An observational feasibility study - does early limb ergometry affect oxygen delivery and uptake in intubated critically ill patients - a comparison of two assessment methods.

BACKGROUND: Early rehabilitation can reduce ventilation duration and improve functional outcomes in critically ill patients. Upper limb strength is associated with ventilator weaning. Passive muscle loading may preserve muscle fibre function, help recover peripheral muscle strength and improve longer term, post-hospital discharge function capacity. The physiological effects of initiating rehabilitation soon after physiological stabilisation of these patients can be concerning for clinicians. This study investigated the feasibility of measuring metabolic demand and the safety and feasibility of early upper limb passive ergometry. An additional comparison of results, achieved from simultaneous application of the methods, is reported. METHODS: This was an observational feasibility study undertaken in an acute teaching hospital's General Intensive Care Unit in the United Kingdom. Twelve haemodynamically stable, mechanically ventilated patients underwent 30 minutes of arm ergometry. Cardiovascular and respiratory parameters were monitored. A Friedman test identified changes in physiological parameters. A metabolic cart was attached to the ventilator to measure oxygen uptake. Oxygen uptake was concurrently calculated by the reverse Fick method, utilising cardiac output from the LiDCO™ and paired mixed venous and arterial samples. A comparison of the two methods was made. Data collection began 10 minutes before ergometry and continued to recovery. Paired mixed venous and arterial samples were taken every 10 minutes. RESULTS: Twelve patients were studied; 9 male, median age 55 years, range (27-82), median APACHE score 18.5, range (7-31), median fraction inspired oxygen 42.5%, range (28-60). Eight patients were receiving noradrenaline. Mean dose was 0.07 mcg/kg/min, range (0.01-0.15). Early ergometry was well tolerated. There were no clinically significant changes in respiratory, haemodynamic or metabolic variables pre ergometry to end recovery. There was no significant difference between the two methods of calculating VO2 (p = 0.70). CONCLUSIONS: We report the feasibility of using the reverse Fick method and indirect calorimetry to measure metabolic demand during early physical rehabilitation of critically ill patients. More research is needed to ascertain the most reliable method. Minimal change in metabolic demand supports the safety and feasibility of upper limb ergometry. These results will inform future study designs for further research into exercise response in critically ill patients. TRIAL REGISTRATION: Clinicaltrials.gov No. NCT04383171. Registered on 06 May 2020 - Retrospectively registered. http://www.clinicaltrials.gov .

Physiological rationale of commonly used clinical exercise tests.

In order to measure cardiopulmonary performance for clinical and investigation purposes we need standardized tests which allow the comparison with standard values, between people, or individuals with themselves over time. The quest for the ideal exercise test has led to the development of several formats, the so called laboratory and field tests. Incremental exercise tests allow measurement of maximal exercise capacity and a host of submaximal variables of great interest. The physiological rationale of the tests and of the detection of interesting submaximal variables can be explained from the oxygen uptake and carbon dioxide output kinetic response to constant power exercise. When the muscles have to produce very high energy, the exercise is physiologically limited to relatively short duration. The minimum power at which an exercise can no longer be sustained for long periods of time is called critical power. Above critical power the time-power function shows a hyperbolic shape. This shape provides the rationale for understanding the properties, limitations and responsiveness to interventions of endurance tests such as constant power test on a cycle-ergometer or treadmill, endurance shuttle walk test and six-minute walk test.

Proposal of accuracy analysis of indoor tracking systems in basketball / Proposta de análise de precisão de sistemas de rastreamento interno em basquetebol

ABSTRACT The development of tracking technology caused a exponentially grow-up of research into this topic. The use of standardized methodologies is useful to contrast data of different studies. On the other hand, a low-cost reference system is needed. For this reason, the main aim of the present research is the description of a specific protocol to accuracy assessment of tracking location in indoor conditions in basketball. It can resume in three steps with detailed and easily procedures in the method section. The accuracy analysis method presented can report the centimeter of accuracy in each coordinate that the tracking system measure. A standardized protocol to evaluate the location on indoor conditions in basketball will provide to the sport science professionals a useful tool to analyze the accuracy and reliability of all tracking system, being the results can compare both within and between-court.

