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PubMed1994

Psychogeriatric training in Australia and New Zealand: a survey of psychiatry trainees and training program co-ordinators.

Psychiatry trainees and training program co-ordinators in Australia and New Zealand were surveyed about psychogeriatric training. Responses were received from the co-ordinators of all training programs and 68% of trainees. Over 94% of responding trainees believe they require at least 3 months' psychogeriatric training. Currently about 70% of trainees obtain a psychogeriatric term by Year 4 of training, with 17 out of 21 training programs having positions available. Most trainees positively rate their psychogeriatric training experiences, with 89% enjoying it and 78% believing it adequate for their needs. It is recommended that psychogeriatric training be available to all trainees before sitting the RANZCP Section 1 examinations.

Australia↗

PubMed1993

Muscimol infused into the entorhinal cortex prior to training blocks the involvement of this area in post-training memory processing.

Muscimol infusions into the entorhinal cortex (ERC) have previously been reported to impair the retention of passive avoidance learning, but only when infusions were delayed until 90min after training. In the present study, three experiments were carried out to examine further the effects of muscimol infusions into the ERC prior to training. In Experiment 1, muscimol infusions prior to training had no effect on retention, confirming earlier findings, but blocked the amnestic effect of a second muscimol infusion 90min post-training. In Experiment 2, muscimol infusions prior to training blocked the improvement of retention normally seen following a second training trial 2h after the first. In Experiment 3, the technique of summation of performance across training trials was used to confirm that the direct effects of muscimol infusions lasted less than 2h. The results indicate that the GABA-ergic mechanism in the ERC is normally involved in the formation of memory for passive avoidance, but if the ERC is inactivated at the time of training, memory formation is diverted to other structures, which appear less capable of integrating consecutive memories across time.

Journal Article↗

PubMed2004

Development of Standards and Criteria for the Selection, Training, and Evaluation of Athletic Training Approved Clinical Instructors.

OBJECTIVE: To develop standards and associated criteria for the selection, training, and evaluation of athletic training approved clinical instructors (ACIs). DESIGN AND SETTING: A previously developed set of 7 physical therapy clinical instructor standards/criteria and 2 additional standards/criteria developed through a review of the literature were systematically adapted, judged, and revised through a Delphi technique. SUBJECTS: Athletic training education experts currently employed as program directors for entry-level Commission on Accreditation of Allied Health Education Programs-accredited athletic training educational programs and who had the following: a doctoral degree, at least 5 years of supervising athletic training students, and familiarity/experience with clinical instruction in various athletic training clinical education settings. MEASUREMENTS: We used panelists' critiques and ratings to make sequential revisions in a series of 3 Delphi rounds. Standards were rated as to whether they were clear, necessary, and appropriate. We rated criteria for the associated standard as to whether they were useful, helpful, clear, specific, and consistent. RESULTS: We developed a final set of 7 standards and 50 associated criteria to measure these standards. The accepted standards include the following: legal and ethical behavior, communication skills, interpersonal relationships, instructional skills, supervisory and administrative skills, evaluation of performance, and clinical skills and knowledge. CONCLUSIONS: The 7 standards and associated criteria developed in this research project could be used not only for selecting, training, and evaluating an ACI but also for developing an understanding of the requirements of clinical education in general. Further research should include validating these standards/criteria among athletic training ACIs representing different types of clinical settings.

Journal Article↗

PubMedDate not supplied

Supervised endurance exercise training compared to home training after first lumbar diskectomy: a clinical trial.

