bluuebunny/crossref_metadata_2025 huggingface dataset:
COMPARING EXERCISE AGAINST A PLACEBO FOR PAIN AND DISABILITY OUTCOMES IN MUSCULOSKELETAL CONDITIONS: A SYSTEMATIC REVIEW & META-ANALYSIS
Authors: Mishra Isha , Hansford Harrison J , Williams Sam A , Devonshire Jack J , Ferraro Michael C , Gilanyi Yannick , Goodman Avi , Jones Matthew D , McAuley James H
Published: May 2024

BACKGROUND

Musculoskeletal conditions are the leading cause of years lived with disability globally, with pain and disability being two of the most important patient-reported outcomes. Exercise is a commonly recommended treatment for musculoskeletal conditions, though it is unclear whether exercise outperforms sham for improving pain and disability. AIM: To determine if exercise improves pain and disability more than sham for people with musculoskeletal conditions.

METHODS

We searched 5 databases and 3 clinical trial registers for randomised controlled trials comparing exercise against sham in people with a musculoskeletal condition. The co-primary outcomes were pain and disability. Data were analysed using random effects meta-analysis or narrative synthesis if < 5 studies were available to be pooled. The certainty of findings was assessed using the Grading of Recommendations, Assessment, Development and Evaluations tool. Data are presented as mean difference [95% CI], with a difference of >10/100 for pain and >14.5/68 for disability (WOMAC physical function sub-scale) considered clinically meaningful.

RESULTS

Within the 15 included studies, all reported pain intensity and 13 reported disability. There was low certainty evidence that exercise was more efficacious than sham for lowering low back pain (-5.94 [-7.74, -4.15], n=1091), osteoarthritis pain (-6.19 [-14.36, 1.97], n=447) and osteoarthritis disability (-7.95 [-11.45, -4.46], n=211). Narrative synthesis showed varied effects of exercise versus sham on pain and disability in neck pain, as well as on disability in low back pain and other measures of disability in osteoarthritis. No studies were located for rheumatoid arthritis.

CONCLUSION

Based on low certainty evidence from a limited number of studies, exercise may not cause clinically significant differences for pain and disability compared to sham in adults with osteoarthritis and back pain. Further research is needed to confirm this for low back pain and osteoarthritis and to extend the findings other musculoskeletal conditions.
THE ACUTE AND LONG-TERM EFFECTS OF REPEATED SUB-CONCUSSIVE IMPACTS ON MENTAL HEALTH OF ATHLETES: A NARRATIVE REVIEW
Authors: Fox-Harding Dr Caitlin , White Mr Troy , Taylor Ms Tyler , Kendall Dr Kristina
Published: May 2024

INTRODUCTION & AIMS

Sub-concussive impacts—traumatic blows to the head that fail to present clinically as concussions—may be contributing factors that lead to long-term negative health consequences seen in athletes, including cognitive and emotional disturbances. The aim of this project is to consolidate the current body of literature examining the relationship between sub-concussive impacts and mental health in athletes via a narrative review examining the acute and long-term effects of sub-concussive impacts in athletes.

METHODS

Two undergraduate research cadets assisted the research team with identifying and organizing relevant literature in the topic area. This systematic search was first conducted in April 2023 with a final search conducted in August 2023 using a combination of manual searching and databases (e.g., PubMed). Studies were saved and exported to Excel for further analysis. Inclusion criteria included the need for the study to have been conducted in an athletic population with mental health outcomes being surveyed as a result of concussion or sub-concussion head impacts. Components of the articles were documented in an Excel spreadsheet with considerations for year of publication, country of origin, study design, sport, and purpose of study.

RESULTS

Fifty-seven studies were thoroughly reviewed via a full-text analysis to determine whether inclusion criteria were met. Six studies were included in the final review. Despite a consistent positive association between history of concussion and depression being identified, limited and inconsistent findings were observed in studies evaluating sub-concussive impacts. Definitions varied for what constituted a sub-concussive head injury, further diluting the availability of high-quality research in this topic area.

CONCLUSION

This narrative review has identified a limited amount of research conducted on the impact of sub-concussive head injuries on the mental health of athletes. This warrants further investigation as the implications of concussion and sub-concussive head impacts continue to affect the lives of athletes everywhere.
EXERCISE PHYSIOLOGY SERVICES FOR INPATIENTS IN AN ACUTE TRANSDIAGNOSTIC MENTAL HEALTH SERVICE
Authors: Wright Dr Kemi , Furzer Dr Bonnie , McMahen Caleb , Luke Jessica , Herbert Brittany , Boyd Conor , Edoo Azam
Published: May 2024

BACKGROUND & AIMS

Exercise interventions are increasingly utilised in mental health services to mitigate the poor physical health and elevated health risks seen in mental illness. To-date much of the research has focused on specific diagnostic classifications, rather than the commonly occurring transdiagnostic presentation. We sought to determine the feasibility of exercise physiology services for inpatients in an acute, transdiagnostic mental health service and whether general affect changed following exercise sessions.

METHODS

Data was collected from service records over a period spanning January 2020 – August 2022, and patient demographics and service information were explored. Additionally, a subset of inpatients (n= 108), reported perceptions of exercise and associations between variables were assessed between- and within-person.

RESULTS

During the 32-month audit 371 inpatients engaged, mean age 36 years (SD=12.33, range = 18-69) and mean length of stay was 36 days (SD=45, range = 3-445). The most frequent principal diagnosis was Schizophrenia or other psychotic disorder (38.4%), with 72% of inpatients had multiple psychiatric diagnoses. Physical health comorbidity was common, with 56% of patients having physical health diagnoses, predominantly cardiometabolic diseases (n= 94). There were 1386 exercise service engagements, with patient engagement ranging from 1-36 exercise session during their stay, of which 98.7% were in the hospital gym. There was a significant positive change in affect, with exertion was not related to changes in affect, however those who exercised for greater than 30min saw larger positive changes in affect.

