Parallel development of Parkinson's-specific competencies for exercise professionals and criteria for exercise education programs.

INTRODUCTION: The Parkinson's Foundation sought to develop Parkinson's specific competencies for exercise professionals who work with people with Parkinson's (PwP). These competencies built upon exercise guidelines and professional competencies for healthy populations. The purpose of this article is to describe the development of the professional competencies, continuing education criteria, and a pilot accreditation process. METHODS: Competency development included: (1) an expert panel conducting an environmental scan, within the USA, related to exercise professional education in Parkinson's and synthesizing Parkinson's-specific exercise guidelines, (2) surveying people with Parkinson's in the USA, and (3) developing the competencies and curriculum criteria with psychometricians. A pilot accreditation process for Parkinson's exercise educational programs and continuing education courses includes an application, baseline, 6- and 12-month assessments. Activities reported here did not require ethical review. The survey was approved by NORC at the University of Chicago's Institutional Review Board (IRB). RESULTS: The environmental scan, exercise guidelines, and survey (n = 627) informed competency development. The five key condition-specific domains were: (1) foundational information on the disease and role of exercise, (2) exercise screening, (3) group and individual exercise design, (4) behavior and counseling for exercise, and (5) interprofessional communication and program development. Seven applicants were accredited as certification programs (n = 3) or continuing education courses (n = 4). DISCUSSION: The competencies, curriculum criteria, and accreditation processes support exercise professionals working with PwP. Reducing variation in the knowledge and skills of exercise professionals can improve the safe implementation and effectiveness of exercise programs, which are a critical part of integrated plan for people with Parkinson's disease (PD).

Comparison of swim recovery and muscle stimulation on lactate removal after sprint swimming.

Competitive swimming requires multiple bouts of high-intensity exercise, leading to elevated blood lactate. Active exercise recovery has been shown to lower lactate faster than passive resting recovery but may not always be practical. An alternative treatment, electrical muscle stimulation, may have benefits similar to active recovery in lowering blood lactate but to date is unstudied. Therefore, this study compared submaximal swimming and electrical muscle stimulation in reducing blood lactate after sprint swimming. Thirty competitive swimmers (19 men and 11 women) participated in the study. Each subject completed 3 testing sessions consisting of a warm-up swim, a 200-yard maximal frontcrawl sprint, and 1 of 3 20-minute recovery treatments administered in random order. The recovery treatments consisted of a passive resting recovery, a submaximal swimming recovery, or electrical muscle stimulation. Blood lactate was tested at baseline, after the 200-yard sprint, and after 10 and 20 minutes of recovery. A significant interaction (p < 0.05) between recovery treatment and recovery time was observed. Blood lactate levels for the swimming recovery were significantly lower at 10 minutes (3.50 +/- 1.57 mmol.L-1) and 20 minutes (1.60 +/- 0.57 mmol.L-1) of recovery than either of the other 2 treatments. Electrical muscle stimulation led to a lower mean blood lactate (3.12 +/- 1.41 mmol.L-1) after 20 minutes of recovery compared with passive rest (4.11 +/- 1.35 mmol.L-1). Submaximal swimming proved to be most effective at lowering blood lactate, but electrical muscle stimulation also reduced blood lactate 20 minutes postexercise significantly better than resting passive recovery. Electrical muscle stimulation shows promise as an alternate recovery treatment for the purpose of lowering blood lactate.