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Service learning opportunities allow students to apply their knowledge and skills through engagement with their community. Previous studies have suggested that student-led exercise testing and health screening can benefit both students and their community participants. In a third-year kinesiology course, "Physiological Assessment and Training," students at the University of Prince Edward Island are provided with an introduction to health-focused personal training and develop and manage personalized training programs for community volunteers. The purpose of this study was to investigate the impact of student-led training programs on student learning. A secondary purpose was to investigate the perceptions of community members participating in the program. Community participants included 13 men and 43 women with stable health (mean age: 52.3 ± 10.0 yr). Students led participants through aerobic and musculoskeletal fitness tests before and after completion of a 4-wk student-designed training program based on participants' fitness and interests. Students reported that the program was enjoyable and improved understanding of fitness concepts and confidence in personal training. Community participants rated the programs as enjoyable and appropriate and viewed students as professional and knowledgeable. These results suggest that student-led personal training programs provide meaningful benefits to students and their community volunteers.NEW & NOTEWORTHY Undergraduate kinesiology students oversaw exercise testing and 4 wk of supervised exercise for community volunteers. Both students and their community participants reported enjoying the experience, and students stated that it also improved their understanding and confidence. These results suggest that student-led personal training programs provide meaningful benefits to students and their community volunteers.
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Teste de Esforço , Estudantes , Masculino , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Aprendizagem , Voluntários , PrescriçõesRESUMO
The purpose of this study was to assess the perceptions and practices around physical activity counselling and exercise prescription of dietitians in Nova Scotia. Dietitians (n = 95) across Nova Scotia completed an online self-reflection survey regarding their current physical activity and exercise (PAE) practices. Most (51%; n = 48) reported no previous PAE educational training. Dietitians infrequently prescribed exercise to their patients (16% ± 26% of appointments) or provided PAE referrals (17% ± 24%). Dietitians reported moderate confidence (57% ± 21%) performing PAE counselling and included PAE-related content in half of patient appointments (52% ± 31%). Almost all respondents (95%) identified interest in further PAE education or training. Open-ended responses also demonstrated the need for community-based exercise programs (28% of providers) and qualified exercise professionals to refer to (25%). Overall, dietitians report rarely providing patients with written exercise prescriptions or referrals to other professionals for PAE content but do frequently include PAE in patient appointments. Dietitians in Nova Scotia are well positioned to promote PAE, but more educational training and improved referral systems to qualified exercise professionals or community exercise programs is strongly desired. Exercise professionals and dietitians should concurrently advocate for these changes and collaborate to help more patients lead physically active lifestyles.
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Nutricionistas , Aconselhamento , Exercício Físico/fisiologia , Humanos , Nova Escócia , PrescriçõesRESUMO
PURPOSE: Some cyclists consume flattened cola during competitive events, but limited research has investigated if cola beverages elicit ergogenic effects, particularly on high-intensity exercise performance. Whether the potentially beneficial effects of cola are due to the caffeine and/or the carbohydrate content is also unclear. This study assessed the ergogenic effects of different cola beverages on performance during a constant power bout (CPB) and subsequent high-intensity interval efforts in competitive cyclists. METHODS: In a randomized, double-blind, cross-over design, competitive cyclists (n = 13; [Formula: see text]O2max 65.7 ± 5.9 ml kg-1 min-1) completed a 45-min CPB at 69% of maximum workload (Wmax), followed by four maximal 1-min high-intensity intervals (HII) against a resistance of 0.5 N kg-1. Participants consumed 16 ml kg-1 total (intermittantly at four time points) of flattened decaffinated diet cola (PLA), caffeinated diet cola (CAF) or cola containing caffeine and carbohydrates (CAF + CHO). RESULTS: During the CPB, ratings of perceived exertion were lower in the CAF + CHO and CAF conditions compared to PLA (both, P < 0.04). Compared to PLA, CAF + CHO and CAF similarly increased (all, P < 0.049) mean power (CAF + CHO: 448 ± 51 W; CAF: 448 ± 50 W; PLA: 434 ± 57 W), minimum power (CAF + CHO: 353 ± 45 W; CAF: 352 ± 51 W; PLA: 324 ± 49 W) and total work (CAF + CHO: 26.9 ± 3.1 kJ; CAF: 26.9 ± 3.0 kJ; PLA: 26.0 ± 3.4 kJ), but not peak power (CAF + CHO: 692 ± 117 W; CAF: 674 ± 114 W; PLA: 670 ± 113 W; all, P > 0.57) during the HII. CONCLUSION: Cola containing caffeine with or without carbohydrates favorably influenced perceived effort during the CPB and enhanced mean and minimum power during repeated maximal intervals. We provide evidence supporting the consumption of commercially available cola for high-intensity cycling in competitive cyclists.
