bluuebunny/crossref_metadata_2025 huggingface dataset:
THRIVING IN MOTION – YOUTH MOVES: MOVEMENT FOR TRANS AND GENDER DIVERSE YOUNG FOLK
Authors: Austin Mrs Felicity , Wright Dr Kemi , Quick Benjamin , Edwards Greta , Russell Kayleen , Kramer Benjamin , Furzer A/Prof Bonnie
Published: May 2024

CASE SETTING

Gender diverse young people have lower rates of exercise, and higher rates of mental and physical health challenges, perpetuated by a lack of trans-friendly physical activity providers and environments. Our collaborative project aimed to create and support community-based exercise opportunities for trans and gender diverse young people (15-25yrs) to increase participation and improve their physical and mental health outcomes. Alongside feasibility data from 18 months delivery, two case studies will be presented (23 yrs non-binary individual, presenting with disordered eating and exercise, neurodivergence and mental illness; 18yrs transfeminine presenting with neurodivergence and participation barriers).

APPROACH AND TREATMENT

Through targeted community collaboration with young people and multidisciplinary support services, a supportive and inclusive structured exercise program was created. Specifically, we delivered and evaluated the feasibility of the exercise program for gender diverse young people; and educated the wider exercise and health community on inclusive exercise practices.

RESULTS

Forty-six gender diverse young people participated across the delivery of 11 x 8-10 week programs in 5 Perth metro locations, totalling 4518 exercise therapy hours. On average 100% of participants reported a score higher than 3/5 for program enjoyment, 79% of participants reported a score higher than 3/5 for motivation to return. Participants on average increased weekly physical activity participation by 50% since commencing the program, and 100% of participants would recommend the program to other trans peers.

REFLECTIONS/LEARNINGS

In WA, the absence of exercise opportunities for gender diverse young people prompted our tailored program. We prioritized inclusivity, safety, and participant-specific needs. Our proactive approach included health screenings, upskilling staff, and encouraging a supportive environment. Listening to participant expectations, involving a Youth Advisory Group, and engaging a Youth Engagement Officer proved vital for program success. Our reflections incorporate the significance of tailored, inclusive programs and community involvement in fostering active, safe spaces.
THRIVING IN MOTION – YOUTH MOVES: MOVEMENT FOR YOUTH MENTAL HEALTH PROGRAM
Authors: Austin Mrs Felicity , Wright Dr Kemi , Edwards Greta , Russell Kayleen , ALMARJAWI Ashley , Furzer A/Prof Bonnie
Published: May 2024

CASE SETTING

A Western Australia community exercise initiative supporting vulnerable youth experiencing poor mental health. Led by professionals and peers, our program offers a non-judgmental space for exercise and education, addressing discrimination, isolation, and service access barriers. Addressing a lack of physical activity options for at-risk groups, the program targets individuals affected or at risk of mental health disorders, recognizing that a quarter of youth face such challenges.

TREATMENT

An 8-week evidence-based program integrating mixed movement and education in alternative or education support settings. Tailored for at risk youth, the goal is to directly improve mental and physical health literacy, and social outcomes of participants through diverse exercise opportunities to manage and maintain thriving mental health. Specifically, we delivered and evaluated the feasibility of the program for at risk youth.

RESULTS

Since 2022, Thriving has delivered 43 8-week programs directly impacting 855 vulnerable youth in various metro (13) and regional (2) Western Australian locations, totalling 20, 860 exercise therapy hours. Forty-two collaborative partnerships and 15 staff have been involved in delivery. On average 85% of participants reported a score higher than 3/5 for program enjoyment, 80% of participants reported a score higher than 3/5 for motivation to return.

REFLECTIONS/LEARNINGS

Despite the abundance of community-based exercise and sporting organizations, a significant gap exists in their ability to address the needs of vulnerable youth, stemming from insufficient specialized skills and training. Informed by the achievements and insights of prior collaborations and projects, our program focuses on establishing inclusive activity environments for youth in low participation groups. Building on successful community relationships, we strive to encourage disengaged youth, allies, friends and families by offering tailored opportunities and pathways for meaningful exercise participation.
PERIPHERAL AND CENTRAL DEMANDS OF REPEATED-SPRINT EXERCISE WITH CONTINUOUS BLOOD FLOW RESTRICTION FOR TEAM-SPORT PLAYERS
Authors: Mckee Mr James , Girard A/Prof. Olivier , Peiffer Professor Jeremiah , Dempsey Associate Professor Alasdair R. , Smedley Miss Kirsten , Scott Associate Professor Brendan
Published: May 2024

INTRODUCTION & AIMS

Team-sport players’ repeated-sprint ability improves following repeated-sprint training with systemic hypoxia (reduced fraction of inspired oxygen) through enhanced metabolic demands compared to sea-level training. Localised hypoxia (i.e., blood flow restriction; BFR) presents a limb-specific alternative strategy, though central and peripheral demands during multiple-set repeated-sprint BFR exercise have not been quantified for team-sport players. Therefore, this study aimed to assess the impact of BFR during repeated-sprint exercise on performance, metabolic, neuromuscular, and perceptual responses for team-sport players.

METHODS

Twenty-six semi-professional and amateur team-sport players performed cycling repeated-sprint exercise (three sets of five 5-second sprints with 25 seconds of passive recovery) with continuous BFR at 45% arterial occlusion pressure or without. Power output, vastus lateralis muscle oxygenation, and cardiorespiratory responses were continuously monitored. Surface electromyography examined vastus lateralis, biceps femoris, and lateral gastrocnemius activation, and root mean square was calculated over eight consecutive cycle revolutions. Exercise-related sensations and blood lactate concentration were assessed following sets. Linear mixed models compared differences in dependent variable means between conditions and sets or repetitions.

