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PubMed1999

[Vocational training for persons with psychiatric illnesses in Gütersloh BTZ. Occupational rehabilitation by training comprehensive key qualifications with concomitant social adjustment services, but without independent training centers--can it be done?].

Gütersloh BTZ has practiced vocational training for the mentally handicapped since August 1995. The main goal is to place the clients into employment in the regular workforce. This is done by intensive vocational training yet without having workshops attached to the institution itself. Gütersloh BTZ is comparable to other training centres in Germany like those in Hamburg, Duisburg, Köln, Dortmund, Paderborn, Straubing, Wiesloch and Schleusingen. They are similar in terms of personnel key, financial support for participants and standards of quality. The main difference between Gütersloh BTZ and other training centres is the absence of attached workshops. In Gütersloh training takes place on the job in the regular labour market like industrial firms, craftsmen establishments and service agencies. The "heart" of Gütersloh BTZ's concept is the reference group. It consists of not more than 8 participants. Two social workers are assigned to each group and provide intensive attention from the participant's first day in BTZ to aftercare on the regular job. The individual rehabilitation aim can only be achieved by establishing a tailor-made concept of support. This calls for a broad range of media, flexible methods and individual aims. In addition to the individual orientated concept, pedagogical group-work with three to five participants plays an important role in the work. Here the emphasis is on close relationship. Incentive, start, duration and contents of internships in agencies and firms are to a high degree individually structured. A flexible graduated plan helps the participants to progress from a trial practicum to a long-term practicum and finally to a regular (and subsidized) job in an agency. The Gütersloh BTZ's quota of successful placement into the regular labour market as well as into subsidized jobs is similar to those in other BTZs in Germany. Participants who can't be placed in a job have to achieve a defined perspective of life and an alternative to regular work. This standard of quality is established in the written concept of BTZ. Gütersloh BTZ compares its work and success with other BTZs through uniform social-scientific BTZ evaluation.

Adult↗
PubMed1999

The effect of bladder training, pelvic floor muscle training, or combination training on urodynamic parameters in women with urinary incontinence. Continence Program for Women Research Group.

The purpose of this study was to compare the effect of three conservative interventions: pelvic floor muscle training, bladder training, or both, on urodynamic parameters in women with urinary incontinence. Two hundred four women with genuine stress incontinence (GSI) or detrusor instability with or without GSI (DI +/- GSI) participated in a two-site trial comparing pelvic floor muscle training, bladder training, or both. Patients were stratified based on severity of urinary incontinence, urodynamic diagnosis, and treatment site, then randomized to a treatment group. All women underwent a comprehensive standardized evaluation including multi-channel urodynamics at the initial assessment and at the end of 12 weeks of therapy. Analysis of covariance was used to detect differences among treatment groups on urodynamic parameters. Post-treatment evaluations were available for 181 women. No differences were found among treatments on the following measurements: maximum urethral closure pressure, mean urethral closure pressure, maximum Kegel urethral closure pressure, mean Kegel urethral closure pressure, functional urethral length, pressure transmission ratios, straining urethral axis, first sensation to void, maximum cystometric capacity, and the MCC minus FSV. The effect of treatment did not differ by urodynamic diagnosis. Behavioral therapy had no effect on commonly measured urodynamic parameters. The mechanism by which clinical improvement occurs remains unknown. Neurourol. Urodynam. 18:427-436, 1999.

Exercise Therapy↗
PubMed1992

Training-overtraining: influence of a defined increase in training volume vs training intensity on performance, catecholamines and some metabolic parameters in experienced middle- and long-distance runners.

