Standard Training Group Research Articles

The Effects of Augmenting Balance Training with Stroboscopic Goggles on Postural Control in Chronic Ankle Instability Patients: A Critically Appraised Topic.

Individuals with chronic ankle instability (CAI) typically complete balance training protocols to improve postural control and reduce recurrent injury risk. However, the presence of CAI persists after traditional balance training protocols suggesting that such programs may be missing elements that could be beneficial to patients. Visual occlusion modalities, such as stroboscopic goggles, may be able to augment balance training exercises to further enhance postural control gains in those with CAI. However, a cumulative review of the existing evidence has yet to be conducted. Does wearing stroboscopic goggles during balance training result in greater improvements to postural control than balance training alone in those with CAI? All 3 studies indicated that the stroboscopic goggles group had statistically significant improvements in either a measure of static or dynamic postural control relative to the standard balance training group. However, significant improvements were not consistent across all postural control outcomes assessed in the included studies. Postural control may improve more in those with CAI when stroboscopic goggles were worn while completing balance training exercises relative to completing balance training exercises alone. Overall, consistent moderate- to high-quality evidence was present in the 3 studies, suggesting grade C evidence for the use of stroboscopic goggles during balance training in those with CAI.

Qualitative and quantitative evaluation of a standardized training model for improving patients' ability to use inhalers.

Training contributes to the effectiveness of aerosol inhalation therapy. However, qualitative and quantitative evaluation of effective training methods is rarely reported. This study aimed to evaluate the effectiveness of a standardized training model by pharmacists based on verbal instruction and physical demonstration in improving patients' ability to use inhalers using qualitative and quantitative methods. Risk or protective factors affecting correct inhaler use were also explored. 431 Outpatients with asthma or COPD were recruited and randomly divided into a standardized training group (n = 280) and a usual training group (control group, n = 151). A framework of qualitative (e.g., multi-criteria analysis) and quantitative comparisons [percentage of correct use (CU%), percentage of complete error (CE%), and percentage of partial error (PE%)] was established to evaluate the two training models. In addition, the changes of key factors (age, education level, adherence, device type, etc.) influencing patients' ability to use inhalers of two models were observed. The multi-criteria analysis showed that the standardized training model had comprehensive advantages in qualitative indicators. The average correct use percentage (CU%) of the standardized training group was significantly higher than that of the usual training group (77.6% vs. 35.5%). A stratified analysis further demonstrated that the ORs (95%CI) in the usual training group of age and educational level was 2.263 (1.165-4.398) and 0.556 (0.379-0.815), while in the standardized training group, age and educational level were not the key factors influencing the ability to use inhaler devices (P > 0.05). Logistic regression analysis demonstrated that standardized training was a protective factor for inhalation ability. These findings indicate that the framework of qualitative and quantitative comparisons could be used to evaluate training models, and the standardized training model by pharmacists can significantly improve patients' ability to use inhalers correctly and address the influence of older age and lower education because of its methodological advantages. Further studies with more extended follow-up are needed to validate the role of the standardized training model by pharmacists in the correct use of inhalers. chictr.org.cn, ChiCTR2100043592 (23-02-2021).

A Dedicated Simulator Training Curriculum Improves Resident Performance in Surgical Management of Pediatric Supracondylar Humerus Fractures.