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Desempenho Atlético , Ciclismo/fisiologia , Cafeína/farmacologia , Cola , Comportamento Competitivo/efeitos dos fármacos , Substâncias para Melhoria do Desempenho/farmacologia , Adulto , Estudos Cross-Over , Carboidratos da Dieta/farmacologia , Método Duplo-Cego , Humanos , Masculino , Consumo de Oxigênio/efeitos dos fármacosRESUMO
PURPOSE: Cardiovagal baroreflex sensitivity (cvBRS) reflects the efficiency of modulating heart rate in response to changes in systolic blood pressure. International guidelines recommend that older adults achieve at least 150 min of moderate-vigorous physical activity per week. We tested the hypothesis that older adults who achieve these guidelines will exhibit greater cardiovagal baroreflex sensitivity versus those who do not. METHODS: A cross-sectional comparison of older adults who did (active, 66 ± 5 years, 251 ± 79 min/week; n = 19) and who did not (inactive, 68 ± 7 years, 89 ± 32 min/week; n = 17) meet the activity guidelines. Beat-by-beat R-R intervals (electrocardiography) and systolic blood pressure (finger photoplethysmography) were recorded. Spontaneous cardiovagal baroreflex sensitivity was assessed using the sequence technique from 10 min of resting supine data. Cardiovagal baroreflex function was also measured during early phase II and phase IV of the Valsalva maneuver. Peak oxygen uptake was determined during maximal cycle ergometry. Moderate-vigorous intensity physical activity and time spent sedentary were assessed over 5 days using the PiezoRx and activPAL, respectively. RESULTS: Groups had similar peak oxygen uptake (active 25 ± 9 vs. inactive 22 ± 6 ml/kg/min; p = 0.218) and sedentary time (active 529 ± 60 vs. inactive 568 ± 88 min/day; p = 0.130). However, the active group had greater (all, p < 0.019) cvBRS at rest (9.1 ± 2.7 vs. 5.0 ± 1.9 ms/mmHg), during phase II (8.2 ± 3.8 vs. 5.4 ± 2.1 ms/mmHg), and during phase IV (9.9 ± 3.8 vs. 5.6 ± 1.6 ms/mmHg). In the pooled sample, moderate-vigorous physical activity was positively correlated (all, p < 0.015) with spontaneous (R = 0.427), phase II (R = 0.447), and phase IV cvBRS (R = 0.629). CONCLUSIONS: Independent of aerobic fitness and sedentary time, meeting activity guidelines was associated with superior cardiovagal baroreflex sensitivity at rest and during the Valsalva maneuver in older adults.
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Barorreflexo/fisiologia , Exercício Físico/fisiologia , Frequência Cardíaca/fisiologia , Guias de Prática Clínica como Assunto/normas , Nervo Vago/fisiologia , Manobra de Valsalva/fisiologia , Idoso , Idoso de 80 Anos ou mais , Antropometria/métodos , Pressão Sanguínea/fisiologia , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Internacionalidade , Masculino , Pessoa de Meia-IdadeRESUMO
Background: Physical activity and exercise (PAE) counselling and exercise prescriptions increase patient physical activity. However, the perceptions/practices of chiropractors are poorly understood. Methods: We surveyed the practices among chiropractors working in Canada (n=50) and Internationally (n=37). Chiropractors completed self-reflection questionnaires regarding their current practices and perceptions towards providing PAE counselling to patients. Chiropractor responses were obtained via Canadian provincial survey and educational workshops. Results: Chiropractor respondents included PAE content and exercise prescriptions in most patient appointments (67±27% and 59±35%, respectively), but the largest barriers (2.5/4.0) and least confidence were in their patients to follow through (52±21%). Canadian respondents reported higher knowledge (~0.4/4.0 higher), greater self-confidence (10-20% higher), and provided more PAE recommendations (8%) and prescriptions (16%) than International respondents. Chiropractor respondents were least comfortable advising patients with cancer. Conclusion: Chiropractor respondents may serve as health promotors to address patient inactivity, and the challenges identified should be addressed through educational training.
Contexte: Les conseils en matière d'activité physique et d'exercice (APE) et les prescriptions d'exercices augmentent l'activité physique des patients. Cependant, les perceptions et les pratiques des chiropraticiens sont mal comprises. Méthodologie: Nous avons enquêté sur les pratiques des chiropraticiens travaillant au Canada (n=50) et à l'étranger (n=37). Les chiropraticiens ont rempli des questionnaires d'auto-réflexion sur leurs pratiques actuelles et leurs perceptions quant à l'offre de conseils aux patients en matière d'APE. Les réponses des chiropraticiens ont été obtenues au moyen d'une enquête provinciale canadienne et des ateliers éducatifs. Résultats: Les chiropraticiens interrogés ont inclus le contenu d'APE et les prescriptions d'exercices dans la plupart des rendez-vous avec les patients (67±27 % et 59±35 %, respectivement), mais les obstacles les plus importants (2,5/4,0) et la confiance la plus faible étaient à propos du fait que leurs patients allaient suivre les conseils (52±21 %). Les répondants canadiens ont fait état d'une meilleure connaissance (~0,4/4,0 de plus), d'une plus grande confiance en soi (1020 % de plus) et ont fourni plus de recommandations (8 %) et de prescriptions (16 %) en matière d'APE que les répondants internationaux. Les chiropraticiens interrogés se sont montrés moins à l'aise pour conseiller les patients atteints de cancer. Conclusion: Les chiropraticiens interrogés peuvent servir de promoteurs de la santé pour lutter contre l'inactivité des patients, et les difficultés relevées devraient être abordées dans le cadre d'une formation.
