bluuebunny/crossref_metadata_2025 huggingface dataset:
BRACHIAL, FEMORAL, AND SKIN HAEMODYNAMIC RESPONSES TO WALKING IN HOT CONDITIONS: COMPARISON BETWEEN MALES AND FEMALES
Authors: Dechichi Mrs Juliene , Carter Mr Howard H. , Loacatelli Mr Joao Carlos , Wigati Ms Kristanti , Criddle Mr Jesse , Haynes Mr Andrew , Naylor Ms Louise H. , Green Mr Daniel John
Published: May 2024

INTRODUCTION & AIMS

Heat exposure induces acute changes in arterial function, but sex differences have not been fully addressed.

METHODS

Participants walked (5km/h; 2% incline) in a climate chamber (42°C;50%RH) for 120mins. Cutaneous microvascular function (laser doppler flowmetry), conduit artery haemodynamics (Doppler ultrasound) and core temperature were measured at baseline, and every 30min.

RESULTS

14♂ and 15♀ completed 120min. At baseline, differences in core temperature (Tc) between males and females were not significant (37.2±0.1 vs 37.0±0.1°C; P=0.06). Across all 5 timepoints, females exhibited larger Tc than males (P=0.019). At baseline, males had larger brachial (3.89±0.11 vs 3.13±0.09mm, P<0.001) and femoral (6.22±0.16 vs 5.29±0.14mm, P=0.001) diameters than females. A significant interaction (P=0.047) indicated that brachial diameter increased more in response to heat exertion than in males, whereas no sex difference was apparent in femoral diameter change. Males and females had similar baseline brachial flows (♂80.1±11.2 vs ♀57.0±7.09ml/min, P=0.087), but males had larger baseline femoral flows (♂263.0±23.9 vs ♀151.5±18.6 ml/min, P=0.010). No sex differences were apparent in the terms of the increases in brachial or femoral flows. Finally, at baseline males and females had similar skin blood flux (♂22.6±2.7 vs ♀18.3±2.9PU), but males demonstrated larger increases during heat exertion (P=0.029).

CONCLUSIONS

Males exhibit larger baseline artery diameters and flows in vessel beds feeding active (femoral) and inactive (brachial) limbs. In response to heat exertion, men and women exhibit similar increases in conduit diameter and flow to active muscle beds (femoral responses). In the inactive forearms, which reflect thermoregulatory responses, females had larger brachial artery diameter changes, but blood flow responses were similar between the sexes and men demonstrated larger increases in skin perfusion. These data indicate that responses to heat exertion differ in the upper and lower limbs, with sex-differences apparent in each of these territories, and at distinct levels of the arterial hierarchy.
REDUCED AEROBIC FITNESS IS ASSOCIATED WITH IMPAIRED CEREBROVASCULAR FUNCTION IN INDIVIDUALS WITH ATRIAL FIBRILLATION
Authors: Thomas Dr Hannah , Roberts Tori , Brayner Dr Barbara , Parker Dr Lewan , Keske Prof Michelle , Smith A/Prof Kurt , Way Dr Kimberley
Published: May 2024

INTRODUCTION & AIMS

Lower aerobic fitness (V̇O2peak) is associated with higher risk of cerebrovascular disease. However, the relationship between V̇O2peak and cerebrovascular function and cerebral blood velocity at rest and during exercise has not been investigated in adults with atrial fibrillation (AF). We aimed to compare resting and exercise cerebral blood velocity responses and cerebrovascular function in individuals with AF to healthy controls.

METHODS

Eight inactive adults either with AF or healthy age-matched controls (AF: n=4, 64±6 years, 50% female; control: n=4, 66±4 years, 75% female) completed a maximal graded exercise test to measure V̇O2peak. Transcranial Doppler was used to measure bilateral middle cerebral artery velocity (MCAv). Vascular function was assessed by measuring MCAv increases and time to peak following a 30s hypercapnia stimulus (9% CO2, 21% O2, and balanced nitrogen), and MCAv during aerobic exercise (3-minute stages at 40%, 60% and 80% V̇O2peak). Blood pressure, heart rate and end-tidal gases were collected alongside MCAv.

RESULTS

Compared to controls, individuals with AF (both P<0.01) had higher BMI (AF: 31.8±2.0 kg/m2; control: 27.3±0.6 kg/m2), lower V̇O2peak (AF: 19.9±2.5 mL/kg/min; control: 33.7±5.8 mL/kg/min), and similar blood pressure. Resting right and left MCAv was higher in the AF group (R: 66.6±34.0 cm/s; L: 44.2±10.1 cm/s) compared to the control (R: 36.1±6.7 cm/s; L: 34.9±8.7 cm/s); this was not significant (P=0.121 and 0.258). Right MCAv was higher than left MCAv in individuals with AF but this was not significant (P=0.247). Hypercapnia and exercise induced MCAv and time to peak were similar between groups (P>0.05).

CONCLUSION

Lower V̇O2peak may be associated with increased resting MCAv in individuals with AF. Furthermore, there may be regional disparities in MCAv in individuals with AF. Future studies with larger sample sizes investigating potential mechanisms and volumetric cerebrovascular changes (e.g., vessel diameter, arterial stiffness) in AF are warranted.
PERSPECTIVES OF KIDNEY TRANSPLANT RECIPIENTS REGARDING THE BARRIERS AND ENABLERS TO EXERCISE
Authors: Bates Alexander , Shen Yulan , Evans Loreen , Mantilla Christine , Letton Meg , Lambert Assoc Prof Kelly , Arnold Assoc Prof Ria
Published: May 2024

BACKGROUND

Kidney transplant is a second chance at life for people with kidney failure. However, the post-transplant journey is difficult with high rates of complications such as new onset diabetes, steroid induced weight gain and cardiovascular disease. While exercise has the potential to improve quality of life and reduce the susceptibility these complications, kidney transplant recipients (KTRs) report lower levels of exercise and physical activity compared to the general population. Our qualitative study aimed to explore the barriers and enablers to exercise in KTRs.

