Longer Training Duration Research Articles

Pushing up or pushing out-an initial investigation into horizontal- versus vertical-force training on swimming start performance: a pilot study.

BackgroundThe block phase in the swimming start requires a quick reaction to the starting signal and a large take-off velocity that is primarily horizontal in direction. Due to the principle of specificity of training, there is a potential benefit of performing a greater proportion of horizontal force production exercises in a swimmers’ dry-land resistance training sessions. Therefore, the purpose of this pilot study was to provide an insight into the effects of a horizontal- (HF) vs vertical-force (VF) training intervention on swim start performance.MethodsEleven competitive swimmers (six males (age 20.9 ± 1.8 years, body mass 77.3 ± 9.7 kg, height 1.78 ± 0.05 m) and five females (age 21.4 ± 2.0 years, body mass 67.5 ± 7.4 kg, height 1.69 ± 0.05 m)) completed 2 weekly sessions of either a horizontal- or vertical-force focused resistance training programme for 8 weeks. Squat jump force-time characteristics and swim start kinetic and kinematic parameters were collected pre- and post-intervention.ResultsAcross the study duration, the swimmers completed an average of nine swimming sessions per week with an average weekly swim volume of 45.5 ± 17.7 km (HF group) and 53 ± 20.0 km (VF group), but little practice of the swim start per week (n = 9). Within-group analyses indicated a significant increase in predicted one repetition maximum (1RM) hip thrust strength in the HF group, as well as significant increases in grab resultant peak force but reductions in resultant peak force of the block phase for the VF group. No significant between-group differences in predicted 1RM hip thrust and back squat strength, squat jump force-time and swim start performance measures were observed after 8 weeks of training. Significant correlations in the change scores of five block kinetic variables to time to 5 m were observed, whereby increased block kinetic outputs were associated with a reduced time to 5 m. This may be indicative of individual responses to the different training programmes.DiscussionThe results of this current study have been unable to determine whether a horizontal- or vertical-force training programme enhances swim start performance after an 8-week training intervention. Some reasons for the lack of within and between group effects may reflect the large volume of concurrent training and the relative lack of any deliberate practice of the swim start. Larger samples and longer training duration may be required to determine whether significant differences occur between these training approaches. Such research should also look to investigate how a reduction in the concurrent training loads and/or an increase in the deliberate practice of the swim start may influence the potential changes in swim start performance.

The Tulane accelerated physician training program (TAP-TP): A novel combination of scholarship and service

Introduction In spite of a projected shortage of physicians in the USA, the relatively long time and duration of training and high expense, the education of U.S. physicians has changed little over the past 120 years. Methods To address these issues, Tulane University developed a program, the Tulane accelerated physician training program (TAP-TP). This unique program allows selected Tulane undergraduate students to complete two years of undergraduate studies, followed by a mandatory year of public service, prior to four years of medical school. Results Students almost exclusively major in Cell and Molecular Biology (CMB), and used credits earned in Medical School to complete the required hours for their Bachelor’s degree. The program was judged to be successful based on its ability to attract, retain, and graduate students into medical residency programs. The shortened time frame needed to complete the undergraduate program is associated with significant cost savings for the students. Educational outcomes were not statistically different between TAP-TP and traditional students despite the accelerated curriculum. Conclusions TAP-TP is a unique model to graduate physicians in an accelerated fashion at significant cost savings.

