bluuebunny/crossref_metadata_2025 huggingface dataset:
HOW IS CARDIOPULMONARY EXERCISE TESTING CONDUCTED IN NSW AND ACT?
Authors: Drury Kate , Cavaleri Dr Rocco , Cochrane A/Prof Belinda , Anderson Charlotte , Seeto Josie , Green A/Prof Simon
Published: May 2024

INTRODUCTION/AIM

Cardiopulmonary exercise testing (CPET) is considered the gold standard of assessing functional capacity under stress. Given the growing utility of CPET, understanding the current standards of practice is crucial. However, little is known about CPET accessibility, protocols used, or barriers to testing in NSW and ACT. This study aimed to understand clinical CPET practices and identify possible areas of protocol variability.

METHOD

40 hospitals were contacted: 28 in metropolitan Sydney, 9 in regional/remote NSW, and 3 in metropolitan Canberra. Hospitals confirming that they had a CPET service were asked to complete a 28-question survey of CPET practices via Qualtrics. The survey explored testing personnel, medical supervision, protocol design, data reporting, and barriers to CPET.

RESULTS

Most hospitals (n = 28) did not have a CPET service. Of the 11 sites that performed CPET, respondents were split evenly between adult (n = 6) and paediatric (n = 5) testing capacity. Cycle ergometry (n = 10) was the dominant exercise modality. Most sites reported using ramp (n = 8) rather than stepwise (n = 3) protocols. 73% of sites adapted the test work-rate to facilitate a test duration of 8-12 minutes. 27% used a standard work-rate, regardless of patient presentation or test indication. All sites reported anaerobic threshold-related variables, ECG-related measurements, and Borg scores. CPET endpoints were typically in line with American College of Sports Medicine guidelines (73%). Barriers to CPET included lack of suitable staffing (n = 10), lack of medical availability (n = 4), and space (n = 3).

CONCLUSION

Despite its value, CPET appears to be underused in NSW/ACT. While consistency in CPET reporting and endpoints was identified, there was variability in protocols across testing sites. This variation has potential to impact consistency and comparability of test results, affecting clinical decision-making.
PERCEPTUAL AND HAEMODYNAMIC RESPONSES DURING MODERATE-SPEED WALKING ARE INCREASED BY BLOOD FLOW RESTRICTION IN OLDER ADULTS, BUT DO NOT EXCEED UNRESTRICTED FAST WALKING
Authors: Scott Associate Professor Brendan , Hill Professor Keith , Marston Dr Kieran , Ghayomzadeh Mr Morteza , Raj Dr Isaac Selva , Peiffer Professor Jeremiah
Published: May 2024

INTRODUCTION & AIMS

Moderate-speed blood flow restriction (BFR) walking is an efficient exercise modality for older adults who cannot tolerate vigorous activity. However, limited data exist to guide the prescription of this exercise. This study examined the impact of different walking speeds and BFR cuff pressures on perceptual and haemodynamic responses, and compared these to unrestricted fast walking.

METHODS

Fifteen older adults (67-77 years) performed 10 sessions of 10-minute treadmill walking. In the first session, participants walked “as quickly as possible” to calculate mean fast walk speed. The following nine randomised sessions included moderate-speed walking with 50, 60 or 70% fast walk speed and 0%, 40 or 60% arterial occlusion pressure (AOP). Ratings of perceived discomfort (RPD) and exertion (RPE) were obtained, and blood pressure was assessed to calculate mean arterial pressure (MAP) and pulse pressure (PP). Perceptual scores were examined with Friedman ANOVA and Wilcoxon signed ranks tests, while MAP and PP were examined using linear mixed models (participants as random effects and speed, AOP or condition as fixed effects).

RESULTS

Higher RPD was observed using 60% AOP, followed by 40%, and 0% (p<0.001). RPE was higher for the fast walk (5.1±0.8 AU) than all other sessions (1.1±0.4 to 2.9±1.4 AU; p<0.001). MAP and PP were increased with higher AOP and walking speeds (p≤0.043). However, MAP (87.2±8.8 to 102.7±15.6 mmHg) and PP (66.3±14.4 to 80.3±21.7 mmHg) from moderate-speed BFR sessions did not significantly exceed measurements during the fast walk trial (MAP=100.1±13.6 mmHg, PP=89.0±22.5 mmHg).

CONCLUSION

Walking with BFR at 40% and 60% AOP increased limb discomfort and haemodynamic demands. Importantly, these responses did not exceed unrestricted fast walking, which caused the highest RPE. This study suggests a dose-response relationship of BFR cuff pressure with limb discomfort and haemodynamics, though these responses were not exacerbated more than unrestricted fast walking.
EFFECTS OF DAILY 5-MINUTE ECCENTRIC-BIASED EXERCISES ON PHYSICAL FITNESS, BODY COMPOSITION, CRITICAL HEALTH MARKERS AND WELL-BEING IN SEDENTARY INDIVIDUALS
Authors: Kirk Mr Ben , Nosaka Prof Ken , Blazevich Prof Anthony , Wilkie Dr Jodie Cochrane , Mavropalias Dr Georgios , Molan Dr Aus
Published: May 2024

INTRODUCTION

Exercise is fundamental for maintaining and improving health and fitness; however, many individuals do not participate in regular exercise, with perceived lack of time a key barrier. Minimal dose strategies, which reduce weekly exercise volumes to less than recommended guidelines, might improve health outcomes with minimal time investment. However, minimal dose strategies and their effects on health and fitness are still unclear. Therefore, we developed a bodyweight eccentric-biased exercise program consisting of 4 exercises (1 set of 10 repetitions each), which took just 5-min to complete, and investigated the effects of the program performed daily for 4 weeks on health and fitness outcomes in sedentary individuals.

