bluuebunny/crossref_metadata_2025 huggingface dataset:
ARE THE ATTITUDES AND BELIEFS OF AUSTRALIAN EXERCISE-BASED PRACTITIONERS ASSOCIATED WITH THEIR USE OF, AND CONFIDENCE IN, TREATMENT MODALITIES FOR PEOPLE WITH CHRONIC LOW BACK PAIN?
Authors: Gibbs Dr Mitchell T. , Jones Matthew D
Published: May 2024

BACKGROUND

Practitioners’ attitudes and beliefs towards chronic low back pain (CLBP) influence their clinical decision making, but few studies have investigated decision making outside the context of patient vignettes, for a range of first- and second-line treatment options for CLBP, or in Accredited Exercise Physiologists (AEPs).

METHODS

Using an online survey, Australian AEPs and physiotherapists rated their use of different treatments for CLBP (exercise, education, manual therapy, cognitive behavioural therapy) and their confidence in these treatments for reducing pain and disability. Their biomedical and biopsychosocial beliefs were also assessed using the Pain and Attitudes Beliefs Scale for Physiotherapists. Differences between disciplines in treatment use and confidence were analysed using Mann-Whitney U tests and independent t-tests, respectively. Multiple linear regression was used to explore factors associated with treatment choices.

RESULTS

Two-hundred thirty-three practitioners (n=143 physiotherapists, n=90 AEPs) completed the survey. Most practitioners were confident treating CLBP, had a moderate-high level of confidence in the different treatments, and regularly used them in practice. Practitioners with higher biomedical beliefs had greater use of, and confidence in, specific exercise, manual therapy, and combined exercise and manual therapy. Practitioners with higher biopsychosocial beliefs were more confident in general exercise, cognitive behavioural therapy, pain education and combined exercise and pain education.

CONCLUSION

Practitioner beliefs influence their use of, and confidence in, different treatments for CLBP. These findings suggest a need for strategies to enhance biopsychosocial beliefs/reduce biomedical beliefs in Australian exercise-based practitioners.
HOW HAS KIDS PHYSICAL ACTIVITY PREVIOUSLY BEEN MEASURED IN AUSTRALIA? AND WHAT QUESTIONS COULD WE USE IN THE FUTURE?
Authors: Booth Verity , Schranz Natasha , Tomkinson Professor Grant , Lubans Professor David , Olds Professor Tim
Published: May 2024

INTRODUCTION & AIMS

The complex nature of children’s and adolescents’ participation in physical activity (PA) makes it difficult to measure. Questions have been used in Australia for many decades to subjectively monitor PA and sedentarism, however there is no consensus on which are the best. Since better data is needed to more accurately determine PA participation, the aim of this research was to identify existing questions and utilise expert opinion to develop a set of recommended questions.

METHODS

An audit of existing research measuring Australian children’s and adolescents’ participation in PA and sedentary behaviours was conducted. Existing questions were collated, classified and described in terms of the behaviours they measured and how they have previously been used. A two-round online Delphi method was chosen to identify experts’ opinions on existing questions measuring PA and sedentary behaviours.

RESULTS

From 1951 to 2019, 362 index questions were identified as previously used to measure PA and sedentary behaviours. The questions were diverse, with varying characteristics such as the behaviours measured, question structure, recall timeframe, and temporal alterations to the questions. Some continuity in data collection was identified, with one question measuring overall PA participation repeated 35 times across different studies. Within the Delphi questionnaire, 29 experts provided feedback on 31 questions which met the pre-determined criteria. The highest-ranked questions measuring participation in overall PA and sedentary behaviours were selected as two key questions for measuring compliance to PA guidelines.

CONCLUSION

Numerous questions exist able to measure compliance to guidelines or more specific measurement needs. If researchers and practitioners utilise recommended questions, it will help to accumulate comparative data and provide further insight on how to meaningfully improve PA of an individual child or a whole population.
THE EFFECTS OF EXERCSE ON PSYCHOLOGICAL HEALTH AND WELLBEING IN PEOPLE DIAGNOSED WITH CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Calder Jay , Toohey Dr Kellie , Kavanagh Dr Phil , Bacon Dr Rachel , Chau Dr Minh
Published: May 2024

INTRODUCTION & AIMS

The high psychological burden reported by adults diagnosed with cancer has a large impact on overall and cancer-specific health outcomes. Accumulating evidence indicates that psychological distress may accelerate tumour progression and increase risk of cancer mortality. Research has highlighted that exercise interventions are safe, feasible, and effective at improving both physical and psychological health for adults diagnosed with cancer. However, there are few systematic reviews that have evaluated psychological health as a primary outcome of interest or analysed the effects of different exercise prescriptions on specific psychological health outcomes. This systematic review aims to meta-analyse the available evidence and determine the effects of exercise on psychological health in individuals diagnosed with cancer.

METHODS

Systematic review with meta-analysis utilising a random effects model. Subgroups analysis was included, defined by psychological health outcomes and further stratified by the FITT principle: Frequency; Intensity; Time; and Type of exercise.

RESULTS

Seventy-eight studies met the inclusion criteria. One hundred and eighty-three individual effect sizes were obtained, which demonstrated small to moderate combined effects of exercise (d = 0.30, 95%CI 0.20; 0.40) across all psychological health outcome measures.

