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Gait Retraining for the Reduction of Injury Occurrence in Novice Distance Runners: 1-Year Follow-up of a Randomized Controlled Trial
Get PDFBackground:
The increasing popularity of distance running has been accompanied by an increase in running-related injuries, such that up to 85% of novice runners incur an injury in a given year. Previous studies have used a gait retraining program to successfully lower impact loading, which has been associated with many running ailments. However, softer footfalls may not necessarily prevent running injury.
Purpose:
To examine vertical loading rates before and after a gait retraining program and assess the effectiveness of the program in reducing the occurrence of running-related injury across a 12-month observation period.
Study Design:
Randomized controlled trial; Level of evidence, 1.
Methods:
A total of 320 novice runners from the local running club completed this study. All the participants underwent a baseline running biomechanics evaluation on an instrumented treadmill with their usual running shoes at 8 and 12 km/h. Participants were then randomly assigned to either the gait retraining group or the control group. In the gait retraining group (n = 166), participants received 2 weeks of gait retraining with real-time visual feedback. In the control group (n = 154), participants received treadmill running exercise but without visual feedback on their performance. The training time was identical between the 2 groups. Participants’ running mechanics were reassessed after the training, and their 12-month posttraining injury profiles were tracked by use of an online surveillance platform.
Results:
A significant reduction was found in the vertical loading rates at both testing speeds in the gait retraining group (P 0.99), whereas the loading rates were either similar or slightly increased in the control group after training (P = .001 to 0.461, Cohen’s d = 0.03 to −0.14). At 12-month follow-up, the occurrence of running-related musculoskeletal injury was 16% and 38% in the gait retraining and control groups, respectively. The hazard ratio between gait retraining and control groups was 0.38 (95% CI, 0.25-0.59), indicating a 62% lower injury risk in gait-retrained runners compared with controls.
Conclusion:
A 2-week gait retraining program is effective in lowering impact loading in novice runners. More important, the occurrence of injury is 62% lower after 2 weeks of running gait modification.
Registration:
HKUCTR-1996 (University of Hong Kong Clinical Trials Registry)
The Effect of Cold Dialysis in Motor and Sensory Symptoms of RLS/WED Occurring During Hemodialysis
No full textRestless legs syndrome/Willis–Ekbom disease (RLS/WED) is a common sensorimotory disorder affecting almost 30% of hemodialysis (HD) patients. RLS/WED induces discomfort during rest hours, and its symptoms have also been observed during HD sessions. Anecdotal reports suggest that cooling the dialysate solution during dialysis could help patients overcome those symptoms and improve restlessness. The aim of this double-blind study was to assess whether a reduction of the dialysate temperature by 1°C could reduce motor and sensory symptoms of RLS/WED occurring during HD. Thirty-two HD patients participated in the study. Patients were divided into two groups: the RLS (N=16) and the non-RLS groups (N=16). Patients were studied on two different scenarios for two consecutive HD sessions, 1 week apart: 1) standard temperature of the dialysate (37°C) and 2) low temperature of the dialysate (36°C cold dialysis scenario). In all sessions, motor (leg movement per hour of HD [LM/hHD]) and sensory symptoms were assessed. The reduction of dialysate temperature by 1°C was effective in reducing motor symptoms as they assessed the LM/hHD by 36% only in patients with RLS, while a significant interaction was found between “LM/hHD affected by temperature” and “RLS status” (p = 0.039). Sensory symptoms also reduced by 10% after the reduction of the dialysate temperature. The reduction of the dialysate temperature by 1°C reduced motor symptoms by 36–54% and sensory symptoms by 10% in HD patients with RLS/WED. Cold dialysis could be considered a safe nonpharmacological approach for the amelioration of RLS/WED symptoms occurring during HD
NQT Mentoring Project Action Research: Newly Qualified Teacher Leadership Development
Get PDFAll Saints Teaching School and Plymouth Marjon University conducted this research working with NQTs from over 14 schools, interacting with 20 teachers and potentially impacting on over 600 of their pupils
Perceived and actual control in patients with severe asthma: results from a global online survey
No full textIntroduction:Asthma control assessment is important in patients (pts) with severe asthma, where OCS use, exacerbations and mortality risk are high. We compared the actual (as per GINA) and perceived control (PC) in pts with severe asthma.
