text:
User:Amyabbey/sandbox

This is a critical analysis of the journal article "Aerobic interval training versus continuous moderate exercise after coronary artery bypass surgery: A randomised study of cardiovascular effects and quality of life" (Trine T. Moholdt, et al. 2009)

What is the background to this research?
Coronary artery disease (CAD) can be defined as the narrowing of coronary arteries due to the build-up of fatty material called plaque. This plaque clogs up the arteries and reduces blood flow to the heart. In some cases surgical procedures are required to help blood flow correctly to the heart. Coronary artery bypass surgery, also known as coronary artery bypass grafting (CABG) is a procedure that uses blood vessels from another part of the body and connects them to blood vessels above and below the narrowed or blocked artery, bypassing the narrowed or blocked coronary arteries, allowing for blood to flow to the heart more efficiently.

The goal of CABG and exercise interventions is to reduce mortality rates. Patients enrolled in rehabilitation programs after CABG surgery have total and cardiac mortality reduced by 20%-26% compared to standard medical care patients. Exercise capacity is however, the best predictor of survival in both healthy individuals and those who suffer from cardiovascular disease. The best intensity, frequency, duration and type of exercise is still unknown. Aerobic interval training (AIT) however, has been shown to be more effective in improving cardiovascular function than moderate continuous training (MCT).

Where is the research from?
The research was completed by a large team from the Department of Circulation and Medical Imaging at the Norwegian University of Science and Technology, in conjunction with multiple different hospitals and medical centres from across the country.

The article was published in the American Heart Journal, which is a highly regarded medical journal consisting of peer-reviewed articles primarily focussed on cardiovascular disease. The journal aims to provide primary investigation, scholarly reviews and opinion based pieces about the practise of cardiovascular medicine.

What kind of research was this?
The study was a randomised controlled study, in which one group participated in Aerobic interval training, and the other completed moderate continuous training. The study aimed to investigate the effects of AIT and MCT on peak oxygen uptake (VO2peak) and quality of life after CABG surgery.

What did the research involve?
The study involved 59 CABG patients; 48 male, 11 female, who were randomly assigned to either AIT or MCT, stratified by gender. The randomisation code was completed using a computer number generation by a different unit at the University. Patients who suffered from heart failure, inability to exercise or drug abuse were excluded from the study.

The aerobic training program (AIT) consisted treadmill walking, 5 days a week for 4 weeks duration. It involved an 8-minute warm-up, followed by 4 sets of 4-minute intervals with the patient at 90% maximum HR and active pauses of 3-minute walking at 70% maximum HR. The session was completed with a 5-minute cool-down.

The moderate training group (MCT) walked continuously at 70% maximum HR for 46-minutes, to meet isoenergetic training protocols.

The intensity was controlled by heart rate monitors, and patients reported their rate of perceived exertion using the Borg CR10 scale. In addition to the MCT or AIT, participants also participated in training sessions held by the rehabilitation centre. These consisted of a variety of exercise modes and intensities, lasting between 45-60minutes duration. Both groups completed the same rehabilitation centre training, and all sessions had intensities measured by HR monitors.

If patients were discharged from rehabilitation centre, they received written exercise plans, which consisted of a 3-4 week training program with exercise at the same intensity and duration as their AIT or MCT group.

What were the basic results?
The study aimed to primarily measure VO2peak, as well as measuring left ventricular function, HR recovery, resting HR, work economy, quality of life and blood markers of cardiovascular disease as secondary outcome measures. These were measured a 3 time points; at baseline, after 4-weeks of rehabilitation and 6-months after being discharged from centre. Secondary measures were only taken at baseline and after 4 weeks.

Baseline characteristics from the two groups were well balanced, with no major complications and only one patient being excluded due to technical error.

The most significant changes from both groups were in VO2peak, HR recovery and quality of life. The AIT increased VO2peak from week 4-6 months and was also superior in increasing HR throughout the duration of the program and through to the 6-month follow up. This is ideal as low HR recovery is an independent predictor of mortality in cardiovascular disease patients. Quality of life also improved significantly in both groups in all three domains and therefore, was deemed to have improved patient's overall perceived quality of life. This can be seen in the table above.

During the 6-month follow up only the AIT group increased their VO2peak through their own at home exercise program, while MCT maintained the same capacity and did not improve. The improvement in the AIT group solely is believed to be caused by the higher intensity the exercise was, and how this transferred into patients at-home exercise routine. This aerobic capacity maintained for 2 years after the initial program was finished and could be due to the fact that patients in the AIT group had their activity pattern change, and were able to make a routine out of it.

What conclusions can we take from this research?
This study was a small, specific study, focussing on coronary artery bypass grafting patients from a small number of institutions in Norway. With only 58 participants including 11 female patients. The study size is too small for the results, evidence and conclusions made to be applicable to the population as a whole, which would require longer duration and more participants.

Interval training has been found to improve cardiovascular fitness more than moderate continuous training does. This research does however, come fundamentally from healthy individuals, and can be difficult to compare to CABG patients due to multiple confounding variables such as body composition, resting heart rate and blood pressure responses, selected risk factors, and cardiac performance. Due to the lack of control, improvements can only be made form baseline measurements.

Overall, the results from the study showed that aerobic interval training increased patients' VO2peak more than moderate continuous training did, although the low change from baseline could be due to the short duration of the exercise program, and results could change if duration was longer. The addition of rehabilitation centre training sessions in conjunction with the AIT/MCT sessions could have also influenced the VO2peak due to the training sessions difference in intensity and duration.

Practical advice
Aerobic interval training has been found to increase both HR recovery and VO2peak and may be the way to help improve cardiovascular function in CABG patient. Both aerobic training and moderate continuous training has been found to increase quality of life.

It may be as simple as just implementing regular exercise into patients routine for positive changes to result.

As cardiovascular diseases are becoming more common, more research and studies need to be completed for conclusions to be made in regard to the ideal duration and intensity of exercise to yield the best results.

Further information/resources
Below are extra studies and resources which provide extra information and may be of interest:

 * Benefits and Risks of High-Intensity Interval Training in Patients With Coronary Artery Disease
 * Effectiveness of High-Intensity Interval Training for the Rehabilitation of Patients With Coronary Artery Disease
 * High-intensity interval training in patients with coronary heart disease: Prescription models and perspectives

title: User:Amyabbey/sandbox


text:
Exercise as it relates to Disease/How childhood motor skills lead to an active life

The following Wikibooks page is an analysis of the journal article; “Childhood Motor Skill Proficiency as a Predictor of Adolescent Physical Activity” by L M. Barnett, M.P.H et al. (2008).

This critique was written as an assessment task for the unit; Health, Disease and Exercise at the University of Canberra, September 2019.

What is the background to this research?
Recent evidence has suggested that sedentary behaviour is becoming an increasingly prevalent issue, especially within the adolescent population. In Australia, it was found that only 2% of adolescents (13-17) met both the physical activity and sedentary guidelines, which is concerning, as sedentary behaviour is heavily associated with metabolic risk and chronic disease-related mortality.

This increase in sedentary behaviour could be attributed to the continual advancements in new-age technology, where by the clicking of a button makes everyday things become more accessible. This in turn has seen a rapid decline in the amount of physical activity being done by adolescents.

This now bids the question of whether or not identifying health factors in children may lead to increased physical activity levels as they get older. There is some evidence to suggest that physical activity habits track from childhood to adulthood – meaning more active kids are more likely to be active adults. However little is known about whether or not fundamental motor skill proficiency is a determinant of physical activity levels.

About the article
This article examines the link between childhood motor skill proficiency and subsequent adolescent physical activity behaviour. The study was undertaken to dissect the relationship between childhood locomotor and object control skill proficiency, and later physical activity, in an attempt to provide evidence for the development of interventions.

Where is the research from?
This study was conducted through the University of Sydney, Department of Rural Health (Northern Rivers), New South Wales, Australia. It was funded by both NSW Health and the University of Sydney. All the authors involved in this study are from recognised and reputable health study institutions across both NSW and America. The article was published in 2009 by the Journal of Adolescent Health, a leading journal in the latest findings of adolescent health and medicine.

What kind of research was this?
Data from this research was obtained via a longitudinal cohort study. Longitudinal cohort studies involve a group of people who share a common characteristic, and are a form of observational research whereby data of the same variables is collected over a period of time. This type of study is useful as it is able to follow change over time in particular individuals within the cohort; as well as by collecting data prior to any participant knowledge of further research – which eliminates recall bias.

What did the research involve?
This article displays that data collection for this study occurred in three stages:

1.Sample Selection

In 2000, 1045 primary school children from 18 randomly selected schools in New South Wales, partook in a school-based physical activity intervention. During the intervention, their proficiency in a collection of motor skills was assessed. In 2006/07, a list of original study participants was sent out to high schools all across NSW to identify the now adolescent students for a follow-up assessment. This was referred to as the ‘Physical Activity and Skills Study’.

2.Motor skill measurement

The initial intervention specified a collection of fundamental motor skills (catch, overhand throw, kick, forehand strike, sprint run, leap, dodge, vertical jump). Each skill was made up of a number of features that were considered integral for performing the skill competently. Each feature of each skill was assessed as either present or absent, and the participant received no verbal feedback.

3.Physical activity measurement

The Adolescent Physical Activity Recall Questionnaire (APARQ) was chosen to assess physical activity participation as it measures type of activity, frequency, duration, and whether it was organised or un-organised. Liner relationships were examined between reported time adolescents spent engaging in physical activity and their childhood skill proficiency.

Limitations
It is well known that the self-report approach can impact on the validity of a study, as interviewees may answer questions about themselves with bias. Participants may over- or under exaggerate their answers; i.e. say they completed more physical activity than they actually did.

