Efficacy of moist heat pack application over static stretching on hamstring flexibility.

Inadequate flexibility is a contributing factor to muscle injury, especially with respect to the hamstring muscle group. Simple therapeutic regimens capable of increasing hamstring flexibility may reduce the injury potential of athletes with below-average hamstring flexibility or history of injury. This study compared 30 seconds of static stretching with 20 minutes of heat application on hamstring flexibility. A secondary purpose was to determine the relationship between the subjects attitude toward each treatment and the efficacy of treatment. Thirty undergraduate student athletes who were current members of a Midwestern collegiate football team participated in a 2 (treatment: heat vs. stretching) by 2 (coun-terbalanced order: heat first vs. stretching first) repeated-measures design. Results indicated that significant benefits to increase hamstring flexibility could be gained by using moist heat packs in comparison with static stretching despite a perceived attitudinal bias in favor of stretching. These findings may have implications for orthopedic fitness as well as injury prevention for an athlete with prior hamstring injury or inadequate flexibility.

Development of a branching submaximal treadmill test for predicting VO2max.

This study determined the reliability and validity of a branching treadmill protocol in predicting VO2max. Thirty-seven, apparently healthy individuals (19 women and 18 men); volunteered to participate. On 2 separate testing days, each subject underwent maximal exercise testing using the protocol developed. Stepwise regression analysis indicated that the percentage of age-predicted maximum heart rate (APMHR) achieved at stage 3, speed and grade at stage 3, and APMHR accounted for 89% of the variance in VO2max. The 4 predictor variables were statistically significant (p < 0.01), and the standard error of the estimate was 4.56 ml x kg(-1) min(-1). Results indicate that health and fitness professionals can incorporate this protocol into their practices for the purpose of predicting VO2max for their clients outside the laboratory environment. Furthermore, our results indicate that using the proposed regression model is reliable and has received preliminary construct validity support.

Progressive strength training in sedentary, older African American women.

PURPOSE: This study investigated effects of an 8-wk, low-frequency and low-volume, supervised, progressive strength training program emphasizing free weight, multijoint movements on the muscular power, strength, endurance, and flexibility of African American women 44 to 68 yr of age. METHODS: Nineteen sedentary African American women were randomly assigned to a strength training (ST) only group (N = 12; mean age, 51 yr) or a nonexercise control (C) group (N = 7; mean age, 52 yr). Maximal power, strength, absolute endurance, and flexibility were assessed before and after training. Subjects trained 2 d x wk(-1) using free weight (barbells and dumbbells) and machine (plate loaded) exercises for two to three sets of 8 to 10 repetitions on both primary and assistance exercises. RESULTS: Upper body power (medicine ball put distance) significantly increased statistically (P = 0.002), but gains possibly lacked practical significance because of measurement variation. Lower body power (peak watts on bicycle) experienced a small, nonsignificant increase in the ST group. Significant increases (P = 0.000) in 1RM muscle strength occurred in the ST group (leg press, +99.8%; bench press, +34.4%). Absolute endurance significantly increased (P = 0.000) in the ST group (leg press repetitions to failure at 70% pretest 1RM, +221%; bench press repetitions to failure at 50% pretest 1RM, +112%). Significant flexibility gains occurred in the ST group (sit-and-reach test, +8.2%; P = 0.017). No significant changes occurred in power, strength, absolute endurance, or flexibility in the C group. CONCLUSION: This study demonstrates that 8 wk of low-frequency, supervised, progressive strength training emphasizing free weight, multijoint movements can safely cause significant gains in muscle strength, absolute endurance, and flexibility in older African American women.

Metabolism, microflora effects, and genotoxicity in haloacetic acid-treated cultures of rat cecal microbiota.

