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Background: Iron facilitates key biological functions underpinning sports performance, and up to 60% of female athletes experience iron deficiency. However, the effects of iron deficiency on sports performance in female athletes is unclear, as are the degree of benefits of iron supplementation (FeSup). This study characterizes the effects of iron deficiency and FeSup on sports performance in high-level female athletes., Methods: Searches of the electronic databases Medline, SPORTDiscus, Web of Science, Scopus, and CINAHL were performed in July 2023. Studies were included that evaluated the effects of iron deficiency or FeSup on sports performance in high-level (maximal oxygen uptake [VO 2max ] > 45 mL/kg/min, or trained > 5 h/week) iron deficient (ID) (serum ferritin [sFer] < 40 µg/L) female athletes. Studies were assessed using a modified Downs and Black Quality Assessment Checklist., Results: A total of 23 studies comprising 669 athletes (age range: 13-47 years) across 16 sports were included in the review. Iron deficiency negatively affects endurance performance by 3%-4%. However, endurance performance improved by 2%-20% when ID athletes were treated with 100 mg/day of elemental iron for up to 56 days via oral supplementation, or bi-daily via parenteral administration over 8-10 days. ID non-anemic athletes with low sFer stores may be predisposed to reduced maximal aerobic capacity. However, maximal aerobic capacity improved by 6%-15% following 16-100 mg/day of elemental iron for 36-126 days. Isokinetic strength and anaerobic power performance may be impeded (-23% to +4%) among ID athletes, but the effect of FeSup on anaerobic power varied markedly (-5% to +9%) following 100 mg/day of elemental iron over 42-56 days, or 100 mg of elemental iron bi-daily over 8-10 days. The quality of studies was moderate (77%), ranging from low (57%) to high (100%). Moststudies (n = 18) contained group sizes ≤ 20 athletes, thus limiting the likelihood of detecting significant effects (statistical power > 0.80)., Conclusion: High-level ID female athletes experience a negative impact on endurance performance, which can be improved by supplementing with ∼100 mg of elemental iron per day or bi-daily. The decrements in other performance parameters characterizing a range of sports coincide with the severity of iron deficiency., Competing Interests: Competing interests The authors declare that they have no competing interests., (Copyright © 2024. Production and hosting by Elsevier B.V.)

Objectives: This study aims to describe the prevalence, characteristics and longitudinal changes in frailty among outpatient chronic kidney disease (CKD) and haemodialysis (HD) populations and their impact on survival., Design: Prospective observational cohort study., Setting: Single-centre ambulatory tertiary care setting, metropolitan Australian teaching hospital., Participants: Adult patients with advanced CKD (defined as estimated glomerular filtration rate <20 mL/min) or undergoing maintenance HD. Consent model was informed opt-out consent., Interventions: Fried frailty assessment at baseline, 6 months and 12 months of longitudinal follow-up., Primary Outcomes: All-cause mortality and kidney transplantation events., Results: Frailty was identified in 36.3% of the 256 participants, while an additional 46.5% exhibited prefrailty. Frailty was equally common among CKD and HD cohorts. Frailty outperformed age, comorbidity and laboratory parameters in predicting mortality risk with HR 2.83 (95% CI 1.44 to 5.56, p<0.001). Frailty also substantially reduced access to transplantation. While most participants exhibited static Fried phenotype over longitudinal assessment, improvements in frailty were observed as frequently as frailty progression. Female gender and symptom burden predicted frailty progression., Conclusions: Frailty is highly prevalent and closely aligned with survival outcomes. Frailty among patients attending routine outpatient care may demonstrate responsiveness to intervention with subsequent improvements in mortality and other patient-level outcomes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Nutrition guidance for athletes must consider a range of variables to effectively support individuals in meeting energy and nutrient needs. Resistance exercise is a widely adopted training method in athlete preparation and rehabilitation and therefore is one such variable that will influence nutrition guidance. Given its prominence, the capacity to meaningfully quantify resistance exercise energy expenditure will assist practitioners and researchers in providing nutrition guidance. However, the significant contribution of anaerobic metabolism makes quantifying energy expenditure of resistance exercise challenging., Objective: The aim of this scoping review was to investigate the methods used to assess resistance exercise energy expenditure., Methods: A literature search of Medline, SPORTDiscus, CINAHL and Web of Science identified studies that included an assessment of resistance exercise energy expenditure. Quality appraisal of included studies was performed using the Rosendal Scale., Results: A total of 19,867 studies were identified, with 166 included after screening. Methods to assess energy expenditure included indirect calorimetry (n = 136), blood lactate analysis (n = 25), wearable monitors (n = 31) and metabolic equivalents (n = 4). Post-exercise energy expenditure was measured in 76 studies. The reported energy expenditure values varied widely between studies., Conclusions: Indirect calorimetry is widely used to estimate energy expenditure. However, given its limitations in quantifying glycolytic contribution, indirect calorimetry during and immediately following exercise combined with measures of blood lactate are likely required to better quantify total energy expenditure. Due to the cumbersome equipment and technical expertise required, though, along with the physical restrictions the equipment places on participants performing particular resistance exercises, indirect calorimetry is likely impractical for use outside of the laboratory setting, where metabolic equivalents may be a more appropriate method., (© 2024. The Author(s).)