RESUMO O desenvolvimento da tecnologia de rastreamento causou um crescimento exponencial das pesquisas sobre esse tópico. O uso de metodologias padronizadas é útil para contrastar dados de diferentes estudos. Por outro lado, é necessário um sistema de referência de baixo custo. Por este motivo, o principal objetivo da presente pesquisa é a descrição de um protocolo específico para avaliação da acurácia do rastreamento de localização em condições internas no basquete. Pode retomar em três etapas com procedimentos detalhados e fáceis na seção do método. O método de análise de precisão apresentado pode relatar o centímetro de precisão em cada coordenada medida pelo sistema de rastreamento. Um protocolo padronizado para avaliar a localização em condições internas no basquetebol fornecerá aos profissionais de ciências do esporte uma ferramenta útil para analisar a precisão e a confiabilidade de todo o sistema de rastreamento, sendo que os resultados podem ser comparados dentro e entre as quadras.

Hyperventilation reduces the decrease of power output in a repeated sprint training in cyclists / La hiperventilación reduce la disminución de potencia en un entrenamiento de sprints repetidos en ciclistas / Hiperventilação reduz o decréscimo de potência em treinamento de sprints repetidos em ciclistas

Objective: To evaluate the effect of hyperventilation during a repeated sprint training on a cycle ergometer. Method: Seven cyclists performed two training sessions (10 maximal sprints of 10 s, with 60 s of rest), one with free ventilatory frequency and another one with hyperventilation (the participants breathed 60 cycles per minute during the last 30 s of recovery). Power, fatigue index and blood lactate concentration were analyzed. Results: The lactate concentrations pre- and post-training did not differ between trainings. Regarding to the maximum absolute and relative power, no differences were found between sprints in the hyperventilation condition, however, the values obtained in the first four sprints were higher than the latter two (p < 0.05) in the normal condition. In relation to the mean absolute and relative power, differences were found between sprints in both conditions. In the hyperventilation condition the value of the first sprint was higher than the penultimate (p < 0.05), while in the normal condition, the value of the first sprint was greater than the last four (p < 0.05) and the value of the second sprint exceeded the last two ones (p < 0.05). For the fatigue index, both protocols showed differences from the first to the eighth sprint (p < 0.05). Conclusion: Despite the absence of differences in lactate concentration between normal condition and hyperventilation condition, hyperventilation between efforts during a repeated sprint training could reduce the decrease in power output on a cycle ergometer

Objetivo: Evaluar el efecto de la hiperventilación durante una sesión de entrenamiento con esfuerzos repetidos en cicloergómetro. Método: Siete ciclistas realizaron dos entrenamientos (10 sprints máximos de 10 s con 60 s de recuperación), uno con frecuencia de respiración normal y otro con hiperventilación (los participantes respiraron a 60 ciclos por minuto durante los últimos 30 s de recuperación). Se analizaron la potencia, el índice de fatiga y la concentración sanguínea de lactato. Resultados: La concentración de lactato pre y postentrenamiento no difirió entre los entrenamientos. En relación con los valores de potencia máxima absoluta y relativa, no se encontraron diferencias entre los sprints en la condición de hiperventilación; sin embargo, en la condición normal, los valores obtenidos en los cuatro primeros sprints fueron superiores a los dos últimos (p < 0.05). En relación con los valores de potencia media absoluta y relativa, se encontraron diferencias entre los sprints en las dos condiciones (p < 0.001). En la condición de hiperventilación, el valor del primer sprint fue superior al penúltimo (p < 0.05), mientras que en la condición normal el valor del primer sprint fue superior a los últimos cuatro (p < 0.05) y el valor del segundo fue mayor que los dos últimos (p < 0.05). Para el índice de fatiga, ambos protocolos presentaron diferencias desde el primer hasta el octavo sprint (p < 0.05). Conclusión: Hiperventilación entre esfuerzos máximos repetidos puede reducir la disminución de potencia en cicloergómetro

