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PubMed2002

Muscular adaptations in response to three different resistance-training regimens: specificity of repetition maximum training zones.

Thirty-two untrained men [mean (SD) age 22.5 (5.8) years, height 178.3 (7.2) cm, body mass 77.8 (11.9) kg] participated in an 8-week progressive resistance-training program to investigate the "strength-endurance continuum". Subjects were divided into four groups: a low repetition group (Low Rep, n = 9) performing 3-5 repetitions maximum (RM) for four sets of each exercise with 3 min rest between sets and exercises, an intermediate repetition group (Int Rep, n = 11) performing 9-11 RM for three sets with 2 min rest, a high repetition group (High Rep, n = 7) performing 20-28 RM for two sets with 1 min rest, and a non-exercising control group (Con, n = 5). Three exercises (leg press, squat, and knee extension) were performed 2 days/week for the first 4 weeks and 3 days/week for the final 4 weeks. Maximal strength [one repetition maximum, 1RM), local muscular endurance (maximal number of repetitions performed with 60% of 1RM), and various cardiorespiratory parameters (e.g., maximum oxygen consumption, pulmonary ventilation, maximal aerobic power, time to exhaustion) were assessed at the beginning and end of the study. In addition, pre- and post-training muscle biopsy samples were analyzed for fiber-type composition, cross-sectional area, myosin heavy chain (MHC) content, and capillarization. Maximal strength improved significantly more for the Low Rep group compared to the other training groups, and the maximal number of repetitions at 60% 1RM improved the most for the High Rep group. In addition, maximal aerobic power and time to exhaustion significantly increased at the end of the study for only the High Rep group. All three major fiber types (types I, IIA, and IIB) hypertrophied for the Low Rep and Int Rep groups, whereas no significant increases were demonstrated for either the High Rep or Con groups. However, the percentage of type IIB fibers decreased, with a concomitant increase in IIAB fibers for all three resistance-trained groups. These fiber-type conversions were supported by a significant decrease in MHCIIb accompanied by a significant increase in MHCIIa. No significant changes in fiber-type composition were found in the control samples. Although all three training regimens resulted in similar fiber-type transformations (IIB to IIA), the low to intermediate repetition resistance-training programs induced a greater hypertrophic effect compared to the high repetition regimen. The High Rep group, however, appeared better adapted for submaximal, prolonged contractions, with significant increases after training in aerobic power and time to exhaustion. Thus, low and intermediate RM training appears to induce similar muscular adaptations, at least after short-term training in previously untrained subjects. Overall, however, these data demonstrate that both physical performance and the associated physiological adaptations are linked to the intensity and number of repetitions performed, and thus lend support to the "strength-endurance continuum".

Adaptation, Physiological↗

PubMed2005

High versus low training frequency in cardiac rehabilitation using a systems model of training.

No study has reported the long term effects of cardiac rehabilitation, concerning the duration of beneficial effects of training program. The present study analyzed the influence of training session frequency on long-term beneficial effects in patients with coronary artery disease (CAD) undergoing phase 2 cardiac rehabilitation. Four patients with CAD completed 20 training sessions. Two patients were assigned to low training frequency (LTF) and two to high training frequency (HTF): three and five sessions per week(-1), respectively. The method was based on the systems model of training and required training quantification and the assessment of real exercise tolerance. Convolution of training quantity with real exercise tolerance provided the model exercise tolerance for every patient. The model parameters, the magnitude factor (k), and the time constant of decay (tau), were fitted from real and model exercise tolerances by the least squares method. LTF and HTF resulted in similar increases in exercise tolerance (12-14%). A model with one-component (fitness) allowed fitting exercise tolerance in all patients with r (2) = 0.77, 0.79, 0.84, and 0.91, respectively (p < 0.05). The addition of a second component did not improve the fit in any patient (p > 0.05). The k value was about twice as high with LTF (0.13 and 0.16 AU) than with HTF (0.05 AU for the two patients), whereas the tau value was about twice as low with LTF (37 and 41 days) than with HTF (72 and 89 days). The long term beneficial effects estimated by 4tau, were twice as long with HTF (288 and 356 days) than with LTF (148 and 164 days). We concluded that exercise tolerance was similarly increased with HTF and LTF but HTF training induced beneficial effects which were sustained twice as long.

