Factors associated with attendance, engagement and wellbeing change in an arts on prescription intervention.

BACKGROUND: Arts on prescription interventions have grown in number in recent years with a corresponding evidence base in support. Despite the growth and presence of these interventions, there have been no evaluations to date as to what factors predict patient success within these referral schemes. METHODS: Using the largest cohort of patient data to date in the field (N = 1297), we set out to understand those factors that are associated with attendance, programme engagement and wellbeing change of patients. Factors associated with these outcomes were assessed using three binary logistic regression models. RESULTS: Baseline wellbeing was associated with each outcome, with higher baseline wellbeing being associated with attendance and engagement, and lower baseline wellbeing associated with positive wellbeing change. Additionally, deprivation was associated with attendance, with those from the median deprivation quintile being more likely to attend. CONCLUSIONS: The role of baseline wellbeing in each outcome of these analyses is the most critical associative factor. Whilst those that are lower in wellbeing have more to gain from these interventions, they are also less likely to attend or engage, meaning they may need additional support in commencing these types of social prescribing interventions.

Influences of Playing Position and Quality of Opposition on Standardized Relative Distance Covered in Domestic Women's Field Hockey: Implications for Coaches.

Vinson, D, Gerrett, N, and James, DVB. Influences of playing position and quality of opposition on standardized relative distance covered in domestic women's field hockey: Implications for coaches. J Strength Cond Res 32(6): 1770-1777, 2018-The purpose of this study was to compare the standardized relative distance covered by the various playing positions (defenders, midfielders, and forwards) against different quality of opponents in domestic women's field hockey. Data were collected from 13 individuals competing for 1 team in the English Premier League across an 18-game season. Data were collected using portable global positioning system technology. Distance data were grouped into 6 speed zones relative to individual players' maximum sprint speeds and then standardized by dividing by the number of on-pitch minutes. Dependent variables included distance covered in the 6 speed zones, as well as the number of sprints and repeated sprint efforts (RSEs) completed in the highest speed zone. Participants covered a significantly greater total distance when competing against opponents from top 3 teams compared with middle 3 teams (111.78 ± 2.65 m·min vs. 107.35 ± 2.62 m·min, respectively). This was also true for distance covered in zone 4 (running) (29.47 ± 1.69 m·min vs. 27.62 ± 1.45 m·min, respectively) and zone 5 (fast running) (23.42 ± 1.76 m·min vs. 21.52 ± 1.79 m·min, respectively). Defenders (99.77 ± 4.36 m·min) covered significantly less total meters per minute than midfielders (117.20 ± 4.36 m·min) and completed significantly fewer RSEs per on-pitch minute (0.21 ± 0.03 and 0.33 ± 0.03, respectively). Midfielders covered significantly less distance in zone 2 (walking) than forwards (19.38 ± 1.64 m·min and 30.33 ± 2.12 m·min, respectively). Conversely, midfielders were shown to cover significantly more distance in zone 3 (jogging) than forwards (32.84 ± 1.10 m·min and 24.61 ± 1.42 m·min, respectively). A standardized and relative assessment may be useful for coaches' and performance analysts' understanding of players' performance in different positions or against different quality opponents.

'Artlift' arts-on-referral intervention in UK primary care: updated findings from an ongoing observational study.

Background: Arts for health interventions are an accepted option for medical management of mental wellbeing in health care. Updated findings are presented from a prospective longitudinal follow-up (observational) design study of an arts on referral programme in UK general practice, over a 7-year period (2009-2016). Methods: Primary care process and mental wellbeing outcomes were investigated, including progress through the intervention, changes in mental wellbeing, and factors associated with those outcomes. A total of n =1297 patients were referred to an eight or 10-week intervention over a period from 2009 to 2016. Patient sociodemographic information was recorded at baseline, and patient progress (e.g. attendance) assessed throughout the intervention. Results: Of all referrals, 51.7% completed their course of prescribed art (the intervention). Of those that attended, 74.7% engaged with the intervention as rated by the artists leading the courses. A significant increase in wellbeing was observed from pre- to post-intervention (t = -19.29, df =523, P < 0.001, two-tailed) for those that completed and/or engaged. A sub sample (N =103) of these referrals self-reported multi-morbidities. These multiple health care service users were majority completers (79.6%), and were rated as having engaged (81.0%). This group also had a significant increase in well-being, although this was smaller than for the group as a whole (t = -7.38, df =68, P < 0.001). Conclusion: Findings confirm that art interventions can be effective in the promotion of well-being for those that complete, including those referred with multi-morbidity, with significant changes in wellbeing evident across the intervention periods.