METHODS

People with a stable kidney transplant treated in the Illawarra Shoalhaven Local Health District were invited to participate in the study. Interviews were conducted with n=11 KTRs with an age of 25-74 years, transplant duration of 1-19 years, and comorbidities included hypertension (n=9), cancer (n=4), diabetes (n=3) and dyslipidemia (n=4). Interviews were transcribed then inductively coded and deductively categorised according to the Theoretical Domains Framework and the Capability, Opportunity, and Motivation Model of Behaviour.

RESULTS

KTRs expressed a desire to exercise though barriers specific to transplant were identified. Barriers included a lack of knowledge and specific guidance, physical limitations (e.g. fatigue, illness related to medications or comorbidities, injury or pain), and fear of harming the kidney (e.g. herniation, pain/pulling at surgical site, dehydration, immunocompromised state). Enablers to exercise included already living an active lifestyle, perceived mental benefits, exercise preferences and social support.

CONCLUSIONS

A key finding of this research was a preference from KTRs specific exercise information and guidance after kidney transplant. The findings of this study can be used to inform the development of exercise resources and interventions for KTRs and their health care professionals within the local community and at a greater level.
OPTIMISING THE LADDER RAISE TASK IN THE PHYSICAL APTITUDE TEST FOR FIRE-FIGHTERS
Authors: Parker Bryany , Watsford Prof. Mark , Fullagar Hugh
Published: May 2024

INTRODUCTION & AIM

Identifying physically capable candidates is a crucial component of recruiting firefighters given the physical demands of the occupation. At the request of a local fire agency, a review of one test item within the physical aptitude testing protocol was undertaken with the aim of this pilot study to compare physical and perceptual performance between the ladder raise task and a suite of surrogate tests to determine suitability for use in recruitment screening.

METHODS

23 participants (unskilled in firefighting) performed the criterion ladder task (‘Ladder’) and three surrogate tasks: stationary constant-tension overhead press (existing test item; ‘Reel’); barbell overhead walk/return (‘Barbell’); overhead modular ladder lift (Modular Under-Running Apparatus (‘MURA’)). The tests were segmented into six components relating to lifting and under-running the device. Task duration, task completion, perceptual and kinetic variables were measured. Pearson’s correlation, OLP regressions and paired t-tests assessed relationships between the Ladder and surrogate tasks.

RESULTS

The Reel most closely reflected the criterion task in component 1 (lifting) for both peak and average forces (dz =-0.11, p=0.920; dz=-0.11, p=0.532 respectively). The MURA and Barbell were most closely aligned to the Ladder in all other objective values with trivial-small differences evident. The MURA was most closely aligned with the Ladder in subjective measures for components-2/5 and components-3/4 including difficulty (dz= -0.41, p=0.133; dz=-0.32, p=0.250, respectively), fatigue (dz= -0.25, p=0.354; dz=-0.10, p=0.796, respectively) and task representation (7.2[1.6]; 7.4[1.6], respectively).

CONCLUSION

The currently used Reel task revealed low construct and content validity. The MURA was shown to be the most appropriate surrogate option for the local fire agency to further investigate for use within recruitment physical testing. Further investigation with a sample of career firefighters should be undertaken to verify face validity at the industry level.
PROMOTING PARTICIPATION IN COMMUNITY RUNNING FESTIVALS FOR INDIVIDUALS WITH PARKINSON’S DISEASE - A MODEL FOR MEANINGFUL PARTICIPATION
Authors: Reeves Mr Nathan , Clanchy Dr Kelly , Atkins Mr Toby , Ternes Mr Matt
Published: May 2024

INTRODUCTION AND AIMS

Community-based walking and running groups have become popular social phenomena in recent years. Integrating individuals with Parkinson’s disease into community-based walking and running events confers multiple socio-biological benefits, but may be problematic for individuals with Parkinson’s disease in the later stages of the disease progression.

METHODS

This research evaluates the participation of a group of individuals with Parkinson’s disease in a long-standing community running festival, the Gold Coast Marathon Festival. Evaluation of participation comprised: 1) description of the activities undertaken by the Exercise Physiologists to ensure the safe and effective participation of the interested parties; and 2) a qualitative evaluation of the participant’s experiences with the event.

RESULTS

Ten adults with Parkinson’s disease (70% male), mean age 69.6 ± 7.8 years (range = 57-79) participated. Time post-diagnosis ranged 1 to 15 years (mean = 6.7 ± 4.4 years). Participants registered to complete one of two distances: 5.7 km (n = 9) or 700 m (n = 1). Activities undertaken by the Exercise Physiologist prior to participating were divided into three themes: participation, safety, and administrative requirements. Participant experiential data was divided into six themes: preparation prior to participating; pre participation planning and organisation; reasons/meaning for choosing to participate; barriers for participating; event recovery; and event suitability. The data collated was triangulated to provide recommendations to facilitate participation in similar events.

