The chronic leukocyte and inflammatory cytokine responses of older adults to resistance training in normobaric hypoxia; a randomized controlled trial.

TRIAL DESIGN: Older adults experience chronic dysregulation of leukocytes and inflammatory cytokines, both at rest and in response to resistance training. Systemic hypoxia modulates leukocytes and cytokines, therefore this study characterized the effects of normobaric hypoxia on the leukocyte and cytokine responses of older adults to resistance training. METHODS: 20 adults aged 60-70 years performed eight weeks of moderate-intensity resistance training in either normoxia or normobaric hypoxia (14.4% O2), consisting of two lower body and two upper body exercises. Venous blood was drawn before and after the training intervention and flow cytometry was used to quantify resting neutrophils, lymphocytes, monocytes, eosinophils and basophils, in addition to the subsets of lymphocytes (T, B and natural killer (NK) cells). Inflammatory cytokines were also quantified; interleukin 1 beta (IL-1ß), IL-4, IL-6, IL-8, IL-10 and tumor necrosis factor alpha (TNF-α). Acute changes in leukocytes and cytokines were also measured in the 24 h following the last training session. RESULTS: After the intervention there was a greater concentration of resting white blood cells (p = 0.03; 20.3% higher) T cells (p = 0.008; 25.4% higher), B cells (p = 0.004; 32.6% higher), NK cells (p = 0.012; 43.9% higher) and eosinophils (p = 0.025; 30.8% higher) in hypoxia compared to normoxia, though the cytokines were unchanged. No acute effect of hypoxia was detected in the 24 h following the last training session for any leukocyte population or inflammatory cytokine (p < 0.05). CONCLUSIONS: Hypoxic training caused higher concentrations of resting lymphocytes and eosinophils, when compared to normoxic training. Hypoxia may have an additional beneficial effect on the immunological status of older adults. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR). TRIAL NUMBER: ACTRN12623001046695. Registered 27/9/2023. Retrospectively registered. All protocols adhere to the COSORT guidelines.

The acute leukocyte and cytokine response of older adults to resistance exercise in normobaric hypoxia.

Ageing causes a decline in leukocyte function and blunted leukocyte responses to resistance exercise. Systemic hypoxia exposure augments the leukocyte response to resistance exercise in young adults, yet this response remains uncharacterised in older adults. This study characterised the effects of normobaric hypoxia on the acute leukocyte and inflammatory cytokine responses to resistance exercise in older adults. We recruited 20 adults aged 60-70 years to perform an acute bout of resistance exercise in normobaric hypoxia (FiO2 14.4%; n = 10) or normoxia (FiO2 20.93%; n = 10). Participants completed 4 × 10 repetitions of lower and upper body exercises at 70% of their predicted 1-repetition maximum. Venous blood was sampled before and up to 24 hours post-exercise to quantify neutrophils, lymphocytes, monocytes, eosinophils, basophils and cytokines (IL-1ß, IL-4, IL-6, IL-8, IL-10, TNFα). Flow cytometry was used to classify lymphocytes as T (CD4+ helper and CD8+ cytotoxic), B and NK cells, in addition to the expression of the senescence marker CD45RA on T cells. The hypoxic group showed a larger lymphocyte response over the 24 hours post-exercise compared to the normoxic group (p = 0.035). Specifically, there were greater concentrations of CD4+ T helper cells following hypoxic exercise compared to normoxia (p = 0.046). There was also a greater proportion of CD45RA+ CD4+ T helper cells, suggesting that the cells were more senescent (p = 0.044). Hypoxia did not impact any other leukocyte population or cytokine following exercise. Normobaric hypoxia increases the lymphocyte response to an acute bout of resistance exercise in older adults.

The effects of normobaric hypoxia on the leukocyte responses to resistance exercise.