The influence of an increase in training volume (ITV; February 1989) vs intensity (ITI; February 1990) on performance, catecholamines, energy metabolism and serum lipids was examined in two studies on eight, and nine experienced middle- or long-distance runners; seven participated in both studies. During ITV, mean training volume was doubled from 85.9 km.week-1 (pretrial phase) to 174.6 km within 3 weeks. Some 96%-98% of the training was performed at 67 (SD 8)% of maximal performance. During ITI, speed-endurance, high-speed and interval runs increased within 3 weeks from 9 km.week-1 (pretrial phase) to 22.7 km.week-1 and the total training distance from 61.6 to 84.7 km.week-1. The ITV resulted in stagnation of running velocity at 4 mmol lactate concentration and a decrease in total running distance in the increment test. Heart rate, energy metabolic parameters, nocturnal urinary catecholamine excretion, low density, very low density lipoprotein-cholesterol and triglyceride concentrations decreased significantly; the exercise-related catecholamine plasma concentrations increased at an identical exercise intensity. The ITI produced an improvement in running velocity at 4 mmol lactate concentration and in total running distance in the increment test; heart rate, energy metabolic parameters, nocturnal catecholamine excretion, and serum lipids remained nearly constant, and the exercise-related plasma catecholamine concentrations decreased at an identical exercise intensity. The ITV-related changes in metabolism and catecholamines may have indicated an exhaustion syndrome in the majority of the athletes examined but this hypothesis has to be proven by future experimental studies.

Adult↗
PubMed2004

Outcomes of Fort Jackson's Physical Training and Rehabilitation Program in army basic combat training: return to training, graduation, and 2-year retention.

Basic trainees at Fort Jackson, South Carolina, who were unable to continue basic combat training (BCT) because of a serious injury were assigned to the Physical Training and Rehabilitation Program (PTRP). Between January 3, 1998 and July 24, 2001, 4258 trainees were assigned to the PTRP. Using a retrospective cohort study design, return to training and BCT graduation rates were evaluated. PTRP graduates were compared with matched non-PTRP graduates for 2-year retention in the Army. More PTRP women than men were discharged from the PTRP (60% and 48%, respectively, p < 0.01). Of PTRP trainees returning to BCT, 10% and 12% of men and women, respectively, were discharged from the Army compared with overall Fort Jackson discharge rates of 9% and 15% for men and women, respectively. Comparing PTRP graduates to matched non-PTRP graduates, there were no differences in 2-year retention for men (14.9% and 14.7%, respectively; p = 0.93) or women (26.6% and 30.1%, respectively; p = 0.19). Despite the high discharge rate in the PTRP, the BCT discharge rate for trainees who successfully rehabilitated was similar to the overall discharge rate at Fort Jackson. The 2-year retention in service for PTRP trainees who graduated from BCT was similar to that of non-PTRP trainees.

Adolescent↗
PubMed1990

Communication skills training, communication skills training with family and cognitive behavioral mood management training for alcoholics.

To evaluate three promising social learning approaches to the treatment of alcoholism, 69 male alcoholics in standard inpatient treatment participated in either a communication skills training group (CST), a communication skills training group with family participation (CSTF) or a cognitive behavioral mood management training group (CBMMT). Alcoholics who received CST or CSTF drank significantly less alcohol per drinking day during 6-month follow-up than those in CBMMT. The groups did not differ in abstinence rates or latency to relapse. All groups improved in skill and anxiety on the extensive battery of process measures, including role-play tests of general and alcohol-specific coping skills, but those in CST improved most in skill in alcohol-specific high-risk role plays and in ability to relax after the role plays. Alcoholics' skill, response latency, anxiety and urge to drink during alcohol-specific role plays were highly correlated with treatment outcome, demonstrating the importance of including comprehensive process measures in treatment outcome research. Implications for patient-treatment matching and future research are discussed.

Adaptation, Psychological↗
PubMed2006

Trained standardized patients can train their peers to provide well-rated, cost-effective physical exam skills training to first-year medical students.

BACKGROUND AND OBJECTIVES: Teaching physical examination skills effectively, consistently, and cost-effectively is challenging. Faculty time is the most expensive resource. One solution is to train medical students using lay physical examination teaching associates. In this study, we investigated the feasibility, acceptability, and cost-effectiveness of training medical students using teaching associates trained by a lay expert instead of a clinician. METHODS: We used teaching associates to instruct students about techniques of physical examination. We measured students' satisfaction with this teaching approach. We also monitored the financial cost of this approach compared to the previously used approach in which faculty physicians taught physical examination skills. RESULTS: Our program proved practical to accomplish and acceptable to students. Students rated the program highly, and we saved approximately $9,100, compared with our previous faculty-intensive teaching program. CONCLUSIONS: We believe that our program is popular with students, cost-effective, and generalizable to other institutions.

