Implications For Prescription Research Articles

The Effects of Postprandial Walking on the Glucose Response after Meals with Different Characteristics.

We evaluated the effect of postprandial walking on the post-meal glycemic response after meals with different characteristics. Twenty-one healthy young volunteers participated in one of two randomized repeated measures studies. Study 1 (10 participants) assessed the effects of 30 min of brisk walking after meals with different carbohydrate (CHO) content (0.75 or 1.5 g of CHO per kg/body weight). Study 2 (11 participants) evaluated the effects of 30 min of brisk walking after consuming a mixed meal or a CHO drink matched for absolute CHO content (75 g). Postprandial brisk walking substantially reduced (p < 0.009) the glucose peak in both studies, with no significant differences across conditions. When evaluating the glycemic response throughout the two hours post-meal, postprandial walking was more effective after consuming a lower CHO content (Study 1), and similarly effective after a mixed meal or a CHO drink (Study 2), although higher glucose values were observed when consuming the CHO drink. Our findings show that a 30 min postprandial brisk walking session improves the glycemic response after meals with different CHO content and macronutrient composition, with implications for postprandial exercise prescription in daily life scenarios.

Dose-response effects of forefoot and arch orthotic components on the center of pressure trajectory during running in pronated feet

BackgroundFoot orthoses are widely used in runners with pronated feet, who are characterized with large forefoot abduction and arch deformation during gait. However, the relationship between the amount of forefoot and arch orthotic correction and the alterations in foot biomechanics remains unclear. Research questionThis study aimed to determine dose-response effects of foot orthoses with forefoot wedge and arch support components on the center of pressure (COP) trajectories and pressure distribution during running in symptomatic pronated feet. MethodsFifteen recreational runners participated in this study. A pressure plate was used to measure plantar pressures during running with control shoe only and ten foot orthoses, varying in forefoot wedges (5 levels) and arch supports (2 levels). The COP trajectory across the entire stance phase was compared between orthotic and control conditions using one-dimensional statistical parametric mapping. The differences in the force-time integral (FTI) and temporal variables were explored between conditions using repeated measures ANOVAs. The main effect of the two orthotic components and their interaction on tested variables were examined using two-way ANOVAs. ResultsA forefoot wedge, whether laterally or medially located, shifted the COP trajectory laterally during some subphases of running (p < 0.05), while using an arch support only had minimal effect on the COP. Almost all orthoses reduced the FTI on the 2nd metatarsal and medial heel, and only medial forefoot wedges reduced the FTI on the hallux. There was a linear effect of forefoot wedges on the medial-lateral COP displacements during the propulsion phase, but no interactions were found between two orthotic components. SignificanceThese findings suggest that forefoot orthotic components rather than arch supports are effective in altering forefoot dynamics in runners with pronated feet. This study could have implications for foot orthotic prescription and running-related injury prevention for individuals with pronated feet.

Punitive Damages and the Place of Punishment in Private Law

AbstractIt has long been orthodoxy that punitive damages, because they are awarded in order to punish, are an anomalous remedy. So entrenched is this understanding that it has never been seriously challenged. However, even apparent truisms about the law should be questioned and, accordingly, this article offers a rival account. It contends that the deeply ingrained view that punitive damages are an aberration is a half‐truth because several other remedial rules are also aimed, at least in certain circumstances, at punishment. We concentrate in this regard on the doctrine of remoteness and its attenuation where the defendant has intentionally injured the claimant, aggravated damages, the account of profits remedy and general damages. Overthrowing the orthodox understanding regarding punitive damages has important prescriptive implications. In particular, it follows that the belief that punitive damages are an alien presence in private law supplies no basis for confining the jurisdiction to award them.

Walking Cadence during Moderate-Intensity Physical Activity in Pregnant Women.

