Strength gain at little cost? Feasibility of \u27low load\u27 eccentric cycling as a tool for strength gain in sedentary men

Symptomatic reporting is a common issue in exercise rehabilitation. When traditional concentric aerobic exercise is used as an exercise stimulus, dyspnoea and fatigue are often reported by elderly5 and by cohorts with cardiorespiratory pathology3. Among the unique attributes of eccentric aerobic exercise is lower metabolic and cardiovascular demand for a given workload 1 ,2. This makes eccentric aerobic exercise more suitable for long-term adherence in rehabilitation. Although, extremely \u27high load\u27 eccentric cycling interventions have shown improvements in strength measurements4, no \u27low load\u27 eccentric cycling studies have been performed to determine if strength adaptations are feasible. Therefore, this study determined if \u27low load\u27 eccentric cycling can stimulate strength adaptations

Does exercise have a role in the management of gestational diabetes mellitus?

Gestational diabetes mellitus (GDM) is associated with a marked increase in the long-term risk of type 2 diabetes and adverse pregnancy outcomes. Engaging in vigorous recreational physical activity prior to and during pregnancy significantly reduces the risk of developing GDM. In contrast, evidence of a therapeutic effect from participation in a structured exercise training regimen, although promising, is limited and requires further more substantial investigation. This paper briefly reviews the pathophysiology of GDM, the evidence related to physical activity participation and exercise regimen intervention on GDM, and the clinical considerations required for prescribing exercise. Key Words: gestational diabetes mellitus • exercise • physical activity • pregnancy • type 2 diabete

The Acute Physiological Responses of Eccentric Cycling During the Recovery Periods of a High Intensity Concentric Cycling Interval Session

Eccentric and concentric exercise is associated with disparate acute and chronic responses. We uniquely interspersed workload equivalent eccentric cycling during each recovery period of a high intensity interval training (HIIT) cycling trial to determine acute cardiopulmonary, thermal and psycho-physiological responses. Twelve males [age 28 years (SD 6), peak oxygen consumption 48 mL ⋅ kg-1 ⋅ min-1 (SD 6)] completed two high intensity interval cycling trials [4 x 5 min, 60% peak power output (PPO)] separated by 7-10 days. The CONR trial required participants to cycle concentrically during each recovery period (5 min, 30% PPO). The ECCR trial modified the recovery to be eccentric cycling (5 min, 60% PPO). High intensity workload (CONR: 187 ± 17; ECCR: 187 ± 21 W), oxygen consumption (CONR: 2.55 ± 0.17; ECCR: 2.68 ± 0.20 L ⋅ min-1), heart rate (CONR: 165 ± 7; ECCR: 171 ± 10 beats ⋅ min-1) and RPE legs (CONR: 15 ± 3; ECCR: 15 ± 3) were equivalent between trials. Eccentric cycling recovery significantly increased external workload (CONR: 93 ± 18; ECCR: 196 ± 24 W, P \u3c 0.01) yet lowered oxygen consumption (CONR: 1.51 ± 0.18; ECCR: 1.20 ± 0.20 L ⋅ min-1, P \u3c 0.05) while heart rate (CONR: 132 ± 13; ECCR: 137 ± 12 beats ⋅ min-1) and RPE of the legs (CONR: 11 ± 7; ECCR: 12 ± 7) remained equivalent. There was no significant difference in the aural temperature between the trials (ECCR: 37.3 ± 0.1°C; CONR: 37.4 ± 0.1°C, P \u3e 0.05), yet during recovery periods mean skin temperature was significantly elevated in the ECCR (ECCR: 33.9 ± 0.2°C; CONR: 33.3 ± 0.2°C, P \u3c 0.05). Participants preferred ECCR (10/12) and rated the ECCR as more achievable (82.8 ± 11.4 mm) than CONR (79.4 ± 15.9 mm, P \u3c 0.01). In conclusion, eccentric cycling during the recovery period of a HIIT training session, offers a novel approach to concurrent training methodology. The unique cardiopulmonary and skeletal muscle responses facilitate the achievement of both training stimuli within a single exercise bout

Positive, limited and negative responders: The variability in physical fitness adaptation to basic military training