Effects of aerobic physical activity to cardio-respiratory fitness of the elderly population: systematic overview

Background and Study Aim. Aerobic training is effective manner of exercising aimed at improving cardio-respiratory fitness of young people. However, its effects to the elderly population (over the age of 60), depending on characteristics of the participant (gender, health status, lifestyle, etc.), is still unclear. Aim of this research is systematic overview of the available literature dealing with the topic of effects of aerobic training to cardio-respiratory fitness of the elderly population over the age of 60, depending of gender (male/female), BMI (overweight/normal weight), lifestyle (active/sedentary), health status (diabetes/hypertension/metabolic syndrome).
 Material and methods: Total number of papers with published research results which met the criteria was 32. Walking is effective manner of exercising which influences improvement of maximum oxygen consumption (mean value: ±SD:12.91±7.40%). Introduction of activities with greater impact (bicycle and jogging) provides more effect to the cardio-respiratory fitness (mean value: ±SD:14.28±7.48%).
 Results: Aerobic training intensity level (moderate vs. high) makes no significant difference to the adaptive response of the cardio-respiratory fitness in elderly population. Training in duration of 6 weeks may significantly influence increase in maximum oxygen consumption, but longer training duration, however, has better effect. Endurance training has similar effects to improvement of cardio-respiratory fitness in both men and women. On the other hand, it seems that active people have lower adaptive response in comparison to sedentary people (8.3% vs. 18.84%). Effect is similar between overweight and normal weight participants (18.48% vs. 8.6%). Positive influence of aerobic training was also observed in participants with hypertension, metabolic system and diabetes type 2.
 Conclusion: Results clearly suggest benefits of aerobic training on cardio-respiratory fitness of elderly population. The effect may, however, vary depending of duration, type of activity, as well as characteristics of the sample.

The impact of mindfulness training on performance in a group decision-making task: Evidence from an experimental study.

It is widely assumed that mindfulness training will lead to a range of benefits, from improved attentional capacities to better decision-making. Indeed, many large corporations have begun to provide workplace mindfulness training with the aim of improving group-based decision-making. Yet, there has been little empirical work testing the effects of mindfulness training on complex group-based task performance. In a randomised experimental study (N = 332), we examine the effects of two different durations of mindfulness training on strategic decision-making using the classic NASA survival task, assessing individual and then group performance. We expected that a longer training duration (seven daily sessions) would be associated with better group performance relative to a "one-off" training session. We did not find such an association: groups in the longer training condition made slightly, but not significantly, more errors than groups in the one-off condition. We did not find any differences across training conditions when examining individual performance. Our findings should be interpreted in light of numerous studies demonstrating the benefits of even short durations of mindfulness practice on cognitive performance. We conclude that our lengthier mindfulness training duration did not confer measurable benefits over a one-off training session at either the individual or the group level on a strategic decision-making task.

Efficacy of an ultrasound training program for nurse midwives to assess high-risk conditions at labor triage in rural Uganda.

Many high-risk conditions of pregnancy are undetected until the time of delivery in low-income countries. We developed a point-of-care ultrasound training protocol for providers in rural Uganda to detect fetal distress or demise, malpresentation, multiple gestation, placenta previa, oligohydramnios and preterm delivery. This was a mixed-methods study to evaluate the 2-week training curriculum and trainees' ability to perform a standard scanning protocol and interpret ultrasound images. Surveys to assess provider confidence were administered pre-training, immediately after, and at 3-month follow up. Following lecture and practical demonstrations, each trainee conducted 25 proctored scans and were required to pass an observed structured clinical exam (OSCE). All images produced 8 weeks post course underwent blinded review by two ultrasound experts to assess image quality and to identify common errors. Key informant interviews further assessed perceptions of the training program and utility of point-of-care ultrasound. All interviews were audio recorded, transcribed, and reviewed by multiple readers using a content analysis approach. Twenty-three nurse/nurse midwives and two physicians from one district hospital and three health centers participated in the training curriculum. Confidence levels increased from an average of 1 point pre-course to over 6 points post-course for all measures (maximum of 7 points). Of 25 participants, 22 passed the OSCE on the first attempt (average score 89.4%). Image quality improved over time; the final error rate at week 8 was less than 5%, with an overall kappa of 0.8-1 for all measures between the two reviewers. Among the 12 key informant interviews conducted, key themes included a desire for more hands-on training and longer duration of training and challenges in balancing clinical duties with ability to attend training sessions. This study demonstrates that providers without previous ultrasound experience can detect high-risk conditions during labor with a high rate of quality and accuracy after training.