Objetivo: Avaliar o efeito da hiperventilação durante um treinamento de sprints repetidos em um cicloergômetro. Método: Sete ciclistas executaram duas sessões de treinamento (10 sprints máximos de 10s, com 60s de descanso), sendo um com frequência ventilatória livre e outro com hiperventilação (o participante respirava 60 ciclos por minuto, durante os 30s de recuperação). Potência, índice de fadiga e as concentrações séricas de lactato foram analisadas. Resultados: As concentrações de lactato pré- e pós-treinamento não diferiram entre os treinamentos. Em relação à potência máxima e relativa, não foram encontradas diferenças entre os sprints na condição de hiperventilação, entretanto, os valores obtidos nos quatro primeiros sprints foram maiores que os dois últimos (p < 0.05) executados em condições normais. Quanto à média da potência absoluta e relativa, foram encontradas diferenças entre ambas as condições. Na condição de hiperventilação, o valor do primeiro sprint foi maior que o penúltimo (p < 0.05), enquanto que em condição normal, o valor do primeiro sprint foi maior que os quatro últimos (p < 0.05) e o valor do segundo sprint excedeu os dois últimos (p < 0.05). O índice de fadiga demonstrou diferenças do primeiro ao oitavo sprint (p < 0.05) em ambos os protocolos. Conclusão: Apesar da ausência de diferenças nas concentrações de lactato entre as condições estudadas, a execução da hiperventilação entre os sprints pode reduzir o decréscimo da potência em um treinamento de sprints repetidos em cicloergômetro

Novel paddle stroke analysis for elite slalom kayakers: Relationship with force parameters.

This study was divided into two complementary parts. In Part 1, we proposed a novel paddle strokes analysis based on the force signal from a 30-s all-out tethered test; and compared these results with video recordings. In Part 2, we investigated the relationship between force data from the same test with paddle stroke results from both methods. Eleven male elite slalom kayakers (Brazilian national team) were evaluated. The tethered test was conducted for force parameters analysis (peak-force, mean-force, impulse). Video recording analysis was conducted, and the performed strokes (V.NumberPaddle) was counted and frequency (V.FrequencyPaddle) calculated by the V.NumberPaddle divided by 30 (i.e. total time of test). The new method consisted of performed strokes and frequency achievement from a load cell force signal analysis (S.NumberPaddle and S.FrequencyPaddle, respectively). Paired test-t did not show difference between methods results, but significant correlations were only obtained for the number of paddle strokes. Force parameters were only correlated with S.NumberPaddle and S.FrequencyPaddle. Overall, considering the theoretical and practical application, we propose that the new method should be used as an alternative to the video recording.

Monitoring Morphologic Changes in Male Rowers Using Limited Portable Echocardiography Performed by a Frontline Physician.

Athletes' hearts have been studied for adaptive changes in response to exercise. Physiologic changes are normal responses to intense athletic training regimens, whereas pathologic changes predispose athletes to sudden cardiac death. The two alterations overlap in clinical presentation. Research continues to investigate the upper limits of cardiac remodeling to aid clinical decision making. Studying normal changes that occur in response to exercise will advance physicians' understanding of physiologic responses to exercise and potentially improve clinical distinction. To expand this body of knowledge, we present an observational case series that describes morphologic changes in athlete's hearts concurrent with performance measurements.

Energy cost and physiological responses during upper body exercise with different postures / Gasto energético y respuestas fisiológicas durante el ejercicio de miembros superiores en diferentes posturas / Custo energético e respostas fisiológicas durante exercício de membros superiores realizado em diferentes posturas

Objective. The physiological and energy demand responses to upper body aerobic exercises performed with different postures are not well known. The aim of the present study was to compare energy cost and physiological responses to upper body aerobic exercises performed with different postures. Method. Eight physically active males (>1 year active), untrained in upper body aerobic exercises, with 28.2 ± 5.7 years, ht 173.7 ± 7.4 cm, body mass 74.1 ± 11.4 kg, VO2Peak 30.2 ± 2.09 ml/kg/min and Body Mass Index 24.4 ± 2.5 kg/m2 performed a preliminary maximal test and two upper body aerobic exercises 30-min sessions in different days. Results. Metabolic and hemodynamic responses to upper body aerobic exercises performed in sit-position and vertical-position were compared. The vertical-position trial showed greater total energy cost (14.3%; p = 0.01), higher lipid catabolism (p = 0.001) and a higher double product (p = 0.04), when compared to the sit-position trial. Conclusion. The upper body aerobic exercises performed in vertical-position induces a higher energetic demand and cardiovascular load than in sit-position (AU)

