scholarly journals Physical fitness of paramedic students during vocational training - a follow-up study

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Heikki Paakkonen ◽  
Joachim Ring ◽  
Jyrki Kettunen

<p align="left">Introduction: Paramedics’ work includes periods of physically light activity, but also involves short periods of relatively intense physical activity.  Even during their studies paramedic students’ days involve a lot of sitting, i.e. physically sedentary behaviour. We initiated a programme to motivate paramedic students to be physically active during their studies. In this study we report physical fitness among paramedic students who for one year participated in brief physical activity counselling consisting of both verbal and a written individually tailored exercise program</p><p align="left">Methods: A total of 40 paramedic students (26 female, 14 male) had participated voluntarily in a physical activity programme alongside their studies. Subjects’ maximal oxygen consumption and muscle strength were measured at baseline and at one-year follow-up. According to the results of the baseline tests all students were given an individual exercise programme, which included aerobic and muscle strength training.</p><p align="left">Results: Sixty-five percent (26/40) of the students participated in the follow-up examinations. At baseline male students had higher mean maximal oxygen consumption (VO<sub>2Max</sub>) and, as expected, greater absolute muscle strength than their female counterparts (all p-values &lt;0.05). During the follow-up females had improved their VO<sub>2Max</sub> on average by 2.4 ml/kg/min. Furthermore, females on average improved the number of squats  by 4.2 [95% Confidence Interval (CI) 0.01 to 8.33] repetitions, and males improved the number of push-ups (mean improvement 4.8, 95% CI 1.93 to 7.57), and left arm grip strength (mean improvement 4.0 kg, 95% CI 1.39 to 6.53).</p><p align="left">Conclusions: It seems to be possible to maintain, and even slightly improve paramedic students’ physical fitness with a self-directed, guided, home exercise programme. This approach could enhance prospective paramedics’ willingness to develop the necessary physical qualities long-term throughout their clinical careers. </p>

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e39-e40
Author(s):  
Sumeet Bhardwaj ◽  
Alexandre McDougall ◽  
Navpreet Dhillon ◽  
Jasleen Grewal ◽  
Sharon Burey

Abstract BACKGROUND Exercise has been shown to have long term effects in improving social skills, scholastic performance and quality of life in all children. Unfortunately, physical education courses continue to have their dedicated curricular times reduced. Students may have as little as one period of curricular physical activity per week. Conversely, there is middle school in Windsor, Ontario that has implemented a daily curricular period dedicated to physical activity. This study aimed to assess the effects of this schools’ exercise programme on their students’ social skills, scholastic performance and quality of life. OBJECTIVES Our objective is to study the effects of a daily physical activity period as part of an educational curriculum on student physical fitness, academic performance and self reported quality of life. DESIGN/METHODS We undertook a naturalistic observational study that examined the results of a daily exercise program for Grade 7 students attending École Secondaire E.J. Lajeunesse in Windsor. At this school, all students in Grade 7 and Grade 8 participate in a daily one-and-a-half-hour exercise programme consisting of two different streams: hockey or dance. All Grade 7 students and their families attending the school were asked to participate in our research trial. To study the effects of the exercise programme, student physical fitness, academic performance, and self-rated quality of life were assessed. Specific outcome measures used include: 20 metre sprint test, beep test, squat strength, bench press strength, the Pediatric Quality of Life Inventory, academic grades in mathematics, English and French, and academic learning skills. RESULTS Due to difficulties in participant recruitment and retention, only the following results could be analyzed. After one year of the structured hockey exercise program, the participants demonstrated significant increases in sprint speed (p < 0.0001), beep test (p < 0.005), squat strength (p < 0.0001) and bench press strength (p < 0.0001). There was also an increase in scores assessing organization, independence, collaboration, initiative and self regulation. An increase was noted in the participant’s grades in English and French. Little change was seen in mathematics and science grades. CONCLUSION After one year of consistent exercise, study participants demonstrated significant improvements in physical fitness, learning skills and language studies performance. Our results outline multiple benefits of implementing an organized daily physical period as part of the educational curriculum. A follow up to this preliminary study is currently underway to evaluate the effectiveness of school exercise programs on ADHD symptoms.


2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0028
Author(s):  
Meghan Kelly ◽  
Ashlee MacDonald ◽  
Rachel Olson ◽  
Grace Weyand ◽  
Ruth Chimenti ◽  
...  

