Exercise during decompression reduces the amount of venous gas emboli.

To determine the effects of moderate, intermittent exercise during decompression on the Doppler detectable amount of venous gas emboli (VGE), 29 healthy male volunteers performed 44 wet (8 degrees +/- 2 degrees C) dives to 45 msw (450 kPa) for 30 min with standard air decompression. During compression and the bottom period, all subjects were inactive; during decompression, 28 remained inactive, 11 performed leg exercise, and 5 did arm exercise. Intermittent exercise was controlled at approximately 50% of each subject's arm or leg aerobic capacity. At 30-min intervals after surfacing, subjects were monitored with a Doppler ultrasonic bubble detector. The Doppler scores were used to calculate the Kisman Integrated Severity Score (KISS). The KISS were log transformed (with zeroes being equivalent to log 0.01) and analyzed with a one-way analysis of variance. No significant differences (P < or = .05) between mean KISS scores after arm or leg exercise were observed, thus these data were pooled and compared to those of the inactive controls. The mean pooled KISS after exercising during decompression were significantly lower than those of the inactive controls. Moderate, intermittent exercise during decompression apparently reduces the amount of Doppler-detectable VGE after diving. The incidence rate of decompression sickness in both groups was not significantly different (P < 0.05).

Reliability for a walk/run test to estimate aerobic capacity in a brain-injured population.

The purpose of this study was to establish the test-retest reliability of a modified 20 m shuttle walk/run test of aerobic capacity for adults with traumatic brain injuries (TBI). A convenience sample of 18 TBI patients (16 males, two females) between 19 and 58 years of age, was tested using an externally paced, progressive, maximal shuttle walk/run, on two separate occasions, within a 1-week period. The test involving walking or running a 20 m shuttle course while maintaining the pace determined by signals from a prerecorded audiotape. The initial slow walking pace (2.4 km/h) was increased gradually, each minute, until the patient could not continue. Statistical analyses revealed excellent reliability for the number of levels completed (ICC = 0.976), total walk/run test time (S) (ICC = 0.983) and maximal heart rate attained during the final level (bpm) (ICC = 0.964). Although small but significant increases were noted for the number of levels completed during the second test, the modified 20 m shuttle walk/run seems to be a reliable field test which may be useful for assessing the aerobic capacity of brain-injured adults.

Screening of health risk factors prior to exercise or a fitness evaluation of adults with traumatic brain injury: a consensus by rehabilitation professionals.

A modified Delphi technique was used to obtain group consensus among 31 rehabilitation professionals (RPs) from nine rehabilitation centres throughout the province of Québec (Canada) to ascertain their expert opinion on the health risk factors (HRF) to be verified prior to beginning an exercise programme or evaluation for patients with traumatic brain injury (TBI). From the initial survey 87 items were generated, which were later regrouped into 27 HRFs. The relative importance of each HRF in regard to being screened before exercise in a population with TBI was then assessed by each RP using a five-point ordinal scale (1 = not important to 5 = extremely important). HRFs that were considered extremely important by at least 50% of HPs include: angina pectoris, aortic stenosis, exertional syncope, musculoskeletal sequelae which are exacerbated by exercise, outward aggressivity, pulmonary embolism, uncontrolled epilepsy (seizures), and ventricular arrhythmias. Professionals involved in exercising patients with TBI may find these factors useful to the efficient conduct of their rehabilitation programme.

Underestimation of subjects' monitored radial pulse rates following traumatic brain injury.

The measurement of heart rate is fundamental to the scientific programming of physical activity. In this analysis, 20 male subjects with traumatic brain injuries underestimated their heart rates as measured by the radial pulse both at rest and after brief, light exercise.

[Adoption of health promotion behaviors in first-year baccalaureate nursing students: pilot study]. / Comportements de promotion de la santé d'étudiantes de première année au baccalauréat en sciences infirmières: etude pilote.

The goal of this pilot study was to test the usefulness of Pender's (1987) theoretical model in predicting the adoption of health-promotion behaviours in 176 first-year undergraduate nursing students. Hierarchical regression analysis indicated that the perception of self-efficacy, perception of one's state of health, the influence of professors, and place of birth are predictive variables of health-promoting behaviours in this group. The results of this study suggest, among other things, that it is important for professors to use strategies that foster and support students' confidence in their ability to commit to health-promoting behaviours. A longitudinal study currently in progress will examine whether a health-oriented program significantly influences the adoption of health-promotion behaviours in nursing students during their university education.

Aerobic and neuromuscular training: effect on the capacity, efficiency, and fatigability of patients with traumatic brain injuries.

To assess the value of exercise training after traumatic brain injury (TBI), 14 sedentary adults with TBI performed a supervised circuit training program three times per week for 16 consecutive weeks. The program was designed to include equal volumes of both aerobic and neuromuscular training to increase the subjects' oxidative capacity and simultaneously improve their locomotor efficiency. Before and after the experimental training program, height, weight, blood pressure, skinfold thickness, grip strength, abdominal muscular endurance, and submaximal and peak rates of oxygen consumption were measured, and the index of physiological fatigue was calculated. The TBI patients manifested subnormal oxidative capacities and above-average oxygen costs locomotion. A 16-week circuit training program of moderate intensity and prolonged duration increased their oxidative capacity (p less than .01) and abdominal muscular endurance (p less than .01), but failed to reduce their oxygen cost of walking. Moderate and prolonged activity seems beneficial in the comprehensive rehabilitation of patients with TBI. The index of physiologic fatigability seems to be useful for the assessment, evaluation, and vocational placement of individuals with TBI.

Respiratory function in the muscular dystrophies.

The purpose of this investigation was to compare the respiratory function of patients with different clinical types of muscular dystrophy (MD). A total of 190 patients representing facioscapulohumeral MD (n = 20), limb-girdle MD (n = 50), Becker MD (n = 20), Duchenne MD (n = 90), and the "intermediate" type of MD (n = 10) were studied using simple spirometric respiratory function tests. The respiratory modifications observed in the 3 adult forms indicate that pulmonary function was almost normal. Respiratory function in Duchenne muscular dystrophy (DMD) was always characterized by a restrictive syndrome which severely impaired pulmonary function. The vital capacity (VC) underwent ascending, plateau, and descending phases during the course of the disease. The VC at the plateau stage may be used as an estimate of life span. The most interesting finding was the high degree of variability in the restrictive syndrome associated with DMD. In the DMD group 30% presented a severe restrictive respiratory syndrome associated with a life span of less than 20 years (Type 1), 40% had a serious restrictive syndrome and variable mortality (Type 2), and the remaining 30% had a moderate restrictive respiratory syndrome (Type 3).

Prone immersion physical exercise therapy in three children with cystic fibrosis: a pilot study.

Prone immersion physical exercise therapy has been used successfully in the physical rehabilitation of middle-aged adults with moderate to severe chronic obstructive pulmonary disease. The purpose of this pilot project was to evaluate the effects of PIPE therapy in children with cystic fibrosis. Three children with CF, two boys aged 6 and 14 years and one girl aged 15 years, voluntarily participated in the experimental training program. The patients performed individualized group exercise three times a week on alternate days for 28 consecutive weeks at an intensity of approximately 75 percent aerobic capacity. Duration of exercise gradually increased from 15 (3 x 5 minutes) to 60 (3 x 20 minutes) minutes while the rest period after each exercise was constant at two minutes. PIPE training resulted in increased physical work capacity and maximal oxygen consumption in all three subjects. Curiously, these changes were not accompanied by training bradycardia.