CONCLUSION

Embedding Clinical Exercise Physiology services within mental healthcare settings can provide tailored exercise interventions for people with transdiagnostic presentations to address both physical and mental health outcomes. Participation in—and importantly, enjoyment of—exercise was linked to changes in general affect and may present a novel and important component of acute mood support for those in inpatient services.
REAL-TIME HIP RANGE OF MOVEMENT MEASUREMENT IN TELEREHABILITATION; COMPARISON OF HUMAN POSE ESTIMATION TOOL, PHYSIOROM, VS 3D MOTION CAPTURE SYSTEM
Authors: Seaby Mr Ray , Ebert Dr Jay , Joss Dr Brendan , Edwards Dr Peter , Ackland Prof Tim
Published: May 2024

INTRODUCTION AND AIMS

Telerehabilitation is widely acknowledged, but its adoption in musculoskeletal cohorts has been restricted due to challenges in accurately measuring objective parameters such as range of movement (ROM). This research assesses the accuracy of a human pose estimation tool utilising two-dimensional (2D) video (PhysioROM, Coviu) for evaluating active hip flexion and abduction ROM during common rehabilitation exercises, compared to three-dimensional (3D) motion capture.

METHODS

Fifty participants (18 to 80 years) were recruited, each performing three common hip movements; standing hip flexion, standing hip abduction and a sit-to-stand. The motions were captured using the 12-camera, 3D Vicon motion capture system in conjunction with simultaneous 2D video, simulating a home telehealth consultation scenario. Joint kinematics were computed using either the Vicon Plug-in Gait model (3D Vicon) or the human pose estimation tool integrated into the PhysioROM algorithm (2D PhysioROM).

RESULTS

No significant differences were observed in peak hip ROM measurements during the tasks undertaken. Mean peak hip flexion was 2.4° (p=1.0) less for 3D Vicon versus 2D PhysioROM in standing hip flexion, though 2.1° (p=0.46) greater during sit-to-stand movement. Hip abduction was 5.3° (p< 0.001) less for 3D Vicon versus 2D PhysioROM in standing hip abduction. Statistical parametric mapping revealed significant differences (p<0.001) in hip flexion between Vicon 3D and 2D PhysioROM for 32% of timepoints for both standing hip flexion and sit-to-stand movements, clustered around full hip extension. During standing hip abduction, significant differences (p<0.001) were found at 58% of timepoints clustered around neutral postures. Overall mean absolute deviation was 10.1°, 9.7° and 9.0° for hip flexion/extension, sit-to-stand, and hip abduction respectively.

CONCLUSION

Validity of PhysioROM to accurately measure peak hip flexion and peak hip abduction was high. PhysioROM may provide an effective method of accurately and objectively quantifying hip movement during a telerehabilitation session using 2D video.
TELEREHABILITATION ASSESSMENT OF KNEE RANGE OF MOVEMENT; COMPARISON OF HUMAN POSE ESTIMATION TOOL, PHYSIOROM, VS 3D MOTION CAPTURE SYSTEM
Authors: Seaby Mr Ray , Ebert Dr Jay , Joss Dr Brendan , Edwards Dr Peter , Ackland Prof Tim
Published: May 2024

INTRODUCTION AND AIMS

Telerehabilitation is increasingly acknowledged, though uptake remains limited by an inability to accurately undertake objective measurement. This study sought to determine the validity of a human pose estimation tool (PhysioROM, Coviu) assessed via two-dimensional (2D) video to measure active knee flexion and extension movement during common rehabilitation exercises, versus gold-standard three-dimensional (3D) motion capture.

METHODS

Fifty participants were recruited (aged 18 to 30), each performing three common knee rehabilitation exercises; sit-to-stand, seated and reclined active knee flexion. Movements were recorded using the 12-camera, 3D Vicon motion capture system simultaneously with 2D video simulating a home telehealth consultation. Joint kinematics were calculated using the Vicon Plug-in Gait model (3D Vicon) or the human pose estimation tool within the PhysioROM algorithm (2D PhysioROM).

RESULTS

Mean peak knee flexion was 3.1°, 9.9° and 24.8° (p<0.001) greater for 3D Vicon versus 2D PhysioROM (sit-to-stand, seated flexion and reclined flexion, respectively). For peak knee extension, Vicon 3D was 2.4° and 1.93° greater than 2D PhysioROM in sit-to-stand (p=0.020) and seated flexion (p< 0.001), whilst 3.6° less than PhysioROM for reclined knee flexion (p=0.030). Statistical parametric mapping revealed significant differences between Vicon 3D and PhysioROM for 71% and 42% of timepoints (p<0.001) for seated and reclined movements, clustered around full knee flexion. Significant differences were also found at an additional 37% (p<0.001) of timepoints clustered around knee extension for reclined postures. Overall mean absolute deviation was 8.7°, 7.6° and 16.5° for sit-to-stand, seated flexion and reclined flexion, respectively.

