Physiological, perceptual, and biomechanical differences between treadmill and overground walking in healthy adults: A systematic review and meta-analysis.

This systematic review and meta-analysis aims to compare physiological, perceptual and biomechanical outcomes between walking on a treadmill and overground surfaces. Five databases (CINAHL, EMBASE, MEDLINE, SPORTDiscus, Web of Science) were searched until September 2022. Included studies needed to be a crossover design comparing biomechanical, physiological, or perceptual measures between motorised-treadmill and overground walking in healthy adults (18-65 years) walking at the same speed (<5% difference). The quality of studies were assessed using a modified Downs and Black Quality Index. Meta-analyses were performed to determine standardised mean difference ± 95% confidence intervals for all main outcome measures. Fifty-five studies were included with 1,005 participants. Relative oxygen consumption (standardised mean difference [95% confidence interval] 0.38 [0.14,0.63]) and cadence (0.22 [0.06,0.38]) are higher during treadmill walking. Whereas stride length (-0.36 [-0.62,-0.11]) and step length (-0.52 [-0.98,-0.06]) are lower during treadmill walking. Most kinetic variables are different between surfaces. The oxygen consumption, spatiotemporal and kinetic differences on the treadmill may be an attempt to increase stability due to the lack of control, discomfort and familiarity on the treadmill. Treadmill construction including surface stiffness and motor power are likely additional constraints that need to be considered and require investigation. This research was supported by an Australian Government Research Training Program (RTP) scholarship. Protocol registration is CRD42020208002 (PROSPERO International Prospective Register of Systematic Reviews) in October 2020.

Relative oxygen consumption is greater on a treadmill when compared with overground when walking at similar speeds and needs to be considered when prescribing exercise.Walking on a treadmill results in several biomechanical changes compared to overground that may be related to changes in gait stability.It may be favourable for rehabilitation purposes for people to initially walk on a treadmill due to lower vertical ground reaction force at push-off and lower joint moments at the knee and ankle.

Many physiotherapists lack preparedness to prescribe physical activity and exercise to people with musculoskeletal pain: A multi-national survey.

OBJECTIVES: Determine physiotherapists' (i) awareness of physical activity, and exercise prescription guidelines; (ii) perceived role, knowledge, confidence, skills and training in prescribing and progressing aerobic exercise and resistance training to people with musculoskeletal pain; (iii) professional development preferences; and (iv) perceived influences of external factors on exercise prescription for people with musculoskeletal pain. DESIGN: Multi-national cross-sectional survey. METHODS: An open online survey was developed specifically for this study. RESULTS: 1,352 physiotherapists from 56 countries participated. The majority of respondents correctly stated physical activity guidelines for adults (60%) and children (53%), but only 37% correctly stated guidelines for older adults. Eleven percent and 16% could name an accepted guideline for aerobic exercise and resistance training, respectively. Most agreed their role included prescribing aerobic exercise (75%) and resistance training (89%). Fewer reported they had the confidence, training or skills to prescribe aerobic exercise (38-50%) and resistance training (49-70%). Workshops were the most preferred (44%) professional development option. Most respondents believed appointment scheduling and access to equipment and professional development (62-79%) affected their ability to prescribe effective exercise. CONCLUSION: Many physiotherapists lack knowledge and training to provide physical activity advice, and to prescribe aerobic exercise and resistance training to people with musculoskeletal pain.

Sex differences in amino acids lost via sweating could lead to differential susceptibilities to disturbances in nitrogen balance and collagen turnover.

Fluid collected during sweating is enriched with amino acids derived from the skin's natural moisturising factors and has been termed "faux" sweat. Little is known about sex differences in sweat amino acid composition or whether faux sweat amino acid losses affect nitrogen balance. Faux sweat collected by healthy adults (n = 47) after exercise, and at rest by chronic fatigue patients, was analysed for amino acid composition. Healthy females had higher total amino acid concentrations in sweat (10.5 ± 1.2 mM) compared with healthy males (6.9 ± 0.9 mM). Females had higher levels of 13 amino acids in sweat including serine, alanine and glycine. Higher hydroxyproline and proline levels suggested greater collagen turnover in females. Modelling indicated that with conservative levels of exercise, amino acid losses in females via faux sweat were triple than those predicted for urine, whereas in males they were double. It was concluded that females were more susceptible to key amino acid loss during exercise and/or hot conditions. Females reporting chronic fatigue had higher levels of methionine in faux sweat than healthy females. Males reporting chronic fatigue had higher levels of numerous amino acids in faux sweat compared to healthy males. Higher amino acid loss in faux sweat associated with chronic fatigue could contribute to a hypometabolic state. Depending on activity levels, climatic conditions and gender, amino acid losses in sweat and skin leachate could influence daily protein turnover where periods of continuously high turnover could lead to a negative net nitrogen balance.

