Holden MacRae

Exercise with Physically Restrained Nursing Home Residents: Maximizing Benefits of Restraint Reduction

OBJECTIVE: To evaluate an exercise protocol designed to improve strength and mobility, and to decrease injury risk factors in physically restrained nursing home residents.

Isometric Exercise Increases the Size of Forearm Veins in Patients with Chronic Renal Failure

ObjectivesDelay in maturation or failure of maturation of Cimino-Brescia fistulae contributes to the significant vascular access-related morbidity of chronic hemodialysis patients. Increased size and capacitance of native veins before the formation of vascular access has been considered an important variable in the success rate of native fistulae. We evaluated whether a formal exercise program might alter the size of native veins. MethodsThe effect of exercise on venous size was evaluated in 5 patients with severe chronic renal failure [glomerular filtration rate, 30.6 ± 5.3 mL/min (mean ± SD)]. Five male patients with a mean age of 57 ± 9 years underwent a 6-week forearm exercise training program, involving nondominant arms, that included isometric hand-grip contractions to 25 to 35% of MVC lasting 40 to 120 seconds and repetitive squeezing of squash and racquet balls. Both the volume and intensity of exercise training was increased weekly based on strength measured by hand-grip dynamometer and on the patients’ indicated level of comfort. Cephalic vessel size in both the nondominant (trained) and dominant (control) arms, with and without a tourniquet, were obtained using Doppler ultrasound before and after the 6-week exercise training program. ResultsThe size of the cephalic vein of the exercised arm increased significantly (P < 0.05) compared with the control arm when measured in both the absence (048 ± 0.016 versus 0.024 ± 0.023 cm2) and the presence of a tourniquet (0.056 ± 0.022 versus 028 ± 0.027 cm2). ConclusionsThese findings indicate that a simple, incremental resistance, exercise-training program can cause a significant increase in the size of the cephalic vein commonly used in the creation of an arteriovenous fistula. The increase in size and resultant probable increase in blood flow might accelerate the maturation of native arteriovenous fistulae, thereby lessening the morbidity associated with vascular access.

Red blood cell omega-3 fatty acid levels and neurocognitive performance in deployed U.S. Servicemembers

Abstract Objective To explore the cross-sectional relationships between blood eicosapentaenoic acid + docosahexaenoic acid (HSOmega-3 Index®) and sleep disorders, depression, anxiety, and neurocognitive performance in Servicemembers deployed to Iraq. Methods Servicemembers with mild-to-moderate depression by the Patient Health Questionnarie-9 from two US military camps were invited to participate in this study. A battery of validated psychosocial (Pittsburgh Sleep Quality Index, and Zung Depression, Zung Anxiety, Epworth Sleepiness, and Combat Experiences scales) and computerized neurocognitive tests were completed by each participant. Five neurocognitive domain scores were calculated – Processing Speed, Complex Attention, Reaction Time, Cognitive Flexibility (CF), and Executive Function (EF). A drop of blood was also collected on an anti-oxidant-treated filter paper card and sent for HS-Omega-3 Index® analysis. An analysis of variance contrast was used to test for linear trends between quartiles of the HS-Omega-3 Index® for both EF and CF. Results The mean HS-Omega-3 Index® was 3.5 ± 0.7% (n = 78). The HS-Omega-3 Index® was not significantly associated with scores for anxiety, depression, or sleep, whether assessed as continuous or dichotomous variables, but was directly associated with CF and EF (P < 0.02 and 0.01, respectively), especially in the 81% who reported poor sleep quality. In those with poor sleep quality (n = 63), EF and CF were higher (P = 0.005) in subjects with Omega-3 levels above versus below the mean. Conclusion Optimal neurocognitive performance is essential during deployment. Our finding that EF and CF were positively related to HS-Omega-3 Index® suggests that improving omega-3 status through an increase in omega-3 intake may improve neurocognitive performance and confer an element of resilience to poor sleep.

Strength training effects on rearfoot motion in running.

