A two-arm non-randomised trial of MedEx IMPACT: a community-based, physical activity behaviour change intervention for survivors of cancer.

PURPOSE: This two-arm non-randomised trial examined the short- and long-term effects of a usual care (UC) community-based exercise programme (MedEx Move On (MMO)), and UC combined with a physical activity (PA) behaviour change (BC) intervention (MedEx IMproved PA after Cancer Treatement (MedEx IMPACT)) on PA levels, cardiorespiratory fitness (CRF) and quality of life (QoL) among survivors of cancer. METHODS: Cancer survivors referred to MMO were recruited (n = 191; mean age (± SD) 56 (± 10y), 73% female). Eighty-seven participants were assigned to UC, and 104 participants were assigned to the MedEx IMPACT intervention group (MI). UC and MI both received twice-weekly supervised exercise classes for 12-weeks. MI also received an independent PA programme, 4 PA information sessions and a 1:1 exercise consultation during the 12-week programme. Assessments of physical and psycho-social health, including 6-day accelerometry, the 6-min time trial and the Functional Assessment of Cancer Therapy-General QoL questionnaire, were conducted at baseline (T1), post-intervention (T2) and 3 months following programme completion (T3). RESULTS: Linear mixed-model analyses of variance demonstrated significant main effects for time for both groups from T1 to T2 with increases in objectively measured daily steps (p < 0.05), CRF (p < .001) and QoL (p < .01), which were maintained for CRF (p < .001) at T3. MI participants also maintained increases achieved at T2, in steps and QoL, at T3 (p < 0.01). CONCLUSION: Twelve weeks of twice-weekly supervised exercise was effective in increasing PA, CRF and QoL among survivors of cancer. MI resulted in the maintenance of all improvements achieved 3 months following programme completion.

Factors influencing physical activity in adults with cystic fibrosis.

BACKGROUND: Physical activity (PA) is a well-documented and accepted adjunct therapy for the maintenance and improvement of long-term health in cystic fibrosis (CF). Although the benefits of PA for CF populations are well-established, adherence to PA programmes within this population remains low. This study aimed to investigate the factors that influence engagement in physical activity, and to explore exercise preferences, among adults with cystic fibrosis (CF). METHODS: Semi-structured telephone interviews were conducted. Participants were twenty-one adults (mean age 35 years, SD ± 8) with an established diagnosis of CF, living in Ireland. Interview scripts were digitally recorded and transcribed verbatim. Thematic analysis was used to analyse the data. RESULTS: Four main themes emerged: barriers, motives, value of exercise-related outcomes, and exercise preferences. The main barriers included: low energy levels, time, the weather, and exercise-related confidence. Enjoyment and perceived competence underpinned autonomous motivation. Participants who self-identified as being regularly active valued personally identified exercise-related outcomes such as, accomplishment and affect regulation. Participants indicated a preference for home-based physical activity programs compared to gym- or facility-based programs. CONCLUSION: Interventions aimed at promoting physical activity among adults with CF should involve programs that foster autonomous motivation, enjoyable activities, personally identified outcomes, competence and that can be conducted from the home environment. CLINICAL IMPLICATIONS: To increase physical activity participation among adults with CF, interventions that can be conducted from the home environment, that pay attention to the patients' personally-valued exercise outcomes may be required.

Physiological and performance responses of sprint interval training and endurance training in Gaelic football players.

