ORCID Profile
0000-0002-2185-5695
Current Organisation
Deakin University
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Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2002
DOI: 10.1097/00008483-200207000-00012
Abstract: The objective of this study was to assess the reliability of testing skeletal muscle strength and peak aerobic power in a clinical population of patients with chronic heart failure (CHF). Thirty-three patients with CHF (New York Heart Association (NYHA) Functional Class 2.3 +/- 0.5 left ventricular ejection fraction 27% +/- 7% age 65 +/- 9 years 28:5 male-female ratio) underwent two identical series of tests (T1 and T2), 1 week apart, for strength and endurance of the muscle groups responsible for knee extension/flexion and elbow extension/flexion. The patients also underwent two graded exercise tests on a bicycle ergometer to measure peak oxygen consumption (VO(2peak)). Three months later, 18 of the patients underwent a third test (T3) for each of the measures. Means were compared using MANOVA with repeated measures for strength and endurance, and ANOVA with repeated measures for VO(2peak). Combining data for all four movement patterns, the expression of strength increased from T1 to T2 by 12% +/- 25% (P <.001 intraclass correlation coefficient [ICC] = 0.89). Correspondingly, endurance increased by 13% +/- 23% (P =.004 ICC = 0.87). Peak oxygen consumption was not significantly different (16.2 +/- 0.8 and 16.1 +/- 0.8 mL.kg(-1).min(-1) for T1 and T2, respectively P =.686 ICC = 0.91). There were no significant differences between T2 and T3 for strength (2% +/- 17% P =.736 ICC = 0.92) or muscle endurance (-1% +/- 15% P =.812 ICC = 0.96), but VO(2peak) decreased from 16.7 +/- 1.2 to 14.9 +/- 0.9 mL.kg(-1).min(-1) (-10% +/- 18% P =.021 ICC = 0.89). These data suggest that in a population of patients with CHF, a familiarization trial for skeletal muscle strength testing is necessary. Although familiarization is not required for assessing oxygen consumption as a single measurement, VO(2peak) declined markedly in the 3-month period for which these patients were followed. Internal consistency within patients was high for the second and third strength trials and the first and second tests of VO(2peak).
Publisher: Elsevier BV
Date: 02-2004
DOI: 10.1016/S1071-9164(03)00583-9
Abstract: Resistance exercise training was applied to patients with chronic heart failure (CHF) on the basis that it may partly reverse deficiencies in skeletal muscle strength and endurance, aerobic power (VO(2peak)), heart rate variability (HRV), and forearm blood flow (FBF) that are all putative factors in the syndrome. Thirty-nine CHF patients (New York Heart Association Functional Class=2.3+/-0.5 left ventricular ejection fraction 28%+/-7% age 65+/-11 years 33:6 male:female) underwent 2 identical series of tests, 1 week apart, for strength and endurance of the knee and elbow extensors and flexors, VO(2peak), HRV, FBF at rest, and FBF activated by forearm exercise or limb ischemia. Patients were then randomized to 3 months of resistance training (EX, n=19), consisting of mainly isokinetic (hydraulic) ergometry, interspersed with rest intervals, or continuance with usual care (CON, n=20), after which they underwent repeat endpoint testing. Combining all 4 movement patterns, strength increased for EX by 21+/-30% (mean+/-SD, P<.01) after training, whereas endurance improved 21+/-21% (P<.01). Corresponding data for CON remained almost unchanged (strength P<.005, endurance P<.003 EX versus CON). VO(2peak) improved in EX by 11+/-15% (P<.01), whereas it decreased by 10+/-18% (P<.05) in CON (P<.001 EX versus CON). The ratio of low-frequency to high-frequency spectral power fell after resistance training in EX by 44+/-53% (P<.01), but was unchanged in CON (P<.05 EX versus CON). FBF increased at rest by 20+/-32% (P<.01), and when stimulated by submaximal exercise (24+/-32%, P<.01) or limb ischemia (26+/-45%, P<.01) in EX, but not in CON (P<.01 EX versus CON). Moderate-intensity resistance exercise training in CHF patients produced favorable changes to skeletal muscle strength and endurance, VO(2peak), FBF, and HRV.
