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1.
J Sports Sci ; 42(4): 323-332, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38493350

ABSTRACT

The perceived value of athlete monitoring systems (AMS) has recently been questioned. Poor perceptions of AMS are important, because where practitioners lack confidence in monitoring their ability to influence programming, and performance is likely diminished. To address this, researchers have primarily sought to improve factors related to monitoring metrics, e.g., validity rather than socio-environmental factors, e.g., buy-in. Seventy-five practitioners (response rate: n = 30) working with Olympic and Paralympic athletes were invited to take part in a survey about their perceptions of AMS value. Fifty-two per cent (n = 13) was confident in the sensitivity of their athlete self-report measures, but only 64% (n = 16), indicated their monitoring was underpinned by scientific evidence. A scientific base was associated with improved athlete feedback (rS (23) = 0.487, p =0.014*) and feedback correlated with athlete monitoring adherence (rS (22) = 0.675, p = <0.001**). If athletes did not complete their monitoring, 52% (n = 13) of respondents felt performance might be compromised. However, most respondents 56% (n = 14), had worked with internationally successful athlete(s) who did not complete their monitoring. While AMS can be a useful tool to aid performance optimisation, its potential value is not always realised. Addressing socio-environmental factors alongside metric-factors may improve AMS efficacy.


Subject(s)
Athletic Performance , Humans , Athletic Performance/physiology , Athletic Performance/psychology , Male , Self Report , Female , Surveys and Questionnaires , Feedback , Adult , Athletes/psychology , Para-Athletes , Social Environment
2.
J Sports Sci ; 40(13): 1450-1457, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35694788

ABSTRACT

Athlete monitoring systems (AMS) aid performance optimisation and support illness/injury prevention. Nonetheless, limited information exists on how AMS are employed across elite sports in the United Kingdom. This study explored how athlete monitoring (AM) data, in particular athlete self-report measures, were collected, analysed and disseminated within elite sports. Thirty elite sports practitioners representing 599 athletes responded to a survey on their AM methodologies. The majority, 83%, (n = 25) utilised an AMS, and a further 84% (n = 21) stated the collection of their AMS data was underpinned by a scientific rationale. Athlete self-report measures (ASRM) were the most commonly employed tool, with muscle soreness, sleep and energy levels amongst the most frequently collected measures. The ubiquitous use of custom single-item ASRM resulted in considerable variability in the questionnaires employed, thus potentially impacting questionnaire validity. Feedback processes were largely felt to be ineffective, with 44% (n = 11) respondents indicating that athletes did not receive sufficient feedback. Some respondents indicated that AMS data was never discussed with athletes and/or coaches. Overall, significant disparities exist in the use of athlete monitoring systems between research and elite sports practice, and the athlete, coach and practitioner experience of monitoring risks being poor if these disparities are not addressed.


Subject(s)
Athletes , Sports , Fatigue , Humans , Self Report , Surveys and Questionnaires
3.
Sensors (Basel) ; 22(12)2022 Jun 09.
Article in English | MEDLINE | ID: mdl-35746153

ABSTRACT

The aim of this study was to assess the validity of electro-goniometers as a tool for recording continuous relative phase data at two joint couplings during cycling tasks at a range of cadences. Seven participants (4 male, 3 female, age: 29 ± 7 years, height: 1.76 ± 0.10 m, mass: 71.97 ± 11.57 kg) performed exercise bouts of 30 s at four prescribed cadences (60, 80, 100, 120 rev·min-1) on a stationary ergometer (Wattbike, Nottingham, UK). Measures were synchronously recorded by bi-axial electro-goniometers (Biometrics, UK) and a 12-camera motion-capture system (Qualisys, Gothenburg, Sweden), with both systems sampling at 500 Hz. Sagittal plane joint angle and joint angular velocity were recorded at the hip, knee and ankle and analysed for ten complete pedal revolutions per participant per condition. Data were interpolated to 100 time points and used to calculate mean continuous relative phase (CRP) per pedal revolution at two intra-limb couplings: (i) knee flexion/extension-ankle plantarflexion/dorsiflexion (KA) and (ii) hip flexion/extension-knee flexion/extension (HK). At the KA coupling, significant differences in mean CRP were found between measurement systems at 120 rev·min-1 (p = 0.006). At the HK coupling, significant differences in mean CRP were found between measurement systems at 80 rev·min-1 (p = 0.043) and 100 rev·min-1 (p = 0.028). ICC values for most comparisons were below 0.5, suggesting poor levels of agreement between systems. Significant differences in mean CRP per pedal revolution and poor levels of agreement between systems suggests that electro-goniometers are not a suitable alternative to motion-capture systems when attempting to record CRP during cycling.