PURPOSE: While ideal for developing aerobic capacity, traditional endurance training (ET) is extremely time-consuming and may lack the specificity to maintain indices of speed and power in team sport athletes. In contrast, low-volume short-duration sprint interval training (SIT) has been shown to improve [Formula: see text]O2max to a similar extent as ET. However, to date, few studies have compared the effects of running-based SIT and ET, on aerobic capacity and indices of speed and power of trained team sport athletes. METHODS: Club level male Gaelic football players were randomly assigned to SIT (n = 13; 26.5 ± 4.87 years) or ET (n = 12; 25.4 ± 2.58 years) groups. Participants trained 3 days week-1 for 6 weeks. [Formula: see text]O2max, RE, v[Formula: see text]O2max, blood lactate concentrations, Wingate test performance, running speed, jump performance and intermittent endurance performance (IEP) were measured at baseline and after 6 weeks. RESULTS: An increase in [Formula: see text]O2max (p < 0.05), v[Formula: see text]O2max (p < 0.001) and IEP (p < 0.001) following 6 weeks of both SIT and ET was observed. Wingate mean power (p < 0.001), peak power (p < 0.001) and fatigue index (p < 0.005) were all significantly improved following training in both groups. Velocity at LT was significantly higher and performance in the 20-m running speed and VJ tests were significantly reduced post training in the ET group (all p < 0.005). CONCLUSION: Despite the large difference in total training time, a running-based protocol of SIT is a time efficient training method for improving aerobic capacity and IEP while maintaining indices of lower body power and running speed in team-sport players.

Maximal oxygen consumption and oxygen uptake efficiency in adolescent males.

BACKGROUND/OBJECTIVE: Measures of oxygen uptake efficiency (OUE) have been used to evaluate cardiorespiratory fitness (CRF) in adolescents unable to perform maximal exercise. The oxygen uptake efficiency slope (OUES) and oxygen uptake efficiency plateau (OUEP) have been proposed as surrogates for maximal oxygen consumption (V̇O2max). We assessed the validity of the OUES and OUEP as predictors of V̇O2max in healthy male adolescents. METHODS: Sixty-three healthy male adolescents aged 15.40 ± 0.34 years underwent an incremental treadmill test to determine V̇O2max, OUES and OUEP. OUE throughout the test was assessed by dividing each V̇O2 value by the corresponding minute ventilation (V̇E) value. OUEP was determined as the 90 s average highest consecutive values for OUE. OUES was determined using data up to the ventilatory threshold (VT) by calculating the slope of the linear relation between V̇O2 and the logarithm of V̇E. RESULTS: Limits of agreement for V̇O2max predicted by OUES (±13.3 mL kg-1.min-1) and OUEP (±16.7 mL kg-1.min-1) relative to V̇O2max were wide and a magnitude bias was found for OUES and OUEP as predictors of V̇O2max (p < 0.001). CONCLUSION: The OUES and OUEP do not accurately predict V̇O2max in male adolescents and should not replace V̇O2max when assessing CRF in this population.

The Development of the MedEx IMPACT Intervention: A Patient-Centered, Evidenced-Based and Theoretically-Informed Physical Activity Behavior Change Intervention for Individuals Living With and Beyond Cancer.

Regular physical activity (PA) can address many of the negative side effects experienced by individuals following cancer treatment and support the optimization of physical and psychosocial well-being. However, many survivors of cancer are not sufficiently active to achieve these health benefits. The purpose of this study was to describe the development of a physical activity behavior change (PABC) intervention, MedEx IMPACT (IMprove Physical Activity after Cancer Treatment), which aims to increase cancer survivors' PA levels. A review of the literature and focus groups with survivors of cancer were conducted in order to generate recommendations to inform the intervention development process. This process was guided and informed by: (1) the Medical Research Council's (MRC) framework for the development, evaluation, and implementation of complex interventions, (2) the Behaviour Change Wheel (BCW), and (3) the Theoretical Domains Framework (TDF). Recommendations for strategies to support habitual PA and adherence to community-based exercise programs, generated by survivors of cancer who participated in 7 focus groups (n = 41), were synthesized with 13 statements of findings that were generated from 10 studies included within the review of the literature. Detailed mapping exercises are presented which outline the link between these sources, the MRC framework, the BCW and TDF, and the intervention content. MedEx IMPACT is the first PABC intervention for survivors of cancer to be developed through the application of the MRC framework, BCW, and TDF. The next phase in this research is to test the acceptability and effectiveness of MedEx IMPACT.

Recommendations to improve physical activity prescription for the cystic fibrosis population: an Irish perspective.

