Psychological needs, self-efficacy, motivation, and resistance training outcomes in a 16-week barbell training program for adults.

Background: Despite extensive research on the relationship between psychological factors and aerobic training, there remains a gap in understanding these relationships within resistance training (RT), particularly barbell-based RT. This study aimed to examine the associations between basic psychological needs, behavioral regulation, self-efficacy, and a longitudinal barbell-based RT program for adults. Methods: Forty-three adults (M age = 45.09 ± 10.72) were recruited from the Competitive Edge resistance training program at a medical fitness center in Northwest Montana. The study followed an 18-week schedule: 8 weeks of training, 1 week of active recovery, and 8 additional weeks of training. Results: The results reveal several significant findings. First, the basic psychological need for competence significantly increased from baseline (M = 5.06) to post-program (M = 5.30), (p = 0.017). Second, the composite score of the BREQ-3 significantly predicting muscular strength improvements in the deadlift (ß = 3.64, p = 0.039). Third, both mastery (p = 0.021) and resilience (p = 0.007) self-efficacy subscales increased from baseline to post-program. Fourth, exploratory analyses indicated that the reasons to exercise scale predicted increases in muscular endurance with the weight management (ß = 10.016, p = 0.046) and solitude (ß = 6.792, p = 0.037) subscales. Conclusion: These findings highlight the importance of psychological factors in predicting strength outcomes and muscular endurance, suggesting that psychological interventions may complement physical training to maximize benefits. This research contributes valuable insights into how psychological factors influence training outcomes, potentially guiding future interventions and program designs to better support strength development and endurance in resistance training contexts.

Evaluation and management of the acutely injured worker.

Approximately 3 million work-related injuries were reported by private industries in 2011, and primary care physicians provided care for approximately one out of four injured workers. To appropriately individualize the treatment of an injured worker and expedite the return to work process, primary care physicians need to be familiar with the workers' compensation system and treatment guidelines. Caring for an injured worker begins with a medical history documenting preexisting medical conditions, use of potentially impairing medications and substances, baseline functional status, and psychosocial factors. An understanding of past and current work tasks is critical and can be obtained through patient-completed forms, job analyses, and the patient's employer. Return to work in some capacity is an important part of the recovery process. It should not be unnecessarily delayed and should be an expected outcome communicated to the patient during the initial visit. Certain medications, such as opioids, may delay the return to work process, and their use should be carefully considered. Accurate and legible documentation is critical and should always include the location, date, time, and mechanism of injury.

Safety of symptom-limited cardiopulmonary exercise testing in patients with chronic heart failure due to severe left ventricular systolic dysfunction.

BACKGROUND: To assess the safety of symptom-limited exercise testing in patients with New York Heart Association class II-IV heart failure symptoms due to left ventricular systolic dysfunction, we investigated the frequency of all-cause fatal and nonfatal major cardiovascular (CV) events among subjects enrolled in a prospective clinical trial (HF-ACTION). We hypothesized that exercise testing would be safe, as defined by a rate for all-cause death of <0.1 per 1,000 tests and a rate of nonfatal CV events <1.0 per 1,000 tests. METHODS: Before enrollment and at 3, 12, and 24 months after randomization, subjects were scheduled to complete a symptom-limited graded exercise test with open-circuit spirometry for analysis of expired gases. To ensure the accurate reporting of exercise test-related events, we report deaths and nonfatal major CV events per 1,000 tests at months 3, 12, or 24 after randomization. RESULTS: A total of 2,331 subjects were randomized into HF-ACTION. After randomization, 2,037 subjects completed 4,411 exercise tests. There were no test-related deaths, exacerbation of heart failure or angina requiring hospitalization, myocardial infarctions, strokes, or transient ischemic attacks. There was one episode each of ventricular fibrillation and sustained ventricular tachycardia. There were no exercise test-related implantable cardioverter defibrillator discharges requiring hospitalization. These findings correspond to zero deaths per 1,000 exercise tests and 0.45 nonfatal major CV events per 1,000 exercise tests (95% CI 0.11-1.81). CONCLUSIONS: In New York Heart Association class II-IV patients with severe left ventricular systolic dysfunction, we observed that symptom-limited exercise testing is safe based on no deaths and a rate of nonfatal major CV events that is <0.5 per 1,000 tests.