Patient Preference and Physical Demand for Hands-Free Single Crutch vs Standard Axillary Crutches in Foot and Ankle Patients

2019 ◽  
Vol 40 (10) ◽  
pp. 1203-1208
Author(s):  
Kevin D. Martin ◽  
Alicia M. Unangst ◽  
Jeannie Huh ◽  
Jamie Chisholm

Background: Weightbearing restrictions following foot and ankle surgery require the use of appropriate assistive devices for nonweightbearing ambulation during the recovery period. Selecting an appropriate assistive device that safely optimizes mobility and participation in daily activities is important to patient compliance and satisfaction. The purpose of this study was to compare physiologic demand, perceived exertion, and patient preference between a hands-free single crutch (HFSC) and standard axillary crutches (SACs) in foot and ankle patients. Methods: Using 44 preoperative orthopedic foot and ankle patients who had a mean age of 32 (19-51) years, a prospective, randomized, crossover study was performed. The sample consisted of 35 males and 9 females. The mean body mass index (BMI) was 26 (19-36), the mean height was 1.7 m, and the mean weight was 82 kg. Patient data and preactivity heart rate were recorded for all patients, who were then randomized to either an HFSC or SACs. Each patient was randomly assigned to the device they would utilize first using a random number generator. They then crossed over to the other device after vitals returned to within 10% of their baseline heart rate. Every subject completed a 6-minute walk test (6MWT) using both assistive devices in a crossover manner. Immediately following each 6MWT, postactivity heart rate, self-selected walking velocity (SSWV), perceived exertion using the OMNI Rating of Perceived Exertion (OMNI-RPE), and perceived dyspnea using the Modified Borg Dyspnea Scale were obtained. After completing both 6MWTs, patients were asked which assistive device they preferred the most. Results: The HFSC was preferred by 86% of patients. Significantly lower dyspnea scores (2.8 vs 5.3; P < .001), fatigue scores (2.4 vs 5.5; P < .001), preactivity and postactivity change in heart rate (28 vs 46 bpm; P < .001), and mean postactivity heart rate (107 vs 122 bpm; P < .001) were found using the HFSC compared with the SACs. The SAC group trended toward a higher SSWV (0.8 vs 0.77 m/s; P = .08). Those with a BMI greater than 25 also preferred iWALK over SACs ( P < .05). Neither group had any falls. Sixty-eight percent of patients complained of axillary/hand pain with the SACs, while 7% complained of proximal leg strap discomfort with the HFSC. Conclusion: The results of the current study in our relatively healthy cohort found that foot and ankle patients who were nonweightbearing preferred the HFSC over SACs. They experienced less physiologic demand as well as discomfort and perceived less exertion when using the HFSC compared with SACs. Level of Evidence: Level II, prospective comparative study.

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0049
Author(s):  
Alicia Unangst ◽  
Kevin Martin ◽  
Anthony Mustovich ◽  
Jaime Chisholm

Category: Ankle Introduction/Purpose: Following lower extremity surgery patients are often required to utilize assistive devices in order to perform activities of daily living. As technology and assistive devices continue to improve, providers are faced with selecting a device that is safe while providing high patient satisfaction and a quick return to actives. The purpose of the current study was to compare physical exertion and subject preference between a hands-free single crutch and standard axillary crutches in foot and ankle patients. Methods: A prospective, randomized crossover study was performed using 35 orthopedic foot and ankle patients from within one treatment facility. Each participant had demographic data and heart rate recorded. The patients were then randomized to an assistive device. All participants completed a 6-minute walk test (6MWT); immediately following each 6MWT heart rate, self-selected walking velocity (SSWV), perceived exertion using OMNI Rating of Perceived Exertion (OMNI-RPE) and perceived dyspnea using Modified Borg Dyspnea Scale was obtained. The patients then completed another 6MWT using the other assistive device and was asked the same questions. After completing both 6MWTs participants were asked which assistive device they would prefer to use. Results: A total of 35 patients were included with a median age of 32-year-old. The hands-free crutch was preferred by 86% of participants. Regression analysis was used to test if factors such as gender, height, weight, BMI predicted patient preference of iWalk vs. Crutch. None of these factors were found to be significant. Student t-tests and ANOVAs were performed separately for dyspnea, fatigue ratings, distance (meters) and heart rate between iWalk and crutch all were found to be significant (p<0.05, p=1.13e-11, p=2.29e-13, p=5.21e-05, respectively). The axillary crutch group had higher SSWV (0.8 vs 0.77m/s) but was not found to be significant. Neither group had any falls, however, 58% of axillary participants complained of axillary/hand pain while the hands-free group had 14% complain of proximal strap discomfort. Conclusion: Patients preferred the hands-free crutch while reporting lower perceived dyspnea and fatigue. The hands-free group demonstrated lower physiologic demand, which correlated with patient perception.