OBJECTIVES: To describe the incidence rate, frequency, severity, recurrence, and burden of musculoskeletal injury in professional ballet. STUDY DESIGN: Descriptive epidemiological (retrospective). METHODS: Professional dancers (n = 73, 40 females, 33 males) provided consent for retrospective review of musculoskeletal injury data. Medical-attention injuries were reported to and recorded by onsite physiotherapists between January 2018 and December 2021. Time-loss injuries were any injury that prevented a dancer from taking a full part in all dance-related activities for >1 day . Injuries were classified using the OSICS-10.1 system. Injury incidence rates (IIRs; injuries/1000 h), severity, recurrence, and burden were calculated. RESULTS: Nine hundred and fifty-three medical-attention injuries were recorded in 72 (98%) dancers at an IIR of 2.79/1000 h (95% confidence interval [CI], 2.62-2.98). 706 were time-loss injuries, which were reported in 70 dancers at an IIR of 2.07/1000 h (95% CI: 1.92, 2.23). Overuse injuries represented 53% of medical-attention injuries. The most frequently injured body area and tissue/pathology were thoracic facet joint (n = 63/953, 7%) and ankle synovitis/impingement (n = 62/953, 6%). Bone stress injuries (BSIs) were the most severe with the highest median time loss (135 days, interquartile range [IQR] 181) followed by fractures (72.5 days, IQR 132). The injuries with the highest burden were tibial BSIs (13 days lost/1000 h; 95% CI: 13, 14). Jumping and lifting were the most frequently reported injury mechanisms. CONCLUSION: Almost all dancers required medical attention for at least one injury during the surveillance period. Approximately 74% of injuries resulted in time loss. BSIs and ankle synovitis/impingement were of high burden, and a high proportion of BSIs were recurrent. J Orthop Sports Phys Ther 2023;53(11):712-722. Epub 14 September 2023. doi:10.2519/jospt.2023.11858 .

