness outcomes (i.e., 1.5-mile run, 1-repetition maximum bench press, sit-up repetitions, …

Application Of Polynomial Regression Model For Joint Stiffness, Youngmin Chun, Craig Mcgowan, Jinah Kim, Joshua P. Bailey

International Journal of Exercise Science

International Journal of Exercise Science 15(1): 1236-1245, 2022. Quasi-stiffness (joint stiffness) is often used to characterize leg properties during athletic and other activities and has been reported by a single slope of angle-moment curve. However, the joint angle-moment relationship of some relationship are not effectively represented by a simple linear regression model. Thus, the purpose of this analysis was to investigate the benefits of utilizing a 2^nd order polynomial regression (quadratic) model as compared to the linear model when calculating lower extremity joint stiffness incorporating subdivided eccentric phases. Thirty healthy and active college students performed 15 drop jumps from …

Energy Cost Of Reclining, Sitting, And Standing Activities In Chinese Adults, Jiajia Liu, Yiyan Li, Minghui Quan, Jie Zhuang, Zhen-Bo Cao, Zheng Zhu, Yongming Li, Stephen D. Herrmann, Barbara E. Ainsworth

International Journal of Exercise Science

International Journal of Exercise Science 15(7): 1202-1211, 2022. The 2011 Compendium presents MET values for sedentary behaviors (SBs) and light-intensity physical activities (LIPAs). Some entries have estimated METs, others have multiple activities in a single entry, and newer activities are not in the Compendium. Accurate MET values are needed to increase the validity and generalizability of the Compendium. This study measured and analyzed SBs and LIPAs’ energy costs in reclining, sitting, standing postures, and fidgeting. Indirect calorimetry measured the energy costs (VO₂, ml^.kg^-1.min^-1) in 11 males and seven females (30.7 ± 7.6 …

Differences In Rate Of Perceived Exertion And Workload Intensity In Males And Females During Submaximal Arm And Leg Ergometry, Konrad J. Dias, Amanda Mungenast, Stephanie Sherwood, Patrick Mcpherson, Allison Verville, Shannon Eaton, Dustin Nadler

International Journal of Exercise Science

International Journal of Exercise Science 15(4): 1222-1235, 2022. Purpose: Arm ergometry (AE) is necessitated for individuals unable to perform leg ergometry (LE) exercise. This study explored gender differences in RPE and workload (WL) during AE and LE at submaximal target heart rates (THR). Methods: 35 healthy college-aged individuals were randomly allocated to begin exercise on either AE or LE. Participants exercised on both modes with increasing WL to achieve submaximal THRs of 110, 120, 130, 140 and 150 beats per minute (bpm). Factorial ANOVAs tested for differences in RPE and WL. Results: No significant differences were found in RPE between …

Effects Of Varying Load Intensity On Skeletal Muscle Damage Between Two Isovolumic Resistance Exercise Bouts, Lee J. Winchester, Cody E. Morris, Patton Allen, Teresa Wiczynski, Scott W. Arnett, T. Scott Lyons

International Journal of Exercise Science

International Journal of Exercise Science 15(4): 1212-1221, 2022. There are limited data comparing the efficacy of resistance loads within the hypertrophy range for promoting muscular growth, particularly when similar training volumes are utilized. The purpose of this study was to determine if two similar volume-loads, utilizing different intensities, would produce dissimilar muscular damage and inflammation. Eleven resistance-trained, college-aged males participated in this study. After testing 1RM barbell squats, participants completed two similar volume-load barbell squat sessions at two different resistance loads (67% and 85% of 1RM) on two separate visits. Venous blood samples were collected at baseline and one hour …

Sex Differences In Measures Of Wave Reflection And Aortic Arterial Stiffness In Response To Weight Machine Resistance Exercise, Emily K. Erb, Stacie Humm, Sarah Kearney, Anthony G. Pinzone, Michelle A. Kern, J. Derek Kingsley

International Journal of Exercise Science

International Journal of Exercise Science 15(2): 1190-1201, 2022. While it has been demonstrated that acute resistance exercise (RE) alters measures of wave reflection and aortic arterial stiffness in young, healthy individuals, limited research has evaluated sex differences. Accordingly, we recruited moderately active, resistance-trained men (Age: 22 ± 3yrs, n=12) and women (23 ± 3yrs, n=10) to perform two randomized conditions consisting of an acute bout of weight machine RE or a quiet control (CON). Measures of aortic wave reflection and aortic stiffness were taken at baseline and 15 minutes following the RE (Recovery). At baseline, women had significantly higher heart …

Efficacy Of A 6-Week Suspension Training Exercise Program On Fitness Components In Older Adults, Christina Pierle, Alexander T. Mcdaniel, Lindsey H. Schroeder, Michel J.H. Heijnen, Wayland Tseh

International Journal of Exercise Science

International Journal of Exercise Science 15(3): 1168-1178, 2022. The purpose of this study was to determine the efficacy of a 6-week suspension training exercise program on fitness components in older adults. Eleven participants (age = 80 ± 5 yrs) completed a 6-week suspension training exercise program. Pre- and post-fitness assessments comprised of body composition, handgrip dynamometer, functional reach, and balance. The 6-week suspension training intervention required individuals to perform suspension training exercises for fifty minutes, twice per week. A paired sample t-test was used to determine differences from pre-and post-assessments. An improvement was observed in functional reach (57.2 ± …

The Association Between Handgrip Strength Asymmetry Severity And Future Morbidity Accumulation: Results From The Health And Retirement Study, Lukus Klawitter, Kyle Collins, Dawson Ringhofer, Bryan Christensen, Ryan Mcgrath

International Journal of Exercise Science

International Journal of Exercise Science 15(3): 1133-1141, 2022. Analyzing the severity of handgrip strength (HGS) asymmetry in aging populations may help to screen for morbidities and add utility to handgrip dynamometer testing. Our study sought to determine the relationships between HGS asymmetry severity and future accumulating morbidities in older Americans. Secondary analyses from the 2006-2016 waves of the Health and Retirement Study included 18,506 adults ≥ 50 years old. The highest recorded HGS values from each hand were used to calculate HGS asymmetry ratio (non-dominant HGS/dominant HGS). If the HGS asymmetry ratio < 1.0, it was inversed to make all asymmetry ratios ≥ 1.0. Participants were categorized into groups based on the severity of their HGS asymmetry ratio: 1) 0.0% - 10.0%, 2) 10.1% - 20.0%, 3) 20.1% - 30.0%, and 4) > 30.0%. Healthcare provider-diagnosed morbidities (hypertension, diabetes, cancer, chronic …