OBJECTIVE: We performed a randomised trial to evaluate if intensive supervised training of the back should be offered to all patients after a first lumbar diskectomy. METHODS: Forty consecutive patients were, after a first lumbar diskectomy, randomly allocated to 2 groups undergoing "supervised training" twice a week for 3 months in an outpatient clinic or "home training" after 2 hours of instruction. RESULTS: The two rehabilitation models both showed a significant effect on spinal mobility, isokinetic trunk flexion strength, isokinetic trunk extension strength and daily function. These improvements were unchanged at follow up 3 months later. The pain score remained unchanged, however, throughout the trial in both groups. No differences in effect between the two rehabilitation models could be found for any of the assessed parameters. Thirteen patients did not complete the trial, including 9 from the supervised endurance trained group, mainly because of increased pain and reprolaps (n = 4). Four patients dropped out of the home trained group, only one because of increased pain. The differences in drop-out rate and training side effects were, however, not statistically significant. CONCLUSION: We conclude that it is not worthwhile to implement 3 months of supervised intensive endurance training as opposed to home training in all cases of first lumbar diskectomy, although a beneficial effect and better compliance might be found for a selected group of such patients.

Adult↗

PubMed2005

Living high-training low altitude training: effects on mucosal immunity.

Secretory immunoglobulin A (sIgA) is the major immunoglobulin of the mucosal immune system. Whereas the suppressive effect of heavy training on mucosal immunity is well documented, little is known regarding the influence of hypoxia exposure on sIgA during altitude training. This investigation examined the impact of an 18-day Living high-training low (LHTL) training camp on sIgA levels in 11 (six females and five males) elite cross-country skiers. Subjects from the control group (n=5) trained and lived at 1,200 m of altitude, whereas, subjects from the LHTL group (n=6) trained at 1,200 m, but lived at a simulated altitude of 2,500, 3,000 and 3,500 m (3x6-day, 11 h day(-1)) in hypoxic rooms. Saliva samples were collected before, after each 6-day phases and 2 weeks thereafter (POST). Salivary sIgA, protein and cortisol were measured. There was a downward trend in sIgA concentrations over the study, which reached significance in LHTL (P<0.01), but not in control (P=0.08). Salivary IgA concentrations were still lower baseline at POST (P<0.05). Protein concentration increased in LHTL (P<0.05) and was negatively correlated with sIgA concentration after the 3,000 and 3,500 m-phase and at POST (P<0.05 all). Cortisol concentrations were unchanged over the study and no relationship was found between cortisol and sIgA. In summary, data were strongly suggestive of a cumulative negative effect of physical exercise and hypoxia on sIgA levels during LHTL training. Two weeks of active recovery did not allow for proper sIgA recovery. The mechanism underlying this depression of sIgA could be mediated by neural factors.

Adult↗

PubMedDate not supplied

Evaluation of retention of safety and survival training content versus industry standard for training.

INTRODUCTION: The accepted standard in the industry for survival and safety training is annual recurrent educational programs. The industry has never looked at nor tested content comprehension or retention on this subject. We decided to conduct a sample testing of crews' ability to understand and retain survival training material. METHODS: This study solicited the participation of four program crews that had received previous training in safety and survival. A test on safety and survival training content was administrated to nurses and paramedics before a refresher course (test 1), then immediately after the course (test 2), and again 6 months later (test 3). Ninety-six crew members took tests 1 and 2, and 79 (82%) took test 3. RESULTS: The average time since any crew member participating in this study had attended a survival course was 1 to 1.5 years. The pretraining test mean score was 60 (60%); the posttraining average score was 92 (92%); and the 6-month mean score was 65 (65%). CONCLUSION: Flight crews do not retain a safe level of survival skill knowledge with annual recurrent training. Therefore the industry needs to reevaluate its position on this standard of annual recurrent training. Survival training is too important for flight crews to undertake only once per year. Rescuer care is as important as patient care.

Air Ambulances↗

PubMed2003

Effects of high intensity resistance and low intensity endurance training on myosin heavy chain isoform expression in highly trained rowers.