RESULTS

Mean, peak power output, and oxygen consumption decreased (p < .01) with BFR (-5.0%, -4.5%, and -6.3%, respectively) compared to without. Vastus lateralis tissue saturation index reduced (p < .001) during sprints and recovery periods for BFR (-6.9% and -5.9%, respectively). Electromyography root mean square decreased (p < .01) for biceps femoris and lateral gastrocnemius muscles with BFR (-2.8% and -8.9%, respectively), but remained unchanged for the vastus lateralis. Perceived limb discomfort increased (p < .001) for BFR, though blood lactate concentration and rating of perceived exertion did not differ between conditions (p > .05).

CONCLUSION

Repeated-sprint exercise with BFR for team-sport players reduced performance and likely increased the physiological and perceptual stimulus for the periphery with greater reliance on anaerobic glycolysis, despite comparable or decreased central demands.
EFFECT OF PRE-EXERCISE EDUCATION ON PAIN RESPONSES TO A SINGLE EXERCISE SESSION IN PEOPLE WITH KNEE OSTEOARTHRITIS: A RANDOMISED CONTROLLED TRIAL
Authors: Jones Matthew D , Ram Mr Adrian , Gibbs Dr Mitchell T. , Thom A/Prof Jeanette , Booth Dr John , Cooke Ms Laura , Kovats Mr Alexandre , Ho Mr Darryl Ser Foong , Ram G Pramod
Published: May 2024

INTRODUCTION & AIMS

In pain-free individuals, pre-exercise education about exercise-induced hypoalgesia (EIH) reduces experimental pain following a single exercise session. However, its effect in people with chronic pain remains unexplored. This study aimed to determine if EIH education influences pain during and following exercise in people with knee osteoarthritis (OA).

METHODS

Participants were randomised into an intervention group (INT) who received 15-minutes of explicit EIH education or a control group (CON) who received 15-minutes of general information about knee OA. Following education, participants’ knowledge and beliefs about exercise and pain were assessed using five questions scored on a Likert scale. Participants then undertook a single 15-minute, low-moderate intensity home-based strength exercise session delivered online. Pain was assessed on a 0-10 scale before, during, and immediately following exercise.

RESULTS

40 people with knee OA (67 ± 10.8 years old; BMI: 27.6 ± 6.5) completed the study. Education did not significantly influence participants’ knowledge or beliefs about exercise and pain. Pain reduced during exercise in both groups (mean difference [95% CI]; INT = -0.50 [-1.39 to 0.39]; CON = -1.58 [-2.55 to -0.62]), with a moderate effect (Cohen’s d) in favour of CON (-1.08 [-2.35 to 0.18], d = 0.54). Pain also reduced following exercise in both groups (INT = -0.95 [-1.77 to -0.12]; CON = -0.98 [-1.74 to -0.22]), with no difference between groups (0.03 [-1.06 to 1.12], d = 0.02).

CONCLUSION

A single exercise session reduces pain in people with knee OA, but this was not influenced by pre-exercise education about EIH. Given the chronic nature of OA pain, any intervention that can potentiate the benefits of exercise, even if marginal, may be beneficial. Therefore, further research is needed to understand if and how EIH can be modulated in people with knee OA.
FOSTERING RECOVERY: A CASE STUDY ON THE JOURNEY FROM UNCERTAINTY TO DIAGNOSIS IN POST-COVID POTS
Authors: Powrie Olivia
Published: May 2024

CASE SETTING

Imagine, one day you are an active 20-year-old, then after a COVID-19 infection, your life is now limited by debilitating symptoms: fainting, palpitations, and exercise intolerance. Your whole world has changed, and you have no diagnosis and no treatment options. This was reality for a patient referred to cardiac rehabilitation in early 2023 as a unique case, not meeting usual service criteria.

TREATMENT

In the absence of a formal diagnosis, there was no clear pathway for treatment and no rehabilitation guidelines to follow. After a comprehensive assessment, marking the start of the road to recovery, a conservative and gradual approach to re-introducing exercise was developed, whereby progressions were only made when no symptoms were experienced during nor following the sessions. Across the next nine months, further symptoms were identified, prompting further research, which shaped a plausible diagnosis: Postural Orthostatic Tachycardia Syndrome (POTS). Whilst initially dismissed as a possibility by the patient’s cardiologist, after further questioning, gaining objective data and referral to specialist physicians, this plausible diagnosis was confirmed.

RESULTS

Through months of rehabilitation, lifestyle modifications and commencing medication, this patient has improved symptom control and increased activity tolerance. Importantly, this has allowed return to studying, return to part time work and return to tolerating daily activities.

