The Impact of Drop Test Conditions on Brain Strain Location and Severity: A Novel Approach Using a Deep Learning Model.

In contact sports such as rugby, players are at risk of sustaining traumatic brain injuries (TBI) due to high-intensity head impacts that generate high linear and rotational accelerations of the head. Previous studies have established a clear link between high-intensity head impacts and brain strains that result in concussions. This study presents a novel approach to investigating the effect of a range of laboratory controlled drop test parameters on regional peak and mean maximum principal strain (MPS) predictions within the brain using a trained convolutional neural network (CNN). The CNN is publicly available at https://github.com/Jilab-biomechanics/CNN-brain-strains . The results of this study corroborate previous findings that impacts to the side of the head result in significantly higher regional MPS than forehead impacts. Forehead impacts tend to result in the lowest region-averaged MPS values for impacts where the surface angle was at 0° and 45°, while side impacts tend to result in higher regional peak and mean MPS. The absence of a neck in drop tests resulted in lower regional peak and mean MPS values. The results indicated that the relationship between drop test parameters and resulting regional peak and mean MPS predictions is complex. The study's findings offer valuable insights into how deep learning models can be used to provide more detailed insights into how drop test conditions impact regional MPS. The novel approach used in this paper to predict brain strains can be applied in the development of better methods to reduce the brain strain resulting from head accelerations such as protective sports headgear.

Metabolic demands of slacklining in less and more advanced slackliners.

Walking or balancing on a slackline has gained increasing popularity as a recreational and school sport, and has been found to be suitable for developing neuromuscular control. The metabolic requirements for neuromuscular control on slackline, however, have not been well described. Therefore, the aim of the study was to determine the metabolic demands of slacklining in less and more advanced slackliners. Nineteen slackliners performed several 4 min balance tasks: parallel and one-leg stance on stable platform (2LS and 1LS), 1 leg stance on a slackline (1LSS), walking at a self-selected speed and at a given speed of 15 m min-1 on a slackline (WSS and WGS). Expired gas samples were collected for all participants and activities using a portable metabolic system. During1 LS and 1LSS, there were 140% and 341% increases in oxygen uptake (V̇O2) with respect to V̇O2 rest, respectively. During slackline walking, V̇O2 increased by 460% and 444% at self-selected and given speed, respectively. More advanced slackliners required mean metabolic demands 0.377 ± 0.065 and 0.289 ± 0.050 kJ·kg-1·min-1 (5.7 ± 0.95 and 3.9 ± 0.6 MET) for WGS and 1LSS, respectively, whilst less advanced slackliners, 0.471 ± 0.081 and 0.367 ± 0.086 kJ·kg-1·min-1 (6.4 ± 1.2 and 5.0 ± 1.1 MET) for WGS and 1LSS, respectively. Our data suggest that balancing tasks on slackline require V̇O2 corresponding to exercise intensities from light to moderate intensity. More advanced slackliners had a ∼25% reduced energy expenditure when compared with lower ability counterparts during simple balance tasks on the slackline.HighlightsBalancing on a slackline is metabolically demanding and slackline training is suitable not only to develop neuromuscular control but also to meet cardiovascular fitness demands.Improved postural control demonstrated by skilled slackliners reduces by ∼25% metabolic cost of balancing tasks on a slackline when compared to less skilled counterparts.Falls during slacklining increase the metabolic demands of the activity. Three falls per minute during walking on a slackline increase the oxygen uptake by ∼50%.

Rugby Fans in Training New Zealand (RUFIT NZ): a randomized controlled trial to assess the effectiveness of a healthy lifestyle program for overweight men delivered through professional rugby clubs.

