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Daniel S Baddeley-White,1 Cheri L McGowan,2 Reuben Howden,3 Benjamin DH Gordon,4 Peter Kyberd,5 Ian L Swaine1,21Department of Life & Sport Sciences, University of Greenwich, Medway Campus, London, UK; 2Department of Kinesiology, Faculty of Human Kinetics, University of Windsor, Windsor, ON, Canada; 3Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA; 4Department of Exercise and Rehabilitative Sciences, Slippery Rock University, Slippery Rock, PA, USA; 5Department of Engineering Science, University of Greenwich, Medway Campus, London, UKBackground: Hypertension is the leading risk factor for global mortality. Isometric resistance exercise training reduces blood pressure (BP). However, the protocols used are often limited by cost/immobility and the use of rigid exercise modalities. In response, a novel more versatile, isometric exercise (IE) device, the IsoBall (IB) was created.Purpose: The aim of this study was to test the BP-lowering effectiveness of this prototype.Methods: Twenty-three healthy participants (29.10±2.19 years old, 173.95±3.83 cm, 75.43±5.06 kg, SBP 127.10±10.37 mmHg, DBP 70.40±6.77 mmHg) were randomly allocated to either a control group (CON) or 2 isometric handgrip (IHG) training groups that used the Zona plus (ZON) and IB devices. The intervention groups completed 3 sessions each week of 4, 2 min IHG at 30% maximal voluntary contraction, with a 1-min rest, for 4 weeks. Resting BP, heart rate (HR) and IHG strength were measured in all groups at baseline and postintervention.Results: Postintervention systolic BP (SBP) was significantly lower in both ZON (114.5±8.2 mmHg, p = 0.000) and IB (119.9±7.0 mmHg, p = 0.000) compared to control (131.0±12.4 mmHg). Postintervention diastolic BP (DBP) was reduced in both intervention groups (ZON 66.6±7.4 mmHg, p = 0.004; IB 65.7±10.0 mmHg, p = 0.012) compared to CON (71.1±8.8 mmHg). Mean arterial pressure (MAP) was reduced in both groups (ZON 82.6±6.8 mmHg, p = 0.000; IB 84.3±9.1 mmHg, p = 0.000) compared to control (91.0±9.7 mmHg). No significant changes were seen in HR or strength (p > 0.05).Conclusion: The results of this study indicate that both the ZON and IB devices elicit significant SBP, DBP and MAP reductions. Despite the ZON group having larger reductions in BP, no significant differences were found between the two devices. Thus, this study indicates the IB device to be an effective alternative to the ZON that can also be used to perform other IE modalities.Keywords: hypertension, antihypertensive intervention, isometric exercise ball, IsoBall, Zona plus device

Assessments of maximal intensity exercise which determine peak power output on friction-baked cycle ergometers have fallen into two categories: correction procedures which account for changes in momentum of the ergometer's flywheel and optimization procedures which attempt to satisfy muscle force-velocity relationships. The aim of this study was to compare performance in each procedure and so investigate assumptions which underpin the tests. Nineteen males aged 20.9-0.4 years and 18 females aged 22.2-0.7 years (mean - S.E.M.), who were fully accustomed to the procedures, participated in a single experimental protocol. After a 5 min warm-up, the subjects performed four bouts of all-out exercise on a Monark 814E cycle ergometer against randomly assigned loads. The loads were selected to produce peak pedalling rates in the range 100-200 rev min[sup -1] and each bout lasted 10 s. From the inverse linear relationship between applied load and peak pedalling rate, optimized peak power output (PP[sub opt]) and the accompanying pedalling rate (RPM[sub opt]) were calculated. One of the bouts used a loading equivalent to 7.5% of body weight and for this bout corrected peak power output (PP[sub corr]) and its corresponding pedalling rate (RPM[sub corr])were calculated. The PP[sub opt] was less than PP [sub corr] in the males (915-35 vs 1005-32 W) and females (673-33 vs 777-39 W) (both P< 0.001).Similarly, RPM [sub opt] was less than RPM[sub corr] (111-1 vs 128-2 rev min[sup -1] and 101-1 vs 111-2 rev min[sup -1] in the males and females, respectively; P < 0.001). The results demonstrate that optimization and correction procedures produce different values of performance. These differences are probably attributable to the mechanical principles which underpin the tests. [ABSTRACT FROM AUTHOR]

