The Need for Advanced Cardiac Life Support Certification for Open-Water Lifeguards at Huntington Beach, CA

The number of people visiting U.S. beaches increased in 2007 to more than 240 million people. This increase in activities does not come without danger. Lifeguards maintain beach safety, but little research is available to assist us in determining appropriate certification levels for lifeguards. The authors analyzed various injuries that occurred in the open-water environment of Huntington Beach, CA. Based on the nature of the injuries, they attempted to determine the level of training lifeguards needed. The vast majority of injuries (99%) were soft-tissue injuries, musculoskeletal injuries, or environmental injuries. It was felt that lifeguards with first-aid and basic-life-support (BLS) -level training were able to handle these injuries adequately and that advanced cardiac life support (ACLS) was not necessary. Injuries that happened at Huntington Beach primarily required lifeguards with first-aid and BLS training. It does not seem necessary that all open-water lifeguards be trained in ACLS

COMPARISON OF NON-MAXIMAL TESTS FOR ESTIMATING EXERCISE CAPACITY

Although maximal incremental exercise tests (GXT) are the gold standard for outcome assessment and exercise prescription, they are not widely available in either fitness or clinical exercise programs. This study compared the prediction of VO2max in healthy, sedentary volunteers using a non-exercise prediction (Matthews et al., 1999), RPE extrapolation to 19 and 20 and the Rockport Walking Test (RWT), and of ventilatory threshold (VT) using the Talk Test and RPE @ 13,14,15. Subjects performed a treadmill GXT with gas exchange, a submaximal treadmill with RPE and Talk Test, the RWT and Matthews. All methods provided reasonable estimates of both VO2max and VT, with correlations of >0.80 and SEE~1.3 METs. VO2max was best estimated with the extrapolation to RPE=19. VT was intermediate between the TT Last Positive and Equivocal stages and between RPE 13 and 14. Non-maximal evaluation can be used in place of maximal GXT with gas exchange to make reasonable estimates of both VO2max and V

No immediate effects of highly cushioned shoes on basic running biomechanics

The aim of the study was to investigate the effects of highly cushioned shoes on running biomechanics. Sixteen recreational runners (8 males, 8 females) participated and ran at a self-selected pace across the force platform in the research laboratory wearing either the standard or highly cushioned shoes, in randomized order. Impact peak (IP), loading rate to IP (LR), active peak (AP), contact time (CT), strike index (SI), running velocity, and knee and ankle kinematics at initial contact (IC) and AP were recorded during the running trials. Overall, there was no effect of footwear on IP, LR, AP, CT and velocity (p>.05) with small effect sizes (ES.05). Our results indicate that the highly cushioned shoes did not show immediate changes in running biomechanics

CAN THE TALK TEST BE USED TO PREDICT TRAINING INDUCED CHANGES IN VENTILATORY THRESHOLD?

This study was designed to assess the ability of the Talk Test (TT) to track training-related changes in ventilatory threshold (VT). Thirteen recreational athletes (mean±SD; age, 20.5±1.91 years, (Males=7, Females=6) completed two incremental exercise tests (one with respiratory gas exchange and one with the TT) before and after 6-weeks of self-directed increases in training load. The TT was used to predict VT by assessing the ability to speak comfortably after 3-minute exercise stages based on speech comfort during a 100-word passage. Training load was documented using exercise logs based on sRPE and training duration. Repeated measures ANOVA, with Tukey’s post-hoc analysis, was used to detect differences between the changes in power output at the equivocal stage of the Talk Test and VT measured by gas exchange (p&lt;.05). Significant mean differences were found between pre vs post training power output at the equivocal stage of the Talk Test (125+40.8 vs 135+29.8 Watts) and measured VT (116+32.4 vs 134+32.4 Watts) (p&gt;.05). However, the increase in power output at VT (+15.5%) was significantly underestimated by the change in power output at equivocal stage of the TT (+8.0%).&nbsp; The correlation between changes in power output at VT and PO at the equivocal stage of the TT was r=0.66. However, about 50% of subjects did not change their power output at the equivocal stage of the TT, so the individual correspondence between Talk Test and measured VT was only moderately strong.</p