Clinical Competence↗
PubMed2003

Relationship between age at initiation of toilet training and duration of training: a prospective study.

OBJECTIVE: To study the relationship between age at initiation of toilet training, age at completion of toilet training, and the duration of toilet training. METHODS: A total of 406 children seen at a suburban private pediatric practice were enrolled in a study of toilet training between 17 and 19 months of age, and 378 (93%) were followed by telephone interviews with the parents every 2 to 3 months until the child completed daytime toilet training. Information obtained at follow-up interviews included how often parents were asking their child to sit on the toilet or potty and where the child urinated and defecated. Parents were considered to have initiated toilet training when they first took out a potty chair and discussed some aspect of training with the child. Intensive toilet training was defined as asking the child to use the toilet or potty >3 times per day. RESULTS: Age of initiation of toilet training correlated with age of completion of training (r = 0.275). The correlation between age at initiation of intensive training and age at completion was even stronger (r = 0.459). Younger age at initiation of intensive toilet training was not associated with constipation, stool withholding, or stool toileting refusal. However, age at initiation of intensive toilet training was negatively correlated with duration of toilet training (r = -0.481), indicating that initiation of training at younger ages was associated with a longer duration of training. In addition, the correlation between age at initiation of intensive toilet training and age at completion of training was not significant for those who began intensive training before 27 months of age (r = 0.107). CONCLUSIONS: Early initiation of intensive toilet training correlates with an earlier age at completion of toilet training but also a longer duration of toilet training. Although earlier toilet training is not associated with constipation, stool withholding, or stool toileting refusal, initiation of intensive training before 27 months does not correlate with earlier completion of toilet training, suggesting little benefit in beginning intensive training before 27 months of age in most children.

Age Factors↗
PubMedDate not supplied

Mental health and psychiatry training in primary care residency programs. Part II. What skills and diagnoses are taught, how adequate, and what affects training directors' satisfaction?

OBJECTIVE: The purpose of this study is to describe the psychiatric skills and diagnostic categories taught in primary care training programs, their adequacy, the perceived needs and desires for curriculum enhancement and the factors affecting training directors' satisfaction. METHOD: All 1365 directors of accredited residency training programs in Internal Medicine (IM), Family Practice (FP), Obstetrics and Gynecology (Ob/Gyn), Pediatrics (Peds) and psychiatry received a 16-item anonymous questionnaire about psychiatry training in their program. Responses to the questionnaire to items concerning the skills and diagnostic categories taught, assessment of adequacy of teaching and desires for curriculum enhancement for specific skills and diagnostic categories were analyzed. The factors affecting training directors' satisfaction were explored. RESULTS: Interviewing skills were taught by a majority of all training programs and were considered adequate by 81% of FP and 54% of IM programs, in contrast to less than a majority of Ob/Gyn and Peds programs (P<.001). A majority provided diagnostic interviewing and counseling training, but only FP considered it adequate. A majority taught psychopharmacology and various psychiatric diagnoses, but only in FP did a majority consider them adequate. Both Peds and FP programs teach child psychiatry; significantly, more Peds compared to FP consider their training to be adequate. A vast majority of IM, Ob/Gyn and Peds programs, and 50% of FP programs desired more training in interviewing techniques and diagnostic interview. A majority of all programs desired more counseling and psychopharmacology training and more training in disorders of childhood and adolescence. The overall satisfaction rate for psychiatric training across specialties was 46% (n=657). Sixty-four percent of FP programs were satisfied compared to 31% of non-FP programs. Satisfaction was associated with increased amount of psychiatric training, diversity of training formats, venues, faculty and settings, the amount of contribution to teaching by psychiatry departments and the presence of current teaching in interviewing skills. There were specialty-specific differences in factors associated with satisfaction. In general, a smaller size of residency program was associated with satisfaction except in IM, where larger size was associated with satisfaction. Satisfaction was associated with the opinion that primary care physician should be ready and willing to treat more psychiatric conditions. CONCLUSION: Most primary care training programs currently offer training in most psychiatric skills and disorders, but a majority of training directors are dissatisfied with their psychiatry training. There is a difference in the estimation of adequacy concerning training between FP, which consistently rates their teaching to be adequate, and all other primary care programs, which consider their teaching inadequate. This difference may be partly due to actual differences in amount and diversity of training as well as differences in the threshold for satisfaction. A vast majority of primary care training programs desire more training in almost all aspects of psychiatry, and there may be specialty-specific needs and areas of curriculum enhancement. To enhance satisfaction, we should improve the quality as well as the quantity of training, as well as the diversity in training formats, venues and faculty.

