Knowledge of Exercise Prescription Guidelines Among Certified Exercise Professionals

The knowledge of movement experts about stretching effects: Does the science reach practice?

OBJECTIVE

Stretching is performed with numerous purposes in multiple settings such as prevention, rehabilitation, fitness training and sports. Its patterns of use substantially depend on the education and beliefs of health care and exercise professionals as they represent the multiplicators recommending and prescribing interventions to clients, patients and athletes. This study investigated movement experts' knowledge about the scientific evidence on stretching effects.

DESIGN

Survey study.

PARTICIPANTS

A total of 117 exercise and health professionals (physiotherapists, sports scientists, coaches) attending a training convention in Austria (male: n = 44, female: n = 73, 36±11 years) completed a digital survey. With its 22 items, the questionnaire addressed the movement experts' awareness of the evidence on stretching effects regarding a variety of related topics selected based on the findings of topical systematic reviews.

RESULTS

The majority of the individuals (57-88%) assumed positive effects of stretching on recovery, prevention of muscle injury, range of motion, muscular imbalance and artery elasticity. No or adverse effects were mostly claimed on bone injury prevention, maximal/explosive strength, and delayed-onset muscle soreness. In only 10 of 22 items, participants' classifications were in accord with the scientific evidence.

CONCLUSIONS

The awareness of research findings on stretching effects among exercise and health professionals is alarmingly low. Future studies may hence be geared to improve implementation and science communication.

Exercise instructors are not consistently implementing the strength component of the UK chief medical officers' physical activity guidelines in their exercise prescription for older adults

Strength training recommendations have been embedded within the UK's Chief Medical Officers' physical activity guidelines since 2011. There is limited evidence that these recommendations are used by exercise instructors in the community to underpin strength training prescription in the older adult population. This study aimed to explore exercise instructors' awareness and utilisation of the guidelines when prescribing strength training to older adults. Fifteen exercise instructors working with older adults in the UK participated in one online interview. A general inductive approach was conducted and thematic analysis allowed for major themes to be identified from the raw data. We found that most exercise instructors (n = 9), but not all (n = 6), were aware of the guidelines. Only one instructor (n = 1) had reportedly implemented the guidelines into their practice; other instructors reported that the guidelines were irrelevant. Instead, each of the instructors had their preferred sources of information that they relied on to underpin their exercise prescription, and each had their own interpretation of 'evidence-based strength training.' This individualised interpretation resulted in exceptionally varied prescription in the community and does not necessarily align with the progressive, evidence-based prescription known to build muscular strength. We suggest that (i) more detail on how to build muscular strength be embedded within the guidelines, (ii) a handbook on how to implement the guidelines be made available, (iii) theoretical and practical teaching materials and courses be updated, and/or (iv) a re-(education) of exercise instructors already in the field may be necessary to bring about a consistent, evidence-based strength prescription necessary for the best possible health and longevity outcomes for our ageing population.

The Development of ICT-Based Exercise Rehabilitation Service Contents for Patients with Musculoskeletal Disorders and Stroke

Exercise rehabilitation services connecting hospitals and communities increase patient participation and improve quality of life by reducing medical expenses. South Korea’s multi-ministerial governments have been working together to develop ICT-based hospital-community-linked services to create an exercise program that the public can easily use. This study aims to develop the exercise rehabilitation service components for the application and prescription of ICT-based exercise programs implemented in hospitals and communities. A literature review was conducted, and an expert committee was comprised to classify the components of exercise rehabilitation services. As a result, we classified the first components as functional classification, rehabilitation area, equipment uses, exercise type, frequency, and intensity. Subsequently, exercise programs were developed by applying the first components. Based on the purpose of exercise rehabilitation, we classified the representative standard exercise and grouped the same exercise movements using tools and exercise machines. The finding of this study will help to give the correct exercise prescription and manage patients’ improvement process for exercise instructors. In addition, it guides patients in need of exercise rehabilitation to participate in an accurate and safe exercise in the community. This study is a novel attempt to develop ICT based hospital-community-linked exercise rehabilitation service for patients.

Identifying priorities for sport and physical activity research in Canada: an iterative priority-setting study

BACKGROUND

There is a need for better alignment between research on sport and physical activity and the needs of those who are in a position to implement the findings. To facilitate advancement and alignment, we identified the top research priorities of sport and physical activity knowledge users from various sectors.

