Elite Distance Runners: A 45-Year Follow-Up.

The present longitudinal study assessed cardiorespiratory capacity and running economy of Olympic athletes over several decades to measure changes in fitness in an elite group during aging. Twenty-six male runners training for the 1968 Olympics were recruited. Heart rate, VO2max, ventilation, and running economy were measured in 1968, 1993, and 2013. In 2013, 22 of the original runners participated: three passed away between 1993 and 2013, and one declined to participate.

The mean (+/-SD) maximum heart rate (bpm) was 178+/-10.6 in 1968, 176+/-13.1 in 1993, and 168+/-16.4 in 2013 with a difference from the predicted maximum heart rates in 1968 and 2013 (both P<.001). The mean (+/-SD) VO2max (mL•min-1•kg-1) was 78+/-3.1 in 1968, 57+/-6.7 in 1993, and 42+/-8.9 in 2013. VO2max based on the original body weight (mL•min-1•kg-1) in 1993 and 2013 were 65+/-6.0 and 47+/-8.1, respectively, which were higher than the measured VO2max values at those times (both P<.001). VEmax (L•min-1) was 177+/-13.1 in 1968, 150+/-24.9 in 1993, and 118+/-22.5 in 2013; and declined at each time (all P<.001). The decline in VEmax predicted (P<.001) the decline in VO2max (R2 for 1993 = .500; R2 for 2013 = .567). Running economy (mL•kg-1•km-1) was 196+/-7.0 in 1968, 205+/-16.5 in 1993, and 240+/-27.0 in 2013; and was greater in 2013 than in 1993 and 1968 (both P<=.001).

The data suggested that higher initial fitness in younger years contributed to higher fitness with aging despite an expected age-related drop in fitness. Also, older adults could maintain high levels of cardiorespiratory fitness as they age. Expectations for fitness during aging should be more robust, especially since higher fitness could bolster quality of life.


Top 5 Fridays! 5 Reason Why You Need a Mentor

There are many reason why you need a mentor if you really want to be successful in your clinic, practice, patient interaction, and business. There are plenty of options out there and after doing it live for several years with fellowship mentoring and intermittently online. I felt like I needed to offer a program as diverse and effective as The Eclectic Approach has been come to be known for. My team of instructors for The Eclectic Approach and I have just launched Modern Rehab Mastery, a group that has 5 mentors, plus a ton of bonuses that pay for your entire first year.

5 Reasons Why You Need a Mentor

1. Mentors provide information and knowledge. 

“Tell me and I forget, teach me and I may remember, involve me and I learn.” – Benjamin Franklin

I knew that I wanted to learn manual therapy and be the best PT I could be. Without the mentorship I had for 2 years in fellowship, all the manual therapy techniques and assessments I learned would be trial and error. That’s the difference between taking courses as you start to fail and learning to integrate and apply the concepts. You can use your mentor’s experience and not make the same mistakes they did. When you make the inevitable mistake, you have your mentor and your mentee group to fall back on for advice and ideas.
2. Mentors can see where we need to what we need to work on when we cannot

 “Mentors have a way of seeing more of our faults that we would like. It’s the only way we grow.” – George Lucas – now if only his mentor told him to sell to Disney earlier and that no one likes Jar Jar

In the same way that you should not assess yourself physically when you have issues, similar biases do not let you see your weaknesses. We all could use a coaches eye with movement and sport and the same goes for Clinical Practice and Decision Making.

3. Mentors find ways to stimulate growth. 
Having a mentor kept me humble and I was always being challenged as to why I chose a particular intervention or assessment for a patient. One of the first things I ask anyone when they reach out to me online or in person is, “Why did you choose that assessment and treatment?” Plus, “What have you taught the patient for home?”
When you don’t have a lot of experience, or a mentor the answer often is some variation of
  • it’s worked for me in the past
  • that’s the way I learned it
To really grow in your Clinical Practice and Decision Making, you need to be able to answer these questions to your patient and yourself. Having original thoughts and not just being a follower of commercial approach x is what growth is all about.
4. Mentors offer encouragement

 “A lot of people have gone further than they thought because someone else thought they could.” – Unknown 

I have failed many patients. I even have an entire podcast about it! There were times when I thought I never want to see another “insert condition here” patient again. Even after my fellowship, I felt much more comfortable with spine patients than extremities. My most hated case was the chronic knee pain that had full ROM, full strength, and no special tests positive. Mentorship can help you with the types of cases and interactions you are unsuccessful with or just do not like dealing with.

I guarantee you, you will fail, but what are you going to learn from it?