BACKGROUND: A healthy lifestyle program that appeals to, and supports, overweight and obese New Zealand (NZ) European, Maori (indigenous) and Pasifika men to achieve weight loss is urgently needed. A pilot program inspired by the successful Football Fans in Training program but delivered via professional rugby clubs in NZ (n = 96) was shown to be effective in weight loss, adherence to healthy lifestyle behaviors, and cardiorespiratory fitness in overweight and obese men. A full effectiveness trial is now needed. AIMS: To determine the effectiveness and cost effectiveness of Rugby Fans In Training-NZ (RUFIT-NZ) on weight loss, fitness, blood pressure, lifestyle change, and health related quality of life (HRQoL) at 12- and 52-weeks. METHODS: We conducted a pragmatic, two-arm, multi-center, randomized controlled trial in NZ with 378 (target 308) overweight and obese men aged 30-65 years, randomized to an intervention group or wait-list control group. The 12-week RUFIT-NZ program was a gender-sensitised, healthy lifestyle intervention delivered through professional rugby clubs. Each intervention session included: i) a 1-h workshop-based education component focused on nutrition, physical activity, sleep, sedentary behavior, and learning evidence-based behavior change strategies for sustaining a healthier lifestyle; and 2) a 1-h group-based, but individually tailored, exercise training session. The control group were offered RUFIT-NZ after 52-weeks. The primary outcome was change in body weight from baseline to 52-weeks. Secondary outcomes included change in body weight at 12-weeks, waist circumference, blood pressure, fitness (cardiorespiratory and musculoskeletal), lifestyle behaviors (leisure-time physical activity, sleep, smoking status, and alcohol and dietary quality), and health-related quality of life at 12- and 52-weeks. RESULTS: Our final analysis included 200 participants (intervention n = 103; control n = 97) who were able to complete the RUFIT-NZ intervention prior to COVID-19 restrictions. At 52-weeks, the adjusted mean group difference in weight change (primary outcome) was -2.77 kg (95% CI -4.92 to -0.61), which favored the intervention group. The intervention also resulted in favorable significant differences in weight change and fruit and vegetable consumption at 12-weeks; and waist circumference, fitness outcomes, physical activity levels, and health-related quality of life at both 12 and 52 weeks. No significant intervention effects were observed for blood pressure, or sleep. Incremental cost-effective ratios estimated were $259 per kg lost, or $40,269 per quality adjusted life year (QALY) gained. CONCLUSION: RUFIT-NZ resulted in sustained positive changes in weight, waist circumference, physical fitness, self-reported physical activity, selected dietary outcomes, and health-related quality of life in overweight/obese men. As such, the program should be recommended for sustained delivery beyond this trial, involving other rugby clubs across NZ. TRIAL REGISTRATION: Australia New Zealand Clinical Trials Registry, ACTRN12619000069156. Registered 18 January 2019, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376740 Universal Trial Number, U1111-1245-0645.

Drop Test Kinematics Using Varied Impact Surfaces and Head/Neck Configurations for Rugby Headgear Testing.

World Rugby employs a specific drop test method to evaluate headgear performance, but almost all researchers use a different variation of this method. The aim of this study was, therefore, to quantify the differences between variations of the drop testing method using a Hybrid III headform and neck in the following impact setups: (1) headform only, with a flat steel impact surface, approximating the World Rugby method, (2 and 3) headform with and without a neck, respectively, onto a flat MEP pad impact surface, and (4) headform and neck, dropped onto an angled MEP pad impact surface. Each variation was subject to drop heights of 75-600 mm across three orientations (forehead, side, and rear boss). Comparisons were limited to the linear and rotational acceleration and rotational velocity for simplicity. Substantial differences in kinematic profile shape manifested between all drop test variations. Peak accelerations varied highly between variations, but the peak rotational velocities did not. Drop test variation also significantly changed the ratios of the peak kinematics to each other. This information can be compared to kinematic data from field head impacts and could inform more realistic impact testing methods for assessing headgear.

Exercise in People With Cancer: A Spotlight on Energy Regulation and Cachexia.

Exercise is increasingly becoming a standard of cancer care, with well-documented benefits for patients including improved mental wellbeing and reduced treatment-related side effects. However, important gaps in knowledge remain about how to optimise exercise prescription for people with cancer. Importantly, it remains unclear how exercise affects the progression of cancer cachexia (a wasting disease stemming from energy imbalance, and a common manifestation of advanced malignant disease), particularly once the condition has already developed. It was recently suggested that the anti-tumour effect of exercise might come from improved energetic capacity. Here, we highlight the possible effect of exercise on energetic capacity and energy regulation in the context of cancer, and how this might affect the progression of cancer cachexia. We suggest that due to the additional energy demand caused by the tumour and associated systemic inflammation, overreaching may occur more easily in people with cancer. Importantly, this could result in impaired anti-tumour immunity and/or the exacerbation of cancer cachexia. This highlights the importance of individualised exercise programs for people with cancer, with special consideration for the regulation of energy balance, ongoing monitoring and possible nutritional supplementation to support the increased energy demand caused by exercise.