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OBJECTIVE: Test the hypothesis that smoking, fast-food consumption, and binge drinking were negatively associated with academic performance in Canadian undergraduate students. PARTICIPANTS: Undergraduate students across Canada [n = 411 (335â) aged: 22 ± 4 years] completed a questionnaire regarding their lifestyle behaviors and academic grades. METHODS: Relationships between lifestyle behaviors and academic performance were assessed via covariate-adjusted multiple regressions. Mediation models were used to test whether significant relationships between smoking/fast-food and grades were explained by binge drinking. RESULTS: Smoking (ß= -4.00, p < .001) and binge drinking (ß= -1.98, p = .002) were independent predictors of grades (average: 84 ± 8%). Binge drinking partially mediated the relationships between smoking (indirect effect ß= -1.19, 95%CI [-2.49, -0.08] and fast-food consumption (indirect effect: ß= -.75, 95%CI [-1.20, -0.29]), with grades. CONCLUSIONS: These findings highlight the negative influence of binge drinking, smoking, and fast-food consumption on academic success, with binge drinking as a partial mediator of these relationships.
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Canadian 24 h movement guidelines recommend engaging in >150 min/week of moderate-vigorous-intensity physical activity and ≤8 h/day of sedentary time. Half of Canadian post-secondary students do not meet physical activity or sedentary time guidelines. This pan-Canadian study aimed to (1) identify commonly cited motivators/barriers to exercise, and (2) determine which motivators/barriers were most influential for attaining physical and sedentary activity guidelines. A total of 341 respondents (279 females, 23 ± 4 years old, 53% met activity guidelines, 49% met sedentary guidelines) completed an online survey regarding undergraduate student lifestyle behaviours. Improved physical health (74% of respondents), mental health (67%), physical appearance (60%), and athletic performance (28%) were the most common motivators to exercise. The most common barriers were school obligations (68%), time commitments (58%), job obligations (32%), and lack of available fitness classes (26%). Students citing improved athletic performance (odds ratio (OR) = 1.94, p = 0.02) were more likely to adhere to activity guidelines, while those who selected physical health (OR = 0.56, p = 0.03) and physical appearance (OR = 0.46, p = 0.001) as motivators were less likely to meet activity guidelines. Students who cited school obligations as a barrier were less likely (OR = 0.59, p = 0.03) to meet sedentary guidelines. The motivators and barriers identified provide a foundation for university-led initiatives aimed at promoting physical activity and reducing sedentary time among undergraduate students. Strategies that positively re-frame students' physical health and appearance-based motivations for exercise may be particularly useful in helping more students achieve national activity recommendations.
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Exercício Físico , Comportamento Sedentário , Adulto , Canadá , Feminino , Humanos , Instituições Acadêmicas , Estudantes/psicologia , Adulto JovemRESUMO
Health care providers (HCPs) are entrusted with providing credible health-related information to their patients/clients. Patients/clients who receive physical activity and exercise (PAE) advice from an HCP typically increase their PAE level. However, most HCPs infrequently discuss PAE or prescribe PAE, due to the many challenges (e.g., time, low confidence) they face during regular patient care. The purpose of this study was to ascertain HCPs' perspectives of what could be done to promote PAE in health care. HCPs (n = 341) across Nova Scotia completed an online self-reflection survey regarding their current PAE practices and ideas to promote PAE. The sample consisted of 114 physicians, 114 exercise professionals, 65 dietitians, and 48 nurses. Quantitative textual analysis (frequency of theme ÷ number of respondents) was performed to identify common themes to promote PAE in health care. In the pooled sample, the primary theme cited was to increase the availability of community programs (24.1% of respondents), followed by more educational opportunities for providers (22.5%), greater promotion of PAE from HCPs (17.1%), reducing financial barriers experienced by patients/clients (16.3%), and increasing availability of qualified exercise professionals (15.0%). Altogether, increased PAE education and greater availability of affordable community PAE programs incorporating qualified exercise professionals, would reduce barriers preventing routine PAE promotion and support the promotion of PAE in Nova Scotia.
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Pessoal de Saúde , Médicos , Aconselhamento , Atenção à Saúde , Exercício Físico , Pessoal de Saúde/educação , HumanosRESUMO
Physical activity is an important component of health and well-being, and is effective in the prevention, management, and treatment of numerous non-communicable chronic diseases. Despite the known health benefits of physical activity in all populations, most Canadians do not meet physical activity recommendations. Physicians play a key role in assessing, counselling, and prescribing physical activity. Unfortunately, many barriers, including the lack of adequate education and training, prevent physicians from promoting this essential health behaviour. To support Canadian medical schools in physical activity curriculum development, a team of researchers, physicians, and exercise physiologists collaborated to develop a key set of learning objectives deemed essential to physician education in physical activity counselling and prescription. This commentary will review the newly developed Canadian Physical Activity Counselling Learning Objectives and give case examples of three Canadian medical schools that have implemented these learning objectives.
