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At least 163 records · Page 9Linked to original sources

PubMed2001

Clinician scientist training program: a proposal for training medical students in clinical research.

There is national alarm about a decline in the number of clinician scientists. Most of the proposed solutions have focused on housestaff and junior faculty. We propose a new national program for training medical students in clinical research. This program, coined "Clinician Scientist Training Program" (CSTP), would consist of a combined degree program in medicine (MD) and clinical research (eg, masters in translational research or masters in clinical epidemiology). Students could enroll in the program at any stage during medical school. After 3 years of medical school, students would spend at least 2 years in a combined didactic and mentored clinical research training program and then complete medical school. Students could elect to pursue more prolonged clinical research training toward a combined PhD and MD. The CSTP is designed to meet six critical challenges: 1) engage students early in clinical research training; 2) provide a didactic clinical research curriculum; 3) expose students to several years of mentored clinical research training; 4) promote debt prevention by providing tuition payments during medical education and a stipend during clinical research training; 5) facilitate prolonged exposure to a community of peers and mentors in a program with national and institutional identity and respect; and 6) permit enrollment in the program as students enter medical school or at any stage during medical school. If the success of the Medical Scientist Training Program in training medical students in basic research is a guide, the CSTP could become a linchpin for training future generations of clinician scientists.

Humans↗

PubMed2003

Strength training vs. aerobic training: cardiovascular tolerance in elderly adults.

The aim of the present study was to evaluate cardiovascular tolerance to two different types of exercise (strength training vs. aerobic training) in healthy elderly subjects. Nineteen healthy elderly subjects aged 65-81 were studied. All the subjects participated in a 6-month combined physical activity program of gymnastics (2 times/week; 50 min.) and strength training (2 times/week; 40-50 min.). The gymnastics sessions consisted of general physical activity that is usually offered to elderly people and included warm-up, aerobic exercises, strength training, some balance and coordination exercises, recreational games and cool-down. The strength training consisted of two sets of 10 to 12 repetitions at 70% of one repetition maximum (1 RM) for "women's double chest"; "leg extension"; "overhead press; "seated leg curl"; "lateral raise"; "leg press" and "abdominal machine". Cardiovascular tolerance was evaluated both by measuring heart rate (HR) continuously (Polar Vantage NV) during the sessions and by measuring systolic (SBP) and diastolic blood pressure (DBP) with an electronic sphygmomanometer at five different times (baseline, after warm-up, 15-20 min., 30-40 min. and after cool-down). Moreover, in order to measure the response according to the type of exercise, in strength training sessions, SBP and DBP were also evaluated in different machines (legs vs. arms). Comparison between the two different types of exercise (gymnastics vs. strength training) and between different machines was performed by an unpaired Student's t test. The level of significance was set at p < 0.05. The results showed no significant differences in HR, SBP and DBP values between the two training types. Both sessions were performed at appropriate intensity without exaggerated cardiovascular response. In strength training, exercises that involved the legs presented higher rises in SBP and DBP values than those performed with the arms. These data suggest that, if appropriate techniques are used, strength training as well as gymnastics can be performed by healthy older subjects so long as basic rules for exercise in this population are followed. Furthermore, the data indicate a greater cardiovascular hemodynamic response after strength exercises with the legs than with the arms.

Age Factors↗

PubMed2004

Subspeciality training in hematology and oncology, 2003: results of a survey of training program directors conducted by the American Society of Hematology.

A survey of directors of adult and pediatric hematology/oncology subspecialty training programs in the United States and Canada was conducted to assess the environment in which recruitment and training is conducted in these medical disciplines. A total of 107 program directors responded to the survey, representing 66% of internal medicine and 47% of pediatric subspecialty programs in hematology or hematology/oncology. Specific areas covered in the web-based questionnaire included the type and demographics of the training program, profile of the training program director, characteristics of the applicant pool and existing trainee recruits, characteristics of the training program environment and curricula, research productivity of trainees, and the career pathways taken by recent training program graduates (including dominant areas of clinical interest). The results of this survey show considerable heterogeneity in the recruiting practices and the environment in which subspecialty training occurs, leading the authors to recommend improvements in or a heightened attention to issues, including recruitment of minority trainees, flexibility to recruit international medical school graduates, timing of trainee acceptance, maintaining the financial support of Medicare graduation medical education (GME), training of physician scientists, organization of the continuity clinic experience, visibility of nonmalignant hematology as a career path, and level of training program director support.

Career Choice↗

PubMed2003

The effects of balance training and high-intensity resistance training on persons with idiopathic Parkinson's disease.

