{"id":6782,"date":"2016-05-12T06:50:47","date_gmt":"2016-05-12T05:50:47","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bjsm\/?p=6782"},"modified":"2016-05-12T06:51:52","modified_gmt":"2016-05-12T05:51:52","slug":"6782","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bjsm\/2016\/05\/12\/6782\/","title":{"rendered":"Rat Races, Referrals and Randomised Trials: Exercise Medicine Updates from Ireland"},"content":{"rendered":"<p><strong><em><span style=\"color: #008000\">Undergraduate perspective on Sports &amp; Exercise Medicine<\/span> <span style=\"color: #ff6600\">&#8211;<\/span><\/em><\/strong><span style=\"color: #ff6600\"><strong>\u00a0<em>a BJSM blog series<\/em><\/strong><\/span><\/p>\n<p>By <strong>Fiachra Maguire<\/strong> (<a href=\"https:\/\/twitter.com\/fiachrama\">@Fiachrama<\/a>)<\/p>\n<p>The annual Spring Study Day forms part of the Faculty of Sports Medicine in Ireland\u2019s (<a href=\"https:\/\/twitter.com\/FSEM_IRL\">@FSEM_IRL<\/a>) educational series. Now in its third successive year, the event aims to provide a mix of sports related pathologies and more clinically applicable exercise medicine.<\/p>\n<p>The standard was high in both presentation and content. For those at preliminary stages, the short feedback sessions provided some additional insight on study design. The <a href=\"http:\/\/www.rcsi.ie\/files\/facultyofsportsexercise\/20160419041657_FINAL%20BOA%20-%20SPRING%20STUDY%20DAY%202.pdf\">abstract booklet<\/a>, with details on each talk is <a href=\"http:\/\/www.rcsi.ie\/files\/facultyofsportsexercise\/20160419041657_FINAL%20BOA%20-%20SPRING%20STUDY%20DAY%202.pdf\">available to view here<\/a>.<\/p>\n<p><span style=\"text-decoration: underline;color: #800080\"><strong>Take-home messages of the 3rd Annual FSEM Ireland Spring Study Day:<\/strong><\/span><\/p>\n<p><strong><em>An Introduction to the MedEx Program\u00a0 \u2014 <\/em><\/strong><a href=\"https:\/\/twitter.com\/BronaFurlong\">Dr. Brona Furlong<\/a><\/p>\n<ul>\n<li>MedEx is a chronic illness rehabilitation programme utilising exercise with parallel educational and related supports.<\/li>\n<li>Primarily consultant led referrals from local hospitals due to specialisation for chronic illnesses.<\/li>\n<li>HSE (NHS equivalent) evaluation of the programme, for feasibility of a national implementation is underway.<\/li>\n<li>12-Month duration Single Arm Observational Trial. Non-Controlled due to ethical consideration of withholding treatment to ill populations where evidence shows exercise to be of benefit.<\/li>\n<\/ul>\n<p><strong><em>Experiences with Exercise in Cancer Patients<\/em><\/strong><em>\u00a0 \u2014 <\/em><a href=\"https:\/\/www.researchgate.net\/profile\/Lisa_Loughney\">Dr. Lisa Loughney<\/a><\/p>\n<ul>\n<li>Treatment for Cancer, Chemotherapy and Surgery, are both significant risk factors for mortality and post-operative complications. Resulting in an increased risk of death pertinent at 3 years.<\/li>\n<li>Stratification based on CardioPulmonary Exercise Testing allows a more accurate (patient specific) assessment of risk.<\/li>\n<li>Facilitates a collaborative decision making process.<\/li>\n<li>The role that Exercise Training can play in \u201cdual hit\u201d neoadjuvant cancer treatment and surgery; safe and feasible but a need for more controlled trials.<br \/>\n(<a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0748798315008227\">Read more here \u2014 Loughney et al., 2016<\/a>)<\/li>\n<li>Read a systematic review of how exercise is beneficial to cancer patient\u2019s <u><a href=\"http:\/\/bjsm.bmj.com\/content\/early\/2015\/12\/30\/bjsports-2015-094787.abstract?sid=07ea8fe4-8731-410b-8c51-634eb62a34b5\">quality of life here<\/a><\/u><\/li>\n<\/ul>\n<p><em><strong>Exercise and Nutrition \u2013 Interplay in Chronic Illness<\/strong>\u00a0 \u2014 <\/em><a href=\"https:\/\/twitter.com\/ConorKerley\">Mr. Conor Kerley<\/a><\/p>\n<ul>\n<li>Significant interplay between some of the top risk factors for morbidity and mortality worldwide.<\/li>\n<li>Nutrition related risk factors have risen to prominence in the last ten year period, versus physical inactivity, which has remained relatively static.<\/li>\n<\/ul>\n<p><em><strong>Exercise and the Brain; Applications in Neurodegeneration\u00a0<\/strong> \u2014 <\/em><a href=\"https:\/\/www.researchgate.net\/profile\/Tim_Lynch\">Professor Tim Lynch<\/a><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-6783 aligncenter\" src=\"https:\/\/stg-blogs.bmj.com\/bjsm\/files\/2016\/05\/exercise-brain.jpg\" alt=\"exercise brain\" width=\"461\" height=\"375\" srcset=\"https:\/\/stg-blogs.bmj.com\/bjsm\/files\/2016\/05\/exercise-brain.jpg 641w, https:\/\/stg-blogs.bmj.com\/bjsm\/files\/2016\/05\/exercise-brain-300x244.jpg 300w\" sizes=\"auto, (max-width: 461px) 100vw, 461px\" \/><\/p>\n<ul>\n<li>Prevailing theory that exercise results in increased connectivity for reserve &amp; resilience<\/li>\n<li>Investigations in rat models of Parkinson\u2019s Disease utilising forced exercise demonstrate that the \u2018lazy\u2019 rats pathological findings were consistent with PD, versus the running rat.