In addition, the recall questionnaire asks a multitude of subjective questions, which leads to the possibility of misinterpretation. Questions may be vague and misunderstood. For example, what one person considers to be strenuous exercise, another may find light.

What were the basic results?
Results show that in childhood, males were more proficient at performing motor skills overall. Males were better at object control skills, however females out-performed males in terms of locomotor skills.

Follow up results of physical activity in adolescents indicate that almost all students participated in some sort of moderate-vigorous activity during adolescent years, however males reported more.

After adjusting for school grade and gender, the data revealed that object control proficiency in childhood was associated with time in moderate-to-vigorous activity in adolescence.

In summary, children with good object control skills have at least a 20% greater chance of participating in at least some vigorous activity in adolescence, compared with those with poor control.

What conclusions can we take from this research?
Overall, the study was valid and took into account the limitations. The recruitment of both male and female participants within specific age ranges supplied thorough and reliable data. It is now obvious that skill proficiency developed in primary school years significantly impacts on later physical activity, with object control skills, rather than locomotor, appearing more crucial to total activity time.

In an age where technology is continually advancing, and young people would rather spend their time on screens, it is necessary that children are encouraged to participate in fundamental motor skills as early as possible. Parents are equally responsible for their child’s engagement in these activities, and should spend time with their children helping them develop these skills.

Practical advice
In order to try and combat the issue, the authors of this article provide practical advice for the development of health interventions.

When developing school and community-based interventions, one should consider directing strategies around fundamental motor skills in an attempt to promote long-term physical activity. It may also be suggested that paying close attention to object control skills in primary aged students specifically, is the most promising way to stimulate physical activity in their adolescent years.

Furthermore, parents and families can refer to the Australian Government Department of Healthand follow the appropriate guidelines relating to how much physical activity and sedentary behaviour is recommended to lead a healthy life.

Further information/resources

 * Kid Sense - Fine Motor Skills
 * Literacy Teaching Toolkit: Fine motor
 * Kids addicted to screens? Here's how to unplug them
 * 50 ways to get your kids moving

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/


text:
Exercise as it relates to Disease/Exercise and postnatal depression and fatigue, how affective can it be?

What is the background to this research?
Postnatal depression (PND) and fatigue are two major common issues that occur during the postnatal period and although it is unclear exactly why this occurs it is believed to be due to a variety of reasons. Pregnancy is one of the most significant changes that occurs in adult life because you have to adapt to new major responsibility’s that can alter the social life, financial status, family rapport, occupation and can impact a woman physically, mentally and emotionally. There are a range of different approaches in dealing with treatment of PND and fatigue. This article by professor Jalil Babapoor heiroddin and colleagues at the university of Tabriz in Iran looks in to the intervention/treatment of PND and fatigue Through home-based antenatal and postnatal exercise. There are a range of studies that show the benefits of exercise on mothers suffering from perinatal depression.

Where is the research from?
This article conducted in Tabriz Iran at the Tabriz University of Medical science published in august 2013. One of the authors of This study ‘Jalil Babapoor heiroddin’ phD is a professor of psychology in the faculty of education and psychology at the university of Tabriz in Iran. He has spent many years teaching and researching the effects of exercise on PDS and recently released a paper in 2017 on “The association of exercise during pregnancy with trimester-specific and postpartum quality of life and depressive symptoms in a cohort of healthy pregnant women”4. The occupation of the other workers includes lectures, associate professor and student research committee of the midwifery department at Tabriz University.The research was financed and supported by the faculty of Research at Tabriz university medical sciences and the midwifery department at the university of Tabriz and it is unlikely there is any bias from the department as there is no commercial gain from this research.

What kind of research was this?
This research is a randomised control trial that aims to reduce certain bias by randomly allocating participants in to groups with different treatments for each group including a control group and two intervention groups. The research was dependent on a self-analysis and questionnaire that can impact the validity and reliability of the research through intrinsic and extrinsic factors

What did the research involve?
The randomised control trial was conducted on three groups of 127 women between 26-32 weeks pregnant who were not currently suffering from PDS or fatigue. Depression and fatigue were measured using the Edinburgh postnatal depression scale (EPDS ) and fatigue identification form (FIF) taken at a baseline, 1 month and two months after delivery. The mean age of women was 25 years with majority of participants being housewives. The participants were recruited from 14 public health centres in Tabriz, Iran based on their medical records. The control group were given an ordinary pre/postnatal 40-minute education session, the women in intervention group one was given a theoretical and practical educational session for 40 minutes these sessions were about the importance of exercise during pregnancy and were recommended to do 20-30 minutes of light exercise (stretching/breathing) per day. Intervention group 2 women were recommended to do the same light intensity exercise until 2 months post-delivery depending on individual capabilities. Intervention group 2 were required to exercise at least 3 times a week altering the frequency and intensity depending on their ability. The method of approach for this study had some limitations that could impact accuracy of results. This is due to the “low level of adherence” of participants with the ‘most common reason being “time management”

What were the basic results?

 * The study results show that neither scores significantly changed between the three groups. The study showed that the majority of participants had a low score in both the EPDS and FIF with a low percentage of participants scoring >13 in each group. There was no significant difference in scores between groups[1].
 * EPDS scores developed no substantial differences in mean rank among the three groups at the baseline or post-partum’.
 * Similarly, the FIF scores presented ‘no significant differences in mean rank among the three groups at baseline or 1-2 months post-partum.[1]
 * The researchers found no significant correlation between home based antenatal and post-natal exercise on the effects of PND and fatigue.
 * Although all three groups showed a slight decrease in EPDS with no significant change in the mean rank the largest decrease in scores >13 came from intervention group 2 who participated in pre-natal and post-partum exercise.

What conclusions can we take from this research?
The conclusion I have made from this research article is very similar to the researcher’s perspective in that they were right in stating that there were no significant results gathered from this study. In the methodology that was used there was no way in which the researchers could develop a definitive way of determining the affect. However, the research can be used as a stepping stone into further research on suitable exercises in the intervention of post-partum depression and fatigue. Cochrane review on ‘exercise and depression ’ state that resistance exercises or higher intensity are more effective than low intensity for treatment of PDS and fatigue. This study provides some examples of other research that show the positive affect exercise can have on PND and fatigue such as Armstrong K and colleague’s, Ko and colleagues , and Drista and colleagues. other recent research articles with similar results include Vargas-Terrones, M. and colleague’s on the positive effect of exercise programs reducing the effect of perinatal depression. Pritchett, R.V. and collegues on the affects of aerobic exercise on post-partum depression.

Practical advice
This research can provide information for a range of health practioners, researchers and also the general public such as mothers looking to broaden their knowledge in this area of health.
 * Mothers struggling with or worried about PND and fatigue should include exercise into their daily or weekly routine., not only does exercise assist with boosting serotonin levels and aiding in reducing PDS and fatigue it also has many health benefits.
 * Exercise recommendations vary depending on a mother’s situational circumstances (i.e. c-section/regular birth, time management, location and severity of fatigue.
 * Group exercise settings such as pram walking has proven to be highly effective for mothers experiencing PND and fatigue.
 * For researchers that are interested in further research of this study another randomised controlled clinical trial would best develop evidence on the relationship between exercise and postnatal depression. The most affective approach would involve a control group (PDS & fatigue non exercise) to be compared with intervention group (PDS & fatigue who participate in exercise program). Both control and intervention group should have similar pre-natal activity levels and similar situational circumstances. This study could be repeated with different exercises noting volume and intensity to increase knowledge on the affect it can have.

Further information/resources
Information for further research
 * Beyond blue https://healthyfamilies.beyondblue.org.au/pregnancy-and-new-parents/maternal-mental-health-and-wellbeing/depression
 * Postnatal depression information https://www.babycenter.com.au/a557236/postnatal-depression-pnd

posnatal depression help support 1300224636 beyond blue


text:
Wikijunior:How Things Are Made/Metal/Scissors

Products
Scissors are cutting instruments consisting of a pair of metal blades connected in such a way that the blades meet and cut materials placed between them when the handles are brought together.

What do we need to make this thing?
Scissors are usually made of 2 types of metal: carbon steel and stainless steel.

Carbon steel is used to make scissors in which the blade and the handle form one continuous piece. Carbon steel is manufactured from iron and about 1% carbon. It has the advantages of being strong and staying sharp. It is usually plated with nickel or chromium to prevent them from rusting.

Stainless steel is used to make scissors in which a plastic handle is fitted to the metal blade. Stainless steel is manufactured from iron, about 1% carbon, and at least 10% chromium. It has the advantages of being light and rustproof. The handles of stainless steel scissors are made from a strong, light substance such as ABS (acrylonitrile-buta-diene-styrene) plastic.

