Objectives Excessive gestational weight gain (GWG) puts women and children at risk of obesity. We piloted an SMS-texting intervention to promote healthy GWG among overweight and obese women. Methods We recruited 35 women and randomized them in a 2:1 fashion to: a tailored SMS-texting intervention (Preg CHAT) vs. a generic texting intervention (Txt4baby). Preg CHAT texts provided personalized feedback based on women's intake of sweetened beverages, fruits and vegetables, fast food, daily steps taken, and weight. We abstracted women's weights from charts and surveyed women at baseline and 32 weeks gestation. Results Few women refused the study; many (30%) did not complete the study, however. Of those in the Preg CHAT arm, 86% responded to texts, and 80% said they would recommend this program to a friend. For women who completed the surveys (n=23), those in the Preg CHAT arm had a mean gain of 6 less pounds than women in the Txt4Baby arm (95% CI -15.9, 4.0; p=0.24). Conclusions This pilot study shows feasibility, acceptability, and potential efficacy of a low-intensity and disseminable intervention to help overweight and obese women reduce GWG. Practice implications An SMS texting program might help overweight women reduce excessive GWG.
The heart rate deflection point (HRDP) is a downward or upward change from the linear HR-work relationship evinced during progressive incremental exercise testing. The HRDP is reported to be coincident with the anaerobic threshold. In 1982, Conconi and colleagues suggested that this phenomenon could be used as a noninvasive method to assess the anaerobic threshold. These researchers developed a field test to assess the HRDP, which has become popularised as the 'Conconi test'. Concepts used to define and assess the anaerobic threshold as well as methodological procedures used to determine the HRDP are diverse in the literature and have contributed to controversy surrounding the HRDP concept. Although the HRDP may be assessed in either field or laboratory settings, the degree of HR deflection is highly dependent upon the type of protocol used. The validity of HRDP to assess the anaerobic threshold is uncertain, although a high degree of relationship exists between HRDP and the second lactate turnpoint. The HRDP appears to be reliable when a positive identification is made; however, not all studies report 100% reproducibility. Although the physiological mechanisms explaining the HRDP are unresolved, a relationship exists between the degree and direction of HRDP and left ventricular function. The HRDP has potential to be used for training regulation purposes. Clinically, it may be incorporated to set exercise intensity parameters for cardiac rehabilitation.
Health promotion (HP) warrants being a clinical competency for health professionals given the global burden of lifestyle-related conditions; these are largely preventable with lifestyle behavior change. Physical therapists have a practice pattern conducive to HP, including lifestyle behavior change. The extent to which HP content is included in entry-level physical therapy (PT) curricula, and how it is taught however, is unknown. The aim of this study was to benchmark lifestyle behavior HP content within entry-level curricula of international PT programs. The sampling frame included 258 accredited PT academic programs spanning six countries. An internet-based survey was used to assess HP curricular content. Descriptive questions for HP topics (smoking cessation, nutrition, weight control, alcohol consumption, exercise, and stress management) included hours allotted and instructional methods used. Chi square tests examined differences between the proportion of programs in the United States (US) and other countries (combined) for HP topics, and among HP topics regarding instructional methods. The response rate was 48 %. Most programs (>80 %) included all HP topics except alcohol consumption (65.5 % of programs). Instructional methods used were primarily theory-based; few programs (range 2.6-24.1 %) combined theory, practical and attainment of clinical competency for all HP topics (exercise prescription notwithstanding). Proportionally, more US programs included alcohol and nutrition than other countries combined. Overall, HP lifestyle behavior topics were included to varying extent; however, instructional methods used and hours allotted per topic varied across PT curricula. Universal standards of HP practice as a clinical competency are warranted within the profession.
Overall, the majority of physical therapists expressed the view that advising people who smoke to quit is a clinical responsibility and endorsed greater involvement of the profession in helping people who smoke quit. Discordance existed, however, between these views and the physical therapists' interest in receiving training on counseling about SC. This is a benchmark study that has practical implications for targeting training consistent with the profession's mission to improve health by increasing physical therapists' preparedness and self-efficacy regarding counseling about SC.
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