L'activité physique est une composante importante de la santé et du bien-être, et elle est efficace dans la prévention, la prise en charge et le traitement de nombreuses maladies chroniques non transmissibles. Malgré les bienfaits qu'on lui reconnaît pour la santé des populations, la plupart des Canadiens ne suivent pas les recommandations en matière d'exercice. Les médecins jouent un rôle clé dans l'évaluation, le counseling et la prescription de l'activité physique, mais de nombreux obstacles, dont le manque de formation adéquate, les empêchent de promouvoir cette habitude de vie essentielle pour la santé. Afin d'aider les facultés de médecine canadiennes dans l'élaboration de leur cursus sur l'activité physique, une équipe composée de chercheurs, de médecins et de physiologistes de l'exercice a collaboré à la définition d'un ensemble d'objectifs d'apprentissage jugés indispensables à la formation des médecins pour qu'ils puissent offrir des conseils sur l'activité physique et la prescrire. Ce commentaire passe en revue les nouveaux objectifs d'apprentissage en matière de counseling en activité physique et donne des exemples de cas de trois facultés de médecine canadiennes qui ont mis en Åuvre ces objectifs d'apprentissage.
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The physical fitness of Canadian adults has decreased over the past 30 years, while sedentary time has increased. However, it is unknown if university students studying human movement exhibit similar population declines. Physical fitness (i.e., anthropometrics, musculoskeletal fitness, and aerobic fitness) and habitual activity (e.g., physical activity, stationary time, etc.) was measured in a cohort of kinesiology students (Post30; 2010-2016; n = 129 males, 224 females) using standardized fitness testing and accelerometry, respectively. Physical fitness was compared to data collected on a cohort of students from the same institution and program, 30 years prior (i.e., Pre, 1984-1987, n = 103 males, 73 females). Post30 had greater waist circumference (males: 83.6 ± 9.1 cm vs. 77.8 ± 8.3 cm, females: 77.1 ± 9.7 cm vs. 70.3 ± 5.2 cm, both p < 0.001) and lower estimated maximal aerobic fitness (males: 55 ± 11 vs. 63 ± 7, females: 45 ± 10 vs. 50 ± 7 mLO2/kg/min, both, p < 0.001). Compared to Pre, male Post30 vertical jump (53.6 ± 10.2 vs. 57.0 ± 8.4 cm, p = 0.04) and female Post30 broad jump (178.7 ± 22.1 vs. 186.0 ± 15.5 cm, p < 0.001) were lower. A subsample (n = 65) of Post30 whose habitual activity was assessed, met the aerobic portion of Canadian physical activity guidelines (~400 min/week), but spent excessive amounts of time stationary (10.7 h/day). Current kinesiology students may not be immune to population decreases in physical fitness. Relative to previous group of students interested in movement, fitness was lower in our sample, potentially attributed to excessive stationary time. Regular assessment of physical fitness in kinesiology curriculums may be valuable to understand these declining trends in undergraduate students that mimic population declines in fitness.
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Aptidão Física , Estudantes , Adulto , Humanos , Masculino , Feminino , Canadá , Exercício Físico , Comportamento SedentárioRESUMO
BACKGROUND: Glioblastoma is the most common primary brain malignancy in adults, accounting for approximately 48% of all brain tumors. Standard treatment includes radiation and temozolomide chemotherapy. Glioblastomas are highly vascular and can cause vasogenic brain edema and mass effect, which can worsen the neurologic symptoms associated with the disease. The steroid dexamethasone (DEX) is the treatment of choice to reduce vasogenic edema and intracranial pressure associated with glioblastoma. However high-dose DEX or long-term use can result in muscle myopathy in 10%-60% of glioblastoma patients, significantly reducing functional fitness and quality of life (QOL). There is a wealth of evidence to support the use of exercise as an adjuvant therapy to improve functional ability as well as help manage treatment-related symptoms. Specifically, resistance training has been shown to increase muscle mass, strength, and functional fitness in aging adults and several cancer populations. Although studies are limited, research has shown that exercise is safe and feasible in glioblastoma populations. However, it is not clear whether resistance training can be successfully used in glioblastoma to prevent or mitigate steroid-induced muscle myopathy and associated loss of function. OBJECTIVE: The primary purpose of this study is to establish whether an individualized circuit-based program will reduce steroid-induced muscle myopathy, as indicated by maintained or improved functional fitness for patients on active treatment and receiving steroids. METHODS: This is a 2-armed, randomized controlled trial with repeated measures. We will recruit 38 adult (≥18 years) patients diagnosed with either primary or secondary glioblastoma who are scheduled to receive standard radiation and concurrent and adjuvant temozolomide chemotherapy postsurgical debulking and received any dose of DEX through the neurooncology clinic and the Nova Scotia Health Cancer Center. Patients will be randomly allocated to a standard of care waitlist control group or standard of care + circuit-based resistance training exercise group. The exercise group will receive a 12-week individualized, group and home-based exercise program. The control group will be advised to maintain an active lifestyle. The primary outcome, muscle myopathy (functional fitness), will be assessed using the Short Physical Performance Battery and hand grip strength. Secondary outcome measures will include body composition, cardiorespiratory fitness, physical activity, QOL, fatigue, and cognitive function. All measures will be assessed pre- and postintervention. Participant accrual, exercise adherence, and safety will be assessed throughout the study. RESULTS: This study has been funded by the Canadian Cancer Society Atlantic Cancer Research Grant and the J.D. Irving Limited-Excellence in Cancer Research Fund (grant number 707182). The protocol was approved by the Nova Scotia Health and Acadia University's Research Ethics Boards. Enrollment is anticipated to begin in March 2022. CONCLUSIONS: This study will inform how individualized circuit-based resistance training may improve functional independence and overall QOL of glioblastoma patients. TRIAL REGISTRATION: ClinicalTrails.gov NCT05116137; https://www.clinicaltrials.gov/ct2/show/NCT05116137. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/37709.