OBJECTIVE: To assess immediate and near-term effects of 2 exercise training programs for persons with idiopathic Parkinson's disease (IPD). DESIGN: Randomized control trial. SETTING: Public health facility and medical center. PARTICIPANTS: Fifteen persons with IPD. INTERVENTION: Combined group (balance and resistance training) and balance group (balance training only) underwent 10 weeks of high-intensity resistance training (knee extensors and flexors, ankle plantarflexion) and/or balance training under altered visual and somatosensory sensory conditions, 3 times a week on nonconsecutive days. Groups were assessed before, immediately after training, and 4 weeks later. MAIN OUTCOME MEASURES: Balance was assessed by computerized dynamic posturography, which determined the subject's response to reduced or altered visual and somatosensory orientation cues (Sensory Orientation Test [SOT]). Muscle strength was assessed by measuring the amount of weight a participant could lift, by using a standardized weight-and-pulley system, during a 4-repetition-maximum test of knee extension, knee flexion, and ankle plantarflexion. RESULTS: Both types of training improved SOT performance. This effect was larger in the combined group. Both groups could balance longer before falling, and this effect persisted for at least 4 weeks. Muscle strength increased marginally in the balance group and substantially in the combined group, and this effect persisted for at least 4 weeks. CONCLUSION: Muscle strength and balance can be improved in persons with IPD by high-intensity resistance training and balance training.

Accidental Falls↗

PubMed2002

Left ventricular long-axis diastolic function is augmented in the hearts of endurance-trained compared with strength-trained athletes.

In order to determine left ventricular global and regional myocardial functional reserve in endurance-trained and strength-trained athletes, and to identify predictors of exercise capacity, we studied 18 endurance-trained and 11 strength-trained athletes with left ventricular hypertrophy (172+/-27 and 188+/-39 g/m(2) respectively), and compared them with 14 sedentary controls. Global systolic (ejection fraction) and diastolic (transmitral flow) function, and regional longitudinal and transverse myocardial velocities [tissue Doppler echocardiography (TDE)], were measured at rest and immediately after exercise. In endurance-trained compared with strength-trained athletes, resting heart rate was lower (59+/-11 and 76+/-9 beats/min respectively; P<0.001), and the increase at peak exercise was greater (+211% and +139% respectively; P<0.001). In addition, exercise duration, workload, maximal oxygen consumption and global systolic functional reserve (but not peak ejection fraction) were higher in the endurance-trained athletes, and resting global diastolic function (E/A ratio 1.62+/-0.40 compared with 1.18+/-0.23; P<0.01) (where E-wave is peak velocity of early-diastolic mitral inflow and A-wave is peak velocity of mitral inflow during atrial contraction) and long-axis diastolic velocities (E(TDE)/A(TDE) ratio 2.2+/-1.2 compared with 1.1+/-0.3; P<0.01) (where E(TDE) and A(TDE) represent peak early- and late-diastolic myocardial or tissue velocity respectively) were augmented. Systolic velocities were similar. Exercise capacity was best predicted from end-diastolic diameter index and E/A ratio at rest, and end-diastolic volume index and diastolic longitudinal velocity during exercise (r=0.74, n=43, P<0.001). In conclusion, endurance-trained athletes had higher left ventricular long-axis diastolic velocities, augmented global early diastolic filling, and greater chronotropic and global systolic functional reserve. Maximal oxygen consumption was determined by diastolic loading and early relaxation rather than by systolic function, suggesting that dynamic exercise training improves cardiac performance by an effect on diastolic filling.

Adult↗

PubMed1991

Physiological adaptations to concurrent endurance training and low velocity resistance training.

This study investigated the effects of concurrent endurances and low velocity resistance training (LVR) on measures of strength and aerobic endurance. One group (ES) performed concurrent endurance training 3 days a week and LVR training on alternate days, 3 days a week for 12 weeks. The other group (S) performed only LVR training 3 days a week for 12 weeks without any endurance training. Measurements and increases in training volume were made every three weeks in both groups. Group ES exhibited increases in submaximal exercise responses after 3, 9 and 12 weeks (p less than 0.05). Knee extension peak torque and total work as well as cross-sectional area of quadriceps femoris were significantly increased after 6 and 9 weeks of training in both groups. These findings indicate that no significant differences in strength gains were observed between subjects performing concurrent endurance and resistance training or resistance training only. However, the time-course of adaptations between groups was somewhat different.

Adaptation, Physiological↗

PubMed1993

Are adaptations to combined endurance and strength training affected by the sequence of training?

The purpose of this study was to determine whether the sequence of strength training before endurance training (ST/ET) is more or less effective than endurance training followed by strength training (ET/ST). Twenty-three females and 11 males were assigned to one of three groups: ST/ET (n = 15), ET/ST (n = 15) or control (n = 4). The 7-week training programme consisted of strength training using 10 exercises for two sets of 3-12 repetitions and running for 20-25 min at 60-90% of heart rate reserve. Maximal oxygen uptake (VO2 max) was measured during a graded treadmill test, and muscular strength was assessed using one-repetition maximum tests for the bench press (BP), shoulder press (SP), arm curl (AC) and leg press (LP). The VO2 max significantly (P < 0.05) increased 6.7 and 6.2% for the ST/ET and ET/ST groups, respectively. There was no significant (P > 0.05) difference between the two experimental groups. Muscular strength significantly (P < 0.05) improved by 15.2% (BP), 16.6% (SP), 17.2% (AC) and 11.9% (LP) for the ST/ET group and 19.9% (BP), 24.1% (SP), 20.9% (AC) and 14.0% (LP) for the ET/ST group. There were no significant (P > 0.05) differences between the two experimental groups for the BP, AC and LP; however, the ET/ST group increased (P < 0.05) SP strength more than the ST/ET group. In conclusion, adaptations to a combination of short-term endurance and strength training as assessed by VO2 max and BP, AC and LP strength appear to be independent of whether endurance training occurs prior to or following strength training.

