High volume of endurance training impairs adaptations to 12 weeks of strength training in well-trained endurance athletes

The purpose of the present study was to compare the effect of 12 weeks of strength training combined with a large volume of endurance training with the effect of strength training alone on the strength training adaptations. Well-trained cyclists with no strength training experience performed heavy strength training twice a week in addition to a high volume of endurance training during a 12-week preparatory period (S + E; n = 11). A group of non-strength trained individuals performed the same strength training as S + E, but without added endurance training (S; n = 7). Thigh muscle cross-sectional area, 1 repetition maximum (1RM) in leg exercises, squat jump performance, and peak rate of force development (RFD) were measured. Following the intervention period, both S + E and S increased 1RM strength, thigh muscle cross-sectional area, and squat jump performance (p < 0.05), and the relative improvements in S were greater than in S + E (p < 0.05). S increased peak RFD while S + E did not, and this improvement was greater than in S + E (p < 0.05). To the best of our knowledge, this is the first controlled study to demonstrate that the strength training response on muscle hypertrophy, 1RM strength, squat jump performance, and peak RFD is attenuated in well-trained endurance athletes during a period of concurrent endurance training.     

Do respiratory therapists receive training and education in smoking cessation? A national study of post-secondary training programs

Objective

To assess the tobacco-related education provided by post-secondary respiratory therapy training programs in the United States.

Methods

A cross-sectional research design was used to survey the entire population of program directors of post-secondary, respiratory therapy training programs in the United States. A valid and reliable questionnaire was developed and mailed using a 2-wave mailing technique (73% return rate). Internal reliability coefficients (Cronbach alpha) for the various components of the questionnaire ranged from 0.78 to 0.91.

Results

More than half of programs (56%) offered no teaching on the 5R's. Nearly half (47%) offered no teaching on the 5A's. Of the 13 tobacco-related topics listed in the basic science and clinical science sections of the questionnaire, only one topic (i.e., diseases linked to tobacco use) received 3 h or more of instruction by approximately a third of programs (35.8%). The majority of programs (>90%) spent no time teaching students about the socio-political aspects of tobacco use cessation. Moreover, 41% of programs did not formally evaluate students’ competence in providing smoking cessation counseling to patients.

Conclusions

Tobacco-related education is a very minor component of the education and training received by respiratory therapy students in the United States.

Practice Implications

Respiratory therapy training programs in the United States have great potential to strengthen the tobacco-related education that they provide to students. Practicing respiratory therapists would likely benefit from continuing medical education focused on how to use evidence-based smoking cessation counseling techniques with patients.     

Can observational training substitute motor training in preventing backward balance loss after an unexpected slip during walking?

A person's awareness of potential slippery walking conditions induces a cautious gait pattern. The purposes of this study were to determine whether neuromechanical changes associated with such cognitive conditioning are sufficient to alter the outcome of a slip and whether the effects of such conditioning are comparable to those of motor training. Prior to their own first slip exposure, 18 young subjects watched videos and slides demonstrating where and how the slip would occur and how people adapted to repeated-slip exposure (observe). The outcomes of the first slip exposure experienced by another 16 subjects who did not receive any such information were used as controls (na?ve). The latter subjects subsequently experienced an additional 23 slips and thus served in a dual-role as the motor training group (motor). Gait stability as measured against backward loss of balance (BLOB) was obtained for pre- and postslip instances. A protective step landing posterior to the slipping-limb identified each BLOB outcome. The observe group had a greater postslip stability and lower slip displacement and velocity than the na?ve group. However, such effects were insufficient to prevent balance loss (100% BLOB). The motor group showed significantly better performance on the last training slip (0% BLOB) than did the observe group. The results indicated that updating the cognitive centers of the CNS with awareness and perceptual knowledge through observational training can yield tangible benefits. Nonetheless observation could not replace the task-specific motor training that adaptively updated the internal representations of stability limits for prevention of BLOB.     