Administrative Personnel↗
PubMed2001

Training high--living low: changes of aerobic performance and muscle structure with training at simulated altitude.

This study was undertaken to test the hypothesis that endurance training in hypoxia is superior to training of the same intensity in normoxia. To avoid adaptation to hypoxia, the subjects lived under normoxic conditions when not training. A secondary objective of this study was to compare the effect of high- vs. moderate-intensity training on aerobic performance variables. Thirty-three men without prior endurance training underwent a cycle ergometer training of 6 weeks, 5 d/week, 30 minutes/d. The subjects were assigned to 4 groups, N-high, N-low, H-high and H-low based on the training criteria normoxia (N; corresponding to a training altitude of 600 m), vs. hypoxia (H; training altitude 3850 m) and intensity (high; corresponding to 80% and low: corresponding to 67% of VO2max). VO2max measured in normoxia increased between 8.5 to 11.1%, independent of training altitude or intensity. VO2max measured in hypoxia increased between 2.9 and 7.2%. Hypoxia training resulted in significantly larger increases than normoxia training. Maximal power that subjects could maintain over a thirty-minute period (measured in normoxia or hypoxia) increased from 12.3 - 26.8% independent of training altitude. However, subjects training at high intensity increased performance more than subjects training at a low intensity. Muscle volume of the knee-extensors as measured by magnetic resonance imaging increased significantly in the H-high group only (+ 5.0%). Mitochondrial volume density measured by EM-morphometry in biopsy samples of m. vastus lat. increased significantly in all groups with the highest increase seen in the H-high group (+ 59%). Capillary length density increased significantly in the H-high group only (+ 17.2%). The main finding of this study is that in previously untrained people, training in hypoxia while living at low altitude increases performance in normoxia to the same extent as training in normoxia, but leads to larger increases of aerobic performance variables when measured under hypoxic conditions. Training intensity had no effect on the gain of VO2max. On the level of skeletal muscle tissue, the combination of hypoxia with high training intensity constitutes the most effective stimulus for increasing muscle oxidative capacity.

Acclimatization↗
PubMed1998

Impact of resistance training on endurance performance. A new form of cross-training?

In accordance with the principles of training specificity, resistance and endurance training induce distinct muscular adaptations. Endurance training, for example, decreases the activity of the glycolytic enzymes, but increases intramuscular substrate stores, oxidative enzyme activities, and capillary, as well as mitochondrial, density. In contrast, resistance or strength training reduces mitochondrial density, while marginally impacting capillary density, metabolic enzyme activities and intramuscular substrate stores (except muscle glycogen). The training modalities do induce one common muscular adaptation: they transform type IIb myofibres into IIa myofibres. This transformation is coupled with opposite changes in fibre size (resistance training increases, and endurance training decreases, fibre size), and, in general, myofibre contractile properties. As a result of these distinct muscular adaptations, endurance training facilitates aerobic processes, whereas resistance training increases muscular strength and anaerobic power. Exercise performance data do not fit this paradigm, however, as they indicate that resistance training or the addition of resistance training to an ongoing endurance exercise regimen, including running or cycling, increases both short and long term endurance capacity in sedentary and trained individuals. Resistance training also appears to improve lactate threshold in untrained individuals during cycling. These improvements may be linked to the capacity of resistance training to alter myofibre size and contractile properties, adaptations that may increase muscular force production. In contrast to running and cycling, traditional dry land resistance training or combined swim and resistance training does not appear to enhance swimming performance in untrained individuals or competitive swimmers, despite substantially increasing upper body strength. Combined swim and swim-specific 'in-water' resistance training programmes, however, increase a competitive swimmer's velocity over distances up to 200 m. Traditional resistance training may be a valuable adjunct to the exercise programmes followed by endurance runners or cyclists, but not swimmers; these latter athletes need more specific forms of resistance training to realise performance improvement.