Factors Affecting the Interest in a Surgical Career among Medical Students at a Nonurban, Tertiary Care Academic Institution

Present day medical students are inherently different from those in the past by growing up in a uniquely different environment that shapes their personal and professional values which affects their career decisions. Vascular surgery (VS) task force is facing a shortage in the near future. The purpose of this analysis is to gain a better understanding of the medical students' perceptions about surgery in general and VS in particular. Our institution is a large, tertiary care medical center, which is in a nonurban location. Our goal was to identify any barriers in the recruitment of prospective students to VS and to implement directives to address such barriers. An online questionnaire was distributed to Penn State Hershey College of Medicine medical students. Our institution has an established 0+5 VS residency program and a VS interest group. It was designed to understand potential barriers in the recruitment of medical students choosing VS as a career. Survey consisted of 23 questions, which were carefully designed to collect information about student demographics, interest in medical profession in general, opinions about the field of surgery, and reasons for having an interest or no interest in VS. Five hundred sixty medical students at Penn State Hershey College of Medicine were surveyed, of whom 143 (26%) completed the survey. About 58.7% were females and two-thirds of the respondents were in the age range of 21-25years. The following factors were significantly associated with pursing surgical career: Medical Student Year III (odds ratio [OR] 0.36, confidence interval [CI] 0.19-0.69), surgical mentorship (OR 6.01, CI 1.30-28), wanting more exposure to VS (OR 6.15, CI 2.07-18.23), and opportunity to complete training within 5years (OR 1.14, CI 1.03-1.25) (all P<0.05). Specifically, for VS, following factors were found to be associated with increased likelihood of choosing a VS career: variety of operative cases, ability to operate on multiple anatomic areas of the body, and opportunity to complete training within 5years (all P<0.05). Following factors were associated with not choosing a VS career: surgical career not for me, long duration of surgical training, financial aid burden, marital status, and complexity of operations (all P<0.05). Students cited following concerns for choosing a surgical career: burnout (61%), stress (12.8%), work hours (12.1%), and stressful life style (5.7%). Potential barriers of students in choosing a surgical career are fundamentally grounded in their overall perception of surgery but are independently associated with their level of education (medical student-III versus others), strong surgical mentorship, the desire to be exposed to VS, and the opportunity to complete subspecialty surgical training within 5years. For VS, attractive factors were variety of operative cases, ability to operate on multiple anatomic areas of the body, and opportunity to complete training within 5years. Overall, burnout associated with surgical career is the most common concern for medical students.

Prospects for Collaborative Industrial Doctoral Education in Russia

The article proposes recommendations on the development of collaborative industrial doctoral education in Russian conditions considering international experience and provides a justification for the Russian high-tech companies’ demand for the competences of graduates of the collaborative doctoral programs. The regression analysis of patent and innovation activity indicators of Russian high-tech companies on the share of employed with academic degrees showed that successful graduates of Russian doctoral schools with specialization in technical sciences have an option to apply their research competences in the real sector of the economy. This determines the need to develop and put into practice specialized doctoral programs aimed at training scientific and engineering personnel for high-tech companies in the form of collaboration with industrial partners. Such programs can be implemented using the industrial PhD model, which is based on a research project in the interests of the employer with dual scientific supervision and funding of the study at the expense of the employer. Collaborative industrial doctoral programs require a longer training duration than traditional academic doctoral programs, as well as a reduced classroom load, especially concerning pedagogical and general disciplines. Grants, tax credits and preferential treatment for procurement by large state-owned companies can be used to encourage Russian high-tech companies with high research and development costs to become industrial partners of doctoral schools.