Anthony W Baross,1 Jonathan D Wiles,2 Ian L Swaine21Sport and Exercise Science, University of Northampton, Northampton, UK; 2Sport and Exercise Science, Canterbury Christ Church University, Canterbury, Kent, UKAbstract: Double-leg isometric training has been demonstrated to reduce resting blood pressure in young men when using electromyographic activity (EMG) to regulate exercise intensity. This study assessed this training method in healthy older (45–60 years.) men. Initially, 35 older men performed an incremental isometric exercise test to determine the linearity of the heart rate versus percentage peak EMG (%EMGpeak) and systolic blood pressure versus %EMGpeak relationship. Thereafter, 20 participants were allocated to a training or control group. The training group performed three double-leg isometric sessions per week for 8 weeks, at 85% of peak heart rate. The training resulted in a significant reduction in resting systolic (11 ± 8 mmHg, P < 0.05) and mean arterial (5 ± 7 mmHg, P < 0.05) blood pressure. There was no significant change in resting systolic blood pressure for the control group or diastolic blood pressure in either group (all P > 0.05). These findings show that this training method, used previously in young men, is also effective in reducing resting systolic and mean arterial blood pressure in older men.Keywords: electromyography, resting blood pressure, heart rate

Surgical prehabilitation aims to optimise patients' physiological reserves to better withstand the stress of surgery, reduce the risk of postoperative complications, and promote a faster and optimal recovery. The purpose of this commentary is to outline the key aspects of prehabilitation before surgery for cancer which seem to impact its effectiveness and wider implementation. Particular attention is paid to the role and integration of resistance training programmes as a key component of multimodal prehabilitation for patients with cancer. We firstly analyse some of the barriers currently hindering the implementation of prehabilitation programmes in the National Health Service (United Kingdom). Later, we describe essential aspects of resistance training design, such as exercise modality and order execution, volume and intensity, rest periods between sets or exercises, and workout frequency. Furthermore, we propose a methodology to use the perception of effort to control patients' progression during a prehabilitation programme., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Roberto Laza-Cagigas is the Operations Lead at QuestPrehabTM (formerly Kent and Medway Prehab). Tara Rampal is the CMO of QuestPrehabTM (formerly Kent and Medway Prehab). Fernando Naclerio, Marcos Seijo, and Ian Swaine declare that they have no conflict of interest.

Background: Chronic kidney disease is common, affecting up to 13 % of the global population, and is predicted to become the fifth leading cause of 'life years lost' by 2040. Individuals with end-stage kidney disease commonly develop complications such as protein-energy wasting and cachexia which further worsens their prognosis. The syndrome of 'renal cachexia' is poorly understood, under-diagnosed and even if recognised has limited treatment options., Objective: To explore the lived experience of renal cachexia for individuals with end-stage kidney disease and the interrelated experiences of their carers., Design: This interpretive phenomenological study was designed to facilitate an in-depth exploration of how patients and carers experience of renal cachexia. To improve and document the quality, transparency, and consistency of patient and public involvement in this study the Guidance for Reporting Involvement of Patients and the Public-Short Format was followed., Setting: The study was conducted across two nephrology directorates, within two healthcare trusts in the United Kingdom., Participants: Seven participants who met the inclusion criteria were recruited for this study, four patients (three female, one male) and three carers (two male, one female)., Methods: We employed a purposive sampling strategy. Data collection was conducted between July 2022 and December 2023. Interviews were semi-structured, audio-recorded, transcribed verbatim and analysed in six steps by two researchers using interpretive phenomenological analysis. Ethical approval was approved by the Office for Research Ethics Committees Northern Ireland (Reference: 22/NI/0107)., Results: Analysis generated six group experiential themes: the lived experience of appetite loss, functional decline and temporal coping, weight loss a visual metaphor of concern, social withdrawal and vulnerability, the emotional toll of eating challenges and psychological strain amidst a lack of information about cachexia., Conclusion: This is the first qualitative study exploring the lived experience of renal cachexia for patients and carers. Our study highlights that psycho-social and educational support is urgently needed. Additionally, healthcare professionals need better information provision to help them to recognise and respond to the needs of this population. Further research is required to develop models of holistic support which could help patients and carers cope with the impact of renal cachexia and optimally manage this syndrome within the family unit., Registration: N/A., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