CONCLUSION

Validity of PhysioROM to accurately measure knee flexion was high, less so in extension, during sit-to stand movements in a seated posture. Measurement in a reclined position were less accurate. PhysioROM may provide an effective method of accurately and objectively quantifying knee movement during a telerehabilitation session using 2D video.
EXERCISE IS MEDICINE, BUT FOR WHAT? A MAPPING REVIEW OF PHYSICAL ACTIVITY RECOMMENDATIONS IN THE UK NICE CLINICAL GUIDELINES
Authors: Jones Matthew D , Goodman Mr Avi , Ferraro Mr Michael , Hansford Mr Harrison , McAuley James H
Published: May 2024

INTRODUCTION & AIMS

Clinical guidelines are used to inform best practice care, with research evidence a key aspect informing guideline recommendations. Physical activity is recommended for the management of a large variety of health conditions; however, the conditions that physical activity is recommended for has not been synthesised, nor has the quality of the evidence that informs these guideline recommendations.

METHODS

To understand the extent and type of evidence for physical activity recommendations across different health conditions in the UK National Institute for Health and Care Excellence (NICE) clinical guidelines.

METHODS

NICE was searched for clinical guidelines that recommended physical activity in the management/treatment of a health condition. Data relating to the condition, guideline date, physical activity recommendation(s) (general or specific), and evidence underpinning the recommendations was extracted. Where applicable, recommendations for research, priorities for implementation, and impact of the recommendations was also extracted.

RESULTS

221 clinical guidelines were reviewed, of which 52 provided one or more physical activity recommendations and were included in the analysis. The guidelines covered a range of conditions including cardiovascular, mental health, metabolic, neurological, musculoskeletal, and others. Most guidelines (n=43) provided general physical activity recommendations (e.g. advice to be active) whereas only 9 provided specific recommendations (e.g. type and dose of physical activity). The evidence underpinning the physical activity recommendations in the guidelines was mixed but was mostly based on very low-moderate quality evidence. Despite this, few guidelines recommended further research around physical activity.

CONCLUSION

Physical activity is recommended in many clinical guidelines, demonstrating its perceived importance for improving health across a wide range of different conditions. The mostly low-quality evidence on which these recommendations are based questions why more guidelines do not recommend further high-quality research into physical activity. This would improve confidence in the evidence and hence confidence in the recommendations made by the guidelines.
EFFECTS OF PRE-MATCH TRAVEL AND TRAINING ON PHYSICAL AND TECHNICAL PERFORMANCE IN INTERNATIONAL FOOTBALL MATCHES
Authors: Clements Ewan , Ehrmann Fabian , Clark Andrew , Jones Dr Mark , McCall Dr Alan , Duffield Professor Rob
Published: May 2024

INTRODUCTION & AIMS

International footballers (soccer) are regularly required to travel directly from club to national team with only a few days to recover and prepare for matches. The combined stress of travel and training loads may therefore influence match performance. This research aims to examine the relationship of pre-match travel and in-camp training on ensuing physical and technical match performance of footballers competing for a national team.

METHODS

Match running and technical performance data were obtained from 68 national team footballers competing in international matches (n=108). Match performance data was aligned with confirmed travel durations, time zone change, travel direction, and the time between arrival and kick-off for travel into the match. Additionally, in-camp training loads for GPS for the 3 days prior to national team matches were also collated. Linear mixed models assessed relationships between travel and training measures with physical and technical match performance outcomes.

RESULTS

Travel variables explained little variance in outcomes (R2=0.02-0.16). Travelling eastward was associated with an increase in total (p=0.042) and very high-speed distance (p=0.030) in matches and a 5% decrease in pass accuracy (p=0.012). Greater time zone difference was associated with increased match decelerations (p=0.027), while arriving earlier for matches was associated with decreased total tackles (p=0.041). Increases in training high-speed distance were associated with increases in match high-speed distance (p=0.004) and number of decelerations (p<0.001). An increase in training total distance was associated with a decrease in match decelerations (p=0.002).

CONCLUSIONS

Pre-match travel appeared to have minimal effects on physical and technical performance in this national team, especially given most players arrived at least 40h prior to matches. Training loads prior to matches may have some relationship with match running performance and thus readiness to train should be a priority for athletes arriving in national team camps.
IT’S NEVER TOO LATE TO START: A CASE FOR PREVENTATIVE OUTPATIENT GERIATRIC SERVICES
Authors: Hawkins Ms Tess , Cooper Ms Ella , Williamson Ms Kate , Pepper Ms Taylah , Cullen A/Prof John , Waite A/Prof Louise
Published: May 2024

INTRODUCTION & AIMS

The population is ageing and the chronic disease burden growing, seeing more older adults present to hospital with preventable non-communicable diseases. Multidisciplinary outpatient teams are well placed to manage modifiable risk factors to prevent disease progression and hospitalisations. A preventative service was launched at Concord Hospital integrating geriatrician, exercise physiologist and dietitian care to optimise the physical and mental health of older adults with chronic disease and frailty. This evaluation aims to determine the success of service implementation and feasibility of the model.

METHODS

Between November 2022 and June 2023, 59 patients (mean age 80.2 years (SD 6.2), 47.5% female) completed 12-weeks of concurrent exercise and diet interventions with medical oversight. Patients were assessed pre- and post-interventions. Exercise was individualised and multimodal, performed twice weekly in a supervised group. Diet was individualised with a protein supplement prescribed as appropriate. The outcomes measured were Fried Frailty Phenotype (FFP), leg strength (one repetition maximum leg press), Short Physical Performance Battery (SPPB), Geriatric Depression Scale Short Form (GDS), and Mini Nutritional Assessment Long Form (MNA). Service activity was measured monthly via rate of referral and occasions of service (OOS). Data were analysed using JASP (v.0.18.1).

RESULTS

Monthly rate of referral and OOS increased from 18 to 51 patients and 49 to 479 occasions respectively, indicating service demand. After 12-weeks there were significant improvements in FFP (mean difference [95%CI] -0.4 [-0.7, -0.2] points), leg strength (34.0 [27.1, 40.8] kilograms), SPPB (1.1 [0.8, 1.5] points), GDS (-1.4 [-2.2, -0.6] points) and MNA (2.6 [1.6, 3.5] points), with no effect of sex observed.