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Qualified exercise professionals (QEPs) have the training, knowledge, and scope of practice to effectively provide physical activity counselling, prescribe exercise, and deliver exercise programming to patients with or without chronic diseases. Healthcare providers identify an interest in referring patients to QEPs; however, the impact of exercise referral schemes (ERS) involving QEPs on patients' physical health is unclear. A scoping review regarding the available evidence of ERS involving healthcare provider referrals to QEPs was performed. A literature search was conducted in 6 databases (initially: n = 6011 articles), yielding n = 23 articles examining QEP delivered physical activity counselling (n = 7), QEP supervised exercise training (n = 4), or some combination (n = 12). Although studies were heterogeneous in methods, procedures, and populations, ERSs increased patients' subjective physical activity levels. Few studies incorporated objective physical activity measures (n = 5/23), and almost half measured aerobic fitness (n = 11/23). ERS involving a QEP that includes activity counselling and/or exercise programming/training report favourable impacts on patients' subjectively measured physical activity and objectively measured aerobic fitness. Based on the existing literature on the topic, this scoping review provides recommendations for designing and evaluating ERS with QEPs that include: objective measures, long-term follow-up, QEP qualifications, and the cost-effectiveness of ERS. Novelty: ERS involving QEPs report increased patients' perceived physical activity level and may improve patients' cardiorespiratory fitness. Promoting the collaboration of QEPs with other healthcare providers can enhance patients' physical fitness and health. This scoping review provides recommendations for the design and evaluation of ERS involving QEPs.
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Terapia por Exercício , Exercício Físico , Comunicação Interdisciplinar , Atenção Primária à Saúde/organização & administração , Encaminhamento e Consulta , Aconselhamento , Humanos , Aptidão FísicaRESUMO
BACKGROUND: Educational workshops help physicians (MDs) include physical activity and exercise (PAE) content in more patient appointments. It is unclear if MDs with varying degrees of confidence discussing PAE with their patients equally benefit from such training. We evaluated whether MDs' initial confidence affects the impact of an educational PAE workshop. METHODS: MDs (n = 63) across Canada completed self-reflection questionnaires initially and 3-months following a PAE workshop. MDs were divided into low-confidence [confidence score (out of 100%): <40%; n = 21], medium-confidence (40-60%; n = 19) and high-confidence (>60%; n = 23). RESULTS: PAE counselling confidence increased in all groups (relative increase: Low=~40%, Medium=~20%, High=~10%). Training increased the low-confidence group's knowledge, awareness of guidance/resources and perception of their patients' interest in lifestyle management (~30% change; all p < 0.001). Compared to baseline, a greater proportion (all p < 0.001) of MDs reported prescribing exercise at 3-month follow-up in each of the low-confidence (10% to 62%) medium-confidence (16% to 89%) and high-confidence (57% to 87%) groups. CONCLUSION: PAE training favorably improved MDs' confidence, perceived impact of many barriers and the proportion of MDs prescribing exercise, at each level of confidence. An educational workshop particularly assisted MDs with low-confidence (i.e., those who needed it the most) integrate PAE into their practice.