Evidence has established that a cadence of 100 steps/min is indicative of the moderate intensity threshold of 3 metabolic equivalents (METs), but this has only been described in non-pregnant individuals. As metabolic alterations are well established during pregnancy, the purpose of this study was to determine if the walking cadence equivalent to 3 METs in pregnant women is similar to non-pregnant populations. Pregnant females (n = 29; age = 30.3 ± 3.2 years, gestational age = 23.9 ± 6.6 weeks) in their second or third trimester (>12 weeks gestation) completed three stages of treadmill walking for 5 min at different standardized walking speeds: 2.5, 3.0, and 3.5 miles per hour (mph). Oxygen consumption (VO2) and heart rate (HR) were measured each minute and METs were calculated for each stage. Real-time continuous monitoring of walking cadence was evaluated by an OptoGait gait analysis system. Following the three standardized speed stages, participants completed an additional stage walking at a speed that elicited 100 steps/min; VO2 and HR were also collected. A one-sample t-test was used to compare MET values at each stage to the heuristic 3 MET cutoff, and Pearson correlation coefficient was calculated to evaluate the relationship between cadence and METs. Mean cadence increased linearly across the three stages (2.5 mph = 103.7 ± 4.5, 3.0 mph = 112.5 ± 5.3, and 3.5 mph = 120.4 ± 6.2 steps/min), as did METs (2.5 mph = 2.7 ± 1.7, 3.0 mph = 3.2 ± 0.8, and 3.5 mph = 4.3 ± 1.8 METs) regardless of trimester. The average treadmill speed at which women walked at 100 steps/min was 2.4 ± 0.4 mph which elicited an oxygen consumption of 9.5 mL•kg−1•min−1, or 2.7 ± 0.7 METs. There was no significant difference between METs at 3.0 mph and the conventional 3 MET cut point for moderate-intensity PA (p < 0.05). There was a moderate and significant relationship between METs and cadence (2nd trimester: r = 0.51; 3rd trimester: r = 0.42). Current data indicate for the first time that the traditionally used 3 MET cutoff for moderate-intensity activity is appropriate for pregnant women despite metabolic alterations associated with pregnancy. This may have important implications for exercise prescription in pregnant populations.

The Biomechanical Characterization of the Turning Phase during a 180° Change of Direction.

The aim of this study was to characterize the turning phase during a modified 505 test. Forty collegiate basketball students, divided into faster and slower performers and high-playing-level and low-playing-level groups, were evaluated for the force-time characteristics (braking and/or propulsive phase) of the penultimate foot contact (PFC), final foot contact (FFC), and first accelerating foot contact (AFC), and for completion time and approach velocity. Based on the composition of the AFC, trials were classified as braking/propulsive or only propulsive. Regression analysis for the prediction of completion time was performed. The AFC contributed to reacceleration through shorter contact times and step length, and lower braking force production (p < 0.05). Faster performers and the high-playing-level group demonstrated (p < 0.05): lower completion times, higher approach velocities, longer steps length in the PFC and FFC, greater braking forces and impulses in the PFC; greater braking and propulsive forces, braking impulses, lower contact times in the FFC; greater braking and propulsive horizontal forces, horizontal impulses, lower contact times and vertical impulses in the AFC. Kinetic variables from only the FFC and AFC and approach velocity predicted 75% (braking/propulsive trials) and 76.2% (only-propulsive trials) of completion times. The characterization of the turning phase demonstrated the specific contribution of each foot contact and the possible implications for training prescription.

The configurational effects of task-technology fit, technology-induced engagement and motivation on learning performance during Covid-19 pandemic: An fsQCA approach.

At the onset of 2020, Covid-19 pandemic began and disrupted teaching and learning activities with substantial implications for resources and operations. Against this backdrop, the configural causal effects of task-technology fit, technology-induced engagement and motivation, gender, and residential location on learning performance are examined. The proposed association was tested with a dyad sample of faculty members and students (n = 16) using fuzzy sets (fsQCA) analysis. Results show that (i) task-technology fit, and technology-induced motivation emerge as necessary conditions for high learning performance; (ii) task-technology fit, technology-induced engagement and motivation are sufficient conditions for high learning performance among female students, (iii) task-technology fit, technology-induced engagement and motivation are sufficient conditions for high learning performance among students living in urban areas and (iv) task-technology fit is a sufficient condition for high learning performance among female students living in rural areas irrespective of technology-induced engagement and motivation. Implications for theory and policy prescriptions are offered for practitioners.

On measuring agreement with numerically bounded linguistic probability schemes: A re-analysis of data from Wintle, Fraser, Wills, Nicholson, and Fidler (2019).