Subject(s)
Ankle Joint , Bicycling , Adult , Biomechanical Phenomena , Exercise , Female , Humans , Knee Joint , Male , Range of Motion, Articular , Young Adult
4.
Sports (Basel) ; 10(5)2022 Apr 28.
Article in English | MEDLINE | ID: mdl-35622476

ABSTRACT

Whilst increasing mental workload has been shown to have a detrimental effect on cycling performance and more generally to increase the risk of harm, no studies have measured how mental workload changes as a function of ultra-distance cycling, indoors or outdoors. Our objective was to measure the difference in mental workload, as indicated by changes in EEG theta power, components of HRV and psychomotor vigilance and as reported using the 'NASA Task Load Index questionnaire', before and after a 5 h indoor ride and outdoor ride completed at 65% of functional threshold power. Results of the NASA-TLX indicated the mental demand of outdoor cycling to be significantly less than that of indoor cycling. There were significant differences in the PVT results between the pre and the post outdoor ride average and median response times. The slowest 10% PVT responses were significantly slower pre than post the indoor ride. There were significant differences in HRV between pre and post outdoor and indoor rides, specifically, in the average RR intervals, RMSSD (ms2), LFPower (ms2), NN50. There were modest changes in indicators of mental workload during an ultra-distance cycle ride. As such, mental workload during ultra-distance cycling is unlikely to be a contributory factor to decreases in performance or to an increased likelihood of accident and injury.

6.
Clin Rehabil ; 35(6): 882-893, 2021 Jun.
Article in English | MEDLINE | ID: mdl-33356519

ABSTRACT

OBJECTIVES: To assess the effect of a home-based over-ground robotic-assisted gait training program using the AlterG Bionic Leg orthosis on clinical functional outcomes in people with chronic stroke. DESIGN: Randomized controlled trial. SETTING: Home. PARTICIPANTS: Thirty-four ambulatory chronic stroke patients who recieve usual physiotherapy. INTERVENTION: Usual physiotherapy plus either (1)10-week over-ground robotic-assisted gait training program (n = 16), using the device for ⩾30 minutes per day, or (2) control group (n = 18), 30 minutes of physical activity per day. MEASUREMENTS: The primary outcome was the Six-Minute Walk Test. Secondary outcomes included: Timed-Up-and-Go, Functional Ambulation Categories, Dynamic Gait Index and Berg Balance Scale. Physical activity and sedentary time were assessed using accelerometry. All measurements were completed at baseline, 10 and 22 weeks after baseline. RESULTS: Significant increases in walking distance were observed for the Six-Minute Walk Test between baseline and 10 weeks for over-ground robotic-assisted gait training (135 ± 81 m vs 158 ± 93 m, respectively; P ⩽ 0.001) but not for control (122 ± 92 m vs 119 ± 84 m, respectively). Findings were similar for Functional Ambulation Categories, Dynamic Gait Index and Berg Balance Scale (all P ⩽ 0.01). For over-ground robotic-assisted gait training, there were increases in time spent stepping, number of steps taken, number of sit-to-stand transitions, and reductions in time spent sitting/supine between baseline and 10 weeks (all P < 0.05). The differences observed in all of the aforementioned outcome measures were maintained at 22 weeks, 12 weeks after completing the intervention (all P > 0.05). CONCLUSION: Over-ground robotic-assisted gait training combined with physiotherapy in chronic stroke patients led to significant improvements in clinical functional outcomes and physical activity compared to the control group. Improvements were maintained at 22 weeks.