Adaptation, Physiological↗

PubMed2002

Training principles: evaluation of modes and methods of resistance training--a coaching perspective.

Current information and evidence indicate that for most activities free weight training can produce superior results compared to training with machines, particularly when the free weight training involves complex, multi-joint exercises. A number of reasons can account for the superiority of free weights; the major factor deals with mechanical specificity. Mechanical specificity is concerned with appropriate movement patterns, force application and velocity of movement. Considering the available evidence that adherence to the concept of specificity of exercise and training can result in a greater transfer of training effect then free weights should produce a more effective training transfer. Therefore, the majority of resistance exercises making up a training programme should include of free weight exercises with emphasis on mechanical specificity (i.e. large muscle mass exercises, appropriate velocity, contraction type etc.). Generally, machines should be used as an adjunct to free weight training and, depending upon the sport, can be used to a greater or lesser extent during various phases of the training period (preparation, pre-competition, competition).

Adaptation, Physiological↗

PubMed2005

Moderate resistance training volume produces more favorable strength gains than high or low volumes during a short-term training cycle.

The purpose of this study was to examine the effects of 3 resistance training volumes on maximal strength in the snatch (Sn), clean & jerk (C&J), and squat (Sq) exercises during a 10-week training period. Fifty-one experienced (>3 years), trained junior lifters were randomly assigned to one of 3 groups: a low-volume group (LVG, n = 16), a moderate-volume group (MVG, n = 17), and a high-volume group (HVG, n = 18). All subjects trained 4-5 days a week with a periodized routine using the same exercises and relative intensities but a different total number of sets and repetitions at each relative load: LVG (1,923 repetitions), MVG (2,481 repetitions), and HVG (3,030 repetitions). The training was periodized from moderate intensity (60- 80% of 1 repetition maximum [1RM]) and high number of repetitions per set (2-6) to high intensity (90-100% of 1RM) and low number of repetitions per set (1-3). During the training period, the MVG showed a significant increase for the Sn, C&J, and Sq exercises (6.1, 3.7, and 4.2%, respectively, p < 0.01), whereas in the LVG and HVG, the increase took place only with the C&J exercise (3.7 and 3%, respectively, p < 0.05) and the Sq exercise (4.6%, p < 0.05, and 4.8%, p < 0.01, respectively). The increase in the Sn exercise for the MVG was significantly higher than in the LVG (p = 0.015). Calculation of effect sizes showed higher strength gains in the MVG than in the HVG or LVG. There were no significant differences between the LVG and HVG training volume-induced strength gains. The present results indicate that junior experienced lifters can optimize performance by exercising with only 85% or less of the maximal volume that they can tolerate. These observations may have important practical relevance for the optimal design of strength training programs for resistance-trained athletes, since we have shown that performing at a moderate volume is more effective and efficient than performing at a higher volume.

Adolescent↗

PubMed2005

Hormonal response to maximal rowing before and after heavy increase in training volume in highly trained male rowers.

AIM: The aim of this study was to investigate the hormonal response at rest and during maximal 2,000 m rowing ergometer test in 12 highly trained male rowers before and after 3 week heavy training, and after 2 week tapering periods. METHODS: Venous blood samples were obtained before, immediately after and after 30 min of recovery of the rowing performance test. Testosterone, cortisol and sex hormone binding globulin were measured, and free testosterone and the free testosterone: cortisol ratio calculated. RESULTS: Mean training time was about 100% higher during the heavy training period (17.5 h x week(-1)) compared to the tapering period (8.9 h x week(-1)). Two thousand meter rowing ergometer performance parameters were not different between 3 tests. Resting testosterone and cortisol values were not different between 3 tests. Three week heavy training period induced significant reductions in resting free testosterone and free testosterone: cortisol ratio. Resting free testosterone and free testosterone: cortisol ratio were increased to the pretraining level after 2 week tapering period. A significantly (p<0.05) lower maximal exercise-induced increase of the free testosterone level was measured after heavy training period. The response of cortisol was unchanged and free testosterone: cortisol ratio demonstrated a trend (p>0.05) for a decrease after heavy training period. CONCLUSIONS: Our findings indicate that the first sign of decreased adaptivity in athletes is a decreased resting level of free testosterone and a lower maximal exercise-induced increase in free testosterone concentration. In addition, heavy training load higher than 1,000 min per week can be sustained for 3 weeks when sufficient tapering period is followed in highly trained male rowers.

Adult↗

PubMed2002