Journal of science and medicine in sport
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Hypertrophic cardiomyopathy is a common genetic disorder with a prevalence of 1:500 in the general population. Amongst a varied spectrum of clinical presentations, the most feared complication of this cardiac disorder is sudden cardiac death. Although only a minority of patients with hypertrophic cardiomyopathy who suffer sudden cardiac death or resuscitated cardiac arrest do so during exercise, strenuous physical activity is regarded as an important trigger for these tragic outcomes. ⋯ Therefore, finding the right exercise level that will offer some of the benefits of physical activity without increasing the risk of sudden cardiac death is of utmost importance. In this review, we discuss the current evidence for and against exercise in this patient population and review national guideline recommendations. We also propose alternative fitness strategies including a novel fitness program implemented by our hypertrophic cardiomyopathy center which may be of particular usefulness for hypertrophic cardiomyopathy patients.
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Identify perceived barriers to leisure-time physical activity during pregnancy to inform future interventions aimed at improving physical activity levels in pregnancy. ⋯ A range of relevant barriers to leisure-time physical-activity engagement during pregnancy were identified in this literature review. Pregnancy-related symptoms and limitations barriers were the most reported in studies, regardless of study design. Mother-child safety concerns, lack of advice/information and lack of social support were also important emphasized pregnancy-related barriers to be targeted in future interventions.
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Review Meta Analysis
Caffeine and diuresis during rest and exercise: A meta-analysis.
Although ergogenic, acute caffeine ingestion may increase urine volume, prompting concerns about fluid balance during exercise and sport events. This meta-analysis evaluated caffeine induced diuresis in adults during rest and exercise. ⋯ Caffeine exerted a minor diuretic effect which was negated by exercise. Concerns regarding unwanted fluid loss associated with caffeine consumption are unwarranted particularly when ingestion precedes exercise.
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Review Meta Analysis
Exercise and the treatment of depression: a review of the exercise program variables.
There is growing interest in the use of exercise in the treatment of depression. A number of randomized controlled trials (RCTs) have demonstrated a reduction in depressive symptoms with both aerobic and non-aerobic exercise interventions. This has been supported in a number of systematic reviews and meta-analyses. However, the heterogeneous nature of the exercise intervention trials makes determining the appropriate program variables (frequency, intensity, duration and type of exercise) difficult. ⋯ There is evidence for the use supervised aerobic exercise, undertaken three times weekly at moderate intensity for a minimum of nine weeks in the treatment of depression. Further research on the manipulation of program variables is warranted.
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Appropriate management of scaphoid fractures is important because of the risk of long-term complications such as delayed or non-union, pain and disability. Up to 25% of scaphoid fractures are not visible on the initial radiographs. Consequently, all clinically suspected scaphoid fractures are treated as fractures with cast immobilisation until cause of the symptoms is clarified. ⋯ Furthermore, the scan may be performed as early as 2.8 days following an injury rather than 10 days later in the case of a bone scan. Although the cost of MRI is higher than other imaging modalities, it may be cost-effective in the overall management of patients with occult scaphoid fractures since it may prevent unnecessary cast immobilisation in active people. The most appropriate method of cast immobilisation is presently unclear but evidence exists for improved clinical outcomes in those that have both the thumb and elbow immobilised for the first six weeks.