CONCLUSION

Initial implementation of a preventative outpatient geriatric service was successful with increasing service demand and significant physical and mental health improvements. The service model is feasible; however, further evaluation is required to determine outcomes after continued service provision.
THE EFFECTIVENESS OF PROGRESSIVE RESISTANCE TRAINING IN MANAGING PROGRESSIVE SUPRANUCLEAR PALSY: A CASE STUDY
Authors: Hawkins Ms Tess , Cooper Ms Ella , Williamson Ms Kate , Pepper Ms Taylah , Cullen A/Prof John , Waite A/Prof Louise
Published: May 2024

SETTING

The Centre for STRONG Medicine is an outpatient multidisciplinary geriatric service at Concord Hospital, Sydney. An 82-year-old male with a primary diagnosis of Progressive Supranuclear Palsy (PSP) with cardiac and metabolic comorbidities was referred in March 2023. PSP is a rare neurological disorder that affects gait, balance, vision, and cognition. The participant mobilised with a rollator and had previously sustained vertebral and wrist fractures secondary to falls.

MANAGEMENT

Management was to use progressive resistance training (PRT) to combat mobility decline, prevent falls and provide education to encourage independent exercise. Initial assessment determined current health status using Falls Self Efficacy Scale (FSE-I) and Fried Frailty Phenotype (FFP) questionnaires, and measured function and strength using maximal gait speed, five times sit-to-stand (5xSTS) and one repetition maximum (1RM), respectively. FSE-I determined a high fear of falling and FFP determined frail classification. Outcomes informed the PRT exercise prescription targeting the major muscle groups for 2-3 sets of 7-9 repetitions at 70-85% 1RM progressed gradually and preformed twice weekly in a supervised group. Education regarding breathing, exercise tempo, rest, progression, and risk mitigation were provided. All outcomes were reassessed after 12-weeks of training.

RESULTS

Attendance was 100% (23 sessions) with improvement in all outcomes. Functional improvements included 0.25metres/second increase in maximal gait speed, 2.5 second reduction in 5xSTS, and safe mobilisation without a rollator. Strength improvements included 101% increase in 1RM leg press, 100% increase in 1RM triceps extension and 72% increase in 1RM seated row. Frailty status improved to pre-frail and fear of falling reduced. Self-reported improvements included increased steadiness and confidence exercising unsupervised.

DISCUSSION

Although PSP is progressive, PRT resulted in meaningful benefits in strength and function that improved daily task performance and confidence. Further research is needed to investigate the effects of PRT on PSP management in a larger cohort.
EFFECTIVENESS OF EXERCISE VIA TELEHEALTH FOR CHRONIC DISEASE: UPDATED SYSTEMATIC REVIEW AND META-ANALYSIS OF EXERCISE INTERVENTIONS DELIVERED VIA VIDEOCONFERENCING
Authors: Brown Mr Riley , Coombes Prof Jeff , Rodriguez Dr. Klaus Jungbluth , Hickman Associate Professor Ingrid , Keating Dr Shelley
Published: May 2024

INTRODUCTION & AIMS

Videoconferencing exercise interventions (VC) involve the synchronous and remote delivery of exercise via a video-linked appointment. A 2022 review investigated the effectiveness and feasibility of VC for people with chronic disease. Considering the emergence of recent trials, this review aimed to investigate these findings with high-quality contemporary evidence.

METHODS

Databases were searched from 1st August 2021 (last date searched in previous review) to April 30th 2023 for randomised controlled trials (RCTs) VC in chronic disease. Meta-analyses were conducted for between-group comparisons of exercise capacity and quality of life for RCTs to determine effectiveness. Standardised Mean Difference (SMD) for pre-post quality of life data was used to combine assessment methods. Feasibility was assessed via session attendance rates, adherence to exercise prescription, safety, technical issues and participant satisfaction. Risk of bias was analysed using the Downs & Black (D&B) quality checklist and the certainty of evidence with GRADE.

RESULTS

Sixteen trials were included in the updated review. RCT-only meta-analyses identified effects favouring VC for exercise capacity (6MWT; Mean Difference (MD)=31.0m (95% CI: 8.3 to 53.6m), p=0.007) and quality of life (SMD=0.365 (95% CI: 0.096 to 0.633), p=0.008) in studies with non-exercising comparators. An effect favouring VC was observed for quality of life in exercising comparator studies (SMD=0.335 (95% CI: 0.078 to 0.592), p=0.011) but not for exercise capacity (MD=4.6m (95% CI: -7.4 to 16.7m), p=0.451). The RCT-only analysis identified good risk of bias (D&B: 20.7±2.7/28), with GRADE certainty ratings of ‘Moderate’ for quality of life and exercise capacity outcomes. Of the new RCTs, session attendance was 74%, no serious adverse events related to VC were identified, 33% of sessions experienced technical issues and positive satisfaction outcomes were identified.

CONCLUSION

In patients with chronic disease, videoconferencing exercise interventions are feasible and effective for improving exercise capacity and quality of life.
EFFECTS OF A SINGLE HEART RATE-CLAMPED CYCLING SESSION UNDER SYSTEMIC HYPOXIA ON RECOVERY OF PHYSICAL AND PSYCHO-PHYSIOLOGICAL RESPONSES FROM EXERCISE-INDUCED FATIGUE
Authors: Li Mr Siu Nam , Peeling Prof Peter , Scott Associate Professor Brendan , Peiffer Professor Jeremiah , Shaykevich Dr Alex , Girard Dr Olivier
Published: May 2024

AIMS

We investigated whether a single heart-rate clamped cycling session under systemic hypoxia affects the recovery of physical and psycho-physiological responses from residual fatigue compared to normoxia.