Adaptation, Physiological↗

PubMed1999

Plasma cortisol and beta-endorphin concentrations in trained and over-trained standardbred racehorses.

The effects of training and over-training on plasma cortisol and beta-endorphin (betaEP) concentrations at rest and after standardised exercise tests and the cortisol responses to adrenocorticotropin (ACTH) administration were investigated in standardbred horses. Twelve horses were divided randomly into control and over-trained (OT) groups after 17 weeks slow- and moderate-intensity treadmill training. The standardised treadmill exercise test consisted of 2 min at velocities corresponding to 30, 50, 70 and 100% of maximum O2 consumption. Over-training, defined as a significant decrease in body weight and treadmill run-time-to-fatigue in an incremental velocity test, occurred in the OT group after 32 weeks of training exercise. Peak cortisol concentrations after exercise decreased significantly in the OT group from 320+/-15.6 at week 8 to 245+/-17.0 nmol l(-1) at week 32, and mean cortisol concentrations over a 120-min period after exercise decreased from 258+/-11.7 to 192+/-16.6 nmol l(-1) (P<0.05). Mean and total cortisol and betaEP concentrations in resting horses were not significantly different after over-training. Peak cortisol concentrations after adrenocorticotropin (ACTH) administration were not significantly different in the over-trained group. Dysfunction of the hypothalamo-pituitary-adrenocortical axis occurs in over-trained horses, but this adaptation is not associated with a change in the adrenocortical responsiveness to ACTH.

Adrenal Glands↗

PubMed1992

Properties of favored patterns in spontaneous spike trains and responses of favored patterns to electroacupuncture in evoked trains.

By using 'the modified detection method', our previous study has shown that all spontaneous spike trains recorded from several areas of brain and spinal cord have favored patterns (FPs). The present study further shows that: (1) all newly detected spike trains from substantia nigra zona compacta, nucleus periventricularis hypothalami and nucleus hypothalamicus posterior also have FPs, and some spike trains from neurons in the same nucleus have a common favored pattern (CF, i.e. they share the same FP), indicating that FP and CF in spike trains are common phenomena; (2) all serial correlation coefficients of FP repetitions (in serial order) in different spike trains detected are less than 0.3 (close to 0), revealing that the repetition of FPs is a renewal process; (3) in different periods of the spike trains evoked by electroacupuncture (EA), the number of different FPs and the number of repetitions of the same representative FP either increase or decrease along with the change of firing rate. The tendencies of these changes are very similar, but after EA the repetitions of different FPs in the same spike trains change differently, showing that different (hidden) responses exist at the same time. The above results suggest that the FPs in spike trains may represent various neural codes, and 'the modified detection method of FP' can pick up more information from spike trains than the firing rate analysis, hence it is a very useful tool for the study of neural coding.

Animals↗

PubMed1982

Variations in plasma glucose, insulin, growth hormone and catecholamines in response to insulin in trained and non-trained subjects.

Previous studies have shown a reduced insulin secretion in trained subjects challenged by a glucose load. In the present study the response to insulin of 8 athletes was compared to that of 8 non-trained subjects. The disappearance of plasma insulin was not different between the two groups, but the level of hypoglycemia was greater in the trained subjects. The injection of insulin increased the plasma levels of epinephrine (E) and norepinephrine (NE) in both groups of subjects, but the raise in E was greater in the trained subjects. Similarly, the increase of growth hormone (GH) was greater in the trained subjects. These findings substantiate previous results showing a decreased insulinic index and an increased insulin binding to monocytes in trained subjects. It is also suggested that the enhanced E and GH secretion found in trained subjects injected with insulin, is possibly related to the greater fall in plasma glucose in the trained subjects compared to the non-trained subjects.