2021 ◽  
Author(s):  
Étienne Chassé ◽  
Daniel Théoret ◽  
Martin P Poirier ◽  
François Lalonde

ABSTRACT Introduction Members of the Canadian Armed Forces (CAF) are required to meet the minimum standards of the Fitness for Operational Requirements of CAF Employment (FORCE) job-based simulation test (JBST) and must possess the capacity to perform other common essential tasks. One of those tasks is to perform basic fire management tasks during fire emergencies to mitigate damage and reduce the risk of injuries and/or death until professional firefighters arrive at the scene. To date however, the physiological demands of common firefighting tasks have mostly been performed on professional firefighters, thus rendering the transferability of the demands to the general military population unclear. This pilot study aimed to quantify, for the first time, the physiological demands of basic fire management tasks in the military, to determine if they are reflected in the FORCE JBST minimum standard. We hypothesized that the physiological demands of basic fire management tasks within the CAF are below the physiological demands of the FORCE JBST minimum standard, and as such, be lower than the demands of professional firefighting. Materials and methods To achieve this, 21 CAF members (8 females; 13 males; mean [SD] age: 33 [10] years; height: 174.5 [10.5] cm; weight: 85.4 [22.1] kg, estimated maximal oxygen uptake [$\dot V$O2peak]: 44.4 (7.4) mL kg−1 min−1) participated in a realistic, but physically demanding, JBST developed by CAF professional firefighting subject matter experts. The actions included lifting, carrying, and manipulating a 13-kg powder fire extinguisher and connecting, coupling, and dragging a 38-mm fire hose over 30 m. The rate of oxygen uptake ($\dot V$O2), heart rate, and percentage of heart rate reserve were measured continuously during two task simulation trials, which were interspersed by a recovery period. Rating of perceived exertion (6-no exertion; 20-maximal exertion) was measured upon completion of both task simulations. Peak $\dot V$O2 ($\dot V$O2peak) was estimated based on the results of the FORCE JBST. Results The mean (SD) duration of both task simulation trials was 3:39 (0:19) min:s, whereas the rest period in between both trials was 62 (19) minutes. The mean O2 was 21.1 (4.7) mL kg−1 min−1 across trials, which represented 52.1 (12.2) %$\dot V$O2peak and ∼81% of the FORCE JBST. This was paralleled by a mean heart rate of 136 (18) beats min−1, mean percentage of heart rate reserve of 61.2 (10.8), and mean rating of perceived exertion of 11 ± 2. Other physical components of the JBST consisted of lifting, carrying, and manipulating a 13-kg load for ∼59 seconds, which represents 65% of the load of the FORCE JBST. The external resistance of the fire hose drag portion increased up to 316 N, translating to a total of 6205 N over 30 m, which represents 96% of the drag force measured during the FORCE JBST. Conclusions Our findings demonstrate that the physiological demands of basic fire management tasks in the CAF are of moderate intensity, which are reflected in the CAF physical fitness standard. As such, CAF members who achieve the minimum standard on the FORCE JBST are deemed capable of physically performing basic fire management tasks during fire emergencies.


2018 ◽  
Vol 3 (4) ◽  
pp. 60 ◽  
Author(s):  
Ramires Tibana ◽  
Nuno de Sousa ◽  
Jonato Prestes ◽  
Fabrício Voltarelli

The aim of this study was to analyze blood lactate concentration (LAC), heart rate (HR), and rating perceived exertion (RPE) during and after shorter and longer duration CrossFit® sessions. Nine men (27.7 ± 3.2 years; 11.3 ± 4.6% body fat percentage and training experience: 41.1 ± 19.6 months) randomly performed two CrossFit® sessions (shorter: ~4 min and longer: 17 min) with a 7-day interval between them. The response of LAC and HR were measured pre, during, immediately after, and 10, 20, and 30 min after the sessions. RPE was measured pre and immediately after sessions. Lactate levels were higher during the recovery of the shorter session as compared with the longer session (shorter: 15.9 ± 2.2 mmol/L/min, longer: 12.6 ± 2.6 mmol/L/min; p = 0.019). There were no significant differences between protocols on HR during (shorter: 176 ± 6 bpm or 91 ± 4% HRmax, longer: 174 ± 3 bpm or 90 ± 3% HRmax, p = 0.387). The LAC was significantly higher throughout the recovery period for both training sessions as compared to pre-exercise. The RPE was increased immediately after both sessions as compared to pre-exercise, while there was no significant difference between them (shorter: 8.7 ± 0.9, longer: 9.6 ± 0.5; p = 0.360). These results demonstrated that both shorter and longer sessions induced elevated cardiovascular responses which met the recommendations for gains in cardiovascular fitness. In addition, both training sessions had a high metabolic and perceptual response, which may not be suitable if performed on consecutive days.