Category: Sports Introduction/Purpose: Insertional Achilles Tendinopathy (IAT) affects 5% of the general population and up to 20% of the athletic population. Despite trials of non-surgical management such as physical therapy and heels lifts, more than 50% of patients ultimately pursue surgery. One hypothesis regarding the development of IAT pain and stiffness is that ankle dorsiflexion and associated calcaneal impingement causes transverse compression of the tendon insertion, inducing metaplastic changes within the Achilles tendon, and bursa, contributing to inflammation. Thus the aim of the current study is to examine the effect of a home exercise program designed to minimize compression of insertional tissues for patients with IAT on patient reported outcomes (PRO) measures at 3 months and one year. Methods: Thirty-five patients with IAT were enrolled in the study from May 2014 until June 2015 as two separate cohorts (21 and 14 patients, respectively) of whom 26 completed the study (mean age: 56.7 + 10.1 years, BMI: 29.5 + 6.0 kg/m2, 58% women). One patient elected for surgery prior to completing the physical therapy protocol. Physical therapy exercises were progressive eccentric loading of the Achilles tendon and seated isometric plantar flexion that were performed 4 times a week for 3 months. The Victorian Institute of Sport Assessment – Achilles (VISA-A), the Foot and Ankle Ability Measure (FAAM) and the SF-36 questionnaires were completed at baseline and at the completion of the 3-month physical therapy protocol. Six of the 14 patients in the second cohort returned for a 1 year follow up visit; four patients were lost to follow up and 4 had undergone surgical intervention prior to 1-year follow up. Results: Completion of the 3 month protocol resulted in statistically significant improvements in VISA-A, FAAM ADL and sports scores as well as multiple subcategories of the SF-36 (physical function, role limiting physical function, energy/vitality, social functioning and general pain). Twenty-two of the 26 patients (~85%) that completed the study had clinically significant, greater than MCID, improvements in their VISA-A and/or FAAM scores. In the second cohort, all six patients that returned for a one year follow up assessment maintained their improved VISA-A and FAAM scores observed at the end of the initial physical therapy protocol. Of the four patients that underwent surgical intervention prior to follow up, two did not demonstrate improvement in any of their outcomes following the initial study period. Conclusion: The results of the present study suggest that a physical therapy home exercise program utilizing eccentric and isometric Achilles exercises may result in a greater improvement in functional outcomes compared to other exercise programs that do not progressively increase both ankle dorsiflexion and Achilles tendon loading. Furthermore, improvements in pain and function result in increased energy and social wellbeing. Finally, symptomatic improvement that occurs after 3 months is likely to persist for at least one year following initial treatment.


2015 ◽  
Vol 40 (11) ◽  
pp. 1186-1192 ◽  
Author(s):  
Sisitha U. Jayasinghe ◽  
Susan J. Torres ◽  
Steve F. Fraser ◽  
Anne I. Turner

This research tested the hypothesis that women who had higher levels of physical fitness will have lower hypothalamo–pituitary–adrenal axis (cortisol) and sympatho-adrenal medullary system (blood pressure and heart rate) responses to food intake compared with women who had low levels of physical fitness. Lower fitness (n = 22; maximal oxygen consumption = 27.4 ± 1.0 mL∙kg−1·min−1) and higher fitness (n = 22; maximal oxygen consumption = 41.9 ± 1.6 mL∙kg−1·min−1) women (aged 30–50 years; in the follicular phase of the menstrual cycle) who participated in levels of physical activity that met (lower fitness = 2.7 ± 0.5 h/week) or considerably exceeded (higher fitness = 7.1 ± 1.4 h/week) physical activity guidelines made their own lunch using standardised ingredients at 1200 h. Concentrations of cortisol were measured in blood samples collected every 15 min from 1145–1400 h. Blood pressures and heart rate were also measured every 15 min between 1145 h and 1400 h. The meal consumed by the participants consisted of 20% protein, 61% carbohydrates, and 19% fat. There was a significant overall response to lunch in all of the parameters measured (time effect for all, p < 0.01). The cortisol response to lunch was not significantly different between the groups (time × treatment, p = 0.882). Overall, both groups showed the same pattern of cortisol secretion (treatment p = 0.839). Systolic blood pressure, diastolic blood pressure, mean arterial pressure, or heart rate responses (time × treatment, p = 0.726, 0.898, 0.713, and 0.620, respectively) were also similar between higher and lower fitness women. Results suggest that the physiological response to food intake in women is quite resistant to modification by elevated physical fitness levels.


2020 ◽  
Author(s):  
Daniel H. Major ◽  
Margreth Grotle ◽  
Chris Littlewood ◽  
Jens Ivar Brox ◽  
Dagfinn Matre ◽  
...  

