ECSS Paris 2023: CP-MH33
INTRODUCTION: Development of clinical skills in areas such as exercise risk stratification, testing, prescription, monitoring and outcome assessment are vital for patient safety and clinical effectiveness in clinical exercise physiology (CEP). This study explored how current CEP courses are being taught and assessed, and how current curricula are aligned with the real-world clinical requirements in the UK. METHODS: Qualitative methods were employed to explore the thoughts of CEPs, academics and current students regarding the teaching and assessment of CEPs in the UK. Research design involved, (i) semi-structured interviews with students (n=16), and (ii) focus groups with academics (n=8) and CEP (n=5) stakeholders. Data obtained were audio recorded using a portable Dictaphone and transcribed verbatim, then thematically analysed manually using reflexive thematic analysis. RESULTS: Three themes: (i) in situ learning / real world practice (working with patients and specialist practitioners); (ii) programme design (scaffold learning and integrated modules) and, (iii) teaching approach (simulated learning and research competency) were generated concerning teaching methods and approaches across CEP postgraduate degrees. The current use of simulated tasks for the delivery of taught content was identified as lacking effectiveness, with clinical placements identified as being the most important source of knowledge and skill attainment due to the real-world exposure to patients and practitioners. Clinical placements and simulated learning were recognised as the main two methods of problem-based learning (PBL) used to develop student knowledge, skills and competency to practice. Two themes (placement tariffs/assessors in situ and role play/simulation) were identified for the assessment of students. CONCLUSION: Clinical placements remain the optimal method for developing the knowledge, skills and competency to practice for student CEPs. However, suitable placements remain limited and novel approaches such as university-led exercise services require consideration for student competency development. A standardized and accredited training pathway from undergraduate through to postgraduate level should be explored to allow student competency to be developed over a longer period, to enhance knowledge, skills and competency upon graduation and registration.
Read CV Gemma MillerECSS Paris 2023: CP-MH33
INTRODUCTION: Persons suffering from rheumatic and musculoskeletal diseases are urged to do aerobic exercise to reduce the risk of cardiovascular disease and symptoms. A suitable case of exercise is constant exercise at an intensity causing the rate of perceived exertion to be 15, on the 6-20 point Borg scale [1,2]. But, the instruction "Now you need to get your heart rate up" is commonly utilised before aerobic exercise. Here, the following hypothesis was tested: Work intensity during ergometer cycling initiated with the instruction "Now you need to get your heart rate up" is lower than when a score of 15 on the Borg scale is targeted. METHODS: This was a counterbalanced crossover study. Individuals (n=15) with rheumatic and musculoskeletal diseases participated. Familiarisation was followed by two test sessions termed reference session and exercise session. In the reference session, the relationship between Borg scale score [3] and intensity was established by a progressive protocol, which included cycling at a target score of 15 on the Borg scale. The protocol was initiated by 2 min of cycling at a target score of 7 on the Borg scale. It continued without interruption with 2 min of cycling at a target value of 8 etc. - until the last 2 min at a target of 16 was completed. In the exercise session, intensity was recorded over 20 min of cycling. The participant received the instruction "Now you need to get your heart rate up" in advance. During cycling, the participant could regulate the power output as preferred. Heart rate, power output, and cadence were noted every second min. Heart rate, as a percentage of maximal heart rate, was estimated as earlier [4] RESULTS: Average values of power output, heart rate, and heart rate as a percentage of maximal heart rate, during cycling at a Borg scale value of 15 in the reference session amounted to 89±40 W, 138±19 (beats/min), and 86±9%, respectively. For comparison, the average values of power output, heart rate, and heart rate as a percentage of maximal heart rate, across the 20 min of cycling in the exercise session, were 7±13%, 5±7%, and 5±6 percentage points, respectively, lower than during cycling at a target score of 15 on the Borg scale in the reference session (p<0.05). Cadence was on average 77 rpm in each session (p>0.05). CONCLUSION: A value separating moderate and high intensity is 82% of the maximal heart rate [2]. Accordingly, the intensity after the instruction "Now you need to get your heart rate up" in the exercise session may be considered moderate. The intensity when targeting a value of 15 on the Borg scale in the reference session may be considered high. In conclusion, work intensity during ergometer cycling, preceded by the instruction "Now you need to get your heart rate up", was lower than during cycling targeting a score of 15 on the Borg scale. REFERENCES: 1 McArdle et al. Exercise Physiology (2009) p. 474 2 Idrættens Træningslære (2019) p. 354-5 3 Borg. Scand J Rehab Med (1970) 4 Tanaka et al. J Am Coll Cardiol (2001)
Read CV Ernst HansenECSS Paris 2023: CP-MH33
INTRODUCTION: Physical activity is essential for health promotion and disease prevention. However, sedentary behavior remains prevalent, with one in four adults not meeting the WHOs recommended levels (WHO, 2016). Exergames, active video games combining movement with digital interaction, have emerged as innovative tools to promote physical activity among both healthy and no-healthy individuals, play a key role in enabling more frequent, comprehensive, and out-of-hospital follow-up. This systematic review analyzes the effectiveness of exergames in improving physical and cognitive health, evaluates their potential implementation in pharmacies to support medication reduction through physical activity. METHODS: This review follows PRISMA guidelines, analyzing studies from the past five years in PubMed and Scopus. Studiess focus on exergames use in healthy and pathological populations, assessing their impact on physical health, cognitive function, and quality of life. Studies were evaluated using PICO model; exclusion criteria were rehabilitation or lacking "systematic review" or "meta-analysis" in their titles were excluded. Data extraction was conducted via Microsoft Excel, and bias risk assessment followed AMSTAR2. RESULTS: The review identified studies involving both healthy and pathological populations. Among healthy individuals, exergames improved fundamental motor skills in children, cognitive functions in the elderly, and physical education outcomes in students. In pathological populations, exergames aided in managing childhood obesity, reducing chronic pain, and enhancing balance and coordination in patients with peripheral neuropathies and Parkinson’s disease. However, some studies highlighted methodological limitations, necessitating further research to standardize interventions. CONCLUSION: Exergames offer a promising strategy to promote physical activity across populations, with potential applications in pharmacies to support public health initiatives. Findings suggest that integrating exergames into pharmacies could reduce medication prescriptions by offering physical activity as an alternative therapy. Further studies are needed to refine their integration into educational and healthcare settings, fostering exercise medicine.
Read CV Miriam GalloroECSS Paris 2023: CP-MH33