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In canoe sprint, the trunk muscles play an important role in stabilizing the body in an unstable environment (boat) and in generating forces that are transmitted through the shoulders and arms to the paddle for propulsion of the boat. Isokinetic training is well suited for sports in which propulsion is generated through water resistance due to similarities in the resistive mode. Thus, the purpose of this study was to determine the effects of isokinetic training in addition to regular sport-specific training on trunk muscular fitness and body composition in world-class canoeists and to evaluate associations between trunk muscular fitness and canoe-specific performance. Nine world-class canoeists (age: 25.6 ± 3.3 years; three females; four world champions; three Olympic gold medalists) participated in an 8-week progressive isokinetic training with a 6-week block “muscle hypertrophy” and a 2-week block “muscle power.” Pre- and post-tests included the assessment of peak isokinetic torque at different velocities in concentric (30 and 140∘s-1) and eccentric (30 and 90∘s-1) mode, trunk muscle endurance, and body composition (e.g., body fat, segmental lean mass). Additionally, peak paddle force was assessed in the flume at a water current of 3.4 m/s. Significant pre-to-post increases were found for peak torque of the trunk rotators at 30∘s-1 (p = 0.047; d = 0.4) and 140∘s-1 (p = 0.014; d = 0.7) in concentric mode. No significant pre-to-post changes were detected for eccentric trunk rotator torque, trunk muscle endurance, and body composition (p > 0.148). Significant medium-to-large correlations were observed between concentric trunk rotator torque but not trunk muscle endurance and peak paddle force, irrespective of the isokinetic movement velocity (all r ≥ 0.886; p ≤ 0.008). Isokinetic trunk rotator training is effective in improving concentric trunk rotator strength in world-class canoe sprinters. It is recommended to progressively increase angular velocity from 30∘s-1 to 140∘s-1 over the course of the training period.
Background
Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients’ age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective.
Methods
The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures.
Discussion
Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances.
Trial registration
German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017.