Surgical training in gynecologic oncology: Past, present, future

The purpose of this paper is to review the surgical care related to training in gynecologic oncology, from past, present and future perspectives. A marked decline in the incidence of cervical cancer as well as improvements in radiation therapy have led to a reduction in the numbers of radical hysterectomies and exenterations being performed. Utilization of neoadjuvant chemotherapy is reducing the extent of cytoreductive operations, including intestinal surgery. The incorporation of sentinel lymphatic mapping has reduced the number of pelvic, paraaortic and inguinal lymphadenectomies being performed. Coupled with these changes are other factors limiting time for surgical training including an explosion in targeted anticancer therapies and more individualized options beyond simple cytotoxic therapy. With what is likely to be a sustained impact on training, gynecologic oncologists will still provide a broad range of care for women with gynecologic cancer but may be quite limited in surgical scope and rely on colleagues from other surgical disciplines. Enhancement of surgical training by off-service rotations, simulation, attending advanced surgical training courses and/or a longer duration of training are currently incorporated into some programs. Programs must ensure that fellows take full advantage of the clinical materials available, particularly those related to the potential deficiencies described. Changing required research training to an additional elective year could also be considered. Based on the perspectives noted, we believe it is time for our subspecialty to reevaluate its scope of surgical training and practice.

The College of Surgeons of East, Central, and Southern Africa: Successes and Challenges in Standardizing Neurosurgical Training

The College of Surgeons of East, Central, and Southern Africa (COSECSA) is a regional accrediting body for general and specialty surgical training programs that has recently expanded to include neurosurgery. As neurosurgical services expand in sub-Saharan Africa, the structure of training and accreditation has become a vital issue. We review the founding and current structures of COSECSA neurosurgical training, identifying accomplishments and challenges facing the expansion of neurosurgical training in this region. The COSECSA model has succeeded in several countries to graduate qualified neurosurgeons, but challenges remain. Programs must balance the long duration of training required to promote surgical excellence against an overwhelming clinical need that seeks immediate solutions. Harnessing global collaboration, rapidly expanding local infrastructure, and a robust multinational training curriculum, COSECSA has emerged as a leader in the effort to train neurosurgeons and is anticipated to dramatically improve on the markedly unmet need for neurosurgical care in sub-Saharan Africa.

Combined Aerobic and Resistance Training for Cardiorespiratory Fitness, Muscle Strength, and Walking Capacity after Stroke: A Systematic Review and Meta-Analysis

BackgroundCardiorespiratory fitness, measured as peak oxygen consumption, is a potent predictor of stroke risk. Muscle weakness is the most prominent impairment after stroke and is directly associated with reduced walking capacity. There is a lack of recommendations for optimal combined aerobic training and resistance training for those patients. The purpose of this study was to systematically review and quantify the effects of exercise training on cardiorespiratory fitness, muscle strength, and walking capacity after stroke. MethodsFive electronic databases were searched (until May 2019) for studies that met the following criteria: (1) adult humans with a history of stroke who ambulate independently; (2) structured exercise intervention based on combined aerobic training and resistance training; and (3) measured cardiorespiratory fitness, muscle strength, and/or walking capacity. ResultsEighteen studies (602 participants, average age 62 years) met the inclusion criteria. Exercise training significantly improved all 3 outcomes. In subgroup analyses for cardiorespiratory fitness, longer training duration was significantly associated with larger effect size. Likewise, for muscle strength, moderate weekly frequency and lower training volume were significantly associated with larger effect size. Furthermore, in walking capacity, moderate weekly frequency and longer training duration were significantly associated with larger effect size. ConclusionsThese results suggest that an exercise program consisting of moderate-intensity, 3 days per week, for 20 weeks should be considered for greater effect on cardiorespiratory fitness, muscle strength, and walking capacity in stroke patients.

Combined Aerobic and Resistance Training for Peak Oxygen Uptake, Muscle Strength, and Hypertrophy After Coronary Artery Disease: a Systematic Review and Meta-Analysis.