METHODS

On separate occasions, twelve trained males had countermovement jump height, leg stiffness, and perceptual fatigue assessed daily during a 3-d acute training camp scenario. On days 1 and 3, participants cycled for 60 min at a constant heart rate (80% of ventilatory threshold). On day 2, fatigue was induced through a simulated team game circuit (STGC), followed by a 60-min heart rate clamped cycling bout in either normoxia, hypoxia (simulated altitude ∼3500 m), or no cycling.

RESULTS

Compared to baseline, jump height decreased at all timepoints following the STGC (all p < 0.05). Leg stiffness and cycling power output only decreased immediately following the STGC, with a 48% further decrease in cycling power output in hypoxia compared to normoxia (p < 0.05). The well-being questionnaire showed that perceived fatigue, decreased sleep quality, and increased muscle soreness responses occurred on day 3 (p< 0.05).

CONCLUSION

In a pre-fatigued state, a single heart rate-clamped cycling session in hypoxia reduced mechanical output without affecting recovery of physical performance and perceptual measures from residual fatigue induced through team sport activity.
PHYSICAL AND TECHNICAL ATTRIBUTES ASSOCIATED ON-WATER ROWING PERFORMANCE IN JUNIOR AND ELITE ROWERS
Authors: Legge Natalie , Slattery Dr Katie , O’Meara Dr Damien , McCleave Dr Erin , Young David , Crichton Sophie , Watsford Prof. Mark
Published: May 2024

INTRODUCTION & AIMS

On-water rowing performance consists of the integration of both physical and technical attributes. The aims of this exploratory study were to describe key physical and technical variables for elite and junior rowers and to examine the associations and predictive capacity of these variables with on-water rowing performance outcomes.

METHODS

Twenty-eight junior (16 females, 16 ± 0.8 years and 12 males, 17 ± 0.7 years) and 24 elite rowers (12 females, 24 ± 2.7 years and 12 males, 27 ± 2.6 years) volunteered to participate in the study. Participants completed an on-water single sculling biomechanics assessment combined with a series of physical, strength and power tests conducted in a high-performance training facility.

RESULTS

Descriptive analysis identified differences between junior and elite rowers separated by sex in several physical and on-water characteristics. Elite men and women were superior in mean gate force, distance per stroke and recovery distance compared to junior groups (P<0.0.17). Large correlations (P<0.01) were found between anthropometry, strength and power assessments with the on-water measures of catch angle, mean gate force, recovery distance and boat speed. Differences in ROM and flexibility attributes did not distinguish between elite and junior rowers, with other factors potentially involved.

CONCLUSION

This unique exploratory study combined a comprehensive physical assessment with an on-water single sculling biomechanical assessment to explore the interaction of physical attributes with on-water rowing technical variables. This battery of testing with world class athletes represents an excellent level of ecological validity for the assessment of rowers pertinent to on-water performance. The results provide a descriptive dataset of physical and technical characteristics for elite and junior rowers, of both sexes, which may be useful when evaluating the status of development rowers and to gauge the possibility of achieving further success in the sport.
ARE THERE NON-RESPONDERS TO HIIT IN CANCER SURVIVORS? CHANGES IN CARDIORESPIRATORY FITNESS, BODY COMPOSITION AND SYSTEMIC INFLAMMATION
Authors: Boytar Alex , Farley Dr Morgan , Salisbury Chloe , Skinner Tina , Jenkins Professor David
Published: May 2024

INTRODUCTION

High intensity interval training (HIIT) has been shown to elicit significant improvements in VO2peak in cancer survivors. Only 46-60% of healthy individuals are reported to respond to exercise interventions, though this rate has not been investigated in cancer survivors. AIMS: To determine the response rate in cancer survivors over 28-weeks of HIIT as measured by changes in cardiorespiratory fitness. Secondarily, the study aimed to observe associations between changes in cardiorespiratory fitness, body composition and inflammatory markers.

METHODS

131 survivors of breast, prostate or colorectal cancer were observed over 28-weeks of HIIT (4x4 minutes; 85-95% HRpeak). VO2peak, body composition and markers of systemic inflammation were assessed at baseline, four-, 16- and 28-weeks. An improvement in VO2peak of 3.5 ml.kg-1.min-1 was used as a standard of minimal clinically important difference (MCID). Body composition was measured using DEXA, and inflammatory markers were assessed for each timepoint.

RESULTS

59.6% of participants improved their VO2peak greater than MCID (+3.5 ml.kg-1.min-1) and these individuals were retrospectively classified as responders. Responders showed improvements in VO2peak at four- and 16-weeks and maintained this change through to 28-weeks (0-4 weeks: +2.92 ml.kg-1.min-1, p<0.001; 0-16 weeks: +5.70 ml.kg-1.min-1, p<0.001; and 0-28 weeks: +5.30 ml.kg-1.min-1, p<0.001). No significant change in VO2peak was seen in non-responders (40.4%). Time since treatment, cancer type, and cancer treatment were all found to contribute to a model predicting VO2peak change (R=0.464, R2 = 21.5%., adj R2=16.1%, p<0.001). Body composition and inflammatory markers improved in response to training however were not associated with VO2peak change.

