Cold-Water Immersion and Lower Limb Muscle Oxygen Consumption as Measured by Near-Infrared Spectroscopy in Trained Endurance Athletes

CONTEXT

Cold-water immersion (CWI) has been reported to reduce tissue metabolism postimmersion, but physiological data are lacking regarding the muscle metabolic response to its application. Near-infrared spectroscopy (NIRS) is a noninvasive optical technique that can inform muscle hemodynamics and tissue metabolism.

OBJECTIVE

To investigate the effects of CWI at 2 water temperatures (10°C and 15°C) on NIRS-calculated measurements of muscle oxygen consumption (mVO2).

DESIGN

Crossover study.

SETTING

University sports rehabilitation center.

PATIENTS OR OTHER PARTICIPANTS

A total of 11 male National Collegiate Athletic Association Division II long-distance runners (age = 23.4 ± 3.4 years, height = 1.8 ± 0.1 m, mass = 68.8 ± 10.7 kg, mean adipose tissue thickness = 6.7 ± 2.7 mm).

INTERVENTION(S)

Cold-water immersion at 10°C and 15°C for 20 minutes.

MAIN OUTCOME MEASURE(S)

We calculated mVO2 preimmersion and postimmersion at water temperatures of 10°C and 15°C. Changes in tissue oxyhemoglobin (O2Hb), deoxyhemoglobin (HHb), total hemoglobin (tHb), hemoglobin difference (Hbdiff), and tissue saturation index (TSI %) were measured during the 20-minute immersion at both temperatures.

RESULTS

We observed a decrease in mVO2 after immersion at both 10°C and 15°C (F1,9 = 27.7801, P = .001). During the 20-minute immersion at both temperatures, we noted a main effect of time for O2Hb (F3,27 = 14.227, P = .001), HHb (F3,27 = 5.749, P = .009), tHb (F3,27 = 24.786, P = .001), and Hbdiff (F3,27 = 3.894, P = .020), in which values decreased over the course of immersion. Post hoc pairwise comparisons showed that these changes occurred within the final 5 minutes of immersion for tHb and O2Hb.

CONCLUSIONS

A 20-minute CWI at 10°C and 15°C led to a reduction in mVO2. This was greater after immersion at 10°C. The reduction in mVO2 suggests a decrease in muscle metabolic activity (ie, O2 use after CWI). Calculating mVO2 via the NIRS-occlusion technique may offer further insight into muscle metabolic responses beyond what is attainable from observing the NIRS primary signals.

A cross-sectional investigation of back pain beliefs and fear in physiotherapy and sport undergraduate students

BACKGROUND

Although low back pain (LBP) beliefs have been well investigated in mainstream healthcare discipline students, the beliefs within sports-related study students, such as Sport and Exercise Science (SES), Sports Therapy (ST), and Sport Performance and Coaching (SPC) programmes have yet to be explored. This study aims to understand any differences in the beliefs and fear associated with movement in students enrolled in four undergraduate study programmes-physiotherapy (PT), ST, SES, and SPC.

METHOD

136 undergraduate students completed an online survey. All participants completed the Tampa Scale of Kinesiophobia (TSK) and Back Beliefs Questionnaire (BBQ). Two sets of two-way between-subjects Analysis of Variance (ANOVA) were conducted for each outcome of TSK and BBQ, with the independent variables of the study programme, study year (1st, 2nd, 3rd), and their interaction.

RESULTS

There was a significant interaction between study programme and year for TSK (F(6, 124) = 4.90, P < 0.001) and BBQ (F(6, 124) = 8.18, P < 0.001). Post-hoc analysis revealed that both PT and ST students had lower TSK and higher BBQ scores than SES and SPC students particularly in the 3rd year.

CONCLUSIONS

The beliefs of clinicians and trainers managing LBP are known to transfer to patients, and more negative beliefs have been associated with greater disability. This is the first study to understand the beliefs about back pain in various sports study programmes, which is timely, given that the management of injured athletes typically involves a multidisciplinary team.

Sports therapists’ perceptions and experiences of graduate employment

Background/Aims Graduate employability is complex and has moved beyond the notion of subject-specific skills being sufficient for acquiring a graduate level job, to now include important transferable skills. Sports therapy is a rapidly expanding profession focusing on assessment, treatment and rehabilitation of musculoskeletal conditions. These facets encompass components of critical thinking, problem solving, interpersonal skills and communication, thus courses can set graduates up for careers within or outside the industry. The three aims of this study were to survey BSc (Hons) Sports Therapy graduates to determine their current employment status and job role, explore graduates’ experience of their undergraduate programme and investigate graduates’ perceptions of how well the programme had prepared them for subsequent employment.