Objetivo. Poco se conoce sobre la influencia de la variación de la postura sobre las respuestas fisiológicas y el gasto energético durante ejercicios con miembros superiores. El objetivo de este estudio fue comparar las respuestas fisiológicas durante ejercicios con miembros superiores realizados en diferentes posturas. Método. Ocho hombres físicamente activos (>1 año), no practicantes de ejercicio con miembros superiores, con 28.2 ± 5.7 años de edad, 173.7 ± 7.4 cm de talla, 74.1 ± 11.4 kg de masa corporal, VO2Pico de 30.2 ± 2.09 ml/kg/min e índice de masa corporal de 24.4 ± 2.5 kg/m2, fueron sometidos a un test máximo preliminar y a 2 sesiones de ejercicios con miembros superiores de 30 min de duración, en días distintos. Resultados. Las respuestas metabólicas y hemodinámicas, en la postura de sentado y vertical, fueron comparadas. La sesión de ejercicio con miembros superiores realizado en postura vertical generó mayor gasto energético total (14.3%; p = 0.01), mayor catabolismo lipídico (p = 0.001) y mayor doble producto (p = 0.04), en comparación con la sesión realizada en postura sentado. Conclusiones. El ejercicio con miembros superiores realizados en postura vertical eleva el gasto energético y la sobrecarga cardiovascular, en comparación con ejercicios con miembros superiores en postura sentado (AU)

Objetivo. As respostas fisiológicas e de custo energético durante exercícios aeróbios de membros superiores realizados em diferentes posturas não são bem conhecidas. O objetivo do presente estudo foi comparar o custo energético e as respostas fisiológicas durante exercícios aeróbios de membros superiores realizados em diferentes posturas. Método. Oito homens fisicamente ativos e não praticantes de exercícios aeróbios de membros superiores, com 28.2 ± 5.7 anos de idade, 173.7 ± 7.4 cm de estatura, 74.1 ± 11.4 kg de massa corporal, VO2Pico de 30.2 ± 2.09 ml/kg/min e Índice de Massa Corporal de 24.4 ± 2.5 kg/m2, foram submetidos a um teste máximo preliminar e a 2 sessões de exercícios aeróbios de membros superiores com duração de 30 min, em dias distintos. Resultados. Respostas metabólicas e hemodinâmicas obtidas nas posturas sentada e verticalizada foram comparadas. A sessão de exercícios aeróbios de membros superiores realizado na postura verticalizada gerou maior gasto energético total (14.3%; p = 0.01), maior catabolismo lipídico (p = 0.001) e maior duplo produto (p = 0.04), quando comparado com a sessão postura sentada. Conclusões. O exercícios aeróbio de membros superiores realizado em postura verticalizada eleva o custo energético e a sobrecarga cardiovascular, quando comparado com oexercício aeróbio de membros superiores em postura sentada (AU)

Defining the number of bouts and oxygen uptake during the "Tabata protocol" performed at different intensities.