METHODS

For this priority-setting study, we used an iterative process of data collection and analysis. Sport and physical activity knowledge users from multiple sectors participated in a workshop (September 2019), which included small working group exercises followed by large-group syntheses leading to the identification of issues that required better understanding. We then sent an online questionnaire to participants for content validation and interim prioritization, to reduce the number of priorities (December 2019 to January 2020). A new questionnaire containing a shortened list of research priorities was sent to an expanded group of respondents to further streamline the list of priorities (January-March 2020).

RESULTS

The 24 workshop participants identified 68 issues, of which 21 were retained by the 18 participants in the interim priority-setting questionnaire. The final prioritization questionnaire was completed by 33 stakeholder groups; this step produced a final list of 8 top research priorities. The final priorities identified for sport and physical activity research related to financial support, suboptimal promotion, dropout, best interventions, participation among Indigenous populations, volunteer engagement, safe and inclusive experiences, and knowledge exchange.

INTERPRETATION

The 8 priorities identified in this study provide guidance to Canadian sport and physical activity researchers. Research efforts on these priorities will reflect pressing issues as identified by representatives of all sport and physical activity sectors.

A structured workshop enhanced Physiotherapists' skills in clinical decision-making: A pre-post study

Context

Effective clinical decision-making skills enhance the quality of patient care. Clinical reasoning and decision-making are fundamental aspects of best physiotherapy clinical practice.

Aims

To evaluate the effectiveness of an evidence-based structured educational workshop in enhancing physiotherapists' clinical decision-making skills.

Settings and Designs

A pre-post design conducted in a medical college.

Methods and Materials

A workshop protocol was developed based on the existing evidence and clinical practice guidelines. The workshop was advertised on the social media page of Nepal Physiotherapy association. On the first come first serve method; physiotherapists were selected. Those who met eligibility criteria were recruited for one of two workshops. Discussion was made on clinical scenarios aimed at enhancing clinical decision-making skills. Data were collected before and after the workshop using a self-administered clinical decision-making skills assessment tool to evaluate effectiveness of the workshop. Paired and unpaired t-tests were used to analyze within and between groups respectively.

Results

Significant improvement in clinical decision-making skills was found for all individual items (P < 0.001 in all items, effect size: 0.6 - 0.9), total EP score (P < 0.001, effect size: 0.8) and total clinical decision-making score (P < 0.001, effect size: 0.9). A significant difference was found between Bachelor and Master level education (P < 0.05).

Conclusions

An evidence-based structured educational workshop enhanced physiotherapists' clinical decision-making skills. The findings of this study could be relevant to all health care professionals working in clinical practice. Larger studies with a control group are recommended to strengthen the findings of this study.

Can Fitness Education Programs Satisfy Fitness Professionals' Competencies? Integrating Traditional and Revised Importance-Performance Analysis and Three-Factor Theory

The purpose of this study is to assess whether fitness education programs could meet the needs or competencies of fitness professionals such as personal trainers and group fitness instructors. A mixed method was adopted to address the objectives of the study. In the first step, a semi-structured interview was conducted with five fitness experts to identify the five dimensions of professional competencies. In the second step, an online survey and paper questionnaires were utilized to collect data from 324 eligible subjects. Traditional importance-performance analysis, revised importance-performance analysis, and the three-factor theory were used to analyze the collected data. The results indicate that “professional skill,” “career development,” and “public relations” are the three most critical professional competencies. “Nutrition” and “coping with stress” should be strengthened and improved in fitness education programs. “Administrative management” is the least important professional competency. Multi-competencies development and lifelong learning are the factors for a successful fitness trainer.

Profiling Rest Intervals between Sets and Associated Factors in Resistance Training Participants

The aims of this study were: (1) to report on and analyse rest interval (RI) control between sets adopted by resistance training (RT) participants; (2) to evaluate how RT participants control RIs; and (3) to describe the factors associated with controlling RIs, such as, gender, RT experience, and professional guidance. Four hundred and fifteen volunteers (198 women and 217 men) answered a questionnaire about RI control. Among the participants, 89.9% (n = 373) reported receiving guidance during physical training, of which 74.5% (n = 278) received instruction from a sports and exercise professional. The proportion of subjects that reported controlling RIs was 71.6% (n = 297). Most subjects that reported controlling RIs (95.0%, n = 282) reported adopting an RI of 60 s or less. There is no association of RI control with gender and professional guidance. The RI adopted by most of the participants might be considered short (<60 s), which is not in line with most RT guidelines. The results of the current study could be used to improve attitudes toward RT.

