Medicine and science in sports and exercise
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Med Sci Sports Exerc · Jan 2002
Implementation of the Ottawa ankle rule in a university sports medicine center.
The Ottawa ankle rule (OAR) is a clinical decision rule used in emergency departments to identify which patients with acute ankle/midfoot injury require radiography. The purpose of this study was to implement the OAR, with a modification to improve the specificity for identifying malleolar fractures (the "Buffalo rule"), in a sports medicine center and measure impact on physician practice and cost savings. ⋯ The OAR reduced radiography in acute ankle/midfoot injury and saved money in relatively younger patients in the outpatient sports urgent care setting without missing any clinically significant fractures. The specificity of the Buffalo malleolar rule in the present implementation study, however, was not a significant improvement over the OAR malleolar rule. Widespread application of the OAR could save substantial resources without compromising quality of care.
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Med Sci Sports Exerc · Jan 2002
VO(2) reserve and the minimal intensity for improving cardiorespiratory fitness.
The American College of Sports Medicine has stated that aerobic training needs to occur at a minimum threshold intensity of 50% VO(2max) for most healthy adults and at 40% VO(2max) for those with a very low initial fitness. Recently, the concept of VO(2) reserve (%VO(2R), i.e., a percentage of the difference between maximum and resting VO(2)) has been introduced for prescribing exercise intensity. This analysis was designed to determine the threshold intensity for improving cardiorespiratory fitness expressed as %VO(2R) units. ⋯ Although evidence for a threshold intensity was not strong, this analysis of training studies supports the use of 45% VO(2R) as a minimal effective training intensity for higher fit subjects and 30% VO(2R) for lower fit subjects.