The Influence of Exercise Intensity on Postexercise Baroreflex Sensitivity.

PURPOSE: The purpose of this study was to investigate the influence of exercise intensity on postexercise supine and tilt baroreflex sensitivity (BRS). METHOD: Nine healthy, active men performed 2 conditions of interval cycling of 40% maximal work rate (WRmax) and 75% WRmax of matched work done and a control condition of no exercise in a counterbalanced order. BRS outcome measures were determined at preexercise and postexercise up to +24 hr in supine and tilt positions. R-R interval and blood pressure data were collected over consecutive 10-min periods and were analyzed by Fast Fourier transformation analysis. RESULTS: A fully repeated analysis of variance revealed a significant interaction (p < .05) between time and condition in supine for BRSαLF, F(3, 134) = 5.19, p < .05, ES = .39, and BRSTFTG, F(3, 134) = 5.65, p < .05, ES = .41, and in tilt for BRSUpUp, F(3, 134) = 3.54, p < .05, ES = .31, BRSDownDown, F(3, 134) = 5.94, p < .05, ES = .43, BRSαLF, F(4, 134) = 6.23, p < .05, ES = .44, and BRSTFTG, F(4, 134) = 9.22, p < .05, ES = .54. There were significant differences (p < .05) between condition comparisons at +15 min and between control and 75% WRmax and between the 40% WRmax and 75% WRmax conditions at +60 min. At +15 min, BRS was lower in the 75% WRmax condition compared with the 40% WRmax condition and the control condition, and it was lower in the 40% WRmax condition than in the control condition. CONCLUSION: The findings demonstrate an intensity-dependent relationship in the BRS response following exercise.

Effects of long-term training cessation in young top-level road cyclists.

In cycling, it is common practice to have a break in the off season longer than 4 weeks while adopting an almost sedentary lifestyle, and such a break is considered to be long-term detraining. No previous studies have assessed the effect of training cessation with highly trained young cyclists. The purpose of the present investigation was to examine effects of 5 weeks of training cessation in 10 young (20.1 ± 1.4 years) male road cyclists for body composition, haematological and physiological parameters. After training cessation, body mass of cyclists increased (P = 0.014; ES = 0.9). [Formula: see text] (L · min-1 = -8.8 ± 5.0%, mL · kg-1·min-1 = -10.8 ± 4.2%,), Wmax (W = -6.5 ± 3.1%, W · kg-1 = -8.5 ± 3.3%,), WLT1 (W = -12.9 ± 7.0%, W · kg-1 = -14.8 ± 7.4%,), WLT2 (W = -11.5 ± 7.0%, W · kg-1 = -13.4 ± 7.6%,) and haematological (red blood cells count, -6.6 ± 4.8%; haemoglobin, -5.4 ± 4.3% and haematocrit, -2.9 ± 3.0%) values decreased (P ≤ 0.028; ES ≥ 0.9). Five weeks of training cessation resulted in large decreases in physiological and haematological values in young top-level road cyclists suggesting the need for a shorter training stoppage. This long-term detraining is more pronounced when expressed relative to body mass emphasising the influence of such body mass on power output. A maintenance programme based on reduced training strategies should be implemented to avoid large declines in physiological values in young cyclists who aspire to become professionals.

'Art Lift' intervention to improve mental well-being: an observational study from U.K. general practice.