CONCLUSION

The results of this study demonstrate that with effective planning and coordination, participation in community-based walking and running events confer physical and mental health benefits for individuals with Parkinson’s disease. However, significant barriers need to be addressed prior to participation to ensure meaningful participation. This paper provides recommendations for practicing Exercise Physiologists who wish to promote participation of their own clients with Parkinson’s disease in similar initiatives.
DOES N-ACETYLCYSTEINE SUPPLEMENTATION DURING AN ALTITUDE TRAINING CAMP ENABLE TRAINING QUALITY AND SUCCESSFUL PERFORMANCE OUTCOMES? A COMPARATIVE CASE STUDY
Authors: Slattery Dr Katie , Sharma Dr Avish , Morris Dr Kirstin
Published: May 2024

INTRODUCTION & AIMS

Elite athletes regularly incorporate training at altitude into their programs to enhance performance. However, the additional stress of exposure to a hypoxic environment needs to be carefully managed by coaches and sport scientists. Supplementation with antioxidants, such as N-acetylcysteine (NAC) may support the athlete’s immune system to cope with this stress. Preliminary evidence also suggests NAC may further promote haematological adaptations to hypoxia. Combined, the potential health and adaptive benefits of NAC warrant further investigation. Conducting ecologically valid and scientifically robust research in an elite sporting setting can be challenging due to small sample sizes, an inability to experimentally manipulate training, and the inherent complexity of the training environment. To account for these challenges, a comparative case study approach was used.

METHODS

Thirteen swimmers completed a three-week ‘Live-High, Train-High’ camp in Flagstaff, USA (elevation 2,100m). Beginning four days prior to the camp commencing, swimmers where randomly assigned in matched groups to consume NAC (1,200mg per day; n = 6) or a placebo supplement (n = 7) for 14 days. With each athlete defined as a case, fuzzy-set qualitative comparative analysis was used to examine the configurational effects of attributes (i.e., antioxidant support, sufficient ferritin, maintained body mass) previously associated with successful altitude training camps on physiological and performance outcomes.

RESULTS

NAC was not a solely sufficient or necessary attribute for increased haemoglobin mass. Higher consistency in haemoglobin mass was observed with high training quality. NAC and high training quality contributed to performance improvements.

CONCLUSION

Swimmer responses were highly individual with successful physiological and performance outcomes achieved by some, irrespective of having attributes that can impair adaptation to altitude training. Subjective training quality provided important contextual information. Fuzzy-set qualitative comparative analysis is a novel approach in sports science to evaluate the interrelationship of attributes that can impact performance.
THE USE OF OUTCOME MEASURES IN EXERCISE PHYSIOLOGY CLINICAL PRACTICE IN AUSTRALIA
Authors: Dwyer Mr. Patrick , Pascoe Dr. Deborah
Published: May 2024

INTRODUCTION AND AIMS

Outcome measure (OM) implementation in clinical settings has become a standard in allied health evidence-based practice over the last 20 years, with their use being encouraged by governing and funding bodies. This study investigated the application of standardised OMs by accredited exercise physiologists (AEPs) in Australia. This study aimed to identify commonly used OMs and explore the barriers and facilitators to OM implementation in AEP clinical practice in Australia.

METHODS

This study utilised a questionnaire-based, cross-sectional, descriptive design to determine the OMs used by AEPs in current clinical practice and investigated trends related to OM use within different AEP demographics and settings. Participants were also asked to identify any barriers and facilitators that affected their use of OMs in clinical practice. The OMs that were most frequently used were identified and the results analysed according to demographic variables, to determine how they influenced OM use in clinical practice.

RESULTS

Eighty-seven OMs were assessed, with 41% ‘never’ used by most participants. A further 48% of the OMs were identified as being underutilised with over 50% of respondents selecting ‘never’ or ‘sometimes’. Only three OMs were used frequently by most respondents. The most common barriers to OM use identified related to a lack of time, knowledge, and limited perceived value from clinicians. These reflect the barriers identified in prior research related to other allied health professions.

CONCLUSIONS

AEPs in Australia experience many of the same barriers to OM use as other allied health disciplines. Currently, the standardised OM resource for AEPs is outdated and underutilised in clinical practice. Updated resources for clinicians in the form of educational seminars and a searchable online database with easy access to evidence-based outcome measures are essential to the promotion of OMs to support evidence-based practice for AEPs.
RESULTS OF THE ECHO-R TRIAL – A PRAGMATIC, TELEHEALTH-DELIVERED EXERCISE INTERVENTION FOR WOMEN WITH RECURRENT OVARIAN CANCER
Authors: Spence Dr Rosa , Creed Melissa , Rye Sheree , Hayes Prof Sandra
Published: May 2024

INTRODUCTION & AIMS

Wide-spread and equitable uptake of exercise into standard cancer care will require evidence of safety and efficacy across all cancer and treatment types. People with rarer cancers, lower survival prospects, and higher morbidity have been under-represented in exercise oncology trials. The ECHO-R trial for women with recurrent ovarian cancer aimed to address this research gap, evaluating the efficacy of a 6-month telephone-delivered, exercise intervention consistent with ESSA exercise oncology prescription guidelines.