Cardiorespiratory and metabolic determinants during moderate and high resistance exercise intensities until exhaustion using dynamic leg press: comparison with critical load

The objective of this study was to assess cardiovascular, respiratory, and metabolic responses during a commonly used dynamic leg press resistance exercise until exhaustion (T_Ex) at different intensities and compare with critical load (CL). This was a prospective, cross-sectional, controlled, and crossover study. Twelve healthy young men (23±2.5 years old) participated. The subjects carried out three bouts of resistance exercise in different percentages of 1 repetition maximum (60, 75, and 90% 1RM) until T_Ex. CL was obtained by means of hyperbolic model and linearization of the load-duration function. During all bout intensities, oxygen uptake (VO₂), carbon dioxide production (VCO₂), ventilation (V_E), and respiratory exchange ratio (RER) were obtained. Variations (peak-rest=Δ) were corrected by T_Ex. In addition, systolic and diastolic blood pressure (SBP and DBP), blood lactate concentration [La-] and Borg scores were obtained at the peak and corrected to T_Ex. CL induced greater T_Ex as well as number of repetitions when compared to all intensities (P<0.001). During CL, Borg/T_Ex, ΔSBP/T_Ex, ΔDBP/T_Ex, and [La-] were significantly lower compared with 90% load (P<0.0001). In addition, VO_2, VCO_2, V_E, and RER were higher during CL when compared to 90 or 75%. T_Ex was significantly correlated with VO₂ on CL (r=0.73, P<0.05). These findings support the theory that CL constitutes the intensity that can be maintained for a very long time, provoking greater metabolic and ventilatory demand and lower cardiovascular and fatigue symptoms during resistance exercise.

Knowledge about sport and exercise science

Purpose

The purpose of this paper was to assess the knowledge on sport and exercise science held by a sample of Brazilian physiotherapists, nutritionists and physical educators.

Design/methodology/approach

A cross-sectional research design was used. The answers given by 1,147 professionals (300 physiotherapists, 705 physical educators and 142 nutritionists) who participated in a qualifying process for a specialization course on exercise physiology were analyzed. Questions were analyzed on maximal oxygen uptake (four questions), physical fitness assessment (three questions), physical training (two questions), bioenergetics (one question) and exercise in extreme environments (one question).

Findings

The results revealed misconceptions held by Brazilian health professionals on a number of concepts related to sport and exercise science, such as maximal oxygen uptake.

Practical implications

These results reinforce the need for continuing education programs to maximize the quality of the service provided by sport and exercise science professionals in Brazil. Improvements in the undergraduate courses curriculum are also recommended.

Originality/value

This is the first study to assess misconceptions about sport and exercise science among Brazilian health professionals.

Knowledge of Exercise Prescription Guidelines Across One 4-Year Kinesiology Curriculum

PURPOSE

Knowledge of evidence-based exercise prescription guidelines is considered a cornerstone of responsible professional practice. While many academics insist that a university degree in kinesiology or a related field should be required for all exercise professionals, the learning of exercise prescription guidelines that takes place during the course of a university degree program has not been investigated.

METHOD

An 11-question knowledge quiz about the frequency, duration, and intensity of cardiovascular exercise recommended by the American College of Sports Medicine (Garber et al., 2011) was administered to 683 undergraduate students majoring in kinesiology and 89 certified exercise professionals.

RESULTS

Knowledge scores improved significantly, F(4, 764) = 16.69, p < .001, η2 = .08, from the freshmen, who scored 24.30%, to the seniors, who scored 36.25%. Seniors did not differ significantly from the professionals, who scored 40.65%, despite the fact that 58.14% of professionals had graduate degrees and 44.95% had multiple certifications. However, 82.77% of seniors perceived that their knowledge of the guidelines (rated 5.48 out of 10) was lower than that required "to be able to function as an exercise professional safely and effectively" (rated 8.17).

CONCLUSION

These data suggest that although significant learning of the guidelines occurs in a typical kinesiology curriculum, there is considerable room for improvement.