CONCLUSION

Exercise is an effective intervention to improve psychological health in adults diagnosed with cancer. The subgroup analysis revealed consistent effects across a range of specific psychological health outcomes, differences were observed between exercise prescriptions, thus highlighting a need for targeted exercise for each psychological health outcome.
EXPLORING PSYCHOLOGICAL NEED SATISFACTION AND MOTIVATION TO EXERCISE AND PHYSICAL ACTIVITY IN AN ARAB CONTEXT
Authors: Suwan Mrs Banan , Grimshaw Associate Professor Paul , McFadden Dr. Bridget , Lock Dr. Merilyn
Published: May 2024

INTRODUCTION & AIMS

Promoting physical activity (PA) requires an understanding of PA behavior, its correlates, and its determinants. This study aimed to assess self-reported PA behavior of adults in Qatar and understand the associations between self-determination theory (SDT) based motivational processes and PA behavior.

METHODS

This cross-sectional study used an anonymous online questionnaire within Qatar comprising demographic questions, the International Physical Activity Questionnaire Short Form (IPAQ-SF), the Behavioral Regulation in Exercise Questionnaire (BREQ-3), and the Psychological Need Satisfaction in Exercise (PNSE) scale.

RESULTS

Respondents (N = 347; nfemales=246, nmales=101) were 21.6% non-Arab expats, 63.7% Arab expats, and 14.7% Qatari nationals. The prevalence of sufficient PA (minimum of 600 MET·min per week according to the IPAQ-SF criteria) was 66%, while 34% of participants were insufficiently active. Males (x¯ = 1808.16±2517.47 MET·min·wk-1) were significantly more active than females (x¯ = 1049.40±1717.31 MET·min·wk-1; P=0.001), and reported more autonomous forms of regulation (x¯ identified=2.86, x¯ integrated=2.33, x¯ intrinsic=2.64) than females (x¯ identified=2.58, x¯ integrated=2.01, x¯ intrinsic=2.36; P<0.05), as well as higher perceived competence satisfaction (x¯ =3.89) than females (x¯ = 3.49; P=0.025). A bivariate correlation showed that total PA and moderate to vigorous physical activity (MVPA) were positively and significantly (P<0.01) associated with autonomous forms of regulation, namely, identified (rtotal_PA=0.16, rMVPA=0.15) integrated (rtotal_PA=0.26, rMVPA=0.25), and intrinsic (rtotal_PA=0.20, rMVPA=0.18) regulation, as well as perceived competence in exercise (rtotal_PA=0.21, rMVPA=0.18; P<0.01).

CONCLUSION

The bivariate correlation results were consistent with the theoretical tenets of SDT, supporting the application of SDT to advance the understanding of psychological associations of PA in predominantly Arab populations. The observed gender gap in physical activity levels is consistent with previous research in Arab populations. Future research could target SDT constructs to promote PA behavior in Arab women through culturally sensitive interventions.
INTERPROFESSIONAL BEHAVIOURAL COUNSELLING; AN ESSENTIAL SKILL FOR OUR UNDERGRADUATE STUDENTS
Authors: Russell Brooke , Lutze Jana , Gibson Dr Neil , Forsyth Dr James , Charman Blake , Sampson Dr John , Peoples Dr Gregory , Kennedy Meredith , Groeller Herb
Published: May 2024

INTRODUCTION

Collaborative healthcare practices have positive impacts on dietary and physical activity behaviours (Patnode, et al., 2022). An immersive interprofessional work-integrated learning experience was developed for UOW Exercise Science and Rehabilitation(ExSc), and Dietetics and Nutrition(DNut) students, to appropriately prepare novice practitioners for significant growth in workforce interprofessional collaboration opportunities.

METHOD

Undergraduate(ExSc:n=47;DNut:n=48) students participated in an Interprofessional Education Workshop(IEW) aimed at improving understanding of interprofessionalism and behaviour counselling techniques. Students then formed into 46 pairs(ExSc:n=1+DNut:n=1) with each pair providing Interprofessional Behavioural Counselling(IBC) to a community client at two separate timepoints; Initial consultation and a 2-week Follow Up(FU). Student volunteers(n=38;ExSc:n=10,DNut:n=28) agreed to participate in the research phase, completing two surveys, Interprofessional Collaborative Competency Attainment Scale(ICCAS) & Students Perceptions of Interprofessional Clinical Education Revised(SPICE-R2) at two timepoints; immediately post IEW, and post FU. Additionally, volunteers(n=14;ExSc:n=3,DNut:n=11) participated in focus groupsfollowing IBC. Significance, set at (p<0.01) with mean score differences, and relative change (%) reported.

RESULTS

Participant responses(n=31) to ICCAS showed improvement across the five key areas of interprofessional practice; communication(0.8,23%), collaboration(1.1,32%), role and responsibilities(1.1, 33%), patient-centred care(1.2,36%), conflict-management and team-functioning(1.1,30%). Similarly, improvements in SPICE-R2 for patient outcomes(0.30,7%) and roles and responsibilities with collaborative-practice(0.67,17%), but not (p=0.06) for interprofessional teamwork and team-based practice. Focus groups indicated that students were confused pre-IBC about effective collaboration, specifically apprehension relating to perceived time constraints involved in having two professionals in one consultation. Conversely, post-IBC student’s reported increased confidence in adopting a collaborative approach, better understanding of scope of practice overlap and could see value in client outcomes following an interprofessional approach.

CONCLUSION

UOW will continue to embed interprofessional work integrated learning experiences in the future to improve understanding of collegial collaboration ensuring patient-centred care and best practice.
NEAR MAXIMAL VELOCITY SPRINTS ARE RARE, BUT HIGH-INTENSITY ACCELERATIONS OCCUR FREQUENTLY DURING INTERNATIONAL MALE FIELD HOCKEY
Authors: Goods Dr Paul , Appleby Dr Brendyn , Scott Associate Professor Brendan , Peeling Prof Peter , Galna Dr Brook
Published: May 2024

INTRODUCTION & AIMS

In team sport, high-intensity running is generally used to describe velocities associated with maximal aerobic speed, with sprints defined by near maximal velocities, which are considered important to team sport performance. However, recent team sport investigations have revealed that near maximal velocities are seldom attained, but high-intensity accelerations occur frequently and may better represent the most demanding aspects of team sport match play. Field hockey research in this area is lacking, and therefore, we aimed to explore the frequency of high-intensity accelerations in elite field hockey, and how often these accelerations resulted in the attainment of sprint velocities.