Hypertension is recognised as a leading attributable risk factor for cardiovascular disease and premature mortality. Global initiatives towards the prevention and treatment of arterial hypertension are centred around non-pharmacological lifestyle modification. Exercise recommendations differ between professional and scientific organisations, but are generally unanimous on the primary role of traditional aerobic and dynamic resistance exercise. In recent years, isometric exercise training (IET) has emerged as an effective novel exercise intervention with consistent evidence of reductions in blood pressure (BP) superior to that reported from traditional guideline-recommended exercise modes. Despite a wealth of emerging new data and endorsement by select governing bodies, IET remains underutilised and is not widely prescribed in clinical practice. This expert-informed review critically examines the role of IET as a potential adjuvant tool in the future clinical management of BP. We explore the efficacy, prescription protocols, evidence quality and certainty, acute cardiovascular stimulus, and physiological mechanisms underpinning its anti-hypertensive effects. We end the review with take-home suggestions regarding the direction of future IET research., (© 2024. The Author(s).)

Microcurrent is a non-invasive and safe electrotherapy applied through a series of sub-sensory electrical currents (less than 1 mA), which are of a similar magnitude to the currents generated endogenously by the human body. This review focuses on examining the physiological mechanisms mediating the effects of microcurrent when combined with different exercise modalities (e.g. endurance and strength) in healthy physically active individuals. The reviewed literature suggests the following candidate mechanisms could be involved in enhancing the effects of exercise when combined with microcurrent: (i) increased adenosine triphosphate resynthesis, (ii) maintenance of intercellular calcium homeostasis that in turn optimises exercise-induced structural and morphological adaptations, (iii) eliciting a hormone-like effect, which increases catecholamine secretion that in turn enhances exercise-induced lipolysis and (iv) enhanced muscle protein synthesis. In healthy individuals, despite a lack of standardisation on how microcurrent is combined with exercise (e.g. whether the microcurrent is pulsed or continuous), there is evidence concerning its effects in promoting body fat reduction, skeletal muscle remodelling and growth as well as attenuating delayed-onset muscle soreness. The greatest hindrance to understanding the combined effects of microcurrent and exercise is the variability of the implemented protocols, which adds further challenges to identifying the mechanisms, optimal patterns of current(s) and methodology of application. Future studies should standardise microcurrent protocols by accurately describing the used current [e.g. intensity (μA), frequency (Hz), application time (minutes) and treatment duration (e.g. weeks)] for specific exercise outcomes, e.g. strength and power, endurance, and gaining muscle mass or reducing body fat., (© 2022. The Author(s).)