Across a wide range of domains, experts make probabilistic judgments under conditions of uncertainty to support decision-making. These judgments are often conveyed using linguistic expressions (e.g., x is likely). Seeking to foster shared understanding of these expressions between senders and receivers, the US intelligence community implemented a communication standard that prescribes a set of probability terms and assigns each term an equivalent numerical probability range. In an earlier PLOS ONE article, [1] tested whether access to the standard improves shared understanding and also explored the efficacy of various enhanced presentation formats. Notably, they found that embedding numeric equivalents in text (e.g., x is likely [55–80%]) substantially outperformed the status-quo approach in terms of the percentage overlap between participants’ interpretations of linguistic probabilities (defined in terms of the numeric range equivalents they provided for each term) and the numeric ranges in the standard. These results have important prescriptive implications, yet Wintle et al.’s percentage overlap measure of agreement may be viewed as unfairly punitive because it penalizes individuals for being more precise than the stipulated guidelines even when the individuals’ interpretations fall perfectly within the stipulated ranges. Arguably, subjects’ within-range precision is a positive attribute and should not be penalized in scoring interpretive agreement. Accordingly, in the present article, we reanalyzed Wintle et al.’s data using an alternative measure of percentage overlap that does not penalize in-range precision. Using the alternative measure, we find that percentage overlap is substantially elevated across conditions. More importantly, however, the effects of presentation format and probability level are highly consistent with the original study. By removing the ambiguity caused by Wintle et al.’s unduly punitive measure of agreement, these findings buttress Wintle et al.’s original claim that the methods currently used by intelligence organizations are ineffective at coordinating the meaning of uncertainty expressions between intelligence producers and intelligence consumers. Future studies examining agreement between senders and receivers are also encouraged to reflect carefully on the most appropriate measures of agreement to employ in their experiments and to explicate the bases for their methodological choices.

Heterogeneity and incidence of non-response for changes in cardiorespiratory fitness following time-efficient sprint interval exercise training

Interindividual variability for training-induced changes in maximal oxygen uptake (VO2max) is well described following continuous aerobic and high-intensity interval training. Whether similar variability is observed following time-efficient sprint interval training with minimal training volume (i.e., reduced-exertion high-intensity interval training; REHIT) is unknown. We conducted a pooled analysis of n=117 (68 men) training participants (mean±SD: age: 30±10 y; VO2max: 34.8±7.5 ml·kg-1·min-1), who completed a VO2max assessment before and 3 days after 6 weeks of REHIT comprising of two 10-20 second 'all-out' cycling sprints per session, and n=40 no-intervention control participants (age: 30±13 y; VO2max: 31.5±6.5 ml·kg-1·min-1) who completed repeated VO2max tests over a comparable timeframe. Individual responses estimated using 50% confidence intervals derived from the technical error were interpreted against a smallest worthwhile change (SWC) of 1.75 ml·kg-1·min-1. The standard deviation of individual responses was 2.39 ml·kg-1·min-1 demonstrating clinically meaningful heterogeneity in training-induced changes in VO2max following REHIT that exceed the technical, biological and random within-subjects variability of VO2max assessment. The likely (75% probability) non-response rate was 18% (21/117), and 49% (57/117) of individuals demonstrated increases in VO2max likely higher than the SWC. We conclude that the well-described increase in VO2max following REHIT at the group level is subject to substantial variability in magnitude at an individual level. This has important implications for exercise prescription and can be harnessed to elucidate mechanisms of adaptation. Novelty: • There is substantial heterogeneity in VO2max responses following time-efficient sprint interval training • Proportion of non-response was 18% and ∽50% of individuals show clinically meaningful increases in VO2max.

The Search for Smart Governance in Agriculture and Natural Resources

We draw on previous positive political-economic models, which explain the seeming disjointedness of observed agricultural and resource policies to develop prescriptive implications that can be actively pursued by a smart government. Smart governments would design and implement a portfolio of both public-good policies (PERTs) and distortionary, redistributive policies (PESTs). Of particular importance in this process is the structuring of smart PESTs that dynamically complement the introduction and adoption of PERT policies. We emphasize the role of smart policy mixes on asset mobility and diversification, both of which lead to more evenly distributed political-economic power and reduced incentives for future rent-seeking. We examine three illustrative examples where a political-economic, portfolio approach could aid in resolving ‘wicked’ social problems and point toward a portfolio of complementary policy prescriptions for sustainable economic growth. Smart governments design and implement portfolios of complementary public goods and redistributive policies simultaneously. We conclude with the characteristics of a smart government and the core principles of sound policy analyses.

