Dignity therapy intervention fidelity: a cross-sectional descriptive study with older adult outpatients with cancer

Objectives Intervention fidelity is imperative to ensure confidence in study results and intervention replication in research and clinical settings. Like many brief protocol psychotherapies, Dignity Therapy lacks sufficient evidence of intervention fidelity. To overcome this gap, our study purpose was to examine intervention fidelity among therapists trained with a systematized training protocol. Methods For preliminary fidelity evaluation in a large multi-site stepped wedge randomized controlled trial, we analyzed 46 early transcripts of interviews from 10 therapists (7 female; 7 White, 3 Black). Each transcript was evaluated with the Revised Dignity Therapy Adherence Checklist for consistency with the Dignity Therapy protocol in terms of its Process (15 dichotomous items) and Core Principles (6 Likert-type items). A second rater independently coded 26% of the transcripts to assess interrater reliability. Results Each therapist conducted 2 to 10 interviews. For the 46 scored transcripts, the mean Process score was 12.4/15 (SD = 1.2), and the mean Core Principles score was 9.9/12 (SD = 1.8) with 70% of the transcripts at or above the 80% fidelity criterion. Interrater reliability (Cohen’s kappa and weighted kappa) for all Adherence Checklist items ranged between .75 and 1.0. For the Core Principles items, Cronbach’s alpha was .92. Conclusions Preliminary findings indicate that fidelity to Dignity Therapy delivery was acceptable for most transcripts and provide insights for improving consistency of intervention delivery. The systematized training protocol and ongoing monitoring with the fidelity audit tool will facilitate consistent intervention delivery and add to the literature about fidelity monitoring for brief protocol psychotherapeutic interventions.

The Pursuit of Effective Working Memory Training: a Pre-registered Randomised Controlled Trial with a Novel Varied Training Protocol

Working memory (WM) training, typically entailing repetitive practice with one or two tasks, has mostly yielded only limited task-specific transfer effects. We developed and tested a new WM training approach where the task paradigm, stimulus type, and predictability of the stimulus sequence were constantly altered during the 4-week training period. We expected that this varied training protocol would generate more extensive transfer by facilitating the use of more general strategies that could be applied to a range of WM tasks. Pre-post transfer effects following varied training (VT group, n = 60) were compared against traditional training (TT group, training a single adaptive WM task, n = 63), and active controls (AC, n = 65). As expected, TT evidenced strong task-specific near transfer as compared to AC. In turn, VT exhibited task-specific near transfer only on one of the measures, and only as compared to the TT group. Critically, no evidence for task-general near transfer or far transfer effects was observed. In sum, the present form of VT failed to demonstrate broader transfer. Nevertheless, as VT has met with success in other cognitive domains, future studies should probe if and how it would be possible to design WM training protocols that promote structural learning where common features of specific tasks would be identified and utilised when selecting strategies for novel memory tasks.

Effects of an Eccentric Training Protocol Using Gliding Discs on Balance and Lower Body Strength in Healthy Adults

Impaired balance and lower body weakness are the main causes of falls, which are considered to be the major cause of fractures and head injuries in the elderly and are recognised as a serious health problem. The aim of this study is to observe the effect of eccentric training, introducing new technologies (gliding discs), on body composition, lower body strength, balance and quality of life. A quasi-experimental study was carried out with 56 healthy participants who were divided into an experimental group (n = 31) who underwent the protocol consisting of 12 training sessions and a control group (n = 25) who did not undergo the training. Before and after the intervention, all participants underwent a measurement of body composition, the SJ jump, balance with accelerometry and quality of life with the Short Form 12 Health Survey. In the experimental group, statistically significant improvements were found in the variables balance and lower body strength. The application of this training protocol improves lower body strength and the ability to control balance in the adult population.