Subject(s)
Gait Disorders, Neurologic/rehabilitation , Paresis/rehabilitation , Robotics/methods , Stroke Rehabilitation/methods , Aged , Exercise Therapy/instrumentation , Female , Home Care Services , Humans , Male , Middle Aged , Orthotic Devices , Walk Test
7.
Am J Sports Med ; 49(5): 1372-1380, 2021 04.
Article in English | MEDLINE | ID: mdl-32960075

ABSTRACT

BACKGROUND: The 2 most common definitive surgical interventions currently performed for the treatment of medial osteoarthritis of the knee are medial opening wedge high tibial osteotomy (HTO) and medial unicompartmental knee arthroplasty (UKA). Research exists to suggest that physically active patients may be suitably indicated for either procedure despite HTO being historically indicated in active patients and UKA being more appropriate for sedentary individuals. PURPOSE: To help consolidate the current indications for both procedures regarding physical activity and to ensure that they are based on the best information presently available. STUDY DESIGN: Systematic review. METHODS: A search of the literature via the MEDLINE, Embase, and PubMed databases was conducted independently by 2 reviewers in accordance with the PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines. Studies that reported patient physical activity levels with the Tegner activity score were eligible for inclusion. Patient demographics, operative variables, and patient-reported outcome scores were abstracted from the included studies. RESULTS: Thirteen eligible studies were included, consisting of 401 knees that received HTO (399 patients) and 1622 that received UKA (1400 patients). The patients' mean age at surgery was 48.4 years for the HTO group and 60.6 years for the UKA group. Mean follow-up was 46.6 months (HTO) and 53.4 months (UKA). All outcome scores demonstrated an equal or improved score for activity and knee function regardless of the operation performed. Operative variables during HTO had a larger effect on outcome than during UKA. CONCLUSION: Patients who underwent HTO were more physically active pre- and postoperatively, but patients undergoing UKA experienced an overall greater increase in their physical activity levels and knee function according to Tegner and Lysholm scores. Activity after HTO may be influenced by operative factors such as the implant used and the decision to include a graft material in the osteotomy gap, although this requires further research. Some studies found that patients were able to return to physical activity postoperatively despite having an age or body mass index that would traditionally be a relative contraindication for HTO or UKA.


Subject(s)
Arthroplasty, Replacement, Knee , Osteoarthritis, Knee , Data Analysis , Exercise , Humans , Knee Joint/surgery , Osteoarthritis, Knee/surgery , Osteotomy , Tibia/surgery , Treatment Outcome
8.
PLoS One ; 14(5): e0216660, 2019.
Article in English | MEDLINE | ID: mdl-31075145

ABSTRACT

The inclusion of an allograft wedge during medial opening wedge high tibial osteotomy has been shown to lead to satisfactory time-to-union in larger corrections (>10°). Such large corrections are associated with greater incidences of intraoperative hinge fracture and reduced construct stability. The purpose of this study was to investigate the biomechanical stability that an allograft wedge brings to an osteotomy. Ten medium-size fourth generation artificial sawbone tibiae underwent 12 mm biplanar medial opening wedge high tibial osteotomy with a standard Tomofix plate. Five tibiae had an allograft wedge inserted into the osteotomy gap prior to plate fixation (allograft group). The gap in the remaining tibiae was left unfilled (control group). Each group underwent static compression testing and cyclical fatigue testing until failure of the osteotomy. Peak force, valgus malrotation, number of cycles, displacement and stiffness around the tibial head were analysed. Intraoperative hinge fractures occurred in all specimens. Under static compression, the allograft group withstood higher peak forces (6.01 kN) compared with the control group (5.12 kN). Valgus malrotation was lower, and stiffness was higher, in the allograft group. During cyclical fatigue testing, results within the allograft group were more consistent than within the control group. This may indicate more predictable results in large osteotomies with an allograft. Tibial osteotomies with allograft wedges appear beneficial for larger corrections, and in cases of intraoperative hinge fracture, due to the added construct stability they provide, and the consistency of results compared with tibial osteotomies without a graft.


Subject(s)
Mechanical Phenomena , Osteotomy/instrumentation , Tibia/surgery , Biomechanical Phenomena , Compressive Strength , Materials Testing , Stress, Mechanical
9.
J Exp Orthop ; 6(1): 13, 2019 Mar 28.
Article in English | MEDLINE | ID: mdl-30923931