Adaptation, Physiological↗
PubMed1997

Lateral specificity in resistance training: the effect of bilateral and unilateral training.

Maximal voluntary strength of simultaneous bilateral exertion has been shown to be small compared to the sum of the unilateral exertions. Three experiments were conducted to determine the effects of bilateral and unilateral resistance training on this bilateral deficit and to compare these in hands, arms, and legs. In each experiment, the subjects were divided into three groups: unilateral training group, bilateral training group, and control group. The subjects of the training group performed maximal isometric handgrip training in experiment I, and maximal isokinetic arm and leg extension training in experiments II and III. In each experiment, the subjects of the training group continued one of these resistance training exercises three times a week, for 6 weeks. The increase in handgrip strength of the bilateral training group produced in the bilateral condition [5.1 (SEM 2.4)%, after 3 weeks, 6.4 (SEM 2.3) %, after 6 weeks] was significantly greater compared with the control group [-1.1 (SEM 1.0) %, after 3 weeks, -1.5 (SEM 1.1) %, after 6 weeks. The increase in leg extension power of the bilateral training group produced in the bilateral condition [16.1 (SEM 9.6) %, after 3 weeks, 24.1 (SEM 7.4) %, after 6 weeks] was significantly greater compared with the unilateral training group [-5.0 (SEM 3.4) %, after 3 weeks, -3.4 (SEM 4.2) %, after 6 weeks] and the control group [-4.3 (SEM 2.5) %, after 3 weeks, 1.5 (SEM 5.5) %, after 6 weeks]. The increase in handgrip strength of the unilateral training group produced in the unilateral condition [7.3 (SEM 1.7) %, after 3 weeks] was significantly greater compared with the control group [-0.9 (SEM 1.8) %, after 3 weeks]. The increase in arm extension power of the unilateral training group produced in the unilateral condition [7.2 (SEM 1.8) %, after 6 weeks] was significantly greater compared with the bilateral training group [-3.0 (SEM 2.3) %, after 6 weeks] and the control group [-2.1 (SEM 2.6) %, after 6 weeks]. Bilateral indexes (BI) were shifted in a positive direction by bilateral training and tended to shift in a negative direction by unilateral training. With regard to the magnitude of change in BI, there were no significant differences among handgrip, arm extension, and leg extension training. It is suggested that there is lateral specificity in resistance training and that there is no difference among body parts in the modification of bilateral deficit by lateral training.

Adult↗
PubMed2005

How can a massive training artificial neural network (MTANN) be trained with a small number of cases in the distinction between nodules and vessels in thoracic CT?

RATIONALE AND OBJECTIVES: To demonstrate that a massive training artificial neural network (MTANN) can be adequately trained with a small number of cases in the distinction between nodules and vessels (non-nodules) in thoracic computed tomography (CT) images. MATERIALS AND METHODS: An MTANN is a trainable, highly nonlinear filter consisting of a linear-output multilayer artificial neural network model. For enhancement of nodules and suppression of vessels, we used 10 nodules and 10 non-nodule images as training cases for MTANNs. The MTANN is trained with a large number of input subregions selected from the training cases and the corresponding pixels in teaching images that contain Gaussian distributions for nodules and zero for non-nodules. We trained three MTANNs with different numbers (1, 9, and 361) of training samples (pairs of the subregion and the teaching pixel) selected from the training cases. In order to investigate the basic characteristics of the trained MTANNs, we applied the MTANNs to simulated CT images containing various-sized model nodules (spheres) with different contrasts and various-sized model vessels (cylinders) with different orientations. In addition, we applied the trained MTANNs to nontraining actual clinical cases with 59 nodules and 1,726 non-nodules. RESULTS: In the output images for the simulated CT images by use of the MTANNs trained with small numbers (one and nine) of subregions, model vessels were clearly visible and were not removed; thus, the MTANNs were not trained properly. However, in the output image of the MTANN trained with a large number of subregions, various-sized model nodules with different contrasts were represented by light nodular distributions, whereas various-sized model vessels with different orientations were dark and thus were almost removed. This result indicates that the MTANN was able to learn, from a very small number of actual nodule and non-nodule cases, the distinction between nodules (spherelike objects) and vessels (cylinder-like objects). In nontraining clinical cases, the MTANN was able to distinguish actual nodules from actual vessels in CT images. For 59 actual nodules and 1,726 non-nodules, the performance of the MTANN decreased as the number of training samples (subregions) in each case decreased. CONCLUSIONS: The MTANN can be trained with a very small number of training cases (10 nodules and 10 non-nodules) in the distinction between nodules and non-nodules (vessels) in CT images. Massive training by scanning of training cases to produce a large number of training samples (input subregions and teaching pixels) would contributed to a high generalization ability of the MTANN.