In-season strength maintenance training increases well-trained cyclists’ performance

We investigated the effects of strength maintenance training on thigh muscle cross-sectional area (CSA), leg strength, determinants of cycling performance, and cycling performance. Well-trained cyclists completed either (1) usual endurance training supplemented with heavy strength training twice a week during a 12-week preparatory period followed by strength maintenance training once a week during the first 13 weeks of a competition period (E + S; n = 6 [♂ = 6]), or (2) usual endurance training during the whole intervention period (E; n = 6 [♂ = 5, ♀ = 1]). Following the preparatory period, E + S increased thigh muscle CSA and 1RM (p < 0.05), while no changes were observed in E. Both groups increased maximal oxygen consumption and mean power output in the 40-min all-out trial (p < 0.05). At 13 weeks into the competition period, E + S had preserved the increase in CSA and strength from the preparatory period. From the beginning of the preparatory period to 13 weeks into the competition period, E + S increased peak power output in the Wingate test, power output at 2 mmol l⁻¹ [la⁻], maximal aerobic power output (W _max), and mean power output in the 40-min all-out trial (p < 0.05). The relative improvements in the last two measurements were larger than in E (p < 0.05). For E, W _max and power output at 2 mmol l⁻¹ [la⁻] remained unchanged. In conclusion, in well-trained cyclists, strength maintenance training in a competition period preserved increases in thigh muscle CSA and leg strength attained in a preceding preparatory period and further improved cycling performance determinants and performance.     

Sex differences in ventricular–vascular coupling following endurance training

Introduction

Ventricular and vascular coupling is defined as the ratio of arterial elastance (Ea) to ventricular elastance (Elv) and describes the interaction between the heart and arterial system. There are sex differences in both arterial and ventricular function in response to both acute exercise and aerobic exercise training.

Purpose

To examine the effects of aerobic exercise training on elastances and the coupling ratio in young adult men and women. We hypothesized a reduction in the coupling ratio in both sexes due to a decrease in Ea that would be more pronounced in men and an increase in Elv that would be larger in women.

Methods

Fifty-three healthy, young adults completed the study. Central pulse wave velocity and heart volumes were measured before and after an 8-week aerobic training intervention. Elastances were calculated as Ea = end-systolic pressure/stroke volume and Elv = end-systolic pressure/end-systolic volume and indexed to body surface area.

Results

After the intervention, women augmented indexed and un-indexed Elv from 2.09 ± 0.61 to 2.52 ± 0.80 mmHg/ml, p < 0.05, and reduced the coupling ratio from 0.72 ± 18 to 0.62 ± 15, p < 0.05, while men maintained their pre-training ratio (from 0.66 ± 0.20 to 0.74 ± 0.21, p > 0.05). Women also reduced end-systolic pressure (from 91 ± 10 to 87 ± 10 mmHg), and both groups reduced central pulse wave velocity (from 6.0 ± 1.0 to 5.6 ± 0.6 m/s, p < 0.05).

Conclusion

We conclude that after 8 weeks of aerobic training, only women reduced their coupling ratio due to an increase in Elv. This suggests that aerobic exercise training elicits sex-dependent changes in the coupling ratio in young, healthy individuals.     

Perceptual learning: how much daily training is enough?

The acquisition of many perceptual skills proceeds over a course of days. However, little is known about how much daily training is needed for such learning to occur. Here we investigated this question by examining how varying the number of training trials per day affected learning over multiple days on two auditory discrimination tasks: frequency discrimination and temporal-interval discrimination. For each task, we compared improvements in discrimination thresholds between different groups of listeners who were trained for either 360 or 900 trials per day for 6 days. Improvement on frequency discrimination required >360 trials of training per day while learning on temporal-interval discrimination occurred with 360 training trials per day, and additional daily practice did not increase the amount of improvement. It therefore appears that the accumulation of improvement over days on auditory discrimination tasks may require some critical amount of training per day, that training beyond that critical amount yields no additional learning on the trained condition, and that the critical amount of training needed varies across tasks. These results imply that perceptual skills are transferred from short- to long-term memory (consolidated) daily, but only if a task-specific initiation requirement has been met.     

Combined effects of very short “all out” efforts during sprint and resistance training on physical and physiological adaptations after 2 weeks of training

Purpose

The aim of this study was to compare the combined effects of resistance and sprint training, with very short efforts (5 s), on aerobic and anaerobic performances, and cardiometabolic health-related parameters in young healthy adults.