Physical Activity, Mental Health and Wellbeing of Adults within and during the Easing of COVID-19 Restrictions, in the United Kingdom and New Zealand.

Physical activity (PA) participation was substantially reduced at the start of the COVID-19 pandemic. The purpose of this study was to assess the association between PA, mental health, and wellbeing during and following the easing of COVID-19 restrictions in the United Kingdom (UK) and New Zealand (NZ). In this study, 3363 adults completed online surveys within 2-6 weeks of initial COVID-19 restrictions (April/May 2020) and once restrictions to human movement had been eased. Outcome measures included the International Physical Activity Questionnaire Short-Form, Depression Anxiety and Stress Scale-9 (mental health) and World Health Organisation-5 Wellbeing Index. There were no differences in PA, mental health or wellbeing between timepoints (p > 0.05). Individuals engaging in moderate or high volume of PA had significantly better mental health (-1.1 and -1.7 units, respectively) and wellbeing (11.4 and 18.6 units, respectively) than individuals who engaged in low PA (p < 0.001). Mental health was better once COVID-19 restrictions were eased (p < 0.001). NZ had better mental health and wellbeing than the UK (p < 0.001). Participation in moderate-to-high volumes of PA was associated with better mental health and wellbeing, both during and following periods of COVID-19 containment, compared to participation in low volumes of PA. Where applicable, during the current or future pandemic(s), moderate-to-high volumes of PA should be encouraged.

Potential of Soft-Shell Rugby Headgear to Mitigate Linear and Rotational Peak Accelerations.

Rugby union is a popular sport played across the world. The physical contact inherent in the game means that players are at increased risk of concussive injury. In 2019, World Rugby created a new category of permitted headgear under Law 4 as a medical device. This established a pathway for headgear designed to reduce peak accelerations to be worn in matches. Investigations of the potential of soft-shelled protective headgear to reduce head impact accelerations have been mostly limited to the analysis of linear kinematics. However rotational head impact accelerations have long been implicated as far more injurious. The aim of this study, therefore, was to assess the linear and rotational acceleration reduction brought about by soft-shelled rugby headgear. A Hybrid III headform and neck were dropped onto a modular elastomer programmer impact surface, impacting at four different velocities (1.7-3.4 m/s) in five different impact orientations. Impact surface angles were 0°, 30°, and 45°. Peak linear and rotational accelerations, PLA and PRA respectively, were recorded. All headgear significantly reduced PLAs and PRAs when compared to a no headgear scenario. The new generation, headgear reduced all measures significantly more than the older generation of headgear. Impact locations offset from the center of mass of the headform resulted in the highest PRAs measured. As the impact surface angle increased, both PLAs and PRAs decreased. The study demonstrated that headgear tested lowered PLAs by up to 50%, and PRAs by up to 60% compared to the bare headform. Our data suggest that new generation headgear could make a difference on the field in reducing injurious impact accelerations in a collision.

Effect of Climbing Speed on Pulmonary Oxygen Uptake and Muscle Oxygen Saturation Dynamics in the Finger Flexors.

PURPOSE: Although sport climbing is a self-paced whole-body activity, speed varies with climbing style, and the effect of this on systemic and localized oxygen responses is not well understood. Therefore, the aim of the present study was to determine muscle and pulmonary oxygen responses during submaximal climbing at differing speeds of ascent. METHODS: Thirty-two intermediate and advanced sport climbers completed three 4-minute-long ascents of the same route at 4, 6, and 9 m·min-1 on a motorized climbing ergometer (treadwall) on separate laboratory visits. Gas analysis and near-infrared spectroscopy were used to determine systemic oxygen uptake (V˙O2) and muscle oxygen saturation (StO2) of the flexor digitorum profundus. RESULTS: Increases in ascent speed of 1 m·min-1 led to increases of V˙O2 by 2.4 mL·kg-1·min-1 (95% CI, 2.1 to 2.8 mL·kg-1·min-1) and decreases in StO2 by -1.3% (95% CI, 1.9% to -0.7%). There was a significant interaction of climbing ability and speed for StO2 (P < .001, ηp2=.224). The results revealed that the decrease of StO2 was present for intermediate but not advanced climbers. CONCLUSIONS: In this study, the results suggest that V˙O2 demand during climbing was largely determined by climbing speed; however, the ability level of the climber appeared to mitigate StO2 at a cellular level. Coaches and instructors may prescribe climbing ascents with elevated speed to improve generalized cardiorespiratory fitness. To stimulate localized aerobic capacity, however, climbers should perhaps increase the intensity of training ascents through the manipulation of wall angle or reduction of hold size.

