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PubMed1992

Plasma potassium and lactate concentrations in thoroughbred horses during exercise of varying intensity.

To investigate the effect of moderate to high intensity exercise of up to 6 min duration on plasma potassium and lactate concentrations, 6 Thoroughbred horses were studied using a treadmill at a 5 degree incline. Each test consisted of an 8-min standardised warm-up followed by an exercise bout at 8, 9, 10 or 12 m/sec. The horses were galloped at each speed for up to a maximum of 6 min or until signs of fatigue were present. The horses were then walked at 0 degree incline. Carotid arterial blood samples were taken during and after the exercise. At 8, 9 and 10 m/sec there was a general pattern of an initial rise in potassium to a peak around 1.5 min of exercise with the concentration then slowly decreasing. At 12 m/sec there was a continuous rise to a peak at the end of exercise in all horses. Immediately after exercise there was a rapid return (within 3-4 min) to the potassium concentrations recorded at the end of the warm-up period. Plasma lactate peaked around the end of exercise at all speeds. At the highest intensity of exercise the mechanisms for the re-uptake of potassium did not appear to be able to match the rate of efflux. In contrast, at less intense work loads, the rate of re-uptake appeared to be similar to or slightly greater than the rate of efflux. It is possible that a disturbance in this balance between efflux and re-uptake could result in a disturbance in normal neuromuscular function during exercise.

Acid-Base Equilibrium↗

PubMed1998

Pulmonary vascular pressures of strenuously exercising Thoroughbred horses after administration of phenylbutazone and frusemide.

The present study was carried out to examine the effects of phenylbutazone treatment on the pulmonary haemodynamic effects of frusemide in strenuously exercising horses. Using catheter mounted manometers, whose in vivo signals were referenced at the point of the shoulder, heart rate, right atrial, right ventricular and pulmonary vascular pressures were measured in 3 different sets of experiments. Seven Thoroughbreds were subjected to 1) control (no medications), 2) frusemide control and 3) phenylbutazone + frusemide. The experiments were carried out in random order and were separated by 7 days. Measurements were made at rest and during incremental exercise performed on a treadmill set at 3.5% uphill grade. In the frusemide control experiment, horses received frusemide 250 mg i.v., 4 h pre-exercise. In the phenylbutazone + frusemide experiment, horses received 4 i.v. injections of phenylbutazone (4.4 mg/kg bwt) at 12 h intervals. Twenty-four hours after the last phenylbutazone injection, horses received frusemide 250 mg i.v. and exercise was performed 4 h later. This latter regimen mimics prevailing veterinary practice at Illinois racetracks. The highest work intensity (14.2 m/s, 3.5% uphill grade) elicited maximal heart rate of horses. Significant right atrial, as well as pulmonary arterial, capillary and venous hypertension occurred with exertion in all 3 experiments. However, in the frusemide-control and the phenylbutazone + frusemide studies, the exercise induced rise in mean right atrial and pulmonary vascular pressures was significantly (P<0.05) attenuated in comparison with that in the control experiments. Statistically significant differences were not found between the frusemide control study and the phenylbutazone + frusemide study either at rest or during any level of exertion. Therefore, it was concluded that the phenylbutazone treatment in our study did not mitigate the pulmonary haemodynamic effects of frusemide in strenuously exercising Thoroughbred horses.

Animals↗

PubMed1999

Cardiovascular demands of competition on low-goal (non-elite) polo ponies.

Knowledge of the competitive demands of different sports or activities is important for designing appropriate training programmes to ensure that animals reach a sufficient level of fitness to reduce the risk of overexertion and injury or illness and to achieve the best possible performance in relation to an individual's genetic potential. Whilst the physiological demands of many equestrian sports have been described, to the best of our knowledge the cardiovascular demands of polo have not. The aims of the present study were therefore to record heart rate during and after competitive polo games in a group of low-goal (non-elite) polo ponies in order to describe the absolute heart rates during play, the relationship of these heart rates to maximal heart rate and the characteristics of a typical chukka in terms of effort. Six low-goal polo ponies were studied during a total of 59 chukkas. Heart rate was monitored continuously before, during and after competition using a commercial heart rate monitor. Maximal heart rate was determined with field and treadmill incremental exercise tests and used to express work intensity in terms of time during play that each ponies heart rate was less than 75% HRmax, between 75 and 90% HRmax and greater than 90% HRmax. Mean maximum heart rate was not different during play or during field and treadmill exercise tests; 215+/-7 (mean +/- s.d.), 211+/-7 and 213+/-2 beats/min, respectively (P>0.05). Mean heart rate for all ponies over all chukkas was 166+/-6 beats/min with a mean chukka duration of 611+/-18 s. Of this time, 44+/-7% of the time was spent below 75% HRmax, 39+/-8% between 75 and 90% HRmax and 17+/-8% of time above 90% HRmax. When only one chukka had been played, there was a good correlation between mean heart rate during play and 3 min recovery heart rate (r = 0.63, P<0.001). Based on these observations, it is proposed that low-goal polo places moderate to high stress on the cardiovascular system.