The primary goal of including simulation in residency training is to improve technical skills while working outside of the operating room. Such simulation-related skill improvements have seldom been measured in the operating room. This is largely because uncontrolled variables, such as injury severity, patient comorbidity, and anatomical variation, can bias evaluation of an operating surgeon's skill. In this study, performance during the wire navigation phase of pediatric supracondylar humerus fracture fixation was quantitatively compared between 2 groups of orthopaedic residents: a standard training group consisting of residents who participated in a single simulator session of wire navigation training and an expanded training group consisting of residents who participated in a dedicated multifaceted wire navigation simulation training curriculum. To evaluate performance in the operating room, the full sequence of fluoroscopic images collected during wire navigation was quantitatively analyzed. Objective performance metrics included number of fluoroscopic images acquired, duration from placement of the first wire to that of the final wire, and wire spread at the level of the fracture. These metrics were measured from 97 pediatric supracondylar humerus fracture pinning surgeries performed by 28 different orthopaedic residents. No differences were observed between the groups for wire spread in the final fluoroscopic images (t(94) = 0.75, p = 0.45), an important clinical objective of the surgery. Residents who received the expanded simulator training used significantly fewer fluoroscopic images (mean of 46 vs. 61 images, t(85) = 2.25, p < 0.03) and required less time from first to final wire placement (mean of 11.2 vs. 14.9 minutes, t(83) = 2.53, p = 0.013) than the standard training group. A post hoc review of Accreditation Council for Graduate Medical Education case logs for 24 cases from the standard training group and for 21 cases from the expanded training group indicated that, at the time of surgeries, residents who received expanded training had completed fewer comparable cases than residents in the standard training group (mean of 13 vs. 21, t(42) = 2.40 p = 0.02). Further regression analysis indicated that the expanded simulator training produced an effect comparable with that associated with completing 10.5 similar surgical case experiences. This study demonstrates that training on a wire navigation simulator can lead to improved performance in the operating room on a critical skill for all orthopaedic residents. By taking fewer images and less time while maintaining sufficient pin spread, simulator-trained residents were objectively measured to have improved performance in comparison with residents who had not participated in the pediatric elbow simulator curriculum. As programs aim to provide safe and effective training for critical orthopaedic skills such as pinning a pediatric elbow, this study demonstrates a simulator curriculum that has demonstrated the transfer of skill from a learning environment to the operating room.

A prospective randomized study to compare standard versus intensive training strategies on long-term improvement in critical care ultrasonography proficiency

BackgroundCritical care ultrasonography (CCUS) has become a daily diagnostic tool for intensivists. While the effective training measures for ultrasound novices are discussed widely, the best curriculum for the novices to retain a long-term proficiency is yet to be determined.MethodsCritical care medicine fellows who underwent an introductory CCUS workshop were randomly allocated into the standard training (ST) or the intensive training (IT) group. The IT group received an 8-h training besides the standardized fellowship education that the ST group received. Participant improvement in CCUS proficiency tests (maximum score, 200) after a 6-month training intervention was compared between the groups. CCUS examinations performed in patient care were observed over 2 years.ResultsTwenty-one fellows were allocated into the ST (n = 10) or the IT (n = 11) group. No statistically significant difference was observed in the median (interquartile range [IQR]) improvement in CCUS proficiency tests between the ST group and the IT group: 18 (3.8–38) versus 31 (21–46) (P = .09). Median (IQR) test scores were significantly higher in postintervention than preintervention for both groups: ST, 103 (87–116) versus 124 (111–143) (P = .02), and IT, 100 (87–113) versus 143 (121–149) (P < .01). Participating fellows performed 226 examinations over the 2 years of observation.ConclusionsFellows improved their CCUS proficiency significantly after 6-month training intervention. However, an additional 8-h training did not provide further benefits.

Moving-Target Intelligent Tutoring System for Marksmanship Training

Intelligent tutoring systems (ITSs) may augment military training systems and mitigate existing limitations in training personnel and resources. A study was conducted to investigate the effectiveness of an embedded rifle marksmanship ITS for Moving Targets (MT-ITS). MT-ITS has two main components: (1) a Smart Sight System that provides a perceptual cue to help trainees adjust their point of aim to account for a target’s speed, direction of movement, and distance, and (2) a performance-based algorithm that delivers shooting performance feedback to trainees.The MT-ITS was tested in an experiment where participants engaged moving targets in a virtual shooting range. Moving targets were presented at different speeds, direction of movement, and distances. Two types of marksmanship training were compared: with ITS and without ITS (a standard training). The ITS training group produced better hit rate and aiming accuracy scores than the standard training group, requiring less practice to achieve asymptotic results. Implications for the design of embedded trainers with ITS for marksmanship specifically and for training motor skills in general are discussed in the context of future research directions.