METHODS

Movement data were collected during 2023 across 3 tournaments (17 matches) from 27 members of the Australian male field hockey team (totalling 266 player matches). Duration, high-intensity accelerations (>2.5m.s-2 for >1s), sprints (>7m.s-1), and repeated high-intensity efforts (≥3 accelerations or sprints with ≤45s recovery between efforts) were extracted. Mixed effects models were used to estimate the mean for each outcome (fixed effect), with random intercepts modelled for player and match.

RESULTS

Players were active for 51min and completed 42 high-intensity accelerations per match, which lasted for 3.6s, covered 12.9m, and reached a peak velocity of 4.8m.s-1. Only 6.4% of high-intensity accelerations resulted in the attainment of sprint velocity (2.5 per match), and these efforts lasted for 6.1s, covered 35.6m, and reached a peak velocity of 7.5m.s-1. Players completed 4.5 bouts of repeated high-intensity accelerations per match, which comprised 3.7 efforts per bout, interspersed with 16.4s of recovery; however, no repeated-sprint bouts were observed.

CONCLUSION

High-intensity accelerations occur frequently in field hockey; however, these rarely result in the attainment of sprint velocities. Practitioners should consider monitoring high-intensity accelerations to ensure players are being adequately prepared for competition demands.
THE INFLUENCE OF SENIOR AUTHOR GENDER ON RESEARCH PRACTICE IN EXERCISE AND SPORTS SCIENCE
Authors: Hagstrom Dr Mandy , Wright Dr Kemi , Engel Dr Alexander , Clifford Dr Briana , Jones Matthew D , Wewege Dr Michael , Jankelowitz Dalya , Maros Tea , Suzuki Emma
Published: May 2024

INTRODUCTION & AIMS

Sex and gender bias have been continually documented in sport and exercise science. There are disparities in both participants and authorship, including those leading the research. Examples from medical research show senior author gender influences practices (e.g., disaggregation of data by sex). We examined the relationship between senior author gender and research practices in sport and exercise science.

METHODS

For this analysis we have included all papers published in the first issue of 2023 of the top 10 sports science journals, according to SJR Sports Science rankings. We extracted senior author gender and data on research practices including study type, exercise modality, and population. This is part of a larger ongoing study.

RESULTS

Our preliminary results include 182 studies from 10 journals. Men represented 84% of all senior authors. Percentage of senior author gender ranged from 100% men as senior authors in Knee Surgery, Sports Traumatology, and Arthroscopy (45 papers led by men, 0 led by women), to 66% women senior authorship in Qualitative Research in Sport, Exercise and Health (6 papers led by women, 3 by men). When the senior author was a man, they were more likely to conduct observational research, including cross sectional, retrospective, and epidemiological research. When women were senior authors, they were more likely to conduct qualitative research. Less than 4% of all letters to the editor were led by women. Approximately 25% of all studies focused on Sport. Within this category, 75% of these studies had men senior authors. Approximately 65% of all studies had a clinical focus. Within this category, 86% of these studies had men senior authors.

CONCLUSIONS

This preliminary data indicates some differences in research practices by senior author gender. This research also highlights differences by journal in their inclusion of research led by women.
SUPPORTING PEOPLE WITH NEUROLOGICAL INJURY TO ENGAGE IN PHYSICAL ACTIVITY-FROM HOSPITAL TO HOME AND BEYOND
Authors: Jeffery Miss Sarah , Hitchener Miss Holly , Beckman Dr Emma
Published: May 2024

Accredited exercise physiologists are perfectly placed to assist people with neurological injury to reengage or explore new opportunities in physical activity. The benefits of physical activity in this population are well documented, however participation rates are low. Research shows that 75% of Australians living with a disability over the age of 15 do not meet the recommended levels of physical activity. While the need is high, the 2021-2022 ESSA workforce report found only 7% of accredited professionals are working with people living with neurological conditions. This highlights the gap between industry demand, workforce capacity and capability to deliver evidence based best practice. As clinicians with a collective experience of 30+ years, we have identified a need for greater dissemination of knowledge, experience, and practical translation of the evidence in this population. This presentation will explore the perspectives of three experienced AEP’s working from hospital to home and beyond. Each presenter will draw on their unique context and experience to describe the challenges and opportunities for AEP’s in each specific area. Sarah will provide an overview of the hospital setting and transition to community, highlighting the opportunities for early intervention and the role in supporting ongoing meaningful physical activity. Holly will discuss an exercise physiologist’s role in community rehabilitation, and our place in a multidisciplinary team. She will further explore what it looks like to move from exercise for rehabilitation mindset, into exercise for life. Emma will detail the opportunities in sports and competitions such as the Paralympics, particularly around how AEP’s can support performance goals. The team will close with provocative discussion around how AEP’s can contribute to the governments ELEVATE 2042 Strategy and we will invite AEP’s to join us on this journey.
THE PROTECT TRIAL - PREOPERATIVE EXERCISE THERAPY FOR PATIENTS WITH CANCER: A PILOT RANDOMISED-CONTROLLED TRIAL
Authors: Hennessy Dr Declan , Wallen Dr Matthew , Brown Dr Stephen , Wong-Shee A/Prof Anna , Rawstorn Dr Jonathan , Miller Dr Kyle , Oqueli Dr Ernesto , Aras Mr Drew , Grace Fergal
Published: May 2024

INTRODUCTION & AIMS

Prehabilitation exercise is a promising strategy in oncology to optimise pre-operative cardiorespiratory fitness (CRF), which could reduce post-operative complications, mortality and enhance quality of life. This trial aimed to investigate the safety, feasibility, and effects of an aerobic prehabilitation exercise program in breast, colorectal, and prostate cancer patients. Primary outcomes were serious adverse events (SAE), adverse events (AE), participant adherence and compliance. Secondary outcomes were CRF variables and patient well-being.

