Metabolic responses of running shod and barefoot in mid-forefoot runners.

BACKGROUND: The purposes of this study were to compare the oxygen cost, metabolic parameters and temporalspatial variables between barefoot and shod running in trained mid-forefoot runners. METHODS: Experienced runners (N.=21; 30±10.9 years; 16 men) performed two separate 20 minute treadmill running bouts at ~77% of estimated maximal heart rate. Rate of oxygen consumption (VO2), energy cost, fuel use and heart rate (HR) were collected continuously using a portable gas analyzer. Three-dimensional motion capture was used to measure temporalspatial parameters. RESULTS: Participants ran at a mean self-selected speed of 3.1±0.3 m/s for both conditions, at intensities corresponding to mean HR values of 146 bpm (shod) and 144 bpm (barefoot). Steady State VO2 was not different between the shod and barefoot conditions (39.4± 4.7 mL/kg*min vs. 40±5.2 mL/kg*min, respectively). The total energy expended in the shod and barefoot conditions was 974±134 kJ and 979±142 kJ. The average non-protein respiratory exchange ratios, proportions and amount of fat and carbohydrate used were not different between conditions. Cadence was 2.5% higher and center of gravity vertical displacement was 0.5 cm less for the barefoot condition (P<0.05). CONCLUSION: In trained mid-forefoot runners experienced with barefoot running, there are not significant metabolic differences between shod and barefoot running conditions. Barefoot running increases cadence and decreases foot contact time and vertical displacement. Experienced participants were likely able to titrate kinematics to standardize energy output and fuel use for a given running distance and speed irrespective of shoe wear.

Acute Effects of Enhanced Eccentric and Concentric Resistance Exercise on Metabolism and Inflammation.

This study compared the metabolic, cardiopulmonary and inflammatory responses of novel acute machine based concentrically-focused resistance exercise (CON RX) and eccentrically-focused resistance exercise (ECC RX). Twenty healthy adults (26.8 ± 5.9 yrs; 25.4 ± 4.0 kg/m2) performed two work-matched RX exercise sessions. Cardiopulmonary responses, rating of perceived exertion (RPE), soreness, oxygen consumption; (VO2) were collected during each session. Blood lactate and levels of inflammatory cytokines interleukin-1 alpha (IL1α), interleukin-6 (IL6) and tumor necrosis factor-alpha (TNFα) were analyzed pre, post ad 24 hours post-exercise. HR were higher (5-15bpm) during ECC RX (p<.05). Soreness ratings were consistently higher post-ECC RX compared to CON RX. VO2 area under the curve was higher during ECC than CON (31,905 ml/kg/min vs 25,864 ml/kg/min; p<.0001). Post-ECC RX, TNFα levels increased compared to CON RX 23.2 ± 23.9% versus 6.3 ± 16.2% ( p=.021). ECC RX induced greater metabolic, cardiopulmonary and soreness responses compared to matched CON RX. This may be due to recruitment of additional stabilizer muscles and metabolic stress during the ECC RX. These factors should be considered when designing ECC RX programs particularly for untrained persons, older adults or those with history of cardiovascular disease.

Outpatient rehabilitation outcomes in obese patients with orthopedic conditions.

BACKGROUND: Obesity is related to the development of functional and mobility impairment, musculoskeletal pain and orthopedic problems. Irrespective of age, obese children and adults have impaired walking capacity and body transfer ability, and difficulties navigating obstacle courses or community spaces. Obesity is related to relative strength deficits, musculoskeletal pain, kinesiophobia, low self-efficacy and a decline in quality of life. AIM: This review provides an update of the available evidence for the efficacy of outpatient rehabilitation programs for the treatment of disabling obesity. RESULTS: Outpatient rehabilitation programs can effectively improve muscle strength, self-confidence and physical function. Key rehabilitation components should include aerobic exercise (AX), resistance exercise (RX) and cognitive strategies to cope with the unique challenges posed by obesity. Available high quality evidence indicates that 3-18 month rehabilitation programs that included aerobic and strengthening exercise (2-3 days per week) with caloric restriction (typically 500-750 kcal deficit/ day), elicited the best changes in functional performance measures compared with exercise or diet alone. CONCLUSION: Comprehensive outpatient rehabilitation interventions coupled with diet can catalyze lifestyle patterns that improve and preserve physical function over the life span.

Myogenic and proteolytic mRNA expression following blood flow restricted exercise.