Objectives: The World Health Organization emphasises the need for cost-effective alternative methods to lower blood pressure (BP). Endorsed nationally in HTN guidelines, isometric handgrip (IHG) training is an alternative method of BP control. The purpose of this study was to compare the BP, heart rate (HR) and rates of perceived exertion (RPE) responses between a bout of IHG training performed using the traditional computerized device and a more affordable, inflatable stress ball., Methods: Twenty healthy adults performed one bout (4, 2-min isometric contractions, with 1-min rests between each contraction at 30% maximal voluntary contraction) of IHG training using the traditional computerized device, and one bout with the inflatable stress ball. BP, HR, and RPE were recorded., Results: No statistically significant differences between devices were observed with HR, BP, and RPE ( p  < 0.05). However, average RPE for both devices ranged between 5 and 6 indicating that participants were rating 30% of their MVC, consistent with previous work., Discussion: The similar cardiovascular and psychophysical responses provide support for the potential use of this low individual- and provider-burden, cost-efficient IHG device, and lay the foundation for a future training study to test the hypothesis of benefit.

In this study, we aimed to develop a theoretical framework for a multimodal, integrative, exercise, anti-inflammatory and dietary counselling (MMIEAD) intervention for patients with renal cachexia with reference to how this addresses the underlying causal pathways for renal cachexia, the outcomes anticipated, and how these will be evaluated. We used a Theory of Change (ToC) approach to guide six steps. Step 1 included inputs from a workshop to obtain key stakeholder views on the potential development of a multimodal intervention for renal cachexia. Step 2 included the findings of a mixed-methods study with Health Care Practitioners (HCPs) caring for individuals with End Stage Kidney Disease (ESKD) and cachexia. Step 3 included the results from our systematic literature review on multimodal interventions for cachexia management. In step 4, we used the body of our research team's cachexia research and wider relevant research to gather evidence on the specific components of the multimodal intervention with reference to how this addresses the underlying causal pathways for renal cachexia. In steps 5 and 6 we developed and refined the ToC map in consultation with the core research team and key stakeholders which illustrates how the intervention components of MMIEAD interact to achieve the intended long-term outcomes and anticipated impact. The results of this study provide a theoretical framework for the forthcoming MMIEAD intervention for those with renal cachexia and in subsequent phases will be used to determine whether this intervention is effective. To the best of our knowledge no other multimodal intervention trials for cachexia management have reported a ToC. Therefore, this research may provide a useful framework and contribute to the ongoing development of interventions for cachexia management.

Renal cachexia is an important consideration in the person-centred care that is needed in end-stage renal disease (ESRD). However, given that clinical guidelines relating to renal cachexia are largely absent, this is an unmet care need. To inform guidelines and future renal service planning, there is an urgency to understand individuals' experiences of renal cachexia and the interrelated experiences of the carers in their lives. We report here the protocol for an interpretative phenomenological study which will explore this lived experience. A purposive sampling strategy will recruit individuals living with ESRD who have cachexia and their carers. A maximum of 30 participants (15 per group) dependent on saturation will be recruited across two nephrology directorates, within two healthcare trusts in the United Kingdom. Individuals with renal cachexia undergoing haemodialysis will be recruited via clinical gatekeepers and their carers will subsequently be invited to participate in the study. Participants will be offered the opportunity to have a face-to-face, virtual or telephone interview. Interviews will be audio-recorded, transcribed verbatim and analysed using interpretative phenomenological analysis. NVivo, will be used for data management. Ethical approval for this study was granted by the Office for Research Ethics Committees Northern Ireland (REC Reference: 22/NI/0107). Scientific evidence tends to focus on measurable psychological, social and quality of life outcomes but there is limited research providing in-depth meaning and understanding of the views of individuals with renal disease who are experiencing renal cachexia. This information is urgently needed to better prepare healthcare providers and in turn support individuals with ESRD and their carers. This study will help healthcare providers understand what challenges individuals with ESRD, and their carers face in relation to cachexia and aims to inform future clinical practice guidelines and develop supportive interventions which recognise and respond to the needs of this population., Competing Interests: The authors have declared that no competing interests exist.