It is usually reported that the Tabata protocol (TP) is performed with eight bouts of 20:10 intervals at a load equivalent to 170% of i V̇ O2max. However, the feasibility of accumulating 160 s of work at 170% i V̇ O2max has been questioned. This article tested the intensity that would allow the performance of the original TP on a cycle ergometer, and measured the highest value of oxygen consumption (V̇ O2) obtained during the TP and the time spent above 90% of the maximal oxygen uptake (V̇ O2max) during the TP performed at different intensities. Thirteen young active males (25.9 ±â€¯5.5 years, 67.9 ±â€¯9.2 kg, 1.70 ±â€¯0.06 m, 23.6 ±â€¯3.1 kg·m-2) participated in the study. Participants performed a graded exertion test (GXT) on a cycle ergometer to obtain maximum oxygen consumption (V̇ O2max) and the intensity associated with V̇ O2max (i V̇ O2max). V̇ O2, maximal heart rate (HRmax), and number of bouts performed were evaluated during the TP performed at 115%, 130%, and 170% of i V̇ O2max. V̇ O2max, HRmax, and iV̇ O2max were 51.8 ±â€¯8.0 mL.kg-1·min-1, 186 ±â€¯10 bpm, and 204 ±â€¯26 W, respectively. The number of bouts performed at 115% (7 ±â€¯1 bouts) was higher than at 130% (5 ±â€¯1 bouts) and 170% (4 ±â€¯1 bouts) (p < .0001). The highest V̇ O2 achieved at 115%, 130%, and 170% of iV̇ O2max was 54.2 ±â€¯7.9 mL·kg-1·min-1, 52.5 ±â€¯8.1 mL·kg-1·min-1, and 49.6 ±â€¯7.5 mL·kg-1·min-1, respectively. Non significant difference was found between the highest V̇ O2 achieved at different intensities, however qualitative magnitude-inference indicate a likely small effect between 115% and 170% of iV̇ O2max. Time spent above 90% of the V̇ O2max during the TP at 115% (50 ±â€¯48 s) was higher than 170% (23 ±â€¯21 s; p < 0.044) with a probably small effect. In conclusion, our data suggest that the adequate intensity to perform a similar number of bouts in the original TP is lower than previously proposed, and equivalent to 115% of the iV̇ O2max. In addition, intensities between 115 and 130% of the iV̇ O2max should be used to raise the time spent above 90% V̇O2max.

Validation of the ADAMO Care Watch for step counting in older adults.

BACKGROUND: Accurate measurement devices are required to objectively quantify physical activity. Wearable activity monitors, such as pedometers, may serve as affordable and feasible instruments for measuring physical activity levels in older adults during their normal activities of daily living. Currently few available accelerometer-based steps counting devices have been shown to be accurate at slow walking speeds, therefore there is still lacking appropriate devices tailored for slow speed ambulation, typical of older adults. This study aimed to assess the validity of step counting using the pedometer function of the ADAMO Care Watch, containing an embedded algorithm for measuring physical activity in older adults. METHODS: Twenty older adults aged ≥ 65 years (mean ± SD, 75±7 years; range, 68-91) and 20 young adults (25±5 years, range 20-40), wore a care watch on each wrist and performed a number of randomly ordered tasks: walking at slow, normal and fast self-paced speeds; a Timed Up and Go test (TUG); a step test and ascending/descending stairs. The criterion measure was the actual number of steps observed, counted with a manual tally counter. Absolute percentage error scores, Intraclass Correlation Coefficients (ICC), and Bland-Altman plots were used to assess validity. RESULTS: ADAMO Care Watch demonstrated high validity during slow and normal speeds (range 0.5-1.5 m/s) showing an absolute error from 1.3% to 1.9% in the older adult group and from 0.7% to 2.7% in the young adult group. The percentage error for the 30-metre walking tasks increased with faster pace in both young adult (17%) and older adult groups (6%). In the TUG test, there was less error in the steps recorded for older adults (1.3% to 2.2%) than the young adults (6.6% to 7.2%). For the total sample, the ICCs for the ADAMO Care Watch for the 30-metre walking tasks at each speed and for the TUG test were ranged between 0.931 to 0.985. CONCLUSION: These findings provide evidence that the ADAMO Care Watch demonstrated highly accurate measurements of the steps count in all activities, particularly walking at normal and slow speeds. Therefore, these data support the inclusion of the ADAMO Care Watch in clinical applications for measuring the number of steps taken by older adults at normal, slow walking speeds.

A BRIEF NOTE ON THE VALIDITY AND RELIABILITY OF THE RATING OF PERCEIVED EXERTION SCALE IN MONITORING EXERCISE INTENSITY AMONG CHINESE OLDER ADULTS IN HONG KONG.