METHODS

We recruited 22 healthy but sedentary individuals (32 – 69 years) whose daily steps were <5000. Participants completed a two-week control period, followed by a 4-week daily exercise intervention. Muscular strength, physical fitness, body composition and critical health markers were assessed before (PRE-1) and after the control period (PRE-2), as well as after the intervention (POST).

RESULTS

Participants adhered to the exercise program >90%. No significant changes in any measures were observed from PRE-1 to PRE-2. Following the exercise intervention, no significant changes in body mass, bone mineral density, fat mass, lean mass, heart rate, blood pressure, grip strength, squat jump or countermovement jump were evident. However, isometric mid-thigh pull, representing lower limb muscle strength (13%), push-ups (42%) and sit-ups (44%), representing upper body strength and sit and reach, representing flexibility (12%) increased significantly (P<0.05), and the increase in heart rate from a 3-minute step test was attenuated (8%) from PRE-2 to POST (P<0.05). Finally, mental health assessed by SF-36 significantly improved (15%) (P<0.05).

CONCLUSION

These results suggest that the 5-min eccentric exercise program was effective for improving physical fitness and mental health of sedentary individuals when performed every day for 4 weeks.
EFFECT INITIAL FOOT POSITION HAS ON WEIGHT DISTRIBUTION SYMMETRY AND FORCE PRODUCTION DURING A SIT-TO-STAND TASK IN OLDER ADULTS
Authors: Pascoe Dr. Deborah , Donaldson Mr Michael
Published: May 2024

INTRODUCTION AND AIMS

Transitioning from a seated position to standing is an important component to everyday living which can be affected by age-related muscle strength loss. Changing foot position has been found to affect a sit-to-stand transition in healthy younger populations however the effect it has on healthy older populations is unknown. The aim of this study was to provide clinicians with greater insight into the effect asymmetrical initial foot positions have on weight distribution symmetry and force production during a sit-to-stand transition in adults over 60 years of age.

METHODS

Three symmetrical and six asymmetrical initial foot positions were investigated on two separate testing sessions. The maximum vertical ground reaction forces collected from each foot placed on individual Kistler force platforms were used to calculate body weight symmetry percentage.

RESULTS

Body weight symmetry reduced when the dominant foot was moved posteriorly 1/3 and 2/3 participant’s foot length compared to the symmetrical positions (102-107%). When the non-dominant foot was moved posteriorly by 1/3 and 2/3 the participant’s foot length, body weight symmetry increased (99-102%) above the symmetrical positions. Maximum vertical ground reaction forces occurred (5.6-6.2N/kg) in the asymmetrical positions with the anterior foot positioned in neutral.

CONCLUSIONS

Asymmetrical foot positions which involved shifting one extremity posteriorly by 1/3 or 2/3 the participant’s foot length reduced transitional stability but increased force production. These results will help guide clinicians to scaffold progressions when prescribing sit-to-stand exercises to rehabilitate unilateral strength deficiencies within an older population.
IMPROVING SPORT SCIENCE IMPACT IN ATHLETE-LED PRACTICE ENVIRONMENTS: A PERSEPCTIVE FROM TRACK CYCLING
Authors: Stadnyk Dr Antony , Impellizzeri Prof Franco , Stanley Dr Jamie , Menaspà Dr Paolo , Slattery Dr Katie
Published: May 2024

INTRODUCTION & AIMS

Like most high performance sports, track cyclists are typically supported within the training environment by coaches and interdisciplinary practitioners who, through evidence-based practices, guide the athlete through the process of performance development. To effectively impact practice and athlete performance, practitioners must be able to implement their knowledge and expertise in a way that complements the wider performance team. The aim of this study was to examine track cycling coaches’ perspectives of the role and impact of sport science and research on their practice and the athlete development process.

METHODS

Semi-structured interviews were conducted with elite track cycling coaches (n=8) who had been working at the highest level of the sport (Olympics, UCI World Championships). The interviews addressed factors contributing to athlete preparation, and the current and potential impact of sport science on the development of elite track cyclists. Reflexive thematic analysis was conducted to identify common themes in participants’ experiences and perspectives.

RESULTS

Three principal themes were identified from the data: ‘conversation & the information dynamic’, highlighting the impact of information and feedback within the performance team for developing collective training intelligence; ‘integrating performance components for the individual’, detailing the importance of individualised and integrated approaches to athletes’ performance needs; and, ‘science to complement the vision’, examining the value of filtered data, and limitations of research in practice.

CONCLUSION

The findings highlighted two key contributors to performance team effectiveness: athletes deeply invested in, and actively contributing to, the development process; and, performance staff identifying and filtering research and data to impact decision making and athlete development. A four-stage model was developed from the collective findings for guiding sport scientists’ impact in athlete-led practice environments. Additionally, the model outlines sport scientist-supportive actions for coaches and athletes, along with practice-supportive actions for researchers, to improve impact within the sport.
COMPARISON OF CONCENTRIC AND IMPACT FORCES ON LAND AND IN WATER
Authors: Pascoe Dr. Deborah , Cheslett Ms Jessica
Published: May 2024

INTRODUCTION AND AIMS

Plyometric jump training has been used in athletic training to improve muscle strength and power and injury prevention in young people and adults. There is evidence to support aquatic plyometric training in young athletes for improving strength and power while providing a safer environment with less impact when landing. The aim of this study was to extend the research to include middle-aged adults (40-60 years) who are at a greater risk of physical decline and would benefit from a greater understanding of the forces generated in land-based and aquatic plyometric jumps for adults aged 40-60 years.

METHOD

Thirteen healthy individuals aged 40- 60 years participated in this study. Participants attended three sessions including a familiarisation session, land-based testing and water-based testing. Participants performed three vertical jumps (VJ) on land, three countermovement jumps (CMJ) and three squat jumps (SJ) on a force plate on land and in water. Force traces were analysed for peak force, impact force, flight time, and jump height.