BACKGROUND: Physical activity (PA) is a well-established therapeutic modality for the maintenance and improvement of long-term health in cystic fibrosis (CF). Healthcare professionals (HCP) are considered credible and well-placed messengers for the delivery of PA advice. Limited research exists investigating the extent of PA prescription within CF care. This study aimed to identify Irish HCP i) knowledge and practice of, and ii) motivators and barriers to PA prescription, and iii) proposed strategies to optimize PA promotion and prescription in CF populations. METHODS: HCP from six designated CF centres in Ireland and members of the national physiotherapy CF clinical interest group were invited to participate. Following an expression of interest, each HCP (n = 81) received an email containing the plain language statement and link to the online survey. 48 HCP (physiotherapists n = 24, other n = 24) completed the 30-item investigator-developed survey, which included multiple choice single answer, matrix style and open-ended questions. RESULTS: Most HCP (81%) acknowledged that discussing PA with CF patients was part of their professional role. Almost all physiotherapists (95%) reported having sufficient knowledge regarding PA prescription, compared to 17% of other HCP. All physiotherapists reported discussing PA at every patient interaction, with 81% employing the current consensus guidelines, compared to 33 and 5% of other HCP, respectively. Among the most common barriers reported by HCP to recommending PA to their CF patients were; lack of motivation and compliance among patients to adhere to PA advice, limited availability of PA programmes to refer their patients to, limited time with patients during clinic visits and a lack of knowledge regarding PA prescription for CF care. Three-quarters of HCP reported a need to improve PA services for CF patients in Ireland. CONCLUSION: As people with CF are living longer, it is imperative that HCP are expanding their scope of practice to include discussions around PA at every patient visit. Formal educational opportunities in the form of continuing professional development programmes are warranted for CF HCP to optimize long-term patient management and outcomes. There is also a need to develop patient-centered and evidence-based PA programmes underpinned by theories of behaviour change to enhance motivation and compliance among CF patients.

Feasibility, Acceptability, and Clinical Effectiveness of a Technology-Enabled Cardiac Rehabilitation Platform (Physical Activity Toward Health-I): Randomized Controlled Trial.

BACKGROUND: Cardiac rehabilitation (CR) is highly effective as secondary prevention for cardiovascular diseases (CVDs). Uptake of CR remains suboptimal (30% of eligible patients), and long-term adherence to a physically active lifestyle is even lower. Innovative strategies are needed to counteract this phenomenon. OBJECTIVE: The Physical Activity Toward Health (PATHway) system was developed to provide a comprehensive, remotely monitored, home-based CR program for CVD patients. The PATHway-I study aimed to investigate its feasibility and clinical efficacy during phase III CR. METHODS: Participants were randomized on a 1:1 basis to the PATHway (PW) intervention group or usual care (UC) control group in a single-blind, multicenter, randomized controlled pilot trial. Outcomes were assessed at completion of phase II CR and 6-month follow-up. The primary outcome was physical activity (PA; Actigraph GT9X link). Secondary outcomes included measures of physical fitness, modifiable cardiovascular risk factors, endothelial function, intima-media thickness of the common carotid artery, and quality of life. System usability and patients' experiences were evaluated only in PW. A mixed-model analysis of variance with Bonferroni adjustment was used to analyze between-group effects over time. Missing values were handled by means of an intention-to-treat analysis. Statistical significance was set at a 2-sided alpha level of .05. Data are reported as mean (SD). RESULTS: A convenience sample of 120 CVD patients (mean 61.4 years, SD 13.5 years; 22 women) was included. The PATHway system was deployed in the homes of 60 participants. System use decreased over time and system usability was average with a score of 65.7 (SD 19.7; range 5-100). Moderate-to-vigorous intensity PA increased in PW (PW: 127 [SD 58] min to 141 [SD 69] min, UC: 146 [SD 66] min to 143 [SD 71] min; Pinteraction=.04; effect size of 0.42), while diastolic blood pressure (PW: 79 [SD 11] mmHg to 79 [SD 10] mmHg, UC: 78 [SD 9] mmHg to 83 [SD 10] mmHg; Pinteraction=.004; effect size of -0.49) and cardiovascular risk score (PW: 15.9% [SD 10.4%] to 15.5% [SD 10.5%], UC: 14.5 [SD 9.7%] to 15.7% [SD 10.9%]; Pinteraction=.004; effect size of -0.36) remained constant, but deteriorated in UC. CONCLUSIONS: This pilot study demonstrated the feasibility and acceptability of a technology-enabled, remotely monitored, home-based CR program. Although clinical effectiveness was demonstrated, several challenges were identified that could influence the adoption of PATHway. TRIAL REGISTRATION: ClinicalTrials.gov NCT02717806; https://clinicaltrials.gov/ct2/show/NCT02717806. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2017-016781.