This study examined the validity and reliability of the Cantonese Borg 6-20 Rating of Perceived Exertion (RPE) scale in monitoring exercise intensity among Chinese older adults. A total of 40 apparently healthy older adults (16 men, 24 women; M age=69.8 yr., SD=4.56) performed two trials of three intermittent exercise tests administered in random order using the cycle ergometer. Results revealed significant differences of RPE, HR, and VO2 between different workloads, and there were moderate to high correlations between RPE and HR and VO2, respectively. Results also found moderate consistency of RPE between Trial 1 and Trial 2. These indicated that the Cantonese 6-20 RPE scale can be used as a valid and reliable tool for monitoring exercise intensity among the Chinese older adults.

Plasma cytokine and exertional responses in relation to exercise intensity and volume of exercising muscle mass during arm-crank ergometry.

This original study investigated the effect of submaximal exercise intensity and volume of contracting muscle mass on plasma inflammation-mediating cytokine and perceived exertional responses to acute arm-crank ergometry (ACE). Twelve recreationally active but upper limb untrained males performed 30 min of (i) low-intensity (40% peak oxygen uptake) ACE (LOW); (ii) moderate-intensity (60% peak oxygen uptake) ACE (MOD); and (iii) concurrent low-intensity (40% peak oxygen uptake) ACE plus lower limb cycle ergometry to match total power output in MOD (HYB). Plasma concentrations of interleukin (IL)-6, IL-10, IL-1ra, adrenaline, and cortisol were determined at rest, immediately postexercise, and 1 h and 2 h postexercise. Heart rate (HR) and differentiated ratings of perceived exertion (RPE) were also recorded. Plasma IL-6 concentrations were elevated (p < 0.05) immediately postexercise and 1 h postexercise (∼ 2.5-fold) in all trials and 2 h postexercise in MOD (3-fold). Plasma IL-1ra concentrations were elevated (p < 0.05) 2 h postexercise in MOD only (2-fold). No plasma IL-10, cortisol, and adrenaline responses were observed. HR and differentiated RPE were significantly higher during MOD than HYB and LOW. Peripheral RPE were significantly higher than central and overall RPE in each trial. Thirty minutes of moderate intensity ACE initiated a plasma cytokine response associated with the protective effect of regular exercise against cardiovascular and metabolic disease risk. Further work is required to establish an optimal intensity and duration of upper limb exercise to maximise the anti-inflammatory potential whilst managing the risk of over-use injury.

Self-pacing increases critical power and improves performance during severe-intensity exercise.

The parameters of the power-duration relationship for severe-intensity exercise (i.e., the critical power (CP) and the curvature constant (W')) are related to the kinetics of pulmonary O2 uptake, which may be altered by pacing strategy. We tested the hypothesis that the CP would be higher when derived from a series of self-paced time-trials (TT) than when derived from the conventional series of constant work-rate (CWR) exercise tests. Ten male subjects (age, 21.5 ± 1.9 years; mass, 75.2 ± 11.5 kg) completed 3-4 CWR and 3-4 TT prediction trial protocols on a cycle ergometer for the determination of the CP and W'. The CP derived from the TT protocol (265 ± 44 W) was greater (P < 0.05) than the CP derived from the CWR protocol (250 ± 47 W), while the W' was not different between protocols (TT: 18.1 ± 5.7 kJ, CWR: 20.6 ± 7.4 kJ, P > 0.05). The mean response time of pulmonary O2 uptake was shorter during the TTs than the CWR trials (TT: 34 ± 16, CWR: 39 ± 19 s, P < 0.05). The CP was correlated with the total O2 consumed in the first 60 s across both protocols (r = 0.88, P < 0.05, n = 20). These results suggest that in comparison with the conventional CWR exercise protocol, a self-selected pacing strategy enhances CP and improves severe-intensity exercise performance. The greater CP during TT compared with CWR exercise has important implications for performance prediction, suggesting that TT completion times may be overestimated by CP and W' parameters derived from CWR protocols.

Accurate prediction of cardiorespiratory fitness using cycle ergometry in minimally disabled persons with relapsing-remitting multiple sclerosis.

