An investigation into the development and validity of progressive fitness tests for rowing, and young people

A Masters thesis submitted in fulfilment of the requirements for the award of Masters by Research of the University of BedfordshireThe aim of this thesis was to develop a new rowing based version of the multistage fitness test to be used on a concept II rowing ergometer in any gymnasium. It was also to quantify the physiological strain and asses the validity of the multistage fitness test on young people and its relationship between speed and strength variables. In Study one, an incremental based rowing protocol (IRT) was developed. A Significant correlation was observed between a treadmill based V02max and the IRT for V02max (r =0.68, SEE 4.7) and heart rate (r =0.76, SEE =5.8). In 41 gym users (35 females, 25 males) V02max values were significantly different between treadmill running (44.7. ± 6.5 mL·kg-1·min,1) and rowing (42.2 ± 7.3 mL'kg,1' min,1; P < 0.05). In all subjects maximum heart rate (HRmax) was significantly higher during the running V02max test (192.2 ± 9.6 beats'min,1) compared to the IRT (184.3 ± 10.6 beats'min-1 ; P < 0.05). In study two, the validity of the MSFT was testing in young people. The MSFT had a significant relationship in girls (n =35) between 10m sprint (r =-0.48; P 0.05), hand grip dynamometer (r = 0.30; P> 0.05) strength and pull dynamometer strength (r =0.29' P> 0.05)