REFLECTIONS/LEARNINGS

As exercise physiologists, we often spend more time with patients than medical practitioners, and resultingly identify characteristics which may otherwise be missed in busy clinics. This case study acts as a reminder of the importance of trusting your instinct and not being afraid to advocate for patients - doing so may just re-direct them down the road to recovery. With the increasing prevalence of dysautonomia, particularly POTS, as consequences of COVID-19 infections, there is an ever-increasing need for awareness, in addition to clinician upskilling to ensure best support and management of these patients.
SAFETY, EFFICACY, AND IMPLEMENTATION OF HOME-BASED HIGH-INTENSITY INTERVAL TRAINING FOR PATIENTS WITH CARDIAC DISEASE: A SYSTEMATIC REVIEW
Authors: Turnbull Ms Rebecca , Perera Mr Dylan , Heng Dr Hazel , Semciw Associate Professor Adam
Published: May 2024

INTRODUCTION & AIMS

High-intensity interval training (HIIT) is safe and more effective than moderate-intensity continuous training for improving cardiorespiratory fitness in adults with cardiac disease. Home-based delivery of cardiac rehabilitation has been introduced to increase the uptake and participation of programs. The aim of this systematic review was to investigate the safety, efficacy, and implementation of home-based HIIT programs for patients with cardiac disease.

METHODS

A systematic review of the literature was conducted in three electronic databases (MEDLINE, CINAHL and EMBASE) before 2nd October 2023. Studies were included if they were written in English, peer-reviewed and compared home-based HIIT to other centre-based or home-based exercise interventions. A secondary analysis investigating intervention safety, efficacy and implementation was conducted using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework.

RESULTS

Five studies, involving 153 participants (62 for home-based HIIT and 91 for other home-based or centre-based exercise interventions) were included in the analysis. There were no differences in functional capacity or quality of life (QOL) between home-based HIIT and other centre-based or home-based exercise interventions (p > 0.05). Across all the studies, the reporting rates were highest for program effectiveness (75%) and adoption (75%), followed by reach (70%), implementation (40%), and maintenance (10%). Adverse events were reported during the home-based HIIT intervention in two studies (3%). Participant attrition within home-based HIIT interventions was 8-12%. In studies where adherence to the home-based HIIT protocol was reported, this ranged between 36% and 85%.

CONCLUSIONS

Home-based HIIT resulted in similar effects in functional capacity and QOL as other centre-based and home-based exercise interventions for patients with cardiac disease. HIIT in the home appears to be safe and effective, however adherence to the protocol varies. Further high-quality studies are needed to inform best practices for prescribing HIIT in the home.
THE EFFECTS OF HYBRID FUNCTIONAL ELECTRICAL STIMULATION INTERVAL TRAINING ON AEROBIC FITNESS AND FATIGUE IN PEOPLE WITH ADVANCED MULTIPLE SCLEROSIS
Authors: Mate Ms Suzie , Soutter Ms Megan , Liaros Ms Jana , Hackett Dr Daniel , Barnett Professor Michael , AM Prof Maria A. Fiatarone Singh , Fornusek Dr Ché
Published: May 2024

INTRODUCTION & AIMS

Improving aerobic fitness in people with multiple sclerosis (MS) can reduce fatigue, and lower the risk of cardiovascular disease. Aerobic training can be challenging due to paresis, access to suitable equipment and fatigue. The aim was to investigate whether functional electrical stimulation (FES) cycling combined with arm crank interval exercise (hybrid FES interval training) is feasible for people with advanced MS, and its effects on aerobic fitness and fatigue.

METHODS

Hybrid FES interval training was performed 2 d/wk for 12 weeks. Each session consisted of 40 minutes of continuous FES cycling with arm crank intervals of 30 seconds work/30 seconds rest added concurrently for 20 minutes. The intensity target was a minimum of 60% of arm crank power and ‘hard’ measured by rate of perceived exertion (RPE) on a scale of 6-20. Feasibility was measured by attendance, compliance to intensity and time targets, adverse events, and drop outs. Aerobic fitness was assessed by an arm crank maximal test. Fatigue was measured via the Modified Fatigue Impact Scale (MFIS).

RESULTS

Seven participants (6 female; age 57.1±7.8y; Expanded Disability Status Scale 7.1±0.8) with advanced MS attended 80±10.4% of the scheduled sessions and there were no adverse events or drop outs. Average RPE at the end of each training session was 15±2, representing vigorous intensity exercise. Aerobic fitness did not change pre- to post-intervention [14.2±5.7 to 14.78±6.0 mL/kg/min (p=0.43)]. There was a trend towards a reduction in the MFIS score pre- to post-intervention [31.0±10.4 to 21.7±11.4 (p=0.10)].

CONCLUSION

Hybrid FES interval training is feasible for people with advanced MS who need exercise equipment appropriate for their condition, and can represent vigorous intensity exercise. The positive findings support the need for future randomized control trials that can assess the aerobic fitness changes and associated health benefits of hybrid FES interval training.
THE SMALLEST WORTHWHILE EFFECT OF EXERCISE THERAPY FOR PEOPLE WITH CHRONIC LOW BACK PAIN: A DISCRETE CHOICE EXPERIMENT STUDY
Authors: Hansford Mr Harrison , Jones Matthew D , Cashin Aidan G , Ostelo Raymond WJG , Chiarotto Alessandro , Williams Sam A , Sharma Saurab , Devonshire Jack J , Ferraro Michael C , Wewege Michael A , McAuley James H , Rose John M
Published: May 2024

INTRODUCTION

Understanding the magnitude of treatment effect patients need to see to consider a treatment worthwhile is of clear clinical and research importance. Current measures of clinical importance, such as the minimum clinical important difference, are limited as they are not determined by patients, and do not reflect specific costs, risks or inconveniences of individual treatments, i.e. you could have the same MCID for surgery as for exercise. We aimed to identify the smallest worthwhile effect (SWE), a new measure of clinical importance, of exercise therapy for people with non-specific chronic low back pain (CLBP) using discrete choice experiment.