METHODS

A CONSORT-compliant pilot randomised controlled trial (RCT) was conducted at a regional hospital in Ballarat, Australia. Prostate, breast, and colorectal cancer patients scheduled for surgery were randomised 1:1 into prehabilitation (PREHAB) or usual care (UCARE). PREHAB involved aerobic exercises informed by baseline cardio-pulmonary testing findings, with supervised sessions every two/three days for a minimum of 2-weeks. UCARE involved standard oncology treatment. Data on physical activity (actigraphy), resting vitals, and post-operative outcomes (Clavien-Dindo) were also collected.

RESULTS

Among 47 approached patients, 23 were randomised. Overall, 11 patients were analysed in the PREHAB and 9 in the UCARE groups. No SAEs were reported, and an exercise-related AE occurred every 756 minutes (total 3780). Participants attended 91.3% of PREHAB sessions. PREHAB participants attended 5.25 (SD = 2.16) sessions and had an average of 15 days from baseline testing to surgery. No significant time x group interactions were observed in V̇O2peak, ventilatory threshold (VT), or overall patient well-being (p = 0.90, 0.58, 0.82); PREHAB achieved small within-group increases in absolute V̇O2peak and VT (+4.9% and +1.8%, respectively).

CONCLUSIONS

The PROTECT trial demonstrated the safety and feasibility of delivering prehabilitation, revealing small clinically relevant increases in CRF fitness measures. Potentially due to the sample size, no significant improvements were observed in well-being or post-operative complications; future research should prioritise larger-scale RCTs further to explore the benefits of prehabilitation in this population.
EVALUATING FEASIBILITY OF A SECONDARY STROKE PREVENTION PROGRAM
Authors: Hunter Steph , Vogel Kimberley , O’Leary Shane , Blennerhassett Dr Jannette
Published: May 2024

INTRODUCTION & AIMS

While 80% of strokes are preventable, stroke remains the second leading cause of disability and death worldwide. Recurrent stroke has an accumulative effect that increases the level of disability and demands on healthcare. Healthy lifestyles that include regular exercise can reduce stroke risk, but stroke survivors lack guidance to modify their lifestyle after hospital discharge. Models of community care may support secondary stroke prevention with guidelines recommending physical activity and cardiovascular exercise, and referrals to support behaviour change to address modifiable risk factors. Our aim was to evaluate the implementation of a secondary stroke prevention program provided within a community rehabilitation service to see if it was feasible to deliver and acceptable for participants.

METHOD

We evaluated the implementation of a secondary stroke prevention program involving supervised exercise, multidisciplinary education and health coaching to address modifiable risk factors. The group-based program involved face-to-face and telehealth sessions. The primary outcomes were feasibility, examined via service information (referrals, uptake, participant demographics, costs), and participant acceptability (satisfaction and attendance). Secondary outcomes examined self-reported change in lifestyle factors, and pre-post scores on standardised clinical tests, [e.g., waist-circumference, 6-Minute-Walk (6MWT)].

RESULTS

We ran seven programs in 12-months, and 37 people participated. Attendance for education sessions was 79%, and 30/37 participants completed the full program. No adverse events occurred. Participant satisfaction was high for ‘relevance’ (100%), ‘felt safe to exercise’ (96%) and ‘intend to continue’ (96%). Most participants (88%) changed (on average) 2.5 lifestyle factors (diet, exercise, smoking, alcohol). Changes in clinical outcomes seemed promising, with some being statistically significant, e.g. 6MWT (MD 59m, 95%CI 38m to 80159m, p<0.001), and waist-circumference (MD –2.1cm, 95%CI -3.9cm to -1.4cm, p<0.001).

CONCLUSION

The program was feasible to deliver, acceptable to participants and seemed beneficial for health. Access to similar programs may assist in secondary stroke prevention.
CHRONIC ADAPTATIONS TO BLOOD FLOW RESTRICTION AEROBIC OR BODYWEIGHT RESISTANCE TRAINING: A SYSTEMATIC REVIEW
Authors: Bommasamudram Mr Tulasiram , Morrell Ms. Zoe , Clarkson Dr Matthew , Nayak Prof. Kirtana Raghurama , K V Dr Rajagopal , Russell Prof. Aaron , Warmington Associate Professor Stuart
Published: May 2024

INTRODUCTION

Blood flow restriction (BFR) training has garnered considerable attention in recent years as an innovative method for enhancing aerobic fitness, muscle strength, and muscular hypertrophy. However, the variation of intervention protocols has impeded consensus in the scientific literature. As a result, the primary objective of this study is to systematically investigate and review the available evidence concerning BFR in conjunction with aerobic and bodyweight resistance training.

METHODS

A thorough search of electronic databases, including PubMed (MEDLINE), Cinahl, SPORTDiscus® (via EBSCOhost), Embase, and Cochrane (Central), was conducted to identify relevant published studies. The inclusion criteria encompassed a healthy sample population aged 18 and above, original studies, chronic exercise sessions (minimum duration of 2 weeks of training) involving BFR in the context of aerobic or bodyweight resistance training, and comparisons with conventional non-BFR training.