The performance analysis of power output in professional male road cyclists

Athletes regularly monitor exercise workload in an attempt to improve and maintain exercise performance. Within road cycling, workload is commonly measured using power output. Yet, it is plausible that power output during road cycling is influenced by several factors such as topography, road gradient or rider specialities. If these factors do influence power output they may influence quantification of workload demands. As such, the purpose of this thesis was to improve our understanding of external workload in professional road cycling and describe the factors which influence power output during performance analysis. Specifically, this thesis examined the power output within single stage (1 day, Study One) and multi-stage races (4-21 days, Study Two, Three and Four). The within seasonal changes in power output of professional cyclists were also examined (Study Five). Study One calculated the frequency distribution of maximal power output (POpeak) values during road cycling events over different topography categories and analysed the power output 600 s prior to POpeak using a new time series analysis called changepoint. Changepoint estimated the four largest statistical changes in power output to find distinct segments. Seven professional male road cyclists (mean ± SD: age 29.5 ± 2.8 y, mass 69.7 ± 5.5 kg, height 182 ± 5 cm) participated in Study One and were all members of a single professional cycling team. It was found that a greater frequency of POpeak values (54%) occurred during flat stages in the final 80 to 100% of race time compared with the previous 0 to 80% race time. Using changepoint, power output was lower (P \u3c0.05) in segment four compared with POpeak in all topography categories (flat: 235 vs. 823 W, semi-mountainous: 157 vs. 886 W and mountainous: 171 vs. 656 W). These results demonstrate that POpeak values occur at differing time points depending on the topography category and that changepoint demonstrated its ability to analyse power output data. Study Two calculated the maximal mean power (MMP) of professional cyclists from grand tour events. The MMP was examined across various topographies and rider specialities. Study Two also examined the percentage of race time spent in different power output bands between topographies, road gradients and rider specialities. Thirteen male professional cyclists (mean ± SD: age 25 ± 3 y, mass 69 ± 7.5 kg, height 178 ± 0.5 cm) participated in Study Two. MMP for durations longer than 1200 s were greater in semi-mountainous and mountainous stages, when compared with flat stages (1200 s: 5.1 ± 0.2, 5.2 ± 0.3, 4.5 ± 0.3 W·kg-1 respectively; P \u3c0.05). Sprinters and climbers spent greater percentage of race time at a power output greater than 7.5 W·kg-1, when compared with general classification riders and domestiques (11.3, 11.4, 7.1 and 5.3%, respectively; P \u3c0.05). A greater proportion of race time was spent at a power output above 3.7 W·kg-1 when cycling at a road gradient greater than 5% (P \u3c0.05), compared with road gradients 0 to 5% and less than 0%. In conclusion, caution should be taken when comparing MMP between different races of varying topography or rider specialities. It was found in Study Two that MMP differs between flat and mountainous stages. Given that critical power (CP) can be estimated from MMP values during competition it is plausible that such differences will influence CP estimation. It is also plausible that difference in MMP between flat and mountainous stages is because cyclists are able to produce greater power output uphill rather than on flat gradients. As such, Study Three examined the use of MMP in the estimation of CP when calculated from stages of differing topographies. Also, Study Three compared estimated CP from a flat (mean gradient 0.4%) and uphill (mean gradient 6.2%) field-based test. Data from thirteen professional male road cyclists (age 29 ± 4 y, height 171 ± 0.9 cm, mass 67 ± 8.2 kg) were analysed. No differences (P \u3e0.05) were observed in estimated CP between topography categories. However, a large effects size (d = 0.8) was observed in CP between flat stages and both semi-mountainous and mountainous stages. Estimated CP was 11.6% lower in flat field-based test, compared with the uphill field-based test (5.0 vs. 5.6 W·kg-1). Study Three demonstrates a large difference between estimated CP from alternative topography categories and from two different gradient specific field-based tests. With an 11.6% difference in CP observed in Study Three between 0 and 6.2% road gradients, Study Four investigated the magnitude of change in 1 and 5 min MMP from grand tour mountain stages. Road gradients of -5% to +5% were compared chronologically from lowest to highest. Seven professional male road cyclists (age 30 ± 4 y, height 169 ± 8 cm, body mass 69 ± 9 kg) from two professional cycling teams were analysed. In total 50 mountainous stages were analysed in Study Four from grand tours between 2011 and 2016. Power output from road gradient -1% was lower (P \u3c0.001) in both 1 and 5 MMP compared with 0% (2.4 to 3.3 and 2.2 to 3.1 W·kg-1, respectively). Power output from road gradient 1% was lower in both 1 and 5 MMP compared with 2% (3.6 to 4.2 and 3.4 to 4.1 W·kg-1; (P \u3c0.05)). These results highlight the need to consider road gradient when using power output for cycling performance analysis. Study Five described the within-season external workloads of professional male road cyclists for optimal training prescription. Four professional male cyclists (mean ± SD: age 24 ± 2 y, body mass 77.6 ± 1.5 kg, height 184 ± 4.3 cm) from the same professional cycling team were monitored for 12 months. Within three seasonal phases (phase one: Oct-Jan, phase two: Feb-May and, phase three: June-Sept), the volume and exercise intensity during training and racing was measured. Total distance (3859 ± 959 vs 10911 ± 620 km) and time (240.5 ± 37.5 vs 337.5 ± 26 h) was lower (P \u3c0.01) in phase one compared with phase two, respectively. Total distance decreased (P \u3c0.01) from phase two compared with phase three (10911 ± 620 vs 8411 ± 1399 km, respectively). Mean absolute (236 ± 12.1 vs. 197 ± 3 W) and relative (3.1 ± 0 vs. 2.5 ± 0 W·kg-1) power output was higher (P \u3c0.05) during racing compared with training, respectively. These results highlight the importance in acknowledging the difference in volume and intensity changes during a season. In conclusion, this thesis demonstrates that cycling power output is affected by multiple factors including topography, road gradient and a rider’s speciality. Caution should be taken when interpreting cycling performance analysis using power output measures such as MMP and CP

The first endovascular repair of an acute type A dissection using an endograft designed for the ascending aorta

Endovascular repair has emerged as a potential alternative to emergency open surgical repair for type A dissection in selected patients, with isolated reports describing the results obtained with a range of devices designed originally for the descending aorta. We believe that we present the first reported repair of an acute ascending aortic dissection using an endovascular stent graft manufactured specifically for the ascending aorta

First Demonstration of Velocity Selective Recording from the Pig Vagus using a Nerve Cuff shows Respiration Afferents

Neural interfaces have great potential to treat disease and disability by modulating the electrical signals within the nervous system. However, whilst neural stimulation is a well-established technique, current neural interfaces are limited by poor recording ability. Low signal amplitudes necessitate the use of highly invasive techniques that divide or penetrate the nerve, and as such are unsuitable for chronic implantation. In this paper, we present the first application of the velocity selective recording technique to the detection of respiration activity in the vagus nerve, which is involved with treatments for epilepsy, depression, and rheumatoid arthritis. Further, we show this using a chronically implantable interface that does not divide the nerve. We also validate our recording setup using electrical stimulation and we present an analysis of the recorded signal amplitudes. The recording interface was formed from a cuff containing ten electrodes implanted around the intact right vagus nerve of a Danish Landrace pig. Nine differential amplifiers were connected to adjacent electrodes, and the resulting signals were processed to discriminate neural activity based on conduction velocity. Despite the average single channel signal-to-noise ratio of − 5.8 dB, it was possible to observe distinct action potentials travelling in both directions along the nerve. Further, contrary to expectation given the low signal-to-noise ratio, we have shown that it was possible to identify afferent neural activity that encoded respiration. The significance of this is the demonstration of a chronically implantable method for neural recording, a result that will transform the capabilities of future neuroprostheses