Constructing Conscience

American politics and law, like other liberal democracies, couches itself in the protection of the free individual, one who possesses both “beliefs” and the unalienable right to those “beliefs.” The “freedom of religion” guaranteed to U.S. citizens in the Establishment and Free Exercise clauses of the First Amendment prioritizes this supposedly private and transcendent realm of “sincerity,” “faith,” and “experience,” kept separate from the contextual and temporal world of society and politics. Historians of American religion, and scholars of religion more broadly, have long taken this “interiority” rhetoric to be self-evident, ignoring the prescriptive implications of positing such an interiority at all. Rather than understanding these rhetorics of “interiority” as referencing a non-empirical and apolitical reality of autonomous “selfhood,” this paper will argue that the constitutional protection of the autonomous individual is constitutive of a particular type of political subjectivity, one that allows for those in power to manage dissent by authorizing some differences and marginalizing others. Using different examples from historical and contemporary American politics and law, I will interrogate the function of institutionalizing such an “interiority” in the first place, in order to understand how and why American society works the way that it does.

Abstract 17010: Predicting Risk of Sudden Death With QT Interval-Prolonging Medications

Background: The ongoing pandemic has re-emphasized how QT-prolonging drugs can increase risk of sudden cardiac death (SCD), but azithromycin and hydroxychloroquine are only 2 of many such medications. There remains a critical need to identify individuals who are at high risk of SCD based on their demographic and clinical profile. Hypothesis: A modified Tisdale Score (TS), originally designed to assess risk of QTc (corrected QT interval) prolongation with QT-prolonging drugs, could also predict risk of SCD. Methods: From the ongoing Oregon Sudden Unexpected Death Study (ORESUDS), we identified a subgroup of SCD patients with coronary artery disease (CAD) and controls (individuals with and without CAD but no history of SCD) on at least one QT-prolonging medication enrolled between 2002 and 2020. Analysis was restricted to subjects with available pre-arrest medical history, including ECGs with QT interval available and details of prescribed medications. We identified QT prolonging drugs from the comprehensive list at crediblemeds.com. Our TS included age, sex, use of loop diuretics, serum potassium levels, history of acute myocardial infarction, history of heart failure, and number of QT prolonging drugs. We used a univariate logistic regression to determine the predictive power of the modified TS for SCD. We performed a backwards stepwise logistic regression considering race/ethnicity, diabetes, and hypertension in addition to TS to improve SCD prediction. Results: A total of 964 cases (60% male, mean age 68 years) and 668 controls (62% male, mean age 67 years) met inclusion criteria. TS ranged from 0 to 12 and mean TS was 5.86 ± 2.93 in cases and 4.29 ± 2.74 in controls (p &lt; 0.001). A 1-unit increase in the modified TS was a significant predictor of SCD (odds ratio (OR) 1.21, 95% confidence interval, 1.17 to 1.26). In the multivariable model predicting SCD, both the modified TS (OR 1.20, 95% CI, 1.15 to 1.25) and diabetes (OR 1.42, 95% CI, 1.14 to 1.78) were significant independent predictors of SCD. Conclusion: A modified Tisdale Score predicts SCD, and history of diabetes could potentially enhance the utility of this user-friendly clinical tool. These findings have implications for prescription of QT-prolonging drugs, especially during the ongoing pandemic.

Length of Initial Prescription at Hospital Discharge and Long-Term Medication Adherence for Elderly, Post-Myocardial Infarction Patients: Protocol for an Interrupted Time Series Study.