RESULTS

Peak forces normalised for bodyweight, jump height, and flight time were significantly higher in the water than on land for the CMJ and SJ (p<.000). Impact forces showed an insignificant increase in the water compared to on land. There was a strong correlation between the VJ and the two land based jumps for all jump characteristics (p<.01) and a strong positive correlation between the percentage of participant height immersed and peak force at take- off for CMJ (r=.794, p<.01) and SJ (r=.682, p<.05).

CONCLUSION

Jump height, flight time, and peak force all increased in the water compared to on land. As the percentage of height immersed increased, so did peak force on take-off. Immersion depths must be considered when prescribing plyometric exercise for adults aged 40-60 years to ensure appropriately targeted exercise prescription.
DELIVERING GROUP-BASED TELE-EXERCISE SESSIONS FOR PEOPLE WITH TYPE 2 DIABETES: RESULTS AND EXPERIENTIAL INSIGHTS OF A PILOT STUDY
Authors: Kolasinski Mr Matthew , Plotnikoff Prof Ronald , Young Dr Myles , Keating Dr Shelley , Drew Dr Ryan , Cox Dr Emily
Published: May 2024

INTRODUCTION & AIMS

Delivery of group-based tele-exercise is an emerging treatment option for people with type 2 diabetes (T2D), but best practice is not yet understood. We evaluated the results and experiential insights of a pilot study investigating this model of care.

METHODS

Sixteen people with T2D (age 58.7±12.6, 63% male, duration of T2D 10.0±8.4years) underwent an 8-week tele-exercise intervention. Participants were assessed at baseline (in-person and via telehealth; results compared using intra-class correlations coefficients) and post-intervention (in-person only). The program was delivered in groups of 3-5, by an Accredited Exercise Physiologist using Zoom. Sessions were held once weekly and incorporated whole-body aerobic and resistance exercise (45min) and health behaviour change education (15min), reflecting the structure of Medicare-subsidised group exercise physiology sessions. Semi-structured interviews were conducted to gain participant and clinician feedback. Adverse events were monitored throughout.

RESULTS

The intervention demonstrated efficacy, with improvements in HbA1c (mean change -0.3±0.5%), fasting glucose (-0.8±0.8mmol/L), systolic blood pressure (-6.4±8.4mmHg), waist circumference (-0.8±4.2cm), muscular strength (30sec sit-to-stand score 1.6±2.9; 30sec bicep curl score 5.6±3.0) and fitness (2min step test score 24.5±11.9). Clients could reliably self-assess outcomes such as waist circumference (ICC 0.98, 95%CI 0.95-0.99), 30sec sit-to-stand (0.94, 0.82-0.98), and 2min step test (0.96, 0.87-0.99) when supervised by the clinician via telehealth, negating the need for in-person consults. No serious adverse events were reported. Key experiential insights include 1) Technological issues were minimised by providing clients with a guide for using Zoom, and conducting individual Zoom familiarisation sessions, prior to program start. 2) Client confidentiality could be managed by using breakout rooms for private conversations. 3) Creative exercise selection (e.g., TheraBand anchor points, non-traditional equipment) allowed participants to envision exercising in their home, which assisted in self-management.

CONCLUSION

This study contributes practical insights to optimise the delivery of group-based tele-exercise interventions to people with T2
THE INFLUENCE OF RESISTANCE TRAINING VARIABLES ON MUSCLE STRENGTH: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Lyristakis Mr. Philip , Wundersitz Dr. Daniel , Cousins Dr. Stephen , Zadow Dr. Emma , Gordon Associate Professor Brett
Published: May 2024

BACKGROUND

Development of muscle strength through resistance training (RT) is associated with health and performance benefits. Prescribing resistance training utilising six different variables (sets × repetitions × exercises × intensity × frequency × duration) is complex to optimise outcomes. It is unclear if, the prescription of these variables to derive a composite variable, RT dosage, influences the development of muscle strength. OBJECTIVES: This study aimed to investigate if variations in RT dosage influence muscle strength.

METHODS

CINAHL, MEDLINE, and SPORTDiscus were systematically searched; adults performing RT were compared against non-exercise controls where muscle strength was assessed. Only randomised controlled trials assessing chest and quadriceps muscle strength were considered. The six RT variables were extracted from eligible studies and were multiplied to generate RT dosage. Quadratic non-linear regressions were performed on pooled muscle strength data. Variable importance and model selection were performed to explore different linear combinations of RT variables to determine the most effective variable in developing muscle strength.

RESULTS

207 articles were eligible that enabled the calculation of RT dosage. Meta-analyses confirmed a significant effect of RT on muscle strength (SMD ≥ 1.3, CI = 1.1-1.6, p < 0.001). Quadratic non-linear regression models for the chest and quadriceps strength indicated that RT dosage as a continuous variable showed a significant dose-response for muscle strength (SMD = > 1.5, CI = 0.01-3.1, P < 0.05). The individual variables of most importance to develop muscle strength appear to be volume and duration (p < 0.03).

CONCLUSIONS

As expected, RT significantly influences muscle strength and as RT dosage increases, so too does muscle strength; however, only up to a point (∼1.5 million arbitrary units) before further increases in RT dosage don’t appear to further develop muscle strength. Prescription of RT volume and duration should be prioritised for developing muscle strength.
COMPARISON OF INTER-SESSION, INTRA-RATER AND INTER-RATER RELIABILITY OF SINGLE AND DOUBLE LEG LANDING ERROR SCORING SYSTEM USING DIFFERENT CALCULATION METHODS
Authors: Rajakaruna Mr Priyankara Manoj , Learmonth Associate Professor Yvonne C. , Dempsey Associate Professor Alasdair R.
Published: May 2024

INTRODUCTION & AIMS

The Landing Error Scoring System (LESS) is used for screening noncontact anterior cruciate ligament (ACL) injury risk. The LESS is deemed a valid and reliable indicator of landing biomechanics that predict noncontact ACL injuries. We have sought to validate a Single-Leg Landing Error Scoring System (SLESS) against the established LESS. There are seven distinct calculation methods for final LESS scores, adding variability to the original version and the risk of misinterpreting results. This study used different calculation methods to investigate the inter-session, intra-rater and inter-rater reliability of the SLESS and LESS scores.