RESULTS

The review identified 24 eligible studies that met the inclusion criteria. The findings demonstrated that chronic adaptations to BFR aerobic training were characterized by substantial improvements in VO2max (4-9%) and muscle strength (6-31%) compared to conventional aerobic training. Furthermore, BFR bodyweight resistance training yielded muscle hypertrophy (3-5%) and strength (4-11%) gains on par with those achieved through conventional resistance training.

CONCLUSION

This systematic review underscores the potential benefits of chronic adaptations stemming from blood flow restriction training in both aerobic and bodyweight resistance training. BFR aerobic training presents itself as a promising avenue for enhancing cardiovascular fitness, muscular strength, and hypertrophy. Meanwhile, BFR bodyweight resistance training shows promise in promoting muscle hypertrophy and strength gains, although it is worth noting that the available evidence is limited. Further research and a broader base of studies are required to validate and expand upon these findings.
UNDERSTANDING THE INDIVIDUALIZATION OF EXERCISE PRESCRIPTION FOR PEOPLE WITH CANCER: A SYSTEMATIC REVIEW
Authors: Cunningham Brent , Chong Jamie , Fariman Ciaran , Skinner Tina , Rose Grace
Published: May 2024

PURPOSE

The importance of prescribing individualized exercise for people with cancer to minimize injury risk and optimize outcomes has been echoed internationally in position and consensus statements. However, it is unclear what individualization processes are employed in exercise oncology research and how exercise individualisation is implemented for people with cancer. This study aimed to systematically review the available evidence to elucidate the individualisation methods being employed in exercise oncology research.

METHODS

A systematic search of PubMed, EMBASE, CINAHL, and Web of Science was performed following the PRISMA guidelines. Eligible randomised controlled trials (RCT), controlled trials (CT), pre-post trials, and comparison trials included men and women aged ≥18 years with a histologically confirmed diagnosis of cancer; undertaking any structured exercise protocol that was ‘individualized’, with or without supervision; and that explored outcomes of intervention fidelity (e.g., recruitment, attendance, adherence, attrition), and/or patient health and wellbeing (i.e., quality of life, symptom improvement, medication use, physical activity). Study quality was assessed using the Delphi list tool.

RESULTS

Forty-nine studies were found to be eligible and subsequently included in the narrative synthesis. Study quality was on average 49% (range 14 to 100%). Individualization of the exercise prescription most occurred prior to intervention commencement (n=23, 47%), based on physiological results from baseline assessments (n=21, 43%). No study individualized exercise based on participant readiness to train. The exercise prescription was predominantly individualized via modulation of both the intensity and volume of exercise (11, 22%).

CONCLUSION

Exercise prescription individualization for people with cancer is highly prescriptive and predetermined. Seldom has exercise prescription been individualized based on participant readiness to train. Future exercise oncology studies should include greater detail on the reporting of exercise individualization methods and rationale to enhance our understanding of the relationship between individualization and exercise adherence and attrition in people with cancer.
STRUCTURED EXERCISE IMPROVES FATIGUE AND HEALTH-RELATED QUALITY OF LIFE IN METASTATIC BREAST CANCER PATIENTS: THE MULTINATIONAL RANDOMIZED CONTROLLED PREFERABLE-EFFECT STUDY
Authors: Zopf Dr Eva , Hiensch Dr Anouk E. , Depenbusch Dr Johanna , Schmidt Dr Martina E. , Monninkhof Dr Evelyn M. , Pelaez Mireia , Clauss Dr Dorothea , Zimmer Dr Philipp , Belloso Jon , Trevaskis Mark , Rundqvist Helene , Wiskemann Joachim , Mueller Jana , Fremd Carlo , Altena Renske , Kufel-Grabowska Joanna , Bijlsma Rhodé , van Leeuwen-Snoeks Lobke , ten Bokkel Huinink Daan , Sonke Gabe , Lahuerta Ainhara , Mann Bruce , Francis Prudence , Richardson Gary , Malter Wolfram , van der Wall Elsken , Aaronson Neil K. , Senkus Elzieta , Urruticoechea Ander , Bloch Wilhelm , Stuiver Martijn M. , Wengstrom Yvonne , Steindorf Karen , May Anne M.
Published: May 2024

INTRODUCTION & AIMS

Exercise has been proven safe and effective for patients with breast cancer in the curative setting, however evidence in patients with metastatic breast cancer (mBC) is scarce. The aim of the PREFERABLE - EFFECT study (NCT04120298) was to evaluate the effects of a structured exercise program on fatigue, health-related quality of life (HRQoL), and other cancer- and treatment-related side effects in patients with mBC.

METHODS

The randomized controlled trial included patients with mBC from five European countries (Germany, Spain, Netherlands, Poland, Sweden) and Australia. Participants were randomly assigned to usual care (UC) or a 9-month supervised and individualized exercise program (EX) involving twice weekly aerobic, resistance, and balance exercises. The primary outcomes, physical fatigue (EORTC QLQ-FA12 subscale) and HRQoL (EORTC QLQ-C30 summary score) were assessed at baseline, 3, 6, and 9 months. Among other physical fitness outcomes, maximal short exercise capacity was assessed with the Steep Ramp Test. Changes from baseline to 3, 6 (primary endpoint) and 9 months were compared between groups using adjusted mixed models for repeated measures.

RESULTS

A total of 357 patients were randomized (EX=178, UC=179). On average, participants were 55.4 years of age (SD=11.1) and 73.9% had bone metastases. EX resulted in a significant reduction in physical fatigue (-5.3 [-10.0; -0.6], p=.027, ES=0.22) and improvement in HRQoL (+4.8 [2.2; 7.4], p=.0003, ES=0.33) compared to UC at 6 months (primary endpoint), as well as at 3 and 9 months. EX also improved physical fitness (+24.3 Watts, [15.5; 33.1], ES=0.42, at 6 months) and numerous relevant QLQ-C30 scales, including social functioning, pain, and dyspnoea.