5. Mentors are disciplinarians that create necessary boundaries that we cannot set for ourselves.

How often are you researching other methods for helping that pain with high fear avoidance? That particular tendinopathy that is not responding to eccentric loading? Are you reading research at least twice a month? Are you critical of it? These are things we should be doing, but often when we set aside time for them. We are hit with a notification and all of a sudden we are watching the latest viral cat video.

Our group has like minded clinicians who are ready to mentor you, push your boundaries and keep you stimulated when your workplace sometimes does not. Check out The Eclectic Approach to Modern Rehab Mastery by clicking the button below.

Keeping it Eclectic…

Can chronic stretching change the muscle-tendon mechanical properties? A review.

It is recognized that stretching is an effective method to chronically increase the joint range of motion. However, the effects of stretching training on the muscle-tendon structural properties remain unclear. This systematic review with meta-analysis aimed to determine whether chronic stretching alter the muscle-tendon structural properties.

Published papers regarding longitudinal stretching (static, dynamic and/or PNF) intervention (either randomized or not) in humans of any age and health status, with more than 2 weeks in duration and at least 2 sessions per week, were searched in PubMed, PEDro, ScienceDirect and ResearchGate databases. Structural or mechanical variables from joint (maximal tolerated passive torque or resistance to stretch) or muscle-tendon unit (muscle architecture, stiffness, extensibility, shear modulus, volume, thickness, cross sectional area, and slack length) were extracted from those papers.

A total of 26 studies were selected, with a duration ranging from 3 to 8 weeks, and an average total time under stretching of 1165s per week. Small effects were seen for maximal tolerated passive torque, but trivial effects were seen for joint resistance to stretch, muscle architecture, muscle stiffness, and tendon stiffness. A large heterogeneity was seen for most of the variables. Stretching interventions with 3-8 weeks duration do not seem to change either the muscle or the tendon properties, although it increases the extensibility and tolerance to a greater tensile force. Adaptations to chronic stretching protocols shorter than 8 weeks seem to mostly occur at a sensory level.

Post-fall reporting in aged acute inpatient mental health units: an 18-month observational cohort study.

Despite the high risk of falling for people with severe mental illness, there is limited falls research in mental health settings. Therefore, the objective of this observational cohort study was to conduct a focused post-fall review of fall episodes within aged acute inpatient mental health units at one of Australia’s largest publicly funded mental health organizations. A post-fall reporting tool was developed to collect intrinsic and extrinsic fall risk factors among three aged acute mental health inpatient units over an 18-month period. Descriptive and inferential analyses were conducted to describe fall risk factors and predictors of fall risk.

There were a total of 115 falls, of which the tool was used for 93 (80.9%) episodes. Falls occurred most often in consumer’s bedroom/bathroom and were unwitnessed. Intrinsic risk factors were most often attributed to postural drop and losing balance during walking. However, that was in contrast to consumer’s who self-reported feeling dizzy as the reason of the fall. Based on the cohort, future falls could be reduced by targeting those aged above 82 years, or with a diagnosis of dementia. Recurrent falls during admission could be reduced by targeting those with psychotic illness and males with a diagnosis of dementia. A clearer dialogue among consumers and clinical staff reporting about fall episodes may support future remedial interventions and inform programs to reduce fall risk and assist the challenge of describing unwitnessed falls in aged acute inpatient mental health settings.

The Job Market Pulse

In the Summer of 2015, we launched UpDoc Media’s first blog content series surrounding the physical therapy job market. The result: You crashed our website with too much traffic 😱! In due time, we created something you very likely know well, called the PT Job Market Pulse. And, for those of you that are new to The Pulse — we created an open source, transparent job market data pool. Every 2-3 months, we’d gather and analyze all the data and publish the raw data for your specific perusals by state, zip code, experience, setting, job type, and other factors.

Well… The Time Has Come!

It is now time to expand the pulse to incorporate the full scope of rehab therapy allied professionals. Here’s what’s new:
  • PT, PTA, OT, OTA, SLP, SLPA, Recreational Therapist, Rehab Aide/Tech, etc. are all part of The New PULSE.
  • There are expanded sections for Travel, Academic/Research, and Management positions.
  • And, there’s a new section for pre/post negotiations data entry.


Please watch the intro video.

To contribute to THE Job Market Pulse….

To sign up to receive THE Job Market Pulse Periodical, please sign up BELOW:

Sign Up To Receive The Pulse Periodical

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Thanks again for joining the movement! Until next time, I remain yours in service,

Ben Fung, PT, DPT, MBA

Co-Founder, COO, UpDoc MediaCo-Founder, CFO, Recharge
Twitter: @DrBenFung
Snapchat: DrBenFungInstagram: @DrBenFung

Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. Live cases, webinars, lectures, Q&A, hundreds of techniques and more! Check out Modern Manual Therapy!

Keeping it Eclectic…