Objectives: To investigate the heterogeneity of physical adaptation in Australian Army recruits completing a 12-week basic military training regimen. Design: A prospective research design. Methods: Volunteer recruits (n = 195) completed 12-weeks of basic military training. Recruit physical fitness was assessed at week 1, weeks 6–8 and week 12. Recruits in the upper (75th) and lower (25th) quartiles for each assessment were then analysed using a repeated measures two-way ANOVA. The relative magnitude of recruit adaptions were classified as positive response (Rpositive, ≥5%), limited response (Rlimited, \u3e−5% to \u3c5%) and negative response (Rnegative, ≤−5%); Chi-square analysis determined the proportional differences in the distribution of each quartile. Results: An interaction (p \u3c 0.001) was observed in the lower and upper recruit quartiles for all assessments of physical fitness at each time point. After 12 weeks of military training the mean difference of the highest quartile was; 20-m multi-stage fitness test 7.4 mL·kg−1·min−1, (CI:5.8:9.1), 2-min push-ups 20.1 reps, (CI:16.2:23.9), 1RM box lift 5.6 kg, (CI:2.6:5.8) and load carriage 222.1 s, (CI:174.7:269.4) compared to the lowest recruit quartile. The highest quartile demonstrated no improvement in 1RM box lift (−4%, −1%) and push-ups (2%, 0%) performance at weeks 6–8 and week 12 respectively. In contrast, adaptations in the lowest quartile for 1RM box lift (16%, 21%) and push-ups (46%, 46%) over the same time periods were observed. Conclusions: A significant proportion of recruits may complete basic military training with a decline in physical performance. Higher relative-intensity cardiorespiratory and resistance exercise should be considered to facilitate physical adaptation in all recruits

Supporting placement supervision in clinical exercise physiology

The continued engagement of the professional workforce as supervisors is critical for the sustainability and growth of work-integrated learning activities in university degrees. This study investigated factors that influence the willingness and ability of clinicians to continue to supervise clinical exercise physiology work-integrated learning opportunities and makes recommendations for future supervision engagement. Themes identified from a supervisor survey were: staffing and time availability; administrative processes and support; student quality, knowledge and attitudes; student learning experiences; supporting the profession; service benefit; clinical personal benefit; funding; workplace support; staff qualifications and experience; prior positive experiences; future recruitment; facilities and infrastructure; and supporting the university. The responses resulted in five key recommendations for future enhanced and sustainable placement supervision. These were: adoption of efficient supervision structures; development and use of a competency checklist; enhanced recognition of supervision; standardized placement paperwork and assessment tools; and broadening of placement scheduling

Determination of clinical competencies for exercise physiology students

Introduction: Clinical placements and assessment are a key part of health professional education. However, quality assessment in a clinical environment is difficult to achieve without a clear picture of what constitutes competence. The aim of this study was to establish a set of competencies that describe the attributes considered critical to ensuring an entry-level exercise physiologist (EP) can practice safely and effectively with a client-centred philosophy. Methods: This study used a mixed methods, multiphase approach. The competencies, which are organised into units of competency with underlying elements, were developed following online surveys and focus groups involving those with expertise in the area, with additional refinement provided by the project team. A first-stage validation was conducted via electronic survey where (i) participants rated the importance of each unit of competency to practice as an entry-level EP; and (ii) those participants who were recently graduated EPs rated the extent to which they perceived they were competent in each unit. Results: The final set of competencies is described as 19 elements organised into 6 units. The units are: (i) Communication, (ii) Professionalism, (iii) Assessment and Interpretation, (iv) Planning and delivery of an exercise and/or physical activity intervention, (v) Lifestyle Modification and (vi) Risk Management. The majority of survey participants (93-97%) considered each unit of competency as being important to practice successfully as an entry-level EP. The majority (78-95%) of the sub-group who identified as new EPs considered themselves competent in each unit, suggesting the competencies are articulated at the level of a new EP. Conclusion: The competencies resulted from an extensive, iterative process involving those with expertise in the area followed by initial validation. The competencies will have a range of applications, including informing the development of a student placement assessment tool

Subjective measures of workload and sleep in Australian Army recruits:Potential utility as monitoring tools

Introduction: Subjective measures may offer practitioners a relatively simple method to monitor recruit responses to basic military training (BMT). Yet, a lack of agreement between subjective and objective measures may presents a problem to practitioners wishing to implement subjective monitoring strategies. This study therefore aims to examine associations between subjective and objective measures of workload and sleep in Australian Army recruits. Materials and Methods: Thirty recruits provided daily rating of perceived exertion (RPE) and differential RPE (d-RPE) for breathlessness and leg muscle exertion each evening. Daily internal workloads determined via heart rate monitors were expressed as Edwards training impulse (TRIMP) and average heart rate. External workloads were determined via global positioning system (PlayerLoad™) and activity monitors (step count). Subjective sleep quality and duration was monitored in 29 different recruits via a customized questionnaire. Activity monitors assessed objective sleep measures. Linear mixed-models assessed associations between objective and subjective measures. Akaike Information Criterion assessed if the inclusion of d-RPE measures resulted in a more parsimonious model. Mean bias, typical error of the estimate (TEE) and withinsubject repeated measures correlations examined agreement between subjective and objective sleep duration. Results: Conditional R2 for associations between objective and subjective workloads ranged from 0.18 to 0.78, P \u3c 0.01, with strong associations between subjective measures of workload and TRIMP (0.65-0.78), average heart rate (0.57-0.73), and PlayerLoad™ (0.54-0.68). Including d-RPE lowered Akaike Information Criterion. The slope estimate between objective and subjective measures of sleep quality was not significant. A trivial relationship (r=0.12; CI -0.03, 0.27) was observed between objective and subjective sleep duration with subjective measures overestimating (mean bias 25 min) sleep duration (TEE 41 min). Conclusions: Daily RPE offers a proxy measure of internal workload in Australian Army recruits; however, the current subjective sleep questionnaire should not be considered a proxy measure of objective sleep measures

