Athletic trainers' attitudes and judgments of injured athletes' rehabilitation adherence.

Certified athletic trainers (ATCs) in District 2 (n=187) of the National Athletic Trainers' Association (NATA) were asked to complete a questionnaire that assessed the attitudes and judgments of ATCs concerning numerous factors presumed to influence sport injury rehabilitation. Gender and experience differences in ATCs' attitudes and judgments about rehabilitation adherence were examined. Successful and unsuccessful adherence strategies also were reported. The questionnaire consisted of 60 statements that were categorized into seven scales: athletic trainer's influence, environmental influences, athlete's personality, pain tolerance, selfmotivation, goals and incentives, and significant others. There were no significant differences for either gender or experience of ATCs on any of the seven scales. An analysis of questionnaire item responses revealed the following as factors ATCs deemed important to injury rehabilitation: a) good rapport and communication between the ATC and the injured athlete, b) explanation of the injury and rehabilitation regimen, c) convenience and accessibility of the rehabilitation facility, d) rehabilitation sessions planned around the athletes' busy schedules, e) athletes' beliefs that the program is worth pursuing, f) personal supervision and regular monitoring, g) need for injured athletes to see immediate results, and h) support from significant others. ATCs reported education, goal setting, encouragement, monitoring progress, and support systems as successful strategies. Threats and rehabilitation without monitoring were reported as unsuccessful strategies.

Exercise intensity and the thermic effect of food.

This study investigated the effect of varying exercise intensity on the thermic effect of food (TEF). Sixteen lean male subjects were matched for VO2 max and randomly assigned to either a high or low intensity group for 30 min of treadmill exercise. Caloric expenditure was measured using indirect calorimetry at rest and at 30-min intervals over 3 hrs following each of three conditions: a 750-kcal liquid meal, high or low intensity exercise, and a 750-kcal liquid meal followed by high or low intensity exercise. Low intensity exercise enhanced the TEF during recovery at 60 and 90 min while high intensity enhanced it only at 180 min but depressed it at 30 min. Total metabolic expense for a 3-hr postmeal period was not differently affected by the two exercise intensities. Exercise following a meal had a synergistic effect on metabolism; however, this effect was delayed until 180 min postmeal when exercise intensity was high. The circulatory demands of high intensity exercise may have initially blunted the TEF, but ultimately the TEF measured over the 3-hr period was at least equal to that experienced following low intensity exercise.

Effect of breathing instruction on blood pressure responses during isometric exercise.

Twenty-seven normotensive, college-aged, female subjects were studied to assess the effects of training in breathing techniques on blood pressure during isometric contractions. Subjects were randomly and equally assigned to one of three training groups: 1) a group that was taught to perform a Valsalva maneuver during isometric efforts (VAL Group), 2) a group that was instructed to avoid performing the Valsalva maneuver (NO-VAL Group), and 3) a control group that was given no instructions (CONT Group). Prior to and following three breathing technique training sessions, two blood pressure measurements were made by amplified auscultation during 10 isometric contractions of the quadriceps femoris muscle with the leg positioned at 65 degrees of knee flexion. Breathing patterns were recorded on an impedance pneumograph. Data were submitted to a 2 X 2 X 3 (time X trial X group) multivariate analysis of covariance using resting systolic and diastolic blood pressures as covariates. A significant (p less than .05) time-x-group interaction revealed posttraining blood pressure response to isometric exercise had significantly decreased in the NO-VAL Group (163/120 vs 148/112 mm Hg), and had not significantly changed in the CONT Group (157/117 vs 153/117 mm Hg). These data illustrate that training to avoid the Valsalva maneuver may help attenuate the pressor response observed during isometric contractions and provide a means for safer patient exercise.

The effect of prophylactic knee bracing on performance.

This study examined the effect of prophylactic knee bracing upon performance in 35 college-aged athletes. Twenty-five male and ten female subjects completed two sets of tests to determine quadriceps peak torque, rise time, time to fatigue, anaerobic power, and blood lactate accumulation. On one trial the subjects wore a Stromgren dual-hinged prophylactic knee brace. MANOVA analysis revealed that bracing did not significantly affect the performance of football players (males) but did inhibit the overall performance of lacrosse players (females) (P less than 0.05). Post hoc analyses determined that rise time (time to develop peak torque) was the greatest contributor among the dependent variables to the multivariate difference observed in the females. However, no isolated variable was identified as significantly different between the conditions by repeated-measures t-tests. Additional analyses disclosed that familiarity with brace wearing, order of testing, or a trial effect (i.e., learning) did not alter the performance results. It was concluded that wearing a protective knee brace does not improve performance and may inhibit performance in some asymptomatic athletes. It is suggested that athletes and coaches reexamine the use of prophylactic braces based upon these findings and other research described in this paper.

Bromocriptine associated with symptom exacerbation during neuroleptic treatment of schizoaffective schizophrenia.

Bromocriptine is a dopamine agonist with potential mental side effects. The authors report a case involving a patient with neuroleptic-induced remission of psychiatric symptoms in whom bromocriptine was associated with temporary exacerbation of schizophrenic symptoms. Other treatment approaches than bromocriptine are suggested for amenorrhea-galactorrhea induced by neuroleptic medication. The use of bromocriptine requires monitoring for changes in mental status.