METHODS

50 women scheduled to receive chemotherapy for recurrent ovarian cancer were recruited to the pre-post exercise trial with assessments at baseline and post-intervention (6 months post-baseline). The intervention was delivered via 12 telephone sessions, with the option of five additional study-funded, in-person sessions with a community-based AEP. The intervention had a global target of 150 minutes of moderate-intensity multimodal exercise per week, with actual volume and prescription individualised at each session, dependent on functional capacity, goals, and barriers. Outcomes included feasibility (volume of exercise completed) and harms profile (occurrence of adverse outcomes) of the intervention, changes in patient-reported outcomes (quality of life [QoL; FACT-O], fatigue [FACT-Fatigue] and neurotoxicity [FACT-GOG-NTX]), and objective assessment of aerobic function (6-minute-walk test), muscular endurance (30-second sit-to-stand) and strength (hand grip).

RESULTS

The average volume of exercise completed did not meet the target (median 100 min/week, min: 0; max 527). QoL, fatigue, neurotoxicity, aerobic function, muscular endurance, and strength remained stable between the pre and post-intervention assessments. There were no serious adverse events.

CONCLUSION

Recurrent ovarian cancer is an incurable disease, characterised by declining QoL and physical capacity. Findings from this study suggest that maintenance of QoL and physical function is possible through participation in an exercise intervention, even if exercise targets are not met. Physical activity guidelines may need to reflect this.
EXERCISE TRAINING IMPROVES GASTROINTESTINAL SYMPTOMS IN PEOPLE WITH A DISORDER OF THE GUT BRAIN INTERACTION (DGBI): SYSTEMIC REVIEW AND META-ANALYSIS
Authors: Bell Miss Katherine , Ferstera Mrs Naomi , Durney Ms Jacinta , Nicol Dr. Jennifer , Holtmann Prof. Gerald , Coombes Prof Jeff
Published: May 2024

INTRODUCTION & AIMS

Approximately 40% of the global population has criteria that meets at least one Disorder of the Gut-Brain Interaction (DGBI). DGBIs are characterised by the absence of structural abnormalities, with chronic symptoms, such as pain, altered bowel movements, and nausea. Current therapy options focus on treating the major symptoms, which can involve pharmacological and lifestyle advice (diet, exercise, and stress management). The aim of this study was to conduct a systematic review and meta-analysis investigating the efficacy of exercise for improving gastrointestinal symptoms in people with a DGBI.

METHODS

A search of relevant databases was completed in February 2023, for randomised controlled trials that applied an exercise intervention in people with DGBI. Comparator groups included usual care, pharmacological therapy, or diet advice. A pairwise random-effects meta-analysis estimated the standardised mean difference (SMD) (Hedges’ g) between exercise and comparator groups for changes in gastrointestinal symptoms. Risk of bias was analysed using the Cochrane Risk of Bias tool.

RESULTS

Ten studies published between 2004–2023 were included. Participants (n=653) were mostly female 77.6%. Eight studies included participants with irritable bowel syndrome and two included individuals with functional dyspepsia. Exercise interventions lasted an average duration of 8 weeks. The modes included yoga (n=5), low intensity (n=1) and moderate intensity aerobic exercise (n=4). Studies ranged from low to high-risk bias. Meta-analysis showed exercise interventions improved gastrointestinal symptoms (SMD=1.2, 95% CI 0.5 to 1.8; p<0.001). The effect was moderated by the intensity of exercise with moderate intensity aerobic exercise having a significant impact (SMD=1.6, 1.2 to 2.0; p<0.001) not evident with yoga and low intensity exercise interventions (SMD=0.9, -0.01 to 1.7; p=0.053).

CONCLUSION

Exercise interventions in people with DGBIs improve gastrointestinal symptoms. Moderate intensity aerobic exercise is more efficacious than yoga and lower intensity exercise.
EFFECTS OF A PRESCRIBED, SUPERVISED EXERCISE PROGRAMME ON HEALTH-RELATED QUALITY OF LIFE IN ONCOLOGY PATIENTS: A RETROSPECTIVE OBSERVATIONAL COHORT STUDY
Authors: Evans Dr Holly , Sharrad Mr Jack , Diebert Ms Crystal , Black-Tiong Dr Sean , Whitting Mrs Lauren
Published: May 2024

INTRODUCTION & AIMS

Individuals diagnosed with cancer experience significant physical and psychosocial consequences from oncological treatment. Based on current research, exercise therapy may be a valuable non-pharmacological approach to improve health-related quality of life (HRQoL). However, the effectiveness of individually tailored exercise programs to improve quality of life in real-world settings is understudied. The current study aims to analyse preliminary clinical data regarding the impact of tailored exercise supervised within an Australian private day hospital (LIFT) on HRQoL in individuals diagnosed with cancer.

METHODS

A retrospective longitudinal cohort study was conducted on adults diagnosed with cancer who attended the LIFT clinical service for at least 12 months between 2020 and 2023. QoL and symptoms were assessed using the Functional Assessment of Cancer Treatment – General Questionnaire (FACT-G). Data collected included diagnosis (type and stage), medical treatment, session frequency, and demographic data.

RESULTS

Overall, 40 patients (age=67.0±16.8 years) met the inclusion criteria. A within-group analysis demonstrated significant findings in the subscales of emotional wellbeing (p = 0.008) and functional wellbeing (p = 0.003), and significance was also found in the total FACT-G score (p = 0.0019). Interestingly, while not statistically significant, a clinically significant difference in HRQoL was found between individuals completing ≤1 or ≥ 2 supervised exercise sessions per week at LIFT cancer care centre, favouring those completing ≥ 2 sessions.