Haloacetic acids are by-products of drinking water disinfection. Several compounds in this class are genotoxic and have been identified as rodent hepatocarcinogens. Enzymes produced by the normal intestinal bacteria can transform some promutagens and procarcinogens to their biologically active forms. The present study was designed to investigate the influence of the cecal microbiota on the mutagenicity of haloacetic acids, and to look at changes in the microbiota populations and enzyme activities associated with exposure to haloacetic acids. PYG medium containing 1 mg/ml of monochloroacetic (MCA), monobromoacetic (MBA), dichloroacetic (DCA), dibromoacetic (DBA), trichloroacetic (TCA), tribromoacetic (TBA), or bromochloroacetic (BCA) acid was inoculated with rat cecal homogenate and incubated anaerobically at 37 degrees C. Growth curves were performed with enumeration of the microflora populations on selective media. Mutagenicity in a Salmonella microsuspension bioassay was determined after incubation for various lengths of time, with or without the cecal microbiota. At 15 h of incubation, enzyme assays determined the activities for beta-glucuronidase, beta-galactosidase, beta-glucosidase, azoreductase, nitroreductase, dechlorinase, and dehydrochlorinase. The haloacetic acids, with the exception of BCA, were toxic to the cecal microbiota, and especially to the enterococci. DBA, TBA, and BCA were mutagenic in the microsuspension assay, but the presence of the intestinal flora did not significantly alter the mutagenicity. BCA increased the activities of several enzymes, and therefore has the potential to affect the biotransformation of co-exposed compounds.

Religion in the home in the 1980s and 1990s: a meta-analytic review and conceptual analysis of links between religion, marriage, and parenting.

The authors reviewed 94 studies published in journals since 1980 on religion and marital or parental functioning. Meta-analytic techniques were used to quantify religion-family associations examined in at least 3 studies. Greater religiousness appeared to decrease the risk of divorce and facilitate marital functioning, but the effects were small. Greater Christian conservatism was modestly associated with greater endorsement and use of corporal punishment with preadolescents. Isolated findings suggested that greater parental religiousness relates to more positive parenting and better child adjustment. The scope, meaningfulness, and potential strength of findings were restricted because of reliance on global or single-item measures of religious and family domains. To facilitate more conceptually and methodologically sophisticated research, the authors delineated mechanisms by which the substantive and psychosocial elements of religion could benefit or harm family adjustment.

The disinfection by-products dichloro-, dibromo-, and bromochloroacetic acid impact intestinal microflora and metabolism in Fischer 344 rats upon exposure in drinking water.

Human consumption of chlorinated drinking water has been linked epidemiologically to bladder, kidney, and rectal cancers. The disinfection by-product (DBP) dichloroacetic acid is a hepatocarcinogen in Fischer 344 rats and B6C3F1 mice. The objective of this study is to determine the effect of the DBPs dichloro-, bromochloro-, and dibromoacetic acids (DCA, BCA, DBA) on intestinal microbial populations and their metabolism, with emphasis on enzymes involved in the bioactivation of procarcinogens and promutagens. One-month-old male Fischer 344 rats were provided water ad libitum containing 1 g/l DCA, BCA, or DBA for up to 5 weeks. At 1, 3, and 5 weeks of treatment, beta-glucuronidase (GLR), beta-galactosidase (GAL), beta-glucosidase (GLU), nitroreductase (NR), azoreductase (AR), and dechlorinase (DC) activities were determined in cecal and small and large intestinal homogenates. After 5 weeks of treatment, intestinal populations were enumerated on selective media. Cecal GAL (DCA, BCA, DBA) and GLR (DCA, DBA) activities were reduced after 1 and 3 weeks of treatment and GAL activity was elevated at 5 weeks (BCA). Large intestinal GAL (DCA, BCA) and GLU (DCA, BCA, DBA) activities were elevated after 5 weeks of treatment. Week 5 cecal AR (DCA, BCA, DBA), NR (DCA), and DC (DCA, DBA) activities were reduced. Even though some significant changes in intestinal populations were observed, use of selective media was not sensitive enough to explain fluctuations in enzyme activity. Haloacetic acids in the drinking water alter intestinal metabolism, which could influence bioactivation of promutagens and procarcinogens in the drinking water.

Cardiopulmonary responses, muscle soreness, and injury during the one repetition maximum assessment in pulmonary rehabilitation patients.

