Is home-based, high-intensity interval training cycling feasible and safe for patients with knee osteoarthritis? Study protocol for a randomized pilot study

Background: Osteoarthritis (OA) is a degenerative joint disease affecting the knee joint of many middle-aged and older adults. As OA symptoms typically involve knee pain and stiffness, individuals with knee OA are often insufficiently physically active, have low levels of physical function, and are at increased risk of other comorbidities and reduced quality of life. While moderate-intensity continuous training (MICT) cycling is often recommended, little is known about the feasibility, safety, and benefits of high-intensity interval training (HIIT) cycling for this population, even though the feasibility, safety, and benefits of HIIT have been demonstrated in other chronic disease groups. Purpose: The primary objective of this pilot study was to examine the feasibility and safety of home-based HIIT and MICT cycling in middle-aged and older adults with knee OA. A secondary objective was to gain some insight into the relative efficacy of HIIT and MICT for improving health status (pain, stiffness, and disability), muscle function, and body composition in this population. This study protocol is being published separately to allow a detailed description of the research methods, explain the rationale for choosing the methodological details, and to stimulate consideration of the best means to simulate a research protocol that is relevant to a real-life treatment environment. Study Design: Randomized pilot study protocol. Methods: This trial sought to recruit 40 middle-aged and older adults with knee OA. Participants were randomly allocated to either continuous (MICT) or HIIT home-based cycle training programs, with both programs requiring the performance of 4 cycling sessions (approximately 25 minutes per session) each week. Participants were measured at baseline and postintervention (8 weeks). Feasibility and safety were assessed by adherence rate, dropout rate, and number of adverse events. The relative efficacy of the cycling programs was investigated by 2 knee OA health status questionnaires (Western Ontario and McMaster Universities Osteoarthritis Index scale[WOMAC] and the Lequesne Index) as well as the timed up and go, sit to stand, preferred gait speed, and body composition. Discussion: This pilot study appears to be the first study assessing the feasibility and safety of a home-based HIIT training program for middle-aged and older adults with knee OA. As HIIT has been demonstrated to be more effective than MICT for improving aspects of health status, body composition, and/or muscular function in other chronic disease groups, the current study has the potential to improve patient outcomes and inform the design of future randomized controlled trials

KINEMATICS OF THE BMX SX GATE START ACTION

The purpose of this study was to identify the sagittal range of motion across five joints and two body segments during the first three cranks of the BMX SX gate start, and to identify difference between females and males across these seven variables. This was achieved with markerless motion capture of 10 athletes, analysing three maximum effort gate starts using a motion capture and data analysis method previously validated in literature. It was found that the average range of motion for the trunk segment was 39 ± 6°, head segment was 38 ± 35°, shoulder joint was 87 ± 7°, elbow joint was 47 ± 15°, hip joint was 62 ± 11°, knee joint was 93 ± 12° and ankle joint was 58 ± 14°. Further analysis showed a statistically significant difference between males and females. This information can be further used to advise strength and conditioning prescription and to assess movement maturatio

Role of perfectionism, self-compassion, and cultural values on help-seeking attitudes of Asian American college students

Perfectionism, cultural values, and self-compassion can all impact the ways in which a person may present themselves. The desire to appear perfect has been found to mask psychological distress. Our study examines how perfectionism, as well as other variables that influence self-presentation, can impact help-seeking attitudes. We focus on the influence of perfectionistic self-presentation on mental health outcomes in Asian American college students. We predicted that self-compassion will be correlated with positive help-seeking attitudes, while perfectionistic self-presentation will be related to more unfavorable help-seeking attitudes. We also examine how culture, specifically emotional self-control and family recognition through achievement, can alter these relationships. Data collection is still ongoing, but preliminary correlations based on 101 Asian American college students indicated that help-seeking attitudes was correlated with cultural value of emotional restraint, and the perfectionistic self-presentation subscale of non-disclosure of imperfection

Is high-intensity interval cycling feasible and more beneficial than continuous cycling for knee osteoarthritic patients? Results of a randomised control feasibility trial

Background Knee osteoarthritis (OA) patients often suffer joint pain and stiffness, which contributes to negative changes in body composition, strength, physical performance (function), physical activity and health-related quality of life. To reduce these symptoms and side effects of knee OA, moderate-intensity continuous training (MICT) cycling is often recommended. While resistance training is considered the optimal form of training to improve sarcopenic outcomes, it imposes higher joint loads and requires supervision, either initially or continuously by trained exercise professionals. Therefore, this pilot study sought to gain some insight into the feasibility and potential benefits of high-intensity interval training (HIIT) cycling as an alternative exercise option to MICT cycling for individuals with knee OA. Methods Twenty-seven middle-aged and older adults with knee OA were randomly allocated to either MICT or HIIT, with both programs involving four unsupervised home-based cycling sessions (∼25 min per session) each week for eight weeks. Feasibility was assessed by enrolment rate, withdrawal rate, exercise adherence and number of adverse effects. Efficacy was assessed by health-related quality of life (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Lequesne index), physical function (Timed Up and Go (TUG), Sit to Stand (STS) and preferred gait speed) and body composition (body mass, BMI, body fat percentage and muscle mass). Results Twenty-seven of the interested 50 potential participants (54%) enrolled in the study, with 17 of the 27 participants completing the trial (withdrawal rate of 37%); with the primary withdrawal reasons being unrelated injuries or illness or family related issues. Of the 17 participants who completed the trial, exercise adherence was very high (HIIT 94%; MICT 88%). While only three individuals (one in the MICT and two in the HIIT group) reported adverse events, a total of 28 adverse events were reported, with 24 of these attributed to one HIIT participant. Pre–post-test analyses indicated both groups significantly improved their WOMAC scores, with the HIIT group also significantly improving in the TUG and STS. The only significant between-group difference was observed in the TUG, whereby the HIIT group improved significantly more than the MICT group. No significant changes were observed in the Lequesne index, gait speed or body composition for either group. Discussion An unsupervised home-based HIIT cycle program appears somewhat feasible for middle-aged and older adults with knee OA and may produce similar improvements in health-related quality of life but greater improvements in physical function than MICT. These results need to be confirmed in larger randomised controlled trials to better elucidate the potential for HIIT to improve outcomes for those with knee OA. Additional research needs to identify and modify the potential barriers affecting the initiation and adherence to home-based HIIT cycling exercise programs by individuals with knee OA

The validity and intra-tester reliability of markerless motion capture to analyse kinematics of the BMX Supercross gate start

The aim of this study was to quantify the validity and intra-tester reliability of a novel method of kinematic measurement. The measurement target was the joint angles of an athlete performing a BMX Supercross (SX) gate start action through the first 1.2 s of movement in situ on a BMX SX ramp using a standard gate start procedure. The method employed GoPro® Hero 4 Silver (GoPro Inc., USA) cameras capturing data at 120 fps 720 p on a ‘normal’ lens setting. Kinovea 0.8.15 (Kinovea.org, France) was used for analysis. Tracking data was exported and angles computed in Matlab (Mathworks®, USA). The gold standard 3D method for joint angle measurement could not safely be employed in this environment, so a rigid angle was used. Validity was measured to be within 2°. Intra-tester reliability was measured by the same tester performing the analysis twice with an average of 55 days between analyses. Intra-tester reliability was high, with an absolute error <6° and <9 frames (0.075 s) across all angles and time points for key positions, respectively. The methodology is valid within 2° and reliable within 6° for the calculation of joint angles in the first ~1.25 s