What is the step by step process?
For first step, there are 3 ways to produce a blank. A blank may consist of a blade and a handle in one piece or it may consist of only the blade. blade is then polished in a similar manner using belts or wheels, containing much smaller particles of abrasive. hollow slots into which the end of the blanks can be inserted. A strong adhesive is used to keep the handle firmly attached.
 * Step 1a: Cold stamping: A sharp die in the shape of the blank is stamped into a sheet of unheated steel. The die cuts through the steel to form the blank.
 * Step 1b: Molding: Molten steel is poured into a mold in the shape of the blank. The steel cools back into a solid and the blank is removed from the mold.
 * Step 1c: Drop forging: Like cold stamping, this process involves shaping the blanks with a die. This die, known as a drop hammer, pounds into a bar of redhot steel to form the blank. The pressure of the drop hammer also strengthens the steel.
 * Step 2: The blanks are trimmed to the proper shape by grinding away excess metal. A hole is drilled through the blank. This hole will later allow two completed blades to be attached to each other.
 * Step 3: The trimmed blanks are hardened by 6heating them, then cooling them quickly in cold air, water, or quenching oil. The temperature to which they are heated and the medium in which they are cooled varies depending on the type of steel from which they are made and the desired characteristics of the blade.
 * Step 4: The hardened blanks are heated again and allowed to cool slowly in air. This second heating, known as tempering, gives the blank a uniform hardness on all places of blanks.
 * Step 5: The repeated heating and cooling causes the blanks to warp. They are straightened by being placed on an anvil and lightly tapped with a hammer. This process is known as peening.
 * Step 6: The blank is ground into a blade by applying the edge to a rapidly moving sanding belt or abrasive wheel. The surface of the belt or wheel is covered with small particles of an abrasive substance and works in the same way as sandpaper. The hard abrasive grinds away enough steel to form a sharp edge. The sharpened
 * Step 7: For many scissors, the handles are formed from the start as part of the blank. If not, they may be made of a metal alloy or from plastic. If they are metal, they are made in the same way as the blanks and then welded to them. If they are plastic, they are made by injection molding. In this process, molten plastic is forced under pressure into a mold in the shape of the handles. It is allowed to cool and the mold is opened to remove the handles. The handles contain
 * Step 8: Two polished blades are attached to each other by a rivet or screw through the previously drilled holes. Rivets, which cannot be adjusted by the consumer, are used to make less expensive scissors. Adjustable screws are used in more costly scissors.


text:
Exercise as it relates to Disease/Tai Chi and its implications on elderly health

This is a critique of the research paper ''‘12-month Tai Chi training in the elderly: its effect on health fitness', published in 1998

What is the background to this research?
It is well documented that physical activity levels and all-round health diminish with age, with only 26.1% of the elderly population engaging in sufficient PA. With the growing burden placed on society, improved health outcomes for elderly would assist in leading a longer, more healthy life.

Tai Chi is an ancient Chinese form of exercise, comprising simple movements aimed at improving both physical and mental health. Studies have proven Tai Chi beneficial in a range of health outcomes; including reductions in depressive and anxious tendencies, improving flexibility, mobility and cardiorespiratory function. This study looks at the practice of Tai Chi and how it can improve the lives and well-being of the elderly.

Where is the research from?
This research was conducted in the city of Taipei, in Taiwan. The study comprised 52 community-dwelling elderly individuals from Taipei, and was overseen by various health bodies, including; The National Taiwan University Hospital and Chang Gung Memorial Hospital. The article was published in the journal ‘Medicine & Science in Sports & Exercise’, written and supervised by four authors; all of whom were employees at the aforementioned hospitals.

What kind of research was this?
This research was a cross-sectional study. The study follows a population over a period of time, and looks at how a particular intervention affects them at a given point in time.

What did the research involve?
Subjects were recruited from various senior citizen centers throughout Taipei. 87 volunteers completed questionnaires to determine their level of health, and the applicability of Tai Chi to each individual. Individuals who had any history of serious diseases or heart conditions were immediately excluded from the study. Baseline examinations on cardiac health, spirometric evaluation and a physical ‘check-up’ were conducted, with a further eight subjects being withdrawn. The remaining 52 subjects enrolled in the study; all of whom were community-dwelling, hadn’t engaged in regular exercise for at least 5 years and ranged in age from 58-70 years.

Prior to the exercise intervention, every participant was run through further assessments to gather important data for comparison at the conclusion of the study. The assessments utilised were :

The subjects were split into two groups; a control (N= 24) and an experimental group (N= 28). A 12 month Tai Chi Chuan (TCC) intervention was designed for the experimental group, with session attendance recorded. Sessions were run by a Tai Chi master every morning in parks around Taipei, easily accessible for all participants. Each session included 108 common Tai Chi postures, with participants following the instructor as well as a pre-recorded sequence to ensure accuracy and reliability.
 * VO2 Max- Completed on a cycle erg (60RPM @10W with a 10W increase every minute until muscular fatigue.
 * Heart rate, Blood Pressure and Blood Lactate were also taken during this assessment
 * Knee Strength- Measured by an isokinetic dynamometer (extensor and flexor)
 * Skinfolds- Measured using calipers (only at tricep and subscapular sites)
 * Respiratory function- Measured using a spirometer
 * Flexibility (Thoracic/Lumbar)- Assessed using an electronic digital inclinometer

Following the conclusion of the TCC intervention, the assessments were repeated to measure the body’s response to the exercise.

Although the study design proves reasonably successful, giving participants complete control over attendance can lead to potentially skewed results. Providing individuals with a less-frequent, but more compulsory session may have led to greater attendance and differing results. Furthermore, a 12 month intervention poses significant concerns regarding commitment and attendance. A shorter intervention would still illicit similar results, and may assist in engaging more participants and enhancing attendance.

What were the basic results?
Throughout the 12 month period, there were some withdrawals from the study. Of the initial 52 participants, 38 (73.1%) completed the study, with an equal proportion of drop-outs from both groups.

Table 1: Male participant results

Table 2: Female participant results

As seen above, the TCC intervention group experienced improvements in nearly all categories. The most significant being in VO2 max, muscular strength (knee), and joint mobility (spinal). This study highlights the positive implications Tai Chi can have on elderly health and quality of life.

The study shows major improvements, however, it was conducted with a reasonably small sample. Gathering more volunteers and a larger sample size would provide more accurate results, giving a better reflection on how TCC affects elderly health.

What conclusions can we take from this research?
Based on this study and available resources, it can be deduced that Tai Chi is an effective form of exercise for an elderly population. This study aligns with similar research, highlighting the importance of PA as individuals age. The results emphasise the importance of active lifestyles for elderly individuals, showing improvements in health can be made late in life, regardless of intensity of exercise.

Practical Advice
With constant research and study into elderly health, it has been undoubtedly proven that physical activity improves quality of life. Life expectancy and medical advancements continue to dominate societal thinking towards elderly health, however, the impact of consistent physical activity can not be discounted. Before engaging in any PA, individuals should consult with their health practitioner to determine what best suits their needs.

Further Information/Resources

 * Tai Chi Australia
 * WHO Physical Activity for Elderly
 * Benefits of Tai Chi


text:
JLPT Guide/JLPT N3 Vocabulary

Below are the vocabulary lists for level N3 of the Japanese Language Proficiency Test.

 * あ行
 * か行
 * さ行
 * た行
 * な行
 * は行
 * ま行
 * や行
 * ら行
 * わ行
 * misc

title: JLPT Guide/JLPT N3 Vocabulary


text:
JLPT Guide/JLPT N2 Vocabulary

Below are the vocabulary lists for level N2 of the Japanese Language Proficiency Test.

 * あ行
 * か行
 * さ行
 * た行
 * な行
 * は行
 * ま行
 * や行
 * ら行
 * わ行
 * misc

title: JLPT Guide/JLPT N2 Vocabulary


text:
JLPT Guide/JLPT N1 Vocabulary

Below are the vocabulary lists for level N1 of the Japanese Language Proficiency Test.

 * あ行
 * か行
 * さ行
 * た行
 * な行
 * は行
 * ま行
 * や行
 * ら行
 * わ行

title: JLPT Guide/JLPT N1 Vocabulary


text:
Template:Japanese/JLPT N3 Vocabulary

JLPT N3 Vocabulary あ行 – か行 – さ行 – た行 – な行 – は行 – ま行 – や行 – ら行 – わ行

title: Template:Japanese/JLPT N3 Vocabulary


text: JLPT Guide/JLPT N3 Vocabulary/Row A

title: JLPT Guide/JLPT N3 Vocabulary/Row A


text:
User talk:DEBABRATA DEHURI

Psychology
Note DEBABRATA DEHURI (discuss • contribs) 08:20, 17 September 2019 (UTC)

title: User talk:DEBABRATA DEHURI


text:
User:LBird BASc/sandbox

User:LBird BASc/sandbox/

Seminar 5 - Thursdays 9-10

Seminar 6 - Thursdays 10-11

Seminar 7 - Thursdays 11-12

"This is for the UCL BASc Approaches to Knowledge Course: https://www.ucl.ac.uk/basc/current/core/atk. This page includes links to pages for students to work on their content for the UCL Wiki book for the end of the term and will be populated over the period 19/09/2019 - 17/12/2019. It has been created by Lauren Bird who is the seminar leader. See https://www.ucl.ac.uk/basc/people/academic-staff/Lauren-Bird. Please do not delete this page."

title: User:LBird BASc/sandbox


text:
Exercise as it relates to Disease/The effects of exercise on glycemic control in patients with Type 2 diabetes

This research study ‘ Effects of Aerobic Training, Resistance Training, or Both on Glycemic Control in Type 2 Diabetes by Ronald J. Sigal, MD, MPH; Glen P. Kenny, PhD; Normand G. Boulé, PhD; George A. Wells, PhD; Denis Prud'homme, MD, MSc; Michelle Fortier, PhD; Robert D. Reid, PhD, MBA; Heather Tulloch, MSc; Douglas Coyle, PhD; Penny Phillips, MA; Alison Jennings, MA; James Jaffey, MSc, is a randomized control trial that will be further critiqued in this Wiki.