An important mechanism of muscle adaptation to exercise is the alteration of myosin heavy chain (MHC) isoform expression. This study investigated the effect of a high intensity resistance training (HIRT) and a low intensity endurance rowing (LIER) on MHC isoform expression in highly trained human muscle. Six well-trained male rowers underwent a training program consisting of a 3-week HIRT and a 3-week LIER, each followed by one-week of recovery. Muscle samples were taken from vastus lateralis before and at the end of each training and recovery phase. MHC isoform was analyzed by SDS-PAGE using silver stain and MHC isoform mRNA by RT-PCR. The maximum oxygen uptake and power output did not change after the training. MHC isoform composition did not change over HIRT or LIER, and there was a decrease in MHC I with concomitant increase in MHC IIa after recovery following HIRT. HIRT led to mRNA upregulation of MHC Ialpha, Ibeta and IIx (127 %, 148 % and 117 %, respectively, p < 0.05), but not MHC I protein (60 % vs 62 %, NS), and LIER led merely to MHC Ibeta mRNA upregulation (131 %, p < 0.05). Thus, different responses of MHC isoform expression to HIRT and LIER occurred in the highly trained muscle, and a "ceiling effect" in terms of MHC I expression could be observed. The upregulation of MHC Ialpha mRNA in human skeletal muscle documented in this study may encourage further observations in this field.

Adult↗

PubMed1977

Low intensity training, inactivity and resumed training in sedentary men.

The effects of a low intensity training regimen, consisting of two 7-week periods with an interspersed 8-week inactivity period were investigated in 16 sedentary men. A follow-up was made on 7 subjects after 38 additional weeks' training. Systemic as well as local effects were studied using exercise tests and leg muscle biopsies. The two 7-week training periods both resulted in a 6% increase in Vo2 max and a lowered heart rate during submaximal work. No persisting training effects were detected by exercise tests after inactivity. In skeletal muscle, however, striking differences in enzyme activity pattern and ultrastructure were observed between the two periods, indicating that some training effect of importance for muscle metabolic adaptation might have persisted during inactivity. It is suggested that such an effect might be associated with the local oxygen supply. During the 38-week training period there was a large increase in muscle metabolic capacity, but no change in maximal oxygen uptake. This separation of systemic and local training effects indicates a lack of a direct causal relationship between muscle metabolic potential and max imal oxygen uptake. It is suggested that the elevated muscle oxidative capacity is of importance for an increased endurance capacity.

Adult↗

PubMed1989

Effects of run-training and swim-training at similar absolute intensities on treadmill VO2max.

Thirty-seven sedentary males, aged 28-35 yr, were either run-trained, swim-trained, or served as controls in an 11 1/2-wk training study. Runners and swimmers exercised once a d, 3 d.wk, at a heart rate (HR) intensity equivalent to 75% of their treadmill VO2max. Treadmill maximal oxygen consumption (VO2max), submaximal cardiorespiratory response, and body composition parameters were measured before and following the training period. Runners, swimmers, and controls experienced a significant increase in treadmill VO2max over the 11 1/2-wk study period. The 28 and 25% increases observed for the runners and swimmers, respectively, were significantly greater than the 5% increase observed for the controls (P less than 0.0001). Runners and swimmers did not differ significantly from each other with respect to this increase in VO2max; nor did they demonstrate significant changes in respiratory exchange ratio (RER) at VO2max between tests. The run-trained and swim-trained groups both experienced a decrease in HR at a standard submaximal walking workload but did not differ significantly from each other. Controls showed no significant change in submaximal exercise response. A significant difference was observed among groups (P less than 0.01) for change in percent body fat. Changes in lean and fat weight over the training period were significant for both the runners (P less than 0.002) and swimmers (P less than 0.03) but not for the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1991

Individualized aerobic and high intensity training for asthmatic children in an exercise readaptation program. Is training always helpful for better adaptation to exercise?

In order to define the role of individualized training intensity in a conditioning program for asthmatic children, we have trained seven asthmatics (age = 11.4 +/- 1.8 years) at their ventilatory threshold (VTh) intensity level for a three-month period (aerobic training) and at maximal intensity also for three months (high intensity training). VTh is the point at which a nonlinear increase of VE occurs. Another group of seven asthmatics (age = 11.4 +/- 1.5) served as control subjects. Cardiopulmonary fitness was determined on a cycle ergometer before and after each training session. This study demonstrated that aerobic training, correctly adapted to the child's physical ability, induces the following: (1) a rapid and marked cardiovascular fitness increase; and (2) a decrease in VE over a given work range so that VTh is increased. This is of great importance because hyperventilation is a major determinant of exercise-induced bronchospasm. In contrast, even if high intensity training is well tolerated in an indoor swimming pool, the long-term effects are unsuitable for asthmatic children because the decrease of VTh will involve an increase of hyperventilation, even when exercise is performed at submaximal intensity.

