A common belief among many clinicians and trainers is that intensive simultaneous training for muscle strength and cardiovascular endurance is counterproductive. To test this premise, 14 healthy, untrained men trained four days per week for 20 weeks on a bicycle ergometer for endurance (END Group, n = 4), on an isokinetic device for increased torque production (ITP Group, n = 5), or on both devices (COMBO Group, n = 5). The ITP and COMBO groups had equal torque gains throughout the study (234 +/- 45 and 232 +/- 23 N.m, respectively). After 11 weeks, both END and COMBO groups had similar gains in maximal oxygen consumption (VO2max) (in milliliters per kilogram of body weight per minute). During the last half of the study, however, the END Group had a significant gain in VO2max (p less than .05) of 4.7 +/- 1.2 mL.kg-1.min-1, whereas the COMBO Group had a nonsignificant gain (p greater than .05) of 1.8 +/- 0.6 mL.kg-1.min-1. In harmony with this finding, the END Group showed a significant increase (p less than .05) in citrate synthase activity (15.5 +/- 7.9 mumol.g-1.min-1), whereas the COMBO Group had no significant increase. The authors concluded that simultaneous training may inhibit the normal adaptation to either training program when performed alone. The extent of the interference probably depends on the nature and intensity of the individual training program. [Nelson AG, Arnall DA, Loy SF, et al: Consequences of combining strength and endurance training regimens.

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Introduction The aim of this pilot study was to measure patient reported outcomes and evaluate their rehabilitation experience following traumatic complex musculoskeletal (CMSK) injury. Methods A mixed methods prospective observational study was undertaken between December 2015 and March 2018 to explore patient reported outcomes following CMSK injury sustained as a result of major trauma and perception of their rehabilitation and its impact on their recovery. The participants were asked to complete a series of outcome measures at 18-months post-injury. The data was anonymised and analysed by the lead researcher. Results Thirty patients were recruited into the study (19 males, 11 females) between 23 and 76 years of age (median 52 years). Their injury profile was split between open fractures 30%, pelvic fractures 23%, multiple fractures 27% and polytrauma 20%. The majority (60%) reported moderate disability at 18-months post injury with 50% returning to full time employment. Patients with multiple or open fractures reported the worst outcomes. There was no relationship between frequency, quantity or duration of physiotherapy and outcome. However, 77% reported supplementing their NHS rehabilitation with other interventions such as gym membership, hydrotherapy and psychological therapies. The thematic analysis showed that patients considered intensity, quality and coordinated timely access to rehabilitation as the most important factors. Conclusion From a patient perspective, the current NHS rehabilitation provision does not appear to meet their complex needs. In addition to physical and vocational rehabilitation, patients wanted effective pain management and psychological support. Strengthening current therapy services and involving other sectors (e.g. Citizen’s Advice) could help achieve this. Early access to an intensive multidisciplinary rehabilitation programme was perceived to have positive benefits and improve outcomes.

High-quality strength training is strongly associated with a reduced risk of hypercholesterolemia, even after controlling for numerous, potentially confounding factors (odds ratio = .46; 95% confidence interval = .23 to .91).

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