METHODS

Thirty-five team sports players performed four drop jump landing variations (dominant leg, non-dominant leg, double-leg and cognitive loading drill with double-leg) over three sessions. Sessions 1 and 2 were conducted on the same day, with Session 3 a week later. Video footage from frontal and sagittal views captured all landings. Three professionals scored recorded trials using standard SLESS and LESS protocols. One scorer assessed intra-session and inter-session reliability, while three evaluated inter-rater reliability. The final SLESS and LESS scores were calculated using original version/OG, average of 3 trials-AV, worst trial/WT, best score/BS, first trial/FT, last trial/LT, error present in at least two of three trials/TT). Reliability was assessed using intraclass correlation coefficient (ICC), standard error of measurement (SEM), and coefficient of variation (CV) with 95% confidence intervals.

RESULTS

The study observed acceptable inter-session reliability across single-leg and double-leg drop jump landing tasks using all seven calculation methods (SLESS: ICC=0.80-0.91, SEM=1.07-1.10, CV=6.5-10.1%; LESS: ICC=0.63-0.90, SEM=1.06-1.11, CV=5.7-11.5%). The study also demonstrated acceptable intra-rater reliability for all tasks using all calculation methods (SLESS: ICC=0.86-0.94, SEM=1.05-1.08, CV=5.0-8.5%; LESS: ICC=0.74-0.93, SEM=1.04-1.08, CV=4.2-8.5%). In addition, acceptable inter-rater reliability was shown for all tasks using all calculation methods (SLESS: ICC=0.69-0.83, SEM=1.11-1.18, CV=10.5-18.0%; LESS: ICC=0.54-0.82, SEM=1.10-1.20, CV=10.3-20.3%).

CONCLUSION

The study indicates the reliability of all seven calculation methods for SLESS and LESS scores. Precise specification of the chosen calculation method is crucial for practitioners and researchers.
DOES EXERCISE PRESERVE FAT FREE MASS DURING A VERY LOW ENERGY DIET IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA?
Authors: Machan (Cayanan) Dr Elizabeth , Lowrie Mr Fraser , Gordon A/Prof Christopher , Phillips A/Prof Craig , Yee Professor Brendon
Published: May 2024

INTRODUCTION AND AIMS

Obesity is a major comorbidity of Obstructive Sleep Apnea (OSA), contributing to 58% of moderate to severe cases in adults. Very low energy diets (VLED) are effective for rapidly reducing weight however are associated with a greater fat free mass reduction compared to other energy restricted diets. Exercise may protect against this and has been shown to improve apnoea hypopnea index (AHI) independently of weight loss. We aimed to assess the feasibility and tolerability of rapid weight loss induced by VLED with or without high-intensity functional exercise in overweight and obese men with OSA.

METHODS

This two-arm open-label pilot randomised trial included 20 participants with a BMI of ≥27kg/m2 and moderate to severe OSA. Patients were randomised to VLED-only (VO) or VLED plus exercise (VEX) for 12-weeks. Both groups followed a VLED providing <800kcal/day for 8 weeks, followed by a 4-week refeeding period. The VEX group also participated in supervised high-intensity functional exercise training consisting of resistance and aerobic training of up to 5 days per week.

RESULTS

A total weight loss of -14.5kg [95%CI -17.5 to -11.5] and -9.3kg FM [95%CI -11.0 to -7.6] was achieved (measured by DEXA). Fat-free mass (FFM) reduction occurred (-3.9kg [95%CI -5.5 to -2.3]), with a trend towards preservation in the VEX group. The VO group reduced AHI by 42.9%, moving from severe to moderate OSA. The VEX group’s AHI change (-32.6%) approached but did not reach the moderate category post-intervention.

CONCLUSION

The VLED, with or without exercise, proved feasible and well-tolerated and demonstrated positive outcomes in body composition and AHI. The VEX group suggested a potential trend in preserving FFM compared to the VO group. These results are promising, indicating the need for a larger, definitive trial to confirm these findings and explore the impact of exercise on FFM preservation in this population.
CONCURRENT VALIDITY OF CLINICAL EQUATIONS TO PREDICT RESTING ENERGY EXPENDITURE COMPARED TO INDIRECT CALORIMETRY IN NON-SEVERE BURN PATIENTS
Authors: Osborne Mr Tyler , Edgar Associate Professor Dale , Fairchild Associate Professor Timothy , Galna Dr Brook , Wood Winthrop Professor Fiona , Allan Ms Brodie , Huray Mr Thomas Le , Wall Associate Professor Bradley
Published: May 2024