Adult↗

PubMed2004

High intensity physical group training in water--an effective training modality for patients with COPD.

The aim of this study was to examine the effect of high intensity physical group training in water and on land for patients with COPD with regard to physical capacity and health related quality of life (HRQoL). A controlled, semi-randomised study was conducted where 30 patients were randomised to training either in water or on land. Thirteen patients constituted a control group. Forty-three outpatients, with moderate to severe COPD (27w/16m), from two local hospitals in northern Sweden, were included in the study. High intensity physical group training in water (water group) or on land (land group) was performed for 12weeks, three times per week, 45min per session. The control group received no intervention. Pre- and post-intervention, all patients performed incremental and endurance shuttle walking tests (ISWT and ESWT), cycle ergometer tests and responded questionnaires about HRQoL (St. Georges Respiratory Questionnaire--SGRQ and SF-36). The patients trained with a mean heart rate of 80-90% of peak heart rate. Both training groups increased the distance walked, i.e. land group in ISWT (25m) and water group in ESWT (179m). The water group increased the distance in ESWT significantly more that both the land and the control groups. Both training groups increased the time cycled (40-85s) and work load (10-20W) in the cycle ergometer test. The control group deteriorated in HRQoL according to total score in SGRQ while the training groups remained constant. The water group improved their activity score in SGRQ and their physical health score in SF-36 and those improvements were significant as compared to the land and the control groups. In conclusion, high intensity physical group training in water is of benefit for patients with COPD. It was in some areas found to be even more effective regarding improvements in physical capacity and experienced physical health compared to the same kind of training on land.

Aged↗

PubMed2004

Laparoscopic training and practice in gynecologic oncology among Society of Gynecologic Oncologists members and fellows-in-training.

OBJECTIVE: To determine the proportion of Society of Gynecologic Oncologists (SGO) members performing laparoscopic procedures and to determine SGO members' and fellows' opinions regarding indications for and the adequacy of training in laparoscopy. METHODS: Surveys were mailed to SGO members and fellows-in-training in December 2002. Anonymous responses were collected by mail or through a Web site. The survey was mailed twice and was estimated to take 5 min to complete. The data were analyzed using frequency distributions and nonparametric tests. RESULTS: Three hundred thirty-six SGO members (45%) and fifty-seven fellows (49%) responded. Among SGO members, 272 (84%) currently performed laparoscopic surgeries. Reasons cited for performing laparoscopy were decreased length of hospital stay (74%), improved patient quality of life (57%), patient preference (48%), improved cosmesis (46%), and better visualization (18%). Among those who did not perform laparoscopy, 50% cited increased operating time as their main reason. When asked to indicate the laparoscopic procedure most commonly performed in their practice, 69% reported diagnosis of an adnexal mass; 11%, prophylactic bilateral salpingo-oophorectomies; and 10%, laparoscopically assisted vaginal hysterectomy and lymph node staging for uterine cancer. Only 3% of SGO respondents performed more than 50% of their procedures laparoscopically, and all respondents reported converting from laparoscopy to laparotomy less than 25% of the time. Most respondents had limited laparoscopic training during their fellowships: 39% received none, and 46% received limited (less than five procedures per month) training. Nevertheless, 78% of SGO respondents rated their laparoscopic skills as either very good or good. Among fellows, only 25% believed they were receiving very good or good laparoscopic training. Eighty percent of SGO respondents believe that at least six procedures per month were necessary for adequate training, yet only 33% of fellows performed that many procedures. CONCLUSIONS: Most SGO respondents used laparoscopy for selective indications, and most developed their laparoscopic skills after their fellowship training. SGO respondents believed laparoscopic instruction is an important part of training, but most fellows perceived their laparoscopic training as inadequate.

Adult↗

PubMed1989

Diazepam prevents post-training drug effects related to state dependency, but not post-training memory facilitation by epinephrine.