OBJECTIVE: To examine the accuracy of predicting peak oxygen consumption (VO(2peak)) primarily from peak work rate (WR(peak)) recorded during a maximal, incremental exercise test on a cycle ergometer among persons with relapsing-remitting multiple sclerosis (RRMS) who had minimal disability. DESIGN: Cross-sectional study. SETTING: Clinical research laboratory. PARTICIPANTS: Women with RRMS (n=32) and sex-, age-, height-, and weight-matched healthy controls (n=16) completed an incremental exercise test on a cycle ergometer to volitional termination. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Measured and predicted VO(2peak) and WR(peak). RESULTS: There were strong, statistically significant associations between measured and predicted VO(2peak) in the overall sample (R(2)=.89, standard error of the estimate=127.4 mL/min) and subsamples with (R(2)=.89, standard error of the estimate=131.3 mL/min) and without (R(2)=.85, standard error of the estimate=126.8 mL/min) multiple sclerosis (MS) based on the linear regression analyses. Based on the 95% confidence limits for worst-case errors, the equation predicted VO(2peak) within 10% of its true value in 95 of every 100 subjects with MS. CONCLUSIONS: Peak VO(2) can be accurately predicted in persons with RRMS who have minimal disability as it is in controls by using established equations and WR(peak) recorded from a maximal, incremental exercise test on a cycle ergometer.

The impact of disseminating the whole-community project '10,000 Steps': a RE-AIM analysis.

BACKGROUND: There are insufficient research reports on the wide-scale dissemination of effective whole-community physical activity (PA) programs. The purpose of this paper is to evaluate the impact of the wide-scale dissemination of '10,000 Steps', using the RE-AIM framework. METHODS: Dissemination efforts targeted a large region of Belgium and were concentrated on media strategies and peer networks of specific professional organizations, such as local health promotion services. Heads of department of 69 organizations received an on-line survey to assess project awareness, adoption, implementation and intended continuation of '10,000 Steps'. On the individual level, 755 citizens living in the work area of the organizations were interviewed for project awareness and PA levels. Measures were structured according to the RE-AIM dimensions (reach, effectiveness, adoption, implementation, maintenance). Independent sample t and chi-square tests were used to compare groups for representativeness at the organizational and individual level, and for individual PA differences. RESULTS: Of all organizations, 90% was aware of '10,000 Steps' (effectiveness - organizational level) and 36% adopted the project (adoption). The global implementation score was 52%. One third intended to continue the project in the future (maintenance) and 48% was still undecided. On the individual level, 35% of citizens were aware of '10,000 Steps' (reach). They reported significantly higher leisure-time PA levels than those not aware of '10,000 Steps' (256 ± 237 and 207 ± 216 min/week, respectively; t = -2.8; p < .005) (effectiveness - individual level). When considering representativeness, adoption of '10.000 Steps' was independent of most organizational characteristics, except for years of experience in PA promotion (7.6 ± 4.6 and 2.9 ± 5.9 years for project staff and non-project staff members, respectively; t = 2.79; p < 0.01). Project awareness in citizens was independent of all demographic characteristics. CONCLUSIONS: '10,000 Steps' shows potential for wide-scale dissemination but a supportive linkage system seems recommended to encourage adoption levels and high quality implementation.

Changes in elbow flexor power with intermittent contractions and various loads.

This study examined intermittent elbow flexion every 2 sec. for 1 min. using various loads to study the properties of muscle power output and their relationship to peak power, defined as the maximum power output. 18 young men performed intermittent explosive elbow flexion (30 times x min.(-1)) using 30%, 40%, and 50% maximal voluntary contraction (MVC). The power outputs at 30% and 40% MVC slightly decreased (rate of decrease from peak power to average power output during the 26 to 30 contractions was about 5%). However, at 50% MVC, there was a marked decrease (33.6%). Power output for 8 contractions was significantly larger at 50% MVC than at 30% and 40% MVC, but after 9 contractions there was no significant difference between 40% and 50% MVC. In addition, after 27 contractions, 40% MVC was significantly larger than 30% and 50% MVC. That is, the tendency for power output to decrease differed among the various loads. The rate of decrease of power outputs showed no significant correlation with peak power for each load. Therefore, the rate of decrease of power output in intermittent contractions may help sustain the power output and cannot be evaluated as accurately as peak power.