Maximal aerobic capacity measured as peak oxygen consumption (VO2peak), muscle strength, and muscle hypertrophy are the potent predictors of survival after coronary artery disease (CAD). The purpose of this study was to review the effects of combined aerobic training (AT) and resistance training (RT) on the three outcomes in CAD patients. Five electronic databases were searched. Combined AT and RT trials in 21 studies had a significantly greater favorable effect on all three outcomes compared with control groups (CON). In subgroup analyses for VO2peak, longer session duration and shorter post-CAD period were associated with larger effect size (ES). For muscle strength, higher training volume, longer post-CAD period, and younger age were associated with larger ES. In hypertrophy, longer training duration was associated with larger ES. Moderate intensity, 2-3 days per week, 50 min (AT), three sets of 10-12 repetitions, and seven exercises (RT) for 14 weeks are recommended.

The Effect of Combined Aerobic and Resistance Exercise on Biochemical Factors in Patients with Type 2 Diabetes Mellitus

Introduction: Diabetes mellitus is a common health problem worldwide, especially in Asia. Exercise training plays an important role in controlling diabetes variables. The aim of this research was to consider the effectiveness of exercise on biochemical parameters in patients with type 2 diabetes mellitus. Materials and Methods: This randomized controlled clinical trial study was carried out with 40 patients with type 2 diabetes mellitus selected out of 702 volunteers. These individuals were randomly divided to two groups, combined (aerobic and resistance) exercise and control. Intervention protocol included 24 sessions (8 weeks) of aerobic exercise on the treadmill with zero slope, three days per week for 30 minutes per session. Intensity of training protocol was 50-70 percent of maximum heart rate, and that subjects wear a weighted vest. Measurements of parameters were done before and after 24 sessions. Results: Basically, there were no significant differences in variable values. After eight weeks, fasting blood sugar (FBS) (P = 0.059), glycosylated hemoglobin (HbA1c) (P = 0.333) were significantly reduced in the combined group; but not low-density lipoprotein (LDL), very low-density of lipoprotein (VLDL), high-density lipoprotein (HDL), total cholesterol, triglyceride, and high-sensitivity C-reactive protein (HS-CRP) (P > 0.050 for all). Alternatively, the value remained unchanged in the combined group while it was increased in the control group (P = 0.001). Conclusion: 24 sessions of aerobic exercise improved FBS and HbA1c in patients with type 2 diabetes mellitus. However, longer training duration is deemed to need to modify other variables.

The Effects of High- Versus Low-Intensity Power Training on Muscle Power Outcomes in Healthy, Older Adults: A Systematic Review.

Power training (PT) improves muscle power in older adults; however, intensity recommendations are less clear. A narrative approach was used to compare high- versus low-intensity PT on muscle power (and function) in healthy, older adults. Searches were performed using Medline, Embase, CINAHL, SPORTDiscus, AgeLine, and Scopus. Interventions in which older subjects (60+ years) were instructed to perform the concentric phase "as fast as possible" were included. After searches were performed, a third category of PT (moderate intensity) was included. Evidence from 27 studies (32 PT groups) showed changes in muscle power that averaged 26.8%, 33.4%, and 21.5% for high-, moderate-, and low-intensity PT, respectively, with greater changes with longer training duration and in mildly mobility-limited older adults. Function improved similarly across categories. In conclusion, both low- and high-intensity PT led to clinically significant changes in power and are viable options for improving power and function in older adults.

The Effect of Functional Home-Based Strength Training Programs on the Mechano-Morphological Properties of the Plantar Flexor Muscle-Tendon Unit in Children With Spastic Cerebral Palsy.