There is growing interest in the use of systemic hypoxia to improve the training adaptations to resistance exercise. Hypoxia is a well-known stimulator of the immune system, yet the leukocyte responses to this training modality remain uncharacterised. The current study characterised the acute leukocyte responses to resistance exercise in normobaric hypoxia. The single-blinded, randomised trial recruited 13 healthy males aged 18-35 years to perform a bout of resistance exercise in normobaric hypoxia (14.4% O2; n = 7) or normoxia (20.9% O2; n = 6). Participants completed 4 × 10 repetitions of lower and upper body exercises at 70% 1-repetition maximum. Oxygen saturation, rating of perceived exertion and heart rate were measured during the session. Venous blood was sampled before and up to 24 hours post-exercise to quantify blood lactate, glucose and leukocytes including neutrophils, lymphocytes, monocytes, eosinophils and basophils. Neutrophils were higher at 120 and 180 minutes post-exercise in hypoxia compared to normoxia (p<0.01), however lymphocytes, monocytes, eosinophils and basophils were unaffected by hypoxia. Oxygen saturation was significantly lower during the four exercises in hypoxia compared to normoxia (p < 0.001). However, there were no differences in blood lactate, heart rate, perceived exertion or blood glucose between groups. Hypoxia amplified neutrophils following resistance exercise, though all other leukocyte subsets were unaffected. Therefore, hypoxia does not appear to detrimentally affect the lymphocyte, monocyte, eosinophil or basophil responses to exercise.

"Prescriptive authority for psychologists: The next step": Correction.

Reports an error in "Prescriptive authority for psychologists: The next step" by Steven Eric Curtis, Samantha Hoffmann and Maeve O'Leary Sloan (Psychological Services, Advanced Online Publication, May 05, 2022, np). In the original article, changes were needed to clarify the timeline of state legalizations of prescriptive authority for psychologists (RxP) and the current status of RxP with regard to the Federal Bureau of Prisons (BOP). In the second paragraph of the "RxP From 2011 to Present" section, the citations relating to legalization in Idaho and Iowa were corrected, and the year in the Prescribing Psychologist reference was corrected in the References section and in text citations throughout. Additionally, in the last paragraph of the "RxP From 2011 to Present" section, the text was updated to clarify that at the present time, prescribing psychologists are not able to prescribe for the BOP. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2022-58802-001). Since the endorsement of prescriptive authority for psychologists (RxP) by the American Psychological Association (APA) in 1995, it has become legal in five states (Idaho, Illinois, Iowa, Louisiana, and New Mexico). The Department of Defense, including the U.S. Air Force, U.S. Army, and U.S. Navy, as well as the Public Health Service, and the Indian Health Service, continue to utilize prescribing psychologists as well. There are now over 200 prescribing psychologists in the United States. Five APA-designated RxP training programs offer a pathway to attain prescription privileges and future board certification when approved. The purpose of this article is to provide information for those with minimal exposure to RxP, updates for those more informed, and recommendations for the next phase of RxP. This article examines scholarship related to RxP as well as newsletter columns, state legislative efforts, current RxP laws, policies, training programs, and critical events in the RxP history. Public access to quality and comprehensive mental health services can be expected to improve as more psychologists complete the necessary RxP training and licensure requirements. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Prescriptive authority for psychologists: The next step.