CONCLUSIONS

HIIT elicited a MCID in VO2peak in almost 60% of cancer survivors. Independent to VO2peak change and cancer type, survivors showed significant favourable changes in inflammation and body composition in response to training.
DETERMINANTS OF PHYSIOLOGICAL RESPONSE TO EXERTIONAL HEAT STRESS IN HUMANS
Authors: Criddle Mr Jesse , Haynes Mr Andrew , Carter Mr Howard H. , Collis Ms Julie , Wigati Ms Kristanti , Dechichi Ms Juliene Goncalves Costa , Loacatelli Mr Joao Carlos , McLaughlin Prof Robert , Green Daniel
Published: May 2024

INTRODUCTION AND AIMS

Previous field studies of exercise undertaken in hot conditions reported dissociation between heat-related symptoms and body core temperature (Tc) elevation. This prompted us to examine physiological mechanisms underpinning responses to exertional heat exposure in a controlled laboratory experiment.

METHODS

Thirty-eight apparently healthy participants had body composition (DEXA) and fitness (V̇O2peak) measured in a preliminary visit. Tc, heart rate (HR), exercise intensity (V̇O2) and echocardiographic measures of end-diastolic volume (EDV), stroke volume (SV) and cardiac output (Q̇) were measured at rest and at 30-minute intervals throughout a two-hour walk (5km/h and 2% gradient) in a climate-controlled chamber (40⸰C and 50% relative-humidity).

RESULTS

Twenty-seven participants completed the experiment (Completers; Com), 7 were stopped due to Tc exceeding 39⸰C (Hyperthermics; Hyp). Four participants did not complete the protocol due to adverse symptoms and were excluded from this analysis. Hyp had significantly greater Tc at 60-minutes (38.6±0.5⸰C vs. 38.0±0.3⸰C; P=<0.001) and 90-minutes (39.0±0.3⸰C vs. 38.3±0.3⸰C; P=<0.001) than Com. Baseline V̇O2peak (ml.kg-1.min-1) did not differ between Hyp and Com (P=0.248). Whilst body weight and lean body mass did not significantly differ between Hyp and Com, visceral adipose tissue (VAT) volume (463.2±194.3cm3 vs. 259.9±284.4cm3 P=0.014) and mass (437.0±183.1g vs. 245.2±268.2g P=0.013) were significantly greater in Hyp vs Com. In Hyp, HR change from baseline was greater at 60-minutes (Δ57±15bpm vs. Δ36±18bpm; P=0.01) and 90-minutes (Δ63±20bpm vs. Δ42±19bpm; P=0.017), whilst change in EDV (Δ-22.7±11.4ml vs. Δ-6.92±11.2ml; P=0.016) and SV (Δ-19.4±6.1ml vs. Δ-0.7±7.5ml; P=<0.001) were significantly reduced in Hyp compared to Com.

CONCLUSION

During walking in the heat, subjects who became hyperthermic had significantly higher baseline visceral fat mass and early signs of exaggerated haemodynamic burden during exertional heat exposure. This study has implications for the identification of appropriate variables for establishing safe work limits during heat exposure in military and work-related contexts.
FRAILTY REDUCTION VIA IMPLEMENTATION OF EXERCISE, NUTRITION AND DEPRESCRIBING (FRIEND) TRIAL: NOVEL IMPLEMENTATION OF THE ASIA-PACIFIC FRAILTY GUIDELINES IN AGED CARE
Authors: Inskip Dr Michael , Arteaga Dr Trinidad Valenzuela , Rangel Mrs Carolina Almendrales , Njoku Sr Chidiamara , Barnett A/Prof Fiona , Shih Ms Isabel , Dahl Ms Sally , O’Neill Mrs Leonie , Mavros Yorgi , AM Maria A. Fiatarone Singh
Published: May 2024

INTRODUCTION

Virtually all adults in aged care are frail, contributing to falls, cognitive decline, hospitalisation, and mortality. polypharmacy, malnutrition, sedentariness, and sarcopenia are risk factors amenable to intervention. Asia-Pacific Frailty treatment guidelines recommend anabolic exercise, medication and dietary optimisation. However, no study has evaluated this best practice intervention in aged care. AIM: Evaluate institutional translation of best-practice frailty treatment in aged care residents.

METHODS

The Frailty Reduction via Implementation of Exercise, Nutritional support and Deprescribing (FRIEND) trial (ANZCTR#:ACTRN12622000926730p) is a 6-month translational trial evaluating resident outcomes, staff/caregiver knowledge and institutional translation in a Townsville aged care facility. Residents received high-intensity resistance and balance training, medication and nutrition optimisation co-implemented by investigators (AEP, geriatrician, pharmacist, nutritionist) and facility staff. Staff and caregivers completed comprehensive education modules and training. We report resident outcomes for Phase-one (6 months exercise with staggered implementation of medication/nutritional arms) in preparation for full implementation (Phase-two).

RESULTS

29 residents (21 female, age:88.6±6.3yrs) were recruited. At baseline, residents were frail (FRAIL-NH;6.3±2.4/14), cognitively-impaired (MoCA;13.8±6.8/30), had low physical function/capacity (SPPB;4.9±3.1/12, 6MWT;222.2±104.4m) and numerous prescribed medications (15.5±5.9). Two residents died & one withdrew before intervention, and nine residents declined exercise intervention. Exercising residents’ adherence was 73.4±18.3% (28±7/38 sessions), with non-significant baseline differences compared to decliners (p>0.05). FRAIL-NH worsened significantly across the entire sample (0.93±1.87,p=.019), however this progression was attenuated in exercisers (0.71±1.83,p=0.35). Furthermore, clinically meaningful improvements in frailty (Fried phenotype;-0.73±1.09,p=.022), Leg press (median{IQR}:40.9%{26.5%)) and knee extension strength (median{IQR):61.9%(259%),p<0.001), 6MWD (35.4±45.8m,p=0.022;30m-MCID), Physical Function (SPPB;1.9±2.3,p=0.007;1-point MCID), and cognition (MoCA;1.31±3.4,p=.131;1.22-point MCID) were observed in exercisers. Only 1 minor exercise-related adverse event occurred.