Introduction: Epidemiological evidence supports an association between higher levels of physical activity and improved cancer survival. Trial evidence is now needed to demonstrate the effect of exercise in a clinical setting. The E xercise during CH emotherapy for O varian cancer (ECHO) trial is a phase III, randomised controlled trial, designed to determine the effect of exercise on progression-free survival and physical well-being for patients receiving first-line chemotherapy for ovarian cancer., Methods and Analysis: Participants (target sample size: n=500) include women with newly diagnosed primary ovarian cancer, scheduled to receive first-line chemotherapy. Consenting participants are randomly allocated (1:1) to either the exercise intervention (plus usual care) or usual care alone, with stratification for recruitment site, age, stage of disease and chemotherapy delivery (neoadjuvant vs adjuvant). The exercise intervention involves individualised exercise prescription with a weekly target of 150 minutes of moderate-intensity, mixed-mode exercise (equivalent to 450 metabolic equivalent minutes per week), delivered for the duration of first-line chemotherapy through weekly telephone sessions with a trial-trained exercise professional. The primary outcomes are progression-free survival and physical well-being. Secondary outcomes include overall survival, physical function, body composition, quality of life, fatigue, sleep, lymphoedema, anxiety, depression, chemotherapy completion rate, chemotherapy-related adverse events, physical activity levels and healthcare usage., Ethics and Dissemination: Ethics approval for the ECHO trial (2019/ETH08923) was granted by the Sydney Local Health District Ethics Review Committee (Royal Prince Alfred Zone) on 21 November 2014. Subsequent approvals were granted for an additional 11 sites across Queensland, New South Wales, Victoria and the Australian Capital Territory. Findings from the ECHO trial are planned to be disseminated via peer-reviewed publications and international exercise and oncology conferences., Trial Registration Number: Australian New Zealand Clinical Trial Registry (ANZCTRN12614001311640; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367123&isReview=true)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: To date, there is limited consensus on post-contest recovery recommendations for natural physique athletes. The available literature emphasizes the negative consequences of extreme dieting associated with physique contests, yet offers only speculative suggestions to facilitate physiological recovery post-contest. This scoping review evaluates evidence-based recommendations for recovery in post-physique contests., Methods: The online search engines and databases Google Scholar, PubMed, and Scopus were searched systematically and 12 peer reviewed journal articles were included in the review., Results: Six key factors were identified that directly impacted on physiological recovery post-contest: (1) body composition, (2) recovery dietary intake, (3) resting metabolic rate (RMR) restoration, (4) endocrine measures recovery, (5) menstrual cycle recovery, and (6) psychological aspects of recovery., Conclusions: Three dietary strategies have been proposed to facilitate physiological recovery post-contest while bearing in mind body composition and future athlete outcomes; (1) a gradual increase in energy intake to maintenance requirements, (2) ad libitum eating, (3) an immediate return to maintenance energy requirements. Future research is required to determine the timeline in which full physiological recovery occurs post-contest and which strategies best support athlete health and performance during post-contest recovery., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Background: Grain mills, feed mills, ethanol plants, flour producers, but also mobile laboratory services need simple and reliable possibilities to analyze grain for mycotoxins during harvest in the field., Objective: The RIDA®SMART APP is a smartphone application, which was developed together with a Lateral Flow Device as a quantitative and fast on-site/on-field tool for mycotoxin analyses., Method: It is a small and light device with its own power supply, very versatile, flexible and easy to use. For quantification, a lot specific calibation curve is uploaded to the RIDA®SMART APP via a QR code from the certificate of analysis. The software application in combination with a compatible smartphone, analyzes the LFD strip via a picture taken with a smartphone and quantifies the mycotoxin contamination within 4 second. Due to the possibility to use mobile networks or WIFI, there are no difficulties in the organization of the collected results. Currently, nine different android-based smartphones from various manufacturers are compatible with the RIDA®SMART APP., Results: In combination with one of the compatible smartphones, the RIDA®SMART APP is able to generate results with a coefficient of variation CV ≤ 13%, even at highly varying lighting conditions. The recovery of certified reference corn samples, previously analyzed with HPLC or LC-MS/MS, shows a mean value between 91% - 119%., Conclusion: The RIDA®SMART APP is highly suitable for an inexpensive, quick and accurate quantitative measurement of mycotoxins in agricultural products (e.g. aflatoxins in corn)., Highlights: To our best knowledge, the RIDA®SMART APP is the only smartphone-based method for quantitative mycotoxin analysis worldwide combined with a broader measuring range as most usual lateral flow analyzers., (© AOAC INTERNATIONAL 2020.)

Background: The use of exercise as a priming strategy to enhance sport performance is becoming increasingly popular in professional sports and as an area of research interest. Early research suggests that the acute physiological responses to exercise can positively influence performance for up to 48 h. There is yet to be a comprehensive review of exercise strategies which could be implemented specifically on the day of competition., Objectives: The aim of this systematic review was to provide a synthesis of research investigating acute exercise interventions as game day priming strategies for team-sport athletes to improve physical performance and athlete readiness when implemented in the 1-12 h prior to competition., Methods: A literature search of SPORTDiscus, PubMed and Cochrane Central Register for Controlled Trials was conducted. A total of 6428 studies were retrieved and assessed against the following inclusion criteria: (1) randomised controlled trials and non-randomised comparative studies with reported pre-post intervention outcomes; (2) exercise interventions were applied 1-12 h prior to the assessment of outcome measures. Studies were excluded if they used nutrition, supplementation, pre-heating, pre-cooling, stretching, massage or vibration training as the priming strategies, or if interventions were performed at altitude or in hypoxic environments. Studies were assessed for methodological quality at the study level using the Physiotherapy Evidence Database (PEDro) scale., Results: Twenty-nine studies satisfied the eligibility criteria and were included in this review. Studies were categorised as resistance training; cycling; running; and other strategies. Resistance training using heavy loads at low volumes increased strength and power measures following a 4-6 h recovery, with limited improvements observed following shorter (1-3 h) and longer (6-12 h) recovery periods. Running-based sprint priming led to improvements in subsequent sprint and repeat sprint performance following a 5-6 h recovery, whereas cycling improved counter-movement jump height in a single study only. No significant differences were reported in any performance measures following endurance-based running or cycling strategies. Physiological markers, such a hormone and blood lactate responses, showed mixed results between studies., Conclusions: High-intensity low-volume resistance training leads to a greater physiological and performance response than high-volume resistance training. Maximal running sprints may be more effective than maximal cycling sprints due to an increased physiological demand; however, loading protocols must also be considered in conjunction with exercise volume and movement specificity to achieve a beneficial response for subsequent performance. There is limited evidence to suggest endurance cycling or running exercise is beneficial as a priming strategy.