What is the background to this research?
Diabetes is a condition that affects the body’s ability to respond to insulin, leading to abnormalities revolving carbohydrate metabolism. Due to this, diabetes heavily affects the body’s ability to monitor blood glucose levels, therefore glycemic control must be monitored to prevent health risks. Glycemic control is defined as the regulation and maintenance of blood glucose levels in the body. Glycemic control is assessed by haemoglobin A1c levels (HbA1c), which are responsible for monitoring blood glucose levels. Research suggests that poor glycemic control can lead to cardiovascular risks such as heart failure and myocardial infarction. Other health related risks include:

 * Cardiovascular disease
 * Kidney damage
 * Nerve damage
 * Damage blood vessels

Evidence has suggested that exercise is a viable option for improving glycemic control for patients with type 2 diabetes. In particularly, aerobic training, resistance training and the combination of both. It can be said that monitoring blood glucose levels is important to prevent further health related risks amongst patients diagnosed with type 2 diabetes.

Where is the research from?
The research was conducted by various professions and institutions including the University of Ottawa, Clinical Epidemiology Program, Ottawa Health Research Institute, and Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada, and University of Calgary, Calgary, Alberta, Canada.

What kind of research was this?

 * The research was conducted as a randomized, control trial that was performed over 26-week time period
 * The evidence behind a randomized control trial reduces bias throughout the study as well as preventing skewed or deliberate manipulation of results
 * Participants were randomly placed in either a control group, aerobic training, resistance training or combined group (both aerobic and resistance training)

What did the research involve?
251 participants aged between 39 to 70 years old with type 2 diabetes underwent a randomized control trial. Each participant was placed in either a control group, aerobic training group, resistance training group or the combination of both types of training, to determine the effects of exercise on improving glycemic control. The study was conducted over a 26-week period to mitigate the effects of exercise on Haemoglobin A1c levels. The first 4 weeks of the study consisted of a run-in phase. The aim of the run-in phase was to allow the body to gradually adapt to incoming stimulus whilst preventing muscle soreness and injury. Aerobic training was performed a cycle ergometer or treadmill at 50% maximum oxygen consumption with the use of polar oy heart monitors to reach the desired intensity. Intensity and duration were increased on a weekly basis to allow for progression and further training adaptations. The resistance training method involved participants to perform a resistance training regimen that outline specific exercises, repetitions and sets. This training regimen was modified to ensure that progressive overload was being achieved. The combined group performed both aerobic and resistance training sessions as one big training session.

Limitations of the study show that the combined group (aerobic and resistance training) had a longer duration of training time when compared to the aerobic and resistance groups.

What were the basic results?
Results of the study indicated that glycemic control was improved through aerobic and resistance training alone, as well as the combination of the two training methods. The findings of the research displayed that all training methods resulted in decreased haemoglobin A1c levels, therefore improving glycemic control. Aerobic activity showed a decrease of HbA1c levels from 7.41% to 6.98%. For optimal glycemic control, evidence indicate the maintenance of 7% or below in HbA1c is efficient for older patients with type 2 diabetes.

Results displayed that resistance training was effective in decreasing haemoglobin A1c levels. Over a 6-month period, haemoglobin A1c showed a decreased of 7.48% to 7.18%. In addition to this, the effect of resistance training improved body composition through fat loss and improved muscular endurance.

The main finding of the study was concluded through the results of the combined training on HbA1c. Over a 6-month period, participants HbA1c dropped from 7.46 to 6.56 (0.9%). This figure represents that the combined trial group was the most effective in terms of improving glycemic control in patients with type 2 diabetes.

What conclusions can we take from this research?
The findings of the research concluded that either aerobic training, resistance training or the combination of both, reduced haemoglobin A1C levels. The study suggests that the combination of aerobic and resistance training on a weekly basis (at least 3 times per week) is optimal for improving glycemic control when compared to aerobic and resistance training alone. The findings of this study conclude that haemoglobin A1c levels were significantly decreased in the combined training group, indicating that a combination of aerobic and resistance training is most appropriate method for improving glycemic control. When compared to other similar studies, this study concludes that the idea of combined training is most beneficial when performed in the combination of both aerobic training at 50% maximum oxygen consumption and high intensity resistance training.

Conclusion of this study also suggests that performing exercises on a weekly basis is directly linked to changes in body composition, by decreasing fat loss and increasing muscular endurance.

Practical advice

 * Engage in the combination of both aerobic and resistance training to maximise the effect of exercise on haemoglobin A1c levels
 * It is recommended that individuals engage in either aerobic or resistance training (or both) at least 3 times per week
 * When performing aerobic sessions, it is recommended that individuals perform aerobic activities at 50% of maximum oxygen capacity to optimise results
 * To ensure optimal results through resistance training, make sure that high intensity is maintained throughout each training session
 * Perform resistance exercises from repetition ranges of 6-12 to allow for hypertrophy and muscle growth
 * Implement various resistance exercises every 4 weeks to allow for new stimulus to shock the muscles
 * To reduce the risk of injury, ensure that warm-up and cooldown protocols are included

Further information/resources
Further information regarding the management of glycemic control and type 2 diabetes can be found below:

 * Managing glycemic control
 * Managing type 2 diabetes

Journal Articles:

 * |Glycemic control and Hypoglycemia


text:
Talk:Yet Another Haskell Tutorial/Type advanced

Should it be  instead of  ?


text:
Exercise as it relates to Disease/Physical training on Rheumatoid Arthritis

The following document is a critique of 'Physical Training in Rheumatoid Arthritis: A Controlled Long-Term Study. I' by Rolf Nordemar, Björn Ekblöm, Lars Zachrisson & Kristina Lundqvist (1981) found in the Scandinavian Journal of Rheumatology.

What is the background to this research?
Rheumatoid Arthritis (RA) is an autoimmune disease that affects the joints within the body. An autoimmune disease involves the body's immune system attacking itself as opposed to its task of protecting against foreign substances. Joints are affected by the thickening of the synovial fluid in the joint which can cause swelling, pain, stiffness and damage in the affected joints. This can adversely impact on the mobility of the person with RA which is why physical activity is a major discussion point for these respective patients. Rheumatoid arthritis is more prevalent in women and affects around 458,000 Australians.

As evident with many diseases, obesity and inactivity are risk factors for Rheumatoid Arthritis clarifying the need for appropriate exercise programs. Contradictory though, RA causes patients to reduce physical activity due to the joint pain suffered and fear of worsening their condition. Studies and information available on arthritis websites do however stress the fact that physical activity is safe for people with RA to participate in. It does however need to be adapted to suit the severity of each specific case of the disease.

Where is the research from?
This research was conducted in Sweden from the Department of Physical Medicine and Rehabilitation, Karolinska Hospital, the Department of Physiology III, Karolinska Institute and the Departments of Diagnostic Radiology and Rheumatology and St. Erik's Hospital, Stockholm. St. Erik's Hospital was the clinic where the patients were selected from. This research is published in the Scandinavian Journal of Rheumatology which is an International journal useful for different health practitioners and focuses on clinical and experimental rheumatology.

The authors for this research have ten years of experience in the field, specifically with RA, making them credible in this area. The lead author Rolf Nordemar has been at the helm of countless other RA studies surrounding different areas of physical activity and the disease.

What kind of research was this?
The study conducted was a controlled long-term study, also regarded as a Randomised Controlled Trial. Studies that use a control involve monitoring a group that changes what it does with a variable, i.e. the exercising cohort, while the other group, the control, continues to live a lifestyle where they are not partaking in this change of variable.

Randomised Controlled Trials can be both highly positive and negative in the results that they produce. If done carefully with the control, it can help to influence the prescription of exercise. If done incorrectly however, prescriptions could be given with the possibility of causing potential harm to a patient.

Participant criteria included: This criteria increased the reliability of the study due to the similarity of the patients.
 * Adhere to ARA criteria,
 * Moderate disease activity and
 * Functional stage I, II or III.

What did the research involve?
This research was a 4 to 8 year study where 23 patients from St. Erik's Hospital took part in a physical training study, with another 23 participants were also in the control group from 1970-1978. There were 19 females and 4 males in both groups within the study since females have a higher prevalence of Rheumatoid Arthritis. These patients ranged in age from 31–70 years old.

The training program consisted of both home-training (which requires high levels of intrinsic motivation) and group-training which was led by a physiotherapist (to ensure that physical activity is completed as safe as possible).

Strengths of the Study
 * Had a control group as part of the study to have a basis for comparison.
 * Completed the study over a number of years which eliminates short-term changes being the basis for the results.
 * Used specific criteria to select participants to ensure certain level of the chronic disease.

Limitations of the Study
 * Lost some participants along the way which reduced the participant pool.
 * Some participants in the active group stopped partaking in physical activity and some from the control group started to exercise on their own accord, but were still classified as their original group classification which decreased reliability.
 * Is an outdated study now, so new technology and studies would be able to reassess outcomes of this study.

What were the basic results?
Key results made evident from the study include:
 * Lower values in Lansbury's joint index in the Training Group (TG).
 * The increase in sick-leave was higher over the 8 year period in the Control Group (CG) - 29% increase as opposed to 1% in the TG.
 * CG spent more time in hospital than the TG - more than two times the amount.
 * There was less progression of joint damage in the TG as opposed the to CG.
 * Improvements in muscle was also seen in the TG along with improved ability to walk up stairs and complete the step test.
 * Positive psychological changes occurred with most participants agreeing that physical activity was beneficial for them in relation to rheumatoid arthritis and that they were likely to participate in this type of exercise into the future.

What conclusions can we take from this research?
Overall the outcome of this research was that physical activity is beneficial for patients with Rheumatoid Arthritis. The study found that physical activity can help to reduce the progression of the disease, which is beneficial for function in daily life. Further to this, it was evident that physical activity completed at an increased rate was more beneficial than less regular exercise.

These conclusions have been backed up by other, more recent studies and website information in the positive correlation between physical activity and Rheumatoid Arthritis. A study conducted in 2008 by Plasqui directly references this study being critiqued within the conclusion, which emphasises its precedence in this area of study. Studies conducted in 1989 and 2004 connecting muscle strength and conditioning in conjunction with moderate to vigorous activity, displayed positive results for RA patients. This confirms that modern studies continue to reinforce the ideas presented within this critiqued study for those with RA.