[Correction Notice: An Erratum for this article was reported online in Psychological Services on Jul 11 2022 (see record 2022-79840-001). In the original article, changes were needed to clarify the timeline of state legalizations of prescriptive authority for psychologists (RxP) and the current status of RxP with regard to the Federal Bureau of Prisons (BOP). In the second paragraph of the "RxP From 2011 to Present" section, the citations relating to legalization in Idaho and Iowa were corrected, and the year in the Prescribing Psychologist reference was corrected in the References section and in text citations throughout. Additionally, in the last paragraph of the "RxP From 2011 to Present" section, the text was updated to clarify that at the present time, prescribing psychologists are not able to prescribe for the BOP. All versions of this article have been corrected.] Since the endorsement of prescriptive authority for psychologists (RxP) by the American Psychological Association (APA) in 1995, it has become legal in five states (Idaho, Illinois, Iowa, Louisiana, and New Mexico). The Department of Defense, including the U.S. Air Force, U.S. Army, and U.S. Navy, as well as the Public Health Service, and the Indian Health Service, continue to utilize prescribing psychologists as well. There are now over 200 prescribing psychologists in the United States. Five APA-designated RxP training programs offer a pathway to attain prescription privileges and future board certification when approved. The purpose of this article is to provide information for those with minimal exposure to RxP, updates for those more informed, and recommendations for the next phase of RxP. This article examines scholarship related to RxP as well as newsletter columns, state legislative efforts, current RxP laws, policies, training programs, and critical events in the RxP history. Public access to quality and comprehensive mental health services can be expected to improve as more psychologists complete the necessary RxP training and licensure requirements. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Longitudinal association of physical activity during pregnancy with maternal and infant outcomes: Findings from the Australian longitudinal study of women's health.

BACKGROUND: Physical activity has known benefits during pregnancy; however, the optimum volume of physical activity through the different stages of pregnancy is not well known. OBJECTIVES: The aims of this study were to investigate the associations of physical activity volume in pregnant women in each trimester of pregnancy with maternal and infant outcomes. DESIGN: The study involved 1657 pregnant women from the Australian Longitudinal Study on Women's Health, who completed surveys from 2006 to 2012 (aged 28-39 years). METHODS: Women reported being in either the first, second or third trimester of pregnancy. Women were grouped into four groups according to their self-reported physical activity during pregnancy: (1) Nil (0-<33.3 MET.min/week), (2) Low (33.3-<500 MET.min/week), (3) Moderate (500-<1000 MET.min/week) and (4) High (⩾1000 MET.min/week). Women who reported their physical activity during pregnancy completed a survey within three years after the birth, relating to outcomes associated with pregnancy and childbirth (gestational diabetes, hypertension, and antenatal depression and anxiety) and infant outcomes (birthweight and prematurity). RESULTS: There was no association of physical activity in any trimester with infant birthweight, prematurity, gestational diabetes, hypertension or antenatal depression. Antenatal anxiety was less prevalent in women who reported low (1.7%) or moderate (1.1%) physical activity than in those who reported no activity (4.7%; p = 0.01). CONCLUSION: Different amounts of physical activity during pregnancy were not associated with the measured adverse health outcomes. However, low and moderate amounts of physical activity were associated with reduced incidence of antenatal anxiety.

Physical activity knowledge, attitudes and behaviours of pre-clinical medical students attending an Australian university.

BACKGROUND: Through the provision of advice and counselling, general practitioners (GPs) play an important part in promoting physical activity (PA). Lack of knowledge is a key barrier to engaging in such practice. Little is known about the knowledge and attitudes of current medical students and their preparedness to engage in PA promoting practice in the future. This study aimed to investigate the PA knowledge, attitudes and behaviours of medical students attending an Australian university. METHODS: A sample of 107 pre-clinical medical students from an Australian university completed an online survey. Questions asked about age, sex and past-week PA behaviour (using the International Physical Activity Questionnaire-Short form) as well as understanding of key PA messages and perceptions of the role of a GP, confidence to engage in PA promoting practices and satisfaction with current medical school training (responses were on 5-point Likert scale). Descriptive statistics (proportions, means) were used to summarise demographic and attitudinal measures. RESULTS: Almost all students (92%) were categorised as being moderately or highly active in the past-week. Knowledge of key PA messages was moderate (3.6 ± 0.9), however understanding of key messages about the dose of PA varied (ranging from 0% to 80.4% agreement). GPs were regarded as having a role to play in promoting PA; with high agreement that discussing the benefits of PA is a part of the role of a GP (4.7 ± 0.5). There was only moderate agreement that participants had received training in the health benefits of PA (3.1 ± 1.0) and in PA counselling (3.2 ± 1.0). Students indicated lower levels of satisfaction with this training (2.5 ± 0.9). CONCLUSIONS: Students in this study were typically physically active, had positive attitudes toward PA and felt that it was the role of the GP to engage in PA promoting practices. Students understood key PA messages, and while they reportedly received some training in providing PA counselling, they were somewhat dissatisfied with this training.