CONTEXTE: Les ateliers éducatifs aident les médecins (MD) à inclure un contenu sur l'activité physique et l'exercice (PAE) dans un plus grand nombre de consultations auprès de leurs patients. On ne peut établir clairement si les médecins, avec divers degrés de confiance en soi pour discuter de l'activité physique et de l'exercice avec leurs patients, bénéficient tous également d'une telle formation. Nous avons évalué si la confiance en soi initiale du médecin influence les effets d'un atelier éducatif sur l'activité physique et l'exercice. MÉTHODES: Des médecins (n = 63) de partout au Canada ont rempli des questionnaires d'introspection au départ et trois mois après un atelier sur l'activité physique et l'exercice. Les médecins ont été divisés selon un niveau de confiance faible [score d'auto-efficacité (sur 100 %) : < 40 %; n = 21], moyen (40 - 60 %; n = 19) et élevé (> 60 %; n = 23). RÉSULTATS: L'auto-efficacité de services de consultation en matière d'activité physique et d'exercice a augmenté dans tous les groupes (augmentation relative : faible = ~40 %, moye n = ~20 %, élevé = ~10 %). La formation a augmenté les connaissances, la sensibilisation aux conseils/ressources et la perception de l'intérêt de leurs patients dans la gestion du style de vie dans le groupe à faible niveau de confiance (changement d'environ 30 %; tous p < 0,001). Par rapport à la valeur initiale, une plus grande proportion (tous p < 0,001) des médecins ont indiqué prescrire de l'exercice au suivi de trois mois dans chacun des groupes avec un degré de confiance faible (10 % à 62 %), moyen (16 % à 89 %) et élevé (57 % à 87 %). CONCLUSION: La formation sur l'activité physique et l'exercice a amélioré la confiance en soi des médecins, les effets perçus de nombreux obstacles et la proportion de médecins prescrivant de l'exercice, à chaque degré de confiance. Un atelier éducatif a aidé plus particulièrement les médecins avec un faible degré de confiance (c.-à-d., ceux qui en avaient le plus besoin) à intégrer l'activité physique et l'exercice dans leur pratique.
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Purpose: We assessed the perceptions and practices of physical activity counselling and exercise prescription of physiotherapists in Nova Scotia. Method: A total of 146 physiotherapists in Nova Scotia completed an online self-reflection survey regarding their current practice of, confidence in, barriers to, and facilitators of providing physical activity and exercise (PAE) counselling to their patients. Results: Physiotherapists included physical activity counselling and exercise content in 85% of patient counselling appointments. They reported a high level of confidence (> 90%) in providing PAE information and answering patients' PAE questions and moderate confidence in their patients' abilities to maintain PAE over the long term (73%) and to follow through on their PAE recommendations (66%). Patients' interest in PAE was the greatest barrier to providing PAE counselling. The physiotherapists reported being most comfortable when prescribing exercise for patients with musculoskeletal conditions and least comfortable with patients with cancer, insulin-dependent diabetes, and respiratory conditions. Most physiotherapists (71%) reported being interested in pursuing further education or training in PAE counselling and prescription. Conclusions: The physiotherapists frequently recommended PAE to their patients, had moderate confidence in their patients' ability to follow through on their advice, and experienced patients' disinterest in PAE as the greatest barrier to providing PAE counselling. The results of this study suggest a desire by physiotherapists for educational training opportunities, which we recommend be focused on providing behavioural strategies and further information to help overcome patient-focused barriers; this will help patients adopt and maintain physically active lifestyles.
Objectif : évaluer les perceptions et les pratiques des physiothérapeutes de la Nouvelle-Écosse en matière de conseils sur l'activité physique et de prescription d'exercice. Méthodologie : au total, 146 physiothérapeutes de la Nouvelle-Écosse ont rempli un sondage d'autoréflexion en ligne sur les conseils qu'ils donnent à leurs patients en matière d'activité physique et d'exercice (APE) à leurs patients, leur confiance, les obstacles et les incitations à cet égard. Résultats : les physiothérapeutes incluaient des conseils en matière d'activité physique et un contenu d'exercice lors de 85 % des rendez-vous de conseils aux patients. Ils déclaraient un taux de confiance élevé (> 90 %) quant à l'information en matière d'APE et aux réponses aux questions des patients à ce sujet, et un taux de confiance modéré envers les capacités de leurs patients à maintenir leur APE à long terme (73 %) et à donner suite à leurs recommandations en matière d'APE (66 %). L'intérêt des patients envers l'APE était le principal obstacles aux conseils sur l'APE. Les physiothérapeutes ont déclaré être plus à l'aise de prescrire des exercices aux patients ayant des affections musculosquelettiques, mais moins à l'aise auprès des patients atteints de cancer, de diabète insulinodépendant et de troubles respiratoires. La plupart des physiothérapeutes (71 %) déclaraient souhaiter poursuivre leur formation sur les conseils et la prescription d'APE. Conclusions : les physiothérapeutes recommandaient fréquemment l'APE à leurs patients, avaient une confiance modérée dans les capacités de leurs patients à donner suite à leurs conseils et trouvaient que le désintérêt de leurs patients envers l'APE était le principal obstacle aux conseils en matière d'APE. Selon les résultats de cette étude, les physiothérapeutes souhaitent pouvoir suivre des formations. Les auteurs recommandent qu'elles portent sur des stratégies comportementales et sur l'information plus approfondie pour vaincre les obstacles liés aux patients, car ces stratégies aideront les patients à adopter et à maintenir un mode de vie actif.