Adaptation, Physiological↗

PubMed2005

Vibration training: an overview of the area, training consequences, and future considerations.

The effects of vibration on the human body have been documented for many years. Recently, the use of vibration for improving the training regimes of athletes has been investigated. Vibration has been used during strength-training movements such as elbow flexion, and vibration has also been applied to the entire body by having subjects stand on vibration platforms. Exposure to whole-body vibration has also resulted in a significant improvement in power output in the postvibratory period and has been demonstrated to induce significant changes in the resting hormonal profiles of men. In addition to the potential training effects of vibration, the improvement in power output that is observed in the postvibratory period may also lead to better warm-up protocols for athletes competing in sporting events that require high amounts of power output. These observations provide the possibility of new and improved methods of augmenting the training and performance of athletes through the use vibration training. Despite the potential benefits of vibration training, there is substantial evidence regarding the negative effects of vibration on the human body. In conclusion, the potential of vibration treatment to enhance the training regimes of athletes appears quite promising. It is essential though that a thorough understanding of the implications of this type of treatment be acquired prior to its use in athletic situations. Future research should be done with the aim of understanding the biological effects of vibration on muscle performance and also the effects of different vibration protocols on muscle performance.

Clinical Protocols↗

PubMed2003

Neuromuscular adaptation to short-term (4 weeks) ballistic training in trained high school athletes.

The effects of a 4-week ballistic training program on neurological adaptation in trained high school athletes was assessed. Thirty-eight senior high school athletes (12 young women and 26 young men) were randomly assigned to either an experimental group (EXP, n = 20) or a control group (CON, n = 18). The only alteration in training was that EXP engaged in a new type of ballistic training over the 4-week experimental period. Measurements included total body weight (TBW), sum of skinfolds (SS), thigh circumference (TC), hip circumference (HC), 36.6-m speed (SP), and vertical jump power (VJP). Data were collected 3 times during the experiment. Results indicated that the ballistic training stimulated a significant improvement in SP in EXP compared with CON, which could not be accounted for by increases in HC or TC in EXP. It was concluded that neurological adaptation does occur in trained athletes when a new training stimulus is implemented.

Adaptation, Physiological↗

PubMed1996

Dynamic training versus relaxation training as home exercise for patients with inflammatory rheumatic diseases. A randomized controlled study.

The aim of the study was to evaluate the effects of a dynamic training program versus a muscle relaxation training program as home exercise in patients with inflammatory rheumatic diseases. Fifty-four patients (mean age 54 years, mean symptom duration 14 years) were randomized to one of the two programs. After personal instructions every patient exercised at home for half an hour, 5 days a week during 3 months. Before and after the interventions, all patients were assessed for health-related quality of life, joint tenderness and physical capacities. The dynamic training group had improved in perceived exertion at the walking test (p < or = 0.05), while the relaxation training group had improved their total Nottingham Health Profile (p < or = 0.01), its subscale for lack of energy (p < or = 0.05), Ritchie's articular index (p < or = 0.05), muscle function of the lower extremities (p < or = 0.01), and arm endurance (p < or = 0.01). Regarding changes in muscle function of the lower extremities during the intervention period, there was a significant difference (p < or = 0.05) between the groups in favour of the relaxation training group. The results of the study thus indicated that progressive muscle relaxation training might improve health related quality of life, reduce joint tenderness and be superior to dynamic muscle training in improving the muscle function of the lower extremities in patients with inflammatory rheumatic diseases. The clinical effects were small and the results have to be interpreted with caution.

Aged↗

PubMed2004

The effect of continuous repetition training and intra-set rest training on bench press strength and power.