Physical Activity, Mental Health and Wellbeing during the First COVID-19 Containment in New Zealand: A Cross-Sectional Study.

Strategies implemented worldwide to contain COVID-19 outbreaks varied in severity across different countries, and established a new normal for work and school life (i.e., from home) for many people, reducing opportunities for physical activity. Positive relationships of physical activity with both mental and physical health are well recognised, and therefore the aim was to ascertain how New Zealand's lockdown restrictions impacted physical activity, mental health and wellbeing. Participants (n = 4007; mean ± SD: age 46.5 ± 14.7 years, 72% female, 80.7% New Zealand European) completed (10-26 April 2020) an online amalgamated survey (Qualtrics): International Physical Activity Questionnaire: Short Form; Depression, Anxiety and Stress Scale-9; World Health Organisation-Five Well-Being Index; Stages of Change Scale. Positive dose-response relationships between physical activity levels and wellbeing scores were demonstrated for estimates that were unadjusted (moderate activity OR 3.79, CI 2.88-4.92; high activity OR 8.04, CI 6.07-10.7) and adjusted (confounding variables: age, gender, socioeconomic status, time sitting and co-morbidities) (moderate activity 1.57, CI 1.11-2.52; high activity 2.85, CI 1.97-4.14). The study results support previous research demonstrating beneficial effects of regular physical activity on mental health and wellbeing. Governments may use these results to promote meeting physical activity guidelines in order to protect mental health and wellbeing during the ongoing COVID-19 restrictions and future pandemics.

Laboratory Validation of Instrumented Mouthguard for Use in Sport.

Concussion is an inherent risk of participating in contact, combat, or collision sports, within which head impacts are numerous. Kinematic parameters such as peak linear and rotational acceleration represent primary measures of concussive head impacts. The ability to accurately measure and categorise such impact parameters in real time is important in health and sports performance contexts. The purpose of this study was to assess the accuracy of the latest HitIQ Nexus A9 instrumented mouthguard (HitIQ Pty. Ltd. Melbourne Australia) against reference sensors in an aluminium headform. The headform underwent drop testing at various impact intensities across the NOCSAE-defined impact locations, comparing the peak linear and rotational acceleration (PLA and PRA) as well as the shapes of the acceleration time-series traces for each impact. Mouthguard PLA and PRA measurements strongly correlated with (R2 = 0.996 and 0.994 respectively), and strongly agreed with (LCCC = 0.997) the reference sensors. The root mean square error between the measurement devices was 1 ± 0.6g for linear acceleration and 47.4 ± 35 rad/s2 for rotational acceleration. A Bland-Altman analysis found a systematic bias of 1% for PRA, with no significant bias for PLA. The instrumented mouthguard displayed high accuracy when measuring head impact kinematics in a laboratory setting.

Potential of Soft-Shelled Rugby Headgear to Reduce Linear Impact Accelerations.

The purpose of this study was to examine the potential of soft-shelled rugby headgear to reduce linear impact accelerations. A hybrid III head form instrumented with a 3-axis accelerometer was used to assess headgear performance on a drop test rig. Six headgear units were examined in this study: Canterbury Clothing Company (CCC) Ventilator, Kukri, 2nd Skull, N-Pro, and two Gamebreaker headgear units of different sizes (headgears 1-6, respectively). Drop heights were 238, 300, 610, and 912 mm with 5 orientations at each height (forehead, front boss, rear, rear boss, and side). Impact severity was quantified using peak linear acceleration (PLA) and head injury criterion (HIC). All headgear was tested in comparison to a no headgear condition (for all heights). Compared to the no headgear condition, all headgear significantly reduced PLA and HIC at 238 mm (16.2-45.3% PLA and 29.2-62.7% HIC reduction; P < 0.0005, η p 2 = 0.987-0.991). Headgear impact attenuation lowered significantly as the drop height increased (32.4-5.6% PLA and 50.9-11.7% HIC reduction at 912 mm). There were no significant differences in PLA or HIC reduction between headgear units 1-3. Post hoc testing indicated that headgear units 4-6 significantly outperformed headgear units 1-3 and additionally headgear units 5 and 6 significantly outperformed headgear 4 (P < 0.05). The lowest reduction PLA and HIC was for impacts rear orientation for headgear units 1-4 (3.3 ± 3.6%-11 ± 5.8%). In contrast, headgear units 5 and 6 significantly outperformed all other headgear in this orientation (P < 0.0005, η p 2 = 0.982-0.990). Side impacts showed the greatest reduction in PLA and HIC for all headgear. All headgear units tested demonstrated some degree of reduction in PLA and HIC from a linear impact; however, units 4-6 performed significantly better than headgear units 1-3.