Underfeeding and overfeeding can inhibit recovery and negatively impact quality of life during and after receiving treatment for a burn injury. Clinicians rely on accurate estimation of resting energy expenditure to avoid overfeeding or underfeeding their patients. The criterion standard for measuring resting energy expenditure is indirect calorimetry. Many burn services use predictive equations to prescribe feeding regimes because they are cheaper, time efficient and logistically more expedient than indirect calorimetry and do not require specialised equipment. However, the validity of these clinical equations has not been established in non-severe burns (<15% total burn surface area, TBSA). In this study, resting energy expenditure was predicted for 35 participants with non-severe burn injuries using seven clinical equations and compared with the criterion-standard (indirect calorimetry). We found that all clinical equations may be inaccurate in predicting resting energy expenditure measured using indirect calorimetry, with the Schofield equation agreeing most closely (95% limits of agreement: -836 to 711 kcal.day-1). Agreement between clinical equations and indirect calorimetry remained poor even after correcting for TBSA. Our findings indicate clinical equations may not accurately predict resting energy expenditure of people who have sustained a non-severe burn. As such, we urge caution against relying solely on the existing predictive equations to guide clinical decisions regarding energy intake after non-severe burns.
THE EFFECT OF WATER DOUSING ON HEAT STRAIN AND PERFORMANCE DURING ENDURANCE RUNNING IN THE HEAT
Authors: Anderson Mr Mitchell , Chaseling Dr Georgia , Bellenger Dr Clint , Chalmers Dr Samuel
Published: May 2024

INTRODUCTION

Water dousing (pouring water on the body) is an easy-to-implement cooling method while running due to the availability of water at race aid stations, and may decrease the risk of heat illness and improve performance. However, dousing has not been investigated in extended duration running (i.e., ≥10 km), a typical distance in both elite and community level events. AIMS: Assess the effect of water dousing on heat strain and performance during self-paced and fixed-intensity exercise in the heat. DESIGN: Crossover, block randomised controlled trial.

METHODS

13 trained runners completed a 10 km time trial (TT) and 60 min fixed pace run (60% velocity of VO2max) in a 30°C, 47% relative humidity environment using either water dousing (DOUSE) or no dousing (CON).

RESULTS

10 km TT performance was faster in DOUSE compared to CON (44:11±6:14 vs. 44:38±6:03 min:s; p=0.033). Change in core temperature (Tc) was not different between groups during the TT (+0.02±0.33°C in DOUSE; p=0.853) or fixed pace run (+0.02±0.30°C; p=0.848). Change in mean skin temperature (Tsk) was lower in DOUSE during the TT (-1.80±0.63°C; p<0.001) and fixed pace run (-1.38±0.78°C; p<0.001). Heart rate (HR) was lower for DOUSE during the fixed pace run (-3.5±5.5 bpm; p=0.041) but not during the TT (-0.2±4.2 bpm; p=0.853). Thermal sensation was lower for DOUSE during the TT (-49.3±41.9 mm; p<0.001) and fixed pace run (-44.7±27.6 mm; p<0.001). Rating of perceived exertion (RPE) was not different between groups for the TT (-0.2±0.9; p=0.390) or fixed pace run (-0.2±1.0; p=0.480).

CONCLUSION

Water dousing improves 10 km TT performance in the heat but does not mitigate a rise in Tc. The positive change in thermal perception (via lower skin temperature) likely drives this ergogenic effect.
EARLY POST-OPERATIVE CLINICAL OUTCOMES IN PATIENTS UNDERGOING TOTAL KNEE ARTHROPLASTY COMPARING IN-PERSON CLINIC VERSUS TELEHEALTH-DELIVERED REHABILITATION PROGRAM: A NON-INFERIORITY TRIAL
Authors: Seaby Mr Ray , Ebert Dr Jay , Joss Dr Brendan , Edwards Dr Peter , Ackland Prof Tim
Published: May 2024

INTRODUCTION AND AIMS

Rehabilitation following total knee arthroplasty (TKA) is essential to mitigate delay in physical recovery and facilitate optimum patient outcomes. Telehealth is emerging as a cost-effective and efficacious delivery method. The aim of this study was to investigate the early post-operative outcomes of patients following a telehealth-delivered rehabilitation program (Tele) compared with those following conventional outpatient rehabilitation (Clinic) in patients following TKA.

METHODS

A single-blinded, randomized controlled non-inferiority trial was conducted, with 108 participants scheduled for primary TKA randomly allocated to a 6-week, telehealth-delivered rehabilitation program (n=54) or a 6-week supervised, in-person rehabilitation program (n=54). Knee flexion range of motion (KF-ROM) and the Quality of Life subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS-QOL) were collected pre-surgery and 7-weeks post-surgery. A linear mixed-effect model was used to assess differences between groups over time for both outcome measures. Change in KOOS-QOL of greater than 10 points was used to establish minimally clinically important change (MCIC), with chi square analyses used to assess between-group differences.

RESULTS

Baseline KF-ROM measures were 124.1° and 122.2° for telehealth-delivered and in-person groups respectively; and 108.7° and 111.6° at 7-week post-surgery. KOOS-QOL scores were 32.7 and 33.3 at baseline for the respective groups; and 60.9 and 62.9 at week-7. There were no significant differences in between group changes over time for both KF-ROM (mean difference = -2.9°, 95% CI = -7.7 to 1.8; p=0.226) and KOOS-QOL (mean difference = -2.1, 95% CI: -10.0 to 5.9; p=0.611). Chi square analyses revealed no differences between groups meeting the MCIC (Tele = 71%; Clinic = 79%) in KF-ROM (X2 = 0.78, p = 0.377).

CONCLUSION

Short term outcomes following TKA are not different between telehealth-delivered and conventional supervised rehabilitation. Telehealth may provide an effective rehabilitation option for patients undergoing TKA.
PAINFUL VS NON-PAINFUL EXERCISE IN PEOPLE WITH KNEE OSTEOARTHRITIS: A FEASIBILITY STUDY
Authors: Ram Mr Adrian , Jones Matthew D , Thom A/Prof Jeanette , Booth Dr John , Gibbs Dr Mitchell T. , Pandit Mr Anurag , Kovats Mr Alexandre , Ram Mr Pramod
Published: May 2024

INTRODUCTION & AIMS

Painful exercise reduces pain in the short-term compared to non-painful exercise in people with chronic pain. However, integration of painful exercise into knee osteoarthritis (OA) treatment is contentious among clinicians, with the clinical implications unknown. This study aimed to explore the feasibility of painful versus non-painful exercise in people with knee OA.