CONCLUSION

This large multinational study demonstrates that supervised exercise improves fatigue, HRQoL, and other clinically relevant outcomes in patients with mBC. Based on these findings, supervised exercise should be recommended to patients with mBC.
PATIENT EXPERIENCES OF A VIRTUALLY SUPERVISED EXERCISE PROGRAM FOR ADULTS WITH ADVANCED CANCER AND CACHEXIA – A QUALITATIVE STUDY
Authors: Zopf Dr Eva , Ratcliffe Dr Madeleine , Krishnasamy Prof Meinir , Nandi Amruta , Parr Dr Evelyn , Martin Prof Peter , Cormie A/Prof Prue , van Loon Prof Luc J.C. , Bland Kelcey
Published: May 2024

INTRODUCTION & AIMS

People with advanced cancer and cachexia experience significant body weight loss, impairing physical function and lowering quality of life (QOL). Effective, evidence-based treatments for cancer cachexia are lacking, leaving patients with unmet needs. Exercise holds promise to improve patient QOL. However, information on patients’ experiences of exercise, including their ability to cope with structured exercise, is limited. The aim of this qualitative study was to explore patient experiences completing a structured, supervised exercise program for people with cachexia due to advanced cancer.

METHODS

Semi-structured interviews were conducted with participants enrolled in a phase II feasibility, randomized controlled trial to explore their experiences of an 8-week virtually supervised exercise program delivered via videoconference technology. Interviews were analysed using reflexive thematic analysis.

RESULTS

Seventeen participants completed interviews (female n = 9, 53%). Main interview themes included: 1) Deciding to exercise involves balancing concerns and expectations, 2) The exercise program is a positive experience, and 3) Moving forward after the exercise program. While some participants initially held doubts about their physical capabilities and exercise safety, most wanted to exercise to enhance their wellbeing. Participants described the exercise program as a positive experience, offering diverse benefits. Some would have preferred in-person exercise, but all agreed the virtual format increased exercise convenience. Participants emphasized the need to extend the program to others in similar circumstances. They underscored the necessity and desire for ongoing support to sustain their new exercise habits.

CONCLUSION

Based on patient experiences, virtually supervised exercise programming appears to be feasible and meaningful to people with advanced cancer and cachexia.
PRESCRIBING BLOOD FLOW-RESTRICTED CYCLING USING RPE BALANCES THE PHYSIOLOGICAL AND PERCEPTUAL DEMANDS IN HEALTHY ADULTS
Authors: Smith Dr Nathan , Girard Dr Olivier , Scott Associate Professor Brendan , Peiffer Professor Jeremiah
Published: May 2024

INTRODUCTION

Aerobic exercise is commonly prescribed using fixed heart rates or power/speed. These methods may not be suitable when incorporating blood flow restriction (BFR), as this technique can influence these measurements. Prescribing exercise via perception of exertion (RPE), which reflects overall psychophysiological stress, may present an alternative to overcome these issues. Aim: Describe physiological and perceptual responses during fixed-power and fixed-RPE cycling performed with blood flow restriction (BFR_{PWR} and BFR_{RPE}) and without (CON_{PWR} and CON_{RPE}).

METHODS

Following baseline testing, twelve active males cycled for ten minutes under four conditions. CON_{PWR} was performed first, then the remaining conditions in a randomised and counterbalanced order. BFR_{PWR} and CON_{PWR} were performed at the power equivalent to the first ventilatory threshold (161±38W). CON_{RPE} and BFR_{RPE} were prescribed at the RPE reported during CON_{PWR}. Continuous ventilatory and heart rate measurements were recorded as two-minute averages. Subjective RPE, effort, muscular discomfort, and cuff pain were recorded every two minutes. Blood lactate was measured pre-exercise, post-exercise, and two-minutes post-exercise.

RESULTS

BFR_{PWR} resulted in the greatest physiological and perceptual responses among all conditions. Power output was lower during BFR_{RPE} (119±48W) than CON_{RPE} (139±47W). Oxygen consumption during BFR_{RPE} (20.8±5.1mL·kg-1·min-1) was lower than CON_{PWR} (25.3±6.0mL·kg-1·min-1, p<0.001) and CON_{RPE} (22.3±5.9mL·kg-1·min-1, p=0.007). Heart rate during CON_{PWR} (143±22beats·min-1) was greater than BFR_{RPE} (133±26beats·min-1, p<0.001) and CON_{RPE} (131±25beats·min-1, p<0.001). Muscular discomfort was not different between BFR_{RPE} (2.5±1.3au) and CON_{PWR}(2.3±1.5au), yet both were greater than CON_{RPE} (p<0.001, 1.8±1.5au). Cuff pain was greater during BFR_{PWR} (3.3±1.7au) than BFR_{RPE} (2.2±1.1au, p<0001). Blood lactate was greater during fixed-power (4.9±3.5mmol·L-1) compared to fixed-RPE trials (3.6±2.7mmol·L-1, p<0.001).