Practical advice
Rheumatoid arthritis is currently incurable, so should be prevented where possible and treated at the earliest signs.

Preventative measures:
 * Avoid smoking.
 * Monitor environmental exposure to substances such as asbestos and silica.
 * Maintain of a healthy weight range i.e. avoid obesity.

Unfortunately risk factors such as aging, being female and having a family history are unmodifiable determinants and therefore, cannot be avoided.

Treatment measures:
 * Seek doctor advice as soon as possible.
 * Participate in regular physical activity.
 * Exercise at a moderate intensity where possible.

Further information/resources
Information for people living with arthritis can be found on these sites:
 * Arthritis Foundation - What is Rheumatoid Arthritis?
 * Mayo Clinic - Rheumatoid Arthritis
 * Arthritis Australia - Rheumatoid Arthritis - What is Rheumatoid Arthritis?

Information specifically linked to exercise and Rheumatoid Arthritis:
 * Exercise and Rheumatoid Arthritis fact sheet by Arthritis Australia
 * Exercise tips for people living with Rheumatoid Arthritis by the Arthritis Foundation


text:
Brief History of Europe/Preface

A Brief History of Europe covers European history from the fall of Rome to the present day. It also covers late antiquity, the rise of Islam, and the Middle East to some extent, as these are important to understanding European history. Some ancient history (6,000 BC–650 AD) is summarized.

This period of history can roughly be divided into the Middle Ages, and the modern period, and the contemporary period.

Author(s)
If you would like to contribute, feel free to add your name below:

 * Jules (Mrjulesd)

Notes and comments
c. = circa or century.

Any comments? Please comment here.

Wikibooks

 * European History
 * A Background of European History
 * A Brief Outline of European History
 * Glossary
 * Dutch Empire

Wikipedia

 * Historical periods
 * History of Europe
 * Classical antiquity
 * Middle Ages
 * Early Middle Ages
 * High Middle Ages
 * Late Middle Ages
 * Modern history
 * Early modern period
 * Late modern period
 * Contemporary history

Many articles on English Wikipedia are used as sources.

title: Brief History of Europe/Preface


text:
MediaWiki talk:Noarticletext-nopermission

Put this in a border. 64.114.239.29 (discuss) 19:42, 17 September 2019 (UTC)
 * ✅ JackPotte (discuss • contribs) 16:07, 24 September 2019 (UTC)


text:
User:KSeignarack/sandbox

This research study ‘ Effects of Aerobic Training, Resistance Training, or Both on Glycemic Control in Type 2 Diabetes by Ronald J. Sigal, MD, MPH; Glen P. Kenny, PhD; Normand G. Boulé, PhD; George A. Wells, PhD; Denis Prud'homme, MD, MSc; Michelle Fortier, PhD; Robert D. Reid, PhD, MBA; Heather Tulloch, MSc; Douglas Coyle, PhD; Penny Phillips, MA; Alison Jennings, MA; James Jaffey, MSc, is a randomized control trial that will be further critiqued in this Wiki.

What is the background to this research?
Diabetes is a condition that affects the body’s ability to respond to insulin, leading to abnormalities revolving carbohydrate metabolism. Due to this, diabetes heavily affects the body’s ability to monitor blood glucose levels, therefore glycemic control must be monitored to prevent health risks. Glycemic control is defined as the regulation and maintenance of blood glucose levels in the body. Glycemic control is assessed by haemoglobin A1c levels (HbA1c), which are responsible for monitoring blood glucose levels. Research suggests that poor glycemic control can lead to cardiovascular risks such as heart failure and myocardial infarction. Other health related risks include:

 * Cardiovascular disease
 * Kidney damage
 * Nerve damage
 * Damage blood vessels

Evidence has suggested that exercise is a viable option for improving glycemic control for patients with type 2 diabetes. In particularly, aerobic training, resistance training and the combination of both. It can be said that monitoring blood glucose levels is important to prevent further health related risks amongst patients diagnosed with type 2 diabetes.

Where is the research from?
The research was conducted by various professions and institutions including the University of Ottawa, Clinical Epidemiology Program, Ottawa Health Research Institute, and Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada, and University of Calgary, Calgary, Alberta, Canada.

What kind of research was this?

 * The research was conducted as a randomized, control trial that was performed over 26-week time period
 * The evidence behind a randomized control trial reduces bias throughout the study as well as preventing skewed or deliberate manipulation of results
 * Participants were randomly placed in either a control group, aerobic training, resistance training or combined group (both aerobic and resistance training)

What did the research involve?
251 participants aged between 39 to 70 years old with type 2 diabetes underwent a randomized control trial. Each participant was placed in either a control group, aerobic training group, resistance training group or the combination of both types of training, to determine the effects of exercise on improving glycemic control. The study was conducted over a 26-week period to mitigate the effects of exercise on Haemoglobin A1c levels. The first 4 weeks of the study consisted of a run-in phase. The aim of the run-in phase was to allow the body to gradually adapt to incoming stimulus whilst preventing muscle soreness and injury. Aerobic training was performed a cycle ergometer or treadmill at 50% maximum oxygen consumption with the use of polar oy heart monitors to reach the desired intensity. Intensity and duration were increased on a weekly basis to allow for progression and further training adaptations. The resistance training method involved participants to perform a resistance training regimen that outline specific exercises, repetitions and sets. This training regimen was modified to ensure that progressive overload was being achieved. The combined group performed both aerobic and resistance training sessions as one big training session.

Limitations of the study show that the combined group (aerobic and resistance training) had a longer duration of training time when compared to the aerobic and resistance groups.

What were the basic results?
Results of the study indicated that glycemic control was improved through aerobic and resistance training alone, as well as the combination of the two training methods. The findings of the research displayed that all training methods resulted in decreased haemoglobin A1c levels, therefore improving glycemic control. Aerobic activity showed a decrease of HbA1c levels from 7.41% to 6.98%. For optimal glycemic control, evidence indicate the maintenance of 7% or below in HbA1c is efficient for older patients with type 2 diabetes.

Results displayed that resistance training was effective in decreasing haemoglobin A1c levels. Over a 6-month period, haemoglobin A1c showed a decreased of 7.48% to 7.18%. In addition to this, the effect of resistance training improved body composition through fat loss and improved muscular endurance.

The main finding of the study was concluded through the results of the combined training on HbA1c. Over a 6-month period, participants HbA1c dropped from 7.46 to 6.56 (0.9%). This figure represents that the combined trial group was the most effective in terms of improving glycemic control in patients with type 2 diabetes.

What conclusions can we take from this research?
The findings of the research concluded that either aerobic training, resistance training or the combination of both, reduced haemoglobin A1C levels. The study suggests that the combination of aerobic and resistance training on a weekly basis (at least 3 times per week) is optimal for improving glycemic control when compared to aerobic and resistance training alone. The findings of this study conclude that haemoglobin A1c levels were significantly decreased in the combined training group, indicating that a combination of aerobic and resistance training is most appropriate method for improving glycemic control. When compared to other similar studies, this study concludes that the idea of combined training is most beneficial when performed in the combination of both aerobic training at 50% maximum oxygen consumption and high intensity resistance training.

Conclusion of this study also suggests that performing exercises on a weekly basis is directly linked to changes in body composition, by decreasing fat loss and increasing muscular endurance.

Practical advice

 * Engage in the combination of both aerobic and resistance training to maximise the effect of exercise on haemoglobin A1c levels
 * It is recommended that individuals engage in either aerobic or resistance training (or both) at least 3 times per week
 * When performing aerobic sessions, it is recommended that individuals perform aerobic activities at 50% of maximum oxygen capacity to optimise results
 * To ensure optimal results through resistance training, make sure that high intensity is maintained throughout each training session
 * Perform resistance exercises from repetition ranges of 6-12 to allow for hypertrophy and muscle growth
 * Implement various resistance exercises every 4 weeks to allow for new stimulus to shock the muscles
 * To reduce the risk of injury, ensure that warm-up and cooldown protocols are included

Further information/resources
Further information regarding the management of glycemic control and type 2 diabetes can be found below:

 * Managing glycemic control

 * Managing type 2 diabetes

Journal Articles:

 * Glycemic control and Hypoglycemia

title: User:KSeignarack/sandbox


text:
Exercise as it relates to Disease/Reduction of children's sport performance anxiety through social support and stress-reduction training for coaches

The purpose of this article is to critique a study titled "Reduction of children's sport performance anxiety through social support and stress-reduction training for coaches" that investigates the effect of coaching behaviour on the mentality of their athletes.

What is the background to this research
Sport performance anxiety (SPA) is a highly prevalent issue in today's society. It occurs when an athlete feels too nervous or fearful to perform to the best of their ability. Generally, anxiety can be divided into two subsections; cognitive and somatic. Cognitive anxiety refers to the mental processes that cultivate anxiety, such as worrying. Somatic anxiety refers to the physical representation of that mentality, for example an elevated heart rate. There are many reasons that cause this anxiety, such as the fear of failure, rejection and social approval. The fear of failure is closely associated with low self confidence and a strong desire to succeed.

Analysing SPA is important as it can be highly detrimental to performance. One way this is shown is through the notion of "choking". This concept is when an athlete's response to anxiety is the physical feeling of being unable to breathe, which may lead to a decrement or cessation of performance.

This research fills a gap in existing knowledge as it is the first study to demonstrate how relevant interventions targeted at coaches may decrease performance anxiety within children. It shows that children who had a high amount of SPA were particularly sensitive to how they were perceived by their coaches. Therefore, this study addresses the association between coaching behaviour and performance anxiety in young athletes.