Rats were trained and tested in a step-down inhibitory avoidance task (0.3-mA footshock). Training-test interval was 6 h. In Experiment 1, animals received, 1 h before training, an ip injection of vehicle or diazepam (2.0 mg/kg) and, 30 s after training and/or 30 min prior to testing, ip saline, epinephrine (6.25 micrograms/kg or 125.0 micrograms/kg), naloxone (0.5 mg/kg), or beta-endorphin (1 micrograms/kg). In the vehicle-pretreated animals, post-training epinephrine (6.25 micrograms/kg) and naloxone enhanced, and post-training beta-endorphin and epinephrine (125.0 micrograms/kg) reduced, retention test performance; and pretest beta-endorphin and epinephrine (125.0 micrograms/kg) reversed the latter effect and enhanced retention on their own. Diazepam lowered memory scores on its own and prevented all other drug effects with the exception of post-training facilitation by epinephrine (6.25 micrograms/kg). In previous papers it was shown that post-training facilitation by epinephrine is due to an influence on storage processes, whereas all the other drug effects described above result from the post-training establishment of state dependency to either beta-endorphin or epinephrine, and therefore to a process involving further acquisition and storage. The present findings suggest that diazepam selectively hindered the acquisition and/or storage processes involved in state dependency. This conclusion is strengthened by the findings from Experiment 2, which showed, using a classic 2 x 2 design, that diazepam itself did not induce state dependency but, rather, depressed acquisition and/or storage of the avoidance task.

Animals↗

PubMed1997

Airway management training using the laryngeal mask airway: a comparison of two different training programmes.

Nurses without prior experience in the use of the laryngeal mask airway (LMA) were randomly allocated to one of two groups to be trained in the emergency technique of insertion of an LMA. Group A (32 nurses) were trained only on a manikin and group B (20 nurses) were trained on a manikin and with live anaesthetised patient practice in theatre (five successful insertions). Without further practice, both groups were asked to insert an LMA in a live patient in theatre 3 months after initial training. Three attempts per nurse were allowed. In group A, 75% passed the LMA successfully at the first attempt, 22% at the second attempt and 3% (one nurse) at the third attempt. In group B, 80% were successful at first attempt and 20% at the second attempt. Skill performance and retention were shown to be high following either training method, with no significant difference between the performance of either group (chi 2). We have shown that manikin-only training in the emergency technique for LMA insertion is as effective as live patient training. It is proposed that manikin training alone may be adopted as a future training modality if, as is expected, the use of the LMA in resuscitation becomes more commonplace.

Cardiopulmonary Resuscitation↗

PubMed1996

Specificity of training velocity and training load on gains in isokinetic knee joint strength.

The present study investigated the effects of three different strength training regimes on the isokinetic strength profile of the knee extensors (quadriceps, Q) and flexors (hamstrings, H) and if increases in isokinetic strength were accompanied by an enhanced performance during a more complex leg movement, the soccer kick. Twenty-two elite soccer players performed 12 weeks of strength training (three times per week) at either high resistance (HR group: 4 sets, 8 reps, 8RM loading), low resistance (LR group: 4 sets, 24 reps, 24RM loading), loaded kicking movements (LK group: 4 sets, 16 reps, 16RM loading) while one group served as controls (CO group). Isokinetic concentric and eccentric moment of force was obtained (KinCom) as peak moment (Mpeak) and moment at 50 degrees knee flexion (M50) at angular velocities of 30, 120, 240 degrees s-1. Isokinetic knee joint strength was unchanged in groups LR, LK, CO. However, after the HR strength training, concentric Mpeak (+/- SD) increased (P < 0.01) at 30 degrees s-1 (Q, 258 +/- 37 to 297 +/- 57 Nm; H, 122 +/- 22 to 140 +/- 21 Nm). Furthermore, eccentric Mpeak increased at 30, 120 and 240 degrees s-1 (Q, 274 +/- 60 to 345 +/- 57 Nm (P < 0.01), 291 +/- 56 to 309 +/- 49 Nm and 275 +/- 43 to 293 +/- 36 Nm (P < 0.05), respectively; H, 143 +/- 32 to 158 +/- 25 Nm, 152 +/- 39 to 169 +/- 31 Nm and 148 +/- 27 to 163 +/- 19 Nm (P < 0.05)). Corresponding increases (P < 0.05) were observed for M50. The H/Q ratio calculated as eccentric hamstring strength divided by concentric quadriceps strength (Hecc/Qcon, representative for knee extension) at 240 degrees s-1 increased (P < 0.05) from 107 to 118% (based on Mpeak) and from 90 to 105% (M50). Kicking performance estimated by maximal ball flight velocity was unaffected by any of the strength training regimes investigated. In conclusion, only heavy-resistance strength training induced increases in isokinetic muscle strength in the absence of learning effects. Concentric strength gains were observed at the actual velocity of training, while eccentric strength gains were found over the entire range of velocities examined. The capacity of the hamstring muscles for providing stability to the knee joint during fast extension was augmented as a result of the heavy-resistance strength training. Strength training should be integrated with other types of training involving the actual movement pattern in order to increase the performance within more complex movement patterns.