PURPOSE: The safety of one repetition maximum (1RM) testing for patients with chronic obstructive pulmonary disease (COPD) has not been determined. Therefore, this study was conducted to determine the prevalence of abnormal cardiopulmonary responses, muscle soreness, and muscle injury of patients with moderate to severe COPD in response to 1RM testing. METHODS: Twenty pulmonary rehabilitation patients (11 women and 9 men) with moderate or severe COPD participated in this investigation. The 1RM testing was performed using the parallel squat and incline press. Blood pressure, heart rate dyspnea ratings, and oxygen saturation responses were measured immediately following the 1RM procedure. Ratings of muscle soreness and injury were measured immediately after 1RM testing and on days 2 and 7. RESULTS: No injury, significant muscle soreness, or abnormal cardiopulmonary responses occurred as a result of 1RM testing. No gender differences were found for any variable measured in response to 1RM testing. CONCLUSIONS: A properly supervised and screened pulmonary rehabilitation population can be 1RM tested without significant muscle soreness, injury, or abnormal cardiopulmonary responses.

Combined high-intensity strength and aerobic training in diverse phase II cardiac rehabilitation patients.

BACKGROUND: Developing adequate levels of muscular strength in the cardiac rehabilitation (CR) patient helps return the patient to an active lifestyle. This study evaluated the effects and safety of an 8-week high-intensity strength training (ST) program combined with a traditional aerobic-based CR program on the muscular strength of a diverse phase II CR population. METHODS: Sixty-one phase II CR patients (age = 60.5 +/- 10.6 years) stratified by risk (high risk: n = 18, ejection fraction = 23.6 +/- 7.8%; intermediate risk: n = 19, ejection fraction = 40.0 +/- 4.6%; low risk: n = 24, ejection fraction = 58.0 +/- 7.7%) and gender (males = 46, females = 15) participated. One repetition maximum (1RM) testing was performed on the horizontal squat, shoulder press, leg extension, lat pulldown, and biceps curl. Patients performed two sets of each exercise 2 days per week at an intensity that started at 60% 1RM and progressed to 80% 1RM by week 4. Weeks 4 to 8 intensity was adjusted individually to maintain 8RM per set. Blood pressure and heart rate/rhythm responses to 1RM testing were monitored in high-risk patients. Muscle soreness and injury were monitored for all patients immediately after 1RM testing and on days 2 and 7. RESULTS: All patient groups made significant gains (P < 0.05) in muscle strength (mean increase: lower body = 15.3%, upper body = 16.7%). No injury or significant muscle soreness occurred due to 1RM testing. No abnormal heart rate/rhythm or blood pressure responses occurred in high-risk patients. CONCLUSIONS: Diverse phase II CR patients can improve their strength significantly with a combination of high-intensity strength and aerobic training.

Injuries and muscle soreness during the one repetition maximum assessment in a cardiac rehabilitation population.

BACKGROUND: Strength training (ST) may be beneficial for preservation of lean tissue, increasing bone mineral content, decreasing falls, and enhancing quality of life. Strength training is becoming an appropriate mode of exercise for cardiac rehabilitation (CR) patients. One method for determining optimal exercise intensity for safe and effective ST requires one repetition maximum (1RM) testing. Clinicians may be reluctant to perform 1RM testing in CR patients because of potential muscle soreness/injury and adverse hemodynamic responses in deconditioned patients. The purpose of this investigation was to perform 1RM testing in CR patients and determine muscle soreness/injury rate. METHODS: Seventy-four CR patients stratified by risk (low n = 30, intermediate n = 21, high n = 23) and sex (males = 55, females = 19) participated. Subject's ages ranged from 39 to 76 years and time from procedure ranged from 19 days to 2 years. No patient had ever undergone 1RM testing. The method of Kraemer and Fry was used to assess 1RM. High-risk patients' heart rates/rhythms and blood pressures were monitored. Patients were evaluated for occurrence of muscle soreness/injury immediately after 1RM testing and on days 2 and 7 using a soreness scale developed by Shaw et al. Muscle soreness/injury was considered significant if a patient reported altering or stopping physical activities. RESULTS: No injury or significant muscle soreness occurred as a result of 1RM testing. No abnormal heart rate/rhythm or blood pressure responses occurred in high-risk patients. CONCLUSIONS: Results indicate that with proper technique, 1RM testing may be performed in CR patients without injury or significant muscle soreness.