Acute and delayed effects of strength training in ball velocity and accuracy in young competition tennis players

This study aimed to investigate the acute and delayed effects of medicine ball throws and resistance training in ball velocity and accuracy of serve, forehand and backhand in young competition tennis players. A crossover-randomized design was used with 10 competition tennis players (6 girls and 4 boys between 14 and 18 years old). The subjects performed 6 stroke test sessions, 3 for each strength protocol. The velocity and accuracy of strokes were measured before (basal situation), 3 minutes, 24 and 48 hours after the protocol. Medicine ball throws protocol was performed by accomplishing 3 sets of 6 repetitions using a 2 kg ball, throwing it at maximal speed. Resistance training protocol was performed by accomplishing 3 sets of 6 repetitions at 75% one-repetition maximum, lifting the load at maximal speed of bench press, dead lift, one hand row and half squat. There were no significant (p > 0.05) differences in all strokes, regarding ball velocity and accuracy after each method and each recovery time, compared to the basal situation. These results suggest that medicine ball throws and resistance training methods have no acute and delayed detrimental effects on stroke velocity and accuracy in young competition tennis players.

Systematic Review and Meta-Analysis of Endurance Exercise Training Protocols for Mice

Inbred and genetically modified mice are frequently used to investigate the molecular mechanisms responsible for the beneficial adaptations to exercise training. However, published paradigms for exercise training in mice are variable, making comparisons across studies for training efficacy difficult. The purpose of this systematic review and meta-analysis was to characterize the diversity across published treadmill-based endurance exercise training protocols for mice and to identify training protocol parameters that moderate the adaptations to endurance exercise training in mice. Published studies were retrieved from PubMed and EMBASE and reviewed for the following inclusion criteria: inbred mice; inclusion of a sedentary group; and exercise training using a motorized treadmill. Fifty-eight articles met those inclusion criteria and also included a “classical” marker of training efficacy. Outcome measures included changes in exercise performance, V˙O2max, skeletal muscle oxidative enzyme activity, blood lactate levels, or exercise-induced cardiac hypertrophy. The majority of studies were conducted using male mice. Approximately 48% of studies included all information regarding exercise training protocol parameters. Meta-analysis was performed using 105 distinct training groups (i.e., EX-SED pairs). Exercise training had a significant effect on training outcomes, but with high heterogeneity (Hedges’ g=1.70, 95% CI=1.47–1.94, Tau2=1.14, I2=80.4%, prediction interval=−0.43–3.84). Heterogeneity was partially explained by subgroup differences in treadmill incline, training duration, exercise performance test type, and outcome variable. Subsequent analyses were performed on subsets of studies based on training outcome, exercise performance, or biochemical markers. Exercise training significantly improved performance outcomes (Hedges’ g=1.85, 95% CI=1.55–2.15). Subgroup differences were observed for treadmill incline, training duration, and exercise performance test protocol on improvements in performance. Biochemical markers also changed significantly with training (Hedges’ g=1.62, 95% CI=1.14–2.11). Subgroup differences were observed for strain, sex, exercise session time, and training duration. These results demonstrate there is a high degree of heterogeneity across exercise training studies in mice. Training duration had the most significant impact on training outcome. However, the magnitude of the effect of exercise training varies based on the marker used to assess training efficacy.

Treadmill Training Improves Aerobic Capacity in Aged Male Mice Compared to Voluntary Wheel Running

Preclinical exercise studies typically use two forms of exercise training protocols: 1) voluntary wheel running and 2) forced treadmill running. Previous work from our group clearly demonstrates that older (18-month-old) male mice do not voluntarily engage in wheel running, especially compared to younger males or female mice. Therefore, we implemented a forced exercise treadmill training protocol to determine if treadmill training was superior to wheel running in improving aerobic capacity in older male mice. Purpose To determine if a 3-week treadmill training protocol improved time to exhaustion (TTE) in older male mice. Methods 18-month-old male mice (n=5) were provided a running wheel in their individual cage for 2 weeks or underwent daily treadmill training (n=6) for 3 weeks with increasing speed/incline. At the end of the training period we assessed TTE. Results Older male mice that trained on the treadmill demonstrated higher TTE compared to wheel (1382 □ 32 seconds versus 500 □ 99 seconds, respectively). In addition, older male mice that trained on the treadmill improved on average ~8% in their TTE test. Conclusion A 3-week treadmill training protocol improves aerobic capacity in older male mice to a greater extent than voluntary wheel running. Ongoing experiments will utilize this training protocol to understand age-related declines in cardiorespiratory fitness, circadian rhythm, and to test exercise as an intervention in the aging population.

