Capacity-building and continuing professional development in healthcare and rehabilitation in low- and middle-income countries-a scoping review protocol.

BACKGROUND: A recent world health report suggests that there is a growing rehabilitation human resource crisis. This review focuses on the capacity-building needed to meet present and future rehabilitation challenges in low- and middle-income countries (LMICs). Capacity-building is the process by which individuals and organizations obtain, improve, and retain the skills, knowledge, tools, equipment, and other resources needed to do their jobs competently. The objectives of this review are (1) to determine how capacity-building has been defined, implemented, and evaluated in LMICs and (2) to provide an overview of the effectiveness of capacity-building initiatives. METHODS: In the first of seven stages, we will refine and delimit the research. Then, we will identify relevant studies by searching five biomedical databases, two rehabilitation databases, three regional databases, and three databases of gray literature. Two independent reviewers will then select the studies using a priori selection criteria. We will exclude incomplete records, records published prior to 2000 for databases and 2010 for gray literature, and records written in languages other than English or Spanish. We will also exclude records focusing on entry-to-practice programs in academic settings. For Objective 1, using qualitative analysis software, we will extract and analyze text from included records that define or explains capacity building. For Objective 2, using an online file-sharing platform, one reviewer will extract data describing the effectiveness of capacity-building interventions and a second reviewer will verify the accuracy, with disagreements resolved by consensus. The results will be collated using tables and charts. After synthesizing the results, we will discuss the practicality and applicability of the findings with partners from Honduras and Colombia. We will use several formats and venues including presentations and publications in English and Spanish to present our results. DISCUSSION: To our knowledge, this will be the first attempt to systematically identify knowledge of capacity-building and rehabilitation in LMICs. This scoping review results will offer unique insights concerning the breadth and depth of literature in the area. It is anticipated that results from this scoping review will guide efforts in future capacity-building efforts in rehabilitation in LMICs. REVIEW REGISTRATION: Busch AJ, Deprez D, Bidonde J, Ramírez PA, Araque EP. Capacity building and continuing professional development in healthcare and rehabilitation in low- and middle-income countries-a scoping review. 2021. https://doi.org/10.17605/OSF.IO/7VGXU .

RESUMEN: INTRODUCCIóN: La literatura mundial sugiere que existe una creciente crisis de recursos humanos en el área de rehabilitación. Esta Revisión Sistemática Exploratoria se centra en el desarrollo de capacidades en el área de rehabilitación en países de ingresos bajos y medianos (PIBM). El desarrollo de capacidades es el proceso mediante el cual las personas y las organizaciones obtienen, mejoran y retienen las habilidades, el conocimiento, las herramientas, el equipo y otros recursos necesarios para realizar su trabajo de manera competente. OBJETIVOS: Determinar cómo se ha definido, implementado y evaluado el desarrollo de capacidades en rehabilitación en los PIBM; y proporcionar una síntesis sobre la eficacia de las iniciativas de desarrollo de capacidades en rehabilitación en los PIBM. MéTODOS: En la primera de siete etapas, refinaremos las preguntas de la investigación. Luego, identificaremos estudios relevantes mediante la búsqueda de cinco bases de datos y tres bases de datos de literatura gris. Dos revisores en forma independiente seleccionarán los estudios utilizando criterios definidos a priori. Excluiremos registros (artículos y otra literatura) incompletos, publicados antes de 2000 para bases de datos y 2010 para literatura gris, y escritos en idiomas que no sean inglés o español. También excluiremos registros que sobre programas de ingreso a la práctica profesional (académicos). Para el Objetivo 1, extraeremos y analizaremos el texto que define las estrategias/iniciativas de desarrollo de capacidades en rehabilitación utilizando un software de análisis cualitativo. Para el Objetivo 2, un revisor extraerá datos que describen la efectividad de las intervenciones y un segundo revisor verificará la precisión de los datos utilizando una plataforma electrónica. Los desacuerdos entre revisores se resolverán por consenso. Los resultados se presentarán usando tablas y gráficos. Consultaremos con colegas de PIBM sobre la aplicabilidad de los hallazgos. Para la diseminación de resultados, usaremos presentaciones y publicaciones en inglés y español. DISCUSIóN: Hasta donde sabemos, esta será la primera revisión exploratoria para identificar el desarrollo de capacidades en rehabilitación en los PIBM. Se prevé que los resultados de esta revisión guiarán los esfuerzos futuros de desarrollo de capacidades en la rehabilitación de los PIBM.

Effects of Creatine Supplementation and Progressive Resistance Training in Stroke Survivors.