Arts for health interventions are emerging as an alternative option to medical management of mental health problems and well-being. This study investigated process and outcomes of an art intervention on patients referred by primary care professionals, including associations between patient characteristics (e.g., sex), progress through the intervention (e.g., attendance), and changes in mental well-being. Referral criteria included people with anxiety, depression, or stress; low self-esteem, confidence, or overall well-being; and chronic illness or pain. The study took place in U.K.-based general practitioner practices, with a total of 202 patients referred to a 10-week intervention. Patient sociodemographic information was recorded at baseline, and patient progress assessed throughout the intervention. Significant improvement in well-being was revealed for the 7-item (t = -6.049, d.f. = 83, P < 0.001, two-tailed) and 14-item (t = -6.961, d.f. = 83, P < 0.001, two-tailed) scales. Of referred patients, 77.7% attended and 49.5% completed. Most patients were female, and from a range of socioeconomic groups, and those who completed were significantly older (t = -2.258, d.f. = 145, P = 0.025, two-tailed). Findings reveal that this art intervention was effective in the promotion of well-being and in targeting women, older people, and people from lower socioeconomic groups.

Heart rate variability: effect of exercise intensity on postexercise response.

The purpose of the present study was to investigate the influence of two exercise intensities (moderate and severe) on heart rate variability (HRV) response in 16 runners 1 hr prior to (-1 hr) and at +1 hr, +24 hr, +48 hr, and +72 hr following each exercise session. Time domain indexes and a high frequency component showed a significant decrease (p < .001) between -1 hr and +1 hr for severe intensity. The low frequency component in normalized units significantly increased (p < .01) for severe intensity at +1 hr. Only severe exercise elicited a change in HRV outcomes postexercise, resulting in a reduction in the parasympathetic influence on the heart at +1 hr; however values returned to baseline levels by +24 hr.

Exploring the perceptions of success in an exercise referral scheme: a mixed method investigation.

BACKGROUND: Exercise referral schemes feature as one of the prevalent primary care physical activity interventions in the United Kingdom, without extensive understanding of how those involved in providing and participating view success. The present research explores and reveals the constituents of "success," through comparison, contradiction, and integration of qualitative and quantitative research findings. METHOD: A population-based cohort design formed the basis for a mixed method approach to the research. The quantitative component used a three-stage binary logistic regression to identify patient sociodemographic characteristics and referral reasons associated with three outcomes (n=1,315). The qualitative component (n=28) comprised four focus groups with patients (n=17), individual interviews with exercise providers (n=4), and referring health professionals (n=7). The research components were compared at discussion stage to offer insights into the concept of "success." RESULTS: The integrated findings highlighted the multidimensional nature of the concept of success, containing a wide range of concepts such as empowerment, inclusion, and confidence. The traditional notions of success such as, attendance, weight loss, and blood pressure reduction featured amid a more holistic view which incorporated psychological and social aspects as both influences and outcomes. CONCLUSION: These findings can enable future development of more representative evaluations of the benefits of exercise referral. This mixed methods research approach can facilitate the development of sophisticated, tailored, evidence-based interventions in the future.

Influence of the duration of a treadmill walking bout on heart rate variability at rest in physically active women.

BACKGROUND: Heart rate variability (HRV) has been promoted as a noninvasive method of evaluating autonomic influence on cardiac rhythm. Although female subjects predominate in the walking studies, no study to date has examined the influence of the duration of a moderate intensity walking physical activity bout on HRV in this population. METHODS: Twelve healthy physically active middle-aged women undertook 2 conditions; 20min (W20) and 60min (W60) bouts of walking on a treadmill. Resting HRV measures were obtained before (-1 h), and 1 h and 24 h after the walking bouts. RESULTS: Mean NN interval (ie, normal-to-normal intervals between adjacent QRS complexes) was significantly lower (P = .017) at +1 h in W60 (832, 686-979ms) compared with W20 (889, 732-1046ms). A borderline main effect for time was observed for both the SDNN intervals in W60 (P = .056), and for low frequency (LF(abs)) power in W60 (P = .047), with post hoc tests revealing a significant increase between -1 h (51, 33-69 ms and 847, 461-1556 ms(2)) and +1 h (65, 34-97ms and 1316, 569-3042 ms(2)) for SDNN and LF(abs) power, respectively, but no increase at +24h compared with -1 h. CONCLUSIONS: It appears that a walking bout of 60 min duration does alter cardiac autonomic influence in healthy active women, and this alteration is not evident after 20 min of walking. Given the rather subtle effect, further studies with larger sample sizes are required to explore the nature of the changes in cardiac autonomic influence following a prolonged bout of walking.