Effects of a periodized circuit training protocol delivered by telerehabilitation compared to face-to-face method for knee osteoarthritis: a protocol for a non-inferiority randomized controlled trial

Background Regular exercise is an effective method for reducing pain and disability in patients with knee osteoarthritis (OA), as well as improving body composition. Thus, a combination of both resistance and aerobic training (circuit training) has shown to be promising for this population. However, access to physical therapy is limited by physical distance, social isolation, and/or treatment costs. Remote rehabilitation seems to be an effective way to minimize these barriers, but the benefits are dependent on the participants’ adherence to the interventions provided at a distance. The objectives of this protocol are to compare the effects of a periodized circuit training applied via telerehabilitation with the same protocol applied in the face-to-face model for individuals with knee OA. Methods This study presents a single-blinded protocol for a non-inferiority randomized controlled trial. One hundred participants diagnosed with knee OA (grades II and III Kellgren and Lawrence system), aged 40 years or more, and BMI < 30 kg/m2 will be randomly divided into two groups: telerehabilitation (TR) and face-to-face (FtF) circuit training. The FtF group will perform a 14-week periodized circuit training protocol supervised by a physical therapist, 3 times a week. The TR group will perform the same exercise protocol at home, at least 3 times a week. In addition, the TR group will be able to follow the execution and orientations of the exercises by DVD, a website, and online file sharing tools, and they will receive periodic phone calls in order to motivate, clarify, and inform some aspects of knee OA. The primary outcomes are changes in self-reported pain intensity (visual analog scale (VAS)) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)), with a primary end-point of 14 weeks and a secondary end-point of 26 weeks. Secondary outcomes include changes in other clinical outcomes, in morphological characteristics, adherence, acceptability, and treatment perspective. Discussion A circuit training through telerehabilitation may contribute to developing early intervention in the causative and potentiating factors of the knee OA, verifying the effects of a low-cost, non-pharmacological and non-invasive treatment. Trial registration Brazilian Registry of Clinical Trials (ReBEC) ID: RBR-662hn2. Registered on 31 March 2019. Link: http://www.ensaiosclinicos.gov.br; Universal Trial Number (UTN) of World Health Organization: U1111-1230-9517.

Effectiveness of Ladder Training Versus Plyometric Training Program on Agility in Kabaddi Players

Background: Sport specific training in Kabaddi players should also focus on agility in consistent with demand of the sport. Since Ladder training and Plyometric training improves agility, it can be useful training strategy to improve the performance of Kabaddi players. Ladder training is more effective and also help the player to catch, strike, and to block or tackle the component, whereas Plyometric training enhances balance and control of body positions during game. Methodology: A comparative study design had made use of Quasi experimental approach by convenience sampling to select 60 samples of semiprofessional Kabaddi players in the age of 18- 25 students of both genders studying in KIMS College of Physiotherapy, Amalapuram. On certain predetermined criteria with a formal written consent samples were taken. The data was gathered following Interventions using Ladder training and Plyometric training protocol which was administered on the Kabaddi players. The outcome measures were assessed before the intervention and at the end of Eighth week. The standardized tool named Agility T-test was taken to assess the Agility before and after the intervention. Result of the Study: The result of the study indicated that Ladder training is a useful training strategy to improve agility more in Kabaddi players than Plyometric training programme. Whereas level of significance taken is P=<0.05. And obtained level of significance P<0.00. Conclusion: This study concluded that Ladder training is a useful training strategy to improve agility than Plyometric training programme in Kabaddi players. Key words: Agility, Ladder Training, Plyometrics, Kabaddi.