Autoxidation of pyridoxalated hemoglobin polyoxyethylene conjugate.

Hemoglobin-based therapeutics are currently in clinical trials in the United States and abroad as blood replacement solutions, nitric oxide scavengers, and radiation sensitizers. The potency of the therapeutics may be influenced by the oxidation state of the iron in the heme moiety. The oxidation state is dependent upon the physical environment of the molecule and is influenced by parameters such as the chemical nature of the hemoglobin therapeutic and its formulation. Pyridoxalated hemoglobin polyoxyethylene conjugate (PHP) is one such compound currently in clinical trials in the U.S. for treatment of nitric oxide-dependent, volume refractory shock. The autoxidation rates for PHP have been determined over a range of temperatures. The oxidation events were shown to be biphasic and were similar to those observed for purified human hemoglobin (HbAo). The initial fast oxidation events were modeled with first order rate constants at 37 degrees C and determined to be 0.022 hr-1 and 0.025 hr-1 for PHP and HbAo, respectively. The autoxidation of PHP was shown to be independent of concentration from approximately 5 to 100 mg/mL.

A randomized trial of early discharge and nurse specialist transitional follow-up care of high-risk childbearing women.

In a randomized clinical trial, quality of health care as reflected in patient outcomes and cost of health care was compared between two groups of high-risk childbearing women: women diagnosed with diabetes or hypertension in pregnancy. The control group (N = 52) was discharged routinely from the hospital. The intervention group (N = 44) was discharged early using a model of clinical nurse specialist transitional follow-up care. During pregnancy, the intervention group had significantly fewer rehospitalizations than the control group. For infants of diabetic women enrolled in the study during their pregnancy, low birth weight (< or = 2,500 g) was three times more prevalent in the control group (29%) than in the intervention group (8.3%). The postpartum hospital charges for the intervention group were also significantly less than for the control group. The mean total hospital charges for the intervention group were 44% less than for the control group. The mean cost of the clinical specialist follow-up care was 2% of the total hospital charges for the control group. A net savings of $13,327 was realized for each mother-infant dyad discharged early from the hospital.

Eight Programs to Consider.

Exercise videos allow patients to improve overall fitness in the comfort of their own homes. But cutting through the Hollywood glitz and hype that surround this lucrative fitness market is difficult. Here are one exercise physiologist's recommendations for exercise videos for patients at various fitness levels.

From diagnosis to home management: nutritional considerations for women with gestational diabetes.

Each year 90,000 women in the United States are diagnosed with gestational diabetes. The transition from diagnosis to home management is a time of high stress for these women. Anxiety may lead to difficulty with self-care in general and the diabetic diet in particular. Follow-up education by a diabetes educator can help clients plan meals that comply with the nutritional meal plan without disrupting the family's eating habits. The client should be taught to measure portions, to recognize sugar as an ingredient in foods and medicines, and to deal with special occasions such as holiday meals, travel, and illness. If extended home care is not feasible, the creative diabetes educator will devise other educational opportunities, such as home videos, telephone support networks, special childbirth classes for women with gestational diabetes, and luncheon meetings at which nutritionally correct meals are served.

Home visits for pregnant diabetic women: environmental assessment as a basis for nursing intervention.

A major goal in management of pregnancies complicated with diabetes is strict control of blood glucose levels. After glucose control is achieved, home visits by the Perinatal Clinical Nurse Specialist (PCNS) who has advanced knowledge and skills in the management of high risk pregnancies can be invaluable. The PCNS systematically assesses the client's environment and its effects upon the client's ability to carry out the many therapeutic self-care demands associated with the diabetic pregnancy. These include the client's ability to: identify and act upon episodes of hypo- or hyperglycemia, monitor blood glucose levels, self-administer insulin, self-monitor fetal activity, and identify and act upon danger signs in pregnancy and signs of labor. The PCNS, by assessing and planning within the framework of the client's environment, facilitates continued control of diabetes as the woman makes the transition from the hospital to the home and/or work environment.

Effects of acute smoking and exercise on high-density lipoprotein-cholesterol and subfractions in black female smokers.