ABSTRACT

BACKGROUND: The purpose of this study was to compare the stability of medial opening-wedge high tibial osteotomy (MOWHTO) with and without different graft materials. Good clinical and radiological outcomes have been demonstrated when either using or not using graft materials during MOWHTO. Variations in the biomechanical properties of different graft types, regarding the stability they provide a MOWHTO, have not been previously investigated. METHODS: A 10 mm biplanar MOWHTO was performed on 15 artificial sawbone tibiae, which were fixed using the Activmotion 2 plate. Five bones had OSferion60 wedges (synthetic group), five had allograft bone wedges (allograft group), and five had no wedges (control group) inserted into the osteotomy gap. Static compression was applied axially to each specimen until failure of the osteotomy. Ultimate load, horizontal and vertical displacements were measured and used to calculate construct stiffness and valgus malrotation of the tibial head. RESULTS: The synthetic group failed at 6.3 kN, followed by the allograft group (6 kN), and the control group (4.5 kN). The most valgus malrotation of the tibial head was observed in the allograft group (2.6°). The synthetic group showed the highest stiffness at the medial side of the tibial head (9.54 kN·mm- 1), but the lowest stiffness at the lateral side (1.59 kN·mm-1). The allograft group showed high stiffness on the medial side of the tibial head (7.54 kN·mm- 1) as well as the highest stiffness on the lateral side (2.18 kN·mm- 1). CONCLUSIONS: The use of graft materials in MOWHTO results in superior material properties compared to the use of no graft. The static strength of MOWHTO is highest when synthetic grafts are inserted into the osteotomy gap. Allograft wedges provide higher mechanical strength to a MOWHTO than when no graft used. In comparison to the synthetic grafts, allograft wedges result in the stiffness of the osteotomy being more similar at the medial and lateral cortices.

10.
J Sports Sci ; 37(2): 156-162, 2019 Jan.
Article in English | MEDLINE | ID: mdl-29932805

ABSTRACT

This study investigated the effect cadence has on the estimation of critical power (CP) and the finite work capacity (W') during the 3-minute all-out cycling test. Ten participants completed 8 tests: 1) an incremental test to calculate gas exchange threshold (GET), maximal aerobic power (MAP) and peak oxygen uptake (V̇O2peak), 2-4) three time-to-exhaustion tests at 80, 100 and 105% MAP to calculate CP and W', 5-7) four 3-minute all-out tests to calculate end power (EP) and work done above EP (WEP) using cadences ranging from preferred -5 to preferred +10 rev·min-1 to set the fixed resistance. Significant differences were seen between CP and EP-preferred (267.5 ± 22.6 W vs. 296.6 ± 26.1 W, P < 0.001), CP and EP-5 (267.5 ± 22.6 W vs. 303.6 ± 24.0 W, P < 0.001) and between CP and EP+5 (267.5 ± 22.6 W vs. 290.0 ± 28.0 W, P = 0.002). No significant differences were seen between CP and EP+10 (267.5 ± 22.6 W vs. 278.1 ± 30.9 W, P = 0.331). Significant differences were seen between W' and WEP at all tested fixed resistances. EP is reduced when cycling at higher than preferred cadences, providing better estimates of CP.


Subject(s)
Exercise Test/instrumentation , Exercise Test/methods , Adult , Anaerobic Threshold , Humans , Male , Muscle Fatigue/physiology , Oxygen Consumption , Pulmonary Gas Exchange , Time Factors
11.
Int J Sports Physiol Perform ; 14(1): 99-104, 2019 Jan 01.
Article in English | MEDLINE | ID: mdl-29952658

ABSTRACT

PURPOSE: Poor athlete buy-in and adherence to training-monitoring systems (TMS) can be problematic in elite sport. This is a significant issue, as failure to record, interpret, and respond appropriately to negative changes in athlete well-being and training status may result in undesirable consequences such as maladaptation and/or underperformance. This study examined the perceptions of elite athletes to their TMS and their primary reasons for noncompletion. METHODS: Nine national-team sprint athletes participated in semistructured interviews on their perceptions of their TMS. Interview data were analyzed qualitatively, based on grounded theory, and TMS adherence information was collected. RESULTS: Thematic analysis showed that athletes reported their main reason for poor buy-in to TMS was a lack of feedback on their monitoring data from key staff. Furthermore, training modifications made in response to meaningful changes in monitoring data were sometimes perceived to be disproportionate, resulting in dishonest reporting practices. CONCLUSIONS: Perceptions of opaque or unfair decision making on training-program modifications and insufficient feedback were the primary causes for poor athlete TMS adherence. Supporting TMS implementation with a behavioral-change model that targets problem areas could improve buy-in and enable limited resources to be appropriately directed.