BackgroundBased on high-quality evidence, guidelines recommend the long-term use of secondary prevention medications post-myocardial infarction (MI) to avoid recurrent cardiovascular events and death. Unfortunately, discontinuation of recommended medications post-MI is common. Observational evidence suggests that prescriptions covering a longer duration at discharge from hospital are associated with greater long-term medication adherence. The following is a proposal for the first interventional study to evaluate the impact of longer prescription duration at discharge post-MI on long-term medication adherence.ObjectiveThe overarching goal of this study is to reduce morbidity and mortality among post-MI patients through improved long-term cardiac medication adherence. The specific objectives include the following. First, we will assess whether long-term cardiac medication adherence improves among elderly, post-MI patients following the implementation of (1) standardized discharge prescription forms with 90-day prescriptions and 3 repeats for recommended cardiac medication classes, in combination with education and (2) education alone compared to (3) usual care. Second, we will assess the cost implications of prolonged initial discharge prescriptions compared with usual care. Third, we will compare clinical outcomes between longer (>60 days) versus shorter prescription durations. Fourth, we will collect baseline information to inform a multicenter interventional study.MethodsWe will conduct a quasiexperimental, interrupted time series design to evaluate the impact of a multifaceted intervention to implement longer duration prescriptions versus usual care on long-term cardiac medication adherence among post-MI patients. Intervention groups and their corresponding settings include: (1) intervention group 1: 1 cardiac center and 1 noncardiac hospital allocated to receive standardized discharge prescription forms supporting the dispensation of 90 days’ worth of cardiac medications with 3 repeats, coupled with education; (2) intervention group 2: 4 sites (including 1 cardiac center) allocated to receive education only; and (3) control group: all remaining hospitals within the province that did not receive an intervention (ie, usual care). Administrative databases will be used to measure all outcomes. Adherence to 4 classes of cardiac medications — statins, beta blockers, angiotensin system inhibitors, and secondary antiplatelets (ie, prasugrel, clopidogrel, or ticagrelor) — will be assessed.ResultsEnrollment began in September 2017, and results are expected to be analyzed in late 2020.ConclusionsThe results have the potential to redefine best practices regarding discharge prescribing policies for patients post-MI. A policy of standardized maximum-duration prescriptions at the time of discharge post-MI is a simple intervention that has the potential to significantly improve long-term medication adherence, thus decreasing cardiac morbidity and mortality. If effective, this low-cost intervention to implement longer duration prescriptions post-MI could be easily scaled.Trial RegistrationClinicalTrials.gov NCT03257579; https://clinicaltrials.gov/ct2/show/NCT03257579International Registered Report Identifier (IRRID)DERR1-10.2196/18981

Naming and framing ecological distress

]We are living in a time of massive anthropogenic ecological and climatic shifts. Awareness of these changes and their effects on human lives is increasing, with recognised impacts on mental health. At present, a variety of different terms exist to describe ecological change-related distress. They range from the philosophical to the clinical, and are already beginning to form part of professional practice, as well as popular discourse, with prescriptive implications. In this piece, I explore some of the different names and frames for ecological distress by drawing on a sample of 30 online articles, blogs, and videos, and bringing these into dialogue with scholarly literature. My purpose is to open up a conversation about how medical anthropologists might attend to the meaning-making processes that surround ecological distress and (individual, institutional, and political) responses to it.

Examining the Priorities, Needs and Preferences of Men with Metastatic Prostate Cancer in Designing a Personalised eHealth Exercise Intervention.

Few individuals with metastatic prostate cancer have access to prostate cancer-specific exercise support, despite demonstrated benefits. eHealth tools, such as websites, may be viable options for increasing access. To be effective and acceptable, future eHealth websites need to consider end-users' perspectives, capacity and needs. We aim to provide insight into these factors by exploring daily priorities, activities and health literacy of individuals with metastatic prostate cancer and their perspectives towards exercise and exercise-based web-based eHealth interventions. Semi-structured interviews explored participant's experiences and understanding of their disease, exercise levels, advice received from health care providers, as well as acceptability of and suggested content for an eHealth tool. A thematic analysis was undertaken. Interviews were conducted with eighteen Australians (55-83 years; M = 71.5, SD = 8.9) living with metastatic prostate cancer. Needing to perform daily responsibilities was a key priority. Participants had limited understanding of the benefits of prostate cancer-specific exercise, and less than half discussed exercise with their health team. Fourteen men felt they could report metastases location, but only four could provide detailed information, which has clinical implications for exercise prescription. A potential web-based intervention was considered acceptable by seventeen men for reasons such as affordability, accessibility and convenience. User-friendly design and practitioner support were important. Results identified key aspects useful for person-centred design of exercise programs. Participants were positive towards the proposed web-based tool and expressed the need for individualised, user-friendly and reliable information with support from a professional embedded. Lastly, not all participants could accurately report metastasis locations.

The Application of Critical Power, the Work Capacity above Critical Power (W'), and its Reconstitution: A Narrative Review of Current Evidence and Implications for Cycling Training Prescription.