Adult↗

PubMed1998

Experience from controlled trials of physical training in chronic heart failure. Protocol and patient factors in effectiveness in the improvement in exercise tolerance. European Heart Failure Training Group.

BACKGROUND: Beneficial effects of physical training on exercise tolerance, autonomic and skeletal muscle function and limb blood flow have been demonstrated in chronic heart failure. Because this rehabilitation is expensive, may involve risk, and has unknown effects on prognosis, the possibility of predicting benefit on the basis of individual patient data is intriguing. The most suitable exercise training programme has not yet been established. METHODS AND RESULTS: We reviewed the progress of 134 stable heart failure patients studied in randomized controlled trials of physical training. A significant training effect (+13% peak oxygen consumption, +17% exercise duration) was associated with improved autonomic indices (resting catecholamines and hormones, heart rate variability), without significant side-effects. No ventilatory, haemodynamic, autonomic or clinical factor at baseline was a predictor of outcome. Similar beneficial effects were observed in both male and female patients. The improvement in oxygen consumption after 16 weeks training was higher than after 6 weeks (+2.6 +/- 3.0 vs +0.3 +/- 3.1 ml.kg.min-1, P < 0.05). The combination of cycle ergometer with calisthenic exercises was more beneficial than cycle ergometer alone (+2.7 +/- 4.2 vs 1.2 +/- 2.0 ml.kg.min-1, P < 0.01). The presence of nonsustained ventricular tachycardia did not preclude a training effect. Patients older than 70 years were able to train, although less effectively than the younger ones. No difference in exercise gain was observed whether the patients trained in the hospital or at home. CONCLUSION: The positive effects of physical rehabilitation in chronic stable heart failure patients are confirmed. No baseline patient factor was significantly correlated with outcome. A tailored, moderate, home-based, combined cycle ergometer, plus calisthenic exercise training seems safe and beneficial in a large cohort of heart failure patients, with similar benefits in a variety of conditions and different hospital settings.

Adult↗

PubMed1997

VO2max and haemoglobin mass of trained athletes during high intensity training.

The correlation between relative haemoglobin mass (Hb mass, g x kg[-1]) and relative maximal oxygen consumption (VO2max, ml x kg(-1) x min[-1]) in 62 trained athletes (33 male runners, 12 male rowers and 17 female rowers) with national and/ or international competitive experience was examined. The correlation between Hb mass and VO2max was highest for the female rowers (n=17, r=0.92, p<0.0001), lower for the male rowers (n = 12, r=0.79, p < 0.005) and lowest for the male runners (n=33, r=0.48, p = 0.005). These results suggest that, within an athletic sample, Hb mass may be used to estimate potential aerobic power. In a second series of experiments, Hb mass was measured before and after three different training programs in sub-sets of the subjects used in the earlier study. Hb mass did not change following 12 weeks of intense rowing training, 4 weeks of heat training (32 degrees C), or 4 weeks of medium-altitude training (1740 m). The corresponding increases in VO2max were 7.8%, no change and 2.1 %, respectively. These results suggest that heat or altitude training does not increase Hb mass in trained athletes. Previous studies that demonstrate increases in total red cell volume following altitude acclimatization used subjects with only modest aerobic power, whereas the present study used trained subjects. It is concluded that trained athletes with erythrocythemic hypervolemia have limited capability to increase further either total red cell volume or Hb mass.