Aim: The aim of this study was to investigate the effectiveness of metformin in diabetes prevention in a prediabetic population across a range of fasting plasma glucose (FPG) levels at baseline. A secondary aim was to assess the effectiveness of metformin in preventing diabetes in those participants where impaired fasting glucose (IFG) was relatively more pronounced as opposed to impaired glucose tolerance (IGT)., Methods: Participants randomised to metformin and placebo arms in the Diabetes Prevention Program study were stratified into cohorts according to level of FPG at baseline. Cumulative incidence of diabetes for the different cohorts was assessed. Change in FPG, insulin sensitivity, and levels of fasting insulin and proinsulin for the different cohorts were also calculated., Results: The largest reductions in incidence of diabetes and FPG occurred within prediabetic persons with a higher level of FPG at baseline. Metformin was able to stabilise insulin sensitivity in every stratified sub-cohort except one. Sub-cohorts which had higher levels of insulin sensitivity at baseline experienced the largest increases in insulin sensitivity. Metformin reduced the incidence of diabetes by 43% (RR 0.57, CI 0.4-0.9) in those prediabetic persons whose IFG was more pronounced compared to a 26% (RR 0.74 CI 0.7-0.8) when all participants in the study were included., Conclusion: The largest reductions in both incidence of diabetes and FPG occurred in prediabetic persons with a higher level of FPG at baseline. Metformin was able to stabilise insulin sensitivity and was more effective in persons with more pronounced IFG.

Background: Cardiovascular disease (CVD) remains the largest cause of death in breast cancer survivors. The aim of this study was to explore the impact of exercise intensity on aerobic fitness and autonomic cardiac regulation (heart rate variability (HRV)) and salivary biomarkers of the stress systems (HPA-axis, cortisol; sympathetic nervous system, α-amylase) and mucosal immunity (secretory(s)-IgA), markers of increased risk of CVD in breast cancer survivors., Methods: Participants were randomly assigned to; 1) high intensity interval training (HIIT); 2) moderate-intensity, continuous aerobic training (CMIT); or 3) a wait-list control (CON) for a 12-week (36 session) stationary cycling intervention. Cardiorespiratory fitness (VO 2peak ), resting HRV and salivary biomarkers were measured at baseline 2-4 d pre-intervention and 2-4 d post the last exercise session., Results: Seventeen participants were included in this study (62 ± 8 years, HIIT; n = 6, CMIT; n = 5, CON; n = 6). A significant improvement (p ≤ 0.05) was observed for VO 2peak in the HIIT group; 19.3% (B = 3.98, 95%CI = [1.89; 4.02]) and a non-significant increase in the CMIT group; 5.6% (B = 1.96, 95%CI = [- 0.11; 4.03]), compared with a 2.6% (B = - 0.64, 95%CI = [- 2.10; 0.82]) decrease in the CON group. Post intervention improvements in HRV markers of vagal activity (log (ln)LF/HF, LnRMSSD) and sympathetic nervous system (α-amylase waking response) occurred for individuals exhibiting outlying (> 95% CI) levels at baseline compared to general population., Conclusion: High intensity interval training improved cardiovascular fitness in breast cancer survivors and improved cardiac regulation, and sympathetic nervous system (stress) responses in some individuals. High-intensity interval training was safe and effective for breast cancer survivors to participate in with promising results as a time efficient intensity to improve physical health and stress, reducing CVD risk., Trial Registration: This pilot study was retrospectively registered through the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12620000684921 .

