Methods and protocols for incremental exercise testing in tetraplegia, using arm-crank ergometry assisted by Functional Electrical Stimulation

Cervical spinal cord injury (SCI) leads to tetraplegia, with paralysis and loss of sensation in the upper and lower limbs. The associated sedentary lifestyle results in an increased risk of cardiovascular disease. To address this, we require the design of exercise modalities aimed specifically at tetraplegia and methods to assess their efficacy. This paper describes methods for arm-crank ergometry (ACE) assisted by Functional Electrical Stimulation (FES) applied to the biceps and triceps. The instrumented ergometer enables work-rate control during exercise, implemented here for incremental exercise testing during FES-ACE. Detailed protocols for the tests are given. Experimental data collected during exercise tests with tetraplegic volunteers are provided to illustrate the feasibility of the proposed approach to testing and data analysis. Incremental tests enabled calculation of peak power output and peak oxygen uptake. We propose that the high-precision exercise testing protocols described here are appropriate to assess the efficacy of the novel exercise modality, FES-ACE, in tetraplegia

The effect of training order on neuromuscular, endocrine and mood response to small-sided games and resistance training sessions over a 24-h period

Objectives: This study examined the acute effect of small-sided-game (SSG) and resistance training sequence on neuromuscular, endocrine and mood response over a 24-hour (h) period. Design: Repeated measures Methods: Fourteen semi-professional soccer players performed SSG-training (4vs4 + goalkeepers; 6x7-min, 2-min inter-set recovery) followed by resistance training 2h later (back-squat, Romanian deadlift, barbell-hip-thrust; 4x4 repetitions, 4-min inter-set recovery; 85% 1 rep-max) (SSG+RES), and on a separate week reversed the session order (RES+SSG). Physical demands of SSG’s were monitored using global positioning systems (GPS) and ratings of perceived exertion (RPE). Countermovement-jump (CMJ; peak power output; jump height) and brief assessment of mood were collected before (pre), during (0h) and after (+24h) both protocols. Salivary testosterone and cortisol concentrations were obtained at the same time-points but with the inclusion of a measure immediately prior to the second training session (+2h). Results: GPS outputs and RPE were similar between SSG-training during both protocols. Between-protocol comparisons revealed no significant differences at +24h in CMJ performance, mood, and endocrine markers. Testosterone was higher at 0h during RES+SSG in comparison to SSG+RES (moderate-effect; +21.4±26.7 pg·ml-1; p= 0.010), yet was similar between protocols by +2h. Conclusions: The order of SSG and resistance training does not appear to influence the physical demands of SSG’s with sufficient recovery between two sessions performed on the same day. Session order did not influence neuromuscular, endocrine or mood responses at +24h, however a favourable testosterone response from the resistance first session may enhance neuromuscular performance in the second session of the day

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Effects of grazing method and fertiliser inputs on the productivity and sustainability of phalaris-based pastures in Western Victoria

The effects of combinations of different fertiliser rates and grazing methods applied to phalaris-based pastures on an acid, saline, yellow sodosol on the Dundas Tablelands of western Victoria (mean annual rainfall 623 mm) were measured from 1997 to 2000. The objective was to help identify management systems that improve phalaris growth and persistence, water use, and animal production, and thereby the productivity and sustainability of grazing systems. Pastures were either set stocked with low [mean 6.4 kg phosphorus (P)/ha.year] or high (mean 25 kg P/ha.year) fertiliser rates, or rotationally grazed with high fertiliser (mean 25 kg P/ha.year). Rotational grazing was implemented as either a simple '4-paddock' system (fixed rotation length), or a more intensive system where rotation length varied with pasture growth rate. Unreplicated paddocks of volunteer pasture (dominated by onion grass and annual grass weeds) receiving an average of 8 kg P/ha.year were also monitored. All treatments were stocked with spring-lambing Merino ewes. Stocking rate was an emergent property of each treatment, and was driven by pasture quality and availability. Total pasture herbage accumulation ranged from 7150 to 9750 kg DM/ha.year and was significantly lower on the set-stocked, low-fertility treatment than on all other treatments. A significant treatment.day effect in the spline analysis of herbage mass was explained by a trend toward higher pasture mass in the rotationally grazed treatments than set-stocked treatments from the break of season until mid-spring. Rotational grazing led to significantly higher phalaris herbage accumulation than set stocking (mean 3680 v. 2120 kg DM/ha.year), but significantly lower subterranean clover herbage accumulation (1440 v. 2490 kg DM/ha.year). Despite the stronger growth of deep-rooted phalaris in the rotationally grazed treatments, maximum soil water deficits at the end of summer differed only slightly between treatments, with the difference between driest and wettest treatments amounting to only 14 mm. Summer growth of phalaris was apparently insufficient to generate significant differences in soil water extraction at depth, even when phalaris content was increased by rotational grazing, and re-wetting of the soil profile occurred at a similar rate for all treatments. Rotationally grazed treatments supported higher stocking rates than set-stocked treatments at high fertiliser rates (mean 14.9 v. 13.7 ewes/ha), but apparent losses in pasture feeding value due to lower legume content under rotational grazing meant that there were few significant differences between treatments in lamb production per hectare. The experiment showed that grazing method can have a substantial and rapid effect on pasture botanical composition. There are clear opportunities for producers to use temporal and spatial combinations of set stocking and rotational grazing to manipulate herbage mass and pasture composition within broad target ranges for achieving both animal production (e.g. high per-head animal performance) and sustainability (e.g. persistence of perennial grasses) objectives. Rigid application of either set stocking or rotational grazing imposes limitations on both pasture and animal production, and neither grazing method will optimise system performance under all conditions. The experiment also demonstrated that management and land-use changes that have much greater potential to increase water use than those examined here will be needed to ensure the sustainability of pasture systems in the high rainfall zone of western Victoria

Core Formation and Mantle Differentiation on Mars

info:eu-repo/semantics/publishe