The purpose of this study was to investigate the effects of functional progressive resistance training (PRT) and high-intensity circuit training (HICT) on the mechano-morphological properties of the plantar flexor muscle-tendon unit in children with spastic cerebral palsy. Twenty-two children (12.8 [2.6]y old, Gross Motor Function Classification System levels I/II = 19/3) were randomly assigned to either a PRT group or an HICT group. The interventions consisted of functional lower limb exercises, which were performed at home 3 times per week for 8 weeks. Measurements at baseline, preintervention, postintervention, and follow-up were taken to assess ankle joint range of motion and the properties of the gastrocnemius medialis, vastus lateralis, rectus femoris, and Achilles tendon (eg,thickness, strength, stiffness). Despite a nonsignificant increase in active torque in the HICT group, neither gastrocnemius medialis morphology nor Achilles tendon properties were significantly altered after the interventions. Vastus lateralis thickness increased following PRT only. Functional home-based strength training did not lead to significant changes at the muscular level in children with cerebral palsy. We therefore assume that a more specific stimulus of higher intensity combined with a longer training duration might be necessary to evoke changes in muscles and tendons in individuals with cerebral palsy.

DEMOGRAPHIC CHARACTERISTICS AND INTERNAL MEDICINE AS A CAREER CHOICE OF FINAL YEAR MEDICAL STUDENTS

Introduction: Medical education requires a long duration of education and training. Medical stream is a diverse field; an assortment of clinical specialties of number of areas; clinical, psychological, surgical, field work, public health to name a few, with varied clinical environment, duties, and contact with patients.&#x0D; Methodology: Study was conducted in ten Medical colleges from three northern states of India (Uttar Pradesh, Punjab and Chandigarh). 677 final year medical students were included in the study. The study was designed as a cross-sectional self- administered questionnaire-based survey. Data were analyzed based on Frequencies, percentage, weighted scores and Chi square test. The findings were tabulated and represented with the help of suitable diagrammatic and graphical presentation.&#x0D; Results: revealed that around two-third were males (67.50%), majority were under 25 years, Hindus, from urban areas, joint families and 6.79% were married. Majority belonged to HIG. Statistically significant association of some demographic Characteristics (area of residence, gender, marital status and type of family) in selection of Internal medicine as specialty choice, whereas the association was not significant for age, religion and income group.

A Meta-Analysis to Determine Strength Training Related Dose-Response Relationships for Lower-Limb Muscle Power Development in Young Athletes.

It is well-documented that strength training (ST) improves measures of muscle strength in young athletes. Less is known on transfer effects of ST on proxies of muscle power and the underlying dose-response relationships. The objectives of this meta-analysis were to quantify the effects of ST on lower limb muscle power in young athletes and to provide dose-response relationships for ST modalities such as frequency, intensity, and volume. A systematic literature search of electronic databases identified 895 records. Studies were eligible for inclusion if (i) healthy trained children (girls aged 6–11 y, boys aged 6–13 y) or adolescents (girls aged 12–18 y, boys aged 14–18 y) were examined, (ii) ST was compared with an active control, and (iii) at least one proxy of muscle power [squat jump (SJ) and countermovement jump height (CMJ)] was reported. Weighted mean standardized mean differences (SMDwm) between subjects were calculated. Based on the findings from 15 statistically aggregated studies, ST produced significant but small effects on CMJ height (SMDwm = 0.65; 95% CI 0.34–0.96) and moderate effects on SJ height (SMDwm = 0.80; 95% CI 0.23–1.37). The sub-analyses revealed that the moderating variable expertise level (CMJ height: p = 0.06; SJ height: N/A) did not significantly influence ST-related effects on proxies of muscle power. “Age” and “sex” moderated ST effects on SJ (p = 0.005) and CMJ height (p = 0.03), respectively. With regard to the dose-response relationships, findings from the meta-regression showed that none of the included training modalities predicted ST effects on CMJ height. For SJ height, the meta-regression indicated that the training modality “training duration” significantly predicted the observed gains (p = 0.02), with longer training durations (>8 weeks) showing larger improvements. This meta-analysis clearly proved the general effectiveness of ST on lower-limb muscle power in young athletes, irrespective of the moderating variables. Dose-response analyses revealed that longer training durations (>8 weeks) are more effective to improve SJ height. No such training modalities were found for CMJ height. Thus, there appear to be other training modalities besides the ones that were included in our analyses that may have an effect on SJ and particularly CMJ height. ST monitoring through rating of perceived exertion, movement velocity or force-velocity profile could be promising monitoring tools for lower-limb muscle power development in young athletes.