The purpose was to investigate the effects of progressive resistance training (PRT) and creatine supplementation in stroke survivors. Participants were randomized to one of two groups: creatine (n = 5; 51 ± 16y) or placebo (n = 3; 73 ± 8y) during 10 weeks of supervised PRT. Prior to and following PRT and supplementation, assessments were made for body composition (lean tissue and fat mass), muscle thickness, muscle strength (1-repetition maximum), functional exercise capacity (6-minute walk test, Berg Balance Scale; BBS), cognition (Montreal Cognitive Assessment; MoCA), and symptoms of anxiety (Generalized Anxiety Disorder Assessment-7; GAD-7) and depression (Center for Epidemiological Studies Depression Scale; CES-D). There were time main effects for leg press strength (increased; p = 0.001), chest press strength (increased; p = 0.003), elbow flexor muscle thickness (increased; p = 0.007), BBS (increased; p = 0.002), MoCA (increased; p = 0.031) and CES-D (decreased; p = 0.045). There was a group x time interaction for the 6 minute walk test (p = 0.039). The creatine group significantly increased walking distance over time (p = 0.002) with no change in the placebo group (p = 0.120). Ten weeks of PRT had some positive effects on measures of muscle strength and size, balance, cognition and depression. The addition of creatine to PRT significantly improved walking performance in stroke survivors.

The impact of the COVID-19 pandemic on the diet, training habits and fitness of Masters cyclists.

Background: The number of Masters-level athletes (≥ 35 years of age) taking part in cycling has increased in the past years which may have beneficial effects on their health. The restrictions brought on by the COVID-19 pandemic has the potential to negatively impact the diet, training and fitness of these individuals due to restrictions in place to slow the spread of the virus. Aim: To investigate how the COVID-19 pandemic impacted the diet, training and fitness of Masters-level cyclists. Methods: 32 Masters cyclists (12 males, 20 females; mean age 47 ± 10 years) completed two incremental exercise tests one month apart during the pandemic to assess sport-specific fitness. Participants also completed online questionnaires to report their sedentary behavior and dietary intake before and during the pandemic, and their training volume and intensity for a specified week in February (before the pandemic) and each of March, April and May (during the pandemic). Results: No differences were seen in fitness (p = 0.6), training volume (p = 0.24) or intensity (p = 0.79) and sedentary behavior (p = 0.14) during the pandemic. Energy intake was unchanged (p = 1.0) during the pandemic, but participants consumed lower amounts of key nutrients such as fiber, vitamin A, omega-3 fatty acids and potassium (p < 0.05) while consuming more alcohol (p = 0.008) and vitamin C (p = 0.03). Conclusions: Our data shows that the COVID-19 pandemic has undesirable effects on nutrient and alcohol intake of Masters cyclists without impacting their training regimes, which may have adverse effects on their overall health and fitness in the long term.

Effects of Postactivation Potentiation on Maximal Vertical Jump Performance After a Conditioning Contraction in Upper-Body and Lower-Body Muscle Groups.

ABSTRACT: Downey, RJ, Deprez, DA, and Chilibeck, PD. Effects of postactivation potentiation on maximal vertical jump performance after a conditioning contraction in upper-body and lower-body muscle groups. J Strength Cond Res 36(1): 259-261, 2022-Postactivation potentiation (PAP) involves preperformance contractions that can condition a muscle to enhance subsequent force generation and power output. Our purpose was to examine the effects of conditioning contractions that are specific or nonspecific to the target performance on PAP. Resistance-trained subjects (14 males and 10 females) performed a 7-second isometric contraction involving back squat, bench press (as conditioning contractions), or a control condition (rest) on different days in random order, before maximal vertical jump performance. The back squat as a conditioning contraction increased maximal vertical jump by 1.1 ± 3.0 cm (p < 0.05); however, the bench press as a conditioning contraction unexpectedly reduced maximal vertical jump performance by 1.4 ± 2.7 cm (p < 0.05). Conditioning contractions used to elicit a PAP response should use muscles that are specific to the performance movement. Contractions that are not biomechanically similar to the performance movement may hinder subsequent performance.

The impact of the COVID-19 pandemic on diet, fitness, and sedentary behaviour of elite para-athletes.