Exercise prescription when there is no exercise test: the talk test

The Talk Test is a subjective measure of exercise intensity which, like RPE, has come to be accepted as an alternative to objective measures (%HRR, %VO2max) for exercise evaluation and prescription. This paper reviews the history and indications for using the Talk Test as a tool for both exercise evaluation and exercise prescription. The Talk Test, in one form or the other, has a long history, dating from at least 1937. It appears to be robust relative to the method of provoking speech and to the exercise mode. In the most widely used version, the subject recites a standard paragraph of 30-100 words, and responds to the question ‘Can you speak comfortably?’ With answers of ‘Yes’ (POSITIVE), ‘Yes, but…’ (EQUIVOCAL), and ‘No” (NEGATIVE), the Talk Test appears to be able to identify exercise intensities closely associated with the ventilatory (VT) and respiratory compensation (RCT) thresholds, and to bracket subjects into %HRR intensities closely associated with the accepted exercise/training intensity guidelines, without the need for performing a maximal exercise test. The Talk Test appears to work well in a range of populations from college students, healthy adults, elite athletes to patients with chronic diseases. It also seems to be a valid and reliable marker of the presence of exertional ischemia. In a variety of populations, the Talk Test appears capable of being translated into absolute exercise training intensities, on the basis of a commonsense step down sequence. The Talk Test appears to work by allowing detection of when the suppression of breathing frequency, which is necessary for speech, begins to lead to CO2 trapping, which interferes with breathing comfort. Its response to disrupting stimuli such as stochastic exercise, exercise training and blood donation follow predictable patterns. Guiding exercise intensity using the Talk Test instead of %HRR provides comparable responses during exercise training, without the need for an anchoring maximal exercise test. In summary, the Talk Test seems to offer a considerable promise as a means of exercise evaluation and prescription, in a wide variety of exercising individuals, without the need for a preliminary exercise test

Exercise prescription when there is no exercise test: the talk test

The Talk Test is a subjective measure of exercise intensity which, like RPE, has come to be accepted as an alternative to objective measures (%HRR, %VO2max) for exercise evaluation and prescription. This paper reviews the history and indications for using the Talk Test as a tool for both exercise evaluation and exercise prescription. The Talk Test, in one form or the other, has a long history, dating from at least 1937. It appears to be robust relative to the method of provoking speech and to the exercise mode. In the most widely used version, the subject recites a standard paragraph of 30-100 words, and responds to the question ‘Can you speak comfortably?’ With answers of ‘Yes’ (POSITIVE), ‘Yes, but…’ (EQUIVOCAL), and ‘No” (NEGATIVE), the Talk Test appears to be able to identify exercise intensities closely associated with the ventilatory (VT) and respiratory compensation (RCT) thresholds, and to bracket subjects into %HRR intensities closely associated with the accepted exercise/training intensity guidelines, without the need for performing a maximal exercise test. The Talk Test appears to work well in a range of populations from college students, healthy adults, elite athletes to patients with chronic diseases. It also seems to be a valid and reliable marker of the presence of exertional ischemia. In a variety of populations, the Talk Test appears capable of being translated into absolute exercise training intensities, on the basis of a commonsense step down sequence. The Talk Test appears to work by allowing detection of when the suppression of breathing frequency, which is necessary for speech, begins to lead to CO2 trapping, which interferes with breathing comfort. Its response to disrupting stimuli such as stochastic exercise, exercise training and blood donation follow predictable patterns. Guiding exercise intensity using the Talk Test instead of %HRR provides comparable responses during exercise training, without the need for an anchoring maximal exercise test. In summary, the Talk Test seems to offer a considerable promise as a means of exercise evaluation and prescription, in a wide variety of exercising individuals, without the need for a preliminary exercise test

Effects of speech passage length on accuracy of predicting metabolic thresholds using the talk test

The Talk Test (TT) is a simple technique for prescribing exercise training intensity, based on the ability to ‘speak comfortably’ after reciting a standard speech provoking stimulus. This study compares the length of the speech provoking stimulus on Power Output (PO) at standard TT speech comfort markers (Last Positive (LP), Equivocal (EQ), Negative (NEG)) in relation to objective markers of exercise intensity, the ventilatory (VT) and respiratory compensation (RCT) thresholds. Eighteen healthy subjects performed incremental (25W/2 min) exercise with concomitant gas exchange to measure VT and RCT. They also performed (random order) incremental exercise without gas exchange while repeating standard speech provoking stimuli of 31, 62 and 93 words to allow identification of the LP, EQ & NEG stages of the TT. The mean (+sd) PO at LP (139+38, 117+39 & 103+38 W), EQ (164+38, 142+38 & 128+33 W) & NEG (196+42, 189+43, & 174+39 W) stages of the TT were analyzed for 31, 62 & 93 word passages, in relation to the PO at VT (128+43 W) & RCT (175+39W). PO@EQ and PO@NEG stages of the TT, with the 93 word speech provoking stimulus were not significantly different than the PO@ VT and PO@RCT, respectively. The mean error for predicting PO@VT approximated zero with the longer (93 word) speech passage duration for EQ (0.1+37 W) and for predicting the PO@ RCT for NEG (0.1+29 W). The results suggest that a longer duration speech provoking passage optimizes the accuracy of the TT estimation of VT and RCT