Methods BSc (Hons) sports therapy graduates from two British universities were surveyed regarding their experience of their undergraduate degree programme and their perceptions of how well the programme had prepared them for employment. The survey was distributed to approximately 150 graduates and had a response rate of 23% (35 graduates). Descriptive statistics were used to describe the responses to the multiple-choice questions and thematic analysis was performed on free-text responses.

Results Overall, 43% of respondents were employed as sports therapists and needed their degree to get their jobs. A total of 71% of respondents felt that their degree had equipped them fully or partly for employment. Free-text responses generated three themes relating to sports therapy specific skills, job availability and work-based learning opportunities. Managing student expectations, continued exposure to the range of career opportunities available and developing students subject-specific skills, ‘soft’ or transferrable skills, as well as personal characteristics, can help with employability.

Conclusions Courses should be sensitive to the demands of a changing employment landscape and, as such, encourage a student-centred approach and support placement opportunities to help with graduate employability.

Large outbreak of infection with Escherichia coli O157 PT21/28 in Eccleston, Lancashire, due to cross contamination at a butcher's counter

An outbreak of infection with Escherichia coli O157 Phage Type 21/28 occurred between the 23rd November 2001 and the 7th December 2001 in Eccleston, Lancashire. There were 30 confirmed cases (23 with positive faecal isolates and seven serologically positive). Eccleston is a village of approximately 5,000 inhabitants with a single medical practice where many of the cases were patients. Initial investigations identified the suspected source as a butcher's counter, operated as a franchise, in a supermarket in Eccleston. The butcher closed voluntarily on the 24th November. The median age of cases was 60 with a mean of 56 and a range of 2-91 years. Of the 30 confirmed cases, 22 were admitted to hospital. Two patients developed serious complications but all 30 made a full recovery. Microbiological investigations confirmed the butcher's counter as the source of the outbreak. The epidemiological evidence implicated cooked meats and microbiological evidence confirmed that contamination had occurred between raw and cooked meats. The deficiencies in meat hygiene practice that were identified could have led to the cross contamination. This outbreak illustrates the risk associated with the handling of raw and cooked meats in the same shop. Complete physical separation of raw and cooked meat operations reduces the risk of such outbreaks.

Exploring the value of clinical nursing practice: the practitioner's perspective

This paper describes a preliminary study which attempted to explore the value of nursing practice from the viewpoint of practitioners. The objective was to further knowledge and develop insights into nursing practice, identifying concepts central to therapeutic care. Integral to the study was the development of a model for reflective practice.

Long-term effects of cancer on children and their families

An increasing number of children now survive malignancies, which has implications for nursing practice in caring for long-term survivors and their families. This article will examine the physical, psychological and social consequences of surviving childhood cancer and will suggest how nurses can meet the needs of long-term survivors.

A change worth the making. Implementing primary nursing

Adopting primary nursing can be a difficult task, involving a great deal of planning, and change for all nursing staff. One haematology ward, however, found it resulted in improved satisfaction for both patients and nurses.

Basing practice on research

Susan Waterworth argues that adopting a research-based model for clinical practice is necessary both to improve standards and to ensure a more informed approach for the delivery of patient care. She outlines the purposes of research in nursing and goes on to describe how clinical practitioners can identify and carry out relevant research topics. A collaborative approach is, she suggests, often the key to addressing problems successfully, and promoting links with a university nursing department may prove beneficial.

Reluctant collaborators: do patients want to be involved in decisions concerning care?

Against the background of the popularity of the concept of 'patient collaboration' in care, this paper describes, from the frame of reference of the patients, how they perceive being involved in decisions concerning their own treatment and nursing care. A convenience sample of 12 patients were selected. The data collection and analysis were informed to some extent by the approach known as grounded theory. Although only 12 in-depth interviews were conducted, one major theme emerged from the data and that was named 'toeing the line'. The data suggests that some patients are more concerned about doing what is right, that is, pleasing the nurse, than participating in decisions concerning care. It is contended that if nurses adopt practices which encourage involvement they may unwittingly coerse patients to comply. It is argued that patients will accept this situation even if they do not wish a collaborative role. Despite the small sample size, interesting questions are raised concerning the underlying rationale of patient involvement. The conclusion is drawn that promoting individualized care is not necessarily synonymous with active patient involvement as advocated in much of the literature.