Validity and reliability of the session RPE method for monitoring exercise training intensity

Objective. The Session Rating of Perceived Extertion (RPE) is a method of measuring exercise intensity that may be useful for the quantitative assessment of exercise training programmes. However, there are inadequate data regarding the validity and reliability of the Session RPE method. This study was designed to evaluate both the validity and reliability of the Session RPE method in comparison to objective measures (%HRpeak, %HRreserve and %VO2peak) of exercise intensity. Methods. Fourteen healthy volunteers (7 male, 7 female) performed 6 randomly ordered 30-minute constant-load exercise bouts at 3 different intensities, with each intensity being repeated. Oxygen consumption (VO2) and heart rate (HR) were measured throughout each exercise bout and normalised to maximal values obtained during a preliminary maximal exercise test. Thirty minutes following the conclusion of each exercise bout, the subject rated the global intensity of the bout using a modification of the Category Ratio (CR) (0 - 10) RPE scale. This rating was compared to the mean value of objectively measured exercise intensity across the duration of the bout. Results. There were significant non-linear relationships between Session RPE and %VO2peak (R2 = 0.76), %HRpeak (R2 = 0.74) and %HRreserve (R2 = 0.71). There were no significant differences between test and retest values of %VO2peak, %HRpeak, %HRreserve and Session RPE during the easy (47 v. 47%, 65 v. 66%, 47 v. 48% and 2.0 v. 1.9), moderate (69 v. 70%, 83 v. 84%, 74 v. 75%, and 4.2 v. 4.3) and hard (81 v. 81%, 94 v. 94%, 91 v. 91% and 7.3 v. 7.4) exercise bouts. Correlations between repeated bouts for %VO2peak (r = 0.98), %HRpeak (r = 0.98), %HRreserve (r = 0.98) and Session RPE (r = 0.88) were significant and strong. Conclusions. The results support the validity and reliability of the Session RPE method of monitoring exercise intensity, although as might be predicted for a subjective method the Session RPE was less precise than the objective measures of exercise training intensity. South African Journal of Sports Medicine Vol. 18 (1) 2006: pp. 14-1

Validity and reliability of the session RPE method for monitoring exercise training intensity

Objective. The Session Rating of Perceived Extertion (RPE) is a method of measuring exercise intensity that may be useful for the quantitative assessment of exercise training programmes. However, there are inadequate data regarding the validity and reliability of the Session RPE method. This study was designed to evaluate both the validity and reliability of the Session RPE method in comparison to objective measures (%HRpeak, %HRreserve and %VO2peak) of exercise intensity. Methods. Fourteen healthy volunteers (7 male, 7 female) performed 6 randomly ordered 30-minute constant-load exercise bouts at 3 different intensities, with each intensity being repeated. Oxygen consumption (VO2) and heart rate (HR) were measured throughout each exercise bout and normalised to maximal values obtained during a preliminary maximal exercise test. Thirty minutes following the conclusion of each exercise bout, the subject rated the global intensity of the bout using a modification of the Category Ratio (CR) (0 - 10) RPE scale. This rating was compared to the mean value of objectively measured exercise intensity across the duration of the bout. Results. There were significant non-linear relationships between Session RPE and %VO2peak (R2 = 0.76), %HRpeak (R2 = 0.74) and %HRreserve (R2 = 0.71). There were no significant differences between test and retest values of %VO2peak, %HRpeak, %HRreserve and Session RPE during the easy (47 v. 47%, 65 v. 66%, 47 v. 48% and 2.0 v. 1.9), moderate (69 v. 70%, 83 v. 84%, 74 v. 75%, and 4.2 v. 4.3) and hard (81 v. 81%, 94 v. 94%, 91 v. 91% and 7.3 v. 7.4) exercise bouts. Correlations between repeated bouts for %VO2peak (r = 0.98), %HRpeak (r = 0.98), %HRreserve (r = 0.98) and Session RPE (r = 0.88) were significant and strong. Conclusions. The results support the validity and reliability of the Session RPE method of monitoring exercise intensity, although as might be predicted for a subjective method the Session RPE was less precise than the objective measures of exercise training intensity. South African Journal of Sports Medicine Vol. 18 (1) 2006: pp. 14-1

Increasing confidence and changing behaviors in primary care providers engaged in genetic counselling.