The effect of Dual-Task balance exercises on cognitive functions among children with mild and borderline mental retardation: a randomized controlled trial

Purpose The aim of this study was to evaluate the effect of dual-task balance training (DTBT) in improving the mental performance of children with intellectual disabilities. Materials and Methods Forty-five children (aged 6–13 years) with mild mental retardation (intelligence quotient: 50–79) were randomised to receive cognitive training and DTBT (group A), standard balance and cognitive training (group B), or only cognitive training (control group). The intervention was provided twice a week for 12 weeks (totally 24 sessions). The WISC-R intelligence and MOXO attention tests were used for outcome analysis. All outcome assessments were made before, after, and three months after the study. Results There were significant improvements after using DTBT compared to the other two sets of interventions, at least in selected aspects of intelligence and mental performance. Conclusions A precisely planned, progressive DTBT program can be effective in developing and sustaining improvements in mental abilities among children with intellectual disabilities. This study is recorded in ClinicalTrials.gov (Identifier: NCT04114487)

Corticomuscular Adaptations in the SingleLeg Jump Task in Response to Progressive Mechanical Perturbation Training in Individuals With Anterior Cruciate Ligament Deficiency

Introduction: Studies have repeatedly discussed the importance of training with sufficient cognitive and sensory-motor challenges in successfully transferring Anterior Cruciate Ligament Deficiencies (ACLDs) from rehabilitation centers to sports facilities. For this purpose, this study investigated the effect of mechanical perturbation training and standard training on the brain and muscle activity of these individuals while jumping on one leg. Materials and Methods: A total of 30 athletes with unilateral Anterior Cruciate Ligament (ACL) rupture (in the coper classification) were randomly assigned to perturbation and standard training groups. To compare the effect of two types of intervention training methods, we examined the Similarity Index (SI) and Voluntary Response Index (VRI) in surface Electromyography (sEMG) tests of eight muscles in the lower extremities and relative power of alpha and beta spectra in Quantitative Electroencephalographic (QEEG) tests between two groups and between two limbs of each group members in the single-leg jump task. Results: Both training groups showed improved neuromuscular control and increased SI on sEMG tests between the two limbs. However, this improvement in the perturbation training group showed an excellent increase in Effect Size (ES) (intra-group comparison values of SI for perturbation training group P=0.0001, ES=3.6; and P=0.008, ES=1.24 in the standard training group; and P=0.04, ES=0.87 in the inter-group comparison). Regarding the post-test of QEEG tests, no significant difference was found between the two groups (alpha P-value: 0.13, beta P-value: 0.07). However, in the intra-group comparison, the perturbation training group achieved excellent symmetry for the relative power spectrum of alpha and beta signals (the similarity values between the two limbs in the perturbation training group for alpha were P=0.92, ES=0.04 and for beta were P=0.92, ES=0.02; and these values for standard training group for alpha were P=0.07, ES=0.86 and for beta as P=0.08, ES=0.87). Conclusion: The present study results showed that mechanical perturbation and standard training are suitable for transporting ACLDs to sports environments. Furthermore, in comparing these two training methods, mechanical perturbation training in the manner used in this study has higher adequacy to eliminate motor control and central nervous system defects.

Effect of Adding a Wheelchair Immersion Program to a Physical Medicine and Rehabilitation Clerkship on Emotions, Behavior, and Attitude: A Prospective Pilot Study.

People with disabilities encounter significant barriers in health care and report that healthcare providers often lack an understanding in caring for them. Currently, there is limited disability awareness training in medical school curricula. This mixed-methods pilot study examined the effects of integrating a short wheelchair immersion program in a physical medicine and rehabilitation clerkship, versus the clerkship alone, on attitudes toward people with disabilities, comfort in treating people with disabilities, knowledge of wheelchair etiquette, and understanding of wheelchair-associated challenges. The standard training group underwent the physical medicine and rehabilitation clerkship, consisting of a 2-wk clinical rotation and didactic program. The intervention group additionally underwent a newly developed 1-hr wheelchair program where they simulated mobility and some activities of daily living as a "wheelchair user" and "caregiver." Quantitative analysis demonstrated that all students who completed the clerkship had significantly improved attitudes toward and comfort in treating people with disabilities, knowledge of wheelchair etiquette, and understanding of wheelchair-associated challenges, whereas students in the wheelchair immersion program had a greater change in understanding wheelchair-associated challenges. Qualitative analysis revealed that the intervention resulted in positive attitudinal changes. These findings suggest that integrating a brief wheelchair immersion program with a physical medicine and rehabilitation clerkship may enhance disability awareness training in medical school curricula.

The effect of Neurolinguistic Programming practices on organizational citizenship behaviour of nurses: A randomized controlled study.