Where is the research from?
The authors of this article, Ronald E. Smith et al., represent the University of Washington. This paper was published in the Journal of Applied Developmental Psychology and was conducted through Little League Baseball in Washington. However, no mention was made of any conflict of interest.

What kind of research was this?
This study was a randomised controlled trial (RCT). An RCT is often referred to as the gold standard of scientific trials, with the aim of decreasing bias while testing the efficacy of one or more interventions. Due to this reduction of bias, RCT’s are generally thought to be a more valid form of investigation.

In this study, the trained group had an intervention program implemented, where the control group remained without.

What did the research involve?
The researchers conducting this study applied an intervention known as Coach Effectiveness Training (CET) to 18 male baseball coaches. To meet the inclusion criteria, the coaches all held a similar style of coaching. The subjects involved were 152 male 10-12 year old Little League Baseball players, all whom competed at a major level within the Seattle area code. Coaches within the trained group received a pre-season intervention in which they were presented with behavioural guidelines to help decrease performance anxiety. Coaches within the control group did not receive any guidelines. Children who played for each coaching group were then interviewed pre and post season using sport-specific anxiety scales. The CET was implemented in the training group 2 weeks prior to the start of the baseball season. The crux of the CET intervention revolved around a set of behavioural guidelines that the coaches were instructed to follow. The guidelines followed concepts of positive control as opposed to aversive, and the ideology that success was defined by maximal effort as opposed to outcome. There were four behaviours that the guidelines targeted: mistake-contingent encouragement, positive reinforcement, corrective and technical instruction. Alongside that, there were four behaviours the guidelines deemed as undesirable: punishment, non-reinforcement, punitive instruction and controlling behaviour. These behaviours by the coaches were linked to influencing the fluctuation of performance anxiety within the young athletes. To minimise bias, trained coaches were asked to keep the intervention guidelines private, which prevented leakage of information.

To assess changes within performance anxiety levels, the boys undertook the Sport Anxiety Scale (SAS) within pre and post season interviews. The SAS is a sport-specific determination of cognitive and somatic anxiety, and provides a competitive trait anxiety score to determine changes in athletes' anxiety levels.

The methodology of implementing a change in behaviour to affect anxiety was an effective approach, as behaviour is a common way coaches may influence anxiety levels in children. However, there were limitations within this intervention that compromised the efficacy of the study. For example, all participants were male. Studies have shown that female athletes tend to experience anxiety to a higher degree than males, which could have possibly skewed the results in the study. It has also been suggested that the positive approach implemented within this intervention may have a greater effect on reducing SPA within females than males. Another limitation is that parental influence was not included. It has been shown that parents can be a major source of anxiety within young athletes. Thus, including parents within the intervention may have resulted in further anxiety decrement.

What were the basic results?
Preseason and postseason anxiety levels were compared through t tests to determine the effectiveness of the CET intervention. A significant reduction in SAS scores were depicted in athletes from the trained group, whereas the control group did not reveal any significant SAS decreases.

Out of the 8 behavioural traits enforced within the guidelines, results from 2 desirable traits (reinforcement and encouragement) and 2 undesirable traits (non-reinforcement and punishment) are shown below:

 * M = Mean
 * SD = Standard Deviation

The statistics above displayed that boys who played for the trained coaches perceived them as possessing greater desirable traits. The boys who played for the control coaches perceived them as having greater undesirable traits.

The researchers determined that the CET intervention was successful in reducing SPA in young boys as a result of the coaches' changed behaviour. They concluded that athletes playing for the trained coaches had an increased level of self confidence, associated with a negative relationship to performance anxiety.

What conclusions can we take from this research?
Based on the evidence presented within this study, applying a behavioural intervention to coaches is likely to decrease children's tendency to experience SPA. A positivity-focused approach in how coaches interact with their athletes results in higher levels of self confidence, thereby reducing anxiety. However, despite the intervention being successful, it doesn't pinpoint whether a reduction in performance anxiety is directly correlated to performance improvement. In my opinion, the findings from this study are an accurate representation of the correlation between coaching influence and performance anxiety due to similar results being presented within more recent studies. An example of this is a study conducted by Joseph Baker analysing the relationship between athletic sport anxiety and coaching behaviours. The majority of research deems that an increase in positive coaching attributes aligns with decreased performance anxiety, supporting the findings of this study.

Practical Advice
Although this study was conducted on young athletes, SPA affects athletes of all ages. Any professional athletes experiencing extreme performance anxiety would benefit greatly from an intervention. Advice for coaches with athletes suffering through this is to reflect upon their own behaviour and see if positive and supportive interventions can be implemented.

Further information/resources
Coaches involved with young athletes, as well as young athletes experiencing anxiety may benefit from the following readings. However, these readings do not substitute professional medical advice.

 * https://sports.bluesombrero.com/Default.aspx?tabid=938506
 * http://www.layups.com/keeping-a-positive-attitude-while-coaching/
 * https://www.psychologytoday.com/au/blog/meaningful-you/201309/how-overcome-sports-performance-anxiety
 * https://foreverfitscience.com/brain-health/4-ways-to-overcome-sports-performance-anxiety/


text:
Exercise as it relates to Disease/The impact of exercise on hyperarousal in veterans diagnosed with PTSD

This is a critical review of "The interactive role of exercise and sleep on veteran recovery from symptoms of PTSD."

What is the background to this research?
PTSD or Post Traumatic Stress Disorder is defined as the inability to recover from a stress reaction following exposure to a traumatic event. The inability to recover after an estimated given time (1 month~), becomes the onset of PTSD and its symptoms. According to US findings on PTSD, military veterans are most at risk of developing PTSD. The Veterans Health Administration (VHA), has estimated that since 2001, there has been a 60% increase to military veterans diagnosed with PTSD. The background of this research has strong foundations, as not only do serving and the veteran population suffer from PTSD- it is increasingly prevalent in civilian society. PTSD has many negative effects on physical health problems, functional impairment including but not limited to marital difficulties, unemployment , financial constraints and separate psychological disorders. There are effective interventions in place, but these can be time consuming, require specialised clinicians and are not always effective in combating PTSD. This research aims to assess the impacts of sleep and exercise to limit hyperarousal in military veterans suffering PTSD. With extensive research going into similar psychological disorders, little has gone into PTSD. This research is based on veterans who have served in Operation Iraqi Freedom or Operation Enduring Freedom.

Where is the research from?
The research is based on military veterans who have served in Operation Iraqi/Enduring Freedom with the US Armed Forces with the study being conducted in the US. The median age of veterans in the study is 52.18 with a range of 24-70. Although there is little evidence to suggest symptoms of PTSD decrease with exercise, the study was only conducted with US veterans in the Iraqi War. The study does not include veterans from Vietnam (pre-Iraq) or Afghanistan (post-Iraq Freedom). The participants of the study did not include veterans from Commonwealth countries, Iraqi or forces or enemy soldiers. Therefore, limiting the research to one country and one war.

What kind of research was this?
The research revolved around military veterans incorporating exercise and sleep on a bike-exercise program. The aim of the study was to incorporate both sleep patterns and exercise to find a degree of relief for PTSD sufferers. The main concept of the study was to limit contributing factors that engaged hyperarousal of suffering veterans. Ethnicity played an important role of this kind of the research as its displacement of ethnicity was comparatively accurate to the US Armed Forces. However, it does not accurately represent PTSD or veterans as a whole.

What did the research involve?
The research involved a few control measures- they were abstinent for the program. This involved toxicology reports before the testing started. A Pittsburgh Sleep Quality questionnaire was completed, a PTSD checklist determining severity of symptoms and the bike program which incorporated total amount of kilometres travelled over the course of the study. There is a margin of error in interpreting questionnaires that have been conducted individually and not professionally. This entails the veterans perceived health and not their actual health. The exercise program did not incorporate different methods of exercise and intensity, it only measured kilometres travelled. Varying intensity levels of exercise can significantly impact on mood. The error and intensity limiting variables significantly decrease the outcome of the research as it does not include a broader exercise study, nor does it have many control measures.

What were the basic results?
The main results of the study indicated that the group who engaged in the bike-exercise program reported lower hyperarousal levels. Importantly, exercise and sleep did not directly contribute to the overall symptoms decreasing, it merely interacted with only hyperarousal symptoms of PTSD. The veterans that had poor sleep and high hyperarousal were impacted more by the exercise program and limiting hyperarousal; whereas those who slept well had little effect of their hyperarousal levels. Those who participated in the bike-exercise program did drop in hyperarousal levels as shown in Fig 1.

What conclusions can we take from this research?
Hyperarousal is a key symptom of PTSD; it is also a negative symptom leading to poor sleep quality. Although this study was limited, there are signs that exercise can improve hyperarousal levels, which in turn can lead to better sleep quality and ultimately improving chronic health disorders in veteran and PTSD suffering populations. Associations between exercise and engaging in treatment are a barrier for veterans, with veterans choosing exercise over the latter. It is important to note that exercise interventions are much cheaper than behavioural or pharmaceutical interventions. The research does have limitations, it is unknown for how long hyperarousal levels are maintained pre/during/post exercise and what happens in between exercise bouts. Intensity and type of exercise limits this study as it does not account for their response- only riding a bike. Overall, the study does show promise in incorporating exercise with PTSD sufferers as hyperarousal levels decrease. However, more and broader research is needed in understanding underlying factors to promote a better and broader foundation for research.