The two-parameter critical power (CP) model is a robust mathematical interpretation of the power–duration relationship, with CP being the rate associated with the maximal aerobic steady state, and W′ the fixed amount of tolerable work above CP available without any recovery. The aim of this narrative review is to describe the CP concept and the methodologies used to assess it, and to summarize the research applying it to intermittent cycle training techniques. CP and W′ are traditionally assessed using a number of constant work rate cycling tests spread over several days. Alternatively, both the 3-min all-out and ramp all-out protocols provide valid measurements of CP and W′ from a single test, thereby enhancing their suitability to athletes and likely reducing errors associated with the assumptions of the CP model. As CP represents the physiological landmark that is the boundary between heavy and severe intensity domains, it presents several advantages over the de facto arbitrarily defined functional threshold power as the basis for cycle training prescription at intensities up to CP. For intensities above CP, precise prescription is not possible based solely on aerobic measures; however, the addition of the W′ parameter does facilitate the prescription of individualized training intensities and durations within the severe intensity domain. Modelling of W′ reconstitution extends this application, although more research is needed to identify the individual parameters that govern W′ reconstitution rates and their kinetics.

Exercise-induced hypoalgesia after acute and regular exercise: experimental and clinical manifestations and possible mechanisms in individuals with and without pain.

Exercise and physical activity is recommended treatment for a wide range of chronic pain conditions. In addition to several well-documented effects on physical and mental health, 8 to 12 weeks of exercise therapy can induce clinically relevant reductions in pain. However, exercise can also induce hypoalgesia after as little as 1 session, which is commonly referred to as exercise-induced hypoalgesia (EIH). In this review, we give a brief introduction to the methodology used in the assessment of EIH in humans followed by an overview of the findings from previous experimental studies investigating the pain response after acute and regular exercise in pain-free individuals and in individuals with different chronic pain conditions. Finally, we discuss potential mechanisms underlying the change in pain after exercise in pain-free individuals and in individuals with different chronic pain conditions, and how this may have implications for clinical exercise prescription as well as for future studies on EIH.

Effects of Different Inertial Load Settings on Power Output using a Flywheel Leg Curl Exercise and its Inter-Session Reliability.

This study aimed to analyze the influence of the inertial load on both concentric and eccentric power output production during the flywheel leg curl exercise, and to assess the reliability of power output variables. Sixteen participants (8 males, 8 females) attended 4 testing sessions. During testing, participants performed one set of eight repetitions using a specific inertial load (0.083, 0.132, 0.182, 0.266 and 0.350 kg·m2) with a flywheel leg curl exercise. Concentric (CON) power, eccentric (ECC) power and the ECC/CON ratio were analyzed. The reliability analysis between sessions was performed. A significant interaction of inertia load x gender was found in CON power (p < 0.001) and in ECC power (p = 0.004), but not in the ECC/CON ratio (p = 0.731). A significant with-in (inertia loads) effect was found in CON power (p < 0.001) and in ECC power (p < 0.001), but not in the ECC/CON ratio (p = 0.096). CON power showed very high reliability scores, ECC power showed high to very high reliability scores, while the ECC/CON ratio ranged from poor to moderate. A significant between gender effect was found in CON power (p < 0.001) and in ECC power (p < 0.001), but not in the ECC/CON ratio (p = 0.752). This study is the first to report that power output in the flywheel leg curl exercise is altered by the inertia load used, as well as power output is different according to gender. CON and ECC power output presents high to very high reliability scores, and the ECC/CON ratio should not be used instead. These results can have important practical implications for testing and training prescription in sports.

Isokinetic eccentric exercise substantially improves mobility, muscle strength and size, but not postural sway metrics in older adults, with limited regression observed following a detraining period

IntroductionEccentric exercise can reverse age-related decreases in muscle strength and mass; however, no data exist describing its effects on postural sway. As the ankle may be more important for postural sway than hip and knee joints, and with older adults prone to periods of inactivity, the effects of two 6-week seated isokinetic eccentric exercise programmes, and an 8-week detraining period, were examined in 27 older adults (67.1 ± 6.0 years).MethodsNeuromuscular parameters were measured before and after training and detraining periods with subjects assigned to ECC (twice-weekly eccentric-only hip and knee extensor contractions) or ECCPF (identical training with additional eccentric-only plantarflexor contractions) training programmes.ResultsSignificant (P < 0.05) increases in mobility (decreased timed-up-and-go time [− 7.7 to − 12.0%]), eccentric strength (39.4–58.8%) and vastus lateralis thickness (9.8–9.9%) occurred after both training programmes, with low-to-moderate weekly rate of perceived exertion (3.3–4.5/10) reported. No significant change in any postural sway metric occurred after either training programme. After 8 weeks of detraining, mobility (− 8.2 to − 11.3%), eccentric strength (30.5–50.4%) and vastus lateralis thickness (6.1–7.1%) remained significantly greater than baseline in both groups.ConclusionDespite improvements in functional mobility, muscle strength and size, lower-limb eccentric training targeting hip, knee and ankle extensor muscle groups was not sufficient to influence static balance. Nonetheless, as the beneficial functional and structural adaptations were largely maintained through an 8-week detraining period, these findings have important implications for clinical exercise prescription as the exercise modality, low perceived training intensity, and adaptive profile are well suited to the needs of older adults.