The Role of Sports Clothing in Thermoregulation, Comfort, and Performance During Exercise in the Heat: A Narrative Review.

The aims of this review are to (1) summarise the current research of sports clothing as it relates to thermoregulation, comfort, and performance during exercise in the heat, (2) identify methodological limitations and gaps in the knowledge base of sports clothing, and (3) provide recommendations for exercise testing protocols to accurately assess the impact of sports clothing in athletic populations during exercise in the heat. Sports clothing consists of lightweight and breathable fabrics, surface treatments, and various designs which aim to enhance sweat evaporation and comfort during exercise in the heat. Sports clothing comprised of natural, synthetic, and chemically treated fabrics has been investigated during exercise of varying durations (15-120 min), intensities (20-70% VO2 max) and types (fixed intensity, incremental, self-paced), and in an array of climatic conditions (18-40 °C, 20-60% relative humidity). To date, few studies have identified significant differences in thermo-physiological, perceptual, and performance measures between natural and synthetic fabrics or compared the effect of chemical treatments to their non-treated equivalent on such measures during exercise. Collectively, previous wearer trials have failed to replicate the upper limit of training and competition demands when assessing sports clothing in endurance-trained individuals who regularly train and compete in hot and humid climates. Clothing comfort has also been evaluated using simple scales which fail to capture intricate detail pertaining to psychological and sensorial parameters. The incorporation of protocols using hot and humid climates (≥ 30 °C, ≥ 70% relative humidity) and longer exercise durations (> 45 min) is warranted. Future research should also consider exploring the effect of sports clothing on thermal, physiological, perceptual, and performance measures between males and females, and assessing clothing comfort using a multi-dimensional approach.

The assessment of a novel lower body resistance garment as a mechanism to increase the training stimulus during running: a randomised cross-over study.

BACKGROUND: This study examined the physiological and perceived impact of wearing a novel lower body resistance garment during exercise and recovery. METHODS: Using a randomised cross-over design, 15 recreationally-active males performed 2 × 10-min steady-state runs followed by a 10-min passive recovery with concomitant monitoring of oxygen consumption (V̇O2), heart rate (HR) and rating of perceived exertion (RPE; exercise portion only), wearing either the resistance garment (experimental) or running shorts (control). RESULTS: During exercise, there was a trend for V̇O2 and RPE to be higher (4.5% and 7.7% respectively) in experimental than control (V̇O2: r = 0.24, p > 0.05; RPE: r = 0.32, p > 0.05) and for HR to be lower (- 0.4%, r = - 0.05, p > 0.05). During recovery, V̇O2 and HR tended to be lower (4.7% and 4.3% respectively) in experimental than control (V̇O2: r = - 0.32, p > 0.05; HR: r = - 0.27, p > 0.05). CONCLUSIONS: Though effects were trivial to small, and not statistically significant, these findings provide proof of concept and suggest that this garment design may increase the training stimulus during running and aid post-exercise recovery.

The Effect of Normobaric Hypoxia on Resistance Training Adaptations in Older Adults.