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PURPOSE: To determine the reliability and validity of a novel trunk maximal isometric force assessment involving 7 different tasks with 200-m times for elite sprint flat-water kayakers. METHODS: Ten elite sprint flat-water kayakers performed a series of maximal isometric voluntary contractions (MVCs) on 2 separate days to assess reliability. MVC force was assessed as the participants sat on a modified kayak ergometer and applied their maximal isometric force to a uniaxial load cell during 7 different tasks. The 7 tasks of interest were a seated trunk-forward flexion, bilateral (left and right) rotational pulls, bilateral rotational pushes, and a sport-specific bilateral kayak-stroke simulation. Twenty elite flat-water kayak athletes (10 male and 10 female) participated in the validity portion by completing the series of tasks in conjunction with a 200-m race. RESULTS: MVC force values ranged from 84 to 800 N across all participants and all tasks. The average coefficient of variation of the 7 tasks ranged from 2.4% to 7.7%. Regression analysis showed Pearson correlations ranging from -.84 to -.22 for both absolute and relative values with 200-m performance times. CONCLUSIONS: MVC force measured in each task was considered reliable as a small degree of variance between trials was found. The summation of the 7 trunk scores showed very strong correlations with on-water performance, indicating that this assessment is valid for elite sprint kayakers.
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Desempenho Atlético/fisiologia , Força Muscular , Tronco/fisiologia , Esportes Aquáticos/fisiologia , Adulto , Teste de Esforço/métodos , Feminino , Humanos , Contração Isométrica , Masculino , Reprodutibilidade dos Testes , Rotação , Análise e Desempenho de Tarefas , Adulto JovemRESUMO
The purpose of the study was to: 1) Validate the PiezoRx® for steps and intensity related physical activity in free-living conditions compared to the criterion measure. 2) Compare PiezoRx®'s steps and intensity related physical activity to physiological assessments. 3) To assess the utility of the PiezoRx® in a subsample of participants. Thirty-nine participants consisting of 28 females aged 54.9±10.6 (33-74) years and 11 males aged 63.9±10.9 (44-80) years wore the PiezoRx® physical activity monitor and the ActiGraph® accelerometer for one full week and completed a physical assessment. A subsample (n=24) wore the PiezoRx® for an additional two weeks and completed a questionnaire regarding usability. The PiezoRx® had strong correlations to the ActiGraph® for step count (r=0.88; p<0.001), moderate-vigorous physical activity (MVPA) (r=0.70; p<0.001), and sedentary activity (r=0.93; p<0.001) in the 1-week monitoring period. The PiezoRx®'s steps/day and MVPA/week were negatively correlated (p<0.001) to body mass index and waist circumference, and positively correlated (p<0.05) to aerobic fitness, pushups, and 30 second sit-to-stand. Within the subsample who completed the additional two-week monitoring, 75% of participants reported that the PiezoRx® increased their physical activity. In conclusion, The PiezoRx® appears to be a valid measure of free-living PA compared to accelerometry. Because of the correlations of the PiezoRx®'s steps/day and MVPA/week to anthropometric, musculoskeletal and aerobic fitness these PA measures may be valuable objective surrogates to use in clinical or professional practice for physical health.
RESUMO
Canadian physical activity guidelines recommend older adults accumulate 150 min of weekly moderate to vigorous physical activity (MVPA). Older adults who are insufficiently active may have reduced blood vessel health and an increased risk of cardiovascular disease. We tested this hypothesis in 11 older adults who did (7 female; age, 65 ± 5 years; MVPA, = 239 ± 81 min/week) and 10 older adults who did not (7 female; age, 68 ± 9 years; MVPA, 95 ± 33 min/week) meet MVPA guidelines. Flow-mediated dilation (FMD) in the brachial (BA) and popliteal (POP) arteries, as well as nitroglycerin-mediated dilation (NMD; endothelial-independent dilation) in the POP were assessed via ultrasonography. Aerobic fitness (peak oxygen uptake) was determined using a graded, maximal cycle ergometry test via indirect calorimetry. MVPA and sedentary time were assessed over 5 days using the PiezoRx and activPAL, respectively. There were no differences in peak oxygen uptake (26 ± 10 vs. 22 ± 10 mL O2/(kg·min); p = 0.26) or sedentary time (512 ± 64 vs. 517 ± 76 min/day; p = 0.87) between groups; however, those who achieved the MVPA guidelines had a higher BA-FMD (5.1% ± 1.3% vs. 3.6% ± 1.7%; p = 0.03), POP-FMD (2.6% ± 1.1% vs. 1.3% ± 0.8%; p = 0.006), and POP-NMD (5.1% ± 1.7% vs. 3.3% ± 2.1%; p = 0.04). In the pooled sample, MVPA was moderately correlated to both BA-FMD (r = 0.53; p = 0.01) and POP-NMD (r = 0.59; p = 0.005), and strongly correlated to POP-FMD (r = 0.85; p < 0.001). Collectively, our results provide supporting evidence that meeting MVPA guidelines is associated with better vascular function and may reduce the risk of developing cardiovascular disease in older adults. Furthermore, these data suggest that weekly MVPA time may have a greater impact on blood vessel function than aerobic fitness and weekly sedentary time.