Uptake and participation in physical activity referral schemes in the UK: an investigation of patients referred with mental health problems.

The study compared outcomes of uptake, attendance, and completion between two patient groups (mental health, n = 134 and physical health, n = 2767) in a physical activity referral scheme in the UK during 2000 to 2003. Despite similar rates for the physical health and mental health groups for initial progression (94% vs. 90%), referral uptake (60% vs. 69%; p < 0.001) and programme completion (22% vs. 34%; p < 0.001) were significantly lower in the mental health referrals. In conclusion, physical activity referral schemes appear to be less well suited to the needs of the mental health patient. Further research is recommended.

Factors associated with physical activity referral uptake and participation.

The aim of this study was to examine participant and scheme characteristics in relation to access, uptake, and participation in a physical activity referral scheme (PARS) using a prospective population-based longitudinal design. Participants (n = 3762) were recruited over a 3-year period. Logistic regression analyses identified the factors associated with the outcomes of referral uptake, participation, and completion (> or = 80% attendance). Participant's age, sex, referral reason, referring health professional, and type of leisure provider were the independent variables. Based on binary logistic regression analysis (n = 2631), only primary referral reason was associated with the PARS coordinator making contact with the participants. In addition to the influence of referral reason, females were also more likely (odds ratio 1.250, 95% confidence interval 1.003-1.559, P = 0.047) to agree to be assigned to a leisure provider. Referral reason and referring health professional were associated with taking up a referral opportunity. Older participants (1.016, 1.010-1.023, P < 0.001) and males were more likely to complete the referral. In conclusion, the PARS format may be less appropriate for those more constrained by time (women, young adults) and those with certain referral reasons (overweight/obesity, mental health conditions). More appropriate targeting at the point of referral could improve participation rates by revealing or addressing barriers that might later result in dropout.

Relationship between maximal oxygen uptake and oxygen uptake attained during treadmill middle-distance running.

Traditionally, it has been assumed that during middle-distance running oxygen uptake (VO2) reaches its maximal value (VO2max) providing the event is of a sufficient duration; however, this assumption is largely based on observations in individuals with a relatively low VO2max. The aim of this study was to determine whether VO2max is related to the VO2 attained (i.e. VO2peak) during middle-distance running on a treadmill. Fifteen well-trained male runners (age 23.3 +/- 3.8 years, height 1.80 +/- 0.10 m, body mass 76.9 +/- 10.6 kg) volunteered to participate in the study. The participants undertook two 800-m trials to examine the reproducibility of the VO2 response. These two trials, together with a progressive test to determine VO2max, were completed in a randomized order. Oxygen uptake was determined throughout each test using 15-s Douglas bag collections. Following the application of a 30-s rolling average, the highest VO2 during the progressive test (i.e. VO2max) was compared with the highest VO2 during the 800-m trials (i.e. VO2peak) to examine the relationship between VO2max and the VO2 attained in the 800-m trials. For the 15 runners, VO2max was 58.9 +/- 7.1 ml x kg(-1) x min(-1). Two groups were formed using a median split based on VO2max. For the high and low VO2max groups, VO2max was 65.7 +/- 3.0 and 52.4 +/- 1.8 ml x kg(-1) x min(-1) respectively. The limits of agreement (95%) for test-retest reproducibility for the VO2 attained during the 800-m trials were +/- 3.5 ml x kg(-1) x min(-1) for a VO2peak of 50.6 ml x kg(-1) x min(-1) (the mean VO2peak for the low VO2max group) and +/- 2.3 ml x kg(-1) x min(-1) for a VO2peak of 59.0 ml x kg(-1) x min(-1) (the mean VO2peak for the high VO2max group), with a bias in VO2peak between the 800-m runs (i.e. the mean difference) of 1.2 ml x kg(-1) x min(-1). The VO2peak for the 800-m runs was 54.8 +/- 4.9 ml x kg(-1) x min(-1) for all 15 runners. For the high and low VO2max groups, VO2peak was 59.0 +/- 3.3 ml x kg(-1) x min(-1) (i.e. 90% VO2max) and 50.6 +/- 2.0 ml x kg(-1) x min(-1) (i.e. 97% VO2max) respectively. The negative relationship (-0.77) between VO2max and % VO2max attained for all 15 runners was significant (P = 0.001). These results demonstrate that (i) reproducibility is good and (ii) that VO2max is related to the %VO2max achieved, with participants with a higher VO2max achieving a lower %VO2max in an 800-m trial on a treadmill.