Influence of combined functional resistance and endurance exercise over 12 weeks on matrix metalloproteinase-2 serum concentration in persons with relapsing-remitting multiple sclerosis-a community-based randomized controlled trial

Background: The relevance of regular moderate to intense exercise for ameliorating psychomotor symptoms in persons with multiple sclerosis (pwMS) is becoming increasingly evident. Over the last two decades, emerging evidence from clinical studies and animal models indicate immune regulatory mechanisms in both periphery and the central nervous system that may underlie these beneficial effects. The integrity of the blood-brain barrier as the main structural interface between periphery and brain seems to play an important role in MS. Reducing the secretion of proteolytic matrix metalloproteinases (MMP), i.e. MMP-2, as disruptors of blood-brain barrier integrity could have profound implications for MS. Methods: In this two-Armed randomized controlled trial 64 participants with relapsing-remitting MS (RRMS) (EDSS 0-4.0) will be allocated to either an intervention group or a passive wait list control group. The intervention group will perform 60 min of combined functional resistance and endurance exercises 3x per week over a period of 12 weeks in a community-based and publicly available setting. Changes in serum concentration of MMP-2 will be the primary outcome. Secondary outcomes are numbers of immune cell subsets, soluble (anti-) inflammatory factors, physical capacity, cognitive performance, physical activity behavior, gait performance, and patient-reported outcomes. All outcome measures will be assessed at baseline and after week 12 with an additional blood sampling before, during and immediately after a single training session in week 6. Discussion: To our knowledge, this will be the first RCT to investigate both the acute and chronic effects of a community-based intense functional resistance and endurance exercise regimen in persons with RRMS. Combining analysis of biological and cognitive or psychological outcomes may provide a better understanding of the MS-specific symptomology. Trial registration: DRKS00017091; 05th of April, 2019; International Clinical Trials Registry Platform

Strategies adopted by men to deal with uncertainty and anxiety when following an active surveillance/monitoring protocol for localised prostate cancer and implications for care: a longitudinal qualitative study embedded within the ProtecT trial.

OBJECTIVES: Active surveillance (AS) enables men with low risk, localised prostate cancer (PCa) to avoid radical treatment unless progression occurs; lack of reliable AS protocols to determine progression leaves uncertainties for men and clinicians. This study investigated men's strategies for coping with the uncertainties of active monitoring (AM, a surveillance strategy within the Prostate testing for cancer and Treatment, ProtecT trial) over the longer term and implications for optimising supportive care. DESIGN: Longitudinal serial in-depth qualitative interviews every 2-3 years for a median 7 (range 6-14) years following diagnosis. SETTING: Four centres within the UK Protect trial. PARTICIPANTS: Purposive sample of 20 men with localised PCa: median age at diagnosis 64 years (range 52-68); 15 (75%) had low-risk PCa; 12 randomly allocated to, 8 choosing AM. Eleven men continued with AM throughout the study period (median 7 years). Nine received radical treatment after a median 4 years (range 0.8-13.8 years). INTERVENTION: AM: 3-monthly serum prostate-specific antigen (PSA)-level assessment (year 1), 6-12 monthly thereafter; increase in PSA ≥50% during previous 12 months or patient/clinician concern triggered review. MAIN OUTCOMES: Thematic analysis of 73 interviews identified strategies to accommodate uncertainty and anxiety of living with untreated cancer; implications for patient care. RESULTS: Men sought clarity, control or reassurance, with contextual factors mediating individual responses. Trust in the clinical team was critical for men in balancing anxiety and facilitating successful management change/continued monitoring. Only men from ProtecT were included; men outside ProtecT may have different experiences. CONCLUSION: Men looked to clinicians for clarity, control and reassurance. Where provided, men felt comfortable continuing AM or having radical treatments when indicated. Clinicians build patient trust by clearly describing uncertainties, allowing patients control wherever possible and being aware of how context influences individual responses. Insights indicate need for supportive services to build trust and patient engagement over the long term. TRIAL REGISTRATION NUMBER: ISRCTN20141297; Pre-results