METHODS

The SWE was estimated as the lowest reduction in pain that participants would consider exercising worthwhile, compared to not exercising i.e., effects due to natural history and other components (e.g., regression to the mean). We recruited English-speaking adults in Australia with non-specific CLBP to our online survey via email from a registry of previous participants and advertisements on social media. We used discrete choice experiment to estimate the SWE of exercise compared to no exercise for pain intensity. We analysed the discrete choice experiment using a mixed logit model, and mitigated hypothetical bias through certainty calibration, with sensitivity analyses performed with different certainty calibration thresholds.

RESULTS

213 participants completed the survey. Mean age (±SD) was 50.7±16.5, median (IQR) pain duration 10 years (5-20), and mean pain intensity (±SD) was 5.8±2.3 on a 0-10 numerical rating scale. For people with CLBP the SWE of exercise was a between-group reduction in pain of 20%, compared to no exercise. This means, for a baseline pain of 5, the SWE would be a 1/10 between-group reduction in pain.

CONCLUSION

This patient-informed threshold of clinical importance should guide the interpretation of findings from randomised trials and meta-analyses of exercise therapy compared to no exercise.
EXERCISE PROGRAM WITHIN ADULT PSYCHIATRIC INPATIENT SERVICES FOR THOSE WITH DISORDERED EATING
Authors: Wright Dr Kemi , Furzer Dr Bonnie , McMahen Caleb , Luke Jessica , Herbert Brittany , Edoo Azam
Published: May 2024

INTRODUCTION & AIMS

Over one million Australians live with an eating disorder, with 40 – 80% reported to undertake dysfunctional exercise practices (e.g., compulsive exercise, exercise dependence). Dysfunctional exercise can be the first symptom to appear and the last symptom to resolved in eating disorder patients, with 41% of eating disorders patients relapsing into dysfunctional exercise patterns 4 to 9 months post inpatient treatment. We evaluated an accredited exercise physiology led program implemented for adult mental health inpatients with disordered eating and exercise behaviours to support patient outcomes and safe exercise participation.

METHODS

Data was collected as part of service evaluation and included patient characteristics, session data (e.g., mood and enjoyment via Exercise Enjoyment Scale) and patient outcomes (e.g., Compulsive Exercise Test (CET); Exercise Dependence Scale (EDS-21)). Characteristics of the cohort was reported and compared to clinical cut-offs, along with program feasibility measures.

RESULTS

Between Sep 2022 and Nov 2023, 20 female patients engaged in the program (mean age= 26 years). Of those 15 were diagnosed with Anorexia Nervosa, 16 with a co-occurring Personality Disorder and 9 with a Trauma Related Disorder. EDS-21 results showed 56% were symptomatic, and 33% exercise dependent, with 80% also presenting with suicidal ideation/self-harm. Across 137 service interactions, patients engaged 65% of the time, and 25% of the time deemed inappropriate. Pre-session mood was low (mean= -2.13 ± 1.46) with an average post-session mood improvement of + 4.46 Session enjoyment was high (mean=3.6±1.20) and no adverse events were recorded.

CONCLUSIONS & IMPLICATIONS

Exercise supported by AEPs is safe for inpatients with disorder eating, with patients valuing engagement in services focused on supporting positive exercise relationships and behaviours. A tailored and evidence-based approach to exercise can improve acute mood of consumers.
DOES A SINGLE DAY OF EXERCISE SNACKING IMPROVE INSOMNIA SEVERITY AND SLEEP ARCHITECTURE IN INDIVIDUALS WITH SELF-REPORTED INSOMNIA?
Authors: Wallen Dr Matthew , Schmidt1 Ms Caitlin , Ashworth Mr Ethan , Dawood Ms Hanna , Simpfendorfer Ms Mary , Hannouch Ms Samara , Smith Ms Chelsea , Aloi Mr Joseph , Manners Jack , Lechat Bastien , Sweetman Alexander , Vakulin Andrew
Published: May 2024

INTRODUCTION & AIMS

Regular exercise may reduce an individual’s insomnia severity, but time constraints remain a significant barrier to participation. Exercise snacking, defined as short bouts of moderate-to-vigorous physical activity performed periodically during the day, shows potential to address time pressures for other chronic conditions. However, its effects on insomnia severity and sleep architecture are unknown. The aim of this study was to explore the impact of a single day of exercise snacking on insomnia severity and sleep architecture in individuals with self-reported insomnia symptoms.

METHODS

Adults self-reporting insomnia symptoms were recruited to participate in a single-arm study. Participants completed a single-day exercise snacking protocol that included three sessions of 3 x 20 second ‘all out’ stair climbing efforts, separated by 1-4 hours. Self-reported insomnia severity was assessed at baseline and at 24-hours using the Insomnia Severity Index (ISI). Sleep architecture (sleep stages, time, and efficiency) was quantified during the night before, and immediately after the exercise protocol, via the Withings Sleep Analyzer.

RESULTS

Fourteen adults aged (median [range]) 23 [19-34] years at baseline, including 64% females, with a body mass index of (mean ± SD) 24.4 ± 5.0 kg/m2, and an ISI score of 15.4 ± 3.2, were recruited. Twelve participants completed all testing timepoints. Adherence to the protocol was 93%. Compared to baseline, there was a significant reduction in the ISI at 24-hours (baseline mean: 15.2, 95% CI 12.8-17.7; 24-hours: 11.4, 95% CI 9.0-13.8; p = 0.001, Cohen’s d = -1.21). No significant changes were found for sleep architecture outcomes including sleep stages, time, or efficiency.