Background: Swallowing difficulties (dysphagia) and community-acquired pneumonia are common in frail older people and maybe addressed through targeted training of the anterior neck musculature that affects the swallow. We have developed a swallowing exercise rehabilitation intervention (CTAR-SwiFt) by adapting a previously established swallowing exercise to ensure patient safety and ease of execution in the frail elderly population. The CTAR-SwiFt intervention consists of a feedback-enabled exercise ball that can be squeezed under the chin, with real-time feedback provided via a mobile application. The aim of this study is to evaluate the feasibility of assessing the effectiveness of the CTAR-SwiFt intervention in reducing dysphagia and community-acquired pneumonia, prior to a larger-scale multi-centre randomised controlled trial., Methods: We will recruit 60 medically stable patients over the age of 75 years who have been admitted with a diagnosis of pneumonia to the acute frailty wards at two participating hospitals in the UK. Study participants will be randomised into one of three groups: standard care, low intensity (once daily) CTAR-SwiFt exercise or high intensity (twice daily) CTAR-SwiFt exercises. The intervention period will last for 12 weeks, the final follow-up assessment will be conducted at 24 weeks. We will assess the feasibility outcomes, including rates of participant recruitment and retention, compliance with the exercise regime and adverse incidents. Additionally, we will assess the usability and acceptability of the intervention device and the performance of different clinical outcome measures (e.g. chin tuck strength, Functional Oral Intake Scale, SWAL-QOL, EQ-5D and swallow speed). A sub-sample of study participants will complete videofluoroscopic assessments of swallowing function before and after the intervention to evaluate the physiological changes (e.g. bolus flow rates, laryngeal elevation, base-of-tongue retraction)., Conclusions: By improving the ability to swallow, using our chin tuck exercise intervention, in frail older patients admitted to hospital with pneumonia, it is anticipated that patients' oral intake will improve. It is suggested that this will further impact clinical, patient and healthcare economic outcomes, i.e. reduce the need for supplemental feeding, improve patient satisfaction with oral intake and swallowing-related quality of life, decrease the occurrence of chest infections and reduce hospital admissions and related healthcare costs., Trial Registration: ISRCTN, ISRCTN12813363 . Registered on 20 January 2020., (© 2022. The Author(s).)