Detection of the Anaerobic Threshold in Endurance Sports: Validation of a New Method Using Correlation Properties of Heart Rate Variability.

Past attempts to define an anaerobic threshold (AnT) have relied upon gas exchange kinetics, lactate testing and field-based evaluations. DFA a1, an index of heart rate (HR) variability (HRV) fractal correlation properties, has been shown to decrease with exercise intensity. The intent of this study is to investigate whether the AnT derived from gas exchange is associated with the transition from a correlated to uncorrelated random HRV pattern signified by a DFA a1 value of 0.5. HRV and gas exchange data were obtained from 15 participants during an incremental treadmill run. Comparison of the HR reached at the second ventilatory threshold (VT2) was made to the HR reached at a DFA a1 value of 0.5 (HRVT2). Based on Bland-Altman analysis and linear regression, there was strong agreement between VT2 and HRVT2 measured by HR (r = 0.78, p < 0.001). Mean VT2 was reached at a HR of 174 (±12) bpm compared to mean HRVT2 at a HR of 171 (±16) bpm. In summary, the HR associated with a DFA a1 value of 0.5 on an incremental treadmill ramp was closely related to that of the HR at the VT2 derived from gas exchange analysis. A distinct numerical value of DFA a1 representing an uncorrelated, random interbeat pattern appears to be associated with the VT2 and shows potential as a noninvasive marker for training intensity distribution and performance status.

Performance Assessment for Rock Climbers: The International Rock Climbing Research Association Sport-Specific Test Battery.

PURPOSE: To examine the validity and reliability of a battery of 10 measures designed to assess the key physiological parameters for successful rock climbing performance. METHODS: In phase 1 of the research, an expert panel, using the Delphi method, established a 10-item test battery based on the key determinants of climbing performance. In phase 2, the tests were assessed for validity and reliability to examine their suitability as sport-specific measures of rock climbing performance. A total of 132 rock climbers, from 7 countries, volunteered to take part in the study. Each climber visited their nearest laboratory on 3 separate occasions in order to enable the required tests and retests to be completed. A minimum of 7 days was allowed between visits. RESULTS: The 10 tests established for phase 2 were designed as sport-specific measures of flexibility, strength, power, and endurance. Results indicated that, while reliable, the flexibility and strength tests were only partially successful in differentiating across climber abilities. The power and endurance tests, however, performed well with regard to validity and reliability, with the finger hang and powerslap tests being most strongly correlated with performance ability (P < .0005 to P < .002). CONCLUSION: The authors' data suggest that climbing may require a threshold level of flexibility and strength for successful performance, beyond which further improvements may not be required. In contrast, the finger hang and powerslap tests were not only reliable measures but also differentiated between climber abilities from lower grade to elite levels.

Influence of Artefact Correction and Recording Device Type on the Practical Application of a Non-Linear Heart Rate Variability Biomarker for Aerobic Threshold Determination.