The aim of this study is to evaluate the effect of Neurolinguistic Programming practices on organizational citizenship behavior in nursing. Neurolinguistic Programming practices are used for different purposes in many areas, and they can also be used to contribute to the acquisition of organizational citizenship behaviour. The research is a randomized controlled trial. The sample of the study consisted of 180 nurses. The data of the study were collected through structured face-to-face interviews conducted with the nurses in the sample group, Neurolinguistic Programming training group, standard training and control groups between January and April 2020 after Neurolinguistic Programming training was received by the researcher. The Chi-squared test and the analysis of variance (ANOVA) were used to analyze the collected data. A statistically significant difference was found in the total score of the organizational citizenship behaviour in the Neurolinguistic Programming training group compared with the standard training group and the control group (p < .05). The use of Neurolinguistic Programming practices can be an effective method for nurses to gain organizational citizenship behaviour. Neurolinguistic Programming practices can be used to achieve the desired goals, especially for the acquisition of informing and participation, tolerance and conscientiousness behaviours. Organizational citizenship behaviour exhibited by employees is very important for organisations. With this behaviour, nurses can improve all processes, from the quality of care services they provide to patients, to satisfaction. Findings of this study may be used to increase work satisfaction of nurses and to improve the quality of services received by patients.

Changes in the Trend of Walking Motor Control in Athletes with Anterior Cruciate Ligament Deficiency in Response to Progressive Perturbation Trainings

Background and Purpose: The beliefs are that sudden and unpredictable balance disturbance by instruments that cause mechanical perturbations can affect individuals with Anterior Cruciate Ligament Deficiency (ACLD) to reach faster and more effective recovery of knee dynamic stabilization strategies to return successfully pre-injury levels. The aim of this study was to investigate the effect of mechanical perturbation training and standard training in the process of changes in motor control during walking task in coper ACLD individuals. Methods: Thirty athletes with a unilateral rupture of the Anterior Cruciate Ligament (ACL), classified as coper, were randomly assigned to perturbation and standard training groups. Intervention training results based on comparison of scores obtained from functional tests in 4 single-leg jump tests, scores of questioners, and surface Electromyography (sEMG) tests were determined between the two groups as well as between the two healthy and ACLD limbs in each group in the walking task. Results: The perturbation training group showed a significant increase in muscle activity in both healthy and ACLD limbs with an increase in similarity index (SI) (p=0.08, ES=0.81), while in the standard training group the results were not significant (p=0.39, ES=0.39). Conclusion: Individuals in the perturbation training group achieved higher scores on all tests compared to the standard training group. This means that the perturbation training group was more mentally and physically prepared in terms of strength, coordination and symmetry between the two limbs to participate in pre-injury sports levels.

A network-based cognitive training induces cognitive improvements and neuroplastic changes in patients with relapsing-remitting multiple sclerosis: an exploratory case-control study

Cognitive impairments are commonly observed in patients with multiple sclerosis and are associated with lower levels of quality of life. No consensus has been reached on how to tackle effectively cognitive decline in this clinical population non-pharmacologically. This exploratory case-control study aims to investigate the effectiveness of a hypothesis-based cognitive training designed to target multiple domains by promoting the synchronous co-activation of different brain areas and thereby improve cognition and induce changes in functional connectivity in patients with relapsing-remitting multiple sclerosis. Forty-five patients (36 females and 9 males, mean age 44.62 ± 8.80 years) with clinically stable relapsing-remitting multiple sclerosis were assigned to either a standard cognitive training or to control groups (sham training and non-active control). The standard training included twenty sessions of computerized exercises involving various cognitive functions supported by distinct brain networks. The sham training was a modified version of the standard training that comprised the same exercises and number of sessions but with increased processing speed load. The non-active control group received no cognitive training. All patients underwent comprehensive neuropsychological and magnetic resonance imaging assessments at baseline and after 5 weeks. Cognitive and resting-state magnetic resonance imaging data were analyzed using repeated measures models. At reassessment, the standard training group showed significant cognitive improvements compared to both control groups in memory tasks not specifically targeted by the training: the Buschke Selective Reminding Test and the Semantic Fluency test. The standard training group showed reductions in functional connectivity of the salience network, in the anterior cingulate cortex, associated with improvements on the Buschke Selective Reminding Test. No changes were observed in the sham training group. These findings suggest that multi-domain training that stimulates multiple brain areas synchronously may improve cognition in people with relapsing-remitting multiple sclerosis if sufficient time to process training material is allowed. The associated reduction in functional connectivity of the salience network suggests that training-induced neuroplastic functional reorganization may be the mechanism supporting performance gains. This study was approved by the Regional Ethics Committee of Yorkshire and Humber (approval No. 12/YH/0474) on November 20, 2013.