CONCLUSION

Preliminary analysis indicated that a “real-world” individualised supervised moderate-vigorous exercise within a day hospital has the potential to significantly improve HRQoL outcomes in individuals diagnosed with cancer.
EXERCISE AND CANCER PROGRAM: A PRESCRIPTIVE EXERCISE PROGRAM IN A NON-CLINICAL SETTING
Authors: Quinn Miss Jaclyn
Published: May 2024

INTRODUCTION & AIMS

This study aimed to establish a low-cost, sustainable exercise program for cancer patients in Gippsland, Australia, where access to such programs was previously limited. By developing and implementing a collaborative program, the program aimed to improve the physical and psycho-social well-being of cancer patients while reducing burden on healthcare services.

METHODS

Collaboration between Latrobe Community Health Service, Morwell Leisure Centre, and Gippsland Integrated Cancer Service led to the development of a prescriptive exercise program to provide cancer survivors a sustainable cost-effective exercise and cancer program in a community leisure centre. Exercise physiologists provided initial assessments, in which clients allocated to group-based, one-on-one, or home-based exercise sessions.

RESULTS

After 12 weeks in the program, 100% of participants that had a reassessment improved on at least one physical test and all improved on a subjective measure like fatigue, depression, or self-worth. On average, they saw a 14.88% increase in leg strength, a 12.70% increase in grip strength, and a 16.65% increase in aerobic fitness. Additionally, they reported an average decrease in anxiety (10.96%), depression (1.59%), fatigue (6.09%), and reported illness symptoms (5.24%). Overall, participant feedback was overwhelmingly positive, highlighting the benefits of the program’s psycho-social support and the opportunity to exercise outside a healthcare setting.

CONCLUSION

Collaboration between healthcare and leisure centres can provide sustainable and cost-effective exercise programs for cancer patients, improving physical and psycho-social well-being while reducing healthcare burden. Participants valued the support, social interaction, and sense of belonging provided by the program.
EXERCISE & CANCER PROGRAM: A COLLABORATIVE APPROACH TO PROVIDE PRESCRIPTIVE EXERCISE OUTSIDE OF THE CLINICAL HEALTHCARE SETTING
Authors: McMillan Jordan
Published: May 2024

CASE SETTING

This study implemented a standardized exercise program for oncology patients in the Latrobe Valley region of Gippsland, Australia, aiming to assess its potential transferability to other regions. This was undertaken due to a lack of structured services available in Gippsland, limiting patient access to these programs, in which patients having to travel up to 2 hours for treatment in Melbourne.

TREATMENT

Implementation of a standardized exercise program for oncology patients, developed by a multidisciplinary team of exercise physiologists, oncology health professionals, and leisure centre fitness professionals. Exercise Physiologists conducted initial assessments and patients were placed in either individual, group exercise sessions and/or home-based programs.

RESULTS

The program demonstrated significant improvements in both physical and psychological well-being. The program has received 73 referrals, of which 48 participants completed initial assessments with an Exercise Physiologist. Of the remaining 25 participants, 2 were discharged to other services due to their location outside the program’s jurisdiction, 18 withdrew or did not attend their appointments, and 5 are currently on the waitlist for assessment. At the time of data collection, 17 participants had completed their reassessments.100% of participants improved on at least one physical test, and all participants improved on one of their subjective measures (fatigue, depression, anxiety, self-worth). Additionally, participant feedback was overwhelmingly positive, highlighting the program’s psycho-social support and the benefits of exercising outside a healthcare setting.

REFLECTIONS/LEARNINGS

This program successfully demonstrated the effectiveness of collaboration between healthcare services and leisure centres in delivering sustainable exercise programs for oncology patients outside of the healthcare setting. It also highlighted the value of providing both physical and psycho-social support, with the inclusion of care coordinators significantly reducing burdens on health services. The program’s success suggests strong potential for transferability to other regions.
EXERCISE PRESCRIPTION TO SUPPORT THE MANAGEMENT OF OSTEOPOROSIS: AN EXPERT STATEMENT FOR EXERCISE PHYSIOLOGISTS
Authors: Beck Prof Belinda , Lord Prof Stephen , Daly Robin M , Weeks AProf Benjamin , Watson Dr Steven , Chen Dr Weiwen
Published: May 2024

INTRODUCTION & AIMS

Low bone density, which includes osteopenia and osteoporosis, leads to roughly 183,000 fractures annually in Australia, with associated direct costs of $2.59B. Osteoporosis is underdiagnosed. Exercise is effective therapy but is underutilised due to a lack of knowledge and unfounded concerns about risk of injury. The aim of the newly developed Exercise Prescription for the Prevention of Osteoporosis Fracture National Statement is to provide clear, actionable, evidence-based exercise advice to improve the bone health of people living with osteopenia and osteoporosis. The project was led and supported by Healthy Bones Australia with funding awarded by the Australian Government Department of Health, Public Health and Chronic Disease Program Osteoporosis – Education and Prevention.

METHODS

An expert working group (scientists, AEP, physiotherapist, endocrinologist and orthopaedic resident) and advisory committee (practising AEPs and physiotherapists) reviewed current evidence and existing guidelines to formulate recommendations for a national statement in the Australian context. A National Exercise Roundtable was convened, including consumers and stakeholders across multiple disciplines, to adapt the recommendations for clinical practice and consumer acceptability.

RESULTS

The final statement is presented as an evidence-based document, and a 2-page user summary. The Statement outlines the general principles of osteogenic loading and falls prevention, then presents a comprehensive exercise prescription based on those principles, along with special considerations for comorbid conditions. Level A consensus was achieved on five summary statements.