CONCLUSIONS

BFR_{RPE} caused less discomfort and pain than BFR_{PWR} without compromising physiological stress compared to CON_{RPE}. BFR_{RPE} should be considered when high mechanical loads are contraindicated, or discomfort/pain is undesirable. These findings improve our understanding of aerobic BFR exercise prescription to healthy adults.
V̇O2PEAK PROVIDES A BETTER PREDICTOR OF ERGOMETER MEAN MAXIMAL POWER THAN MAXIMAL OXYGEN EXTRACTION IN TRAINED ROWERS
Authors: Lanigan Mr Bryce , Tinely Mr Zeke L , Binnie Dr Martyn J , Peeling Professor Peter , Scott Associate Professor Brendan R , Peiffer Professor Jeremiah J , Galna Dr Brook , Dennis Mr Myles C , Billaut Professor François , Goods Dr Paul SR
Published: May 2024

INTRODUCTION & AIMS

Muscle oxygenation characteristics are suggested to better explain performance than peak oxygen uptake (V̇O2peak) in highly trained canoe-kayak athletes (Paquette et. al, 2018), but this has not been explored with rowers. Therefore, this investigation aimed to 1) determine whether maximal oxygen extraction improved prediction of rowing ergometer mean maximal power (MMP; W/kg) compared to V̇O2peak alone, and 2) assess differences in muscle oxygen extraction between anatomical sites during incremental rowing.

METHODS

Trained male (n=16) and female (n=6) rowers completed a 7x4min graded exercise test on a rowing ergometer to determine mean power output for each stage and V̇O2peak and MMP during the final stage. Change in muscle oxygen extraction (Δ[HHb]) during each stage was determined using near infrared spectroscopy (NIRS) at the vastus lateralis (VL), gastrocnemius medialis (GM), and biceps brachii (BB). The best predictor of MMP was determined using linear regression, and mixed-effects models were used to assess Δ[HHb] across sites and stage.

RESULTS

V̇O2peak was a significant predictor of MMP (R2=0.74); however, Δ[HHb] (at each site individually or combined) had no association with MMP (R2≤0.05). The strongest model included V̇O2peak and GM Δ[HHb] (R2=0.83); however, the improvement in model fit was modest (mean absolute error decreased from 0.211W.kg-1 to 0.193W.kg-1). A significant site x stage interaction was observed for Δ[HHb] at each site across all stages. Post-hoc analysis revealed VL Δ[HHb] was higher than GM Δ[HHb] for each stage; VL Δ[HHb] was lower than BB Δ[HHb] from stages 1-4, then higher from stages 5-7; and GM Δ[HHb] was lower than BB Δ[HHb] for stages 1-6, but higher in the final stage.

CONCLUSION

Maximal oxygen extraction alone cannot predict ergometer MMP in trained rowers. However, NIRS derived muscle oxygen extraction may provide additional useful information regarding relative muscle contributions at varying exercise intensities.
THE EFFECT OF DRY AND HUMID HEAT ACCLIMATION ON PERFORMANCE IN EACH ENVIRONMENT
Authors: McDonald Mr Peter , John Mr Kevin , Topham Dr Tom , Sawka Prof Mike , Clark Dr Brad , Périard Prof Julien
Published: May 2024

BACKGROUND

Athletes adopt heat acclimation (HA) to partly restore heat-mediated decrements in performance. However, the influence of environmental characteristics during HA on performance in dry and humid conditions is unclear. Therefore, this study aimed to compare dry and humid HA on performance in each environment.

METHODS

In a counterbalanced crossover study, ten trained male cyclists (age 43 ± 9 y; body mass 80.8 ± 7.3 kg; maximal oxygen uptake; 59 ± 7 mL.kg-1.min-1) completed a 30-min time-trial in hot-dry (TT-DRY; 42°C, 25% RH) and warm-humid (TT-HUM; 33°C, 80% RH) conditions before and after 8 days of controlled heart rate (HR) HA in either dry (DRY-HA) or humid conditions (HUM-HA). A Bayesian multi-level model was used to determine posterior means, 90% credible intervals, and probability of direction (%).

RESULTS

The improvement in power output during TT-HUM was similar following DRY-HA (13 W [3, 22]; 99%) and HUMID-HA (11 W [3, 19]; 98%). In TT-DRY, the improvement in power output was 12 W ([1, 22]; 97%) higher following DRY-HA (19 W [10, 28]; >99%) compared to HUM-HA (7 W [-2, 17]; 91%). During TT-HUM, mean rectal temperature changed following HUM-HA (0.03°C [-0.11, 0.17]; 63%) and DRY-HA (-0.14°C [-0.29, 0.02]; 92%), with a difference of 0.16°C ([-0.36, 0.03]; 92%). During TT-DRY, the difference was -0.20°C ([-0.40, 0.01]; 94%) between HUM-HA (-0.22°C [-0.38, -0.06]; 98%) and DRY-HA (-0.03°C [-0.19, 0.13]; 63%). Mean HR during TT-DRY (3 beats·min-1 [-2, 8]; 85%) and TT-HUM (-4 beats·min-1 [-10, 2]; 85%) was similar following DRY-HA and HUM-HA.

CONCLUSIONS

DRY-HA further improved mean power output during TT-DRY compared to HUM-HA. However, HUM-HA tended to lower rectal temperature more than DRY-HA during TT-DRY. HA condition did not influence HR during either TT. Our data indicate that performance is further improved in hot-dry conditions when acclimating to the same environment.
IDENTIFYING THE CURRENT PRACTISE IN PHYSICAL ACTIVITY ADVICE GIVEN TO WOMEN FOLLOWING A MISCARRIAGE AND THEIR ATTITUDES TOWARDS PHYSICAL ACTIVITY
Authors: Edwards Dr Kate , Lee Vivian , Keep Melanie
Published: May 2024

INTRODUCTION & AIMS

Miscarriage is the most common adverse pregnancy outcome, with up to 36% of women reporting a miscarriage by 40-45 years old. While physical activity is known for its benefits on physical and mental health in various population, the evidence in women following a miscarriage is lacking. Therefore, the aim of the study is to identify current practice and advice on physical activity following a miscarriage, assess current physical activity levels and to identify women’s attitudes to physical activity following a miscarriage. Women’s willingness to participate in future studies on the benefits of physical activity following miscarriage was also examined.