Methods:Data were collected in 1333 pts [adult (>18yrs) and caregivers of minor pts (6–17yrs)] with severe persistent asthma from 9 countries via a global 20-minute online survey conducted by GfK for Novartis during 2016.
Results:A discrepancy was seen between real-life asthma control as per GINA guidelines (6%) and PC (42%). A decision tree analysis showed that higher WHO-5 score (Figure 1a) was a predictor of positive subjective perception of asthma control by pts with uncontrolled asthma based on GINA (disconnect between objective and subjective disease control; Figure 1b). More days on oral corticosteroids and bad sleep quality were predictors of negative objective asthma control (based on GINA) for pts who subjectively perceive their asthma as well controlled. These analysis fall short in explaining what drives the discrepancy between objective and subjective control of asthma in general due to small sample sizes in particular subgroups.
Conclusion:A discrepancy exists in ‘asthma control’ as per GINA and as perceived by patients. We identified the predictors of perceived and actual control (GINA); however, the reason for disconnect between these measures still remains unknown
An Offer of Standpoint to Social Work, Ethics and Law
Get PDFAs I prepared to design and write a third Year University course for social workers, an open campus course for sociologists entitled Social Work Law and Ethics for the University of the West Indies, and materials for other social scientists on the issue of law and ethics in social work, I realised that the primary issue was one of a dilemma or contradicting forces that needed to be reconciled. How was I going to answer their main questions: What do I do? And whose side should I be on? (Becker 1967; Leibling 2001). And What if there is no compelling answer be able to refute their default position of “anything goes”? (Feyerbend, 1975). I had an idea that in the same way that I taught my research students to anchor the production of knowledge in a feminist standpoint methodology, this might just work for other social science practitioners, such as educators, criminal justice workers and philosophical inquirers. This paper outlines a re-conjuration of the concept of standpoint and how it can be used to assist and ground applying ethics and the engagement with law in the theorising of ethics in professional practice
An Examination of Students’ Entrepreneurial Learning through Extracurricular Enterprise Activities
No full textExtracurricular enterprise activities have steadily increased over the past decade within universities (Rae et al., 2012), as has the domain of entrepreneurial learning research (Wang and Chugh, 2014) yet limited empirical research examines links between the two phenomena. This thesis connects educational theory, entrepreneurial learning theory and entrepreneurial education research to examine the role that extracurricular enterprise activities may have within the entrepreneurial learning processes of students at United Kingdom Higher Education Institutions. Utilising a social constructionist paradigm of enquiry this thesis critically examines perceptions of the value of extracurricular enterprise activities from an educator and student perspective. A semi-structured survey (n=55) and in depth interviews with students (n=23) and enterprise educators (n=3) across 24 UK universities explored what extracurricular enterprise activities students engaged in, their motivations for engagement and the perceived value of extracurricular enterprise activities in relation to entrepreneurial learning processes. Findings suggest that extracurricular enterprise activities not only provide value in the experiential and social learning opportunities afforded for participants, but the positioning of these activities outside of the main curriculum enables students to develop their autonomous learning capabilities. The results contribute to an emerging body of literature examining self-directed learning activities and entrepreneurial learning (Van Gelderen, 2010; Tseng, 2013). The thesis concludes that while experiential and social learning opportunities occupy a central role within entrepreneurial learning processes of university students, self-directed learning activities are increasingly important, and emphasis should be placed upon enabling students to self-direct their entrepreneurial learning processes. For policy and practice, this research provides additional scrutiny of the proposition that extracurricular enterprise activities positively enhance learning through examining what extracurricular enterprise activities students choose to engage in and the benefits they perceive they attained. This research also provides an enhanced understanding of how students interpret and apply the theoretical concept of entrepreneurial learning. Research examining entrepreneurial learning is important in enabling a more effective understanding of the entrepreneurial process yet studies examining student perceptions of entrepreneurial learning remain limited (Mueller and Anderson, 2014; Wang and Chugh, 2014). Finally, this thesis presents the central role of self-directed learning activities to students’ entrepreneurial learning processes and provides recommendations for enhancing entrepreneurial education