The investigation examined isokinetic (IK) and nonisokinetic (NIK) strength training programs for the inversion (INV) and eversion (EV) muscles on pronation during running. Seventy-seven volunteers were videotaped running on a treadmill at 3.8 m.s-1 and total pronation (delta beta PRO) was computed. Eighteen heel-strike runners with the largest values of delta beta PRO (X = 16.7 degrees) were selected as subjects. During the pre- and posttests, isokinetic muscle strength at 20 and 180 degrees.s-1 was determined for the concentric (CON) and eccentric (ECC) actions of the INV and EV muscle groups. The subjects also were videotaped running on a treadmill (3.8 m.s-1). The IK training group performed three sets of eight CON and ECC repetitions at 20, 90, and 180 degrees.s-1 for both muscle groups; and the NIK subjects did exercises commonly used in ankle rehabilitation. Each group trained three times weekly for 8 wk. The IK group showed significantly (P < or = 0.05) CON and ECC strength increases for all INV test conditions and three of the four EV conditions (20 degrees.s-1 CON and ECC, and 180 degrees.s-1 CON). They also demonstrated significant decreases in the rearfoot (2.2 degrees) and pronation/supination (2.9 degrees) angles at heel strike and in delta beta PRO (-2.2 degrees).l The NIK group exhibited no change in rearfoot motion and only increased INV strength at the 180 degrees.s-1 ECC test condition. The findings suggest that pronation can be decreased by an isokinetic strength training program for the INV and EV muscles.

Cycling with Video Feedback Improves Performance in Untrained, but Not in Trained Women

The objectives of this study were to assess whether exercise performance responses could be altered when subjects were exposed to interactive video feedback and music (VFM), compared to music only feedback (M). Ten women, 5 well-trained (46.4 ± 4.7 ml × kg-1 × min-1) and 5 untrained (34.5 ± 5.7 ml × kg-1 × min-1) participated in the study. Neither the trained nor the untrained group exhibited significant differences in HR and VO2 between the VFM and M conditions. The trained subjects cycled at similar speeds and for similar distances during the VFM and M conditions, and also cycled at a higher average speed (23.5 ± 2.1 vs. 15.6 ± 3.2 km × h-1) and further (11.9 ± 1.1 vs. 7.8 ± 1.6 km) than the untrained subjects (p < 0.01). The untrained subjects cycled further and faster in the VFM versus M condition (p < 0.05), and both the average speed (15.6 ± 3.2 vs. 13.9 ± 2.3 km × h-1) and average distance cycled (7.8 ± 1.6 vs. 7.0 ± 1.2 km) were also improved in the VFM versus M condition (p < 0.05). No group or exercise condition differences were observed for ratings of perceived exertion or psychological performance. We conclude that VFM does not improve cycling performance in trained women, but untrained women cycle faster and further during a 30-min exercise session when exposed to a combination of interactive video and music feedback.

Effects of Omega-3 Fatty Acid Supplementation on Neurocognitive Functioning and Mood in Deployed U.S. Soldiers: A Pilot Study

Omega-3 fatty acids (FAs) may have neuroprotective properties for psychological health and cognition. The objective of this study was to evaluate the effectiveness of omega-3 FAs (eicosapentaenoic + docosahexaenoic; Harris-Schacky [HS]-Omega-3 Index) on neuropsychological functioning among U.S. Soldiers deployed to Iraq. This randomized, double-blind, placebo-controlled trial included Soldiers between the ages of 18 and 55 years who were randomly assigned to either the active treatment group (n = 44) or placebo group (n = 34). Active treatment was 2.5 g per day of eicosapentaenoic + docosahexaenoic (Lovaza; GlaxoSmithKline, Research Triangle Park, North Carolina). The placebo was corn oil ethyl esters. HS-Omega-3 Index, a neurocognitive battery (Central Nervous System-Vital Signs, Morrisville, North Carolina), and psychological health scales were assessed at baseline and after 60 days of treatment. Although the results revealed that omega-3 FAs significantly increased the HS-Omega-3 Index (p = 0.001), there were no significant effects on indices psychological health and neurocognitive functioning by treatment group. Nevertheless, there was a significant inverse correlation between the changes in the HS-Omega-3 Index and daytime sleepiness (r = 0.30, p = 0.009). Short-term treatment with 2.5 g of omega-3 FAs did not alter measures of neurocognition or psychological health, but there was evidence of a relationship between omega-3 levels and daytime sleepiness.