AIM: The purpose of this research was to compare the effects of continuous repetition and intra-set rest training on maximal strength and power output of the upper body. METHODS: The 6 repetition maximum (6RM) and bench press throw power output against masses of 20, 30 and 40 kg of 26 elite junior male basketball and soccer players were tested on 2 separate occasions for reliability purposes. Subjects were then randomly assigned to either a continuous repetition (CR - 4 sets x 6 repetitions) or intra-set rest (ISR - 8 sets x 3 repetitions) training regime over 6-weeks. Volume (sets x repetitions x %6RM) between groups was equated and both groups completed all sets in the same time period (13 minutes and 20 seconds). The total concentric work time was determined to identify differences in training regimes. Independent sample t-tests on preintervention and postintervention percentage change scores were analysed for significant differences (p<0.05). RESULTS: The observed coefficients of variation (1.7% to 4.8%) and intraclass correlation coefficients (r=0.87 to 0.98) indicated stability of these measures across testing occasions. The CR group significantly increased 6RM strength (9.7%) compared with the ISR group (4.9%). The total concentric work time was significantly longer in CR training than ISR (36.03+/- 4.03 s and 31.74+/-4.71 s; p=0.13). Power output increases across the 20, 30 and 40 kg loads ranged from 5.8% to 10.9% for both training groups but the between-group percentage change scores were not significantly different. CONCLUSIONS: Bench press training involving 4 sets of 6 continuous repetitions elicited a greater improvement in bench press strength than 8 sets of 3 repetitions at the same percentage load of their 6RM. Both ISR and CR training were equally effective in increasing power output.

Adolescent↗

PubMed1997

Insular cortex and amygdala lesions induced after aversive training impair retention: effects of degree of training.

These experiments examined the effects of N-methyl-D-aspartate (NMDA)-induced lesions of the amygdala and insular cortex induced 1 week after rats were trained on a footshock motivated escape task in a two-compartment runway. In the first experiment, male rats were given 10 training trials and, 1 week later, received microinjections of a buffer solution or NMDA into either the insular cortex (IC) or the amygdala (AM). In an inhibitory avoidance retention test 1 week after the microinjections, the retention latencies (i.e., latencies to enter the compartment where shock had been delivered) of both the AM- and "IC-lesioned" groups were significantly lower than those of the buffer-injected groups. Additionally, in comparison with the buffer controls, rats in the two lesioned groups made significantly more crossings between the two compartments during the retention test. In a second experiment, male rats were given 1, 10, or 20 escape training trials 1 week before receiving either sham or NMDA lesions in the IC. The retention test was given 1 week after microinjection. Those sham or lesioned animals that were given only one training trial did not demonstrate retention. Both lesioned groups given 10 or 20 training trials were significantly disrupted on both the step-through latencies, and the number of crossings between the two compartments. The retention-impairing effects of NMDA-induced lesions were slightly attenuated in the group given 20 escape training trials. The findings provide additional evidence that the AM and the IC are involved in regulating the long-term retention of aversively motivated training.

Amygdala↗

PubMed2004

[The stakes of force perseverance training and muscle structure training in rehabilitation. Recommendations of the German Federation for Prevention and Rehabilitation of Heart-Circulatory Diseases e.v].