CONCLUSION

Six months of AEP-led high-intensity exercise with preliminary, staggered implementation of medication and nutrition optimisation in aged care improved frailty and risk factors in residents. Phase-two results following 6-months of full, concurrent implementation of exercise, medication and nutrition arms are anticipated May, 2024.
IDENTIFYING BARRIERS AND ENABLERS TO EXERCISE ADHERENCE IN PEOPLE WITH CHRONIC LOW BACK PAIN: A QUALITATIVE STUDY
Authors: Gilanyi Mr Yannick , Rizzo Dr Rodrigo , Sharma Saurab , Venter Ms Martjie , McAuley James H , Jones Matthew D
Published: May 2024

INTRODUCTION

Exercise leads to clinically meaningful pain reductions in people with chronic low back pain and is recommended as a first line treatment. However, it has been shown that exercise effectiveness decreases over time and no longer has a meaningful effect for chronic low back pain at long-term follow up. It is likely that a lack of exercise adherence is a major contributing factor responsible for these reductions in efficacy. We aimed to identify the barriers and enablers to exercise adherence from the perspective of people with chronic low back pain.

METHODS

This qualitative study was underpinned by a constructivist epistemology and used a critical realist ontological perspective. Adults (18-65yrs) with chronic low back pain who had exercised since the onset of their back pain were recruited to participate in focus groups and individual interviews. Audio data were transcribed and then analysed in two stages: (1) inductive coding using reflexive thematic analysis, followed by (2) deductive analysis through mapping codes onto the Theoretical Domains Framework.

RESULTS

Five enablers and three barriers were identified across six of the fourteen Theoretical Domain Framework domains. Exercise identity and confidence in deciding to self-manage pain were enablers, whereas beliefs about the consequences of exercise, exercise context and relationships could function as either/both barriers and enablers.

CONCLUSION

Analysis of these barriers and enablers found that they were not static factors isolated to influencing a single decision of ‘to exercise or not’. Instead barriers and enablers were complex and fluid, with participants reporting conflicting barriers and enablers that were subject to change, depending on context. These findings improve our understanding of the barriers and enablers to exercise adherence from the individual perspective of people with chronic low back pain and can be utilised for more effective exercise treatment in this population.
THE EFFECTS OF DOWNHILL WALKING ON INSULIN SENSITIVITY, ARTERIAL HEALTH, MUSCLE STRENGTH AND FUNCTIONAL PHYSICAL FITNESS IN PEOPLE WITH TYPE 2 DIABETES MELLITUS
Authors: Ansari Mrs Misha , Williams Associate Professor Andrew , Hardcastle Dr Sibella , Schmidt Dr Matthew , Myers Dr Stephen
Published: May 2024

INTRODUCTION & AIMS

Exercise is effective in preventing and managing Type 2 Diabetes Mellitus (T2DM). However, a significant number of people do not exercise as they perceive exercise to be physically challenging. Eccentric exercise, a novel aerobic exercise modality is less metabolically demanding and has been shown to have positive effects on blood glucose levels, cardiovascular fitness, and muscle strength in healthy populations. This research was conducted to explore the impact of eccentric exercise, specifically downhill walking, on insulin sensitivity, arterial health, muscle strength, and physical functional fitness in individuals with T2DM.

METHODS

A 12-week randomised controlled trial was conducted to investigate the effects of downhill, level, and uphill walking on people with T2DM. Sedentary adult participants with T2DM were randomised to perform downhill walking (DW), level walking (LW), or uphill walking (UW) for 30 minutes twice a week for twelve weeks at a standard speed of 2.5km/hr. The primary outcome measure was glycosylated haemoglobin (HbA1c), while secondary measures included arterial stiffness, strength, and physical fitness.

RESULTS

A significant reduction in HbA1c between baseline and 12 weeks was observed in the UW group However, per-protocol analysis showed a significant decrease in HbA1c in the DW group post-intervention as well. Central Systolic blood pressure significantly decreased between baseline and post-intervention in the DW group. Participants in DW group and UW group showed significant improvements in distance walked in 6MWT post-intervention. A significant increase in knee extensors isometric strength between baseline and 12 weeks was observed for the DW group only.

CONCLUSION

DW was as effective as UW for improving insulin sensitivity and more effective than LW and UW for improving central systolic blood pressure, muscle strength and functional physical fitness. DW is a viable option for those seeking a less demanding form of exercise.
BARRIERS AND ENABLERS TO EXERCISE ADHERENCE IN PEOPLE WITH CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW OF QUALITATIVE EVIDENCE
Authors: Gilanyi Mr Yannick , Shah Ms Brishna , Cashin Dr Aidan , Gibbs Dr Mitchell T. , Bellamy Ms Jessica , Day Dr Richard , McAuley James H , Jones Matthew D
Published: May 2024

INTRODUCTION

Exercise is a first line treatment for chronic low back pain, reducing pain and disability in the short-term. However, exercise benefits decrease over time, with a lack of long-term exercise adherence a potential reason for this. This study aimed to synthesize the perceptions and beliefs of individuals with chronic low back pain and identify their barriers and enablers to exercise adherence.