Effects of robot-assisted gait training combined with virtual reality on motor and cognitive functions in patients with multiple sclerosis: A pilot, single-blind, randomized controlled trial.

Studies on robot-assisted gait training rehabilitation in multiple sclerosis have reported positive effects on mobility and quality of life. However, their effects on cognitive functions are difficult to determine because not all trials have included cognition assessments. Virtual reality-based training provides enhanced opportunity for stimulating cognitive abilities by repetitive practice, feedback information, and motivation for endurance practice. To compare the effects of innovative robot-assisted gait training combined with virtual reality versus standard robot-assisted gait training on information processing speed, sustained attention, working memory, and walking endurance in patients with multiple sclerosis. Seventeen outpatients were randomly assigned to receive robot-assisted gait training either with or without virtual reality. The robot assisted gait training + virtual reality group underwent end-effector system training engendered by virtual reality. The standard training group underwent end-effector system training. A blinded rater evaluated patients before and after treatment and at one month follow-up. The outcome measures were the Paced Auditory Serial Addition Test, Phonemic Fluency Test, Novel Task, Digit Symbol, Multiple Sclerosis Quality of Life-54, 2-Minutes Walk Test, 10-Meter Walking Test, Berg Balance Scale, gait analysis, and stabilometric assessment. Between-group comparisons showed a significant change on the 2-Minutes Walk Test (p = 0.023) after treatment in the robot-assisted gait training + virtual reality group. Significant improvement were obtained also in executive functions (p = 0.012). Both gains were maintained at the 1-month follow-up evaluation (p = 0.012, p = 0.012) in the robot-assisted gait training + virtual reality group. Both group improved quality of life after treatment (Multiple Sclerosis Quality of Life-54: Mental Health p = 0.018, Physical Health p = 0.017). Both training lead to positive influenced on executive functions. However larger positive effects on gait ability were noted after robot-assisted gait training engendered by virtual reality with multiple sclerosis. Robot-assisted gait training provides a therapeutic alternative and motivational of traditional motor rehabilitation.

Is online training in family-based treatment for anorexia nervosa feasible and can it improve fidelity to key components affecting outcome?

Abstract In order to evaluate the feasibility of conducting an online training focusing on two key treatment components (externalization and agnosticism) to improve fidelity to Family-based Treatment (FBT), we conducted a study that compared the training outcomes of therapists randomized to standard online training or enhanced online training with increased emphasis on the two key components of FBT. Forty-six therapists were randomized to: (1) standard online training, or (2) enhanced online training in FBT on key components. The main outcome was change in knowledge and skills related to the two key components that were targeted in the enhanced training condition. The study appeared feasible from a recruitment and retention perspective. We were able to recruit 57 therapists into the study, which was above our target of 46. Of the therapists who entered the study, 9 (19%) dropped out. Neither training approach significantly improved knowledge, with no differences within or between training groups. For behavioral skills assessment using videotapes of recorded therapeutic responses to clinical vignette/role plays, externalization significantly improved in both groups, but there was no difference between groups. However, agnosticism scores were significantly higher in the enhanced training group compared to the standard training group with a large effect size (1.069, 95% confidence interval [0.179,1.963]). It is feasible to conduct an RCT of therapists using online training in FBT addressing key components of fidelity.

Application of virtual-simulation laparoscopic training system in the teaching of general surgery skills

Objective To investigate the effect of virtual-simulation laparoscopic training system in the training of basic skills of endoscopic surgery in trainees with different clinical experience. Method s Eight refresher physicians, eight residents who received standardized residency training, and eight undergraduate interns in five-year clinical medicine were selected. All of them received the training of endoscopic operations with the laparoscopic training box and the virtual-simulation laparoscopic training system for 30 minutes every day for 4 weeks. Data analyses were performed using SPSS 19.0 and t-test was adopted to compare the scores before and after training among the three groups. Result s Before training, there were significant differences in endoscopic operations between the undergraduate intern group and the other two groups (P 0.05), and the undergraduate intern group had a significantly higher score of complex operations than did the standardized residency training group and the refresher physician group (P<0.05). Conclusion The virtual-simulation laparoscopic training system can improve the laparoscopic skills of clinical trainees at different levels, therefore, it is worth being promoted in the teaching of clinical skills. Key words: Virtual-simulation training system; Laparoscopy; Simulation teaching; Application

Dynamic Surface Exercise Training in Improving Trunk Control and Gross Motor Functions among Children with Quadriplegic Cerebral Palsy: A Single Center, Randomized Controlled Trial.