Introduction: Controlled trials support the efficacy of exercise as a treatment modality for chronic conditions, yet effectiveness of real-world Exercise Physiology services is yet to be determined. This study will investigate the efficacy and cost-effectiveness of services provided by Accredited Exercise Physiologists (AEPs) for clients with type 2 diabetes (T2D) in clinical practice., Methods and Analysis: A non-randomised, opportunistic control, longitudinal design trial will be conducted at ten Exercise Physiology Clinics. Participants will be individuals with T2D attending one of the Exercise Physiology Clinics for routine AEP services (exercise prescription and counselling) (intervention) or individuals with T2D not receiving AEP services (usual care) (control). The experimental period will be 6 months with measurements performed at baseline and at 6 months. Primary outcome measures will be glycosylated haemoglobin (HbA1c), resting brachial blood pressure (BP), body mass index, waist circumference, 6 min walk test, grip strength, 30 s sit to stand, Medical Outcomes Short-Form 36-Item Health Survey and Active Australia Questionnaire. Secondary outcomes will be medication usage, out-of-pocket expenses, incidental, billable and non-billable health professional encounters and work missed through ill health. Healthcare utilisation will be measured for 12 months prior to, during and 12 months after trial participation using linked data from Medicare Benefits Schedule and Pharmaceutical Benefits Scheme data., Ethics and Dissemination: The study is a multicentre trial comprising: University of Tasmania, University of New South Wales Lifestyle Clinic, University of Canberra, Baker Heart and Diabetes Institute (covered under the ethics approval of University of Tasmania Health and Medical Ethics Committee H0015266), Deakin University (Approval number: 2016-187), Australian Catholic University (2016-304R), Queensland University of Technology (1600000049), University of South Australia (0000035306), University of Western Australia (RA/4/1/8282) and Canberra Hospital (ETH.8.17.170). The findings of this clinical trial will be communicated via peer-reviewed journal articles, conference presentations, social media and broadcast media., Trial Registration Number: ACTRN12616000264482., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: This study aimed to establish the true influence of spinal cord injury (SCI) level on core temperature and sweating during exercise in the heat independently of biophysical factors., Methods: A total of 31 trained males (8 with tetraplegia [TP; C5-C8], 7 with high paraplegia [HP; T1-T5], 8 with low paraplegia [LP; T6-L1], and 8 able bodied [AB]) performed 3 × 10 min of arm ergometry with 3-min rest at a metabolic heat production of (a) 4.0 W·kg (AB vs TP) or (b) 6.0 W·kg (AB vs HP vs LP), in 35°C, 50% relative humidity. Esophageal (Tes) and local skin temperatures and local sweat rate (LSR) on the forehead and upper back were measured throughout., Results: Change in Tes was greatest in TP (1.86°C ± 0.32°C vs 0.29°C ± 0.07°C, P < 0.001) and greater in HP compared with LP and AB, reaching 1.20°C ± 0.50°C, 0.66°C ± 0.23°C, and 0.53°C ± 0.12°C, respectively (P < 0.001). Approximately half of the variability in end-trial ΔTes was described by SCI level in paraplegics (adjusted R = 0.490, P = 0.005). Esophageal temperature onset thresholds of sweating at the forehead and upper back were similar among HP, LP, and AB, whereas no sweating was observed in TP. Thermosensitivity (ΔTes vs ΔLSR) was also similar, except for LP demonstrating lower thermosensitivity than AB at the upper back (0.78 ± 0.26 vs 1.59 ± 0.89 mg·cm·min, P = 0.039). Change in skin temperature was greatest in denervated regions, most notably at the calf in all SCI groups (TP, 2.07°C ± 0.93°C; HP, 2.73°C ± 0.68°C; LP, 2.92°C ± 1.48°C)., Conclusion: This study is the first to show the relationship between ΔTes and SCI level in athletes with paraplegia after removing variability arising from differences in metabolic heat production and mass. Individual variability in ΔTes is further reduced among athletes with TP because of minimal evaporative heat loss secondary to an absence of sweating.

Objective Nursing and allied health professionals (AHPs) are in an ideal position to promote physical activity (PA) as part of their health care provision. The aim of this study was to investigate current promotion and knowledge of PA among people in these disciplines. Methods A cross-sectional online survey of practicing Australian physiotherapists, nurses, exercise physiologists, occupational therapists, dietitians and pharmacists was conducted in 2016. Results A total of 433 nurses and AHPs completed the survey. All disciplines agreed that providing PA advice was part of their role, although nurses were less likely to agree. All disciplines felt they had the skills to promote PA but nurses were more likely to report a lack of time as a barrier. Physiotherapists and exercise physiologists were more confident giving PA advice to patients. Most health professionals (68%) were aware of the PA guidelines, although only 16% were accurately able to describe all relevant components. In logistic regression modelling, women and those working in public hospitals were less likely to encourage PA. Awareness of the PA guidelines doubled the odds of encouraging PA in patients (odds ratio 2.01, 95% confidence interval 1.18-3.43). Conclusions Australian nurses and AHPs perceive that PA promotion is part of their role, however few have specific knowledge of the PA guidelines. To increase PA promotion by nurses and AHPs awareness of the PA guidelines appears to be essential. What is known about the topic? Nurses and AHPs are in an ideal position to promote PA, although there is limited evidence of their PA promotion and knowledge. What does the paper add? Australian nurses and AHPs are confident and think it is feasible to promote PA to patients in several healthcare settings but many lack sufficient PA knowledge, limiting their PA promotion. What are the implications for practitioners? Increasing PA knowledge of nurses and AHPs could generate increased levels of PA in the Australian population and improve national health and wellbeing.

