The course provides knowledge on the basic elements of physiology, clinic, and statistics in the evaluation of the efficacy of prescribing physical exercise for different patient categories for the prevention of primary and secondary cardiovascular disease, cardiopulmonary rehabilitation, and for increasing cardiovascular fitness. The course will provide basic knowledge in statistics and methods for interpreting the content of relevant scientific studies, from large epidemiological studies to clinical studies on the efficacy and safety of physical treatment and rehabilitation.
Expected learning outcomes
Students will acquire the ability to: evaluate the results of a scientific study and classify bibliographic and/or study data; read and interpret the results of a cardiopulmonary stress test (respiratory gas analysis and pulmonary ventilation); read (for interpretation not diagnosis) resting and stress ECG; evaluate cardiovascular risk according to validated models listed in the current guidelines of major international scientific societies; understand the principles of sports therapy and the prescription of physical exercise in diverse contexts and pathophysiological models.
Data Analysis module: 1. Structure of a scientific article and the role of data analysis 2. Descriptive statistics, tables, graphs, and measurement of central tendency and variability (mean, variance, standard deviation, median, percentiles, quartiles) 3. Gaussian distribution 4. Elements of inferential statistics - Population and sample - Estimating the mean and variance in a sample - Central limit theorem - Distribution of the sample mean and standard error - Student's t distribution - Confidence intervals 5. Hypothesis testing and statistical significance. Type I and type II errors 6. Testing the mean 7. Studies in which subjects are observed before and after treatment: Student's t-test for paired data 8. How to determine the difference in the mean values between two distinct groups: Student's t-test for non-paired data 9. The Fisher-F-distribution. Analysis of variance for independent groups and for repeated measures. 10. Overview of alternative to t-tests and analysis of variance on ranks 11. Analyzing the relationship between two variables: correlation and regression 12. Analysis of categorical data. The chi-squared distribution and the chi-squared test for independence. 13. Fundamentals of biological signals analysis. 14. Case study: the actigraphic study for the monitoring of diurnal activity and sleep quality. 15. Case study: analysis of endocrine-metabolic data by means of mathematical modelling.
Monitoring and Evaluation of the Efficacy of Physical Exercise module 1. Monitoring physical activity: cardiopulmonary stress test; basics, indications, interpretation 2. Monitoring physical activity: basics, interpretation of the ECG 3. Evaluation of efficacy of physical activity: methods for evaluating the cardiovascular benefit of physical exercise 4. Monitoring physical activity: evaluation of cardiovascular risk in adults and the elderly for prescribing physical exercise, international guidelines 5. High-intensity physical exercise in the elderly 6. Evaluation of body composition: sarcopenia, osteoporosis, obesity 7. Efficacy of physical activity: effects and evaluation of the immune system 8. Efficacy of physical activity: effects and evaluation of the metabolic system 9. Physical exercise and arterial blood pressure 10. Physical exercise and heart rate 11. Monitoring and evaluation of the efficacy of physical activity in children
Prerequisites for admission
Data Analysis module: knowledge of first level secondary school mathematics Monitoring and Evaluation of the Efficacy of Physical Exercise module: prior knowledge of the principles of physical exercise and physiological parameters for the evaluation of athletes and patients in rehabilitation
Data Analysis module: frontal lessons alternate theoretical lectures and practical exercises in preparation for the final exam. Monitoring and Evaluation of the Efficacy of Physical Exercise module: frontal lectures.
Data Analysis module The reference material consists of the material presented during the lectures (pdf documents uploaded onto the Ariel portal. Additional material for further reading can be found in the Tutorial section on the Ariel portal. Recommended (not compulsory) reading list: 1) Marc M. Triola e Mario F. Triola - Statistica per le discipline biosanitarie, Pearson Editore. 2) S. A. Glantz- Statistica per le Discipline Biomediche, McGraw-Hill Editore. 3) David S. Moore - Statistica di base, Apogeo Editore. The reference material for the "Monitoring and evaluation of motor activity effectiveness" module consists of the material presented during the lectures. Recommended (not compulsory) reading list: . J.N. Shanahan. Exercise for health. Adis Books, Wolters Kluwer Health. Milan, 2000 . F. Giada, A. Biffi for the FMSI Task Force, SIC sport, ANCE, ANMCO. The prescription of physical exercise in cardiology. S&O Gutemberg, Rome, 2003 . V. F. Froelicher. S. Quaglietti. Stress test. Centro Scientifico Editore, Turin 1997 . P. Cerretelli. Physiology of the exercise. Sport Environment, age, gender. Universo Publishing Company, Rome, 2001 . D. Dubin. ECG interpretation. Monduzzi Editore. Bologna, 2008.
Assessment methods and Criteria
Data Analysis module: written exam, 1 hour allowed, 31 multiple choice questions. Grading: 30 and with honors for 31 correct answers, 30 for 30 correct answers, and so on down. The questions will cover the entire course content. Students are required to bring Student's Z and T tables, a calculator, and correction fluid to the exam; use of a mobile phone calculator is not allowed. Monitoring and Evaluation of the Efficacy of Physical Exercise module: oral exam with 1 or 2 questions on the topics covered during the course and an interpretation (not diagnosis) of an ECG (heart rate, electrical heart axis, ectopic beats, etc.). The final grade is based on the average of the grades on the two modules.