12.
Int J Sports Physiol Perform ; 14(6): 855­858, 2019 07 01.
Article in English | MEDLINE | ID: mdl-30569791

ABSTRACT

PURPOSE: To (1) evaluate agreement between the PowerTap P1 (P1) pedals and the Lode Excalibur Sport cycle ergometer, (2) investigate the reliability of the P1 pedals between repeated testing sessions, and (3) compare the reliability and validity of the P1 pedals before (P10) and after (P1100) ∼100 h of use. METHODS: Ten participants completed four 5-min submaximal cycling bouts (100, 150, 200, and 250 W), a 2-min time trial, and two 10-s all-out sprints on 2 occasions. This protocol was repeated after 15 mo and ∼100 h of use. RESULTS: Significant differences were seen between the P10 pedals and the Lode Excalibur Sport at 100 W (P = .006), 150 W (P = .006), 200 W (P = .001), and 250 W (P = .006) and during the all-out sprints (P = .020). After ∼100 h of use, the P1100 pedals did not significantly differ from the Lode Excalibur Sport at 100 W (P = .799), 150 W (P = .183), 200 W (P = .289), and 250 W (P = .183), during the 2-min time trial (P = .583), or during the all-out sprints (P = .412). The coefficients of variation for the P10 and P1100 ranged from 0.6% to 1.3% and 0.5% to 2.0%, respectively, during the submaximal cycling bouts. CONCLUSION: The P1 pedals provide valid data after ∼100 h of laboratory use. Furthermore, the pedals provide reliable data during submaximal cycling, even after prolonged use.


Subject(s)
Bicycling , Ergometry/instrumentation , Adult , Exercise Test , Humans , Male , Reproducibility of Results
14.
PLoS One ; 13(11): e0206329, 2018.
Article in English | MEDLINE | ID: mdl-30383781

ABSTRACT

BACKGROUND: This study examined the short-term reproducibility of non-invasive estimates of central and peripheral blood pressure and markers of central systolic loading (augmentation index [AIx; a measure of central systolic loading] and AIx75 [AIx standardised to 75 b·min-1 heart rate]) and the effect of posture and fasting state on these variables in patients with acute stroke. METHODS: Twenty-two acute stroke patients (72 ± 10y) had blood pressure measured using the SphygmoCor XCEL in supine and seated postures and whilst fasted and non-fasted. RESULTS: Acceptable short-term reproducibility (ICC >0.75) was reported for all peripheral and central variables in all conditions (ICC = 0.77-0.90) and for AIx and AIx75 in both fasted postures (ICC = 0.78-0.81). Food consumption significantly lowered all blood pressures (p <0.05; η2p = 0.20-0.55). The seated posture resulted in a significantly greater AIx than supine (p <0.05; η2p = 0.22). Fasting state had significant main effects on AIx and AIx75 (p <0.05; η2p = 0.14-0.22). CONSLUSIONS: Oscillometric estimates of central blood pressure have high short-term reproducibility in different postures and fasting states but markers of systolic load should be assessed whilst fasted. Fasting state has a large effect on central and peripheral blood pressures and on measures of systolic loading. It is important for clinicians to be aware of optimal assessment conditions without this impacting on patient wellbeing. TRIAL REGISTRATION: Clinical trial registry name: NCT02537652.


Subject(s)
Blood Pressure Determination/methods , Blood Pressure/physiology , Fasting/physiology , Oscillometry/methods , Posture/physiology , Stroke/physiopathology , Acute Disease , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pulse Wave Analysis , Reproducibility of Results , Stroke/diagnosis , Systole , United Kingdom
15.
Sports (Basel) ; 6(3)2018 Sep 05.
Article in English | MEDLINE | ID: mdl-30189585

ABSTRACT

The use of mobile power measuring devices has become widespread within cycling, with a number of manufacturers now offering power measuring pedals. This study aimed to investigate the validity of PowerTap P1 pedals by comparing them with the previously validated Wattbike ergometer. Ten trained cyclists performed three simulated 10-mile (16-km) time trials on a Wattbike, while using PowerTap P1 pedals. There were no statistically significant differences (p > 0.05) between PowerTap P1 pedals and a Wattbike for maximum, minimum, and mean power output, or for maximum, minimum, and mean cadence. There were good to excellent levels of agreement between the PowerTap P1 pedals and Wattbike (ICC > 0.8) for all measured variables except minimum cadence (ICC = 0.619). This suggests that PowerTap P1 pedals provide a valid measurement of power output.