Algorithms↗
PubMed1999

Aerobic training involving a minor muscle mass shows greater efficiency than training involving a major muscle mass in chronic heart failure patients.

BACKGROUND: Beneficial training outcomes have been reported in sedentary patients with chronic heart failure (CHF) after exercise training. However, data on training effects in previously trained patients, as well as comparisons of different exercise modes, are lacking. The aim of this study is to compare exercise training on a cycle ergometer (major muscle mass) and aerobic knee-extensor training (minor muscle mass) in previously trained patients with CHF. METHODS AND RESULTS: Twenty-four men and women (age, 63 +/- 10 years [mean +/- SD]) with stable, moderate CHF (left ventricular ejection fraction, 30% +/- 11%) who had completed their first exercise training period more than 1 year ago were allocated to either the exercise or control group. After stratification for sex, age, ejection fraction, and cardiac output response, the training group was further randomized to either cycle ergometer or knee-extensor training for 8 weeks. The control and training patients did not differ at baseline, and the measured variables did not change in the control group during the 8 weeks. Citrate synthase activity in skeletal muscle increased after cycle training (23%; P < .02) and knee-extensor training (45%; P < .008), and blood lactate concentration at submaximal intensities decreased (P < .04) in both groups. However, only after knee-extensor training did the peak oxygen uptake increase (19%; P < .01) and sympathetic nervous system activity, measured as plasma norepinephrine concentration at rest (P < .05) and during exercise (P < .008), decrease. Minnesota Living with Heart Failure questionnaire scores also showed improvement in the health-related quality of life (P < .05) only after knee-extensor training. CONCLUSION: Physical training is beneficial in previously trained patients with CHF. Aerobic training involving a minor muscle mass shows greater efficiency than training involving a major muscle mass.

Aged↗
PubMed1997

Hormonal responses to excessive training: influence of cross training.

The purpose of this investigation was to examine the changes in blood hormone levels elicited by increases in training volume. After 30 d of recording their training volume and intensity (normal training, 57.5 +/- 10.9 km.wk-1), 11 well-trained distance runners completed two randomly assigned 10 day periods of increased training volume (200% normal training). Each increased training regimen was preceded by two weeks of reduced training (80% normal training). The increased training regimens consisted of either running only (RT) at 200% of normal training distance or running (100% normal training) and cycling (kcal = 100% normal training: CT). During each increased training regimen the subjects ran 10 consecutive afternoons at a distance equivalent to 100% of normal training (approximately 75% VO2max) and performed eight additional morning sessions (0500-0800 h). During RT the subjects performed their morning workouts on a treadmill and during CT the workouts were performed on a bicycle ergometer. Blood samples were obtained (0500-0700 h) after 15 min supine rest after normal training, and before (day 0), on day five (day 5) and following ten days (day 11) of RT and CT. Serum was analyzed for testosterone, free testosterone, cortisol, adrenocorticotropic hormone, luteinizing hormone, and dehydroepiandrosterone sulfate. Free testosterone was significantly (p < 0.05) reduced on day 5 and day 11 of RT and CT compared to day 0 and total testosterone was lower on day 5 than day 0. However, no significant treatment or interaction effects were observed for total testosterone or free testosterone. Dehydroepiandrosterone sulfate was also significantly lower across time, i.e., day 11 was lower than day 0 and day 5; however, cortisol, adrenocorticotropic hormone, and luteinizing hormone were not significantly altered during RT or CT. The endocrine responses to an increased training volume with cross training and mode specific training were similar.