CONCLUSION

A single day of exercise snacking improves acute insomnia severity symptoms, but not objectively measured sleep architecture, in adults with self-reported insomnia symptoms. A randomised controlled trial with an extended follow-up period and wider age range of participants is required.
CALL FOR ACTION: GUIDELINES FOR PHYSICAL ACTIVITY BASED INTERVENTIONS IN ADDICTION
Authors: Gould Mrs Kirrily , Dowla Dr Rhiannon
Published: May 2024

With the evidence supporting the extensive benefits of exercise for people experiencing substance use disorders (SUD) rapidly growing, the demand for clinical exercise interventions in SUD services is expanding through Australia. However, at present there are no clear safety considerations or guidelines specific to SUD, leaving exercise physiologists falling to broader guidelines when working with SUD, often using those developed for severe mental illness (SMI). When working with SUD, many considerations differ to those being treated with SMI. This includes differences in the common comorbidities seen in SUD compared to SMI, as well as considerations relating to withdrawal and craving management. Furthermore, the different impacts and considerations of each substance class in relation to exercise needs to be elucidated. Therefore, standardised safety considerations and contraindications need to be developed to allow Exercise Physiologists to provide safe and effective interventions for those in the withdrawal and recovery phase of SUD. This call for action proposes the development of a multidisciplinary informed clinical exercise guideline for safety protocols, considerations and contraindications for physical activity-based interventions within substance use disorder treatment.
CAN AN INTERVAL-BASED RUNNING EXERCISE INTERVENTION IMPROVE LUMBAR INTERVERTEBRAL DISC HEALTH? THE ASTEROID RANDOMISED CONTROL TRIAL
Authors: Samanna Claire L , Neason Christopher , Tagliaferri Scott , Belavy Daniel , Bowe A/Prof Steven J , Clarkson Matthew , Connell A/Prof Daniel , Craige Ms Emma A , Gollan Romina , Main Luana C , Miller Clint , Mitchell Ulrike , Mundell Niamh , Scott David , Tait Jamie L , Vincent Grace E , Owen Patrick
Published: May 2024

BACKGROUND AND AIMS

Low back pain is the leading cause of global disability, with lumbar disc pathologies estimated to contribute to up to 40% of cases. Exercise training is an established treatment to reduce pain intensity and disability in individuals with low back pain; however, the effect of exercise training on intervertebral discs is unknown. Cross-sectional studies have shown that endurance running (>50km per week) is associated with healthier intervertebral discs, as evidenced by greater T2-relaxation (hydration) and intervertebral disc height. However, no studies have explored the relationship between running and disc health prospectively. This study aims to examine the impact of a 12-week progressive run-walk exercise intervention on intervertebral disc health in individuals with chronic low back pain.

METHODS

Forty individuals with non-specific low back pain were enrolled in a 12-week parallel randomised control trial and allocated to either a digitally-delivered progressive run-walk interval exercise intervention (supervised by an accredited exercise physiologist) or waitlist control. All participants underwent magnetic resonance imaging at baseline, 6 and 12 weeks to examine intervertebral disc health (e.g. T2-relaxation, intervertebral disc height, Pfirrmann grade).

RESULTS

Thirty-nine participants (20 intervention and 19 waitlist control; mean [SD] age: 33 [6] years, female: 50%) underwent MRI at baseline, 6 and 12 weeks. At baseline, intervertebral disc outcomes were no different in either group (T2-relaxation[ms] mean[SD]:81.07[6.61] and 85.11[9.33]; p=0.939, height[mm] mean[SD]: 8.77[0.87] and 9.03[0.90]; p=0.819, respectively). Six and 12-week outcomes are currently being analysed and results will be available for presentation at the conference.

CONCLUSION

This randomised control trial will provide world-first evidence on the effects of a progressive run-walk exercise intervention on lumbar intervertebral disc health in adults with non-specific chronic low back pain. Should this intervention prove effective, findings will have marked implications for current guidelines and clinical management of this debilitating chronic condition.
ENGAGE: COMMUNITY – A STUDENT LED, TELEHEALTH EXERCISE PHYSIOLOGY SERVICE DELIVERY MODEL TO COMBAT SOCIAL ISOLATION IN OLDER ADULTS
Authors: Borges Dr Nattai , Shah Ms Brishna , Nilsson Professor Michael , Wright Dr Kemi , Smith Dr Mitchell , Walker Professor Frederick Rohan
Published: May 2024

BACKGROUND AND AIMS

EngAGE: Community is a student-led Exercise Physiology service delivery model that provides accessible, enjoyable and socially engaged exercise programs for older adults to combat loneliness. We aimed to assess the impact of EngAGE: Community on social, psychological, and quality of life outcomes in community-dwelling older adults, and student development.

METHODS

EngAGE: Community was a 15-week telehealth group-exercise program that recruited community-dwelling older adults and student Exercise Physiology practitioners. Classes were supervised by an Accredited Exercise Physiologist. Each EngAGE session consisted of exercise, educational and community-developing activities. Participant survey outcomes for social and psychological health, and quality of life were collected online before and following the program. Student development outcomes were also collected online before and following the program.