METHODS

Participants were randomised into a painful (INT; RPE 5-6) or non-painful (CON; RPE 4-5) who performed exercise twice per week for 6 weeks. Both groups also received standardised education. The primary outcomes were feasibility, assessed using participant recruitment, retention, adherence, and compliance rates. Secondary outcomes included pain, function, strength, pressure pain thresholds, psychosocial measures and adverse events. Immediate pre- and post-exercise pain were also measured.

RESULTS

21 people with knee OA (66 ± 9 years old; BMI: 29.4 ± 8.1) completed the study. Feasibility was achieved and supported by high rates of recruitment (INT = 89%, CON 89%), retention (INT = 91%, CON = 100%), adherence (INT = 91%, CON = 92%), and compliance (INT = 72%, CON = 81%). Pain reduced in both groups (mean difference [95% CI]; INT = -0.7 [-1.8 to 0.4]; CON = -1.5 [-2.7 to 0.4]), and strength (1-RM leg press) improved with a moderate effect in favour of INT (12.8 [0.2 to 25.9], d = 0.97, p = 0.046).

CONCLUSION

Incorporating painful exercise into treatment for individuals with knee OA is feasible. Several potential benefits include positive changes in maladaptive beliefs and behaviours and enhanced systemic benefits associated with higher intensity exercise. Future research comparing the efficacy of painful versus non-painful exercise in knee OA and other chronic musculoskeletal conditions is warranted.
DEVELOPMENT OF A NOVEL ALGORITHM FOR THE AUTOMATIC DETECTION OF MULTIDIRECTIONAL LOCOMOTION WITHIN TEAM SPORTS
Authors: Cummins Dr Cloe , Handley Mr Caleb , Charlton Mr Glen , Shorter Dr Kathleen
Published: May 2024

INTRODUCTION & AIMS

Field-based sports are characterised by their intermittent nature requiring both, multidirectional locomotion and, sports-specific movements at a range of intensities. Traditionally, athlete-monitoring has focused on quantifying workload based on movement intensity with minimal regard to the direction of locomotion [1]. The aim of this study was to develop and evaluate an algorithm to detect and classify multidirectional movement using signal characteristics from a microtechnology device.

METHODS

Rugby league referees (n=13) undertook a match-play simulation protocol (i.e., changes in movement speed and locomotion direction) [2], with microtechnology and video data collected across five-trials. Video data was reviewed to identify movement anomalies outside of the simulation protocol for exclusion. From the 100Hz microtechnology data, acceleration measures were used to classify the start and end point of each movement (i.e., backwards, forwards, sideways or other) or marked for exclusion from the algorithm development. The classified sensor data was processed in Python (v3.11), where data were split into training and testing datasets. A Recurrent Neural Network (Long Short-Term Memory) [3] was implemented to develop and validate an algorithm. Model performance was assessed via accuracy, sensitivity, precision and Area Under the Receiver Operating Characteristic Curve (AUC), using the testing dataset.

RESULTS

The accuracy of the model was 0.973 ± 0.010. Sensitivity and precision of the model varied between movement direction, but was >0.928 and >0.922, respectively. The AUC of the model was 0.988 ± 0.007.

CONCLUSION

The current study highlights the effectiveness of a microtechnology based algorithm for automatically classifying multidirectional locomotion of various velocities. Practically, such algorithm can be used to inform evidence-based training in relation to multidirectional locomotion. Whilst model performance was very-high, further research should examine the feasibility of applying the algorithm to match-play datasets to enhance athlete-monitoring processes.
DETERMINANTS OF ADULT CARDIAC STRUCTURE: DEVELOPMENTAL INFLUENCE OF PHYSICAL ACTIVITY, SYSTOLIC BLOOD PRESSURE AND TV WATCHING
Authors: Haynes Mr Andrew , Collis Ms Julie , Carson Mrs Jennie , Srivastav Miss Khushie , Naylor Ms Louise H. , Green Mr Daniel John
Published: May 2024

INTRODUCTION

The impacts of health-related behaviours and risk factor exposures across childhood and adolescence on the adult heart are largely unexplored. We investigated whether early-life trajectories for physical activity (PA), sedentary behaviour and systolic blood pressure (SBP) are associated with cardiac structure in adulthood.

METHODS

Data collected throughout childhood and adolescence on PA, TV watching and SBP in a cohort study were used to develop antecedent trajectories. At age ∼29yrs, participants were invited to undergo an echocardiogram, to assess left ventricular mass (LVM), LV internal diameter (LVID) and LV wall thickness (LVWT). Analysis was performed between trajectories, separately by sex.

RESULTS

723 participants were included. In males, LVM was greater in the antecedent High-PA trajectory (184.1±35.6g), compared to both Mid-PA (171.7±36.1g, P=0.014) and Low-PA (166.7±38.0g, P=0.021). This was related to greater LVID in High-PA compared to both Mid-PA (Δ1.3±0.5cm, P=0.018) and Low-PA (Δ1.3±0.8cm, P=0.087) groups; there were no differences in LVWT (all P>0.050). No differences were found in heart structure between PA trajectory groups in females (all P>0.050). For antecedent SBP, LVM was lower in both the Low-SBP (155.7±30.5g) and Normal-SBP groups (172.9±36.7g) compared to both High-normal (184.8±32.9g) and High-SBP (206.2±41.3g) in males (all P<0.001). This was primarily driven by larger LVWT in High-normal (Δ1.2±0.2g, P=0.001) and High-SBP groups (1.9±0.5g, P=0.001); no differences were observed for LVID (P=0.398). These findings for SBP were similar in females, with the highest SBP group having the greatest LVM and LVWT (all P<0.001). There were no significant impacts of antecedent TV trajectories on adult cardiac measures (all P>0.050).