Comparison of Sprint Interval and Endurance Training in Team Sport Athletes.

Kelly, DT, Tobin, C, Egan, B, Carren, AM, O'Connor, PL, McCaffrey, N, and Moyna, NM. Comparison of sprint interval and endurance training in team sport athletes. J Strength Cond Res 32(11): 3051-3058, 2018-High-volume endurance training (ET) has traditionally been used to improve aerobic capacity but is extremely time-consuming in contrast to low-volume short-duration sprint interval training (SIT) that improves maximal oxygen uptake (V[Combining Dot Above]O2max) to a similar extent. Few studies have compared the effects of SIT vs. ET using running-based protocols, or in team sport athletes. Club level male Gaelic football players were randomly assigned to SIT (n = 7; 21.6 ± 2.1 years) or ET (n = 8; 21.9 ± 3.5 years) for 6 sessions over 2 weeks. V[Combining Dot Above]O2max, muscle mitochondrial enzyme activity, running economy (RE), and high-intensity endurance capacity (HEC) were measured before and after training. An increase in V[Combining Dot Above]O2max (p ≤ 0.05) after 2 weeks of both SIT and ET was observed. Performance in HEC increased by 31.0 and 17.2% after SIT and ET, respectively (p ≤ 0.05). Running economy assessed at 8, 9, 10, and 11 km·h, lactate threshold and vV[Combining Dot Above]O2max were unchanged after both SIT and ET. Maximal activity of 3-ß-hydroxylacyl coenzyme A dehydrogenase (ß-HAD) was increased in response to both SIT and ET (p ≤ 0.05), whereas the maximal activity of citrate synthase remained unchanged after training (p = 0.07). A running-based protocol of SIT is a time-efficient training method for improving aerobic capacity and HEC, and maintaining indices of RE and lactate threshold in team sport athletes.

Physiological Profile and Activity Pattern of Minor Gaelic Football Players.

Cullen, BD, Roantree, M, McCarren, A, Kelly, DT, O'Connor, PL, Hughes, SM, Daly, PG, and Moyna1, NM. Physiological profile and activity pattern of minor Gaelic football players. J Strength Cond Res 31(7): 1811-1820, 2017-The purpose of this study was to evaluate the physiological profile and activity pattern in club- and county-level under-18 (U-18) Gaelic football players relative to playing position. Participants (n = 85) were analyzed during 17 official 15-a-side matches using global positioning system technology (SPI Pro X II; GPSports Systems, Canberra, Australia) and heart rate (HR) telemetry. During the second part of this study, 63 participants underwent an incremental treadmill test to assess their maximal oxygen uptake (V[Combining Dot Above]o2max) and peak HR (HRmax). Players covered a mean distance of 5,774 ± 737 m during a full 60-minute match. The mean %HRmax and %V[Combining Dot Above]O2max observed during the match play were 81.6 ± 4.3% and 70.1 ± 7.75%, respectively. The playing level had no effect on the distance covered, player movement patterns, or %HRmax observed during match play. Midfield players covered significantly greater distance than defenders (p = 0.033). Playing position had no effect on %HRmax or the frequency of sprinting or high-intensity running during match play. The frequency of jogging, cruise running, striding (p = 0.000), and walking (p = 0.003) was greater in the midfield position than in the forward position. Time had a significant effect (F(1,39) = 33.512, p-value = 0.000, and (Equation is included in full-text article.)= 0.462) on distance covered and %HRmax, both of which showed a reduction between playing periods. Gaelic football is predominantly characterized by low-to-moderate intensity activity interspersed with periods of high-intensity running. The information provided may be used as a framework for coaches in the design and prescription of training strategies. Positional specific training may be warranted given the comparatively greater demands observed in the midfield playing position. Replicating the demands of match play in training may reduce the decline in distance covered and %HRmax observed during the second half of match play.