RESULTS

Across four programs, 73 community participants and 15 student participants were recruited, providing 1042 community engagement hours and 900 student development hours. Of these, 45 community participants completed sufficient attendance for data inclusion, and 14 student datasets were included. Community participants reported significant improvements in social [UCLA Loneliness Scale (p=0.001), Social Anxiety and Phobias Scale (p=0.007)] and psychological health [Kessler-10 (p=0.03)], as well as quality of life [SF-12 (p=0.02) and Satisfaction with Life Scale (p=0.05)]. A subset of the population demonstrated significant improvements in lower (p<0.001) and upper body strength (p=0.003). Student practitioners reported significant improvements in Work Self-Efficacy (p=0.002), Confidence in Skills (p=0.02) and Work Readiness (p=0.03). Community participants (n=48) provided an 81-98% agree/strongly agree response to qualifying statements suggesting the program was enjoyable, educational, social, and beneficial for their wellbeing. The cost per practitioner contact minute for all EngAGE: Community rotations was calculated as $1.92 compared to $4.21 for usual care (45% saving).

CONCLUSION

EngAGE: Community is a viable and cost-effective telehealth strategy to improve older Australians social and psychological health while developing Exercise Physiology student practitioners.
THE PHYSIOLOGICAL VALIDITY OF CRITICAL SPEED DERIVED FROM A 3-MINUTE ALL-OUT SWIM TEST
Authors: Bulte Miss Karla , Mitchell Dr Lachlan , Siegel Dr Rodney , Warmington Associate Professor Stuart , Hoffmann Dr Samantha
Published: May 2024

INTRODUCTION AND AIMS

The boundary between heavy and severe exercise domains is one of the most consistent predictors of swimming performance. The gold standard approach to assessing this physiological threshold (numerous 30-minute constant-load trials) is complex and time-consuming, leading practitioners to explore other methodologies, which has left coaches questioning the validity of testing outcomes and reducing testing implementation. The recent proposal of a modified 3-minute all-out swim test has produced reliable estimates of critical speed (CS), however the estimates have not been validated against physiological measures. The aim of this study was to establish the physiological validity of CS derived from the modified 3-minute all-out swim test in elite swimmers.

METHODS

16 elite swimmers completed a 3-minute test consisting of 12 maximal 25-m efforts separated by 5s of rest. CS was calculated as the average speed of the slowest two 25-m efforts from the last four completed. To identify MLSS, swimmers completed a 30-minute trial broken into 6 x 5-minute intervals. Blood lactate concentration collected at each interval determined the subsequent interval speed. Over two additional visits, participants completed a 30-minute constant speed trial – at 2% above and 2% below CS to determine the physiology surrounding CS. Statistical analyses were conducted to compare CS and MLSS and determine their association, and to compare physiological measures within the two constant load trials.

RESULTS

MLSS and CS were not statistically different (p>0.05) and had a strong positive correlation (r=0.98). A physiological steady state was verified in the below CS trial (p>0.05). A physiological steady state was not obtained in the above CS trial (p<0.05).

CONCLUSIONS

These findings suggest the modified 3-minute all-out swim test as a valid methodology to assess the CS of elite swimmers. Implementation of this methodology could enable critical insight into how athletes are adapting to training and contribute significantly to swimming talent identification.
EXERCISE IN ADULTS WITH ATTENTION-DEFICIT/HYPERACTIVITY DISORDER: A SYSTEMATIC REVIEW
Authors: Hanbury-Brown Christopher , AM Prof Maria A. Fiatarone Singh , Inskip Dr Michael , Ogrodnik Dr Michelle , Heisz Dr Jennifer , Mavros Dr Yorgi
Published: May 2024

INTRODUCTION & AIMS

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in adults. Stimulant medications are first-line treatments, they have many side effects and do not address common comorbidities such as cardiometabolic disease, depression, and anxiety. Exercise, by contrast, not only improves ADHD symptoms in youth but effectively treats such comorbidities, making it a potentially valuable treatment option. However, exercise efficacy in adults with ADHD has not been systematically reviewed. Therefore, we aimed to summarise the results of acute exercise and training interventions on health-related outcomes for adults with ADHD, including ADHD symptoms, cognitive function, and psychological well-being.

METHODS

Using PRISMA guidelines, fifteen databases were searched (including grey literature) on 27/08/2020, yielding 22,088 unique publications. Database alerts were created to capture additional studies (n= 2). Screening, data extraction, Risk of Bias and GRADE assessment was conducted by CEHB.

RESULTS

Seven acute (6 cycling, 1 self-selected, 1 yoga) and 6 training studies (Yoga, Pilates, Kickboxing, Tai Chi, General Coordination, Group Circuit Class, Cycling) were included. Among acute studies, those reporting small-to-moderate improvements in cognitive function were characterised by longer duration exercise (>30 minutes), withholding ADHD medication before exercise, and using cohorts with clinician-confirmed ADHD diagnosis. Among the training studies, only one reported an improvement in cognition following Pilates when compared to an inactive control. It was longer (6 months vs. <8 weeks), prescribed progressive intensity and volume, and had high adherence compared to the non-significant trials. The certainty of evidence was low or very low for all outcomes.

