The effect of acute aerobic exercise on central arterial stiffness,wave reflections,and hemodynamics in adults with diabetes: A randomized cross-over design

BackgroundIndividuals with diabetes have greater central arterial stiffness, wave reflections, and hemodynamics, all of which promote the accelerated cardiovascular pathology seen in this population. Acute aerobic exercise has been shown to be an effective strategy for reducing central arterial stiffness, wave reflections, and hemodynamics in healthy individuals; however, the effects of acute aerobic exercise in reducing these outcomes is not well established in people with diabetes. Recently, implementation of high-intensity interval exercise (HIIE) has shown superior improvements in cardiovascular health outcomes when compared to traditional aerobic exercise. Yet, the effect of HIIE on the aforementioned outcomes in people with diabetes is not known. The purpose of this study was to (i) describe the central arterial stiffness, wave reflections, and hemodynamic responses to a bout of HIIE and moderate-intensity continuous exercise (MICE) in adults with diabetes; and (ii) compare the effects of HIIE and MICE on the aforementioned outcomes.MethodsA total of 24 adult men and women (aged 29–59 years old) with type 1 (n = 12) and type 2 (n = 12) diabetes participated in a randomized cross-over study. All participants completed the following protocols: (i) HIIE: cycling for 4 × 4 min at 85%–95% of heart rate peak (HR_peak), interspersed with 3 min of active recovery at 60%–70%HR_peak; (ii) MICE: 33 min of continuous cycling at 60%–70%HR_peak; and (iii) control (CON): lying quietly in a supine position for 30 min.ResultsA significant group × time effect was found for changes in central systolic blood pressure (F = 3.20, p = 0.01) with a transient reduction for the HIIE group but not for the MICE or CON groups. There was a significant group × time effect for changes in augmentation index at a heart rate of 75 beats/min (F = 2.32, p = 0.04) with a decrease following for HIIE and MICE but not for CON. For all other measures of central arterial stiffness and hemodynamics, no significant changes were observed (p > 0.05).ConclusionA bout of HIIE appears to lead to a greater transient reduction in central systolic blood pressure than the reduction observed following MICE; however, both HIIE and MICE improved augmentation index at a heart rate of 75 beats/min in people with diabetes. There was no significant difference in response to HIIE and MICE in all outcomes. This provides preliminary evidence on the role of HIIE on such outcomes in people with diabetes.     

Examiner scoring of ambiguous WISC-R responses

Fabricated test protocols were used to study how effectively examiners agree in scoring ambiguous WISC-R responses. Clinical and school psychologists (N = 62) and graduate students (N = 48) scored WISC-R Similarities, Comprehension, and Vocabulary responses obtained in a group administration procedure. From over 15,000 responses obtained, only unusual, atypical, or ambiguous responses were selected; 726 responses were scored, with 11 groups of 10 raters each scoring 66 responses. Considerable scoring disagreement occurred. Unanimous agreement (within each group of 10 raters) was found on only 13% of the responses, while 80% of the raters agreed on 44% of the responses. Rates of scoring agreement were not related to level of rater experience, but were related to specific subtests. Higher rates of agreement were found on the Similarities and Comprehension subtests than on the Vocabulary subtest for both experienced and inexperienced raters. The results suggest that even with the improved WISC-R manual, scoring remains a difficult and challenging task.