Exercise Duration Affects Maximal Fat Oxidation In Post- Menopausal Women: Implications For Exercise Prescription

The relative exercise intensity at maximal fat oxidation (FATmax, %VO2max) is used for exercise prescription for weight loss and metabolic health. In young men, FATmax is affected by exercise duration, with more prolonged testing protocols leading to higher values. PURPOSE: Since no data exist on post-menopausal women, we determined the effect of exercise duration on FATmax in this population. METHOD: 18 non-obese women (54±4 years; 4±3 years from menopause; 22±3 BMI) performed on a cycle ergometer a ramp test and 30-min steady-state trials at 40, 50, 60, 70 and 80% of the pre-determined VO2max. Based on VO2 and respiratory exchange ratio we calculated and compared (2-way RM ANOVA) absolute fat oxidation (FO, g-1·min-1) across intensities and duration. We compared FATmax derived from ramp (rFATmax), 5 (5FATmax) and 30-min data (30FATmax) (1-way RM ANOVA). We estimated FATmax using exercise duration (1, 5 and 30 min) and rFATmax as explanatory variables. RESULTS: FO was significantly affected by exercise duration, intensity and their interaction (for all p<0.001). Any exercise between 40 and 70% %VO2max, > 30 min, lead to an identical MFO (overall 0.21±0.09 g-1·min-1). 30FATmax occurred at a significantly higher %VO2max (57±10%) than rFATmax and 5FATmax (44±6 and 49±9%, not different). FATmax can be predicted from the linear combination of exercise duration (p<0.001) and rFATmax (p=0.01) as independent explanatory variables (r=0.69, SEE=8.8%). CONCLUSIONS: In post-menopausal women exercises at 40-80%VO2max of longer durations are associated with higher FATmax compared to ramp or short, steady-state sessions. Moreover, any intensity greater than rFATmax will maximize fat oxidation for exercises > 30 min. Finally, the intensity that maximizes fat oxidation can be predicted by exercise duration and rFATmax. This approach offers a valid approach for individualized exercise intensity prescription for weight loss and metabolic health in postmenopausal women.

Exercise-induced Hypoalgesia Is Impaired in Chronic Whiplash-associated Disorders (WAD) With Both Aerobic and Isometric Exercise.

Exercise-induced hypoalgesia (EIH) can be impaired in patients with chronic pain and may be dependent on exercise type. Factors predictive of EIH are not known. This study aimed to: (1) compare EIH in participants with chronic whiplash-associated disorders (WAD) to asymptomatic controls, (2) determine if EIH differs between aerobic and isometric exercise, (3) determine predictors of EIH. A pre-post study investigated the effect of single sessions of submaximal aerobic treadmill walking and isometric knee extension on EIH in 40 participants with chronic WAD and 30 controls. Pressure pain thresholds were measured at the hand, cervical spine, and tibialis anterior. Pain intensity, reported previous week physical activity, temporal summation, and conditioned pain modulation (CPM) were measured at baseline. Participants with WAD demonstrated impaired EIH. Although, the WAD participants demonstrated a partial EIH response (EIH induced at the hand during exercise), no EIH response was found immediately after exercise. There was no difference in EIH between exercise types. In the WAD group, moderate physical activity levels predicted EIH at the hand and high physical activity levels predicted impaired EIH at the neck. More efficient CPM predicted EIH at the hand and less efficient CPM predicted impaired EIH at the neck. These associations were found for isometric exercise only. Individuals with chronic WAD have impaired EIH with both aerobic and isometric exercise. Higher levels of physical activity and less efficient CPM may be associated with impaired EIH. This may have implications for exercise prescription in this patient group.