Determination of clinical competencies for exercise physiology students

Introduction: Clinical placements and assessment are a key part of health professional education. However, quality assessment in a clinical environment is difficult to achieve without a clear picture of what constitutes competence. The aim of this study was to establish a set of competencies that describe the attributes considered critical to ensuring an entry-level exercise physiologist (EP) can practice safely and effectively with a client-centred philosophy. Methods: This study used a mixed methods, multiphase approach. The competencies, which are organised into units of competency with underlying elements, were developed following online surveys and focus groups involving those with expertise in the area, with additional refinement provided by the project team. A first-stage validation was conducted via electronic survey where (i) participants rated the importance of each unit of competency to practice as an entry-level EP; and (ii) those participants who were recently graduated EPs rated the extent to which they perceived they were competent in each unit. Results: The final set of competencies is described as 19 elements organised into 6 units. The units are: (i) Communication, (ii) Professionalism, (iii) Assessment and Interpretation, (iv) Planning and delivery of an exercise and/or physical activity intervention, (v) Lifestyle Modification and (vi) Risk Management. The majority of survey participants (93-97%) considered each unit of competency as being important to practice successfully as an entry-level EP. The majority (78-95%) of the sub-group who identified as new EPs considered themselves competent in each unit, suggesting the competencies are articulated at the level of a new EP. Conclusion: The competencies resulted from an extensive, iterative process involving those with expertise in the area followed by initial validation. The competencies will have a range of applications, including informing the development of a student placement assessment tool

The development of an accreditation scheme for accredited exercise physiologists

Background: Accredited Exercise Physiologists provide exercise services for people living with chronic disease, disability or injury and are recognised in Australia as Accredited Exercise Physiologists (AEP) under a national certification system administered by Exercise and Sport Science Australia (ESSA). A major breakthrough occurred for the AEP in 2006 when the Australian Department of Health and Ageing approved the AEP to deliver clinical exercise services for people with chronic medical conditions under the taxpayer-funded national health scheme, Medicare Australia. Aims: In light of these developments, the authors recognised the need for new accreditation criteria, and our report summarises the work that we did on behalf of the profession and ESSA in restructuring the accreditation system. Methods and Outcomes: We first performed a background study that defined the scope of practice of the AEP and benchmarked the AEP against other allied health professions in Australia and Clinical Exercise Physiologists internationally. We then constructed a new set of accreditation criteria comprising sets of pathologyspecific knowledge and experiences, together with a set of generic standards including communication, professional behaviour and risk management. All participating Australian universities (18 out of 27 responded) and 29 practitioner experts were then invited to provide comment and input into the draft guidelines. There was strong support for the new system that was implemented nationally on 1 January 2008 and is now administered by ESSA. Conclusions: This work has stimulated an unprecedented level of activity in the Australian university sector in developing new curricula in clinical exercise science and practice, and is intended to lead to improved standards of clinical exercise practice.<br /

The sustainability of habitability on terrestrial planets: Insights, questions, and needed measurements from Mars for understanding the evolution of Earth-like worlds

What allows a planet to be both within a potentially habitable zone and sustain habitability over long geologic time? With the advent of exoplanetary astronomy and the ongoing discovery of terrestrial-type planets around other stars, our own solar system becomes a key testing ground for ideas about what factors control planetary evolution. Mars provides the solar system's longest record of the interplay of the physical and chemical processes relevant to habitability on an accessible rocky planet with an atmosphere and hydrosphere. Here we review current understanding and update the timeline of key processes in early Mars history. We then draw on knowledge of exoplanets and the other solar system terrestrial planets to identify six broad questions of high importance to the development and sustaining of habitability (unprioritized): (1) Is small planetary size fatal? (2) How do magnetic fields influence atmospheric evolution? (3) To what extent does starting composition dictate subsequent evolution, including redox processes and the availability of water and organics? (4) Does early impact bombardment have a net deleterious or beneficial influence? (5) How do planetary climates respond to stellar evolution, e.g., sustaining early liquid water in spite of a faint young Sun? (6) How important are the timescales of climate forcing and their dynamical drivers? Finally, we suggest crucial types of Mars measurements (unprioritized) to address these questions: (1) in situ petrology at multiple units/sites; (2) continued quantification of volatile reservoirs and new isotopic measurements of H, C, N, O, S, Cl, and noble gases in rocks that sample multiple stratigraphic sections; (3) radiometric age dating of units in stratigraphic sections and from key volcanic and impact units; (4) higher-resolution measurements of heat flux, subsurface structure, and magnetic field anomalies coupled with absolute age dating. Understanding the evolution of early Mars will feed forward to understanding the factors driving the divergent evolutionary paths of the Earth, Venus, and thousands of small rocky extrasolar planets yet to be discovered