Sex differences of intermittent elbow flexion power using various loads.

This study was designed to clarify a sex difference in muscle power output properties by intermittent elbow flexion using various loads. 10 young males and 10 young females performed intermittent elbow flexion power outputs at 30 times x min.(-1) for 1 min. using 30%, 40%, and 50% MVC loads. For both sexes, the decreasing peak power showed a similar trend between trials at all loads, and the reliability of each power parameter was good. The power outputs decreased largely with increasing load mass, and the power output in 50% MVC for males markedly decreased to the same level as that during the final phase in 30% MVC. Although the absolute value of regression coefficients for males became significantly larger with increasing load mass, that for females showed a significant difference only between 30% and 50% MVC. In 50% MVC, a large decrease for males was observed. Maximal peak power outputs were significantly larger with increasing load mass for both sexes, but for males more than for females. In both sexes, there were no significant differences among final powers of each load mass, and between total powers of 40% and 50% MVC. For the sum of every 5 consecutive power outputs, males showed significant differences between 30% and 40% MVC in all periods after the 6th contraction, but females did not and also between 30% and 50% MVC in periods after the 16th contraction. In conclusion, it is considered that power outputs in the latter phases in 50% MVC are affected largely by muscle fatigue, and an intermittent power output test with 50% MVC can measure sustained power (fatigue resistance) in the latter phases, but there is a sex difference in the tendency to decrease.

Differences in left ventricular mass between overweight and normal-weight preadolescent children.

This study examined cardiac and arterial differences between overweight and normal-weight preadolescent children. Twenty children (10.2 +/- 0.4 years of age) classified as overweight, on the basis of age-appropriate body mass index (BMI) cutoffs, were compared with 43 normal-weight controls. Height, mass, and body surface area were measured. Relative body fat and lean body mass were estimated from skinfold thickness. Each child's weekly physical activity metabolic equivalent (PAME) was calculated using a standardized questionnaire, and his or her sexual maturation was self-assessed using the Tanner scale. Peak aerobic power was assessed using a cycle ergometer and normalized to lean body mass. Mean arterial pressure was calculated from systolic and diastolic blood pressure (DBP) measurements taken with a Finapres. Cardiac dimensions were measured, using Mu-mode 2-dimensional echocardiography, and normalized to body surface area and height2.7. Left carotid artery pulse pressure (CaPP) was assessed with applanation tomometry. Overweight boys and girls had a higher left ventricular mass (LVM) and LVMHT2.7 than normal-weight boys and girls. CaPP was signficantly lower in the overweight than in the normal-weight groups, whereas PAME and relative peak aerobic power were significantly higher in the boys than the girls. Although overweight children had significantly higher stroke volumes and cardiac outputs than normal-weight children, ejection fraction was similar in the weight groups. Adjusted LVMHT2.7 was associated with cardiac volume measurements, BMI, and DBP in normal-weight children, whereas in the overweight children LVMHT2.7 did not significantly correlate with any variable. In conclusion, we found that cardiovascular adaptations can be seen in prepubescent overweight children as young as 10 years of age.

Validation of the Omni Scale of Perceived Exertion in a sample of Spanish-speaking youth from the USA.

Whether the translation of verbal descriptors from English to Spanish affects the validity of the Children's OMNI Scale of Perceived Exertion is not known, so the validity of a Spanish version of the OMNI was examined with 32 boys and 36 girls (9 to 12 years old) for whom Spanish was the primary language. Oxygen consumption, ventilation, respiratory rate, respiratory exchange ratio, heart rate, and ratings of perceived exertion for the overall body (RPE-O) were measured during an incremental treadmill test. All response values displayed significant linear increases across test stages. The linear regression analyses indicated RPE-O values were distributed as positive linear functions of oxygen consumption, ventilation, respiratory rate, respiratory exchange ratio, heart rate, and percent of maximal oxygen consumption. All regression models were statistically significant. The Spanish OMNI Scale is valid for estimating exercise effort during walking and running amongst Hispanic youth whose primary language is Spanish.