The Development of Activity Profiles in Adolescent Females and their Association with Adiposity.

OBJECTIVES: This study aims to (1) use the objective activPAL activity monitor to assess physical activity behaviors, including sitting/lying, standing, and both light (LIPA) and moderate-to-vigorous physical activity (MVPA); (2) to develop distinct activity profiles based on time spent in each behavior in a sample of adolescent females; and (3) examine whether levels of adiposity differ across these activity profiles. METHODS: Female adolescents (n = 195; 14-18 y) had body mass index (median = 21.7 [IQR = 5.2] kg/m2) and 4-site skinfold thickness (median 62.0 mm; IQR = 37.1) measured. Physical activity behaviors were measured using the activPAL. Hierarchical cluster analysis grouped participants into activity profiles based on similar physical activity characteristics. Linear mixed models explored differences in body composition across activity profiles. RESULTS: Three activity profiles were identified, a low (n = 35), moderate (n = 110), and a high activity profile (n = 50). Significant differences across activity profiles were observed for skinfold thickness (p = .046), with higher values observed in the low activity profile compared with the high activity profile. CONCLUSIONS: Profiling free-living activity using behaviors from across the activity intensity continuum may account for more of the variability in energy expenditure then examining specific activity intensities, such as MVPA alone. The use of activity profiles may enable the identification of individuals with unhealthy activity behaviors, leading to the development and implementation of more targeted interventions.

Hyperleptinemia is associated with CRP, but not apolipoprotein E, and is reduced by exercise training.

The purpose of this study was to examine whether leptin levels affect the response of leptin to exercise training (ET) and whether this is also affected by C-reactive protein (CRP) or the three common Apolipoprotein E genotypes (APOE). Ninety-seven (male = 45, female = 52) sedentary individuals underwent 6 months of supervised ET. Blood was sampled before the initiation of ET, and again 24 and 72 hr after completion of the final training session. ET resulted in a small reduction in body mass (80.47 ± 18.03 vs 79.42 ± 17.34 kg, p < .01). Leptin was reduced 24 hr after the final exercise session (p < .01), but returned to normal after 72 hr (p > .05)--Pre: 13.51 ± 12.27, 24hr: 12.14 ± 12.34, 72 hr: 12.98 ± 11.40 ng/ml. The most hyperleptinemic individuals had a greater initial response, which was sustained through to 72 hr after the final session in the pooled study population (p < .01), and in both males (p < .05) and females (p < .05) separately. CRP was related to leptin independently of body weight and positively related to the reductions in leptin. APOE genotype was not related to leptin levels and did not affect the response to ET. Leptin levels may only be reduced by ET in those with hyperleptinemia. In addition, both the initial extent of hyperleptinemia and the subsequent reduction in leptin may be related to low grade chronic systemic inflammation.

'The illness isn't the end of the road'-Patient perspectives on the initiation of and early participation in a multi-disease, community-based exercise programme.