ABSTRACT: Allsopp, GL, Hoffmann, SM, Feros, SA, Pasco, JA, Russell, AP, and Wright, CR. The effect of normobaric hypoxia on resistance training adaptations in older adults. J Strength Cond Res 36(8): 2306-2312, 2022-The effect of normobaric hypoxia on strength, body composition, and cardiovascular fitness was investigated after a resistance training intervention in older adults. A single-blinded, randomized control trial recruited 20 healthy adults aged 60-75 years for an 8-week resistance training intervention in normoxia ( n = 10) or normobaric hypoxia (14.4% O 2 ; n = 10). Subjects performed 2 sessions per week of upper-body and lower-body exercises at 70% of 1 repetition maximum (1RM). Pretraining and post-training, maximal oxygen uptake (V̇O 2 max), muscular endurance (30 maximal knee flexions/extensions), and 5RM were assessed, with 5RM used to calculate 1RM. Subjects underwent whole-body dual-energy x-ray absorptiometry (DXA) at pretraining and post-training for fat and lean mass quantification. Significance was set at p < 0.05. Subjects in both groups substantially improved their calculated 1RM strength for leg extension, pectoral fly, row, and squat (normoxia; 30, 38, 27, and 29%, hypoxia; 43, 50, 28, and 64%, respectively); however, hypoxia did not augment this response. Hypoxia did not enhance V̇O 2 max or muscular endurance responses after the training intervention, with no improvements seen in either group. Fat mass and lean mass remained unchanged in both groups after the intervention. In summary, 8 weeks of resistance training in hypoxia was well tolerated in healthy older adults and increased upper-body and lower-body strength. However, the magnitude of strength and lean muscle improvements in hypoxia was no greater than normoxia; therefore, there is currently no evidence to support the use of hypoxic resistance training in older adults.

Behaviors and Actions of the Strength and Conditioning Coach in Fostering a Positive Coach-Athlete Relationship.

ABSTRACT: Carson, F, Blakey, M, Foulds, SJ, Hinck, K, and Hoffmann, SM. Behaviors and actions of the strength and conditioning coach in fostering a positive coach-athlete relationship. J Strength Cond Res 36(11): 3256-3263, 2022-A number of models have been developed to explain the various factors that affect coach-athlete interactions; however, they have had limited application to strength and conditioning (S&C). A systematic review of the literature was completed using the databases SPORTDiscus Full Text, MEDLINE, Global Health, Academic Search Complete, and PsychINFO, sourcing articles related to S&C coach-athlete relationships. An initial search yielded 1,364 articles, which when screened against the inclusion criteria was narrowed to 8 articles relating specifically to the S&C coach-athlete relationship. Four major themes were identified throughout the included articles: leadership styles; perceptions of leadership; coach knowledge, experience, and training; and building relationships. These themes highlighted that positive coach-athlete interactions are fostered through a mutual understanding of the S&C coach's responsibility to improve performance and reduce injury through scientific methods, with an awareness of different psychosocial behaviors of both the coach and the athlete. This will create a mutual interconnectedness whereby both parties can participate in a functional dyad. Three practical applications deduced from the findings identified the importance of building an autonomy-supportive environment, keeping knowledge and expertise at a high standard, and embracing the whole person rather than just the athlete. These teachings aim to guide S&C coaches through the necessary actions and behaviors recommended to successfully build and foster positive S&C coach-athlete relationships.

Comparison of training responses and performance adaptations in endurance-trained men and women performing high-intensity interval training.

The efficacy of high-intensity interval training (HIIT) to elicit physiological and performance adaptations in endurance athletes has been established in men and to a lesser extent in women. This study compared lactate threshold (LT2) and performance adaptations to HIIT between men and women. Nine male and eight female cyclists and triathletes completed trials to determine their LT2 and 40 km cycling performance before, and after 10 HIIT sessions. Each HIIT session consisted of 10 × 90 s at peak power output, separated by 60 s active recovery. Main effects showed that HIIT improved peak power output (p = 0.05; ES: 0.2); relative peak power output (W.kg-1; p = 0.04; ES: 0.3 and W.kg-0.32; p = 0.04; ES: 0.3); incremental time to fatigue (p = 0.01; ES: 0.4), time trial time (p < 0.001; ES: 0.7) and time trial power output (p < 0.001; ES: 0.7) equally in both sexes. Although LT2 power output explained 77% of the performance improvement in women, no variable explained the performance improvement in men, suggesting another mechanism(s) was involved. Although HIIT improved cycling performance in men and women, it might not be appropriate to evaluate the effectiveness of HIIT using the same variables for both sexes.