METHODS

A cross-sectional survey consisting of 21 questions across 5 subsections including demographics, pregnancy loss experience, physical activity advice, physical activity participation and research participation was used. Participation was opened to all Australian women who had ever experienced a miscarriage.

RESULTS

A total of 77 surveys were complete and suitable for analysis. Most participants (82%, n=63) reported receiving no physical activity guidance following their miscarriages and said they would like physical activity advice specific to their experiences (84%, n=65). The proportion of women who do not meet the recommended physical activity guideline increase from pre-pregnancy (32%) to following a miscarriage (83%) and continues to be higher (58%) than it was pre-pregnancy. The most frequently identified barriers to physical activity was feeling mentally/emotionally unprepared (34%, n=51). Majority of participants (68%, n=52) were willing to participate in future studies on the benefits of physical activity for women post-miscarriage.

CONCLUSION

This study strongly supports the need for further research into appropriate physical activity guidelines for women following a miscarriage. There is a clear unmet need in this population who are being disadvantaged by the current lack of support and guidance.
UNDERSTANDING THE BARRIERS AND ENABLERS TO ACCREDITED EXERCISE PHYSIOLOGIST’S INTEGRATION WITHIN THE AUSTRALIAN HEALTHCARE SETTING
Authors: Beecroft Mr Aaron , Sahlqvist Dr Shannon , Bolton Dr Kristy , Kremer Dr Peter , Mundell Dr Niamh
Published: May 2024

INTRODUCTION

Physical activity (PA) is crucial in managing the high rates of non-communicable disease (NCD) within Australia. Accredited Exercise Physiologists (AEPs) are well-placed to assist individuals in managing symptoms of NCD through PA intervention. However, General Practitioner referral rates to AEPs are very low (< 1%), with a lack of time and education reported as key barriers to their referral practices. Research has yet to explore the underutilization of AEPs from the AEP’s perspective. AIM: To explore the perspectives of Australian AEPs regarding their role and utilisation within the healthcare setting.

METHODS

Currently practicing AEPs (n=15) participated in audio-recorded, individual semi-structured interviews between May to July 2023. Interviews were transcribed and data were analysed via an inductive, semantic approach to reflexive thematic analysis.

RESULTS

Four primary themes emerged. The first, understanding is important, identified that a key barrier to AEP practice was the general population’s lack of understanding regarding the role of an AEP. The second, education and support of AEPs is crucial, reflected the perception that some recent graduates required further support to be better integrated within the healthcare setting and to provide a higher quality service. The third, interaction is key, highlighted that AEPs regarded communication with referrers as crucial to improve referral processes. The final theme, systematic and policy barriers impact AEP services, highlighted systematic barrier’s including time-consuming administration tasks and cost, as impacting AEP services.

CONCLUSION

The findings highlight a need to promote the role of AEPs to the general population. Ongoing support is required to ensure recent graduate AEPs can integrate effectively within the healthcare setting. Enhanced connection between AEPs and referrers may assist in generating referrals and broadening the understanding of the profession. Addressing systematic barriers, such as reducing clients’ financial constraints through increased funding, may help improve AEP service uptake.
CAN REFERRAL TO COMMUNITY-BASED EXERCISE PHYSIOLOGIST SERVICES REDUCE EMERGENCY DEPARTMENT BURDEN? A CHART AUDIT
Authors: Mundell Dr Niamh , Buntine Dr Paul , Considine Prof Julie , Miller Mr Joseph , Hackett Mr Liam , Lawson Dr Heather , MacMahon Dr Iseult , Neason Christopher , Neilson Alice , Patel Diya , Samanna Claire , Owen Patrick
Published: May 2024

INTRODUCTION & AIMS

Despite the rapid growth of exercise physiology in Australia, its potential within the healthcare system remains underutilised. Healthcare system strain, characterised by increased emergency department (ED) waiting times and length-of-stay is exacerbated by preventable, non-urgent ED attendances. In 2022, musculoskeletal conditions constituted the majority of >800,000 non-urgent ED presentations. Community care and underutilised allied health services, such as exercise physiology, may offer better management options. This study aimed to examine characteristics of patients presenting to ED for musculoskeletal conditions, treatment advice provided on physical activity, and referral practices to community-based exercise physiology services.

METHODS

A retrospective chart audit (n=267) examined patient characteristics, referral patterns and treatment advice due to non-urgent musculoskeletal conditions at Eastern Health EDs.

RESULTS

Most (n=223, 84%) patients presented with conditions that had persisted for a mean (SD) duration of 9.3 (32.4) days. Conditions affecting the leg (n=92, 34%), lower back (n=59, 22%) and arm (n=44, 16%) were most common. Sharp pain was the most common descriptor of pain (n=33, 12%). Almost half (45%, n=119) had comorbid cardiovascular disease (n=59, 22%), metabolic conditions (n=31, 12%) or mental health issues (n=29, 11%). Treatment advice on physical activity was provided for 17% to patients with 12% advised to avoid physical activity (n=31, 12%) and 5% to stay active (n=12). Advice to return to (n=2, 1%) or take time off (n=47, 18%) work was provided for 19% (n=49) patients. No patients were referred to exercise physiology services.

CONCLUSION

Patients presenting to EDs for musculoskeletal conditions appeared suitable for referral to community-based exercise physiology services, yet no referrals were identified. Moreover, few patients received advice on whether to stay active or avoid physical activity. Strategies to increase external ED referral to exercise physiology are warranted to alleviate burden within this setting.