Recent study points to the value of a non-linear heart rate variability (HRV) biomarker using detrended fluctuation analysis (DFA a1) for aerobic threshold determination (HRVT). Significance of recording artefact, correction methods and device bias on DFA a1 during exercise and HRVT is unclear. Gas exchange and HRV data were obtained from 17 participants during an incremental treadmill run using both ECG and Polar H7 as recording devices. First, artefacts were randomly placed in the ECG time series to equal 1, 3 and 6% missed beats with correction by Kubios software's automatic and medium threshold method. Based on linear regression, Bland Altman analysis and Wilcoxon paired testing, there was bias present with increasing artefact quantity. Regardless of artefact correction method, 1 to 3% missed beat artefact introduced small but discernible bias in raw DFA a1 measurements. At 6% artefact using medium correction, proportional bias was found (maximum 19%). Despite this bias, the mean HRVT determination was within 1 bpm across all artefact levels and correction modalities. Second, the HRVT ascertained from synchronous ECG vs. Polar H7 recordings did show an average bias of minus 4 bpm. Polar H7 results suggest that device related bias is possible but in the reverse direction as artefact related bias.

Investigating the effect of bouncing type on the physiological demands of trampolining.

Purpose: The aim of this study was to investigate whether altering the bounce style affects the physiological demands of trampolining. Methods: Twenty-eight healthy adults completed five, three-minute exercise bouts on a trampoline where; heart rate (HR), V ˙ O 2 (mL/min) and rate of EE (kJ/min) were collected for five different bouncing variations. Results: A one-way repeated measures MANOVA was then used to assess whether significant differences existed between the different bounce types for HR V ˙ O 2 and EE. A significant difference was found ( F 12 , 280 = 20.886, p = 0.0005), so a series of one-way repeated measures ANOVAs were used to identify the degree of significance. For V ˙ O 2 ( F 2.421 , 27 = 64.079, p = 0.0005, ηp 2 = 0.7) and EE ( F 2.989 , 27 = 44.979, p = 0.0005, ηp 2 = 0.6). Post-hoc tests found that for both V ˙ O 2 and EE a significant difference existed between the conventional bounce and each of the bounce variates (p = 0.0005). Conclusion: The results from this study indicated altering the bounce style does have a significant effect on the physiological demands of trampolining. The energy expenditure (EE) equation for trampolining can now be updated to more accurately reflect the rate of EE while performing different bounce styles.

Developing a mathematical model to predict energy expenditure while bouncing on a trampoline.

Trampolining has become a popular recreational activity, but currently no method exists by which energy expenditure can be indirectly measured while bouncing. Therefore, the aim of this study was to produce a model to measure energy expenditure while bouncing on a trampoline. To achieve this, the study was completed in two stages. First, a model was developed which calculated the energy absorbed by the trampoline for a known weight. This was achieved using drop tests on a trampoline. Second, the efficiency of energy conversion while trampolining was measured. This involved healthy adults bouncing on a trampoline while energy expenditure was recorded using a gas analyser. The combined datasets from the two parts allowed the formation of a model which can predict energy expenditure while bouncing on a trampoline using only the user's weight as an input. This model can now be used with an on-trampoline measurement method to track energy expenditure while jumping, thereby facilitating the use of trampolines for health and fitness.

Physical activity, mental health and well-being of adults during initial COVID-19 containment strategies: A multi-country cross-sectional analysis.

OBJECTIVES: To assess physical activity (PA), mental health and well-being of adults in the United Kingdom (UK), Ireland, New Zealand and Australia during the initial stages of National governments' Coronavirus disease (COVID-19) containment responses. DESIGN: Observational, cross-sectional. METHODS: An online survey was disseminated to adults (n=8,425; 44.5±14.8y) residing in the UK, Ireland, New Zealand and Australia within the first 2-6 weeks of government-mandated COVID-19 restrictions. Main outcome measures included: Stages of Change scale for exercise behaviour change; International Physical Activity Questionnaire (short-form); World Health Organisation-5 Well-being Index; and the Depression Anxiety and Stress Scale-9. RESULTS: Participants who reported a negative change in exercise behaviour from before initial COVID-19 restrictions to during the initial COVID-19 restrictions demonstrated poorer mental health and well-being compared to those demonstrating either a positive-or no change in their exercise behaviour (p<0.001). Whilst women reported more positive changes in exercise behaviour, young people (18-29y) reported more negative changes (both p<0.001). Individuals who had more positive exercise behaviours reported better mental health and well-being (p<0.001). Although there were no differences in PA between countries, individuals in New Zealand reported better mental health and well-being (p<0.001). CONCLUSION: The initial COVID-19 restrictions have differentially impacted upon PA habits of individuals based upon their age and sex, and therefore have important implications for international policy and guideline recommendations. Public health interventions that encourage PA should target specific groups (e.g., men, young adults) who are most vulnerable to the negative effects of physical distancing and/or self-isolation.