Adrenocorticotropic Hormone↗
PubMed2000

Physical training in Syndrome X: physical training counteracts deconditioning and pain in Syndrome X.

OBJECTIVES: The aim of this study was to evaluate the effects of exercise training and body-awareness training in female patients with Syndrome X. BACKGROUND: Patients with Syndrome X, defined as effort-induced angina pectoris, a positive exercise test and a normal coronary angiogram, suffer from a chronic pain disorder. We hypothesized that this disorder results in physical deconditioning with decreased exertional pain threshold. METHODS: Twenty-six patients were randomly assigned to two training groups (A, B) and a control group (C). Group A (n = 8) started, after baseline measurements, with eight weeks of body-awareness training followed by eight weeks of exercise training on a bicycle ergometer three times a week for 30 min at an intensity of 50% of peak work rate. Group B (n = 8) performed only eight weeks of exercise training. Group C (n = 10) acted as controls without any intervention whatsoever. The effects on exercise performance, hormonal secretion, vascular function, adenosine sensitivity and quality of life were evaluated. RESULTS: Body-awareness training did not change the pain response. The two training groups did not differ in effects of exercise training. Exercise capacity before training was below the gender- and age-matched reference range and improved by 34% with training to a level not different from the reference range. Onset of pain was delayed by 100% from 3 +/- 2 to 6 +/- 3 min (p < 0.05) while maximum pain did not change. Thus the pain-response-to-exercise curve was shifted to the right. Syndrome X patients showed a hypersensitivity to low-dose adenosine infusion compared to healthy age- and gender-matched controls (p < 0.0001) that did not change with exercise training. Endothelium-dependent blood flow increase was at baseline within reference range and tended to increase (p < 0.06) following training. In Group A the concentration of cortisol in urine decreased by 53% after body-awareness training (p < 0.05), and this change from baseline remained after physical exercise training (p < 0.05). A similar decrease occurred with only exercise training (Group B). CONCLUSIONS: Physical deconditioning with lower exertional threshold for pain is a prominent feature in Syndrome X. Physical training in Syndrome X results in an increased exercise capacity with lesser anginal pain. We suggest physical training as an effective treatment in Syndrome X.

Exercise Therapy↗
PubMed2004

Neural, metabolic, and performance adaptations to four weeks of high intensity sprint-interval training in trained cyclists.

The purpose of this study was to investigate the effects of short-term, high-intensity sprint training on the root mean squared (RMS) and median frequency (MF) derived from surface electromyography (EMG), as well as peak power, mean power, total work, and plasma lactate levels in trained cyclists when performed concurrently with endurance training. Seventeen trained cyclists were randomly assigned to a sprint training (S) group (n = 10, age 25 +/- 2.0 y) or a control (C) group (n = 7, age 25 +/- 0.5 y). Sprint training was performed bi-weekly for four weeks, comprising a total of 28 min over the training period. EMG measurements were taken before and after training during a series of four 30-s sprints separated by four minutes of active recovery. Plasma lactate, peak power, mean power, and total work were measured during each sprint bout. Following sprint training a significant increase occurred in the RMS of the vastus lateralis with a decrease in MF of the same muscle. Values for the vastus medialis did not change. Pre training exercising plasma lactate values were higher (p < 0.05) in C compared to S, but did not change with training. Exercising plasma lactate values increased (p < 0.05) from pre to post training in S, but were not different from C post training. Total work output increased from pre to post in S (p = 0.06). Peak power, mean power, and V.O (2)max increased (p < 0.05) pre to post training in S and C, indicating C was not a true control. In conclusion, these data suggest that four weeks of high-intensity sprint training combined with endurance training in a trained cycling population increased motor unit activation, exercising plasma lactate levels, and total work output with a relatively low volume of sprint exercise compared to endurance training alone.

Adult↗