ABSTRACT

Background: Clinical placements and assessment are an essential part of education to become a health professional. However, quality assessment in a clinical environment is challenging without a clear representation of what constitutes competence. The aim of this study was to establish core clinical learning competencies for Australian exercise physiology students.

Methods: This study used a mixed-methods, multiphase approach. The competencies were developed following electronic surveys and focus groups, with additional refinement provided by the project team. Preliminary validation was conducted via electronic survey where (i) participants rated the importance of each unit of competency for entry-level practice, and (ii) participants who had recently graduated (n = 23) rated the extent to which they perceived they were competent in each unit.

Results: The competencies are described as 19 elements organized into 6 units. The units are (i) communication, (ii) professionalism, (iii) assessment and interpretation, (iv) planning and delivery of an exercise and/or physical activity intervention, (v) lifestyle modification, and (vi) risk management. Of 126 survey participants, the majority (93%–98%) considered each unit as being important for entry-level practice. The majority (78%–95%) of recent graduates considered themselves competent in each unit, suggesting the competencies are articulated around the level of a new practitioner.

Conclusion: The core clinical learning competencies resulted from an extensive, iterative process involving those with expertise in the area. The competencies have a range of applications, including informing the development of a student placement assessment tool for use in a clinical placement environment.

ABSTRACT

Background: Past research has compared the effects of moderate-intensity continuous training (MCT) versus high-intensity interval training (HIIT) in phase 2 cardiac rehabilitation patients, but with conflicting results. Therefore, the purpose of this study was to evaluate if HIIT leads to greater improvements in functional capacity when compared with MCT in a group of phase 2 cardiac rehabilitation patients.

Methods: Eighteen patients in a phase 2 cardiac rehabilitation program completed precardiopulmonary and postcardiopulmonary exercise tests, a 12-min walk test (12MWT), and resting blood pressure (BP). After 2 weeks of run-in, patients were randomly assigned to 10 weeks of HIIT (alternating periods of 80%–90% heart rate [HR] reserve and 60%–70% HR reserve) or MCT (60%–80% HR reserve) exercise group. Changes in VO₂ peak, 12MWT distance, and BP (mm Hg) were analyzed by independent t test.

Results: The average patient was 65 years old, 1.75 m tall, and overweight. VO₂ peak values improved for individuals in both exercise modalities. There was no significant difference between the exercise groups (P = 0.174). In addition, both groups improved their 12MWT distance, resting systolic, and diastolic BP (DBP), with no significant difference in improvements between the 2 exercise groups.

Conclusion: In this study, HIIT was not more effective than MCT for improving functional capacity in a group of phase 2 cardiac rehabilitation patients. However, since HIIT was equally effective compared with MCT in several measures, it provides another option for exercise prescription to the traditional prescription for this population.

ABSTRACT

Heart failure with preserved ejection fraction (HFpEF) accounts for approximately 50% of all heart failure (HF) cases and is the fastest growing form of HF in the United States. The cornerstone symptom of clinically stable HFpEF is severe exercise intolerance (defined as reduced peak exercise oxygen uptake, VO_2peak) secondary to central and peripheral abnormalities that result in reduced oxygen delivery to and/or use by exercising skeletal muscle. To date, pharmacotherapy has not been shown to improve VO_2peak, quality of life, and survival in patients with HFpEF. In contrast, exercise training is currently the only efficacious treatment strategy to improve VO_2peak, aerobic endurance, and quality of life in patients with HFpEF. In this updated review, we discuss the specific central and peripheral mechanisms that are responsible for the impaired exercise responses as well as the role of exercise training to improve VO_2peak in clinically stable patients with HFpEF. We also discuss the central and peripheral adaptations that contribute to the exercise training-mediated improvement in VO_2peak in HFpEF. Finally, we provide clinical exercise physiologists with evidence-based exercise prescription guidelines to assist with the safe implementation of exercise-based cardiac rehabilitation programs in clinically stable patients with HFpEF.

ABSTRACT

An understanding of epidemiologic methods is important for the clinical exercise physiologist to assess the complex relationships between physical activity and health and disease. It is essential to the practice of preventive and rehabilitative care to understand the web of causation and complex interactions among agent (exercise), host (individual), and environment (affects transmission of agent source to host) in relationship to disease/injury and clinical outcomes. Application of the epidemiologic measures of disease/injury occurrence, variations in occurrence, and statistical measures of attributable risk and population attributable risk contribute to the clinician's skill level in assessing potential cause-effect relationships reported in the literature about exercise medicine, physical activity, and public health. By becoming familiar with the study methods used in epidemiology, the clinical exercise physiologist will be better positioned to assess criteria for a cause-effect relationship as well as to critically evaluate the assessment efforts used across a variety of study designs and applications of epidemiology in clinical research and practice.

ABSTRACT

Background: Scientists are using social media to amplify their scientific impact. As such, researchers are looking for novel ways to engage this medium to promote scientific findings and communicate research to a broader audience. Here, we examine the use of a Twitter conference as a means to effectively communicate advances in the field of exercise oncology.

Methods: The Exercise Oncology Twitter Conference (ExOncTC) occurred in October 2018. Each presentation consisted of 6 tweets over 15 min. Attendees were able to interact during a presentation via the conference hashtag (#ExOncTC). Registration data were used to characterize presenters and participants while Twitter Analytics/Union Metrics were used to aggregate data to determine engagement and reach.

Results: The ExOncTC featured 68 presenters from 13 countries and 48 institutions. Presenters varied in academic background (ranging from undergraduate students [1.5%] to terminal degree holders [46%]) and profession (including researchers [42.5%] and physicians [6%]). Participants, including researchers, physicians, students, patients, and organizations could register via the Web site (n = 231), follow the @ExOncTC Twitter handle (n = 805), and/or search the #ExOncTC hashtag. During the conference, #ExOncTC was tweeted 1,501 times by 483 unique users for 4,943 total engagements (number of times a user interacts with a tweet). Collectively, these tweets reached 453,900 distinct users with potential impressions equaling 1.8 million (number of views possible).

Conclusion: Reach of the ExOncTC demonstrates the potential effectiveness of using a Twitter conference as a platform to communicate the field of exercise oncology, suggesting Twitter conferencing should be explored as a tool for scientific dissemination to the broader field of clinical exercise physiology.