Introduction: This systematic scoping review sought to summarise and synthesise the qualitative evidence on adolescent idiopathic scoliosis (AIS) to understand the experiences of AIS, and of its diagnosis and treatment, and effective coping strategies to inform directions for future research., Method: A systematic scoping review and textual narrative synthesis was undertaken. Qualitative or mixed-methods studies with extractable qualitative data were included if participants had AIS, and patient or patient relative perspectives about AIS or its treatment were reported., Results: Fifteen papers were included. These suggested that AIS can influence self-image and perceptions of appearance and can cause those with the condition to reluctantly adjust parts of their lives and avoid some activities. The diagnosis and treatment of AIS is a major event and is often accompanied by shock, uncertainty, and anxiety. Whilst some find surgery stressful, others were relieved to have the surgery, and were generally happy with the outcome. Immediate family members may be distressed by the diagnosis and treatment of AIS., Discussion: AIS diagnosis and treatment has a substantial impact on adolescents and their families that is only addressed in part in this review. There is a pressing need for more qualitative research to understand needs, perspectives and experiences of adolescents with AIS and their families from the point of diagnosis, throughout treatment, and in the longer-term., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background and Aims: Although it has been widely recognized the potential of physical activity to help cancer patients' preparation for and recovery from surgery, there is little consideration of patient reflections and recovery experiences to help shape adherence to exercise programs. The aim was to explore the acceptability of our newly proposed isometric exercise program in a large general hospital trust in England providing specialist cancer care by using patient recollections of illness and therapy prior to undertaking a randomized controlled trial., Methods: Four Focus groups (FGs) were conducted with cancer survivors with an explicit focus on patient identity, functional capacity, physical strength, exercise advice, types of activities as well as the timing of our exercise program and its suitability. Thematic framework analysis was used with NVivo 11., Results: FG data was collected in January 2016. A total of 13 patients were participated, 10 were male and 3 were female with participants' ages ranging from 39 to 77. Data saturation was achieved when no new information had been generated reaching "information redundancy." Participants reflected upon their post-surgery recovery experiences on the appropriateness and suitability of the proposed intervention, what they thought about its delivery and format, and with hindsight what the psychological enablers and barriers would be to participation., Conclusion: Based upon the subjective recollections and recovery experiences of cancer survivors, isometric-resistance exercise interventions tailored to individuals with abdominal cancer has the potential to be acceptable for perioperative patients to help increase their physical activity and can also help with emotional and psychological recovery., Competing Interests: The authors declare no conflicts of interest., (© 2020 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Introduction : With increasing age the prevalence of frailty, sarcopenia, undernutrition and dysphagia increases. These are all independent markers of outcome. This study explores the prevalence of these four and explores relationships between them. Methods : A convenience sample of 122 patients admitted to acute medical and frailty wards were recruited. Each was assessed using appropriate screening tools; Clinical Frailty Score (CFS) for frailty, SARC-F for sarcopenia, Nutritional Risk Tool (NRT) for nutritional status and 4QT for dysphagia. Results : The mean age of the participants was 80.53 years (65-99 years), and 50.37% (68) were female. Overall, 111 of the 122 (91.0%) reported the presence of at least one of the quartet. The median CFS was 5 (1-9), with 84 patients (68.9%) having a score of ≥5 (moderate or severely frail); The median SARC-F was 5 (0-10), with 64 patients (52.5%) having a score of ≥5; The median NRT was 0 (0-8) and 33 patients (27.0%) scored ≥ 1. A total of 77 patients (63.1%) reported no difficulty with swallowing/dysphagia (4QT ≥ 1) and 29 (23.7%) had only one factor. Sixteen patients (13.1%) had all four. There was a significant correlation between nutritional status and dysphagia, but not with frailty or sarcopenia. There were significant correlations between frailty and both sarcopenia and dysphagia. Conclusions : In our sample of acute medical and frailty ward patients, there was a much higher prevalence than expected (91%) of either: frailty, sarcopenia, undernutrition or dysphagia. The prevalence of all four was present in 13% of patients. We suggest that frailty, sarcopenia, nutritional risk and dysphagia comprise an "Older Adult Quartet". Further study is required to investigate the effect of the "Older Adult Quartet" on morbidity and mortality.

Background: Previous meta-analyses based on aggregate group-level data report antihypertensive effects of isometric resistance training (IRT). However, individual participant data meta-analyses provide more robust effect size estimates and permit examination of demographic and clinical variables on IRT effectiveness., Methods: We conducted a systematic search and individual participant data (IPD) analysis, using both a one-step and two-step approach, of controlled trials investigating at least 3 weeks of IRT on resting systolic, diastolic and mean arterial blood pressure., Results: Anonymized individual participant data were provided from 12 studies (14 intervention group comparisons) involving 326 participants (52.7% medicated for hypertension); 191 assigned to IRT and 135 controls, 25.2% of participants had diagnosed coronary artery disease. IRT intensity varied (8-30% MVC) and training duration ranged from 3 to 12 weeks. The IPD (one-step) meta-analysis showed a significant treatment effect for the exercise group participants experiencing a reduction in resting SBP of -6.22 mmHg (95% CI -7.75 to -4.68; P < 0.00001); DBP of -2.78 mmHg (95% CI -3.92 to -1.65; P = 0.002); and mean arterial blood pressure (MAP) of -4.12 mmHg (95% CI -5.39 to -2.85; P < 0.00001). The two-step approach yielded similar results for change in SBP -7.35 mmHg (-8.95 to -5.75; P < 0.00001), DBP MD -3.29 mmHg (95% CI -5.12 to -1.46; P = 0.0004) and MAP MD -4.63 mmHg (95% CI -6.18 to -3.09: P < 0.00001). Sub-analysis revealed that neither clinical, medication, nor demographic participant characteristics, or exercise program features, modified the IRT treatment effect., Conclusion: This individual patient analysis confirms a clinically meaningful and statistically significant effect of IRT on resting SBP, DBP and mean arterial blood pressure.