Optimized versus corrected peak power during friction-braked cycle ergometry in males and females.

The aim of this study was to compare optimization and correction procedures for the determination of peak power output during friction-loaded cycle ergometry. Ten male and 10 female sports students each performed five 10-s sprints from a stationary start on a Monark 864 basket-loaded ergometer. Resistive loads of 5.0, 6.5, 8.0, 9.5, and 11.0% body weight were administered in a counterbalanced order, with a recovery period of 10 min between sprints. Peak power was greater and occurred earlier, with less work having been done before the attainment of peak power, when the data were corrected to account for the inertial and frictional characteristics of the ergometer. Corrected peak power was independent of resistive load (P > 0.05), whereas uncorrected peak power varied as a quadratic function of load (P < 0.001). For males and females, optimized peak power (971 +/- 122 and 668 +/- 37 W) was lower (P < 0.01) than either the highest (1074 +/- 111 and 754 +/- 56 W respectively) or the mean (1007 +/- 125 and 701 +/- 45 W respectively) of the five values for corrected peak power. Optimized and mean corrected peak power were highly correlated both in males (r = 0.97, P < 0.001) and females (r = 0.96, P < 0.001). The difference between optimized and mean corrected peak power was 37 +/- 30 W in males and 33 +/- 14 W in females, of which approximately 15 W was due to the correction for frictional losses. We conclude that corrected peak power is independent of resistive load in males and females.

Socio-demographic patterning of referral, uptake and attendance in Physical Activity Referral Schemes.

BACKGROUND: Inadequate monitoring and participant profiling have so far prevented a detailed examination of who Physical Activity Referral Schemes (PARS) are accessible to and appropriate for. As a result, the nature of the role for PARS within public health is unknown. METHODS: Participants were all those referred to a countywide PARS during a three-year period (n = 3568). Participant age, gender and the deprivation level and rurality of their area of residence were compared with the average for the county population. Characteristics associated with referral uptake (attending > or =1 exercise session) and completion (> or =80% attendance), were identified using logistic regression. RESULTS: Compared with the county average, participants were older, more predominantly female (61.1 vs 51.4%) and lived in more deprived areas (p < 0.001). Referral uptake (n = 2864) was most likely in those aged 60-69 years, and least likely for residents of rural villages and the most deprived areas (all p < 0.001). For participants who took up referral, completion was most likely in men and the over-seventies (p < 0.001). CONCLUSIONS: The PARS format may be inappropriate for younger adults or people living in relative deprivation and rural areas. They appear most appropriate for adults of middle-to-old age who are more likely to require supervision, and should be targeted accordingly.

Effect of starting cadence on sprint-performance indices in friction-loaded cycle ergometry.