CONCLUSION

Higher developmental SBP is associated with larger heart size and wall thickness in adulthood. Higher developmental PA levels are associated with larger cardiac chamber dimension in adult males, but not females. These findings suggest adult cardiac structure may be influenced by early-life risk factor exposures.
EXERCISE INTERVENTIONS ON THE ACUTE MEDICAL WARD: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: McCaig Mrs Jane , Gordon Associate Professor Brett , Taylor Dr Carolyn
Published: May 2024

INTRODUCTION & AIMS

An acute hospital stay is associated with high proportions of sedentary time, and bed rest, with low physical activity participation for the stay duration. Exercise prescription on the acute inpatient medical ward can prevent decline, or at least maintain, physical outcomes in the adult population. The purpose of this systematic review with meta-analyses was to evaluate the effectiveness of exercise intervention on the acute inpatient medical ward on physical outcomes of muscle strength, aerobic capacity and balance in adults, compared with usual care.

METHODS

Medline, CINAHL and EMBASE were searched from inception to 20th April 2023. Randomised controlled trials in English, which reported muscle strength, aerobic capacity or balance outcomes for adults who received an exercise intervention on an acute medical ward were included. Studies were excluded if they did not have a control group receiving usual care. Study quality was assessed using the PEDro and TESTEX scales. The GRADE rating assessed quality of evidence to evaluate certainty of effect. Where studies with continuous data used different measures of assessment, and reported post-test outcomes, standardised mean differences with a random effects model was used. For studies with continuous data that used different measures of assessment, and reported change from baseline scores, a weighted mean difference with a random effects model was used. Significance was set at p<0.05.

RESULTS

Twelve studies were included, with 1,273 unique participants, which compared exercise intervention with usual care. Low quality evidence demonstrated a significant difference between groups for aerobic capacity (p=0.02) and maximum isometric strength (p=0.001). A meta-analysis of balance outcomes could not be performed.

CONCLUSION

Exercise prescribed during an acute medical ward stay may improve participants’ aerobic capacity and maximum isometric strength.
PAINFUL VS NON-PAINFUL EXERCISE ON CREPITUS IN PEOPLE WITH KNEE OSTEOARTHRITIS: A MIXED-METHODS ANALYSIS
Authors: Kovats Mr Alexandre , Ram Mr Adrian , Jones Matthew D , Booth A/Prof John , Gibbs Dr Mitchell T. , Thom A/Prof Jeanette
Published: May 2024

INTRODUCTION & AIMS

Crepitus (or physiological noise) is a key criterion in the diagnosis of knee osteoarthritis (OA). Exercise is foundational to guideline-based care for knee OA, however the effect exercise on knee crepitus is unknown. This study aimed to explore the perceptions of people with knee OA following a 6-week accredited exercise physiologist (AEP) led intervention involving painful vs non-painful exercise, especially in relation to their knee crepitus.

METHODS

Participants were randomly assigned to either a painful (higher intensity) or non-painful (lower intensity) exercise program supervised by an AEP twice a week for six weeks with concurrent education. Volunteers partook in a post-intervention semi-structured interview with questions surrounding their experience and perceived outcomes of the program. Thematic qualitative analysis was conducted and compared to the Knee Injury and Osteoarthritis Outcome Score (KOOS) crepitus question (0 - 4 scale).

RESULTS

Eleven participants volunteered. Qualitatively, approximately half of the participants self-reported a decrease in their knee crepitus following the program “I haven’t had the creaky knees so much”, with the rest stating their crepitus did not change. No participants perceived their crepitus increased (n=9 no change, n=2 decreased) or said that their crepitus was worse, “the noise and grinding doesn’t become evident (now) until the weights become higher”. Quantitatively, KOOS crepitus scores also did not change following the intervention [mean (SD) (2.4(1.0) to 2.1(1.3), p=0.19)]. There were no differences between exercise groups in self-perceived crepitus results, and most said that the exercise program was beneficial “Right after this whole program, I find that I can move much easier.”

CONCLUSION

Exercise at higher intensities (into painful range) does not change crepitus or may improve it for some. People with OA perceive that exercise at both higher and lower intensity is beneficial and enjoyable.
A LITTLE BIT OF EXERCISE GOES A LONG WAY – INCREASING INDEPENDENCE OF AGED CARE RESIDENTS WITH PARKINSON’S DISEASE
Authors: Raynor Associate Professor Annette , Casson Ms Sally , Scott Ms Stacey , Grieve Ms Jennifer , Fortington Dr Lauren
Published: May 2024

INTRODUCTION & AIMS

Supporting people with Parkinson’s Disease to remain active when living in residential aged care (RAC) is assumed to have benefits, such as reducing falls risk, improving ability to transfer independently, and reducing time spent being sedentary. However, many RAC-facilities are under-resourced making it difficult for staff to support residents with exercise. Accredited exercise physiologists (AEP) enable residents to improve or maintain movement through exercise. The aim of this study was to establish feasibility and value of AEP-services for people with Parkinson’s Disease in RAC.

METHODS

A 12-week AEP-led exercise program was delivered at multiple RAC-sites across Perth. An individualised exercise plan was designed for each participant, comprising 2 x 50-minute supervised group sessions per week, together with a 15-minute unsupervised morning program. Baseline and follow-up testing was undertaken by the AEP, inclusive of balance (mini-Balance-Evaluation-System-Test (miniBESTest)), mobility (2-minute-walk-distance, Actigraph), fatigue (PD fatigue scale) and quality of life. Descriptive analysis will be presented, reflecting the total hours of AEP-training provided, room attendance records from RAC-staff, and changes in pre-post balance, mobility, falls, quality of life, depression, behaviour, and fatigue.