Practical advice
This research concluded with positive findings, yet limited and narrow control measures/assessments. Veterans suffering PTSD from Iraqi Freedom/Enduring understand the importance of exercise post-military, however, the resources to continue exercise are either limited, expensive or shadowed by chronic disorders including PTSD. The study would show more practicality in broadening the participant parameters, exercise type and intensity and objective sleep assessments e.g. sleep study. Exercise interventions are medication free, low cost and more importantly, can be easily accessed. Veterans associations not only in the US, but any veteran worldwide, should have access either free or for a small price to access exercise programs. From this study, it has proven to be highly beneficial in limiting PTSD symptoms which will overall improve chronic health disorders in PTSD populations. Australia has a Veterans Program run by Exercise Physiologists and other Allied Health Professionals called VIDA. However, this program is only accessible for war veterans with a white or gold card and does not incorporate peace time efforts or general service. There are steps in the right direction, but there is still a long way to go to ensure military veterans and PTSD sufferers can access exercise interventions to improve overall health and limit chronic health disorders.

Further information/resources

 * Vida Wellness
 * Arent, D. Landers and J. Etnier Journal of Aging and Physical Activity, 8 (2000), pp. 407-430 Retrieved via PubMed
 * Department of Veteran's Affairs - Health and Wellbeing


text:
User:Moe Ai Officiallyby Moe Ai

WV:Admin — Wikiversité

title: User:Moe Ai Officiallyby Moe Ai


text:
Exercise as it relates to Disease/Does Physical Activity Improve Walking Efficiency For Elderly Dementia Patients?

This is a critique of research article: Effects of a Physical Training Programme on Cognitive Function and Walking Efficiency in Elderly Persons with Dementia. by Kemoun G, Thibaud M, Roumagne N, Carette P, Albinet C, Toussaint L, Paccalin M, Dugué B. 2010 Apr 1;29(2):109.

What Is The Background To This Research?
Cognitive function commonly refers to the ability to be able to perform a variety of skills including memory, thinking, orientation, comprehension reasoning, attention, learning capacity, imagination, language, calculation, visuospatial abilities and judgement. An impairment in cognitive function can result in a declined ability to perform these skills as well as a deterioration in emotional control, social behaviour or motivation may be present. A decline or deterioration in ones’ cognitive function may be indicative of a diagnosis of chronic or progressive Dementia. Dementia can be associated with a variety of diseases and / or injuries that primarily or secondarily affect the brain, example the onset of Alzheimers’s Disease or Stroke

The progression of Dementia can lead to motor impairments such as balance issues and gait abnormalities and a decline in physical activity may arise. There is an underlying risk of fear of falling in elderly patients. Therefore, participation in physical activity is important in managing and suppressing the progression of dementia.

Where Is The Research From?
This study was completed at University of Poitiers, France and University Hospital of Poitiers, France, by lead Author Prof. Gilles Kemoun. Kemoun works as head of Department of Physical Medicine and Rehabilitation within the University Hospital of Poitiers. Kemoun has published many studies and reviews looking at various cognitive impairments in the elderly population as well as a variety of exercise and performance based studies.

Although this study was conducted in France and examined the cognitive decline in elderly people living in a nursing home, there is a wide variety of international studies that obtained similar results. A systematic review conducted by Blankevoort CG, Van Heuvelen MJ, Boersma F, Luning H, De Jong J and Scherder EJ stated that there is a strong association between higher levels of physical activity reducing the risk of cognitive decline and dementia.

What Kind Of Research Was This?
This study was a randomised controlled trail that looked at the effects of physical stimulation based on walking exercises, equilibrium and endurance on cognitive function and walking efficiency in patients with dementia A randomised control trail is a type of study in which participants are randomly assigned to one of two clinical interventions. Randomised controlled trials are the most scientifically rigorous method of hypothesis testing available and therefore there is a minimal risk of confounding factors influencing the results. This trail method is considered to provide the most reliable evidence on the effectiveness of the tested intervention and because of this it is regarded as the gold standard trial.

What Did The Research Involve?
This trail compared 16 subjects who suffer from dementia to a control group of 15 participants who had not been diagnosed with dementia or any other cognitive impairment. All 31 subjects (aged 81 +/-5.3 years) were recruited from the same nursing home and were evaluated with the Rapid Evaluation of Cognitive Functions test (ERFC French version) as well as undertook a walking analysis before and after the rehabilitation process. The intervention group (n = 16) undertook a 15-week physical activity programme involving three 1-hour supervised sessions per week. The control group (n = 15) did not practice any physical activities. Each session focused on a specific walking parameter to aid in gait efficiency. One session was dedicated to motor route exercises (e.g. walking by striding over boards, going up a step, zigzagging). The second weekly session was devoted to stamina-based exercises, particularly on an ergocycle. The final weekly session involved activities that combined stamina, equilibrium and walking e.g. dance and stepping activities.

The inclusion of the participants was based on two criteria: one looked at cognition, a diagnosis of Alzheimer-type dementia by a neurologist according to DSM IV criteria with a score on the Mini Mental State Examination lower than 23; the other assessed motor-based skill, the ability to walk 10 metres without technical assistance. Each participant walked the 10 metres while the longitudinal movement of each foot and spatiotemporal walking cycle data was collected. The analysis of their walking efficiency data was measured with a Bessou locometer and SATEL software. The movement of each foot was transmitted, by means of a thread attached from each of the participants foot, to an optical sensor. Although this study found that physical activity programme can slow the cognitive decline and improve the quality of walking efficiency in elderly persons suffering from dementia, further research in this area is necessary.

Whilst the methodology and recruitment of participants in this study was effective in obtaining results, a reasonably low number of participants (a total of 31) were used. The study did not include intensity, frequency, duration or type of activity as a parameter. It was also deemed difficult to standardise the amount of activity each participant partook pre-study intervention. Medications and co-morbidities of the participants were unknown, this may have affected their locomotion abilities.

What Were The Basic Results?

 * The study found a strong correlation (p < 0.001) between changes in cognitive score and walking efficiency in dementia patients.

 * A significant correlation between higher cognitive scores and walking speed ( p = 0.76, p < 0.01), stride length ( p  = 0.61, p <  0.01) and double limb support time (p = 0.74, p <  0.01) was also found.

What Conclusions Can We Take From This Research?
The authors of this article conclude that partaking in a regular exercise programme can suppress the effects and slow the progression of cognitive impairments such as Dementia and Alzheimer's Disease. The results obtained within this study follow trends reflected in other literature. Authors state that stamina-based physical activity programmes have proven beneficial in slowing cognitive decline and improving locomotion and walking efficiency in patients suffering cognitive impairment

The conclusion I draw from this study and other literature in this field, is that, like the authors, regular physical activity and participation in training programmes slows the onset and decreases the effects of cognitive impairments in the elderly.

Practical Advice
This article provides practical advice for the general public, health practitioners and future researchers interested in this area of health.

 * For those who suffer from cognitive impairments, exercising has been shown to improve cognition whilst slowing the onset of Dementia and Alzheimer's Disease. As cognitive decline is most prevalent in the elderly population, adopting exercise programmes within nursing homes may encourage more motivation and interest with being active at an older age. Public activities such aqua aerobics and Pilates has been seen to improve walking efficiency and decreases the risk of falling within this population.

 * For researchers interested in further developing this area, in-depth research could be undertaken to look at participation frequency, activity intensity and the minimum duration needed to design an optimum intervention.

Further Information / Resources
For interest in more readings regarding exercise and its effect on cognition in the elderly population, the following reviews and websites provide a sufficient overview of the topic:

 * 'Does Physical Activity Prevent Cognitive Decline and Dementia?: A Systematic Review and Meta-Analysis of Longitudinal Studies' (Research article)
 * 'The Effect of Exercise Interventions on Cognitive Outcome in Alzheimer's Disease: A Systematic Review' (Research article)
 * 'Recommended Measures for the Assessment of Cognitive and Physical Performance in Older Patients with Dementia: A Systematic Review' (Research article)
 * Health Direct - Dementia Prevention (website)
 * Integrated Living - Dementia Care (website)


text:
Exercise as it relates to Disease/Does the inclusion of physical activity within nursing homes, increase self-efficacy for those with dementia?

This is a critique of the article “Increase self-efficacy: the experience of high-intensity exercise of nursing home residents with dementia” by Cecilie Fromholt Olsen, Elisabeth Wiken Telenius, Knut Engedal and Astrid Bergland.

What is the background to this research?
Dementia is a syndrome that causes deterioration in memory, thinking, behaviour and physical ability in people. It is a major source of morbidity and mortality that affects up to 50 million people worldwide. Research designed to discover strategies and to delay the onset and progression of dementia is ongoing. The most effective preventative strategy would result in improved quality of life, prolonged life expectancy and financial savings for sufferers.

Physical activity is an important element in overall health promotion, it has well-known benefits for many chronic diseases including osteoporosis, stroke and diabetes. There is little evidence that suggests physical activity may delay cognitive loss and physical impairment. In clinical settings, beneficial effects of physical fitness intervention on memory and other aspects of psychological conditions has been documented in elderly people, although inconsistently.

This study evaluates the association between regular High-Intensity Functional Exercise program (HIFE) and dementia patients within a nursing home. The study implies that the overall outcome will increase the self-eficiacy of patients, therefore, delaying further cognitive dysfunction.

