Pub Date : 2013-01-01DOI: 10.1249/01.fit.0000437275.48286.a1
J. A. Peterson
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Pub Date : 2013-01-01DOI: 10.1249/fit.0b013e3182a95110
F. Brennan
Treatment and Prevention of Foot Friction Blisters M ost of us whowalk, run, hike, or bike are well aware of the pain and discomfort caused by a simple foot friction blister. These hot spots and eventual blisters can make what was supposed to be an enjoyable workout a miserable hobbling experience. The U.S. military is well aware of the detrimental effects of blisters on mission readiness and complications from what seemed to be a simple foot problem. Blisters have been shown to reduce a soldier’s mobility in the field, lessen his or her concentration, and affect critical decision-making skills (12,17). Complications from blisters including cellulitis, sepsis, and death are reported and occur between 2.5% and 5% in military personnel (2,13). Health and fitness professionals and recreational and elite athletes alike should have basic knowledge of those factors that influence blister formation, how to treat blisters should they occur, and, most importantly, how to prevent them. Foot blisters may be the most common sports injury. The incidence of blisters in marathon runners is 0.2% to 39% (15). During military training, the blister incidence ranges from 5.4% to 69% (8,9,17). During Operation Iraqi Freedom I (OIF I), 33% of deployed military reported friction blisters during their deployment (4). Hikers also experience blisters with an incidence up to 48% (12). Clearly, blisters are a common problem among recreational athletes, elite athletes, and military personnel. A friction blister is caused by frictional shear forces that cause a split or cleavage within the outermost layer or epidermis of the skin. As the forces or number of cycles of friction increase, a blister cleft forms and fills with plasma-like fluid, forming the blister within the epidermis (1,7). Friction blisters only form on those areas of the body where the stratum corneum section of the epidermal layer is quite thick; palms of the hands and soles of the feet. Note that chaffing occurs on other areas of the body where the stratum corneum is relatively thin. For example, friction blisters do not form on our inner thighs where the skin is much thinner. By identifying those factors that most influence blister formation, an athlete may reduce the risk by avoiding them or preparing for them. Common factors include moist damp feet, foot temperature greater than 104-F, emollients like petroleum jelly after an hour of exercise, tobacco use, heavier pack loads, and lack of an ability to train in a shoe (i.e., ‘‘foot harden’’) (11,16). Among women aged 26 to 34 years who had a history of blisters and those soldiers who were not able to ‘‘foot harden’’ before their deployment, the highest risk of blister formation during OIF I was observed (4). The goals of treatment are to minimize pain, limit the size and severity of the blister, prevent complications such as skin infections, and optimize return to full sport/recreational activities. Clinicians have varying opinions about how to treat blist
脚部摩擦水泡的治疗和预防我们大多数走路、跑步、徒步旅行或骑自行车的人都很清楚脚部摩擦水泡引起的疼痛和不适。这些热点和最终的水泡会使原本愉快的锻炼变成痛苦的一瘸一拐的经历。美国军方很清楚水泡对任务准备的不利影响，以及看似简单的脚部问题引起的并发症。水泡已被证明会降低士兵在战场上的机动性，降低他或她的注意力，并影响关键的决策技能(12,17)。据报道，水疱并发症包括蜂窝织炎、败血症和死亡，发生率在军事人员中为2.5%至5%(2,13)。健康和健身专业人员以及娱乐和精英运动员都应该对影响水疱形成的因素，如果发生水疱如何治疗，以及最重要的是如何预防水疱的基本知识有所了解。足部水泡可能是最常见的运动损伤。马拉松运动员的水疱发生率为0.2%至39%(15)。在军事训练期间，水疱的发生率为5.4% ~ 69%(8,9,17)。在第一次伊拉克自由行动(OIF I)中，33%的被部署军人在部署期间报告了摩擦水泡(4)。徒步旅行者也经历了水泡，发生率高达48%(12)。显然，水泡是休闲运动员、精英运动员和军人的共同问题。摩擦水泡是由摩擦剪切力引起的，摩擦剪切力在皮肤的最外层或表皮内引起分裂或劈裂。随着力或摩擦循环次数的增加，水泡裂缝形成并充满等离子体样液体，形成表皮内的水泡(1,7)。摩擦性水泡只在身体表皮角质层部分相当厚的部位形成;手掌和脚底。注意，摩擦发生在角质层相对较薄的身体其他部位。例如，摩擦水泡不会在大腿内侧形成，因为那里的皮肤要薄得多。通过识别那些最能影响水疱形成的因素，运动员可以通过避免它们或为它们做准备来降低风险。常见的因素包括潮湿的脚，足部温度高于104华氏度，运动一小时后使用像凡士林这样的润肤剂，吸烟，更重的背包负荷，缺乏穿鞋训练的能力(即“脚硬化”)(11,16)。在26至34岁有水疱病史的女性和那些在部署前不能“足部硬化”的士兵中，观察到在OIF I期间水疱形成的风险最高(4)。治疗的目标是尽量减少疼痛，限制水疱的大小和严重程度，预防并发症，如皮肤感染，并优化恢复充分的运动/娱乐活动。临床医生对如何治疗水疱有不同的看法。然而，Cortese等人的一篇经典文章。阐明了最被接受的治疗方法(5)。小于5mm的水泡和“热点”应保守处理。它们不应该没有屋顶或排水。相反，保护水泡免受压力的保护覆盖物，如鼹鼠皮，甜甜圈垫，Blist-O-Ban敷料(SAM Medical Products, Tualatin, OR)，或水胶体凝胶垫(3)。一种产品没有被证明比另一种产品优越。对于大于5mm的水泡，等待24小时，清洁皮肤，然后在无菌技术下从水泡周围排出水泡。不要打开水泡的顶部，除非“顶部”被撕裂，并且可能卷曲或起皱，从而对底层皮肤造成更多刺激。此外，如果排出的液体物质出现浑浊、不透明(可能是感染)或恶臭，那么应该清除水泡，并考虑开始口服抗生素。用抗菌药膏覆盖排干的水泡，每天检查是否有感染迹象。可以使用鼹鼠皮或其他保护性覆盖物，以尽量减少对愈合水泡的压力和摩擦力。存在许多其他的轶事治疗方案，其中一些可能有效;然而，需要进行科学可靠的研究来证实它们的功效。医学报告
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Pub Date : 2012-09-01DOI: 10.1249/FIT0b013e318264cae8
Brian C Focht
Symptomatic knee osteoarthritis (OA) is a prevalent chronic degenerative disease that is associated with impaired quality of life and physical functioning. Although there is no cure for knee OA, regular exercise participation consistently results in improvements in quality of life, physical function, and knee OA symptoms. Findings from contemporary randomized controlled trials also demonstrate that lifestyle interventions involving modification of exercise and dietary behaviors yield superior improvements in relevant quality of life outcomes relative to either intervention alone.