CONCLUSION

Bone health is an essential part of general health. While exercise prescription for other chronic diseases, such as, heart health and diabetes, is quite well established, there is a care gap for bone which we have addressed. Our National Statement, informed by high level evidence and expert insight, delivers best practice for prescribing exercise for osteoporosis to achieve best patient outcomes. We will present the document to the intended end users – exercise physiologists.
ENHANCING REFLECTIVE CAPACITIES IN EXERCISE PHYSIOLOGY: BRIDGING EDUCATION AND LIFELONG PROFESSIONAL LEARNING
Authors: Vecchio Dr Luke Del , Irwin Associate Professor Pauletta , Coutts Associate Professor Rosanne
Published: May 2024

INTRODUCTION & OBJECTIVES

Essential to both students and experienced exercise physiology practitioners, reflective practice is a cornerstone of lifelong learning and improved client care. In clinical settings reflection, characterised by awareness, is the critical analysis of experience and requires integration into higher education curriculum.

METHODOLOGY

Final-year exercise physiology students (N = 21) and 5 clinical exercise physiology supervisors completed a reflective practice learning activity. The stepped process of SPROUT was utilised, via classroom teaching and 14 weeks of clinical practicum. SPROUT represents the Situation, Past experiences, Read and refer, Other influences, Understanding, and Taking it forward. Teaching modes included group discussion, clinical situations, and student-led practice along with the completion of written reflections. Each student responded to the Reflection in Learning Scale (RLS) and further questions about their confidence. Written scripts were analysed for meaning and each ranked. Supervisors responded to open-ended questions during a focus group.

FINDINGS

Student scores for the RLS revealed higher scores for planning, knowledge integration and mental processing and lower for interactions with knowledge, mindful summarising and coping with negative emotions. 75% of students indicated that they were confident with reflective practice and that SPROUT, however time-consuming, had been helpful. Written scripts showed a range of developing abilities, from novice requiring more depth to those more advanced who demonstrated meaningful engagement and solution-orientated reflective ability. Clinical supervisors supported the importance of reflective practice and were positive about the application of the stepped approach of SPROUT.

CONCLUSIONS

The SPROUT framework supported reflective practice learning, benefiting both students and qualified practitioners, facilitating not only increased confidence but also a more profound understanding of clinical encounters. The structured approach of SPROUT proved beneficial in guiding reflective thinking. This research underscores the importance of reflective practice in exercise physiology, endorsing its role in ongoing professional development.
CONSUMER EXPERIENCE OF AN AUSTRALIAN MULTIDISCIPLINARY LONG COVID CLINIC THAT INCORPORATES PERSONALISED EXERCISE PRESCRIPTION: A QUALITATIVE ANALYSIS
Authors: Buettikofer Ms Tanya , Maher Ms Allison , Rainbird Ms Veronica , Bennett Ms Michelle , Freene Associate Professor Nicole , Mitchell Professor Imogen , Huang Dr Hsin-Chia Carol , Gaughwin Dr Phil , Johnson Mary , Paratz Jenny , Bissett Bernie
Published: May 2024

INTRODUCTION & AIMS

Little is known about the Australian experience of Long COVID recovery, particularly with respect to exercise prescription. The aim of this study was to understand the consumer experience and acceptability of a novel Australian Long COVID Recovery Clinic that incorporates personalised exercise prescription, including respiratory and peripheral strengthening and carefully monitored cardiovascular training.

METHODS

Qualitative study; semi-structured interviews with a convenience sample of participants who have completed a multidisciplinary, individually-tailored and supervised programme at our Long COVID Recovery Clinic. Interviews were conducted by a researcher external to the clinic delivery. Major themes were identified by inductive thematic analysis.

RESULTS

15 participants were interviewed. 14/15 (93%) participants described the clinic model as acceptable or highly acceptable. Five core themes were identified, including (1) encouraging staff and light-filled facilities are key to support recovery; (2) individually tailored, supervised exercise and pacing helped to improve confidence in building exercise capacity; (3) peer support and group therapy augments recovery; (4) recovery from Long COVID is incomplete, and other services augment the Long COVID Recovery Clinic model; and (5) importance of GP involvement in connection with clinic participation. Suggestions for improvement included extending the duration of the clinic programme beyond 2 months, reducing wait times by increasing staffing levels and adjusting the clinic schedule to broaden access options.

CONCLUSION

The majority of participants found the Long COVID Recovery Clinic, which incorporates both supervised exercise and pacing, acceptable and would recommend it to others. From the consumer perspective, the Long COVID Recovery Clinic aids recovery alongside GP management through a combination of peer support and an individually tailored program.
MEANINGFUL MULTIDISCIPLINARY REHABILITATION FOR HEART AND LUNG CONDITIONS: A COLLABORATION BETWEEN ORGANISATIONS AND SECTORS TOWARDS SELF-MANAGEMENT
Authors: Ghidella Mrs Katrina
Published: May 2024

It is well documented that mainstream services are not always well attended by Aboriginal and Torres Strait Islander people due to a range of issues including transport and culturally safe practice. Establishing these services within the community-controlled sector is one way to increase access and culturally responsive care.

This initiative involved a new model of service delivery, whereby a partnership between Hospital Health Services and community-controlled Aboriginal and Torres Strait Islander primary healthcare organisations enabled the establishment of new Cardiac and Pulmonary Rehabilitation Programs within the Institute for Urban Indigenous Health (IUIH) Network for First Nations people. This Network is comprised of the five Aboriginal and Torres Strait Islander Community Controlled Health Organisations (ATSICCHO’s) who operate as a regional collective with IUIH providing leading strategic direction and coordination.