Author(s):  
Juan Pedro Fuentes-García ◽  
Vicente J. Clemente-Suárez ◽  
Miguel Ángel Marazuela-Martínez ◽  
José F. Tornero-Aguilera ◽  
Santos Villafaina

Objective: The present research aimed to analyse the autonomic, anxiety, perceived exertion, and self-confidence response during real and simulated flights. Methods: This cross-sectional study participated 12 experienced male pilots (age = 33.08 (5.21)) from the Spanish Air Force. Participants had to complete a real and a simulated flight mission randomly. The heart rate variability (HRV), anxiety, self-confidence, and rating of perceived exertion were collected before and after both manoeuvres, and HRV was also collected during both simulated and real flights. Results: When studying the acute effects of real and simulated flights, the mean heart rate, the R-to-R interval, the cognitive anxiety and the perceived exertion were significantly impacted only by real flights. Furthermore, significant differences in the mean heart rate and RR interval were found when compared to the acute effects of real and simulated flights (with higher acute effects observed in real flights). Additionally, when compared the HRV values during simulated and real flights, significant differences were observed in the RR and heart rate mean (with lower RR interval and higher heart rate mean observed during real flights). Conclusion: Real flights significantly reduced the RR interval and cognitive anxiety while increased the heart rate mean and the rating of perceived exertion, whereas simulated flights did not induce any significant change in the autonomic modulation.


2021 ◽  
Vol 36 (1) ◽  
pp. 39-44
Author(s):  
Encarnación Liébana ◽  
Cristina Monleón ◽  
Consuelo Moratal ◽  
Amador Garcia-Ramos

This study aimed to describe the response of heart rate (HR) and the subjective rating of perceived exertion (RPE) during a simulated DanceSport competition. The mean and maximum HR of 18 dancers of the highest level were evaluated during a simulated DanceSport competition consisting of 5 Latin dances. RPE values were recorded immediately after each dance. The dances were ranked as follows according to the mean HR (samba [165.3 ± 16.3 bpm] < rumba bolero [176.9 ± 9.9 bpm] < cha-cha-chá [179.1 ± 11.4 bpm] = paso doble [182.5 ± 12.5 bpm] = jive [184.3 ± 11.4 bpm]); maximum HR (samba [185.6 ± 8.9 bpm] = rumba bolero [187.0 ± 9.1 bpm] < cha-cha-chá [190.1 ± 8.0 bpm] = paso doble [191.4 ± 9.0 bpm] < jive [194.2 ± 8.1 bpm]); and RPE (rumba bolero [5.22 ± 1.40] < samba [6.42 ± 2.06] = cha-cha-chá [6.78 ± 1.31] = paso doble [7.39 ± 1.04] < jive [8.33 ± 0.91]). The only significant correlation between RPE and HR values was observed for the maximum HR during the first dance of the competition (samba) (r = 0.485). A simulated DanceSport competition causes high physiological stress being influenced by the type of dance.


Author(s):  
Cristina Cortis ◽  
Andrea Fusco ◽  
Mitchell Cook ◽  
Scott T. Doberstein ◽  
Cordial Gillette ◽  
...  

