bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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 (&gt;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&lt;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&gt;0.05) and had a strong positive correlation (r=0.98). A physiological steady state was verified in the below CS trial (p&gt;0.05). A physiological steady state was not obtained in the above CS trial (p&lt;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 (&gt;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. &lt;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 (&lt;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&lt;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&lt;0.001) and function increased 76% (4.41 [4.21, 4.62] points, P&lt;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.