BackgroundScreening and counseling for genetic conditions is an increasingly important part of primary care practice, particularly given the paucity of genetic counselors in the United States. However, primary care physicians (PCPs) often have an inadequate understanding of evidence-based screening; communication approaches that encourage shared decision-making; ethical, legal, and social implication (ELSI) issues related to screening for genetic mutations; and the basics of clinical genetics. This study explored whether an interactive, web-based genetics curriculum directed at PCPs in non-academic primary care settings was superior at changing practice knowledge, attitudes, and behaviors when compared to a traditional educational approach, particularly when discussing common genetic conditions.MethodsOne hundred twenty one PCPs in California and Pennsylvania physician practices were randomized to either an Intervention Group (IG) or Control Group (CG). IG physicians completed a 6 h interactive web-based curriculum covering communication skills, basics of genetic testing, risk assessment, ELSI issues and practice behaviors. CG physicians were provided with a traditional approach to Continuing Medical Education (CME) (clinical review articles) offering equivalent information.ResultsPCPs in the Intervention Group showed greater increases in knowledge compared to the Control Group. Intervention PCPs were also more satisfied with the educational materials, and more confident in their genetics knowledge and skills compared to those receiving traditional CME materials. Intervention PCPs felt that the web-based curriculum covered medical management, genetics, and ELSI issues significantly better than did the Control Group, and in comparison with traditional curricula. The Intervention Group felt the online tools offered several advantages, and engaged in better shared decision making with standardized patients, however, there was no difference in behavior change between groups with regard to increases in ELSI discussions between PCPs and patients.ConclusionWhile our intervention was deemed more enjoyable, demonstrated significant factual learning and retention, and increased shared decision making practices, there were few differences in behavior changes around ELSI discussions. Unfortunately, barriers to implementing behavior change in clinical genetics is not unique to our intervention. Perhaps the missing element is that busy physicians need systems-level support to engage in meaningful discussions around genetics issues. The next step in promoting active engagement between doctors and patients may be to put into place the tools needed for PCPs to easily access the materials they need at the point-of-care to engage in joint discussions around clinical genetics

Dependence of aptamer activity on opposed terminal extensions: improvement of light-regulation efficiency

Aptamers that can be regulated with light allow precise control of protein activity in space and time and hence of biological function in general. In a previous study, we showed that the activity of the thrombin-binding aptamer HD1 can be turned off by irradiation using a light activatable ‘caged’ intramolecular antisense-domain. However, the activity of the presented aptamer in its ON state was only mediocre. Here we studied the nature of this loss in activity in detail and found that switching from 5′- to 3′-extensions affords aptamers that are even more potent than the unmodified HD1. In particular we arrived at derivatives that are now more active than the aptamer NU172 that is currently in phase 2 clinical trials as an anticoagulant. As a result, we present light-regulatable aptamers with a superior activity in their ON state and an almost digital ON/OFF behavior upon irradiation

Dependence of aptamer activity on opposed terminal extensions: improvement of light-regulation efficiency

Aptamers that can be regulated with light allow precise control of protein activity in space and time and hence of biological function in general. In a previous study, we showed that the activity of the thrombin-binding aptamer HD1 can be turned off by irradiation using a light activatable ‘caged’ intramolecular antisense-domain. However, the activity of the presented aptamer in its ON state was only mediocre. Here we studied the nature of this loss in activity in detail and found that switching from 5′- to 3′-extensions affords aptamers that are even more potent than the unmodified HD1. In particular we arrived at derivatives that are now more active than the aptamer NU172 that is currently in phase 2 clinical trials as an anticoagulant. As a result, we present light-regulatable aptamers with a superior activity in their ON state and an almost digital ON/OFF behavior upon irradiation

Microcephaly with or without chorioretinopathy, lymphoedema, or mental retardation (MCLMR): review of phenotype associated with KIF11 mutations

Microcephaly with or without chorioretinopathy, lymphoedema, or mental retardation (MCLMR) (MIM No.152950) is a rare autosomal dominant condition for which a causative gene has recently been identified. Mutations in the kinesin family member 11 (KIF11) gene have now been described in 16 families worldwide. This is a review of the condition based on the clinical features of 37 individuals from 22 families. This report includes nine previously unreported families and additional information for some of those reported previously. The condition arose de novo in 8/20 families (40%). The parental results were not available for two probands. The mutations were varied and include missense, nonsense, frameshift, and splice site and are distributed evenly throughout the KIF11 gene. In our cohort, 86% had microcephaly, 78% had an ocular abnormality consistent with the diagnosis, 46% had lymphoedema, 73% had mild-moderate learning difficulties, 8% had epilepsy, and 8% had a cardiac anomaly. We identified three individuals with KIF11 mutations but no clinical features of MCLMR demonstrating reduced penetrance. The variable expression of the phenotype and the presence of mildly affected individuals indicates that the prevalence may be higher than expected, and we would therefore recommend a low threshold for genetic testing

Supporting genetics in primary care: investigating how theory can inform professional education

Evidence indicates that many barriers exist to the integration of genetic case finding into primary care. We conducted an exploratory study of the determinants of three specific behaviours related to using breast cancer genetics referral guidelines effectively: 'taking a family history', 'making a risk assessment', and 'making a referral decision'. We developed vignettes of primary care consultations with hypothetical patients, representing a wide range of genetic risk for which different referral decisions would be appropriate. We used the Theory of Planned Behavior to develop a survey instrument to capture data on behavioural intention and its predictors (attitude, subjective norm, and perceived behavioural control) for each of the three behaviours and mailed it to a sample of Canadian family physicians. We used correlation and regression analyses to explore the relationships between predictor and dependent variables. The response rate was 96/125 (77%). The predictor variables explained 38-83% of the variance in intention across the three behaviours. Family physicians' intentions were lower for 'making a risk assessment' (perceived as the most difficult) than for the other two behaviours. We illustrate how understanding psychological factors salient to behaviour can be used to tailor professional educational interventions; for example, considering the approach of behavioural rehearsal to improve confidence in skills (perceived behavioural control), or vicarious reinforcement as where participants are sceptical that genetics is consistent with their role (subjective norm)