ABSTRACTBackground:Dynamic surface provides proprioceptive and vestibular feedback with optimal level of arousal. The activities on unstable environment have greater sensorimotor experiences. There is a lack of evidence examining the benefits of dynamic surface exercise training (DSET) among the children with spastic quadriplegic cerebral palsy (CP).Aim:The aim of the study was to analyze the effect of dynamic surface exercises on trunk control and gross motor functions in children with quadriplegic CP.Materials and Methods:A total of 30 children with spastic quadriplegic CP with Gross Motor Function Classification System of levels III and IV were recruited by the simple random sampling method (random number generator) to participate in this randomized controlled study. Recruited children were randomly divided into two groups, DSET group and standard physiotherapy training group. Both the groups received active training program lasting for 60 min, 4 days/week for 6 weeks. Gross Motor Function Measure (GMFM)-88 and Pediatric Balance Scale (PBS) scores were recorded at baseline, and at the end of 6-week post-intervention.Results:Total 30 children with quadriplegic CP with mean age 6.64 ± 2.15 years in experimental group and 6.50 ±1.59 years in control group participated in the study. Experimental group showed a significant difference for GMFM and PBS scores between pre- and post-intervention with P < 0.005. A significant difference was observed in GMFM scores between experimental and control group with P < 0.005.Conclusion:Six-week dynamic surface exercise therapy along with standard physiotherapy was effective in improving trunk control and gross motor function performance among children with spastic quadriplegic CP aged 6–12 years.

Persistence of Causal Illusions After Extensive Training

We carried out an experiment using a conventional causal learning task but extending the number of learning trials participants were exposed to. Participants in the standard training group were exposed to 48 learning trials before being asked about the potential causal relationship under examination, whereas for participants in the long training group the length of training was extended to 288 trials. In both groups, the event acting as the potential cause had zero correlation with the occurrence of the outcome, but both the outcome density and the cause density were high, therefore providing a breeding ground for the emergence of a causal illusion. In contradiction to the predictions of associative models such the Rescorla-Wagner model, we found moderate evidence against the hypothesis that extending the learning phase alters the causal illusion. However, assessing causal impressions recurrently did weaken participants’ causal illusions.

Comparison of the effect of standardized patient-based training with team-based learning on the knowledge of midwifery students in providing services to victims of rape.

BACKGROUND:Rape is a widespread and important issue in the field of public health, and its victims require comprehensive and gender-sensitive health services. Healthcare providers, especially midwives, play an important role in the diagnosis and treatment of rape, and improving their knowledge has been an essential factor in enhancing the quality of service provided.OBJECTIVE:The objective of the study is to compare the impact of standardized patient-based training and team-based learning on midwifery students’ knowledge for providing services to rape victims.MATERIALS AND METHODS:In this randomized quasiexperimental study, 75 midwifery students of Mashhad School of Nursing and Midwifery were selected using available sampling method and were assigned to two groups of standardized patient-based training (n = 38) and team-based learning (n = 37). After performing pretest, standardized patient-based training group and team-based learning group were trained separately for 6 h. One week after intervention, posttest was performed. Data were collected and analyzed using the Academic Specifications Questionnaire and the Knowledge Assessment Questionnaire. Significance level was considered at P < 0.05.RESULTS:The two groups were homogeneous in terms of demographic characteristics. There was no statistically significant difference between the two groups in the posttest in terms of knowledge score (P = 0.079). However, there was a statistically significant difference in the level of knowledge between the two groups (P = 0.037).CONCLUSIONS:Given the effectiveness of both standardized patient-based training method and team-based learning method on enhancing midwifery students’ knowledge for providing services to rape victims, these methods can be used in students’ education.

The Effects of Two Different Resisted Swim Training Load Protocols on Swimming Strength and Performance.