Animals↗

PubMed1999

Pulmonary vascular resistance of horses decreases with moderate exercise and remains unchanged as workload is increased to maximal exercise.

This study was carried out to examine changes in pulmonary vascular resistance (PVR) induced by moderate and strenuous exercise; the objective being to understand why pulmonary artery blood pressure of exercising horses increases progressively as work intensity increases. Pulmonary arterial and wedge pressures (referenced at the point of the left shoulder) were determined simultaneously with cardiac output in 2 groups of healthy, sound, exercise-trained horses. Horses in Group 1 (n = 8) were studied at rest and during exercise performed at 8 and 13 m/s; the latter workload eliciting maximal heart rate (mean +/- s.e. 212 +/- 3 beats/min). Horses in Group 2 (n = 7 Thoroughbreds) were studied at rest and during galloping at 14.5 m/s on 5% uphill grade, a workload which elicited maximal heart rate (217 +/- 3 beats/min) and could not be sustained for > 90 s. Pulmonary vascular resistance was calculated by dividing pulmonary perfusion pressure gradient (i.e. mean pulmonary arterial pressure minus mean pulmonary wedge pressure) with cardiac output. Pulmonary arterial and wedge pressures, pulmonary perfusion pressure gradient and cardiac output increased significantly (P < 0.05) with exercise in both groups. There were no differences in PVR between the 2 groups of horses at rest. In Group 1 horses PVR decreased significantly (P < 0.05) with exercise at 8 m/s, but further pulmonary vasodilation did not occur as workload increased to 13 m/s. During exercise at 14.5 m/s on 5% grade, PVR of Group 2 horses also decreased significantly and was not different from values for 8 or 13 m/s in Group 1 horses. It is concluded that PVR reaches its nadir during moderate exercise, presumably due to upper limit of recruitment and distension having been reached. Therefore, in accordance with Ohm's law (P alpha Q x PVR), in going to higher workloads pulmonary blood flow (Q) remained the sole determinant of the rise in pulmonary arterial blood pressure (P). Our data also indicate that pulmonary artery wedge pressure is another variable that is important in determining the absolute value of pulmonary arterial blood pressure.

Animals↗

PubMed1967

Athletes at altitude.

1. Six international middle-distance runners were investigated during 4 weeks in England and during a similar period in Mexico City (2270 m (7450 ft.))2. In 3-mile (4828 m) time trials at 2270 m the increase in time taken by four subjects compared with sea level was 8.5% on the 4th day and 5.7% on the 29th day. There was thus a gain of 2.8% or 20 sec in time associated with acclimatization.3. In 1-mile (1609 m) time trials the times were increased by 3.6% in the first week at altitude and by 1.5% in the 4th week. The improvement amounted to 2.1%, or 4.9 sec.4. In 5 min maximum exercise on the ergometer maximum O(2) intake for six subjects at altitude was reduced by 14.6% on the 2nd day and 9.5% on the 27th. Only one subject showed no change in maximum oxygen intake (V(O2, max)) with time spent at altitude.5. Although V(O2, max) was persistently reduced at altitude work rates finally exceeded sea-level values, owing to increased over-all efficiency.6. Forty-minute recovery O(2) intakes after 5 min maximum exercise averaged 17.35 l. at sea level and 17.53 l. at altitude. Mean values from 40th to 50th min were within +/- 7% of pre-exercise values.7. Serial tests at increasing loads yielded a straight-line relation between O(2) intake and work rate over a wide range of work rates at sea level and at altitude. Heart rate and ventilation for given work intensity were maximal in the first 2-10 days at altitude and thereafter declined.8. Capillary HbO(2) saturation fell from 93% at rest to 87% in maximum exercise. The corresponding alveolar gas tensions were P(A, O2) 89 mm Hg, P(A, CO2) 24 mm Hg. About half the total unsaturation in maximum exercise was explained by the Bohr effect.9. In six of eight pairs of determinations V(O2, max) measured on the ergometer was within +/- 0.15 l./min of V(O2, max) measured on the running track. Nevertheless, it was not possible to predict running performance from ergometer measurements.