Through a multidisciplinary team, specialised cardiac and pulmonary rehabilitation is provided to First Nations people as a culturally capable alternative to hospital cardiac and pulmonary rehabilitation, particularly for those not currently accessing treatment.

The specialised rehabilitation programs are supported by the IUIH System of Care that supports clients to access a wide array of holistic health services and programs designed to meet community needs and strengthen pathways for clients to self-manage their health needs in a self-led manner.

The Rehabilitation Programs are a multidisciplinary exercise and education program delivered by a range of health professionals including Accredited Exercise Physiologist’s, Physiotherapists, Nurses and Aboriginal and Torres Strait Islander Allied Health Assistants. Clients also have access to a range of other Allied Health Professionals, including Dieticians Occupational Therapists, Pharmacists, Social Health, Podiatrists, Optometrists, Speech Therapists and Audiologists.

Referrals are received from ATSICCHOS, Queensland Health and Primary Health General Practitioners and Specialists. The client journeys through a multidisciplinary assessment to then determine their goals and health needs. This presentation will provide insights into the First Nations-led partnership, challenges and solutions to working across the whole health sector and outcomes for clients.
ESSA ADVOCACY NETWORK
Authors: Hocking Elyse , Powell Judy
Published: May 2024

INTRODUCTION AND AIMS

Advocacy is an important and effective way to influence policy changes to improve outcomes. Best practice advocacy is when efforts are coordinated, multifaceted, structured, and collective.

The ESSA Advocacy Network was piloted in 2021, to improve engagement with members, and strengthen ESSA advocacy efforts, whilst simultaneously building members capacity and confidence, to engage in activities for positive change.

METHOD

ESSA advocacy priorities are broad and diverse, aiming to enhance workforce opportunities to benefit all member groups. These areas include chronic conditions, mental health, rural and remote health, disability, aged care, physical activity, primary healthcare, public health, sport, and, workplace and personal injury. These priorities are affected by enablers including technology and innovation, data and evidence and funding mechanisms such as GST and fee schedules in compensable scheme. All advocacy efforts aim to reduce barriers, enhance enablers and increase access to the exercise and sports science workforce. The advocacy network self-identify interest in priorities and are engaged when opportunities arise to share knowledge, experience and their expertise to inform and shape advocacy.

RESULTS

In 2023, members were engaged in the development of over 300 submissions and letters. Advocacy efforts resulted in member engagement in meetings with Members of Parliament, Senators, Parliamentary advisors, and senior government officials plus representation on advisory groups for the development of clinical guidelines, strategic plans and resources for allied health.

CONCLUSION

As the advocacy network emerges from its infancy into the next stage of maturity as an integral part of advocacy for exercise physiology, exercise science, and sport science, a professional and streamlined approach is required. ESSA will grow the network in terms of members engaged and the output.
EXERCISE PRESCRIPTION IN A MULTIDISCIPLINARY LONG COVID CLINIC: METHODOLOGY FROM AN AUSTRALIAN EXPERIENCE
Authors: Johnson Ms Mary , Maher Ms Allison , Bennett Ms Michelle , Buettikofer Ms Tanya , Huang Dr Hsin-Chia Carol , Gaughwin Associate Professor Phil , Rainbird Ms Veronica , Mitchell Professor Imogen , Bissett Professor Bernie
Published: May 2024

INTRODUCTION & AIMS

The University of Canberra Hospital Post-COVID Recovery Clinic is one of Australia’s few multidisciplinary outpatient clinics. Our model includes personally-prescribed exercise of both inspiratory and peripheral muscles. We have treated > 200 people with Long COVID with no serious adverse events, and our model is highly acceptable to consumers. This paper offers a detailed description of our methodology capturing how we achieve safe, tailored personal exercise, and carefully manage post-exertional symptom exacerbation (PESE).

METHODOLOGY

Initial screening appointments last 2 hours, and clients are referred for medical review if they have signs or symptoms of an acute or life-threatening complication (e.g. unexplained chest pain). Individualised exercise programs are prescribed, progressed, and monitored by an Exercise Physiologist or Physiotherapist initially on an individual basis, then in a supervised group setting. The group program consists of twice weekly sessions of 60 minutes duration. Clients attending group therapies are provided with a home exercise program to enable self-management. Clients are screened at baseline assessment for PESE triggered by participation in activities of daily living. All clients receive education about activity modification and pacing strategies. For clients experiencing PESE, activity is not progressed until they can tolerate 2 weeks of activity without PESE. For peripheral muscles, progressive resistance exercises are prescribed at a submaximal intensity (RPE 4-6/10), with 4-6 exercises completed 3 days/week. Once able to tolerate ADLs, low intensity cardiovascular exercise is gradually introduced with increased monitoring from a clinician. For patients with dyspnoea, high-intensity inspiratory muscle training is prescribed as 5 sets of 6 breaths at least 50% of their maximal inspiratory pressure (30 breaths total) 5 days per week.

