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OBJECTIVES: This cross-sectional study aims to characterise the understanding and attitudes medical practitioners have towards sports and exercise medicine (SEM). By identifying knowledge gaps, misunderstandings and barriers to SEM referral, interventions may be suggested to improve the integration of SEM within a multidisciplinary approach to healthcare. DESIGN: A survey was constructed with a multidisciplinary expert panel. Refinement and consensus were achieved through a modified Delphi method. Both quantitative and qualitative data were analysed and intergroup comparisons made using χ2 test of independence and post-hoc paired comparisons. SETTING: The questionnaire was distributed across Australian public and private health sectors, in community and hospital-based settings. PARTICIPANTS: Australian medical doctors practising in specialties likely to intersect with SEM were invited; including general practice, orthopaedics, emergency, rheumatology and anaesthetics/pain. Invitation was uncapped with no reportable response rate. A total of 120 complete responses were collected RESULTS: The minority (42.5%) of respondents understood the role and scope of sports and exercise physicians. SEM was poorly recognised and comprehended, with the most common misconception being that SEM is solely for elite athletes and performance. Few (20%) doctors were familiar with referral pathways to SEM services. Lack of awareness, clear scope and public presence were seen as major barriers. There was near unanimous (92.5%) agreement that 'exercise is medicine'. A strong majority felt SEM would be valuable to collaborate with more in their current practice (63.3%) and as a part of the Australian public health system (82.5%). There were some significant differences among subgroups, including that junior doctors were more likely to express confusion about SEM. CONCLUSIONS: Among non-SEM doctors, there is significant lack of clarity regarding the role of SEM and its optimal integration. Interdisciplinary education and addressing misconceptions may improve the contribution of SEM to community healthcare.
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Anestesiología , Médicos , Medicina Deportiva , Humanos , Estudios Transversales , Australia , ConfusiónRESUMEN
This paper provides a review of studies containing safety and ergonomic outcomes in lean manufacturing (LM) environments over the past 40 years. The aim is to identify effects from specific LM methods on specific safety/ergonomic outcomes, to understand the relationship in greater detail. One hundred and one studies containing one hundred and seventy outcomes were identified. Thirty-seven outcomes pertained to just-in-time (JIT) production, which contained twenty-three negative, eleven neutral, and three positive safety/ergonomic outcomes. Conversely, twenty-six outcomes pertained to 5S and consisted of twenty-four positive, two negative, and no neutral outcomes. The most common negative JIT outcome was stress and mental strain, while the most common positive 5S outcome was a tie between safety performance and hazard exposure. Studies containing other methods were fewer in number with more mixed outcomes. These findings suggest that individual LM methods, especially JIT and 5S, uniquely contribute to the safety/ergonomic outcomes attributed to LM.
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Ergonomía , HumanosRESUMEN
Compression socks have become a popular recovery aid for distance running athletes. Although some physiological markers have been shown to be influenced by wearing these garments, scant evidence exists on their effects on functional recovery. This research aims to shed light onto whether the wearing of compression socks for 48 hours after marathon running can improve functional recovery, as measured by a timed treadmill test to exhaustion 14 days following marathon running. Athletes (n = 33, age, 38.5 ± 7.2 years) participating in the 2012 Melbourne, 2013 Canberra, or 2013 Gold Coast marathons were recruited and randomized into the compression sock or placebo group. A graded treadmill test to exhaustion was performed 2 weeks before and 2 weeks after each marathon. Time to exhaustion, average and maximum heart rates were recorded. Participants were asked to wear their socks for 48 hours immediately after completion of the marathon. The change in treadmill times (seconds) was recorded for each participant. Thirty-three participants completed the treadmill protocols. In the compression group, average treadmill run to exhaustion time 2 weeks after the marathon increased by 2.6% (52 ± 103 seconds). In the placebo group, run to exhaustion time decreased by 3.4% (-62 ± 130 seconds), P = 0.009. This shows a significant beneficial effect of compression socks on recovery compared with placebo. The wearing of below-knee compression socks for 48 hours after marathon running has been shown to improve functional recovery as measured by a graduated treadmill test to exhaustion 2 weeks after the event.
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Recuperación de la Función/fisiología , Carrera/fisiología , Medias de Compresión , Adulto , Método Doble Ciego , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Esfuerzo Físico/fisiología , Distribución AleatoriaRESUMEN
OBJECTIVE: To assess a typical commercial trekking cohort for cognitive impairment after gradual ascent to 5100 m. METHODS: We performed a prospective, controlled, repeated-measures study within a trekking expedition to Nepal. A sample of expedition participants was studied; 36 were enrolled and 26 completed all testing. Additional normative data were sourced from sea level studies. Participants underwent cognitive assessment before travel with written, verbal, and computerized tests, then within 24 hours of arrival at 5100 m after an 18-day ascent from 400 m. Changes in performance in 6 written and 7 computerized tests were analyzed at an individual and group level using paired t tests. Effect size analysis was performed for individual performance. RESULTS: No individual demonstrated significant cognitive impairment at 5100 m. The subject group performed significantly better than the normative population in 3 of the 6 written tests. The group performed worse at 5100 m in 1 written test (digit span forwards, P < .01) and better in 2 written (digit-symbol substitution, P < .01; trail-making test, part B, P < .05) and 1 computerized test (monitoring test reaction time, P < .01). Performance was more variable in the written than the computerized tests. CONCLUSIONS: Gradual ascent to high altitude causes no significant cognitive impairment in the majority of individuals. Computerized testing produced less variable results than written testing, but logistical difficulties are likely to preclude widespread use of such technology in the field.