Background/objectives: Humans appear to have innate energy regulation mechanisms that manifest in sensations of satiation during a meal and satiety post ingestion. Interactions between these mechanisms and the macronutrient profile of their contemporary food environment could be responsible for the dysregulation of this mechanism, resulting in a higher energy intake. The aim of this systematic review was to determine the impact of dietary fibre and fat both in isolation and combination on satiation and satiety., Subjects/methods: A systematic review of the literature was undertaken, from inception until end December 2017, in accordance with the PRISMA guidelines, in: Scopus, Food Science and Tech, CINAHL, and Medline databases. The search strategy was limited to articles in English language, published in peer-reviewed journals and human studies. Studies were selected based on inclusion/exclusion criteria., Results: A total of 1490 studies were found initially using the selected search terms that were reduced to 12 studies suitable for inclusion. Following on from this, a meta-analysis was also conducted to determine any satiety effects from any potential interaction between dietary fat and fibre on satiety, no significant effects were found., Conclusions: Owing to high energy density, fat (per kJ) had a weak effect on satiation as determined by the effect per gram for each unit of energy. The addition of fibre theoretically improves satiety by slowing the absorption of various nutrients including fat, although the meta-analysis as part of this review was unable to demonstrate an effect, perhaps reflecting a lack of sensitivity in research design. The potential to improve satiation and satiety responses by consuming fat together with carbohydrates containing fibre warrants further investigation.

Objective: To examine the effect of a physical treatment (speed, power, and strength [SPS] training) and psychosocial treatment (group motivational presentation) on salivary testosterone (sal-T), salivary cortisol (sal-C), and sal-T-to-sal-C ratio (T:C) in professional rugby., Methods: Fourteen male rugby players (age = 25.9 [2.5] y, height = 186.1 [6.7] cm, and body mass = 104.1 [12.7] kg) participated in this study. Testing occurred across 2 d on 2 separate occasions (week 1 and week 2). On day 1 of both weeks, participants completed an SPS training session. On day 2 of both weeks, participants undertook a field-based rugby training session. In week 2, participants underwent an additional treatment in the form of a motivational presentation given by a respected former player before the rugby session. Saliva was collected before and after SPS training and before and after the rugby session and was assayed for testosterone and cortisol., Results: No differences were found between weeks for sal-T at any time point, but sal-C was higher in week 2 before and after SPS and before rugby on day 2 (P < .05). In both weeks, T:C increased following SPS (P < .02, ES > 0.91 [0.13, 1.69]). T:C increased when the motivational presentation accompanied rugby training (P = .07, ES = 1.06 [0.27, 1.85]). Sal-C, not sal-T, drove changes in T:C (P < .001)., Conclusions: Physical or psychosocial treatments may affect sal-T, sal-C, and T:C, and individual variation in responses to treatments may exist.

Aim: To determine the impact of low volume high-intensity interval training (LVHIIT) and continuous low to moderate-intensity exercise training (CLMIT) on cardiovascular disease (CVD) risk and health outcomes in cancer survivors., Methods: Sedentary cancer survivors ( n = 75, aged 51 ± 12 year) within 24 months of diagnosis, were randomised into three groups for 12 wk of LVHIIT ( n = 25), CLMIT ( n = 25) or control group ( n = 25). The exercise intervention involved 36 sessions (three sessions per week). The LVHIIT group performed 7 x 30 s intervals (≥ 85% predicted maximal heart rate) with a 60 s rest between intervals, and the CLMIT group performed continuous aerobic training for 20 min (≤ 55% predicted maximal heart rate) on a stationary bike. Outcome variables were measured at baseline and at 12 weeks and analysed using a 3 x 2 (group x time) repeated measures ANCOVA to evaluate main and interaction effects., Results: Significant improvements (time) were observed for seven of the 22 variables (ES 0.35-0.97, P ≤ 0.05). There was an interaction effect ( P < 0.01) after 12 wk in the LVHIIT group for six-minute walk test ( P < 0.01; d = 0.97; 95%CI: 0.36, 1.56; large), sit to stand test ( P < 0.01; d = -0.83; 95%CI: -1.40, -0.22; large ) and waist circumference reduction ( P = 0.01; d = -0.48; 95%CI: -1.10, 0.10; medium). An interaction effect ( P < 0.01) was also observed for quality of life in both the LVHIIT ( d = 1.11; 95%CI: 0.50, 1.72; large) and CLMIT ( d = 0.57; 95%CI: -0.00, 1.20; moderate) compared with the control group ( d = -0.15; 95%CI: -0.95, 0.65; trivial)., Conclusion: Low-volume high-intensity training shows promise as an effective exercise prescription within the cancer population, showing greater improvements in cardio-respiratory fitness, lower body strength and waist circumference compared with traditional CLMIT and control groups. Both LVHIIT and CLMIT improved quality of life. A proposed benefit of LVHIIT is the short duration (3 min) of exercise required, which may entice more cancer survivors to participate in exercise, improving health outcomes and lowing the risk of CVD., Competing Interests: Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.