16.
PLoS One ; 13(5): e0197761, 2018.
Article in English | MEDLINE | ID: mdl-29787610

ABSTRACT

The link between athlete physique and performance in sports is well established. However, a direct link between somatotype three-numeral rating and anaerobic performance has not yet been reported. The purpose of this study was to assess the relations between somatotype and anaerobic performance using both singular and multivariate analyses. Thirty-six physically active males (mean ± standard deviation age 26.0 ± 9.8 years; body mass 79.5 ± 12.9 kg; height 1.82 ± 0.07 m) were somatotype-rated using the Heath-Carter method. Subjects were assessed for 3 repetition maximum (3 RM) bench press and back squat, and completed a 30-second maximal sprint cycle test. Positive correlations were observed between mesomorphy and 3 RM bench press (r = 0.560, p < 0.001), mesomorphy and 3 RM back squat (r = 0.550, p = 0.001) and between mesomorphy and minimum power output (r = 0.357, p = 0.033). Negative correlations were observed between ectomorphy and 3 RM bench press (r = -0.381, p = 0.022), and ectomorphy and 3 RM back squat (r = -0.336, p = 0.045). Individual regression analysis indicated that mesomorphy was the best predictor of 3 RM bench press performance, with 31.4% of variance in 3 RM bench press performance accounted for by the mesomorphy rating (p < 0.001). A combination of mesomorphy and ectomorphy best predicted 3 RM back squat performance (R2 = 0.388, p < 0.04). Around one third of strength performance is predicted by somatotype-assessed physique in physically active males. This could have important implications for the identification of those predisposed to perform well in sports containing strength-based movements and prescription of training programmes.


Subject(s)
Athletic Performance/physiology , Somatotypes/physiology , Adolescent , Anaerobic Threshold , Analysis of Variance , Humans , Male , Young Adult
17.
Atherosclerosis ; 269: 79-85, 2018 02.
Article in English | MEDLINE | ID: mdl-29339276

ABSTRACT

BACKGROUND AND AIMS: The between-day reliability of oscillometric pulse wave analysis has been demonstrated in a young, healthy population but not in an older sample. This study examined the between-day reliability of the SphygmoCor XCEL in individuals over 50 years. As blood pressure is measured in a range of postures and fasting states (supine/seated, fasted/non-fasted), this study also investigated the effect of these variables on central blood pressure and central systolic loading. METHODS: Fifty-one adults (m = 21; age 57 ±â€¯6.4 y) were tested on three mornings in supine and seated conditions and in fasted and non-fasted states. Data was analysed as a whole and for normotensive (n = 25) and hypertensive participants (n = 26). RESULTS: SphygmoCor XCEL demonstrated strong reliability in the whole sample for central systolic and diastolic blood pressures, augmentation index (AIx) and AIx75 (ICC = 0.77-0.95). Significant interaction effects were observed in central diastolic blood pressure, central pulse pressure, augmentation index (AIx) and AIx75 (p < 0.05; ηp2 = 0.10-0.23). Fasting state had a greater influence on central pressures in a seated than supine posture, but a greater effect on central systolic loading measures in a supine posture. CONCLUSIONS: The SphygmoCor XCEL is a reliable tool to assess central haemodynamic variables in an older population. It would be pertinent for clinicians and researchers to record central measures in a supine posture to minimise the effects of food consumption. Conversely, the assessment of central systolic loading should occur in a seated condition to minimise the influence of varying fasting states.


Subject(s)
Blood Pressure Determination/methods , Blood Pressure , Fasting , Hypertension/diagnosis , Patient Positioning/methods , Posture , Pulse Wave Analysis/methods , Vascular Stiffness , Age Factors , Aged , Aged, 80 and over , Blood Pressure Determination/instrumentation , Case-Control Studies , Female , Humans , Hypertension/physiopathology , Male , Middle Aged , Oscillometry , Predictive Value of Tests , Pulse Wave Analysis/instrumentation , Reproducibility of Results , Sitting Position , Supine Position , Systole
18.
J Stroke Cerebrovasc Dis ; 27(2): 372-380, 2018 Feb.
Article in English | MEDLINE | ID: mdl-29097056