Abstract Background: Exercise is recommended for patients with subacromial pain. It has been suggested that good exercise adherence improves clinical outcomes. Despite this, little attention has been paid to the need for behavioural frameworks to enhance adherence to home exercise programs for patients with subacromial pain.Methods: A feasibility study with pre-post design was used. Participants aged > 18 years, with subacromial pain, who had received conservative treatment during the past six months, were recruited. The Ad-Shoulder intervention consisted of 1-5 individual sessions provided over 3 months and was based on 5 self-management skills, which aimed to enhance the patients’ self-efficacy and adherence to self-managed exercises. The primary objectives were assessed according to predefined progression criteria: 1) The recruitment rate (10 patients enrolled within 12 weeks); 2) Follow-up rate (≥80% on all self-reported measures); 3) Objective physical activity measures (≥80% of participants would contribute valid data at each time point), 4) Adherence with the self-managed exercises (≥80% of the participants would adhere to ≥80% of the assigned home exercise program); 5) Fidelity of the delivery of the intervention (The therapists delivered the intervention according to the protocol); 6) Adverse events (<30% would report adverse events (including mild)). The results were reported using descriptive statistics.Results: Eleven patients were recruited during 16 weeks. Ten patients completed the self-reported measures at baseline and Week 12. Objective physical activity measures were successfully obtained for 100% at baseline, 64% at week six and 82% at week 12. 55% of the participants satisfactorily completed at least 80% of their home exercise program. All sessions were delivered according to the protocol. None of the patients reported any adverse events. Conclusions: Objective physical activity data measures at baseline and week 12, follow-up, the physiotherapists’ fidelity to the intervention and adverse events met our pre-specified progression criteria. Recruitment and adherence to the self-managed exercise program were both below the anticipated level. Further intervention development is necessary to understand whether adherence to the self-managed exercises could be enhanced and additional methods of recruitment would need to be considered, including additional recruitment sites, in any planning for a future main trial.Trial registration: ClinicalTrials.gov NCT04190836, Registered December 9, 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04190836


2016 ◽  
Vol 68 (2) ◽  
Author(s):  
Duccio Rossini ◽  
Massimo Bulckaen ◽  
Stefano Di Marco ◽  
Roberto Giovannetti ◽  
Franco Giuntoli ◽  
...  

Background: Physical training is believed the primary treatment of claudication symptoms. Although exercise therapy is self-effective, some drugs improving functional capacity have additive effects. TASC (Trans Atlantic Society Consensus) considers Propionil-L-Carnitine (PLC) and prostaglandin-E1 (PGE1) as poorly studied drugs with potential benefits in improving claudication. This retrospective, observational study was performed to compare the efficacy of PGE1 and PLC, and to evaluate both the immediate results of an intensive, short-course rehabilitation program and the outcome at one year follow-up. Methods: Twenty-five patients with severe-moderate claudication were selected. All patients were subjected to an intensive, supervised exercise program for 4 weeks in combination with either PGE1 (10 patients) or PLC (15 patients). Drugs were infused i.v. before every exercise session: 60 μg PGE1 within 2 hours and 600 mg PLC within 10 minutes. Patients were trained with the same supervised treadmill walking-exercise program. At the end of the rehabilitation period, patients were instructed to keep walking (advised home exercise). Initial claudication distance (ICD) and absolute claudication distance (ACD) were evaluated during a constant treadmill test (3 km/hour speed, 10% grade) at entry, after 4 weeks and at one year follow-up. A patient was considered as no-responder if his/her improvement in ACD was &lt;33%. Results: A significant increase of both ICD and ACD was detected after both 4 weeks (+269% and +135%, respectively, in PGE1 group; +245% and +125%, respectively, in PLC group) and one year (+364% and +202%, respectively, in PGE1 group; +279% and +176%, respectively, in PLC group). No-responder patients after the intensive training period (2 in PGE1 group and 4 in PLC group) remained noresponders also at one year follow-up. Both PGE1 and PLC treatments were well tolerated. No serious drug-related side effect requiring interruption of the treatment was observed. Conclusions: A short-course of intensive exercise treatment plus PLC or PGE1 may enhance walking ability. The result was confirmed at one year follow-up.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Daniel H. Major ◽  
Margreth Grotle ◽  
Chris Littlewood ◽  
Jens Ivar Brox ◽  
Dagfinn Matre ◽  
...  

