bluuebunny/crossref_metadata_2025_split huggingface dataset:
DOES EXERCISE PRESERVE FAT FREE MASS DURING A VERY LOW ENERGY DIET IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA?
Authors: Machan (Cayanan) Dr Elizabeth , Lowrie Mr Fraser , Gordon A/Prof Christopher , Phillips A/Prof Craig , Yee Professor Brendon 
Published: May 2024

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

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

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

CONCLUSION
The VLED, with or without exercise, proved feasible and well-tolerated and demonstrated positive outcomes in body composition and AHI. The VEX group suggested a potential trend in preserving FFM compared to the VO group. These results are promising, indicating the need for a larger, definitive trial to confirm these findings and explore the impact of exercise on FFM preservation in this population.
THE EFFECT OF WATER DOUSING ON HEAT STRAIN AND PERFORMANCE DURING ENDURANCE RUNNING IN THE HEAT
Authors: Anderson Mr Mitchell , Chaseling Dr Georgia , Bellenger Dr Clint , Chalmers Dr Samuel 
Published: May 2024

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

CONCLUSION
Older adults attended and enjoyed the AEP led Diabetes Clinic program, while also improving fitness and cardiometabolic health outcomes. Ways to enhance referrals and engage older adults in the programs warrant further investigation. The potential for additional sessions to achieve greater physical activity engagement and diabetes self-management should be further investigated.