Acclimatization↗

PubMed1993

Ventilatory responses during arm and leg exercise at varying speeds and forces in untrained female humans.

1. Involvement of neural stimuli, central and/or peripheral in origin, in exercise ventilatory control was ascertained by examining the ventilatory responses to varying mechanical conditions of arm and leg cycle ergometries. Twelve untrained women underwent each of two modes of exercise at three levels of loading (0, 5 and 10 N), each at three levels of speed (30, 50 and 72 r.p.m.), during which steady-state values of minute ventilation (VE), tidal volume (VT), respiratory frequency (f) and CO2 excretion (VCO2) were measured. 2. Using the data obtained at the aerobic work intensities, the relationship of ventilatory responses (VE, VT and f) to the metabolic (VCO2) and mechanical (speed and load) variables were studied by multiple linear regression analysis. Coefficient of determination (r2) of the regression model was lowest (0.84) for f in the arm exercise and highest (0.99) for VE in the leg exercise. 3. Standardized partial regression coefficients of the model indicated that VE response is related to VCO2 at the rate of 94 +/- 3% (mean +/- S.E.M.) and to the pedal rate at 8 +/- 3% during the leg exercise, while it is closely related to VCO2 in the arm exercise. For f response, influence of the rate of limb movement was seen in the leg exercise but not in the arm exercise. The different effects of the rate of limb movement between the two exercise modes may be related to familiarity with the exercise modes, suggesting that a familiarity-related mechanism is involved in exercise ventilatory control. 4. A heavier load imposed on the limb muscles elicited a greater VT both in the arm and leg exercise and a lower f in the arm exercise. Postural control in the upper torso during increased limb muscle tension seems to affect VT and f.

Adult↗

PubMed1996

Nitric oxide and exercise in the horse.

1. The effects of exercise on the production rate of nitric oxide (NO) in exhaled air (VNO) and the effects of inhaled NO (80 p.p.m.) on cardiovascular and respiratory parameters were investigated in five Throughbred horses. 2. The concentration of NO ([NO]) in exhaled air collected from within the nasal opening was lower when collected at a high flow rate of 80 l min-1 than at a low flow rate of 20 l min-1: when trotting at 3.7 m s-1 the values were 0.78 +/- 0.15 and 1.23 +/- 9.14 p.p.b., respectively, and when cantering at 9 m s-1 the values were 1.69 +/- 0.31 and 2.25 +/- 0.32 p.p.b., respectively. 3. Nebulized methoxamine (40 mg ml-1 for 60 s), an alpha 1-adrenergic agonist, further reduced [NO] during the 9 m s-1 canter to 1.05 +/- 0.14 and 1.99 +/- 0.41 p.p.b. when collected at 80 and 20 l min-1, respectively, and induced cyclical changes in the breathing pattern. 4. Exercise induced a linear increase in VNO with work intensity to a maximum (428.1 +/- 31.6 pmol min-1 kg-1) which coincided with the maximal oxygen uptake for the horses (138.3 +/- 11.7 ml min-1 kg-1), although a further increase in VNO (779.3 +/- 38.4 pmol min-1 kg-1) occurred immediately after exercise. The changes in VNO correlated well with the tidal volume (r = 0.968; P < 0.01) and the haematocrit (r = 0.855; P < 0.01). 5. In the first 2 min of high intensity exercise, inhaled NO (80 p.p.m.) significantly (P < 0.05) reduced the pulmonary artery pressure: during the first minute, pulmonary artery pressure was 83.1 +/- 7.6 mmHg compared with a control value of 94.4 +/- 6.3 mmHg, and during the second minute, 84.2 +/- 7.1 mmHg compared with a control value of 98.4 +/- 4.7 mmHg. There were no other significant changes in cardiovascular or respiratory indices, including cardiac output, measured during exercise between control and inhaled NO tests. 6. The results show that exhaled NO is released from the airways of the horse and may contribute to the regulation of pulmonary vascular tone during exercise.