Acclimatization↗

PubMed2001

Training seniors in the operation of an automated external defibrillator: a randomized trial comparing two training methods.

STUDY OBJECTIVE: This study evaluated the differences in efficacy of 2 methods for training seniors in the use of an automated external defibrillator (AED). We tested the hypothesis that each training method (face-to-face instruction compared with video-based instruction) would result in similar AED performance on a manikin. METHODS: Two hundred ten seniors from various senior centers were randomized to receive face-to-face or video-based instruction on AED skills. Seniors were assessed individually and tested on the speed and quality of AED performance. We retested 177 of these initial trainees 3 months after initial training. Similar performance measures were assessed. RESULTS: Although there were statistically significant differences between the 2 training methods in terms of average time to shock at both evaluations, the results in general demonstrate that there were no clinically meaningful distinctions (time differences of <20 seconds) between the AED performance of seniors trained with a video and seniors trained in a face-to-face setting at the initial training or at the retention assessment. At the initial evaluation, overall performance was satisfactory, with greater than 98% trained with either method delivering a shock. However, at the 3-month follow-up, almost one fourth of trainees were not able to deliver a shock, and almost half were not able to correctly place the pads on the manikin. CONCLUSION: We believe that seniors can be trained equally well in AED performance with video-based self-instruction or face-to-face instruction. How to maintain acceptable AED performance skills over time remains a challenge.

Aged↗

PubMed2002

Effect of the movement speed of resistance training exercises on sprint and strength performance in concurrently training elite junior sprinters.

The aim of this study was to determine the effects of 7 weeks of high- and low-velocity resistance training on strength and sprint running performance in nine male elite junior sprint runners (age 19.0+/-1.4 years, best 100 m times 10.89+/-0.21 s; mean +/- s). The athletes continued their sprint training throughout the study, but their resistance training programme was replaced by one in which the movement velocities of hip extension and flexion, knee extension and flexion and squat exercises varied according to the loads lifted (i.e. 30-50% and 70-90% of 1-RM in the high- and low-velocity training groups, respectively). There were no between-group differences in hip flexion or extension torque produced at 1.05, 4.74 or 8.42 rad x s(-1), 20 m acceleration or 20 m 'flying' running times, or 1-RM squat lift strength either before or after training. This was despite significant improvements in 20 m acceleration time (P < 0.01), squat strength (P < 0.05), isokinetic hip flexion torque at 4.74 rad x s(-1) and hip extension torque at 1.05 and 4.74 rad x s(-1) for the athletes as a whole over the training period. Although velocity-specific strength adaptations have been shown to occur rapidly in untrained and nonconcurrently training individuals, the present results suggest a lack of velocity-specific performance changes in elite concurrently training sprint runners performing a combination of traditional and semi-specific resistance training exercises.

Adult↗

PubMed1995

The influence of strength training, swim training and ageing on the Achilles tendon and m. soleus of the rat.

Different age groups of male Wistar rates were submitted to intense strength training, swim training or no training. It was found that the tetanic of the m. soleus decreased with age. This was counteracted by strength training, whereas swim training had no effect on tetanic tension. Force at ultimate failure and yield point in the Achilles tendon decreased with age, but were not influenced by strength training. Swim training, on the other hand, appeared to compensate for the ageing process in the tendon. We conclude that tendon strength decreases with age and that tendon strength does not reflect muscle strength. The absolute tensile strength of tendons appears to be influenced by physical activity of endurance-type exercise. However, it is not known whether the tissue responds to the number of mechanical muscle contractions or physiological factors connected with endurance training. Although it is questionable to extrapolate from the rat to humans, it is speculated that intensive muscle strength training should be accompanied by endurance exercise in order to prevent the muscles from damaging connective tissue structures, such as the tendons and ligaments.

