Biomedical subjects

F M Perna

Publications and source records attributed to F M Perna.

6 recordsLinked to original sources

PubMed2000

Psychology/Counseling: a universal competency in athletic training.

OBJECTIVE: To present the rationale that certified athletic trainers (ATCs) may require structured educational training in the psychological aspects of athletic injury. DATA SOURCES: We searched MEDLINE, Psych Lit, Psyc- INFO, First Search, and SPORT Discus databases for the years 1990 through 1999 under the search terms "psychological distress," "depression," "athletic injury," and "rehabilitation adherence." DATA SYNTHESIS: Psychological factors are significant predictors of athletic injury. Athletic injury is accompanied by significant psychological distress, which has been shown to impair rehabilitation compliance and possibly physical recovery. Although "counseling" and knowledge of psychological aspects of injury are required National Athletic Trainers' Association competencies, extant data suggest that athletic trainers may lack training in this competency. CONCLUSIONS: Evidence suggests that (1) psychological distress is prospectively associated with the incidence of athletic injury, and prolonged psychological distress, specifically depression, may occur after athletic injury; (2) psychological factors may also either hinder or facilitate rehabilitation adherence, compliance, and recovery; (3) psychological distress may persist even after physical recovery has been completed; (4) psychosocial factors related to injury occurrence and injury recovery may be overlooked by ATCs, but knowledge of these factors and appropriate use of referral sources may enhance the effectiveness of ATCs; and (5) ATCs may benefit from structured educational experiences specific to the National Athletic Trainers' Association psychology/counseling competency. RECOMMENDATIONS: With 75% of a national survey of ATCs indicating that they do not have access to a sport psychologist, it would be advantageous for ATCs to gain adequate training in the recognition, evaluation, and treatment of psychological factors associated with athletic injury. The literature also suggests that structured educational training with respect to psychological aspects of athletic injury would be well received by ATCs.

Journal Article↗

PubMed1999

Cardiopulmonary and CD4 cell changes in response to exercise training in early symptomatic HIV infection.

PURPOSE: The purposes of the present study were to assess the effects of a 12-wk laboratory based aerobic exercise program on cardiopulmonary function, CD4 cell count, and physician-assessed health status among symptomatic pre-AIDS HIV-infected individuals (N = 28) and to assess the degree to which ill health was associated with exercise relapse. METHODS: Responses to graded exercise test, physician-assessed health status, and CD4 cell counts were determined at baseline and 12-wk follow-up for participants randomly assigned to exercise or control conditions, and reasons for exercise noncompliance were recorded. RESULTS: Approximately 61% of exercise-assigned participants complied (> 50% attendance) with the exercise program, and analyses of exercise relapse data indicated that obesity and smoking status, but not exercise-associated illness, differentiated compliant from noncompliant exercisers. Compliant exercisers significantly improved peak oxygen consumption (VO2peak; 12%), oxygen pulse (O2pulse; 13%), tidal volume (TV; 8%), ventilation (VE; 17%), and leg power (25%) to a greater degree than control participants and noncompliant exercisers (all P < 0.05). Although no group differences in health status were found, a significant interaction effect indicated that noncompliant exercisers' CD4 cells declined (18%) significantly, whereas compliant exercisers' cell counts significantly increased (13%; P < 0.05). CONCLUSION: We conclude that although aerobic exercise can improve cardiopulmonary functioning in symptomatic HIV-infected individuals with minimal health risks, attention to factors associated with exercise adherence is warranted.

Adult↗

PubMed1998

Cognitive-behavioral intervention effects on mood and cortisol during exercise training.

The purpose of the present study was to assess the effect of a time limited cognitive-behavioral stress management program (CBSM) on mood state and serum cortisol among men and women rowers (N = 34) undergoing a period of heavy exercise training. After controlling for life-event stress (LES), CBSM was hypothesized to reduce negative mood state and cortisol among rowers during a period of heavy training; mood and cortisol changes over the intervention period were hypothesized to be positively correlated. LES was positively associated with negative affect at study entry. After covariance for LES, rowing athletes randomly assigned to the CBSM group experienced significant reductions in depressed mood, fatigue, and cortisol when compared to those randomized to a control group. Decreases in negative affect and fatigue were also significantly associated with cortisol decrease. These results suggest that CBSM may exert a positive effect on athletes' adaptation to heavy exercise training.

Adolescent↗

PubMed1998

Social cognitive and physical health determinants of exercise adherence for HIV-1 seropositive, early symptomatic men and women.

This study examined social cognitive and physical health factors that might explain variations in exercise adherence in a 3-month supervised exercise intervention for a group of mildly symptomatic, HIV-1 seropositive men and women. The social cognitive predictor variables were outcome expectations and self-efficacy. The physical health predictor variables included CD4+ cell counts, self-report inventories of physical symptoms, and physicians' examinations. Self-report inventories of physical symptoms were associated with physicians' examinations and combined into a composite measure of physical health. Criterion variables included exercise adherence rates, VO2max change, and status as a 'remainder' versus 'drop-out.' The composite measure of physical health emerged as a significant predictor of adherence rate and gave perfect prediction of remainers and a moderate prediction of dropouts. No significant associations were observed between the social cognitive predictors and adherence. Results suggest that for this population physical health status is a better predictor of exercise adherence than either perceived self-efficacy or outcome expectancy.

Journal Article↗

PubMed1997

Psychological stress, exercise and immunity.

In terms of cardiovascular, endocrine and immune responses, acute high-intensity aerobic exercise stress may be considered as a subcategory of stressful active coping. The cardiorespiratory responses of both include increases in heart rate, cardiac output, systolic blood pressure, skeletal muscle vasodilation and oxygen consumption. Neurohormonal responses include increases in catecholamines as well as elevations in cortisol under high but relatively low sympathetic activation. Immune system responses include increases in natural killer (NK) cell number and cytotoxicity and suppressor/cytotoxic lymphocytes as well as decreased proliferative response to mitogens. Task and recovery periods for both acute psychological stress or exercise show biphasic changes in immune response such that immune status is negatively impacted during recovery. Chronic life stressors influence acute cardiovascular, endocrine and immune responses to acute stressors. In addition, both chronic stress and unusually heavy chronic exercise can negatively impact immune status. Given impaired immune status following chronic stress and interactive effects of acute and chronic stressors (e.g. blunted acute NK responses to acute stressors), it is suggested that these factors may extend the window of vulnerability for infectious agents to act following acute psychological (e.g. examinations) or strenuous exercise (competitive athletics) stressors.

Exercise↗

PubMed1995

Role of psychological stress in cortisol recovery from exhaustive exercise among elite athletes.

Life-event stress (LES) was used to classify elite athletes (n = 39) into high- and low-LES groups. A repeated measures analysis of variance revealed higher cortisol concentration after a graded exercise lest among the high-LES group relative to the low-LES group, which was maintained for up to 20 hr. Subsequent prospective analyses further indicated that high-LES athletes were more likely lo he symptomatic than low-LES athletes and that elevated cortisol level was positively correlated with symptomatology. To the extent that cortisol is a marker of exercise recovery in competitive athletes. our results suggest that chronic stress prolongs the recovery process, which may potentially widen a window of susceptibility for illness and injury among competitive athletes.

Journal Article↗