Adrenergic alpha-Agonists↗

PubMed2003

Energy metabolism in heart failure.

Heart failure (HF) is a syndrome resulting from the inability of the cardiac pump to meet the energy requirements of the body. Despite intensive work, the pathogenesis of the cardiac intracellular abnormalities that result from HF remains incompletely understood. Factors that lead to abnormal contraction and relaxation in the failing heart include metabolic pathway abnormalities that result in decreased energy production, energy transfer and energy utilization. Heart failure also affects the periphery. Patients suffering from heart failure always complain of early muscular fatigue and exercise intolerance. This is linked in part to intrinsic alterations of skeletal muscle, among which decreases in the mitochondrial ATP production and in the transfer of energy through the phosphotransfer kinases play an important role. Alterations in energy metabolism that affect both cardiac and skeletal muscles argue for a generalized metabolic myopathy in heart failure. Recent evidence shows that decreased expression of mitochondrial transcription factors and mitochondrial proteins are involved in mechanisms causing the energy starvation in heart failure. This review will focus on energy metabolism alterations in long-term chronic heart failure with only a few references to compensated hypertrophy when necessary. It will briefly describe the energy metabolism of normal heart and skeletal muscles and their alterations in chronic heart failure. It is beyond the scope of this review to address the metabolic switches occurring in compensated hypertrophy; readers could refer to well-documented reviews on this subject.

Animals↗

PubMed1980

Cytosolic and microsomal epoxide hydrolases: differential properties in mammalian liver.

The epoxide hydrolase activities of the 100,000 g pellet (microsomal) and 100,00 g soluble (cystosolic) fractions of mouse, rat, and guinea pig liver were measured with three closely related compounds used as substrates. Differences between the species in the distribution of the cytosolic and microsomal hydrolases and in their substrate specificities and pH optima demonstrate why epoxide hydrolase activity in the cytosolic fraction was not detected earlier in spie of intensive work on the microsomal epoxide hydrolase.

Allyl Compounds↗

PubMed2006

Low genetic variation and no detectable population structure in aspergillus fumigatus compared to closely related Neosartorya species.

Aspergillus fumigatus is an anamorphic euascomycete mold with a ubiquitous presence worldwide. Despite intensive work to understand its success as a pathogen infecting immunosuppressed patients, the population dynamics and recent evolutionary history of A. fumigatus remain understudied. We examined patterns of genetic variation at three intergenic loci for 70 natural isolates from Europe, North America, South America, Asia, Africa, and Australia. The same loci were used to analyze within-population genetic variation for 33 isolates obtained from five geographic locations. Neither data set detected evidence of population differentiation or found any association between the genetic and geographic distances among these isolates. No evidence for genetic differentiation within the two A. fumigatus mating types was detected. The genetic diversity of A. fumigatus, contrasted with that of its close teleomorphic relatives, Neosartorya fischeri and Neosartorya spinosa, is remarkably low.

Aspergillus fumigatus↗

PubMed2003

rpoB-based identification of nonpigmented and late-pigmenting rapidly growing mycobacteria.

Nonpigmented and late-pigmenting rapidly growing mycobacteria (RGM) are increasingly isolated in clinical microbiology laboratories. Their accurate identification remains problematic because classification is labor intensive work and because new taxa are not often incorporated into classification databases. Also, 16S rRNA gene sequence analysis underestimates RGM diversity and does not distinguish between all taxa. We determined the complete nucleotide sequence of the rpoB gene, which encodes the bacterial beta subunit of the RNA polymerase, for 20 RGM type strains. After using in-house software which analyzes and graphically represents variability stretches of 60 bp along the nucleotide sequence, our analysis focused on a 723-bp variable region exhibiting 83.9 to 97% interspecies similarity and 0 to 1.7% intraspecific divergence. Primer pair Myco-F-Myco-R was designed as a tool for both PCR amplification and sequencing of this region for molecular identification of RGM. This tool was used for identification of 63 RGM clinical isolates previously identified at the species level on the basis of phenotypic characteristics and by 16S rRNA gene sequence analysis. Of 63 clinical isolates, 59 (94%) exhibited <2% partial rpoB gene sequence divergence from 1 of 20 species under study and were regarded as correctly identified at the species level. Mycobacterium abscessus and Mycobacterium mucogenicum isolates were clearly distinguished from Mycobacterium chelonae; Mycobacterium mageritense isolates were clearly distinguished from "Mycobacterium houstonense." Four isolates were not identified at the species level because they exhibited >3% partial rpoB gene sequence divergence from the corresponding type strain; they belonged to three taxa related to M. mucogenicum, Mycobacterium smegmatis, and Mycobacterium porcinum. For M. abscessus and M. mucogenicum, this partial sequence yielded a high genetic heterogeneity within the clinical isolates. We conclude that molecular identification by analysis of the 723-bp rpoB sequence is a rapid and accurate tool for identification of RGM.