Achilles Tendon↗

PubMed2001

Effects of articulation training on the production of trained and untrained phonemes in conversations and formal tests.

The aim of this study was to investigate the effectiveness of articulation training for specific phonemes on the production of phonemes in conversational language samples, the 108 Single Word Articulation Test (Paatsch, 1997), and the Phonetic Level Evaluation (Ling, 1976). Speech production skills of 12 hearing-impaired children were assessed using these evaluation tools pre- and posttraining. A total of six phonemes were selected for each child to be trained during 15-to 20-minute daily sessions throughout an 8-week speech production program. Three phonemes, with a particularly high error rate, were trained at a phonetic level (category 1) while three phonemes, with an intermediate error rate of 40% to 70%, were trained at a phonological level (category 2). Results showed improvements in the percentage of correctly articulated category 1 phonemes and category 2 phonemes. The improvements for category 2 phonemes were larger than for category 1 phonemes for all test materials. It may be that phonological level training is more effective than phonetic level training or that phonemes with an intermediate error rate are easier to train than phonemes with a high error rate. Untrained vowels and consonants also improved slightly after training. Phonological process analysis showed that many of the errors apparent in the trained phonemes also had occurred in the untrained phonemes. This may have resulted in the generalization and carryover of taught speech skills into other aspects of the child's spoken language.

Journal Article↗

PubMedDate not supplied

Influence of aerobic exercise training and relaxation training on physical and psychologic health following stressful life events.

An experiment was conducted to determine whether aerobic exercise training or relaxation training would be effective for reducing the deleterious effects of life stress on physical and psychologic health. Over 1000 college students were surveyed, and 55 of those who reported experiencing a high number of negative life events over the preceding year were assigned to an aerobic exercise training condition, a relaxation training condition, or a no-treatment control condition. Physical and psychologic health were assessed with self-report measures before, halfway through, immediately following, and 8 weeks after the 11-week training (and control) period. Heart rate data collected during a treadmill test indicated that the aerobic exercise training was effective for improving cardiovascular fitness. Psychologic measures indicated that the exercise training condition was more effective than the other two conditions for reducing depression during the first 5 weeks of training. No differences were found among the conditions on self-report measures of physical health. These findings suggest that aerobic exercise training may be useful for reducing the severity and duration of depressive reactions following stressful life change.

Adaptation, Psychological↗

PubMed1998

A UK training programme for nurse practitioner flexible sigmoidoscopy and a prospective evaluation of the practice of the first UK trained nurse flexible sigmoidoscopist.

BACKGROUND: Flexible sigmoidoscopy is a technical skill that has been successfully performed by suitably trained colorectal nurse practitioners in the USA. However, no recognised training course exists for nurse practitioners in the UK. AIMS: To design and evaluate a training programme for nurse endoscopists. METHODS: A multidisciplinary committee of nurses and clinicians developed a structured programme of study and practice. This involved a staged process of observations, withdrawals, and ultimately, full procedures. Once training had been completed the nurse practitioner was permitted to practice independently. Patients with colorectal symptoms referred for flexible sigmoidoscopy were examined for the final stages of training and independent practice. A prospective evaluation of the training and practice of the first trained nurse flexible sigmoidoscopist was performed. Barium enema, video, clinical follow up, and histology were used to validate the results of the flexible sigmoidoscopies. RESULTS: The training programme required that 35 observations, 35 withdrawals, and 35 supervised full procedures were performed prior to the development of independent practice. Subsequent to the completion of this programme 215 patients have been examined independently by the nurse practitioner. Ninety three per cent of the examinations were judged successful and pathology was identified in 51%. The nurse endoscopist successfully identified all "significant" pathology whereas barium enema failed to identify pathology in 12.5%. There were no complications. CONCLUSION: With suitable training nurse endoscopists are able to perform flexible sigmoidoscopy safely and effectively.

Clinical Competence↗