Abstract Background Exercise is recommended for patients with subacromial pain. It has been suggested that good exercise adherence improves clinical outcomes. Despite this, little attention has been paid to the need for behavioural frameworks to enhance adherence to home exercise programmes for patients with subacromial pain. Methods A feasibility study with pre-post design was used. Participants aged > 18 years, with subacromial pain, who had received conservative treatment during the past 6 months, were recruited. The Ad-Shoulder intervention consisted of 1–5 individual sessions provided over 3 months and was based on 5 self-management skills, which aimed to enhance the patients’ self-efficacy and adherence to self-managed exercises. The primary objectives were assessed according to predefined progression criteria: (1) the recruitment rate (10 patients enrolled within 12 weeks), (2) follow-up rate (≥ 80% on all self-reported measures), (3) objective physical activity measures (≥ 80% of participants would contribute valid data at each time point), (4) adherence with the self-managed exercises (≥ 80% of the participants would adhere to ≥ 80% of the assigned home exercise programme), (5) fidelity of the delivery of the intervention (the therapists delivered the intervention according to the protocol) and (6) adverse events (< 30% would report adverse events (including mild)). The results were reported using descriptive statistics. Results Eleven patients were recruited during 16 weeks. Ten patients completed the self-reported measures at baseline and week 12. Objective physical activity measures were successfully obtained for 100% (11/11) at baseline, 64% (7/11) at week six and 82% at week 12. Fifty-five percent (6/11) of the participants satisfactorily completed at least 80% of their home exercise programme. All sessions were delivered according to the protocol. None of the patients reported any adverse events. Conclusions Objective physical activity data measures at baseline and week 12, follow-up, the physiotherapists’ fidelity to the intervention and adverse events met our pre-specified progression criteria. Recruitment and adherence to the self-managed exercise programme were both below the anticipated level. Further intervention development is necessary to understand whether adherence to the self-managed exercises could be enhanced and additional methods of recruitment would need to be considered, including additional recruitment sites, in any planning for a future main trial. Trial registration ClinicalTrials.gov, NCT04190836, Registered December 9, 2019—retrospectively registered


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michał Waszczykowski ◽  
Bożena Dziankowska-Bartkowiak ◽  
Michał Podgórski ◽  
Jarosław Fabiś ◽  
Arleta Waszczykowska

AbstractThe aim of this study was to estimate the long-term results of complex and supervised rehabilitation of the hands in systemic sclerosis (SSc) patients. Fifty-one patients were enrolled in this study: 27 patients (study group) were treated with a 4-week complex, supervised rehabilitation protocol. The control group of 24 patients was prescribed a home exercise program alone. Both groups were evaluated at baseline and after 1-, 3-, 6-, and 12-months of follow-up with the Disability of the Arm, Shoulder and Hand Questionnaire (DAHS) as the primary outcome, pain (VAS—visual analog scale), Cochin Hand Function Scale (CHFS), Health Assessment Questionnaire Disability Index (HAQ-DI), Scleroderma-HAQ (SHAQ), range of motion (d-FTP—delta finger to palm, Kapandji finger opposition test) and hand grip and pinch as the secondary outcomes. Only the study group showed significant improvements in the DASH, VAS, CHFS and SHAQ after 1, 3 and 6 months of follow-up (P = 0.0001). Additionally, moderate correlations between the DASH, CHFS and SHAQ (R = 0.7203; R = 0.6788; P = 0.0001) were found. Complex, supervised rehabilitation improves hand and overall function in SSc patients up to 6 months after the treatment but not in the long term. The regular repetition of this rehabilitation program should be recommended every 3–6 months to maintain better hand and overall function.


2021 ◽  
Vol 10 (6) ◽  
pp. 1190
Author(s):  
Victoria Alcaraz-Serrano ◽  
Ane Arbillaga-Etxarri ◽  
Patricia Oscanoa ◽  
Laia Fernández-Barat ◽  
Leticia Bueno ◽  
...  

Background: Low physical activity and high sedentary behaviour in patients with bronchiectasis are associated with hospitalisation over one year. However, the factors associated with longitudinal changes in physical activity and sedentary behaviour have not been explored. We aimed to identify clinical and sociodemographic characteristics related to a change in physical activity and sedentary behaviour in patients with bronchiectasis after one year. Methods: This was a prospective observational study during which physical activity measurements were recorded using a SenseWear Armband for one week at baseline and at one year. At each assessment point, patients were classified as active or inactive (measured as steps per day) and as sedentary or not sedentary (measured as sedentary time). Results: 53 patients with bronchiectasis were analysed, and after one year, 18 (34%) had worse activity and sedentary levels. Specifically, 10 patients became inactive and sedentary. Multivariable analysis showed that the number of exacerbations during the follow-up period was the only outcome independently associated with change to higher inactivity and sedentary behaviour (odds ratio (OR), 2.19; 95% CI, 1.12 to 4.28). Conclusions: The number of exacerbations in patients with bronchiectasis was associated with changes in physical activity and sedentary behaviour. Exacerbation prevention may appear as a key factor in relation to physical activity and sedentary behaviour in patients with bronchiectasis.


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