Although cycling class intensity can be modified by changing interval intensity sequencing, it has not been established whether the intensity order can alter physiological and perceptual responses. Therefore, this study aimed to determine the effects of interval intensity sequencing on energy expenditure (EE), physiological markers, and perceptual responses during indoor cycling. Healthy volunteers (10 males = 20.0 ± 0.8years; 8 females = 21.3 ± 2.7years) completed three randomly ordered interval bouts (mixed pyramid—MP, ascending intervals—AI, descending intervals—DI) including three 3-min work bouts at 50%, 75%, and 100% of peak power output (PPO) and three 3-min recovery periods at 25% PPO. Heart rate (HR) and oxygen consumption (VO2) were expressed as percentages of maximal HR (%HRmax) and VO2 (%VO2max). EE was computed for both the work bout and for the 5-min recovery period. Session Rating of Perceived Exertion (sRPE) and Exercise Enjoyment Scale (EES) were recorded. No differences emerged for % HRmax (MP = 73.3 ± 6.1%; AI = 72.1 ± 4.9%; DI = 71.8 ± 4.5%), % VO2max (MP = 51.8 ± 4.6%; AI = 51.4 ± 3.9%; DI = 51.3 ± 4.5%), EE (MP = 277.5 ± 39.9 kcal; AI = 275.8 ± 39.4 kcal; DI = 274.9 ± 42.1 kcal), EES (MP = 4.9 ± 1.0; AI = 5.3 ± 1.1; DI = 4.9 ± 0.9), and sRPE (MP = 4.9 ± 1.0; AI = 5.3 ± 1.1; DI = 4.9 ± 0.9). EE during recovery was significantly (p < 0.005) lower after DI (11.9 ± 3.2 kcal) with respect to MP (13.2 ± 2.5 kcal) and AI (13.3 ± 2.5 kcal). Although lower EE was observed during recovery in DI, interval intensity sequencing does not affect overall EE, physiological markers, and perceptual responses.


2013 ◽  
Vol 38 (6) ◽  
pp. 597-604 ◽  
Author(s):  
Andrew H. Hall ◽  
Michael D. Leveritt ◽  
Kiran D.K. Ahuja ◽  
Cecilia M. Shing

Researchers have focused primarily on investigating the effects of coingesting carbohydrate (CHO) and protein (PRO) during recovery and, as such, there is limited research investigating the benefits of CHO+PRO coingestion during exercise for enhancing subsequent exercise performance. The aim of this study was to investigate whether coingestion of CHO+PRO during endurance training would enhance recovery and subsequent exercise performance. Ten well-trained male cyclists (aged 29.7 ± 7.5 years; maximal oxygen uptake, 66.2 ± 6 mL·kg−1·min−1) took part in a randomized, double-blind, cross-over trial. Each trial consisted of a 2.5-h morning training bout during which the cyclists ingested a CHO+PRO or energy-matched CHO beverage followed by a 4-h recovery period and a subsequent performance time trial (total work, 7 kJ·kg−1). Blood was collected before and after exercise. Time-trial performance was 1.8% faster in the CHO+PRO trial compared with the CHO trial (p = 0.149; 95% CI, −13 to 87 s; 75.8% likelihood of benefit). The increase in myoglobin level from before the training bout to after the training bout was lower in the CHO+PRO trial (0.74 nmol·L−1; 95% CI, 0.3–1.17 nmol·L−1) compared with the CHO trial (1.16 nmol·L−1; 95% CI, 0.6–1.71 nmol·L−1) (p = 0.018). Additionally, the decrease in neutrophil count over the recovery period was greater in the CHO+PRO trial (p = 0.034), and heart rate (p < 0.022) and rating of perceived exertion (RPE) (p < 0.01) were lower during training in the CHO+PRO trial compared with the CHO trial. Ingesting PRO, in addition to CHO, during strenuous training lowered exercise stress, as indicated by reduced heart rate, RPE, and muscle damage, when compared with CHO alone. CHO+PRO ingestion during training is also likely to enhance recovery, providing a worthwhile improvement in subsequent cycling time-trial performance.


2021 ◽  
pp. bjsports-2020-103758
Author(s):  
Simon Driver ◽  
Megan Reynolds ◽  
Katelyn Brown ◽  
Jakob L Vingren ◽  
David W Hill ◽  
...  