BACKGROUND: With the declaration of the COVID-19 pandemic the 2020 Paralympic Games were postponed, impacting the athletes' competition schedule for the year. Due to the interrupted competition schedule and potentially decreased motivation, Paralympic athletes may be at risk for a highly disrupted training schedule, impacting their ability to prepare for the 2021 Games. OBJECTIVE: Our purpose was to investigate the impact of the COVID-19 pandemic on the training, diet, and fitness of Paralympic cyclists and triathletes. METHODS: Twenty-four paracyclists and one paratriathlete (15 females and 10 males; age 37.6 ± 9.3 years) completed two incremental exercise tests to assess sport-specific fitness and reported their training volume and intensity for a specified week prior to the pandemic (February) and again in March, April, and May (during pandemic). Participants also reported their dietary intake and sedentary screen time prior to and during the pandemic. RESULTS: The amount of time spent engaging in sedentary screen time increased from 4.5 to 6.1 h (p < .001). No effect of the pandemic was found for training volume (14.2 vs 12.5 h; p = .18), intensity (678 vs 650; p = .36), or dietary intake (p > .05). While fitness test duration was nominally increased for the second test (27.3 vs 27.9 min; p = .02), no difference was seen in fitness (average power output: 201 W vs 204 W; p = .5). CONCLUSION: Time spent engaging in sedentary screen time activities increased during the COVID-19 pandemic, but there were no differences in training, fitness, or dietary intake over a short-term (3 months), demonstrating the resilience of these athletes.

The impact of the coronavirus disease 2019 (COVID-19) pandemic on university students' dietary intake, physical activity, and sedentary behaviour.

University students are a vulnerable group for poor dietary intake, insufficient physical activity and sedentary behaviour. The purpose of this study was to examine the impact of coronavirus disease (COVID-19) on university students' dietary intake, physical activity, and sedentary behaviour. Participants were students (n = 125) from the Universities of Saskatchewan and Regina. An online questionnaire was administered retrospectively (for prepandemic) and prospectively (during the pandemic) to examine students' dietary intake, physical activity, and sedentary behaviour. Overall, nutrient and caloric intakes were significantly reduced (p < 0.05) during the pandemic, and alcohol intake increased (p = 0.03). Before the pandemic, 16% and 54% of the participants were meeting the Canadian 24-Hour Movement Guidelines for Adults (18-64 years) of 150 min of moderate-vigorous physical activity and 8 h or less of sedentary activity, respectively. Only 10% met the guidelines for physical activity while 30% met the guidelines for sedentary behaviour during the pandemic. The minutes per week spent engaging in moderate to vigorous physical activity during the pandemic decreased by approximately 20% (p < 0.001). The hours spent in sedentary activities increased by 3 h per day (p < 0.001). Our findings confirm that during the pandemic, students' inadequate dietary intake, high alcohol consumption, low physical activity, and high sedentary behaviour were significantly compounded. Novelty: During COVID-19, the nutrient and caloric intakes of university students decreased, and alcohol intake increased significantly. University students' physical activity levels decreased, and sedentary activity increased significantly during COVID-19. During COVID-19 students did not engage in sufficient physical activity to offset the increased sedentary behaviour.

Stretching is Superior to Brisk Walking for Reducing Blood Pressure in People With High-Normal Blood Pressure or Stage I Hypertension.

BACKGROUND: Aerobic exercise is recommended for reducing blood pressure; however, recent studies indicate that stretching may also be effective. The authors compared 8 weeks of stretching versus walking exercise in men and women with high-normal blood pressure or stage 1 hypertension (ie, 130/85-159/99 mm Hg). METHODS: Forty men and women (61.6 y) were randomized to a stretching or brisk walking exercise program (30 min/d, 5 d/wk for 8 wk). Blood pressure was assessed during sitting and supine positions and for 24 hours using a portable monitor before and after the training programs. RESULTS: The stretching program elicited greater reductions than the walking program (P < .05) for sitting systolic (146 [9] to 140 [12] vs 139 [9] to 142 [12] mm Hg), supine diastolic (85 [7] to 78 [8] vs 81 [7] to 82 [7] mm Hg), and nighttime diastolic (67 [8] to 65 [10] vs 68 [8] to 73 [12] mm Hg) blood pressures. The stretching program elicited greater reductions than the walking program (P < .05) for mean arterial pressure assessed in sitting (108 [7] to 103 [6] vs 105 [6] vs 105 [8] mm Hg), supine (102 [9] to 96 [9] vs 99 [6] to 99 [7] mm Hg), and at night (86 [9] to 83 [10] vs 88 [9] to 93 [12] mm Hg). CONCLUSIONS: An 8-week stretching program was superior to brisk walking for reducing blood pressure in individuals with high-normal blood pressure or stage 1 hypertension.