Introduction: The first widely-available dry-land training machines for swimmers were introduced about 40 years ago. They were designed so that swimmers could perform resistance exercise whilst more-closely replicating the movements of swimming, than when using other gymnasium-based resistance training machines. These machines were subsequently adapted and used as measurement tools (ergometers) in an array swimming research study. This narrative review categorizes and summarizes what has been shown by the research studies that have utilized this laboratory-based ergometry., Evidence Acquisition: A search was conducted in PubMed, Web of Science, ScienceDirect and Scopus (1970-2018) and relevant publications were included. Publications were grouped into 4 main areas of research: 1) physiological responses to exercise; 2) functional evaluation of swimmers; 3) monitoring of training; 4) muscular work output of swimmers., Evidence Synthesis: Significant differences were showed between swim bench exercise and real swimming, especially in regard to the muscles involved. The difficulties of accurate reproduction of the movements and coordinated dynamic actions of swimming have not been overcome. Nevertheless, the literature shows that the use of these devices has provided a valuable contribution to swimming physiology, while overcoming difficulties presented by attempting to make physiological measurements in the water., Conclusions: In spite of its limitations, laboratory-based ergometry has allowed a valuable contribution to the understanding of the physiology, effects of training and efficiency of swimming.

Isometric exercise training (IET)-induced reductions in resting blood pressure (RBP) have been achieved in laboratory environments, but data in support of IET outside the laboratory are scarce. The aim of this study was to compare 12 weeks of home-based (HOM) IET with laboratory-based, face-to-face (LAB) IET in hypertensive adults. Twenty-two hypertensive participants (24-60 years) were randomized to three conditions: HOM, LAB, or control (CON). IET involved isometric handgrip training (4 × 2 minutes at 30% maximum voluntary contraction, 3 days per week). RBP was measured every 6 weeks (0, 6, and 12 weeks) during training and 6 weeks after training (18 weeks). Clinically meaningful, but not statistically significant reductions in RBP were observed after 12 weeks of LAB IET (resting systolic blood pressure [SBP] -9.1 ± 4.1; resting diastolic blood pressure [DBP] -2.8 ± 2.1; P > .05), which was sustained for 6 weeks of detraining (SBP -8.2 ± 2.9; DBP -4 ± 2.9, P > .05). RBP was reduced in the HOM group after 12 weeks of training (SBP -9.7 ± 3.4; DBP -2.2 ± 2.0; P > .05), which was sustained for an additional 6 weeks of detraining (SBP -5.5 ± 3.4; DBP -4.6 ± 1.8; P > .05). Unsupervised home-based IET programs present an exciting opportunity for community-based strategies to combat hypertension, but additional work is needed if IET is to be used routinely outside the laboratory., (Copyright © 2018 American Heart Association. Published by Elsevier Inc. All rights reserved.)

Objective: To determine whether there is an association between hypermobility and sports injury., Methods: A quantitative observational approach using a cross-sectional survey was adopted. Individuals were identified as hypermobile or not. All participants were asked to complete two questionnaires: one asking demographic information and the other injury-specific. Fisher's exact test was used for statistical analysis., Results: 114 individuals participated in the study, 62 women and 52 men. 26% of the participants were hypermobile. There was no significant association between hypermobility and sports injury (p=0.66). There was a significant increase in joint and ligament sprain among the non-hypermobile (NH) group covering all sports (p=0.03). Joint dislocation was found exclusively among hypermobile individuals. The duration of injury in hypermobile individuals was higher than NH. The use of oral painkillers or anti-inflammatories in the semiprofessional group was greater than the general population., Conclusion: Hypermobility is relatively common among individuals, and there is a lot of anecdotal evidence associating it with increased rates of injuries. This project finds that NH individuals are more likely to sustain a ligament or joint sprain in sports. This is due to increased joint laxity and flexibility preventing injury. There were important limitations to this study which will be addressed in further work. These include assessing for pauciarticular hypermobility and focusing on one sport to investigate its association with sports injury in those who are hypermobile or not. It would also be important to focus on one specific joint, assessing its flexibility and association with injury., Competing Interests: Competing interests: None declared.