BACKGROUND: Exercise is the cornerstone of cardiac rehabilitation (CR). Hospital-based CR exercise programmes are a routine part of clinical care and are typically 6-12 weeks in duration. Following completion, physical activity levels of patients decline. Multi-disease, community-based exercise programmes (MCEP) are an efficient model that could play an important role in the long-term maintenance of positive health behaviours in individuals with cardiovascular disease (CVD) following their medically supervised programme. AIM: To explore patients experiences of the initiation and early participation in a MCEP programme and the dimensions that facilitate and hinder physical activity engagement. METHODS: Individuals with established CVD who had completed hospital-based CR were referred to a MCEP. The programme consisted of twice weekly group exercise classes supervised by clinical exercise professionals. Those that completed (n = 31) an initial 10 weeks of the programme were invited to attend a focus group to discuss their experience. Focus groups were transcribed and analysed using reflexive thematic analysis. RESULTS: Twenty-four (63% male, 65.5±6.12yrs) patients attended one of four focus groups. The main themes identified were 'Moving from fear to confidence', 'Drivers of engagement,' and 'Challenges to keeping it (exercise) up'. CONCLUSION: Participation in a MCEP by individuals with CVD could be viewed as a double-edged sword. Whilst the programme clearly provided an important transition from the clinical to the community setting, there were signs it may breed dependency and not effectively promote independent exercise. Another novel finding was the use of social comparison that provided favourable valuations of performance and increased exercise confidence.

Safety, feasibility and effectiveness of the remotely delivered Pulmonary Hypertension and Home-Based (PHAHB) physical activity intervention.

Background: Pulmonary hypertension (PH) is a heterogeneous condition, associated with a high symptom burden and a substantial loss of exercise capacity. Despite prior safety concerns regarding physical exertion, exercise training as a supportive therapy is now recommended for PH patients. Currently, most programmes are hospital-based, which limits accessibility. There is a need to provide alternative approaches for physical activity engagement for PH patients. The aim of this research was to develop, implement and evaluate the safety, feasibility and effectiveness of home-based physical activity intervention for PH. Methods: An entirely remotely delivered home-based physical activity intervention underpinned by behaviour change theory and informed by end-users, was assessed using a single-arm feasibility study design. Participants (n=19; 80% female) with a mean±sd age of 49.9±15.9 years with a diagnosis of PH undertook a 10-week, home-based physical activity intervention with induction training, support materials, telecommunication support, health coaching, exercise training and assessments, all remotely delivered. Training involved respiratory training along with a combination of aerobic and resistance exercises. Results: The intervention was deemed safe as no adverse events were reported. A high level of feasibility was demonstrated as the protocol was implemented as intended, sustained a high level of engagement and adherence and was well accepted by participants in terms of enjoyment and utility. There was a significant improvement in functional capacity, physical activity, exercise self-efficacy and quality of life, between baseline and post-training. Conclusion: The study demonstrates that an entirely remotely delivered home-based physical activity programme is safe, feasible and effective in improving functional capacity, physical activity and quality of life in PH patients.

Fitness profiling of elite level adolescent Gaelic football players.

The purpose of this study was to evaluate the anthropometric characteristics and fitness levels of elite level under 18 (U-18) Gaelic football players to establish normative centile scores for selected fitness parameters and to compare the physical and fitness characteristics relative to each playing position. A total of 265 male U-18 Gaelic football players (age: 16.96 ± 0.7 years; height: 178.11 ± 6.27 cm; weight: 72.07 ± 8.68 kg) participated in the study. According to positional roles, players were categorized as goalkeepers (n = 13), defenders (n = 113), midfielders (n = 30), and forwards (n = 109). Height and weight were measured, and skinfolds were taken before participants sequentially performed a sit and reach test (S&R), countermovement jump (CMJ), standing long jump (SLJ), 5- and 20-m speed test, and the Yo-Yo Intermittent Recovery Test Level 1 (YYIRT1). The percentage body fat was higher (p < 0.01) in goalkeepers than the other playing positions. Goalkeepers had a higher body mass index than defenders (p < 0.05) and forwards (p < 0.01). Midfielders and goalkeepers were taller (p < 0.01) and heavier (p < 0.01) than defenders and forwards. The total distance covered in the YYIRT1 was significantly lower (p < 0.01) in goalkeepers than the other playing positions. There was no significant positional difference in the performance scores in the S&R test, CMJ, SLJ, and 5- and 20-m running speed. The study findings indicate minimal differences in the anthropometric and physiological characteristics between playing positions in elite youth level Gaelic football players. The norm-referenced percentile scores will enable conditioning coaches to benchmark elite performance and design training programs.