Purpose: There is an increasing body of evidence underpinning high-intensity exercise as an effective and time-efficient intervention for improving health in cancer survivors. The aim of this study was to, (1) evaluate the efficacy and (2) the safety of high-intensity exercise interventions in improving selected health outcomes in cancer survivors., Methods: Design Systematic review. Data sources Google Scholar and EBSCO, CINAHL Plus, Computers and Applied Sciences Complete, Health Source-Consumer Edition, Health Source: Nursing/Academic Edition, MEDLINE, Web of Science and SPORTDiscuss from inception up until August 2017. Eligibility criteria Randomized controlled trials of high-intensity exercise interventions in cancer survivors (all cancer types) with health-related outcome measures. The guidelines adopted for this review were the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)., Results: The search returned 447 articles, of which nine articles (n = 531 participants mean, age 58 ± 9.5 years) met the eligibility criteria. Exercise interventions of between 4 and 18 weeks consisting of high-intensity interval bouts of up to 4-min were compared with a continuous moderate intensity (CMIT) intervention or a control group. High-intensity exercise interventions elicited significant improvements in VO 2 max, strength, body mass, body fat and hip and waist circumference compared with CMIT and/or control groups. The studies reviewed showed low risk in participating in supervised high-intensity exercise interventions. Mixed mode high-intensity interventions which included both aerobic and resistance exercises were most effective improving the aerobic fitness levels of cancer survivors by 12.45-21.35%, from baseline to post-intervention., Conclusion: High-intensity exercise interventions improved physical and physiological health-related outcome measures such as cardiovascular fitness and strength in cancer survivors. Given that high-intensity exercise sessions require a shorter time commitment, it may be a useful modality to improve health outcomes in those who are time poor. The risk of adverse events associated with high-intensity exercise was low.

Poor adherence to lifestyle intervention remains a key factor hindering treatment effectiveness and health outcomes for adults with obesity. The aim of this systematic review and meta-analysis is to determine if behavioural treatment strategies (e.g. goal setting, motivational interviewing, relapse prevention, cognitive restructuring etc.) improve adherence to lifestyle intervention programmes in adults with obesity. Randomized controlled trials that investigated the use of behavioural treatment strategies in obesity management were identified by systematically reviewing the literature within Medline, PsycINFO, CINAHL, SPORTDiscus and Web of Science from their inception to August 2016. This meta-analysis shows that behavioural treatment interventions have a significant positive effect on session attendance (percentage) and physical activity (total min/week) in adults with obesity (M = 17.63 (95% confidence interval (CI) = 10.77, 24.50), z =5.0337, P < 0.0001 and M = 105.98 (95% CI = 58.64, 153.32), z =4.3878, P < 0.0001, respectively). This meta-analysis of randomized controlled trials provides evidence that behavioural treatment strategies improve adherence to lifestyle intervention programmes in adults with obesity. These strategies should be routinely incorporated into lifestyle intervention, obesity management and weight loss programmes with the aim of improving engagement and adherence. If adherence were improved, treatment effectiveness, health outcomes and the ultimate burden of chronic disease could also be improved., (© 2017 World Obesity Federation.)