Training models and status of clinical neuropsychologists in Europe: Results of a survey on 30 countries

Objective: The aims of the study were to analyze the current European situation of specialist education and training within clinical neuropsychology, and the legal and professional status of clinical neuropsychologists in different European countries. Method: An online survey was prepared in 2016 by a Task Force established by the European Federation of Psychological Associations, and representatives of 30 countries gave their responses. Response rate was 76%. Results: Only three countries were reported to regulate the title of clinical neuropsychologist as well as the education and practice of clinical neuropsychologists by law. The most common university degree required to practice clinical neuropsychology was the master’s degree; a doctoral degree was required in two countries. The length of the specialist education after the master’s degree varied between 12 and 60 months. In one third of the countries, no commonly agreed upon model for specialist education existed. A more systematic training model and a longer duration of training were associated with independence in the work of clinical neuropsychologists. Conclusions: As legal regulation is mostly absent and training models differ, those actively practicing clinical neuropsychology in Europe have a very heterogeneous educational background and skill level. There is a need for a European standardization of specialist training in clinical neuropsychology. Guiding principles for establishing the common core requirements are presented.

Does High-Intensity Endurance Training Increase the Risk of Atrial Fibrillation? A Longitudinal Study of Left Atrial Structure and Function.

Exercise mitigates many cardiovascular risk factors associated with atrial fibrillation. Endurance training has been associated with atrial structural changes which can increase the risk for atrial fibrillation. The dose of exercise training required for these changes is uncertain. We sought to evaluate the impact of exercise on left atrial (LA) mechanical and electrical function in healthy, sedentary, middle-aged adults. Sixty-one adults (52±5 years) were randomized to either 10 months of high-intensity exercise training or yoga. At baseline and post-training, all participants underwent maximal exercise stress testing to assess cardiorespiratory fitness, P-wave signal-averaged electrocardiography for filtered P-wave duration and atrial late potentials (root mean square voltage of the last 20 ms), and echocardiography for LA volume, left ventricular end-diastolic volume, and mitral inflow for assessment of LA active emptying. Post-training data were compared with 14 healthy age-matched Masters athletes. LA volume, Vo2 max, and left ventricular end-diastolic volume increased in the exercise group (15%, 17%, and 16%, respectively) with no change in control (P<0.0001). LA active emptying decreased post-exercise versus controls (5%; P=0.03). No significant changes in filtered P-wave duration or root mean square voltage of the last 20 ms occurred after exercise training. LA and left ventricular volumes remained below Masters athletes. The athletes had longer filtered P-wave duration but no difference in the frequency of atrial arrhythmia. Changes in LA structure, LA mechanical function, and left ventricular remodeling occurred after 10 months of exercise but without significant change in atrial electrical activity. A longer duration of training may be required to induce electrical changes thought to cause atrial fibrillation in middle-aged endurance athletes. URL: https://www.clinicaltrials.gov. Unique Identifier: NCT02039154.