Base Sequence↗

PubMed1978

Serum insulin and glucose response to graded exercise in adults. Part I: the influence of fitness status.

The effect of acute exercise upon serum immunoreactive insulin levels (IRI) and serum glucose concentrations (GC) was studied in groups of middle-aged men of contrasting physical fitness status. Two groups of subjects, one active and one sedentary (both N = 11, mean age 44 years), performed a graded cycle ergometer exercise test in the post-absorptive state. Venous blood samples were taken at rest, during low and high work intensities, and after recovery. The response of serum IRI to exercise was similar in both groups of subjects with significant increases observed during exercise followed by a return to resting values during recovery. However, the magnitude of serum IRI response was lower in the active group. In contrast, the sedentary group demonstrated little or no change in serum GC during exercise, whereas significant increases in serum GC were observed during exercise in the active group.

Adult↗

PubMed1978

Serum insulin and glucose response to graded exercise in adults. Part II. The effect of exercise conditioning.

The effect of conditioning to severe exercise upon serum immunoreactive insulin levels (IRI) and serum glucose concentrations (GC) was studied in active and sedentary groups of middle-aged men. The responses of serum IRI and serum GC were determined during graded cycle ergometer exercise which required similar low and high relative work intensities, before (pre) and after (post) a four month physical fitness programme. Both groups demonstrated a marked decline in serum IRI during high intensity exercise from pre to post tests, and a tendency to maintain serum, GC (sedentary group) or elevate serum GC (active group) during exercise, following the conditioning programme. The data provides evidence of a bi-directional response of serum IRI and serum GC to graded exercise, with only minor modifications in the response patterns resulting from exercise conditioning.

Blood Glucose↗

PubMed2006

Regular exercise did not modify significantly superoxide dismutase activity in adolescents with Down's syndrome.

BACKGROUND: Superoxide dismutase (SOD) overexpression in people with Down's syndrome negatively modifies the equilibrium SOD/glutathione peroxidase+catalase, which may ultimately lead to an increased hydroxyl radical formation. OBJECTIVE: To assess the influence of regular exercise on erythrocyte SOD activity to determine the ability of exercise to attenuate increased oxidative damage. METHOD: Thirty one male adolescents with Down's syndrome (mean (SD) age 16.3 (1.1) years) performed a 12 week training programme (three days a week), consisting of a warm up, exercise at a work intensity of 60-75% of peak heart rate (the latter calculated from 194.5 - (0.56 x age)), and a cool down period. The reduction of cytochrome c at 550 nm was used to monitor SOD activity in the supernatant of erythrocyte haemolysates. RESULTS: Mean (SD) SOD activity in non-exercised adolescents with Down's syndrome was 679.0 (82) U/g haemoglobin (95% confidence interval 642.2 to 715.8). After the 12 week training programme, it had increased to 706.8 (91) U/g haemoglobin (95% confidence interval 663.9 to 749.8). This increase was not significant (p = 0.099). CONCLUSION: Regular exercise did not significantly increase SOD activity and consequently did not affect the unbalanced equilibrium SOD/glutathione peroxidase+catalase observed in patients with Down's syndrome. Further studies are required to assess the behaviour of other antioxidant enzymes included in this pathway in order to highlight potential benefits of regular exercise in redox metabolism of patients with Down's syndrome.

Adolescent↗

PubMed1992

Fall in skin temperature of exercising man.