Objective: To investigate the physiological and perceptual effects of three precooling strategies during pre-exercise rest in athletes with a spinal cord injury (SCI)., Design: Randomized, counterbalanced. Participants were precooled, then rested for 60 minutes (22.7 ± 0.2°C, 64.2 ± 2.6%RH)., Setting: National Wheelchair Basketball Training Centre, Australia., Participants: Sixteen wheelchair basketball athletes with a SCI., Interventions: Participants were precooled through; 1) 10 minutes of 15.8°C cold water immersion (CWI), 2) ingestion of 6.8 g/kg -1 of slushie (S) from sports drink; 3) ingestion of 6.8 g/kg -1 of slushie with application of iced towels to the legs, torso and back/arms (ST); or 4) ingestion of 6.8 g/kg -1 of room temperature (22.3°C) sports drink (CON)., Outcome Measures: Core temperature (T gi ), skin temperature (T sk ), heart rate (HR), and thermal and gastrointestinal comfort., Results: Following CWI, a significant reduction in T gi was observed compared to CON, with a greatest reduction of 1.58°C occurring 40 minutes post-cooling (95% CI [1.07, 2.10]). A significant reduction in T gi following ST compared to CON was also observed at 20 minutes (0.56°C; [0.03, 1.09]) and 30 minutes (0.56°C; [0.04, 1.09]) post-cooling. Additionally, a significant interaction between impairment level and time was observed for T gi and HR, demonstrating athletes with a higher level of impairment experienced a greater reduction in HR and significant decrease in rate of decline in T gi , compared to lesser impaired athletes., Conclusion: CWI and ST can effectively lower body temperature in athletes with a SCI, and may assist in tolerating warm conditions.

Objective: The aim of this study was to determine the feasibility of a combined supervised and home-based exercise intervention during chemotherapy for women with recurrent ovarian cancer. Secondary aims were to determine the impact of physical activity on physical and psychological outcomes and on chemotherapy completion rates., Methods: Women with recurrent ovarian cancer were recruited from 3 oncology outpatient clinics in Sydney and Canberra, Australia. All participants received an individualized exercise program that consisted of 90 minutes or more of low to moderate aerobic, resistance, core stability, and balance exercise per week, for 12 weeks. Feasibility was determined by recruitment rate, retention rate, intervention adherence, and adverse events. Aerobic capacity, muscular strength, fatigue, sleep quality, quality of life, depression, and chemotherapy completion rates were assessed at weeks 0, 12, and 24., Results: Thirty participants were recruited (recruitment rate, 63%), with a retention rate of 70%. Participants averaged 196 ± 138 min · wk of low to moderate physical activity throughout the intervention, with adherence to the program at 81%. There were no adverse events resulting from the exercise intervention. Participants who completed the study displayed significant improvements in quality of life (P = 0.017), fatigue (P = 0.004), mental health (P = 0.007), muscular strength (P = 0.001), and balance (P = 0.003) after the intervention. Participants completing the intervention had a higher relative dose intensity than noncompleters (P = 0.03)., Conclusions: A program consisting of low to moderate exercise of 90 min · wk was achieved by two-thirds of women with recurrent ovarian cancer in this study, with no adverse events reported. Randomized control studies are required to confirm the benefits of exercise reported in this study.

Purpose: Resistance exercise has great potential to aid in the management of breast cancer-related lymphedema (BCRL); however, little is known regarding optimal exercise prescription. The pervasive view is that resistance exercise with heavy loads may be contraindicated, disregarding the dose-response relationship that exists between the load utilised in resistance exercise and the magnitude of structural and functional improvements. No previous research has examined various resistance exercise prescriptions for the management of BCRL. This study compared the effects of high load and low load resistance exercise on the extent of swelling, severity of symptoms, physical function and quality of life in women with BCRL., Methods: Sixty-two women with a clinical diagnosis of BCRL (>5 % inter-limb discrepancy) were randomly assigned to a high-load resistance exercise (n = 22), low-load resistance exercise (n = 21) or usual care (n = 19) group. Participants in the experimental groups completed a 3-month moderate- to high-intensity resistance exercise program in which the load of the exercises was manipulated from 10-6 repetition maximum (75-85 % of one repetition maximum [1RM]) for the high-load group or from 20-15 repetition maximum (55-65 % 1RM) for the low-load group. Outcome measures included the extent of swelling in the affected arm, symptom severity, physical function and quality of life., Results: There were no differences between groups in the extent of affected arm swelling or severity of symptoms. The change in muscle strength, muscle endurance and quality of life-physical functioning was significantly greater in both high-load and low-load groups compared with the control group (p < 0.040). Change in quality of life-physical function was significantly associated with the change in symptom severity and muscle strength. No lymphedema exacerbations or other adverse events occurred during this trial., Conclusion: Women with BCRL can safely lift heavy weights during upper body resistance exercise without fear of lymphedema exacerbation or increased symptom severity., Implications for Cancer Survivors: Women with breast cancer-related lymphedema can be informed that appropriately prescribed and supervised upper body resistance exercise is safe and can aid in the management of lymphedema through improvements in physical function and quality of life.