CONCLUSIONS

Overall, acute exercise may have a small positive effect on cognition in adults with ADHD; however, certainty of the evidence is low. Further research is needed to investigate the impact of different modalities, durations, and intensities of acute exercise and chronic exercise on adult ADHD.
LONG-TERM SPORT OR EXERCISE COMMENCED BEFORE 16 YEARS OF AGE REDUCES ADVERSE BODY COMPOSITION OUTCOMES IN CEREBRAL PALSY
Authors: Fleeton Dr Jennifer , Fornusek Dr Ché , Mavros Dr Yorgi , Sanders Professor Ross
Published: May 2024

INTRODUCTION & AIMS

Bone mineral density (BMD) and appendicular lean mass (ALM) deficits are common in people with cerebral palsy (CP), increasing sarcopenia and osteoporosis risk, while sport/exercise participation before age 16 improves adult peak bone mass accretion. This study investigated the effects of high-level sport/exercise participation commenced before 16 years of age on body composition in ambulatory adults with CP.

METHODS

Body composition was measured via dual-energy X-ray absorptiometry in a cross-sectional observational pilot study of 26 adults (m=19; f=7; GMFCS I-III) grouped via self-reported activity level into Low (<150 minutes moderate-vigorous activity weekly; n=10), Post-16 (active but commenced participation after 16; n=6), and Pre-16 (active and commenced participation before 16; n=10). Between-group Z-score differences were assessed via Kruskal-Wallis one-way ANOVA, with post-hoc comparisons via Mann-Whitney U-test.

RESULTS

Whole body, spine and hip BMD Z-scores were significantly higher in Pre-16 (1.020 (0.639), 1.210 (1.102), and 0.450 (1.325), respectively) versus Low (-0.500 (0.715), -0.840 (0.957), and -1.020 (1.059), respectively) (p<0.001-0.008). Thirteen participants, including four competitive athletes, had low BMD, and 15, including eight athletes, had moderate-significant ALM deficits, versus age- and sex-specific reference populations.

CONCLUSION

Ambulatory adults with CP who exceed physical activity guidelines and commenced participation before 16 years of age have higher BMD than those who are sedentary or commenced participation after 16 years. Sport and exercise across the lifespan are critical to ameliorate adverse body composition outcomes common in CP, however, some athletes remain at-risk and require targeted combined resistance training and dietary interventions in addition to sport training to address low ALM and BMD.
EXERCISE PHYSIOLOGIST-LED PAIN SCIENCE COACHING VIA TELEHEALTH IMPROVED PAIN AND FUNCTION IN LIFE INSURANCE CLAIMANTS: A PRAGMATIC COHORT STUDY
Authors: Phillips Dr Vicky , Mundell Dr Niamh , Sinclair Mr Chris , Owen Dr Patrick
Published: May 2024

INTRODUCTION & AIMS

Personal injury and illness compensation claimants are more likely to experience persistent pain and poorer clinical/vocational outcomes than non-compensated clients. Evidence supports the effectiveness of pain science coaching to help people understand and re-train their pain system. This consequently reduces pain intensity, improves function and quality of life. However, the effectiveness of telehealth-delivered, exercise physiologist-led pain science coaching is yet to be evaluated. This study aimed to determine the effectiveness of an accredited exercise physiologist-led pain science coaching intervention via telehealth in Australian life insurance claimants.

METHODS

This pragmatic cohort study included 1,275 claimants receiving a pain science coaching intervention supported by life insurance compensation. Ethics was approved via Deakin University Human Research Ethics Committee (2023-347). Outcome measures were pain intensity (11 item numerical pain rating scale, range: 0-10 points) and function (two 11-item patient-specific functional scale, range: 0-20 points). Linear mixed models determined within-group change over time.

RESULTS

Clients (female: 75%, male: 25%) had a mean (SD) age of 50 (10) years (range: 20-69 years) and claim duration of 2 (2) years (range: 0-20 years). Mean (SD) intervention duration was 10 (6) weeks (range: 3-41 weeks), financial cost was A$1,149 (A$202; range: A$510-A$2,040) and included 5 (1) hours (range: 2-11 hours) of pain science coaching. Following the intervention, pain intensity decreased 25% (estimated marginal mean change [95%CI]: -1.49 [-1.59, -1.40] points, P<0.001) and function increased 76% (4.41 [4.21, 4.62] points, P<0.001). Changes surpassed established clinically meaningful effect thresholds for pain intensity (1.17 points) and function (2.6 points). Client Net Promotor Score was +60 (Australian Healthcare Index benchmark ≥ +30) and 91% were satisfied with the intervention.

CONCLUSION

An exercise physiologist-led pain science coaching intervention resulted in clinically meaningful improvements in pain intensity and function in compensation claimants. Clients reported high satisfaction rates.
THE EFFECTS OF MODERATE TO HIGH-LOAD RESISTANCE TRAINING WITH BLOOD FLOW RESTRICTION IN HEALTHY ADULTS: A SYSTEMATIC REVIEW
Authors: Raj Dr Isaac Selva , Marston Dr Kieran , Mckee Mr James , Marco Ms Kristen De , Beere Mr Michael , Nosaka Prof Ken , Peiffer Professor Jeremiah , Galna Dr Brook , Scott Brendan
Published: May 2024

INTRODUCTION AND AIMS

Low-load resistance training (RT) with blood flow restriction (BFR; 20–40% of 1-repetition maximum [1RM]) increases muscle mass and strength comparably to unrestricted high-load RT. As healthy populations are not limited to low-loads, some researchers have also examined whether the adaptations to high-load RT could be enhanced with BFR, though results are inconsistent. Therefore, we conducted a systematic review to investigate whether moderate to high-load resistance training (M-HL RT) with BFR increases muscle mass or strength more than the equivalent training without BFR.