Activity profile of elite Gaelic football referees during competitive match play.

The purpose of this study was to examine the activity profile of elite Gaelic football referees (GFR) and to examine temporal changes between the first and second half and across the four quarters. Global positioning systems technology (10-Hz) was used to collect activity data during 202 competitive games from 23 elite GFR. Relative distance, peak running speed and relative distance covered in six movement categories [very low-speed movement (VLSM) (<0.70 m·s-1), walking (≥0.70-1.65 m·s-1), low-speed running (LSR) (≥1.66-3.27 m·s-1), moderate-speed running (MSR) (≥3.28-4.86 m·s-1), high-speed running (HSR) (≥4.87-6.48 m·s-1), very high-speed running (VHSR) (≥6.49 m·s-1)] were examined during the full game, first and second half, and across the four quarters. The relative distance covered was 122.6 ± 8.4 m·min-1, with 13.1 ± 4.9 m·min-1 of HSR and VHSR. The peak running speed was 6.75 ± 0.49 m·s-1. The relative (ES=0.60), MSR (ES=0.50) and HSR (ES=0.14) distance was higher in the first half than the second half. A higher relative (ES=0.62-0.91) and HSR (ES=0.51-0.61) distance was found in the first quarter than any other period. No differences in HSR distance were found between the second, third and fourth quarters (ES=0.04-0.10). This study provides, for the first time, a detailed insight into the activity profile of elite GFR during competitive games and demonstrates the demanding, intermittent nature of elite refereeing in Gaelic football. This information may be used as a framework for coaches to design training programmes specific to GFR.

Competitive level differences in the activity profile of elite Gaelic football referees.

The purpose of this study was to compare the activity profile of elite Gaelic football referees (GFR) between the National Football League (NFL) and the All-Ireland Championship (AIC), and across the four divisions of the NFL and three phases of the AIC. Match activity data was collected during 125 NFL and 201 AIC games using 10-Hz global positioning system technology from 41 elite GFR. Game duration, total distance, very low-speed movement (<0.70 m·s-1), walking (≥0.70-1.65 m·s-1), low-speed running (≥1.66-3.27 m·s-1), moderate-speed running (≥3.28-4.86 m·s-1), high-speed running (≥4.87-6.48 m·s-1), very high-speed running (≥6.49 m·s-1) distance, and peak running speed were compared between competitions. Games in the AIC were longer than in the NFL (ES = 0.59) but the total distance was similar between the NFL (119.6 ± 9.5 m·min-1) and AIC (122.6 ± 8.4 m·min-1, ES = 0.11). No other differences were found between the NFL and AIC or across the four divisions of the NFL and three phases of the AIC, except for a higher peak running speed during the All-Ireland Series (6.93 ± 0.52 m·s-1) than the All-Ireland Qualifiers (6.65 ± 0.46 m·s-1, ES = 0.35). This information can be used to design specific conditioning programmes to ensure optimal physical development of GFR at all competitive levels.

Exploration of physical activity knowledge, preferences and support needs among pulmonary hypertension patients.

OBJECTIVE: Physical activity (PA) is an established adjunct therapy for pulmonary hypertension (PH) patients to mitigate PH symptoms and improve quality of life. However, PA engagement within this population remains low. This study investigated PH patients' knowledge of PA, recalled advice, exercise preferences and PA support needs. METHODS: Semi-structured interviews were conducted with 19 adults (mean age 50 years; SD ±12 years) diagnosed with PH, living in Ireland. Interview scripts were digitally recorded and transcribed verbatim. Thematic analysis was used to analyse the data. RESULTS: Four key themes were identified: Lack of PA knowledge; exercise setting preference; accountability and monitoring; and clinician delivered PA information and guidance. CONCLUSION: This study found that PH clinicians provide suboptimal PA advice, yet patients desired clinician-delivered PA guidance. Home-based exercise was preferred with monitoring and external accountability deemed as important to facilitate sustained engagement. PRACTICE IMPLICATIONS: PH clinicians are well positioned to play a critical role in assisting and empowering PH patients to engage in PA. Providing training and education to PH clinicians regarding exercise prescription may be beneficial. Further research is needed to evaluate the feasibility and efficacy of home-based exercise interventions to improve quality of life and physical activity in PH.