Effect of Height on Perceived Exertion and Physiological Responses for Climbers of Differing Ability Levels.

PURPOSE: The purpose of this study was to examine differences in perceived exertion (RPE) and physiological responses for climbers of different abilities completing an identical route low and high above the ground. MATERIALS AND METHODS: Forty-two male (N = 18) and female (N = 24) sport climbers divided into three groups, lower-grade (N = 14), intermediate (N = 14), and advanced climbers (N = 14), completed two visits to a climbing gym, separated by 7 days. In a random order, the climbers completed a close-to-the-ground ascent (treadwall) and climb to height (climbing gym). Immediately after the test, climbers provided their RPE (6-20). Indirect calorimetry was used to assess physiological response during the ascent and recovery. RESULTS: The mean (±standard deviation) RPE was higher for lower-grade climbers when ascending the route on the wall (RPE = 12 ± 1) when compared to the treadwall route (RPE = 11 ± 1, P = 0.040; d = 0.41). For all ability groups, the physiological response was higher on the climbing gym wall as opposed to the treadwall: ventilation (P = 0.003, η p 2 = 0.199), heart rate (HR) (P = 0.005, η p 2 = 0.189), energy cost (EC) (P = 0.000, η p 2 = 0.501). The RPE demonstrated a moderate relationship with physiological variables (R 2 = 0.14 to R 2 = 0.45). CONCLUSION: Climbing to height induced a greater metabolic stress than climbing at a low height (treadwall) and led to higher RPE for lower-grade climbers. In this study, RPE appeared to be a good proxy measure of the physiological demands for advanced climbers but not for intermediate and lower-grade climbers. Therefore, using RPE in climbing with less experienced athletes may perhaps overestimate actual exercise intensity and should be interpreted carefully.

Rugby Fans in Training New Zealand (RUFIT-NZ): protocol for a randomized controlled trial to assess the effectiveness and cost-effectiveness of a healthy lifestyle program for overweight men delivered through professional rugby clubs in New Zealand.

BACKGROUND: A healthy lifestyle program that appeals to, and supports, obese New Zealand (NZ) European, Maori (indigenous) and Pasifika men to achieve weight loss is urgently needed. In Scotland, Football Fans in Training (FFIT), a weight management and healthy lifestyle program for overweight and obese men aged 35-65 years , delivered by community coaching staff at professional football clubs, has been shown to be beneficial and cost-effective. A pilot program inspired by FFIT but delivered by professional rugby clubs in NZ (n = 96) was shown to be effective in weight loss, improved physiological outcomes, and adherence to healthy lifestyle behaviors in overweight and obese men. The objective of this trial is to determine the effectiveness and cost-effectiveness of the Rugby Fans in Training New Zealand (RUFIT-NZ) program. METHODS: A pragmatic, two-arm, multi-center, randomized controlled trial involving 308 overweight and obese men aged 30-65 years, randomized to either an intervention group (n = 154) or a wait-list control group (n = 154). The intervention-group participated in the 12-week RUFIT-NZ program, a gender-sensitized, healthy lifestyle intervention adapted to the environment and cultural diversity of NZ and delivered through professional rugby clubs. Participants in the intervention group undergo physical training sessions, in addition to workshop-based sessions to learn about nutrition, physical activity, sleep, sedentary behavior, and a range of behavior-change strategies for sustaining a healthier lifestyle. The control group receives the program after 52 weeks. The primary outcome is change in body weight from baseline to 52 weeks. Secondary outcomes include change in body weight at 12 weeks; waist circumference, blood pressure, fitness, and lifestyle behaviors at 12 and 52 weeks; and cost-effectiveness. A process evaluation informed by the RE-AIM framework will evaluate potential implementation of RUFIT-NZ as an ongoing program in NZ after the trial. DISCUSSION: This trial will investigate the effectiveness and cost-effectiveness of the RUFIT-NZ program in overweight and obese NZ men. TRIAL REGISTRATION: Australia New Zealand Clinical Trials Registry, ACTRN12619000069156. Registered on 18 January 2019, according to the World Health Organization Trial Registration Data Set. Universal Trial Number, U1111-1245-0645.