METHODS

Studies involving M-HL RT (≥60% 1RM) with BFR applied during exercise sets or rest intervals were included. The following databases were searched: PubMed, Web of Science, Scopus, ScienceDirect, ProQuest Central, and Google Scholar. Two researchers independently screened the titles and abstracts for eligibility based on the inclusion and exclusion criteria. The full texts of included studies were then independently screened by two researchers. Conflicts were resolved by a third researcher. Following screening, study and participant characteristics, intervention protocol for each group and outcome measures were extracted for each included study.

RESULT

Ten studies met the criteria for inclusion in this review. All included studies measured muscle strength, with only three reporting greater strength increases after M-HL RT with BFR compared to equivalent training without BFR. Five studies assessed muscle mass, with four reporting similar increases after M-HL RT with and without BFR. One observed a smaller increase in mass after M-HL RT with BFR than without.

CONCLUSION

Most studies did not observe additional benefit of applying BFR during M-HL RT for muscle strength or mass. Studies which did report benefits of BFR may be limited by methodological issues, impacting the applicability of their findings. Overall, this review does not support using BFR during M-HL RT for additional improvements in muscle strength or mass.
UPRIGHT BIPEDAL EXERCISE TRAINING IMPROVES INTERVERTEBRAL DISC HEALTH: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Samanna Claire L , Owen Patrick , Mitchell Ulrike , Ehrenbrusthoff Katja , Saueressig Tobias , Moreira Eva , Arora Nitin K , Mundell Niamh , Tait Jamie L , Donath Lars , Karner Vera , Belavy Daniel
Published: May 2024

INTRODUCTION & AIMS

The structure and function of human tissue, such as bone, muscle and tendon, can be improved with targeted exercise training. However, the effects of exercise training on intervertebral disc tissue has received comparably less attention. With a scope to identify types of exercise training that improve intervertebral disc health, this study examined the impact of historical exercise, sport and/or physical activity on quantitative intervertebral disc outcomes.

METHODS

The protocol was prospectively registered with PROSPERO (CRD42022366391). Five databases (inception to 30th September 2022), 17 trial registries and reference lists and forwards/backwards citations were searched. Inclusion criteria followed the Participants (human), Exposure (exercise, sport or physical activity for greater than one week), Comparators (non-exercise, sport or physical activity control group), Outcomes (magnetic resonance imaging measures of lumbar intervertebral disc health on a continuous scale [e.g. T2, signal intensity, intervertebral disc height]) and Study design (any) framework. Pairwise random-effects restricted maximum likelihood meta-analysis estimated standardised mean difference (Hedges g).

RESULTS

From the search yield of 2,150 records, 12 reports representing 10 studies (participants: 874) were deemed eligible. When compared to any comparator, upright bipedal exposures (g [95%CI]: 0.31 [0.06, 0.55]; P=0.014; studies: 6; participants: 346; I2: 87%), were associated with greater intervertebral disc health. However, no physical loading exposure (g [95%CI]: 0.29 [-0.23, 0.82]; P=0.275; studies: 10; participants: 874), non-upright/non-contact exposures (g [95%CI]: 0.70 [1.25, 2.64]; P=0.336; studies: 5; participants: 260), extreme trunk range of motion exposures (g [95%CI]: -0.28 [-1.60, 1.04]; P=0.456; studies: 3; participants: 230) and aerobic-based exposures (g [95%CI]: 0.48 [0.08, 1.04]; P=0.094) were associated. Sensitivity analyses supported the robustness of primary and secondary effect estimates.

CONCLUSION

Greater intervertebral disc health associated with a prior history of upright bipedal physical loading indicates prospective interventions examining upright bipedal exercise effects on intervertebral disc health are warranted.
EDUCATION FOR EXERCISE PROFESSIONALS, DELIVERED BY EXERCISE PROFESSIONALS: THE ACTIVE EDUCATION PROGRAM
Authors: Pithers Miss Nicola , Sharp Miss Tijana
Published: May 2024

CASE SETTING

Experience as director of a young exercise physiology clinic has facilitated extensive supervision of practicum students and graduates. This exposure has highlighted the inconsistent learning opportunities offered in pilates exercise prescription. This is alarming given the emergence of recent findings that suggest pilates is beneficial in the management of various pathologies.

TREATMENT/INTERVENTION

“The Active Education Program” was developed in January 2023 to facilitate structured learning opportunities for allied health students, graduates and professionals, particularly in the prescription and delivery of pilates based exercise. The courses involved in the program provide professional development in matwork, reformer, other studio equipment and rehabilitation based pilates exercise. Course participants receive a workbook and online exercise library for each course. The foundations and learning outcomes of this program are also embedded in a self-developed exercise science and physiology student placement strategy. Participants were asked to complete a survey on course completion pertaining to resource quality, experience and satisfaction.

RESULTS

A total of 32 participants completed at least one course in 2023. The quality and volume of the online exercise library was rated as ‘exceeding expectations’ by 87.5% and 90.6% participants respectively. The majority of participants (93.8%) felt confident in their ability to prescribe and deliver a matwork pilates class following participation, while 84.4% felt the course provided a high value of contribution to their professional development. Finally, 100% of attendees felt they received enough feedback during the course.

REFLECTIONS/LEARNINGS

The Active Education Program has demonstrated high quality learning experiences and promoted industry readiness. Previous feedback has facilitated the refinement of content and delivery strategies for forthcoming courses. For example, future endeavours include offering an online delivery option to increase program reach. The program will continue to connect professionals and provide a network of support while providing a high quality of professional development.