Diverse characteristics of the urinary excretion of amino acids in humans and the use of amino acid supplementation to reduce fatigue and sub-health in adults.

BACKGROUND: The excretion of amino acids in urine represents an important avenue for the loss of key nutrients. Some amino acids such as glycine and histidine are lost in higher abundance than others. These two amino acids perform important physiological functions and are required for the synthesis of key proteins such as haemoglobin and collagen. METHODS: Stage 1 of this study involved healthy subjects (n = 151) who provided first of the morning urine samples and completed symptom questionnaires. Urine was analysed for amino acid composition by gas chromatography. Stage 2 involved a subset of the initial cohort (n = 37) who completed a 30 day trial of an amino acid supplement and subsequent symptom profile evaluation. RESULTS: Analyses of urinary amino acid profiles revealed that three groups could be objectively defined from the 151 participants using k-means clustering. The amino acid profiles were significantly different between each of the clusters (Wilks' Lambda = 0.13, p < 0.0001). Cluster 1 had the highest loss of amino acids with histidine being the most abundant component. Cluster 2 had glycine present as the most abundant urinary amino acid and cluster 3 had equivalent abundances of glycine and histidine. Strong associations were observed between urinary proline concentrations and fatigue/pain scores (r = .56 to .83) for females in cluster 1, with several other differential sets of associations observed for the other clusters. CONCLUSIONS: Different phenotypic subsets exist in the population based on amino acid excretion characteristics found in urine. Provision of the supplement resulted in significant improvements in reported fatigue and sleep for 81% of the trial cohort with all females reporting improvements in fatigue. TRIAL REGISTRATION: The study was registered on the 18th April 2011 with the Australian New Zealand Clinical Trials Registry ( ACTRN12611000403932 ).

Running performance and thermal sensation in the heat are improved with menthol mouth rinse but not ice slurry ingestion.

The purpose of this study was to compare the effects of a cooling strategy designed to predominately lower thermal state with a strategy designed to lower thermal sensation on endurance running performance and physiology in the heat. Eleven moderately trained male runners completed familiarization and three randomized, crossover 5-km running time trials on a non-motorized treadmill in hot conditions (33 °C). The trials included ice slurry ingestion before exercise (ICE), menthol mouth rinse during exercise (MEN), and no intervention (CON). Running performance was significantly improved with MEN (25.3 ± 3.5 min; P = 0.01), but not ICE (26.3 ± 3.2 min; P = 0.45) when compared with CON (26.0 ± 3.4 min). Rectal temperature was significantly decreased with ICE (by 0.3 ± 0.2 °C; P < 0.01), which persisted for 2 km of the run and MEN significantly decreased perceived thermal sensation (between 4 and 5 km) and ventilation (between 1 and 2 km) during the time trial. End-exercise blood prolactin concentration was elevated with MEN compared with CON (by 25.1 ± 24.4 ng/mL; P = 0.02). The data demonstrate that a change in the perception of thermal sensation during exercise from menthol mouth rinse was associated with improved endurance running performance in the heat. Ice slurry ingestion reduced core temperature but did not decrease thermal sensation during exercise or improve running performance.

The Reliability of Running Performance in a 5 km Time Trial on a Non-motorized Treadmill.