Methods

Thirty young physically active individuals were randomly allocated into four groups: resistance training (RTG), sprint interval training (SITG), concurrent training (CTG), and control (CONG). Participants trained 3 days/week for 2 weeks in the high-intensity interventions that consisted of 6–12 “all out” efforts of 5 s separated by 24 s of recovery, totalizing ~ 13 min per session, with 48–72 h of recovery between sessions. Body composition, vertical jump, lower body strength, aerobic and anaerobic performances, heart rate variability (HRV), and redox status were evaluated before and after training. Total work (TW), rating of perceived exertion (CR-10 RPE) and mean HR (HR_mean) were monitored during sessions. Incidental physical activity (PA), dietary intake and perceived stress were also controlled.

Results

Maximum oxygen consumption (VO_2max) significantly increased in SITG and CTG (P < 0.05). Lower body strength improved in RTG and CTG (P < 0.05), while countermovement jump (CMJ) was improved in RTG (P = 0.04) only. Redox status improved after all interventions (P < 0.05). No differences were found in TW, PA, dietary intake, and psychological stress between groups (P > 0.05).

Conclusions

RT and SIT protocols with very short “all out” efforts, either performed in isolation, or combined, demonstrated improvement in several physical fitness- and health-related parameters. However, CT was the most efficient exercise intervention with improvement observed in the majority of the parameters.

     

Does personal initiative training work as a stress management intervention?

An experimental trial is reported that compares 2 stress management intervention programs and a waitlist control. Both programs involved training in problem-focused strategies of identifying and changing the sources of stress. One of the programs contained additional content on how to display more personal initiative (PI). Both programs involved 2 sessions held 1 week apart, each session lasting 3-4 hr. Strain was measured before training and at 7 and 13 weeks after the initial session. Results show that both programs were effective at reducing strain, whereas the waitlist group showed no change in strain. The PI program increased proactive behavior at 7 weeks as determined by independent evaluations, although the same pattern was not observed for PI self-reports. Proactive behavior did not appear to mediate the effects of training programs on strain.     

Histopathology training in Europe: a lesson for other specialties?

Critical shortages of trained histopathologists limit the capacity of cancer and other clinical services. A survey of histopathology training in 18 European countries conducted by the European Union of Medical Specialists Section of Pathology/European Board of Pathology revealed a considerable shortage of both trained and trainee histopathologists in several of the responding countries. Demographic data indicate a high preponderance of trained histopathologists over 55 years of age and a notable proportion of part-time personnel. Although the training capacity in some countries has been increased, the immediate future of histopathology and the clinical services dependent on the specialty is worrisome. The histopathology workload is growing, and, in some countries, recruitment of trainees is insufficient for future needs. To avert the serious consequences for dependent clinical specialties and their patients, there should be a concerted European action to promote and expand histopathology training.     

Test–retest errors and the apparent heterogeneity of training response

Published reports have shown large apparent inter-individual differences of gains in maximal oxygen intake (O_2max) in response to a standard 20-week programme of aerobic conditioning that progressed to 75% of the individuals initial O_2max. The observed gains of O_2max ranged from 0 to 1,000 ml min^–1, with a coefficient of variation (CV) of 8.4%. The present analysis evaluates the potential contribution of test–retest errors to these apparent large inter-individual differences in training response. The 2-day test–retest CV for O_2max readings in 742 healthy adults was initially 5.0%, dropping to 4.1% after training. Published training responses were estimated from the mean of paired measurements obtained before and after training if readings agreed by <5%, but from the highest of paired values if these differed by >5%. Taking account of the relative proportions of single and paired observations, the weighted O_2max data for the entire sample had an effective 2-day CV of 4.3% before and 3.4% after training. Assumption 1: if the 20-week test–retest error remained similar to the 2-day figure, measurement error would contribute a CV of 5.5% to apparent training responses, or (for the stated initial mean O_2max of 2,409 ml min^–1) an SD of 132 ml min^–1. Assumption 2: if the 20-week CV was similar to that in other long-term studies (~5%), measurement error would contribute a CV of 6.1%, or a SD of 146 ml min^–1. The published data show a total SD of 202 ml min^–1 for apparent inter-individual differences in training response, with age, gender, race and baseline O_2max accounting for only 11% of this variance. After estimating the likely effect of test–retest measurement errors, the SD due to inter-individual differences would decrease to 138 ml minO_2max (assumption 1) or 123 ml min^–1 (assumption 2). We conclude that when estimating the extent of inter-individual differences in training response, allowance must be made not only for the minor effects of recognized covariates (age, gender, race and initial fitness), but also for the larger influence of test-retest measurement errors. Nevertheless, substantial inter-individual differences persist after making such adjustments. The most likely explanation of these differences is a familial aggregation of training responses.     