Diversity of Diptera families that pollinate Ceropegia (Apocynaceae) trap flowers: An update in light of new data and phylogenetic analyses
Get PDFPollination by flies (Diptera) has been important to the diversification and ecology of the flowering plants, but is poorly understood in contrast to pollination by other groups such as bees, butterflies and birds. Within the Apocynaceae the genera Ceropegia and Riocreuxia temporarily trap flies, releasing them after a fixed, species-specific period of time, during which pollination and/or pollen removal occurs. This “trap flower” pollination system shows convergent evolution with unrelated species in other families and fascinated Stefan Vogel for much of his career, leading to ground-breaking work on floral function in Ceropegia (Apocynaceae). In this new study we extend the work of the latest broad analysis published by some of the authors (Ollerton et al., 2009 − Annals of Botany). This incorporates previously unpublished data from India and Africa, as well as recently published information, on the diversity of pollinators exploited by Ceropegia. The analyses are based on a more accurate phylogenetic understanding of the relationships between the major groups, and significantly widens the biogeographic scope of our understanding of fly pollination within Ceropegia. Information about the pollinators of 69 taxa (species, subspecies and natural varieties) of Ceropegia is now available. Twenty five families of Diptera are known to visit the flowers of Ceropegia, of which sixteen are confirmed as pollinators. Most taxa are pollinated by species from a single family. Overall, there were no major biogeographic differences in the types of Diptera that were used in particular regions, though some subtle differences were apparent. Likewise there were no differences between the two major clades of Ceropegia, but clear differences when comparing the range of Diptera exploited by Ceropegia with that of the stapeliads. This clade, one of the largest in the Asclepiadoideae, is a fascinating example of a species radiation driven by an apparently relatively uniform set of pollinators
Modulators of actin-myosin dissociation: basis for muscle type functional differences during fatigue
Get PDFThe muscle types present with variable fatigue tolerance, in part due to the myosin isoform expressed. However, the critical steps that define “fatigability” in vivo of fast vs. slow myosin isoforms, at the molecular level, are not yet fully understood. We examined the modulation of the ATP-induced myosin subfragment 1 (S1) dissociation from pyrene-actin by inorganic phosphate (Pi), pH, and temperature using a specially modified stopped-flow system that allowed fast kinetics measurements at physiological temperature. We contrasted the properties of rabbit psoas (fast) and bovine masseter (slow) myosins (obtained from samples collected from New Zealand rabbits and from a licensed abattoir, respectively, according to institutional and national ethics permits). To identify ATP cycling biochemical intermediates, we assessed ATP binding to a preequilibrated mixture of actomyosin and variable [ADP], pH (pH 7 vs. pH 6.2), and Pi (zero, 15, or 30 added mM Pi) in a range of temperatures (5 to 45°C). Temperature and pH variations had little, if any, effect on the ADP dissociation constant (KADP) for fast S1, but for slow S1, KADP was weakened with increasing temperature or low pH. In the absence of ADP, the dissociation constant for phosphate (KPi) was weakened with increasing temperature for fast S1. In the presence of ADP, myosin type differences were revealed at the apparent phosphate affinity, depending on pH and temperature. Overall, the newly revealed kinetic differences between myosin types could help explain the in vivo observed muscle type functional differences at rest and during fatigue
Restless legs syndrome in adolescents: Relationship with sleep quality, cardiorespiratory fitness and body fat
Get PDFThe aim of the current study was to investigate the relationship between restless legs syndrome (RLS) and cardiorespiratory fitness, body composition and sleep quality in a sample of adolescents. One hundred fifty seven volunteer adolescents (16.6±0.7 yrs) participated in the study. Sleep quality was assessed by the Pittsburg sleep quality index. Cardiorespiratory fitness was assessed by the 20 m shuttle run test and body composition by bioelectrical impedance analysis. The prevalence of RLS was 5.1%. The adolescents with RLS were found to exhibit significantly higher body fat levels and poorer sleep quality score compared to their free-RLS counterparts