While aerobic endurance training has been a substantial part of international recommendations for cardiac rehabilitation during the last 30 years, there is still a rather reserved attitude of the medical community to resistance exercise in this field. Careful recommendations for resistance exercise in cardiac patients was only published a few years ago. It has been taken for granted that strength exercise elicits a substantial increase in blood pressure and thus imposes, especially in cardiac patients, a risk of potentially fatal cardiovascular complications. Results of the latest studies show that the existing recommended overcaution is not justified. Strength exercise can indeed result in extreme increases of blood pressure, but this is not the case for all loads of this kind. The actual blood pressure response to strength exercise depends on the isometric component, the exercise intensity (load or resistance used), muscle mass activated, the number of repetitions in the set and/or the duration of the contraction as well as involvement of Valsalva maneuver. Intra arterially performed blood pressure measurements during resistance exercise in patients with heart disease showed that strength training carried out at low intensities (40-60% of MVC) and with high numbers of repetitions (15-20) only evokes a moderate increase of blood pressure comparable with blood pressure measures induced by moderate endurance training. If used properly and performed accurately, individually dosed, medically supervised and controlled through experienced sport therapists, a dynamic resistance exercise is-at least for a certain group of patients-not associated with higher risks than an aerobic endurance training and can in addition to endurance training improve muscle force and endurance, have a positive influence on cardiovascular function, metabolism, cardiovascular risk factors as well as psychosocial well-being and overall quality of life. However, with respect to currently available data, resistance exercise cannot be generally recommended for all groups of patients. The appropriate kind and execution of training is highly dependent on current clinical status, cardiac capacity as well as possible accompanying diseases of the patient. Most of the studies carried out up to date included small samples of middle-aged male patients with almost normal levels of aerobic endurance performance and good left ventricular function. Data is missing for risk groups, older patients and women. Therefore, an integration of dynamic resistance exercises in cardiac rehabilitation can only be recommended without hesitation for CHD patients with high physical capacity (good myocardial function, revascularized). Since patients with myocardial ischemia and/or low left ventricular functioning might develop wall motion disturbances and/or dangerous ventricular arrhythmia when performing resistance exercises, prevalence of the following conditions is recommend: moderate to high LV-function, high physical performance (>5-6 metabolic equivalents= >1.4 watts/kg body weight) in absence of angina pectoris symptoms or ST-depression, by maintained current medication. In the proposed recommendations, a classification of risks for resistance training in cardiac rehabilitation is being made based on current data and is complemented by specific recommendations for particular groups of patients and detailed guidelines for setup and completion of the therapy program.

Blood Pressure↗

PubMed1998

Effects of amount of training on the saliva concentrations of cortisol, dehydroepiandrosterone and on the dehydroepiandrosterone: cortisol concentration ratio in women over 16 weeks of training.

This study was designed to investigate in the saliva the influence in female athletes of handball or volleyball training on concentrations of cortisol [C], dehydroepiandrosterone [DHEA], and on the [DHEA]:[C] ratio over 16 weeks of training. Data were compared to those of sedentary women. Saliva samples were collected upon waking after an overnight fast during the 1st week (W1) of the training programme and in the 16th week (W16). The training programme increased the resting concentrations of saliva [DHEA] in all the sportswomen. In contrast, a decrease of [DHEA] was noted in the sedentary group (W16 < W1; P < 0.05). In none of the women did the [C] at rest change significantly during the study. Between W1 and W16, the [DHEA]:[C] ratio increased by more than 30% in all the sportswomen. In addition, the athletes with the highest performance levels and greatest amount of training had the lowest [DHEA]:[C] ratio. Negative linear relationships between the amount of training and the [DHEA]:[C] ratio were found both at W1 (r = -0.53 P < 0.001), and W16 (r = -0.73 P < 0.001), suggesting that the latter could be used as an indicator of the training status of sportswomen.

Adult↗

PubMed2006

Virtual reality simulator training equals mechanical robotic training in improving robot-assisted basic suturing skills.

BACKGROUND: This study aimed to investigate the effect of a virtual reality simulator on the learning of basic robotic suturing skills. METHODS: Two randomized groups of students underwent a controlled training program. Both groups completed an identical test before and after training. The increase in the number of stitches placed during the pretest and posttest was used as an objective measure of the training effect. To evaluate the subjective feeling of understanding and mastering, the students indicated this on a visual analog scale. RESULTS: Both groups showed a significant increase in the number of stitches placed during the posttest, and an increase in subjective feeling of understanding and mastering. The increase did not differ between the groups, indicating that the virtual reality simulator equaled the mechanical trainer in training of robotic suturing technique. CONCLUSIONS: Training in basic robot-assisted suturing skills using a virtual reality simulator without additional training equaled training using a mechanical simulator.

Computer Simulation↗