AIM: Resistance exercise performed at low loads (20-30% of maximal strength) with blood flow restriction (BFR) acutely increases protein synthesis and induces hypertrophy when performed chronically. We investigated myogenic and proteolytic mRNA expression 8 h following an acute bout of knee extension exercise. METHODS: Fifteen subjects (22.8 ± 3.7 years, eight men and seven women) were randomized to two exercise conditions: BFR or control exercise. All participants performed four sets of exercise (30, 15, 15 and 15 repetitions) at 20% of maximal strength. Persons in the BFR group had a cuff placed on the upper thigh inflated to 1.5 times brachial systolic blood pressure (cuff pressure range: 135-186 mmHg). Muscle biopsies from the vastus lateralis were excised 24 h before and 8 h following the exercise. RESULTS: RT-PCR analysis demonstrated no change in myogenic gene expression (insulin-like growth factor-1, MyoD, myogenin, myostatin - a negative regulator) with either exercise condition (P > 0.123). However, BFR exercise downregulated mRNA expression in transcripts associated with proteolytic pathways (FOXO3A, Atrogin-1 and MuRF-1) with no change in the control exercise condition. Specifically, median mRNA expression of FOXO3A decreased by 1.92-fold (P = 0.01), Atrogin-1 by 2.10-fold (P = 0.01) and MuRF-1 by 2.44-fold (P = 0.01). CONCLUSION: These data are consistent with the downregulation of proteolytic transcripts observed following high-load resistance exercise. In summary, myogenic genes are unchanged and proteolytic genes associated with muscle remodelling are reduced 8 h following low-load BFR exercise.

Obesity and mobility disability in the older adult.

Mobility disability is becoming prevalent in the obese older population (> or = 60 years of age). We included a total of 13 cross-sectional and 15 longitudinal studies based on actual physical assessments of mobility in the obese older population in this review. We systematically examined existing evidence of which adiposity estimate best predicted mobility disability. Cross-sectional studies (82-4000 participants) showed poorer lower extremity mobility with increasing obesity severity in both men and women. All longitudinal studies (1-22 years) except for one, reported relationships between adiposity and declining mobility. While different physical tests made interpretation challenging, a consistent finding was that walking, stair climbing and chair rise ability were compromised with obesity, especially if the body mass index (BMI) exceeded 35 kg m(-2). More studies found that obese women were at an increased risk for mobility impairment than men. Existing evidence suggests that BMI and waist circumference are emerging as the more consistent predictors of the onset or worsening of mobility disability. Limited interventional evidence shows that weight loss is related with increased mobility and lower extremity function. Additional longitudinal studies are warranted that address overall body composition fat and muscle mass or change on future disability.

Alterations in bilateral force judgment following strenuous eccentric exercise.

This study investigated the effects of strenuous eccentric exercise on bilateral force-matching ability. After unilaterally performing 50 maximal eccentric elbow actions, participants were evaluated for bilateral force-matching ability. Participants were asked to match a reference force held by the control (CNT) arm with their exercised (EXD) arm. The experimental condition was then reversed. Constant error (bias) of the EXD arm was increased through 5 days postexercise, when it underestimated the CNT force in all trials. In contrast, an overestimation of the EXD force by the CNT arm resulted in an increased constant and variable error (variability around the bias) through 5 days postexercise, when the EXD arm served as the force reference. Strenuous eccentric exercise severely compromises bilateral force-matching ability, regardless of whether the EXD attempted to match the reference force or served as the force reference, indicating central or peripheral alterations to force judgment.

The effect of training status on the serum creatine kinase response, soreness and muscle function following resistance exercise.

Untrained individuals develop muscle soreness and increased serum creatine kinase (CK) activity in the blood after strenuous, unaccustomed exercise. An unpublished observation in our laboratory revealed that trained weightlifters also experience considerable soreness after unaccustomed exercise, but may not show a dramatic CK response. This study examined the CK and soreness responses to strenuous exercise in weightlifters (TR, n = 10) and untrained subjects (UTR, n = 10). Trained subjects had a minimum of three years weightlifting experience, and regularly performed squats and leg presses. Untrained subjects had not participated in any regular resistance exercise for the past three years. Following two acclimation sessions, subjects reported to the lab on seven consecutive days and on the tenth day after knee extensor exercise. Weight training sessions occurred on day 1 for the knee extensors (KE) and day 2 for the knee flexors (KF). The weight training consisted of these exercises (sets): squat (5), leg press (3), leg extension and lunge (3) for the KE, double leg curls (6), single leg curls (3), stiff-legged deadlifts (4, TR group only) for the KF at 12 RM for all exercises. To document the stress due to exercise, the loss in strength (isometric peak torque, IPT) was assessed on a Biodex isokinetic dynamometer. Maximal voluntary IPT of the KE at 90 degrees and the KF at 80 degrees decreased 17-30% with no significant differences between groups. Muscle soreness during simulated squat leg curl movement was assessed by a 100 mm visual analog scale (VAS). Average peak KE soreness was 76 mm for TR and 58 mm for UTR, KF soreness was 60 mm for TR and 47 mm for UTR post-exercise. Serum CK levels were significantly different between groups with a peak of 1349 IU for TR and 3272 IU for the UTR (p < 0.01). Although the TR group experienced greater soreness than the UTR, peak serum CK activity was significantly lower, suggesting that trained individuals can develop severe soreness without the same degree of increase in serum CK activity observed in untrained individuals.