This study investigated the effects of acute bouts of both exercise and smoking on high-density lipoprotein-cholesterol subfractions, HDL2-C and HDL3-C in black females. During two testing trials, seven subjects were exposed to either acute exercise or smoking. Treadmill exercise was performed at 70% of heart rate reserve for 15 minutes. Blood samples were taken before, immediately after, and 10 minutes after exercise. The smoking trial consisted of subjects smoking two cigarettes followed by 30 minutes of nonsmoking. Blood samples were taken before smoking, after each cigarette, and after two 15-minute intervals of nonsmoking. The exercise protocol resulted in a 10.8% increase in total HDL-C, primarily through an increase in the HDL2-C subfraction. The values returned to baseline within 10 minutes after exercise. Smoking one cigarette decreased total HDL-C by 10%. Neither subfraction was significantly effected by smoking; however, the HDL3-C subfraction was decreased 11% and HDL2-C subfraction was decreased 14.7% from resting values. The maximum reduction in HDL3-C subfraction occurred after the smoking of the first cigarette, while the maximum reduction in the HDL2-C subfraction occurred after the first 15-minute nonsmoking period. Acute cigarette smoking was associated with a decrease in total HDL-C that was maintained through 15 minutes of nonsmoking. It is suggested that the adverse effect on HDL-C by acute smoking is a significant contributor to coronary heart disease (CHD) risk in black females. Results further indicate that low-intensity exercise is capable of transiently increasing the total HDL-C via an increase in the anti-atherogenic HDL2-C subfraction.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of induced alkalosis on perception of exertion during intermittent exercise.

The purpose of this study was to evaluate the effects of metabolic alkalosis on differentiated ratings of perceived exertion during intermittent high-intensity exercise. Six endurance-trained females participated as subjects in this investigation. Each subject underwent three separate experimental trials in which NaHCO3 was ingested in either a single (0.3 g NaHCO3/kg body wt) or periodic schedule (0.12 g NaHCO3/kg body wt initially, with 0.18 g/kg body wt distributed in equal doses before each 5-min exercise bout). Calcium carbonate served as a placebo control. An intermittent exercise protocol was used in which each subject rode a cycle ergometer at 90% maximum O2 consumption for 5 min. Within each acid-base condition, the exercise protocol was repeated three times with 10-min rest periods interspersed. Differentiated ratings of perceived exertion for the legs (RPE-L), chest (RPE-C), and overall body (RPE-O) were attenuated under alkalotic treatment relative to placebo control regardless of pattern of NaHCO3 administration. RPE-L, RPE-C, and RPE-O were negatively correlated to the bicarbonate concentration of venous blood. This investigation suggests that perception of effort during high-intensity intermittent exercise can be related to buffering capacity of the blood.

The effect of acute exercise on high density lipoprotein-cholesterol and the subfractions in females.

The effect of an acute exercise session on high density lipoprotein-cholesterol (HDL-C) and the subfractions HDL2-C and HDL3-C was determined for 9 healthy females (VO2max = 46.62 +/- 4.82 ml X kg-1 min-1). Each subject underwent a continuous 40-min run on a treadmill at a workload corresponding to 70% of VO2max. A venous blood sample was obtained immediately prior to exercise and 5 min, 24, 48 and 96 h after the exercise. Pre-exercise values were: HDL-C (61.7 +/- 3.7 mg X dl-1); HDL2-C (22.4 +/- 2.1 mg X dl-1); HDL3-C (39.3 +/- 2.0 mg X dl-1). At 5 min after exercise, HDL-C (66.2 +/- 4.4 mg X dl-1) and HDL3-C (44.5 +/- 2.8 mg X dl-1) were significantly elevated (P less than 0.01) when compared to pre-exercise values. HDL-C and HDL3-C were not significantly different from pre-exercise at the remaining time points. In comparison with pre-exercise, HDL2-C showed no significant change at any of the post-exercise time points. Results indicated that the rise in HDL-C following acute exercise was due to an increase in the subfraction HDL3-C. The change in total HDL-C and HDL3-C was transient in that pre-exercise values were re-attained within 24 h following acute submaximal exercise.