Where is the research from?
The following article was written by four persons:
 * Cecilie Fromholt Olsen- A previous student and now an employee at the Oslo Metropolitan University, in the Department of Physiotherapy. Has so far completed five research studies, based on the topics, of mind, health care and the impact of exercise on these areas.
 * Elisabeth Wilken Telenius- Is a Norwegian National Advisory Unit on Ageing and Health Care. She has completed nine studies, which mainly focus on, different forms of exercise affecting patients with dementia and improving mental health within nursing homes.
 * Knut Engedal- Is a current employee at Oslo University Hospital in the Department of Geriatric Medicine and previous Professor in Psychogeriatric Medicine. He has completed hundreds of studies focusing on Alzheimer patients within nursing homes and how this can be improved.Is also working on eleven projects, that have a focus on improving the knowledge, attitude and exercise of Alzheimer's within nursing homes in India.
 * Astrid Bergland- Affiliated with Oslo Metropolitan University, has completed a few study as well

These researchers, are highly regarded for their work on exercise science and its effects on chronic disorders in special reference to individuals who are placed in healthcare and are diagnosed with dementia.

This study was published on the BioMed Central (BMC). A webpage, that allows for individuals to have access to quality peer-review journals specifically within the interest of biology and medicine.

BMC has a strong focus on the innovation of better support for the community, whilst ensuring the reliability and validity of the research that is published.

What kind of research was this?
The research conducted was a randomised, controlled clinical trial of the High-Intensity Functional Exercise Program (HIFE), within a nursing home in Norway. All patients participated in the exercise program and completed a semi-structured survey, for this qualitative study. Randomised, controlled clinical trials are effective for examining safety and efficacy to answer, patient-related questions and the use of the semi-structured interviews, allows for the researchers to gather, the main attitude, experience and themes within the study. Overall, effective methods and proven methods have been utilised for this study.

What did the research involve?
The main criteria for this study was that the patients had to have a mild to moderate dementia diagnosis. 12 participants volunteered for the study, however, only eight were interviewed as the study reached capacity.

Using the HIFE program,each session consisted of: All exercises targeted the lower body. The duration of each session was 50-60 minutes, three times a week, for 10 weeks.
 * Five minute warm-up sessions
 * Two strengthening exercises with 12 repetitions each
 * Two balance exercises (throwing balls, stepping over obstacles and reaching for objects)

After the completion of the exercise program, participants were asked a series of open-ended questions, to gather common attitudes, experiences and themes, throughout the group.

Detailed results were recorded for all patients every week.

Strengths
 * Robust methodology utilised to ensure reliability and viability of outcomes
 * Research based on the point of view of dementia patients, rather than from the family and carers

 * Length of study, was long and sufficient enough to make the results reliable and valid

Limitations
 * Small sample size;may not be representative of the larger nursing home community
 * All participants were Norwegian, though all have dementia in common, certain traits and behaviours, may differ from other cultures and nationalities.

 * Semi-structured interviews provide a generalisation of common themes. This could potentially narrow down the themes, attitudes and experiences, to find the root of the cause.

What were the basic results?
The study found the following key results:

 * Participants reported positive experiences with the exercise, finding the HIFE exercises, challenging, but, fun. Reportedly, patients preferred to fel exhausted after being physically active, rather than from lack of activity. Patients felt that the exercises being performed were relevant and meaningful to everyday activities.
 * Participants felt a sense of acknowledgment, invested-in and noticed, providing a sense of value. They also thoroughly enjoyed the level of interacting with other patients, through exercise, rather than, sitting and talking.
 * Physical activity should be encouraged, as a voluntary activity, twice a week.

This positive experience, of feeling achievement, is a powerful source of self-efficacy according to Bandura ],therefore, supporting the purpose of this study.

What conclusions can we take from this research?
Overall, the following study provides enough evidence, that the HIFE program, had a positive effect, on the self-efficacy of this group of patients. In most nursing homes, there is a general perception in the community that there is a lack of concern, for physical activity with the patients, though, these relative results, suggest otherwise. Healthcare professionals need to be made aware, of the positive results and further promote physical activity within, nursing homes.

Practical advice
Physical activity can be beneficial for patients that are diagnosed with dementia, however, to get more insight into the mechanism underlying the effects of physical activity, we need more high-quality studies. Though, for the time being, carers and family, can encourage them to perform physical activities such as walking or stretching, for at least 20 minutes, into their routine. This can be proven to be a source of motivation for patients and help maintain an active physical regime.

Further information/ resources
For more information on Dementia and importance of physical activities or even ways to incorporate exercise into fun activities for the nursing home patients. Links have been attached below.

 * WHO Dementia : https://www.who.int/news-room/fact-sheets/detail/dementia
 * Carers Perspective of Dementia: https://www.caregiver.org/caregivers-guide-understanding-dementia-behaviors
 * Importance of Physical Activity: https://www.dementia.org.au/files/NSW/documents/AANSW_DiscussionPaper11.pdf
 * 12 Ideas for Exercise and Physical activity: https://dailycaring.com/12-ideas-for-exercise-and-physical-activities-for-seniors-with-dementia/


text:
Exercise as it relates to Disease/Home based exercise to improve quality of life in elderly women with osteoporosis-related vertebral fractures

This is a critique of the research article: Papaioannou A, Adachi J, Winegard K, Ferko N, Parkinson W, Cook R, et al. Efficacy of home-based exercise for improving quality of life among elderly women with symptomatic osteoporosis-related vertebral fractures. Osteoporosis International. 2003;14(8):677-82.

It was written for an assignment in the unit, Health, Disease and Exercise at the University of Canberra.

What is the background to this research?
Osteoporosis is defined as a systemic skeletal disease characterised by low bone mass and microarchitectural deterioration of bone tissue, which leads to increased bone fragility and higher risk of fracture.

Research into osteoporosis and how the severity of the condition can be alleviated or managed via the use of exercise is crucial as osteoporosis can occur in many populations and ethnic groups, with elderly people being at the greatest risk. Hence, the possible benefits that home-based exercise can have on this disease need to be explored, to help those suffering from the disease and possibly create a cost-effective method of getting treatment.

Where is the research from?
This research article was published in the Journal "International Osteoporosis".

The primary author of this article is Dr. Alexandra Papaioannou. She is a geriatrician and has a special interest in osteoporosis, pharmacology and falls and quality of life in the elderly population. She has been involved with many papers regarding osteoporosis. In addition, many of the other authors have completed research on osteoporosis in some capacity.

What kind of research was this?
This study was a randomized control trial. Two groups were created, an exercise and control group. The exercise group participated in the intervention whereas the control group did not participate in the intervention but were later used for comparison. Randomized control trials are considered to be the most credible method of finding out whether a cause and effect relationship exists.

What did the research involve?
The study involved 74 female participants over the age of 60 split randomly into either an exercise or control group.

All subjects had to meet the following criteria:
 * Lumbar spine bone mineral density ≥ -2.5 SD below young adult mean
 * At least one vertebral fracture

In this study, the exercise group had to complete exercises for 60 minutes a day, 3 days a week. Their exercises included stretching, upper and lower body resistance training and aerobics. The control group had no guidelines for exercise and were told to continue with their usual daily activities.

At baseline, 6 months and 12 months, participants had to complete the Osteoporosis Quality of Life Questionnaire (OQLQ), the Sickness Impact Profile (SIP), the Sway Test and the Timed Up and Go Test. At baseline and 12 months participants had to complete a dual-energy X-ray absorptiometry (DEXA) scan assessing bone mineral density (BMD) at the lumbar spine and femoral neck.

A limitation of the study was that the OQLQ had not been validated, therefore the results might not be of any significance. Also, some of the participants had asymptomatic vertebral fractures, but it was thought that the intervention would be best suited for those with symptomatic fractures. Furthermore, 17 participants failed to complete the study and adherence to the intervention dropped after the first 6 months, this may be attributed to the fact that there was decreased supervision by the therapist after 6 months.

What were the basic results?
6 Months
 * Exercise group had greater improvement in symptoms, specifically in lack of energy, pain from carrying, pain from standing, pain from walking and tiredness. (p=0.03)
 * Change in emotion was displayed, specifically they were not as upset about having the disease. (p=0.01)
 * Change in leisure/social, specifically being able to do more physical activity and being able to go on holidays. (p=0.03)
 * In the sway test, participants had improved in range of displacement. (p=0.01)

12 Months
 * Improvements seen in symptoms at the 6 month recordings such as pain from bending, pain from standing and pain from walking were all maintained. (p=0.01)
 * There was improvements in activities of daily living. (p=0.04)
 * In the sway test there was significant improvements for results in lateral and anteroposterior directions as well as velocity of movement. (p=0.01)

SIP, Timed Up and Go and BMD were noted as not having any significant changes.

The results are consistent with what the researchers concluded. The researchers deducted that over a 6 month period, a home exercise program improved quality of life in symptoms, emotion, leisure and social activities. Furthermore they believed that if home based exercises are completed over 12 months, improvements recorded at 6 months will be sustained.

What conclusions can we take from this research?
Despite not having the largest final group size, this article has put forward evidence that home-based exercises can improve the quality of life in postmenopausal women with osteoporosis-related vertebral fractures. However, the validity of this evidence is negatively impacted due to not using a validated test (OQLQ) and low adherence to the intervention. In saying that the data provided is valuable in showing how quality of life can be improved in this population. The findings in this paper correlate with other research done in this area, in that exercise induces positive effects in women with osteoporosis whether or not they have a vertebral fracture. Nevertheless, more research should be conducted on what exercises prove to be more useful in improving the quality of life and overall health of those suffering from osteoporosis and/or vertebral fractures.

Practical advice
Increasing home-based exercise in this population will prove beneficial, as seen above. However, as this population is highly susceptible to injury via falls, it would be wise to consult a specialist (i.e exercise physiologist) before participating in any physical activity to check for any contradictions to exercise. Also, regular check-ups or perhaps even monitored exercise would be advantageous in making sure the individual is safe.

Further information/resources
Osteoporosis Australia

Osteoporosis - An Overview

Exercise Recommendations for Osteoporosis