Neuromuscular control following maximal eccentric exercise.

Kinematic and electromyographic (EMG) analysis of a target-directed, maximal velocity movement was used to investigate the effects of high-force eccentric exercise on the neuromuscular control of elbow flexion. Ten non-weight-trained females [19.6 (1.6) years old] performed 50 maximal velocity elbow flexion movements from 0 to 1.58 rad (90 degrees), as rapidly as possible in response to a light stimulus, while kinematic and triphasic EMG parameters were measured. This was done three times pre-exercise, immediately and 1, 2, 3, 4, and 5 days following the 50 maximal eccentric elbow flexion actions. The eccentric exercise caused lengthening of kinematic parameters including total movement time and time to peak velocity. The EMG elements of the biceps brachii (b.) motor time, time to peak EMG, biceps b. burst duration, and the latency period between biceps b. and triceps b. bursts were lengthened post-exercise. These changes persisted for up to 5 days post-exercise. The exercise also caused a large increase in serum creatine kinase (CK) activity. It was concluded that high-force eccentric exercise in this population caused prolonged changes in neuromuscular control that were a function of exercise-induced disruption of the skeletal muscle. Compensation in the central motor program was such that the components of the triphasic EMG pattern were systematically lengthened.

The Exner Rorschach: an analysis of its clinical validity.

Data from Exner's 1985 and 1989 normative samples on nonpatient adults and comparison samples of patients with schizophrenia, depression, and character problems were reanalyzed using a standard of clinical significance appropriate for N = 1. The 1989 norms, which exclude Rorschach protocols with less than 14 responses, alter not only the number of significant variables, but also alter the ability of most variables that relate to form quality to differentiate among the patient comparison groups. The Exner Rorschach is judged to be a valid test for schizophrenia, but to have demonstrated little differential utility for depression and character disorders. It is recommended that the scoring of nonsignificant variables be abandoned.

Black/white IQ differences: does age make the difference?

Data are presented on racial differences from the norms of the Kaufman Assessment Battery for Children, the recent renorming of the Wechsler Adult Intelligence Scale-Revised, the Stanford-Binet IV, and Raven's Progressive Matrices. The premise of the present article is that, while the one standard deviation IQ difference between Black and White adults has remained constant, IQ differences between Black and White children are declining. These data are discussed in the context of previous studies on possible racial bias of IQ tests, as well as marked changes in educational and economic opportunities that have occurred in the United States in the decades since Jensen's (1969) article.

The fragile nature of MMPI code types.

The percent of code type agreement with the original MMPI is compared with the new MMPI-2, an earlier re-norming of the MMPI by Colligan, Osborne, Swenson, and Offord (1983), the MMPI-168, and test/retest comparisons of the MMPI with itself. Code type agreement ranges from lows of 31 to 41% for the test/retest comparability of the original MMPI with itself to 40 to 67% hit rates for the MMPI-2, the MMPI 1983 norms, and the MMPI-168. The effect of this on interpretation is discussed in the context of previous studies on the MMPI code types in relation to broadband diagnosis and comparisons of clinical accuracy of computerized reports that have utilized various MMPI versions.

DSM-III-R diagnosis and code types of the diagnostic inventory of personality and symptoms in an adolescent clinical population.

The relationships of high-point code types of the Diagnostic Inventory of Personality and Symptoms (DIPS) to the Diagnostic and statistical manual III-R (DSM-III-R; American Psychiatric Association, 1987) were explored for adolescent patients (N = 263). Twelve DIPS code types that relate code types to Axis I diagnoses are prepared. The three DIPS personality disorder cluster scales and the eight combinations thereof are presented as well. Six of the personality disorder cluster scale code types that relate to DSM-III-R Axis II categories are identified. Finally, a narrative summation of each of the code types is given.