有症状的膝关节骨性关节炎（OA）是一种常见的慢性退行性疾病，与生活质量和身体功能受损有关。虽然膝关节 OA 无法根治，但定期参加锻炼可持续改善生活质量、身体功能和膝关节 OA 症状。当代随机对照试验的研究结果还表明，涉及改变运动和饮食行为的生活方式干预措施在改善相关生活质量方面的效果要优于单独采取其中一种干预措施。
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Pub Date : 2012-07-01DOI: 10.1249/01.FIT.0000416000.09526.eb
James A Blumenthal, Patrick J Smith, Benson M Hoffman
Depression is a common disorder that is associated with compromised quality of life, increased health care costs, and greater risk for a variety of medical conditions, particularly coronary heart disease. This review examines methods for assessing depression and discusses current treatment approaches. Traditional treatments include psychotherapy and antidepressant medications, but such treatments are not effective for all patients and alternative approaches have recently received increased attention, especially the use of aerobic exercise. This review examines evidence that exercise is effective in improving depressive symptoms among patients with major depression and offers practical suggestions for helping patients initiate and maintain exercise in their daily lives.
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Pub Date : 2011-01-01DOI: 10.1249/fit.0b013e31823373b2
Don L. Jones
{"title":"CLINICAL INTEGRATION AS A SUBVERSIVE ACTIVITY","authors":"Don L. Jones","doi":"10.1249/fit.0b013e31823373b2","DOIUrl":"https://doi.org/10.1249/fit.0b013e31823373b2","url":null,"abstract":"","PeriodicalId":50908,"journal":{"name":"Acsms Health & Fitness Journal","volume":"15 1","pages":"32-36"},"PeriodicalIF":1.5,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1249/fit.0b013e31823373b2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66082308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-01-01DOI: 10.1249/fit.0b013e318235a891
J. A. Peterson
{"title":"Health/Medical Problems No One Wants to Receive as a Holiday Gift","authors":"J. A. Peterson","doi":"10.1249/fit.0b013e318235a891","DOIUrl":"https://doi.org/10.1249/fit.0b013e318235a891","url":null,"abstract":"","PeriodicalId":50908,"journal":{"name":"Acsms Health & Fitness Journal","volume":"15 1","pages":"54"},"PeriodicalIF":1.5,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1249/fit.0b013e318235a891","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66082334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-01-01DOI: 10.1249/fit.0b013e318229cc13
S. Volpe
The 2010 USDA Dietary Guidelines for Americans and Other Tools to Providing Sound Nutrition Information M any ofmy colleagueswho are in health care, but who are not registered dietitians (R.D.s), often ask me what general advice they can give to their patients that would be safe and healthy. These colleagues realize they cannot provide nutritional counseling because they are not R.D.s; however, they often get general questions about nutrition. If the patient requires one-on-one counseling, I definitely tell my colleagues to refer their patients to an R.D. However, here are some good sources they (and you) can use to provide general nutrition advice to some of your clients.
{"title":"The 2010 USDA Dietary Guidelines for Americans and Other Tools to Providing Sound Nutrition Information","authors":"S. Volpe","doi":"10.1249/fit.0b013e318229cc13","DOIUrl":"https://doi.org/10.1249/fit.0b013e318229cc13","url":null,"abstract":"The 2010 USDA Dietary Guidelines for Americans and Other Tools to Providing Sound Nutrition Information M any ofmy colleagueswho are in health care, but who are not registered dietitians (R.D.s), often ask me what general advice they can give to their patients that would be safe and healthy. These colleagues realize they cannot provide nutritional counseling because they are not R.D.s; however, they often get general questions about nutrition. If the patient requires one-on-one counseling, I definitely tell my colleagues to refer their patients to an R.D. However, here are some good sources they (and you) can use to provide general nutrition advice to some of your clients.","PeriodicalId":50908,"journal":{"name":"Acsms Health & Fitness Journal","volume":"26 1","pages":"37-39"},"PeriodicalIF":1.5,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66082717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-01-01DOI: 10.1249/fit.0b013e318229cc71
M. Nadel
{"title":"MEDICAL FITNESS CENTERS: A Strategy for Hospitals to Thrive Under Health Care Reform—But Where Can We Find Capital?","authors":"M. Nadel","doi":"10.1249/fit.0b013e318229cc71","DOIUrl":"https://doi.org/10.1249/fit.0b013e318229cc71","url":null,"abstract":"","PeriodicalId":50908,"journal":{"name":"Acsms Health & Fitness Journal","volume":"15 1","pages":"28-34"},"PeriodicalIF":1.5,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66082728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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