ABSTRACT

Stroke is a major global health problem whereby many survivors have unmet needs concerning mobility during recovery. As such, the use of robotic-assisted devices (i.e., a bionic leg) within a community setting may be an important adjunct to normal physiotherapy in chronic stroke survivors. This study will be a dual-center, randomized, parallel group clinical trial to investigate the impact of a community-based training program using a bionic leg on biomechanical, cardiovascular, and functional outcomes in stroke survivors. Following a baseline assessment that will assess gait, postural sway, vascular health (blood pressure, arterial stiffness), and functional outcomes (6-minute walk), participants will be randomized to a 10-week program group, incorporating (1) a physiotherapy plus community-based bionic leg training program; (2) physiotherapy only; or (3) usual care control. The training program will involve participants engaging in a minimum of 1 hour per day of bionic leg activities at home. Follow-up assessments, identical to baseline, will occur after 10 weeks, and 3 and 12 months postintervention. Given the practical implications of the study, the clinical significance of using the bionic leg will be assessed for each outcome variable. The potential improvements in gait, balance, vascular health, and functional status may have a meaningful impact on patients' quality of life. The integration of robotic devices within home-based rehabilitation programs may prove to be a cost-effective, practical, and beneficial resource for stroke survivors.


Subject(s)
Artificial Limbs , Bionics/instrumentation , Community Health Services , Lower Extremity/innervation , Stroke Rehabilitation/instrumentation , Stroke/therapy , Biomechanical Phenomena , Chronic Disease , Clinical Protocols , England , Gait , Humans , Program Evaluation , Prosthesis Design , Quality of Life , Recovery of Function , Research Design , Stroke/diagnosis , Stroke/physiopathology , Time Factors , Treatment Outcome
19.
BMC Public Health ; 17(1): 300, 2017 04 05.
Article in English | MEDLINE | ID: mdl-28381272

ABSTRACT

It is well known that physical activity and exercise is associated with a lower risk of a range of morbidities and all-cause mortality. Further, it appears that risk reductions are greater when physical activity and/or exercise is performed at a higher intensity of effort. Why this may be the case is perhaps explained by the accumulating evidence linking physical fitness and performance outcomes (e.g. cardiorespiratory fitness, strength, and muscle mass) also to morbidity and mortality risk. Current guidelines about the performance of moderate/vigorous physical activity using aerobic exercise modes focuses upon the accumulation of a minimum volume of physical activity and/or exercise, and have thus far produced disappointing outcomes. As such there has been increased interest in the use of higher effort physical activity and exercise as being potentially more efficacious. Though there is currently debate as to the effectiveness of public health prescription based around higher effort physical activity and exercise, most discussion around this has focused upon modes considered to be traditionally 'aerobic' (e.g. running, cycling, rowing, swimming etc.). A mode customarily performed to a relatively high intensity of effort that we believe has been overlooked is resistance training. Current guidelines do include recommendations to engage in 'muscle strengthening activities' though there has been very little emphasis upon these modes in either research or public health effort. As such the purpose of this debate article is to discuss the emerging higher effort paradigm in physical activity and exercise for public health and to make a case for why there should be a greater emphasis placed upon resistance training as a mode in this paradigm shift.


Subject(s)
Health Services Needs and Demand , Obesity/prevention & control , Resistance Training , Humans , Public Health , State Medicine , United Kingdom
20.
Int J Sports Med ; 38(6): 462-467, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28388783

ABSTRACT

Research suggests that critical power (CP) can be estimated from a single 3-min bout of all-out cycling. The purpose of this study was to investigate the reliability and validity of the 3-min all-out cycling test when carried out at a constant cadence (isokinetic) and against a fixed resistance (linear). 12 participants completed 8 tests: 1) a ramp test; 2-4) 3 fixed power tests to calculate CP and W' using the 1/time mathematical model; 5-8) four 3-min all-out tests to calculate EP and WEP; 2 isokinetic and 2 linear tests. There was no significant difference between EP-isokinetic and CP (P=0.377). There were significant differences between EP-linear and CP (P=0.004), WEP-isokinetic and W' (P<0.001) and WEP-linear and W' (P<0.001). The coefficient of variation in EP-isokinetic, EP-linear, WEP-isokinetic and WEP-linear was 1.93, 1.17, 8.44 and 5.39%, respectively. The 3-min all-out isokinetic test provides a reliable estimate of EP and a valid estimate of CP. The 3-min all-out linear test provides a reliable estimate of EP, but not a valid estimate of CP. Furthermore, these results suggest that the 3-min all-out test should not be used to estimate W'.


Subject(s)
Bicycling/physiology , Exercise Test/methods , Adult , Humans , Male , Oxygen Consumption , Reproducibility of Results
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