<\/li>\n<li>Structural change in the connectivity in the basal ganglia of the exercised PD rats; more efficient in processing dopamine than the unexercised.<\/li>\n<li><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/26512345\">Read more here \u2014 Petzinger et al., 2015<\/a><\/li>\n<li>Fascinating case report on Exercise and Progressive Multiple Sclerosis.\n<ul>\n<li>Combined with pharmacological management, the patient initiated a physiotherapist prescribed exercise intervention.<\/li>\n<li>Stringent adherence to the regime and augmentation with a wearable activity monitor has precipitated significant &amp; rare improvements in symptomatic scoring.<\/li>\n<\/ul>\n<\/li>\n<li>Read an editorial piece on the <a href=\"http:\/\/bjsm.bmj.com\/content\/48\/12\/943.extract?sid=7cfbccfd-9044-4672-a353-24788b29351b\">cognitive effects of exercise here<\/a> or click the following link to read about the <a href=\"http:\/\/bjsm.bmj.com\/content\/43\/1\/22.extract?sid=7cfbccfd-9044-4672-a353-24788b29351b\">effects of aerobic exercise on neural plasticity here<\/a><\/li>\n<\/ul>\n<p><em><strong>Hypertension and Exercise<\/strong>\u00a0 \u2014 <\/em>Dr Eamonn Dolan<\/p>\n<ul>\n<li>Exaggerated hypertensive response to exercise is abnormal.<\/li>\n<li>High Blood Pressure is <em>always<\/em> a negative.<\/li>\n<li>Within day variation contributes to inaccurate assessment. Nocturnal blood pressure of increasing clinical utility due to 24-hour monitoring.<\/li>\n<li>Gold Standard is 24-hour Ambulatory Blood Pressure Monitoring; <a href=\"http:\/\/bhsoc.org\/bp-monitors\/bp-monitors\/\">see BHSoc<\/a> for details on validated devices.<\/li>\n<li>Read more here from BJSM \u2014 <a href=\"http:\/\/bjsm.bmj.com\/content\/early\/2016\/01\/19\/bjsports-2015-095786\">Physical activity and exercise lower blood pressure in individuals with hypertension: narrative review of 27 RCTs<\/a><\/li>\n<\/ul>\n<p><em><strong>Exercise and Pulmonary Arterial Hypertension <\/strong>\u00a0\u2014 <\/em>Professor Paul McLoughlin<\/p>\n<ul>\n<li>Exercise training improves exercise tolerance in PAH.<\/li>\n<li>Magnitude of improvement on 6-Minute Walk Test in line with pharmacological intervention.<\/li>\n<li>Improves Quality of Life scores.<\/li>\n<li>Accompanied by significant incidence of transient adverse effects [10 &#8211; 15%], such as syncope, which necessitates medical supervision.<\/li>\n<\/ul>\n<p>There will be plenty more to listen to and learn from at <a href=\"https:\/\/twitter.com\/FSEM_IRL\">@FSEM_IRL<\/a>\u2019s next event, which is the Annual Scientific Meeting (<a href=\"https:\/\/twitter.com\/FSEM_ASC2016\">@FSEM_ASC2016<\/a>) taking place from the 15th to 17th of September. The special topic is the Female Athlete and the scope will be similarly broad, from performance to clinical medicine.<\/p>\n<p><em>More information is<\/em> <a href=\"http:\/\/fsem2016.com\"><em>available here<\/em><\/a><em>.<\/em><br \/>\n<em>Note that both *Student Discount* and *Early Bird Pricing* exists, making the invitation increasingly difficult to decline.<\/em><\/p>\n<p>*************************************************************************<\/p>\n<p>Fiachra Maguire (<a href=\"https:\/\/twitter.com\/fiachrama\">@Fiachrama<\/a>) is a medical student of Trinity College Dublin, Ireland. He has a healthy interest in sports and exercise medicine and is currently undertaking an MSc research project on gait &amp; cognitive impairment.<\/p>\n<p><em>Dr. Liam West\u00a0 (<\/em><a href=\"https:\/\/twitter.com\/liam_west\">@Liam_West<\/a>) coordinates the \u201cUndergraduate Perspective on Sports &amp; Exercise Medicine\u201d Blog Series.<\/p>\n<p>If you would like to contribute to the \u201cUndergraduate Perspective on Sports &amp; Exercise Medicine\u201d Blog Series please email <a href=\"mailto:liamwestsem@hotmail.co.uk\">LIAMWESTSEM@HOTMAIL.CO.UK<\/a> for further information.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Undergraduate perspective on Sports &amp; Exercise Medicine &#8211;\u00a0a BJSM blog series By Fiachra Maguire (@Fiachrama) The annual Spring Study Day forms part of the Faculty of Sports Medicine in Ireland\u2019s (@FSEM_IRL) educational series. Now in its third successive year, the event aims to provide a mix of sports related pathologies and more clinically applicable exercise [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/bjsm\/2016\/05\/12\/6782\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-6782","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/posts\/6782","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/comments?post=6782"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/posts\/6782\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/media?parent=6782"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/categories?post=6782"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/tags?post=6782"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}