Fall in skin temperature during initial muscular work was investigated in ten healthy men. Bicycle exercise was performed at workloads of 50-150 W in a climatic chamber at ambient temperatures of 10-40 degrees C (relative humidity 45-55%). Skin temperatures at seven or eight points over the body surface were measured using thermography and thermocouple recording systems. Sweat rates were significantly higher at 40 degrees C than at 30 degrees C, whereas the fall in skin temperature was almost equal. The reduction of skin temperature during exercise was the same throughout the year, although sweat rate was significantly higher in summer than in winter. In coloured thermographics of the skin temperature distribution during exercise of both 50 and 150 W at 10 or 20 degrees C, the skin temperature began to decline immediately at the onset of the exercise. Increased work intensities reduced skin temperature. The results suggest that fall in skin temperature during initial exercise was not due to increased evaporative cooling but to vasoconstriction, probably caused by non-thermal factors.

Bicycling↗

PubMed2000

A comparison of lactate concentration in plasma collected from the toe, ear, and fingertip after a simulated rowing exercise.

OBJECTIVE: To examine the validity of using blood taken from the toe for the assessment of plasma lactate concentration in rowers. To achieve this, values were compared with those taken from the fingertip and earlobe. METHODS: Nine subjects exercised at two separate submaximum workloads on the Concept II rowing ergometer. The loads, each lasting four minutes, elicited mean (SD) heart rate responses of 160.1 (8.5) and 180.1 (5.7) beats/min, which corresponded to 76.4 (6.1)% and 91.9 (4.7)% of the estimated heart rate maximum of the subjects. Blood was simultaneously removed after the cessation of exercise by three experimenters and was analysed for plasma lactate concentration. RESULTS: At 76.4% of estimated heart rate maximum, the mean (SD) plasma lactate concentrations sampled from the fingertip, toe, and earlobe were 6.36 (1.58), 5.81 (1.11), and 5.29 (1.24) mmol/l respectively. At 91.9% of estimated heart rate maximum, respective values were 8.81 (2.30), 8.53 (1.37), and 8.41 (2.35) mmol/l. No significant differences (p > 0.05) were found between any of the sites at either work intensity. CONCLUSIONS: The toe may offer a practical alternative for assessing the concentration of lactate during rowing, having the advantage that repeated blood samples can be removed without interruption of the rowing action.

Adult↗

PubMed2003

Heart rate response to ultraendurance cycling.

The heart rate (HR) response to ultraendurance cycling is poorly understood. This case report describes the exercise intensity of ultraendurance cycling by means of HR monitoring in a well trained male amateur cyclist performing the Otztal Radmarathon twice en bloque in a circuit of two identical laps (distance 460 km; cumulative altitude difference 11,000 m). The overall intensity was moderate (HR(mean) = 130 beats/min; HR(mean)/HR(max) = 0.71) corresponding to an average individual workload of 47% of VO(2)MAX. Almost the whole race was performed under aerobic conditions (99.6%); high intensity work was negligible (0.4%). The average speed and the HR response also declined in the course of the two laps, average speed by 17.2% (23.8 to 19.7 km/h), HR(mean) by 10.1% (138 to 124 beats/min), and HR(mean)/HR(max) by 10.7% (0.75 to 0.67). This scale of HR decrease corresponds to comparable data gained in the field of triathlon and represents a specific cardiac feature of ultraendurance exercise in general.

Adult↗

PubMed1999

An intervention to reduce playground equipment hazards.

OBJECTIVES: A community intervention trial was carried out to evaluate the relative effectiveness of two methods of reducing playground hazards in schools. The study hypotheses were: (1) a health promotion programme addressing barriers to implementing the New Zealand Playground Safety Standard will reduce playground hazards and (2) the intervention programme will be more successful than providing information alone. METHODS: Twenty four schools in Wellington, New Zealand were randomly allocated into two groups of 12 and their playgrounds audited for hazards. After the audit, the intervention group received a health promotion programme consisting of information about the hazards, an engineer's report, regular contact and encouragement to act on the report, and assistance in obtaining funding. The control group only received information about hazards in their playground. RESULTS: After 19 months, there was a significant fall in hazards in the intervention schools compared with the control schools (Mann-Whitney U test, p = 0.027). No intervention schools had increased hazards and eight out of 12 had reduced them by at least three. In contrast, only two of the control schools had reduced their hazards by this amount, with three others increasing their hazards in that time. CONCLUSIONS: It is concluded that working intensively with schools to overcome barriers to upgrading playground equipment can lead to a reduction in hazards, and that this form of intensive intervention is more effective than providing information alone.

Accident Prevention↗