Body temperature is one of the fundamental measures considered in the assessment of health and well-being, with various medical conditions known to give rise to abnormal changes in temperature. In particular, abnormal variations in dynamic temperature patterns during walking or exercise may be linked to a range of foot problems, which are of particular concern in diabetic patients.A number of studies have investigated normative temperature patterns of a population by considering data from multiple participants and averaging results after an acclimatisation interval. In this work we demonstrate that the temperature patterns obtained using such an approach may not be truly representative of temperature changes in a population, and the averaging process adopted may yield skewed results.An alternative approach to determine generic reference temperature patterns based on a minimization of root mean square differences between time-shifted versions of temperature data collected from multiple participants is proposed. The results obtained indicate that this approach can yield a general trend that is more representative of actual temperature changes across a population than conventional averaging methods. The method we propose is also shown to better capture and link the effects of factors that influence dynamic temperature trends, which could in turn lead to a better understanding of underlying physiological phenomena.

Objective: To systematically review the effects of preoperative and postoperative resistance exercise training on the recovery of physical function in patients undergoing abdominal surgery for cancer., Data Sources: A systematic review of English articles using Medline, Physiotherapy Evidence Database, CINAHL and the Cochrane Library electronic databases was undertaken., Eligibility Criteria for Selecting Studies: Studies were included if they used a randomised, quasi-randomised or controlled trial study design and compared the effects of a muscle-strengthening exercise intervention (±other therapy) with a comparative non-exercise group; involved adult participants (≥18 years) who had elected to undergo abdominal surgery for cancer; and used muscle strength, physical function, self-reported functional ability, range of motion and/or a performance-based test as an outcome measure., Results: Following screening of titles and abstracts of the 588 publications retrieved from the initial search, 24 studies met the inclusion criteria and were accessed for review of the full-text version of the article, and 2 eligible studies met the inclusion criteria and were included in the review. One exercise programme was undertaken preoperatively and the other postoperatively, until discharge from hospital. The exercise interventions of the included studies were performed for five and eight sessions, respectively. There were no differences between groups in either study., Conclusion: The only two studies designed to determine whether preoperative or postoperative resistance muscle-strengthening exercise programmes improved or negatively affected physical function outcomes in patients undergoing abdominal surgery for cancer provide inconclusive results., Competing Interests: Competing interests: None declared.

The purpose of this study was to explore the relationships between mechanical power, thrust power, propelling efficiency and sprint performance in elite swimmers. Mechanical power was measured in 12 elite sprint male swimmers: (1) in the laboratory, by using a whole-body swimming ergometer (W' TOT ) and (2) in the pool, by measuring full tethered swimming force (F T ) and maximal swimming velocity (V max ): W' T  = F T  · V max . Propelling efficiency (η P ) was estimated based on the "paddle wheel model" at V max . V max was 2.17 ± 0.06 m · s -1 , η P was 0.39 ± 0.02, W' T was 374 ± 62 W and W' TOT was 941 ± 92 W. V max was better related to W' T (useful power output: R = 0.943, P < 0.001) than to W' TOT (total power output: R = 0.744, P < 0.01) and this confirms the use of the full tethered test as a valid test to assess power propulsion in sprinters and to estimate swimming performance. The ratio W' T /W' TOT (0.40 ± 0.04) represents the fraction of total mechanical power that can be utilised in water (e.g., η P ) and was indeed the same as that estimated based on the "paddle wheel model"; this supports the use of this model to estimate η P in swimming.