Publisher: Elsevier BV
Date: 04-2004
DOI: 10.1016/J.CARDFAIL.2003.09.004
Abstract: We sought to determine whether skeletal muscle oxidative capacity, fiber type proportions, and fiber size, capillary density or muscle mass might explain the impaired exercise tolerance in chronic heart failure (CHF). Previous studies are equivocal regarding the maladaptations that occur in the skeletal muscle of patients with CHF and their role in the observed exercise intolerance. Methods and results Total body O(2) uptake (VO(2peak)) was determined in 14 CHF patients and 8 healthy sedentary similar-age controls. Muscle s les were analyzed for mitochondrial adenosine triphosphate (ATP) production rate (MAPR), oxidative and glycolytic enzyme activity, fiber size and type, and capillary density. CHF patients demonstrated a lower VO(2peak) (15.1+/-1.1 versus 28.1+/-2.3 mL.kg(-1).min(-1), P<.001) and capillary to fiber ratio (1.09+/-0.05 versus 1.40+/-0.04 P<.001) when compared with controls. However, there was no difference in capillary density (capillaries per square millimeter) across any of the fiber types. Measurements of MAPR and oxidative enzyme activity suggested no difference in muscle oxidative capacity between the groups. Neither reductions in muscle oxidative capacity nor capillary density appear to be the cause of exercise limitation in this cohort of patients. Therefore, we hypothesize that the low VO(2peak) observed in CHF patients may be the result of fiber atrophy and possibly impaired activation of oxidative phosphorylation.
Publisher: Public Library of Science (PLoS)
Date: 30-10-2023
Publisher: Wiley
Date: 22-01-2022
DOI: 10.1111/DME.14790
Abstract: To explore the preferences of adults with type 2 diabetes regarding the approach to weight management discussions in clinical care. Online survey of Australian adults with type 2 diabetes, recruited via a national diabetes registry. Three open‐ended questions explored participants’ experiences and ideal approach to discussing weight management with health professionals. Data subjected to inductive thematic template analysis. Participants were 254 adults, 58% aged 60+ years, 52% women and 35% insulin‐treated. Five themes were developed to categorise participants’ preferences for, as well as differing experiences of, weight management discussions: (1) collaborative, person‐centred care: working together to make decisions and achieve outcomes, taking personal context into consideration (2) balanced communication: open, clear messages encouraging action, empathy and kindness (3) quality advice: knowledgeable health professionals, providing specific details or instructions (4) weight management intervention: suitable modalities to address weight management and (5) system‐wide support: referral and access to appropriate multi‐disciplinary care. Participants expressed preferences for discussing weight management in collaborative, person‐centred consultations, with quality advice and personalised interventions across the health system, delivered with empathy. By adopting these recommendations, health professionals may build constructive partnerships with adults with type 2 diabetes and foster weight management.
Publisher: BMJ
Date: 11-2019
DOI: 10.1136/BMJDRC-2019-000701
Abstract: In a s le of adults with type 2 diabetes mellitus (T2DM), the aim of this study was to examine whether self-reported physical activity level is associated with recall of specific physical activity-related interactions used by general practitioners (GP). Adults with T2DM completed an online survey reporting physical activity behaviors and recall of 14 GP–patient interactions about physical activity, mapped onto discrete behavior change techniques (BCT). Stepped logistical regression examined associations between recommended physical activity (≥600 MET-min/week) and GP–patient interactions, controlling for body mass index, diabetes-related comorbidities, depressive symptoms and self-efficacy. In total, 381 respondents (55% men, mean±SD age: 62±10 years and T2DM duration 8±8 years) provided complete data. Most (73%) reported receiving ‘general advice’, while interactions related to goal setting, monitoring, and relapse prevention were least commonly reported (all %). Self-reported achievement of the recommended physical activity level was significantly associated with recall of GP interactions involving praise for ‘efforts to be active’ (OR 2.1 95% CI 1.24 to 3.53), ‘lost weight’ (OR 1.81 95% CI 1.05 to 3.12) or lowering ‘glucose levels as a result of being active’ (OR 1.75 95% CI 1.03 to 2.96). Findings suggest GPs can be somewhat effective in promoting physical activity with simple, positive, reinforcing messages/interactions. Future research to develop and evaluate very brief primary care BCT-based physical activity interventions is needed.
No related grants have been discovered for Ralph Geerling.