The Efficacy of the Lactate Threshold: A Sex-Based Comparison.

Hoffmann, SM, Skinner, TL, van Rosendal, SP, Osborne, MA, Emmerton, LM, and Jenkins, DG. The efficacy of the lactate threshold: A sex-based comparison. J Strength Cond Res 34(11): 3190-3198, 2020-The second lactate threshold (LT2) has previously been associated with endurance performance; however, comparisons between sexes are lacking regarding its efficacy. The aim of this study was to compare LT2 between men and women, specifically regarding its (a) relationship with endurance performance and (b) capacity to establish training and competition intensities. Competitive male (mean ± SD: age, 27.7 ± 4.7 years; V[Combining Dot Above]O2max, 59.7 ± 5.2 ml·kg·min; n = 10) and female (mean ± SD: age, 27.3 ± 6.2 years; V[Combining Dot Above]O2max, 54.5 ± 5.3 ml·kg·min; n = 12) cyclists and triathletes completed an incremental cycle trial to volitional fatigue (for determination of V[Combining Dot Above]O2max and LT2 via the modified D-max method), a constant load (±5%) exercise trial of 30 minutes at LT2 power output, and a 40-km cycle time trial. The LT2 significantly correlated with 40-km cycling performance in both men (r = -0.69 to -0.77; p < 0.01-0.05) and women (r = -0.63 to -0.75; p < 0.01-0.05). All men sustained LT2 power output for 30 minutes, compared with 82% of women. Despite LT2 reflecting a similar heart rate, V[Combining Dot Above]O2, and [La] to those elicited during a 40-km time trial in both men and women, power output at LT2 was 6% higher (p < 0.05) than mean time trial power output in women, with no significant difference in men. Based on these findings, sex-specific recommendations have been suggested in regard to the use of LT2 for establishing performance potential, prescribing endurance training intensities and setting 40-km performance intensity.

Anterior cruciate ligament injuries in Australian football: should women and girls be playing? You're asking the wrong question.

Anterior cruciate ligament (ACL) injuries have been a rising concern in the early years of the women's Australian Football League (AFLW), eliciting headlines of a 'knee crisis' surrounding the league. There has been a focus on female biology as the primary factor driving the high rate of ACL injuries in the AFLW. Emphasising Australian football (AF) as being dangerous predominantly due to female biology may be misrepresenting a root cause of the ACL injury problem, perpetuating gender stereotypes that can restrict physical development and participation of women and girls in the sport. We propose that an approach addressing environmental and sociocultural factors, along with biological determinants, is required to truly challenge the ACL injury problem in the AFLW. Sports science and medicine must therefore strive to understand the whole system of women in AF, and question how to address inequities for the benefit of the athletes.

The Coach-Athlete Relationship in Strength and Conditioning: High Performance Athletes' Perceptions.

The primary purpose of this study was to investigate high performance athlete perceptions of strength and conditioning coaches, specifically, (1) their character traits, (2) the effective behaviours that display these traits, and (3) how these relationships were fostered. Using the 3+1 C's model of coach-athlete relationships as a framework (Jowett, 2007), 12 semi-structured interviews were conducted with high performance athletes (six female; six male) representing a variety of sports (i.e., freestyle wrestling, triathlon, field hockey, cycling, rowing, rugby union, netball, table tennis, and ice hockey). Participants ranged in age from 18 to 53 years (M = 29, SD = 9). Interviews took between 19-47 min and were transcribed verbatim. The transcripts equated to a total of 188 pages of data that were analyzed, coded, and further grouped into higher-order themes and general dimensions. The findings revealed 14 higher-order themes categorized under the 3+1 C's general dimensions of closeness, commitment, complementarity, and co-orientation.