CONCLUSION

Our experience indicates that it is possible to safely prescribe exercise in people with Long COVID, incorporating both peripheral and inspiratory muscle training, while carefully monitoring and managing PESE.
YOUNG STRONG AND DEADLY PROGRAM EVALUATION
Authors: Fraser Mr Andrew , D’Urso Mr Tano , Biles Dr Brett , Macniven Dr Rona , Fletcher-Lartety Dr Stephanie
Published: May 2024

INTRODUCTION & AIMS

For Aboriginal young people, physical activity declines through puberty, adolescence, and early adulthood. Western Sydney Local Health District (WSLHD) departments, Aboriginal Health Hub and Youth Health, together with western Sydney Aboriginal communities co-designed the Young, Strong, and Deadly program. The program is an assertive intervention which aims to increase healthy behaviours and improve social and emotional wellbeing among young Aboriginal adolescents aged 12-16 years. The program is an Aboriginal researcher led, 14-week health education and physical exercise program that includes paid PCYC gym memberships, guided gym sessions, transport provision and nutrition education.

METHODS

The study used a mixed method pre-post design with a process evaluation. Participants were recruited through convenience and snowball sampling including engagement with schools and Aboriginal community-controlled organisations. Data were collected on participation and attendance, performance, satisfaction and intention to continue with activities.

RESULTS

For the first of three cohorts, 31 participants were recruited, of which 24 completed the 14week program. All participants demonstrated significant improvements in strength & conditioning. Five focus groups were conducted with 20 adolescents and seven parents, individually or in pairs. Adolescents enjoyed the program, particularly achieving gains in strength and fitness, learning and practicing new recipes and having an Aboriginal specific program. Parents spoke favourably of the program including improvements in their children’s health behaviours, focus on school and confidence, and appreciated the staff input and program operations.

CONCLUSION

Young Strong and Deadly has been implemented in community settings and has demonstrated feasibility and acceptability among Aboriginal adolescents and their families. Initial findings show that a culturally appropriate assertive intervention program can impact on social and emotional wellbeing as well as improving the health of young Aboriginal people.
BENEFICIAL EFFECTS OF A COMBINED AEROBIC AND STRENGTH TRAINING PROGRAM IN PATIENTS WITH MOTOR NEURON DISEASE
Authors: Ferri Dr Alessandra , Lanfranconi Francesca
Published: May 2024

INTRODUCTION & AIMS

Motor Neuron Disease (MND) is a neurodegenerative disease characterised by the progressive degeneration and death of motor neurons, which leads to a reduction in muscle strength and physical function. Although “Exercise as Medicine” is accepted for many diseases, the role of exercise in individuals with MND is still debated. The aim of this study was to evaluate the effect of a combined, moderate-intensity, aerobic and strength training program on aerobic capacities, strength and physical function in individuals with MND.

METHODS

Fifteen individuals with MND were randomly assigned to either a training (3 times/week for 12 weeks; TRAIN, n=8) or a control (continued their usual standard of care; CTRL, n=7) group. The peak aerobic capacity (VO2peak) and the maximal capacity of oxygen extraction (via Near-Infrared Spectroscopy) were evaluated during an incremental test to exhaustion on a cycle ergometer. The strength of both the lower- and upper-limb muscles was evaluated with a 1-Repetition Maximum (1RM) test on the leg press, leg extension, biceps curl, and vertical chest press. Participants also performed the “Timed Up and Go” test (TUG) and the 6-min walking test (6MWT).

RESULTS

The adherence to training was 86 ± 6%, and the satisfaction with the exercise program was 9.6 out of 10. VO2peak did not change significantly in both groups, but the maximal capacity of O2 extraction improved significantly in TRAIN (from 44 ± 3 to 67 ± 4%). In TRAIN, the 1RM for the leg press and leg extension increased significantly by 47 ± 8% and 50 ± 13%, respectively, while this parameter did not change in CTRL. While the 6MWT increased by 5% in TRAIN and decreased by 3% in CTRL, the change was not significant.

CONCLUSION

These preliminary results support the beneficial role of a combined aerobic and strength training program in individuals with MND.
DEVELOPMENT OF THE SUBJECTIVE TRAINING QUALITY SCALE FOR TEAM SPORTS SCALE
Authors: McGrath Jed , Coutts Distinguished Professor Aaron , Slattery Dr Katie , Davies Steph
Published: May 2024

INTRODUCTION & AIMS

In team sports, training is strategically designed to incorporate all training factors (i.e., physical, technical, tactical, mental) to improve an athlete’s performance during competition. The ultimate goal is for individual athletes to work together as a cohesive unit to complete training objectives and train at high quality. Although anecdotal, training quality is considered a key component in the training process. However, there is currently no team sport literature that has defined this construct. Nor a validated measurement instrument available to assess the quality of team sport training. Therefore, the present study developed the Subjective Training Quality for Team Sports (STQ-TS) scale. Furthermore, this study investigated the application of this scale within the context of a professional National Rugby League (NRL) team.

METHODS

Eleven rugby league players (24 ± 2 y; 62 ± 47 NRL games) were interviewed to explore how they define and assess training quality. Thematic analysis was used to analyse interview transcripts. The identified themes were used to develop a preliminary STQ-TS scale. The STQ-TS scale was completed by forty-two NRL players across two seasons.

RESULTS

Four themes were identified for the STQ-TS scale. These themes included physical, technical, mental, and teamwork (i.e., communication; connectedness). Players perceived pre-season training to be lower quality compared to in-season. In-season training quality showed a gradual improvement throughout both seasons, reaching its peak late in the season.

CONCLUSION

Professional rugby league players perceive training quality as their ability to complete physical, technical, mental, and teamwork objectives. The STQ-TS scale serves as a valuable tool for practitioners to assess training quality in team sports. The integration of the STQ-TS scale with external load, internal load, and athlete response measures can provide practitioners with a more nuanced and holistic understanding of the training process.