METHODS

We searched CENTRAL, EMBASE, CINAHL, SPORTDiscus, PubMed, PsycINFO, CINAHL, and Scopus databases from inception to 28th February 2023 for qualitative studies that explored the factors influencing exercise adherence for people with chronic low back pain. A hybrid approach combining inductive analysis using thematic synthesis and a deductive analysis, which included the Theoretical Domains Framework of behaviour change was used to analyse data. We assessed methodological quality using the Critical Appraisal Skills Programme checklist and the level of confidence of the themes found using the Confidence in the Evidence from Reviews of Qualitative Studies (GRADE-CERQual).

RESULTS

Twenty-three papers (n=21 studies) were included (n=478 participants). Four main themes impacted exercise adherence: 1) exercise, pain, and the body, 2) psychological factors, 3) social factors and 4) external factors. These themes contained 16 subthemes that were predominantly both barriers and enablers to exercise adherence. There was moderate to high confidence across the findings.

CONCLUSION

Our analysis found that individual’s experiences of barriers and enablers were most appropriately represented across a spectrum, where influencing factors could be a barrier or enabler to exercise adherence. Barriers and enablers were also found to be specific to pre-exercise, during exercise and post-exercise situations. This may lead to an improved and targeted approach to increasing exercise adherence. Further research is required to develop interventions that can use these findings for a more personalised and patient centred approach to treatment.
HIITING CANCER BACK: THE EFFECTS OF ONE MONTH OF HIGH INTENSITY INTERVAL TRAINING ON INFLAMMATION, BODY COMPOSITION, AND CARDIORESPIRATORY FITNESS IN CANCER SURVIVORS
Authors: Farley Dr Morgan , Boytar Mr Alexander , Adlard Ms Kirsten , Salisbury Dr Chloe , Schaumberg Dr Mia , Jenkins Professor David , Skinner Associate Professor Tina
Published: May 2024

INTRODUCTION/AIMS

Chronic inflammation, low fitness, and unfavourable body composition are often side effects of anti-cancer therapies and are associated with an increased risk of cancer recurrence. However, the response of these variables to high intensity interval training (HIIT), and the relationship among these predictors of cancer recurrence, is yet to be explored in cancer survivors. The aim of this study was to investigate the effect of one month of HIIT on inflammation, body composition, and cardiorespiratory fitness and explore the relationships among these variables in breast, prostate, and colorectal cancer survivors.

METHODS

Survivors (n=131) of breast, prostate, and colorectal cancer (60.1±10.3 years, 26.9±4.9 kg/m2, 67% female) completed one month of HIIT (12 sessions: 4x4min at 85-95% peak heart rate (HRpeak), interspersed with 3-minutes at 50-75% HRpeak). Body composition via dual-energy X-ray absorptiometry, cardiorespiratory fitness via V̇O2peak, and fasted blood were measured at baseline and at one month. Blood was analysed for inflammatory factors (interleukin (IL)-6, IL-10), and tumour necrosis factor alpha (TNF-α)).

RESULTS

HIIT resulted in significant reductions in IL-6, IL-10, TNF-α (-37-39%, p<0.001) and significant increases in leg lean mass (+400g, p=0.008) and absolute V̇O2peak (+0.2 L/min, p<0.001). Despite this, the only significant association among the changes in these variables was a weak correlation between IL-10 and absolute V̇O2peak (rs=0.256, p=0.013).

CONCLUSION

One month of HIIT elicited significant improvement in markers of systemic inflammation, body composition, and cardiorespiratory fitness. However, improvements in these variables were not strongly related and occur independent of each other. The findings of this study demonstrate 4x4 HIIT is an effective prescriptive tool to elicit rapid improvements in physiological markers, through apparent independent pathways. Therefore, exercise physiologists working with cancer survivors should consider utilising 4x4 HIIT to their exercise prescriptions as a time efficient means to reduce the risk of cancer recurrence and improve survivorship.
PHYSICAL ACTIVITY IS ASSOCIATED WITH IMPROVED SECONDARY PREVENTION OF CARDIOVASCULAR DISEASE IN THE UK BIOBANK
Authors: Gower Bethany , Girard Dr Danielle , Boyle Dr Terry , Davison A/Prof Kade
Published: May 2024

INTRODUCTION & AIM

Physical activity (PA) is known to be associated with a decreased risk of all-cause and cardiovascular mortality in apparently healthy adults. The association between PA and risk of death for individuals with prevalent cardiovascular disease (CVD) at baseline is less well understood. Therefore, the aim of this study was to determine the association between PA levels and survival in individuals with prevalent CVD at baseline.

METHODS

A survival analysis involving 38,291 UK Biobank participants with prevalent CVD at baseline was conducted. Physical activity was assessed using accelerometry-calibrated PA which measures total energy expended in PA. Prevalent CVD, all-cause mortality, and CVD mortality were determined through ICD-10 codes and data linkage through death and hospital records. Cox proportional hazard models were used to estimate the risk of all-cause, overall cardiovascular, and specific CVD category mortality for quartiles of PA after adjusting for known confounders.

RESULTS

There were 6,540 all-cause deaths and 3,559 cardiovascular deaths with median follow up time of 11.98 years. The risk of all-cause and overall cardiovascular mortality reduced with increasing dose of PA (highest vs lowest PA; HR = 0.70, 95% CI: 0.64 - 0.76 and 0.70, 95% CI: 0.62 - 0.79, respectively). Those in the highest quartile of PA had a 41% reduced risk of dying from cerebrovascular disease and a 38% reduced risk of dying from and hypertensive diseases (including hypertensive heart disease with heart failure).

CONCLUSION

Higher levels of PA are associated with lower risk of all-cause and overall cardiovascular mortality in individuals with prevalent CVD at baseline. These findings highlight the importance of PA in secondary prevention of cardiovascular disease.