Urine melatonin and citrate excretion during the elite swimmers’ training season

The objectives of the study were to evaluate the influence of a whole training season on 6-sulfatoxymelatonin (αMT6s) and citrate excretion in 12 elite swimmers. Urine samples were obtained (before bedtime and after waking up) at the beginning of the season, basic training, macrocycle I, tapering and macrocycle II stages. For αMT6s, at basic training, mainly with aerobic training, the evening concentrations were significantly lower (P < 0.01; P < 0.05) than at the beginning, tapering and macrocycle II stages. At macrocycle II stage, with the maximal training workload, the total sum (evening plus morning) was significantly higher (P < 0.05) than at the beginning, basic training and macrocycle I stages. The ratio (morning/evening) that represents the capacity to produce melatonin at night depending on the evening values at the basic training stage and the nocturnal increment at the macrocycle II stage were significantly higher (P < 0.01) than at all other stages. Citrate morning values at basic training and tapering stages were significantly lower (P < 0.01) than in the evening indicating that a metabolic recuperation took place. The total sum significantly decreased (P < 0.05) as the aerobic training progressed from the beginning to macrocycle I. The basic training ratio (morning/evening) was significantly lower compared to the beginning and macrocycle II stages, and the nocturnal increment was significantly higher (P < 0.05) compared to the beginning. Melatonin and citrate represent complementary markers that could be used to evaluate the assimilation of the training workload by noninvasive methods.     

Anaphylaxis and epinephrine auto-injector training: who will teach the teachers?

BACKGROUND: Anaphylaxis is the most urgent clinical immunologic event. Effective treatment is best achieved by administration of epinephrine. Accidental exposure to the responsible allergen is the most common cause of anaphylaxis, and because it could be fatal within minutes, epinephrine in preloaded syringes and auto-injectors has been introduced. In our experience patients and medical personnel are not familiar with the use of this device. OBJECTIVE: We sought to assess community-based professionals' knowledge of epinephrine auto-injector use and their ability to educate patients. METHODS: Study participants consisted of a medical convention's delegates and emergency department personnel in metropolitan Toronto, as well as pharmacists of the target hospitals and retail pharmacists. Research assistants approached eligible professionals to fill out a questionnaire and demonstrate their ability to use a standard placebo auto-injector trainer. RESULTS: A total of 122 professionals (composed of emergency physicians, family practitioners, and pediatricians) consented to participate in this study. The majority of participants (81%) did not have a placebo trainer to educate their patients; 76% did not know the 2 available dose strengths. To provide instructions and reinforcement, physicians clearly must have the necessary skills and knowledge, yet only 25% of the study participants were able to demonstrate the 3 steps of injection correctly. CONCLUSION: Our study highlights a specific and important deficiency in medical professionals' care of patients at risk for anaphylaxis. The results challenge the current methods of educating professionals, as well as patients, when prescribing or using epinephrine auto-injectors. Clearly a new approach to educating and maintaining such skills is required.     

Learning to prescribe – pharmacists' experiences of supplementary prescribing training in England

Background  

The introduction of non-medical prescribing for professions such as pharmacy and nursing in recent years offers additional responsibilities and opportunities but attendant training issues. In the UK and in contrast to some international models, becoming a non-medical prescriber involves the completion of an accredited training course offered by many higher education institutions, where the skills and knowledge necessary for prescribing are learnt. Aims: to explore pharmacists' perceptions and experiences of learning to prescribe on supplementary prescribing (SP) courses, particularly in relation to inter-professional learning, course content and subsequent use of prescribing in practice.     

Which books are perceived as helpful in the training of psychotherapists?

Psychotherapy and Clinical Fellows responded to a survey that requested them to recommend books they thought were of substantial help in training the prospective clinician to do psychotherapy. Responses indicated that there was little agreement among clinicians with regard to which books are helpful. Also, a minority of clinicians felt that no books were helpful. Those books found most helpful are referenced.