Lipoprotein particle distribution and skeletal muscle lipoprotein lipase activity after acute exercise.

BACKGROUND: Many of the metabolic effects of exercise are due to the most recent exercise session. With recent advances in nuclear magnetic resonance spectroscopy (NMRS), it is possible to gain insight about which lipoprotein particles are responsible for mediating exercise effects. METHODS: Using a randomized cross-over design, very low density lipoprotein (VLDL) responses were evaluated in eight men on the morning after i) an inactive control trial (CON), ii) exercising vigorously on the prior evening for 100 min followed by fasting overnight to maintain an energy and carbohydrate deficit (EX-DEF), and iii) after the same exercise session followed by carbohydrate intake to restore muscle glycogen and carbohydrate balance (EX-BAL). RESULTS: The intermediate, low and high density lipoprotein particle concentrations did not differ between trials. Fasting triglyceride (TG) determined biochemically, and mean VLDL size were lower in EX-DEF but not in EX-BAL compared to CON, primarily due to a reduction in VLDL-TG in the 70-120 nm (large) particle range. In contrast, VLDL-TG was lower in both EX-DEF and EX-BAL compared to CON in the 43-55 nm (medium) particle range. VLDL-TG in smaller particles (29-43 nm) was unaffected by exercise. Because the majority of VLDL particles were in this smallest size range and resistant to change, total VLDL particle concentration was not different between any of these conditions. Skeletal muscle lipoprotein lipase (LPL) activity was also not different across these 3 trials. However, in CON only, the inter-individual differences in LPL activity were inversely correlated with fasting TG, VLDL-TG, total, large and small VLDL particle concentration and VLDL size, indicating a regulatory role for LPL in the non-exercised state. CONCLUSIONS: These findings reveal a high level of differential regulation between different sized triglyceride-rich lipoproteins following exercise and feeding, in the absence of changes in LPL activity.

Effects of home-based resistance training and neuromuscular electrical stimulation in knee osteoarthritis: a randomized controlled trial.

BACKGROUND: Quadriceps femoris muscle (QFM) weakness is a feature of knee osteoarthritis (OA) and exercise programs that strengthen this muscle group can improve function, disability and pain. Traditional supervised resistance exercise is however resource intensive and dependent on good adherence which can be challenging to achieve in patients with significant knee OA. Because of the limitations of traditional exercise programs, interest has been shown in the use of neuromuscular electrical stimulation (NMES) to strengthen the QFM. We conducted a single-blind, prospective randomized controlled study to compare the effects of home-based resistance training (RT) and NMES on patients with moderate to severe knee OA. METHODS: 41 patients aged 55 to 75 years were randomised to 6 week programs of RT, NMES or a control group receiving standard care. The primary outcome was functional capacity measured using a walk test, stair climb test and chair rise test. Additional outcomes were self-reported disability, quadriceps strength and cross-sectional area. Outcomes were assessed pre- and post-intervention and at 6 weeks post-intervention (weeks 1, 8 and 14 respectively). RESULTS: There were similar, significant improvements in functional capacity for the RT and NMES groups at week 8 compared to week 1 (p ≤ 0.001) and compared to the control group (p < 0.005), and the improvements were maintained at week 14 (p ≤ 0.001). Cross sectional area of the QFM increased in both training groups (NMES: +5.4%; RT: +4.3%; p = 0.404). Adherence was 91% and 83% in the NMES and RT groups respectively (p = 0.324). CONCLUSIONS: Home-based NMES is an acceptable alternative to exercise therapy in the management of knee OA, producing similar improvements in functional capacity. TRIAL REGISTRATION: Current Controlled Trials ISRCTN85231954.