A systematic scoping review: Resources targeting the training and education of health and recreation practitioners to support physical activity among people with physical disabilities

BackgroundHealth and recreation practitioners play an important role in promoting and supporting leisure time physical activity (LTPA) among persons with physical disabilities (PWPD), yet many practitioners lack training and education to provide the basic knowledge, skills, and resources necessary.¹ Little is known about existing LTPA information and training resources for health and recreation practitioners and there has been no known systematic effort to identify existing resources.ObjectiveThe purpose of the current study was to engage systematic scoping methodologies to identify resources that target the training and education of health and recreation practitioners to promote and support LTPA among PWPD. To further analyze the identified resources, an assessment of quality was conducted.MethodsSystematic scoping review methodologies were employed, which included searches of academic and grey literature, online materials (i.e., Google search) and expert consultation. Results: Several (N = 46) resources were identified from academic, government and non-government, and professional organizations. Most resources were targeted to a specific PWPD population. The resources were of high technical quality. Conclusion: The paper serves as a listing of existing resources for practitioners working with PWPD in LTPA settings. The review provides a catalyst for action in further research and practice regarding the analysis, design, development, implementation and evaluation of optimally effective resources targeting practitioners to promote and support LTPA among PWPD.ResultsSeveral (N = 46) resources were identified from academic, government and non-government, and professional organizations. Most resources were targeted to a specific PWPD population. The resources were of high technical quality.ConclusionThe paper serves as a listing of existing resources for practitioners working with PWPD in LTPA settings. The review provides a catalyst for action in further research and practice regarding the analysis, design, development, implementation and evaluation of optimally effective resources targeting practitioners to promote and support LTPA among PWPD.     

Personalized Blood Flow Restriction Therapy: How,When and Where Can It Accelerate Rehabilitation After Surgery?

Personalized (based on a percentage of a patient's limb occlusion pressure) blood flow restriction is emerging as a potential advancement in orthopaedic surgery. Safe application of the technology requires the use of medical devices capable of customizing the pressures applied to individual patients. In those circumstances, it is a low risk and noninvasive technique. By limiting muscle atrophy and aiding in the recovery of strength and function, it has the potential to significantly reduce the morbidity from limb trauma and surgery, and aid in achieving a substantially earlier return to full activity.     

Platelet release of beta-thromboglobulin within the coronary circulation during cold pressor stress

Cold stress by increasing circulating catecholamines may sensitize blood platelets to aggregate and release their constituents. This study investigates the effect of cold stress on the release of the platelet-specific protein beta-thromboglobulin into the coronary venous blood of 12 subjects with atherosclerotic coronary artery disease (CAD) and 7 subjects with angiographically normal coronary arteries (NCA). Cold pressor stress caused a greater increase in systolic arterial pressure in patients with CAD than in subjects with NCA (p less than 0.05). There was no significant difference between the platelet counts in the arterial or coronary venous blood either before or during cold stress. Arterial beta-thromboglobulin was higher in the group with CAD (77 +/- 18 ng/ml) than in subjects with NCA (49 +/- 12 ng/ml, p less than 0.01). Although there was no arteriovenous difference of beta-thromboglobulin at rest in either group, during cold stress, coronary venous beta-thromboglobulin increased in both the NCA (53 +/- 16 to 95 +/- 26 ng/ml, p less than 0.05) and CAD groups (76 +/- 13 to 117 +/- 53 ng/ml, p less than 0.025) despite no change in arterial beta-thromboglobulin. Release of beta-thromboglobulin, although not related to the presence of angiographic arterial disease, correlated with the systolic arterial pressure during cold stress (r = 0.66) and inversely with the platelet's ability to generate cyclic adenosine monophosphate (r = 0.69). The release of platelet constituents in the coronary circulation is provoked by cold stress and may play a role in stress-induced acute coronary occlusion in patients with atherosclerotic disease and in those with apparently normal vessels.     

Comparison of gas-liquid chromatography and EMIT assay for serum valproic acid

We describe a simple direct extraction method for the gas-liquid chromatography determination of serum valproic acid. The working range for the assay is 2-180 mg/L and our within-run precision was 5.8 and 4.3% at the 40 and 90 mg/L concentrations respectively. Hemolyzed and lipemic sera as well as samples from patients with hyperbilirubinemia and from patients with decreased renal function were put through the assay and no interfering peaks were noted. Interference occurred when teflon-lined screw caps were used during the extraction step. The method was proven to be accurate by linear regression analysis of samples containing weighed-in amounts of valproic acid. The above assay was compared to an enzyme immunoassay technique (EMIT). The working range for the latter is 10-150 mg/L and the with-run precision was 10.8 and 5.9% and 90 mg/L concentration respectively. Samples were run by both the gas-liquid chromatograph and enzyme immunoassay methods and gave very similar results over the range 16-139 mg/L.