The aims of the study were to investigate whether starting cadence had an effect on 10-s sprint-performance indices in friction-loaded cycle ergometry and to investigate the influence of method of power determination. In a counterbalanced order, 12 men and 12 women performed three 10-s sprints using a stationary (0 rev/min), moderate (60 rev/min), and high (120 rev/min) starting cadence. Calculated performance indices were peak power, cadence at peak power, time to peak power, and work to peak power. When the uncorrected method of power determination was applied, there was a main effect for starting cadence in female participants for peak power (stationary 635 +/- 183.7 W, moderate 615.4 +/- 168.9 W, and high 798.4 +/- 120.1 W) and cadence at peak power (89.8 +/- 2.3 rev/min, 87.9 +/- 21.5 rev/min, and 113.1 +/- 12.5 rev/min). For both the uncorrected and directly measured methods of power determination in men and women, there was a main effect for starting cadence for time to peak power and work to peak power. In women, for an uncorrected method of power determination, it can be concluded that starting cadence does affect peak power and cadence at peak power. This effect is, however, negated by a direct-measurement method of power determination. In men and women, for both uncorrected and directly measured methods of power determination, time to peak power and work to peak power were affected by starting cadence. Therefore, a higher-cadence start is unsuitable, particularly when sprint-performance indices are determined from an uncorrected method.

VO2 attained during treadmill running: the influence of a specialist (400-m or 800-m) event.

PURPOSE: Previously it has been observed that, in well-trained 800-m athletes, VO2max is not attained during middle-distance running events on a treadmill, even when a race-type pacing strategy is adopted. Therefore, the authors investigated whether specialization in a particular running distance (400-m or 800-m) influences the VO2 attained during running on a treadmill. METHODS: Six 400-m and six 800-m running specialists participated in the study.A 400-m trial and a progressive test to determine VO2max were completed in a counterbalanced order. Oxygen uptakes attained during the 400-m trial were compared to examine the influence of specialist event. RESULTS: A VO2 plateau was observed in all participants for the progressive test, demonstrating the attainment of VO2max. The VO2max values were 56.2 +/- 4.7 and 69.3 +/- 4.5 mL x kg-1 x min-1 for the 400-m- and 800-m-event specialists, respectively (P = .0003). Durations for the 400-m trial were 55.1 +/- 4.2 s and 55.8 +/- 2.3 s for the 400-m- and 800-m-event specialists, respectively. The VO2 responses achieved were 93.1% +/- 2.0% and 85.7% +/- 3.0% VO2max for the 400-m- and 800-m-event specialists, respectively (P = .001). CONCLUSIONS: These results demonstrate that specialist running events do appear to influence the percentage of VO2max achieved in the 400-m trial, with the 800-m specialists attaining a lower percentage of VO2max than the 400-m specialists. The 400-m specialists appear to compensate for a lower VO2max by attaining a higher percentage VO2max during a 400-m trial.

The effect of prior moderate- and heavy-intensity running on the VO2 response to exhaustive severe-intensity running.

We tested the hypothesis that prior heavy-intensity exercise reduces the difference between asymptotic oxygen uptake (VO2) and maximum oxygen uptake (VO2max) during exhaustive severe-intensity running lasting ?2 minutes. Ten trained runners each performed 2 ramp tests to determine peak VO2 (VO2peak) and speed at ventilatory threshold. They performed exhaustive square-wave runs lasting ?2 minutes, preceded by either 6 minutes of moderate-intensity running and 6 minutes rest (SEVMOD) or 6 minutes of heavy-intensity running and 6 minutes rest (SEVHEAVY). Two transitions were completed in each condition. VO2 was determined breath by breath and averaged across the 2 repeats of each test; for the square-wave test, the averaged VO2 response was then modeled using a monoexponential function. The amplitude of the VO2 response to severe-intensity running was not different in the 2 conditions (SEVMOD vs SEVHEAVY; 3925 +/- 442 vs 3997 +/- 430 mL/min, P = .237), nor was the speed of the response (?; 9.2 +/- 2.1 vs 10.0 +/- 2.1 seconds, P = .177). VO2peak from the square-wave tests was below that achieved in the ramp tests (91.0% +/- 3.2% and 92.0% +/- 3.9% VO2peak, P < .001). There was no difference in time to exhaustion between conditions (110.2 +/- 9.7 vs 111.0 +/- 15.2 seconds, P = .813). The results show that the primary VO2 response is unaffected by prior heavy exercise in running performed at intensities at which exhaustion will occur before a slow component emerges.