Construct validity of the Diagnostic Inventory of Personality and Symptoms: external correlates.

This study extended knowledge of the construct validity of Vincent's Diagnostic Inventory of Personality and Symptoms (DIPS) by examining the relationships between the DIPS and the MMPI, the Millon Clinical Multiaxial Inventory, the Profile of Mood States, the Symptom Check List-90, and the California Psychological Inventory. Subjects were 300 predominantly male psychiatric inpatients. Correlational analyses revealed that the DIPS clinical scales were related most strongly to MMPI and MCMI clinical scales. Eleven of 14 DIPS clinical scales showed clinically significant correlations with similar scales of the external measures. The validities of the Stress-Adjustment Disorders and Psychological Factors Affecting Physical Condition scales were not ascertained directly.

Psychological profile of patients with Menière's disease.

Forty-eight patients with Menière's disease underwent psychological assessment with the Minnesota Multiphasic Personality Inventory and Diagnostic Inventory of Personality and Symptoms. Using the presence or absence of recurrent vertigo or chronic dysequilibrium as the differentiating feature, the results of two groups were compared. A clinical diagnosis of depression (axis I) was evident in 80% of the patients with active vestibular symptoms examined by the Minnesota Multiphasic Personality Inventory and 70% by the Diagnostic Inventory of Personality and Symptoms compared with 32% (Minnesota Multiphasic Personality Inventory) and 39% (Diagnostic Inventory of Personality and Symptoms) in the inactive group. The data support the addition of depression to the clinical picture of active Menière's disease.

DSM-III diagnosis and code types of the Diagnostic Inventory of Personality and Symptoms in public hospital settings.

The relationships of high-point code types of the Diagnostic Inventory of Personality and Symptoms (DIPS) to the Diagnostic and statistical manual III of the American Psychiatric Association (DSM-III) were explored for public hospital patients (N = 448). Nineteen DIPS code types that relate code types to Axis I diagnoses are prepared. The three DIPS personality disorder cluster scales and the eight combinations thereof are presented as well. Eight of the personality disorder cluster scale code types that relate to DSM-III Axis II categories are identified. Finally, a narrative summation of each of the code types is given.

DSM-III diagnosis and code types of the Diagnostic Inventory of Personality and Symptoms.

The relationships of high-point code types of the Diagnostic Inventory of Personality and Symptoms (DIPS) to the Diagnostic and Statistic Manual III of the American Psychiatric Association (DSM-III) were explored for patients (N = 316) in private mental health settings. Sixteen DIPS code types that relate code types to Axis I diagnoses are presented. The three DIPS personality disorder cluster scales and the eight combinations thereof are presented as well. Five of the personality disorder cluster scale code types that relate to DSM-III Axis II categories are identified. Finally, a narrative summation of each of the code types is given.

Factor structure of the Adolescent Multiphasic Personality Inventory in a psychiatric population.

The factor structure of the Adolescent Multiphasic Personality Inventory (AMPI) in a mental health center psychiatric patient population was examined (N = 70). Principal components factor analysis with Varimax rotation yielded four well defined factors, which accounted for 78% of the total variance. These factors can be conceptualized as neurotic, psychotic, characterological, and validity-defensiveness. Results support the construct validity of the AMPI and are discussed in relation to previous psychometric studies of psychopathology that used other objective personality inventories.

Diagnostic hit rates of high point codes for the Diagnostic Inventory of Personality and Symptoms using random assignment, base rates, and probability scales.

Diagnostic hit rates for the Diagnostic Inventory of Personality and Symptoms (DIPS) were compared to diagnosis by psychiatrists of the same patients (N = 60). Three methods were employed to determine the DIPS hit rates. The Probability Scale employing Bayesian concepts and base rates correctly classified 70% of the patients and was more accurate by far than the other two methods.

Factor structure of the Diagnostic Inventory of Personality and Symptoms in a private psychiatric hospital population.

The factor structure of the Diagnostic Inventory of Personality and Symptoms (DIPS) in a private psychiatric patient population was examined (N = 60). Principal components factor analysis with Varimax rotation yielded three well-defined factors, which accounted for 70% of the total variance. These factors can be conceptualized as neurotic, psychotic, and characterological. Results support the construct validity of the Diagnostic Inventory of Personality and Symptoms and are discussed in relation to previous psychometric studies of psychopathology that employed the MMPI.