Assuntos
Artéria Braquial/fisiologia , Exercício Físico , Envelhecimento Saudável , Estilo de Vida Saudável , Aptidão Física , Artéria Poplítea/fisiologia , Comportamento Sedentário , Vasodilatação , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Artéria Braquial/diagnóstico por imagem , Canadá , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/prevenção & controle , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio , Artéria Poplítea/diagnóstico por imagem , Comportamento de Redução do Risco , Fatores de TempoRESUMO
Adults are recommended to engage in 150 min of moderate (MPA) to vigorous (VPA) aerobic physical activity per week, with the public health message of obtaining 3000 steps in 30 min. There is a paucity of research on step rate thresholds that correspond to absolute MVPA (moderate = 3 METs, vigorous = 6 METs) with no research evaluating adult relative MVPA (moderate = 40% VO2max, vigorous = 60% VO2max). Anthropometric differences also influence intensity-related step rate thresholds. The purpose of this study was to identify step rates across a range of walking intensities so that mathematical models incorporating anthropometric factors could be used to identify individualized MVPA step rate thresholds. Forty-three adults (25â; age = 39.4 ± 15.2 years) completed a staged treadmill walking protocol with pedometers and indirect calorimetry: six-minutes at 2.4, 3.2, 4.0, 5.6, 6.4, 7.2 km/h. Mathematical modelling revealed absolute and relative MPA step rate thresholds of ~100 steps/minute (spm) and ~125 spm, respectively. VPA corresponded to step rates of ~133 spm and ~139 spm for absolute and relative thresholds respectively. The current public message of 3000 steps in 30 min is valid for absolute MPA. However, VPA is achieved at higher thresholds than previously reported, more than 130 spm for healthy adults.
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Monitorização Fisiológica/estatística & dados numéricos , Caminhada/fisiologia , Adulto , Pesos e Medidas Corporais , Calorimetria Indireta , Exercício Físico/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Monitorização Fisiológica/métodosRESUMO
Exercise is Medicine Canada (EIMC) is an initiative that promotes physical activity (PA) counselling and exercise prescription within health care. The purpose of this study was to compare physicians' perceptions and practices around PA counselling and exercise prescription following EIMC training. Physicians (n = 46) from 7 different provinces completed questionnaires initially and 3 months following an EIMC workshop. Three months after intervention, physicians reported greater confidence compared with baseline for providing physical activity and exercise (PAE) information to patients (79% vs 55%; p < 0.001), assessing patients' PAE (69% vs 44%, p = 0.005), answering patients' PAE questions (78% vs 54%, p < 0.001), providing PAE advice (71% vs 43%, p < 0.001), and identifying which patients would benefit from referral to qualified exercise professionals (77% vs 52%, p = 0.002). At follow-up, physicians reported PA prescription barriers as less impactful (out of 4; all p < 0.05), including perceived patients' lack of interest (2.75 to 2.25), lack of available resources (2.59 to 2.00), and lack of time (2.41 to 2.14). The proportion of physicians providing written exercise prescriptions increased from 20% to 74%. This study suggests that the completion of a 1-day EIMC workshop increases physicians' confidence, knowledge, and counselling behaviours of physicians in prescribing PAE.
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Aconselhamento , Terapia por Exercício , Exercício Físico , Padrões de Prática Médica , Atitude do Pessoal de Saúde , Canadá , Feminino , Seguimentos , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Médicos , Encaminhamento e Consulta , Tamanho da Amostra , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: The purpose of the present study was to examine the impact of the Canadian Diabetes Association's (CDA) resource titled Building Competency in Diabetes Education: Physical Activity and Exercise and associated workshops, on diabetes care providers' (DCPs) confidence and practices regarding physical-activity promotion 8 to 12 months after attending a workshop. METHODS: In this action research study, 2 separate cross-sectional samples of DCPs were recruited. DCPs at baseline (N=462) completed a questionnaire assessing their current physical-activity promotion practices, intended changes in practice and intended implementation of the toolkit. At follow up, DCPs (n=132) completed an online questionnaire assessing their physical-activity counselling practices, confidence in their physical-activity counselling, use of the specific CDA resources as well as changes to practice and ongoing challenges. RESULTS: At baseline, 58% of DCPs incorporated physical-activity content in the majority of their sessions; however, 66% of DCPs discussed physical activity in >50% of their sessions following the launch of the training initiative. Following the training, DCPs reported increased confidence across all 6 aspects of physical-activity counselling that were examined. Improvements were most frequently found in providing advice regarding the benefits of activity (86%) and providing instruction regarding resistance training (86%). DCPs most often changed their practices by discussing physical activity more frequently and confidently (27%); however, lack of time was frequently reported (37%) as an ongoing challenge to providing physical-activity counselling. CONCLUSIONS: This evaluation highlights the impact of this national initiative and suggests that the resource is effective in improving physical-activity promotion in diabetes care.