The purpose of the study was to establish the reliability of performance and physiological responses during a self-paced 5 km running time trial on a non-motorized treadmill. 17 male runners (age: 32±13 years, height: 177±7 cm, body mass: 71±9 kg, sum of 7 skinfolds: 55±21 mm) performed familiarization then 2 separate maximal 5 km running time trials on a non-motorized treadmill. Physiological responses measured included heart rate, oxygen uptake, expired air volume, blood lactate concentration, tissue saturation index and integrated electromyography. Running time (1,522±163 s vs. 1,519±162 s for trials 1 and 2, respectively) demonstrated a low CV of 1.2% and high ICC of 0.99. All physiological variables had CVs of less than 4% and ICCs of >0.92, with the exception of blood lactate concentration (7.0±2 mmol·L(-1) vs. 6.5±1.5 mmol·L(-1) for trials 1 and 2, respectively; CV: 12%, ICC: 0.83) and the electromyography measures (CV: 8-27%, ICC: 0.71-0.91). The data demonstrate that performance time in a 5 km running time trial on a non-motorized treadmill is a highly reliable test. Most physiological responses measured across the 5 km run also demonstrated good reliability.

Nutritional supplementation habits and perceptions of elite athletes within a state-based sporting institute.

The purpose of this investigation was to examine the nutritional supplement intake of athletes from a state-based sports institute. Athletes (n=72) from seven sports (kayaking, field hockey, rowing, waterpolo, swimming, athletics and netball) completed a questionnaire detailing their daily usage and rationale therefore. The large majority (63/72; 87.5+/-12.5%) of surveyed athletes reported using nutritional supplements, with no difference between female (31/36; 86.1+/-13.9%) and male (32/36; 88.9+/-11.1%) athletes. Kayakers (6.0+/-2.9) consumed a higher number of nutritional supplements than swimmers (4+/-2.2), field hockey (1.5+/-1.0), rowing (2.4+/-1.4), waterpolo (2.3+/-2.4), athletics (2.5+/-1.9) and netball (1.7+/-1.0) athletes. The athletes believed that nutritional supplements are related to performance enhancements (47/72; 65.3%), positive doping results (45/72; 62.5%), and that heavy training increases supplement requirements (47/72; 65.3%). The cohort was equivocal as to their health risks (40/72; 55.6%) or their need with a balanced diet (38/72; 52.8%). The most popular supplements were minerals (33/72; 45.8%), vitamins (31/72; 43.1%), other (23/72; 31.9%), iron (22/72; 30.6%), caffeine (16/72; 22.2%), protein (12/72; 16.7%), protein-carbohydrate mix (10/72; 13.9%), creatine (9/72; 12.5%) and glucosamine (3/72; 4.2%). The majority of supplementing athletes (n=63) did not know their supplements active ingredient (39/63; 61.9%), side effects (36/63; 57.1%) or mechanism of action (34/63; 54.0%) and admitted to wanting additional information (36/63; 57.0%). Only half of the athletes knew the recommended supplement dosages (33/63; 52.4%). The performance enhancing perception may explain the large proportion of athletes that reported using nutritional supplements, despite over half of the athletes believing that supplements are not required with a balanced diet and can cause positive doping violations.

The reliability of the i-STAT clinical portable analyser.

The purpose of this investigation was to assess the reliability of the i-STAT clinical portable analyser and CG(4)(+) cartridge measures of blood pH, partial pressures of O(2) (pO(2)) and CO(2) (pCO(2)), bicarbonate ([HCO(3)(-)]), base excess (BE), total carbon dioxide (TCO(2)), oxygen saturation (sO(2)) and blood lactate ([BLa(-)]) at various exercise intensities. A comparison between [BLa(-)] measured by the i-STAT and the Accusport lactate analysers during an intermittent treadmill run was also undertaken. The technical error of measurement (TEM%) at rest, at moderate (200W) and maximal exercise (V O(2)max) was acceptable (<15%) for all parameters. The intra-class correlation coefficients for each analyte ranged from weak-to-strong across resting (ICC=0.19-0.96) and moderate (ICC=0.30-0.96) exercise intensities. The ICC for all analytes were observed to be strong following maximal intensity exercise (ICC=0.77-0.95). The comparison of the [BLa(-)] measures between the i-STAT and Accusport showed that the difference between measures was acceptable at both low (<4mmolL(-1)) (-0.39+/-0.27mmolL(-1)), moderate to high concentrations (>4mmolL(-1)) (0.58+/-1.22mmolL(-1)), and across all [BLa(-)] data (0.36+/-1.13mmolL(-1)). In conclusion, the i-STAT clinical analyser and CG(4)(+) cartridge provides reliable measures of a number of blood parameters across exercise intensities. The [BLa(-)] measures from the i-STAT analyser are consistent with that of the Accusport lactate analyser.