Effects of blood flow restricted exercise training on muscular strength and blood flow in older adults

BackgroundIn young adults, blood flow restricted exercise (BFRE) at relatively low intensities can increase muscle strength as effectively as conventional high intensity training. Ischemic exercise can also increase collateral blood flow in skeletal muscle. However, the effects of chronic BFRE on muscle strength and blood flow in older adults remain unknown. The purpose of this study was to compare the effects of 4weeks of BFRE training on skeletal muscle strength and blood flow between young and older subjects and between older adults performing BFRE and conventional high intensity resistance exercise. MethodsMaximum voluntary contraction (MVC), forearm girth, peak forearm blood flow (FBF) and forearm vascular conductance (FVC) were assessed before and after 4weeks of forearm resistance training with BFRE in older adults (O-BFRE, 63±1 y, n=9) and younger adults (Y-BFRE, 22±1 y, n=8) and with high intensity training at 75% maximum voluntary contraction in older adults (O-HI, 63±1 y, n=10). ResultsMVC increased in all groups (O-BFRE, 33.4±4.7 to 36.3±4.7kg; Y-BFRE, 37.2±4.9 to 43.0±5.0kg; O-HI, 34.0±4.4 to 39.8±4.4kg; all p<0.05). Forearm girth increased in O-BFRE (26.3±1.1 to 26.7±1.1cm; p<0.05) and Y-BFRE (23.9±0.9 to 25.1±1.5cm; p<0.05) but not in O-HI (25.9±1.0 to 26.1±1.0cm; p=0.26). Peak forearm vascular conductance increased in Y-BFRE (0.190±0.016 to 0.311±0.031units; p=0.01) but not in O-BFRE (0.157±0.024 to 0.193±0.029units; p=0.48) and O-HI (0.188±0.035 to 0.227±0.035units; p=0.18). ConclusionThese data suggest that chronic BFRE training is effective in increasing muscular strength, muscle size and vascularity in young adults but, in older adults, increases only muscular strength and size. Longer training durations or higher volumes may be required to evoke similar vascular adaptations in older adults.

Improvement in Biochemical Parameters in Patients with Type 2 Diabetes After Twenty-Four Sessions of Aerobic Exercise: A Randomized Controlled Trial

Background: Diabetes is a cosmopolitan health problem worldwide, especially in Asia. It is a metabolic disorder originating from insulin secretion deficiency, insulin performance or both. When both factors are involved, abnormal complications may result. Exercise training plays an important role in controlling diabetic parameters, including biomechanical variables. Objectives: This study aimed at assessing the effectiveness of exercise on biochemical parameters in patients with diabetes. Methods: This study was a randomized control trial. A total of 30 volunteers met the inclusion criteria and were randomly divided to 2 groups, aerobic and control, by block randomization method. This study was performed during May to October 2016 in Iran. The intervention protocol included 24 sessions (8 weeks) of aerobic exercise on the treadmill with zero slope, 3 days per week for 30 minutes per session. Intensity of training protocol was 50 to 70 maximum heart rate. Measurements of biochemical parameters were done before and after the 24 sessions Results: There were no significant differences in anthropometric, gender, age, diabetic history, cardiac ejection fraction, and biochemical variables (P > 0.05). After 8 weeks, results were as follows: fasting blood glucose (FBS) (130.92 (45.43) Mg/dL), glycosylated hemoglobin (HbA1c) (6.62 (1.52) percent), cholesterol (150.62 (24.07) Mg/dL), triglyceride (119.62 (39.18) Mg/dL), Low density lipoprotein (LDL) (77.23 (26.73) Mg/dL), and very low density of lipoprotein (VLDL) (23.92 (7.90) Mg/dL); these were significantly reduced in the training group (P < 0.05), yet, not in the control group. Alternatively, high density lipoprotein (HDL) remained unchanged in the aerobic group (47.85 (17.83) Mg/dL) while it was increased in the control group (42.07 (8.86) Mg/dL). Also, C-reactive protein (CRP)) 2.43 (1.03) Mg/L) and microalbumin (12.32 (1.21) Mg) values didn’t change between the 2 groups. Conclusions: Eight weeks of aerobic exercise was shown to be effective in controlling biochemical parameters. However, longer training duration is needed in order to modify CRP. © 2017, Iranian Red Crescent Medical Journal.