This study used a power rack device to evaluate the effects of 2 different approaches to resisted swim training loads on swimming strength and performance. Sixteen male, youth national-level swimmers (mean age, 16.22 ± 2.63 years; body height, 169 ± 10.20 cm; body mass, 61.33 ± 9.90 kg) completed a 6-week specific strength-training program, and were then randomly assigned to one of the two groups: a standard training group (GS, n = 8) and a flat pyramid-loading pattern group (GP, n = 8). Strength and power tests along with specific swimming tests (50-m crawl and 50-m competition-style time trials) were conducted at baseline (pre-test), before the third week (mid-test), and after 6 weeks of intervention (post-test). Isokinetic swim bench tests were conducted to obtain measurements of force production and power, and 1RM tests with the power rack system were conducted to measure the maximum drag load (MDL) and specific swimming power. Following 6 weeks of intervention, the mean MDL increased (p < 0.05) by 13.94%. Scores for the 50-m competition style and 50-m crawl time trials improved by 0.32% and 0.78%, respectively, in the GP; however, those changes were not statistically significant. The GS significantly increased their time in the 50-m competition style by 2.59%, and their isokinetic force production decreased by 14.47% (p < 0.05). The 6-week strength-training program performed with the power rack device in a pyramidal organization was more effective than a standard linear load organization in terms of producing improvements in the MDL; however, it did not produce significant improvements in performance. The use of a strength-training program with a pyramidal organization can be recommended for specific strength-training in young swimmers during a preparatory period. However, in our study, that program did not produce significant changes in 50-m crawl and main competition style performance.

Improved Compliance and Comprehension of a Surgical Safety Checklist With Customized Versus Standard Training: A Randomized Trial.

This study aimed to determine the effect of customized training versus standard readily available training on surgical safety checklist (SSCL) compliance and comprehension. The success of the SSCL in reducing surgical mortality and morbidity depends largely on the degree of compliance among health care workers with the checklist's components. We hypothesized that a customized training program would improve comprehension of the SSCL components among health care workers. We prospectively evaluated compliance and comprehension of a locally modified SSCL among surgeons, anesthesiologists, nurses, and perfusionists who were randomized to standard versus customized training in the department of cardiac and thoracic surgery. Standard training included videos, posters, and didactic sessions obtained from the World Health Organization. Customized training consisted of a department-specific orientation video (using local staff as actors), locally made posters, and didactic sessions. Comprehension was assessed by a written exam after each training program. Verbal and written compliance with the SSCL was measured within the operating theater by trained observers. We observed a total of 244 surgeries for SSCL compliance. Comprehension of the didactic material provided in the training programs was higher in the customized versus the standard training group (75% versus 30%; P < 0.0001). Verbal compliance was higher in the customized versus standard training groups (87% versus 49%; P < 0.0001). Written compliance was 100% for both the customized and standard training groups. A customized training program improves verbal compliance and comprehension among health care workers when implementing an SSCL, compared with standard readily available training.

Effect of Artificial Respiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease

Chronic obstructive lung disease (COPD) is a chronic lung pathology that leads to respiratory muscle weakness and decreased function capacity. Patients need to have pulmonary rehabilitation to increase respiratory muscle strength. The aim of the study was to assess the effect of artificial respiratory muscle training (ARMT) on respiratory muscle function and exercise performance in chronic obstructive pulmonary disease (COPD). Thirty patients in the mild to moderate COPD stage were randomly classified into an ARMT (n = 10), a control group (n = 10), and a standard respiratory muscle training group (SRMT; n = 10) by following the blind procedure. The control group received no training. The training groups, however, were trained at home for 30 min per day, every day, for 6 weeks. The measurement analyses included spirometry, an inspiratory muscle strength examination, and an exercise performance test. Exercise performance was evaluated by a 6 min walk test (SWT). The results showed that the maximal inspiratory pressure (PImax) and the maximal expiratory pressure (PEmax) were observed to have significantly increased in both the ARMT group and the SRMT group compared with the control group (p &lt; 0.05). Moreover, the ARMT group was found to have significantly increased the 6 min walking distance in comparison with the control group. However, the ARMT group and the SRMT group did not differ significantly in those parameters. We conclude that it would be possible for the ARMT group among COPD patients to have improved respiratory muscle strength and increased capacity to walk.