ObjectivesTo (1) determine if wearing a cloth face mask significantly affected exercise performance and associated physiological responses, and (2) describe perceptual measures of effort and participants’ experiences while wearing a face mask during a maximal treadmill test.MethodsRandomised controlled trial of healthy adults aged 18–29 years. Participants completed two (with and without a cloth face mask) maximal cardiopulmonary exercise tests (CPETs) on a treadmill following the Bruce protocol. Blood pressure, heart rate, oxygen saturation, exertion and shortness of breath were measured. Descriptive data and physical activity history were collected pretrial; perceptions of wearing face masks and experiential data were gathered immediately following the masked trial.ResultsThe final sample included 31 adults (age=23.2±3.1 years; 14 women/17 men). Data indicated that wearing a cloth face mask led to a significant reduction in exercise time (−01:39±01:19 min/sec, p<0.001), maximal oxygen consumption (VO2max) (−818±552 mL/min, p<0.001), minute ventilation (−45.2±20.3 L/min), maximal heart rate (−8.4±17.0 beats per minute, p<0.01) and increased dyspnoea (1.7±2.9, p<0.001). Our data also suggest that differences in SpO2 and rating of perceived exertion existed between the different stages of the CPET as participant’s exercise intensity increased. No significant differences were found between conditions after the 7-minute recovery period.ConclusionCloth face masks led to a 14% reduction in exercise time and 29% decrease in VO2max, attributed to perceived discomfort associated with mask-wearing. Compared with no mask, participants reported feeling increasingly short of breath and claustrophobic at higher exercise intensities while wearing a cloth face mask. Coaches, trainers and athletes should consider modifying the frequency, intensity, time and type of exercise when wearing a cloth face mask.


2016 ◽  
Vol 11 (3) ◽  
pp. 388-392 ◽  
Author(s):  
Maurizio Fanchini ◽  
Ivan Ferraresi ◽  
Roberto Modena ◽  
Federico Schena ◽  
Aaron J. Coutts ◽  
...  

Purpose:To examine the construct validity of the session rating perceived exertion (s-RPE) assessed with the Borg CR100 scale to measure training loads in elite soccer and to examine if the CR100 is interchangeable and can provide more-accurate ratings than the CR10 scale.Methods:Two studies were conducted. The validity of the CR100 was determined in 19 elite soccer players (age 28 ± 6 y, height 180 ± 7 cm, body mass 77 ± 6 kg) during training sessions through correlations with the Edwards heart-rate method (study 1). The interchangeability with CR10 was assessed in 78 soccer players (age 19.3 ± 4.1 y, height 178 ± 5.9 cm, body mass 71.4 ± 6.1 kg) through the Bland–Altman method and correlations between change scores in different sessions. To examine whether the CR100 is more finely graded than the CR10, the proportions of responses corresponding to the verbal expressions were calculated (study 2).Results:Individual correlations between the Edwards method and s-RPE were large to very large (.52–.85). The mean difference between the 2 scales was –0.3 ± 0.33 AU (90% CI –0.41 to –0.29) with 95% limits of agreements (0.31 to –0.96 AU). Correlations between scales and between-changes scores were nearly perfect (.95 and .91–.98). Ratings corresponding to the verbal anchors were 49% in CR10 and 26% in CR100.Conclusions:The CR100 is valid for assessing the training load in elite soccer players. It can be used interchangeably with the CR10 and may provide more-precise measures of exercise intensity.


2016 ◽  
Vol 11 (3) ◽  
pp. 328-336 ◽  
Author(s):  
Daniel Hammes ◽  
Sabrina Skorski ◽  
Sascha Schwindling ◽  
Alexander Ferrauti ◽  
Mark Pfeiffer ◽  
...  

The Lamberts and Lambert Submaximal Cycle Test (LSCT) is a novel test designed to monitor performance and fatigue/recovery in cyclists. Studies have shown the ability to predict performance; however, there is a lack of studies concerning monitoring of fatigue/recovery. In this study, 23 trained male cyclists (age 29 ± 8 y, VO2max 59.4 ± 7.4 mL · min−1 · kg−1) completed a training camp. The LSCT was conducted on days 1, 8, and 11. After day 1, an intensive 6-day training period was performed. Between days 8 and 11, a recovery period was realized. The LSCT consists of 3 stages with fixed heart rates of 6 min at 60% and 80% and 3 min at 90% of maximum heart rate. During the stages, power output and rating of perceived exertion (RPE) were determined. Heart-rate recovery was measured after stage 3. Power output almost certainly (standardized mean difference: 1.0) and RPE very likely (1.7) increased from day 1 to day 8 at stage 2. Power output likely (0.4) and RPE almost certainly (2.6) increased at stage 3. From day 8 to day 11, power output possibly (–0.4) and RPE likely (–1.5) decreased at stage 2 and possibly (–0.1) and almost certainly (–1.9) at stage 3. Heart-rate recovery was likely (0.7) accelerated from day 1 to day 8. Changes from day 8 to day 11 were unclear (–0.1). The LSCT can be used for monitoring fatigue and recovery, since parameters were responsive to a fatiguing training and a following recovery period. However, consideration of multiple LSCT variables is required to interpret the results correctly.


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