RESULTS

To date, five participants have enrolled (3 women; 2 men) (recruitment is ongoing). Individual results for baseline testing showed the range of abilities and challenges for these participants (Mini-BESTest range of 5-16 and 2-minute walk distance of range 0-61). Not all tests could be completed by all participants. Post-test and change scores will be presented.

CONCLUSION

Due to the clinical heterogeneity of the disease, the AEP is required to prescribe according to each individual needs whilst maintaining the fidelity of the exercise intervention. Challenges have been presented with conducting research in this environment including recruitment of participants due to level of cognition, conflicts with participant scheduling, operational needs of the facility and facility closures (Covid- and gastro-outbreak).
FEASIBILITY, ACCEPTABILITY, AND EFFICACY OF A PILOT EXERCISE PHYSIOLOGY GROUP SERVICE FOR OLDER ADULTS WITH TYPE 2 DIABETES
Authors: McLeod Dr Kelly , Thom A/Prof Jeanette , Jones Matthew D , Parmenter A/Prof Belinda
Published: May 2024

INTRODUCTION & AIMS

Type 2 diabetes prevalence increases with ageing, affecting over half a million older Australians. Medicare type 2 diabetes group interventions can support older adults’ diabetes management. However, Accredited Exercise Physiologist (AEP) delivered service feasibility and acceptability is yet to be assessed. This study aimed to assess feasibility, acceptability and preliminary efficacy of a Medicare type 2 diabetes group exercise and education intervention for older adults.

METHODS

This study was a single arm feasibility, acceptability, and preliminary efficacy trial of an AEP delivered type 2 diabetes group service for older adults. Participants attended the Diabetes Clinic once per week for 8 weeks, for a group exercise and education session. Attendance, participation, enjoyment, suitability, usefulness, and pre-post clinical health outcomes were assessed.

RESULTS

The intervention was feasible and acceptable, with 40 participants (71.8±4.5 years old, range 65-81 years, 45% female) attending 87% of sessions, with high treatment compliance within sessions (aerobic training: 86%; resistance training: 86%; education: 87%). Almost all participants (97%) strongly agreed that the program was enjoyable. Significant post intervention improvements (mean difference [95% CI]) were observed for right arm systolic blood pressure (SBP) (-7mmHg [-12, -2], p=0.007), left arm diastolic blood pressure (DBP) (-3mmHg [-5, -0], p=0.021), body weight (-0.7kg [-1.3, -0.0], p=0.039), waist circumference (-1.3cm [-2.2, -0.4], p=0.006), 6-minute walk test (22.8m, [9.1. 36.5], p=0.002), 5 times sit to stand (-0.8sec [-1.2, -0.5], p<0.001), short physical performance battery ordinal scale (0.3 [0.1, 0.5], p=0.009), and whole-body muscle strength (32.2kg [22.3, 42.1], p<0.001).

CONCLUSION

Older adults attended and enjoyed the AEP led Diabetes Clinic program, while also improving fitness and cardiometabolic health outcomes. Ways to enhance referrals and engage older adults in the programs warrant further investigation. The potential for additional sessions to achieve greater physical activity engagement and diabetes self-management should be further investigated.
SEX DIFFERENCES IN CEREBRAL BLOOD FLOW VELOCITY RESPONSES TO EXERCISE IN THE HEAT
Authors: Loacatelli Mr Joao Carlos , Carter Mr Howard H. , Collis Ms Julie , Haynes Mr Andrew , Dechichi Ms Juliene Goncalves Costa , Wigati Ms Kristanti , Criddle Mr Jesse , Naylor Ms Louise H. , Green Mr Daniel John
Published: May 2024

INTRODUCTION & AIMS

Global warming poses a risk for the development of heat-related physiological impairment, which can be aggravated when exercising in hot conditions. The aim of the present study was to investigate acute effects of exercising in hot conditions on cerebral blood flow velocity and systolic function in healthy individuals and to explore possible sex differences.

METHODS

The experimental condition consisted of walking on a treadmill, at 5km/h and 2% incline, inside a heat chamber at 40°C (50%RH), for 90 minutes. Middle cerebral artery blood flow velocity (MCAv) and left ventricular global longitudinal strain (GLS; a sensitive index of systolic function), were assessed at baseline and every 30 minutes by means of transcranial Doppler and speckle-tracking echocardiography, respectively. Data is expressed in delta (Δ) and standard error.

RESULTS

Twenty-six individuals (13♂,13♀ 27.1±1.0yrs, P=0.02) completed the experimental protocol. Both males and females exhibited non-significant increases in MCAv from baseline at 30 minutes (♂Δ=2.55±2.15 P>0.05; ♀Δ=0.54±2.53cm.s-1, P>0.05; interaction P=0.63), followed by significant decreases relative to 30min, at 60min (♂Δ=-4.0±1.23 P=0.04; ♀Δ=-5.41±1.56cm.s-1, P=0.03; interaction P=0.63) and 90 minutes (♂Δ=-6.08±1.37 P<0.01; ♀Δ=-7.39±1.40cm.s-1, P<0.01; interaction P=0.63). In males, there was a significant decrease in GLS from baseline at 30min (Δ=2.44±0.69%, P<0.05), 60 (Δ=2.79±0.73%, P=0.03), and 90 (Δ=3.49±0.89%, P=0.03) minutes; no significant changes were observed in females.

CONCLUSION

Males and females presented similar patterns of change in cerebral blood flow velocity, including significant decreases with prolonged heat exertion. These changes occur in both sexes, despite changes in systolic strain only being apparent in males. These data suggest that sex differences may exist in the regulation of cerebrovascular responses to exercise in the heat in humans.