"It's a Very Good Second Option": Older Adults' Experience of Telehealth.

INTRODUCTION: The growing ability to provide online services has enabled the proliferation of exercise-based telehealth interventions; however, adoption in older adults may be impacted by low digital literacy and "technophobia." OBJECTIVES: The aim of this study was to explore the experience of community and aged-care dwelling older adults following exercise-based telehealth services to provide insights that could guide future telehealth exercise delivery. DESIGN: Semi-structured interviews for qualitative analysis. METHODS: Participants (age ≥60) who had completed at least one online exercise session from a registered health professional were recruited through a combination of purposeful and snowball sampling methods via their exercise facility or provider. A semi-structured interview guide was used by 2 interviewers to investigate participants' experiences and a "critical friends" approach used to identify common themes. RESULTS: Thirteen interviews with 21 participants were conducted from 2 different facilities. Analysis identified meaning units within 3 themes and subthemes. Technology subthemes related to digital confidence prior to telehealth and changes during interventions, as well as the usability of technology for telehealth. Clinical practice subthemes described the different motivations to exercise, perceived benefits of telehealth, important implications for practitioners, and perceptions of safety. The social connection theme related to the social benefits of telehealth. CONCLUSIONS: Older adults in our sample were technologically confident and capable of performing exercise sessions delivered via telehealth. They notice benefits from this form of exercise delivery however, prefer face-to-face exercise delivery.

The Stride program: Feasibility and pre-to-post program change of an exercise service for university students experiencing mental distress.

Rates of mental illness are disproportionately high for young adult and higher education (e.g., university student) populations. As such, universities and tertiary institutions often devote significant efforts to services and programs that support and treat mental illness and/or mental distress. However, within that portfolio of treatment approaches, structured exercise has been relatively underutilised and greater research attention is needed to develop this evidence base. The Stride program is a structured 12-week exercise service for students experiencing mental distress. We aimed to explore the feasibility of the program and assess pre- and post-program change, through assessments of student health, lifestyle, and wellbeing outcomes. Drawing from feasibility and effectiveness-implementation hybrid design literatures, we conducted a non-randomised feasibility trial of the Stride program. Participants were recruited from the Stride program (N = 114, Mage = 24.21 years). Feasibility results indicated the program was perceived as acceptable and that participants reported positive perceptions of program components, personnel, and sessions. Participants' pre-to-post program change in depressive symptomatology, physical activity levels, mental health-related quality of life, and various behavioural outcomes were found to be desirable. Our results provide support for the feasibility of the Stride program, and more broadly for the delivery and potential effectiveness of structured exercise programs to support university students experiencing mental distress.

Structured exercise programs for higher education students experiencing mental health challenges: background, significance, and implementation.

The incidence of mental illness is greatest among young adults, and those enrolled in higher education may be particularly vulnerable compared to the general young adult population. Many higher education institutions employ student support staff tasked with implementing strategies to improve student wellbeing and mental illness. However, these strategies tend to be focused on clinical therapies and pharmacological interventions with limited lifestyle approaches. Exercise is an effective method for addressing mental illness and promoting wellbeing, yet widespread provision of structured exercise services to support treatment options for students with mental health challenges has not been fully realized. In an effort to guide exercise strategies for student mental health, we synthesize considerations for developing and delivering exercise programs in higher education settings. We draw directly from the evidence base on existing exercise programs in higher education; and the broader behavior change, exercise adherence, health psychology, implementation science, and exercise prescription literatures. Our broad considerations cover issues regarding program engagement and behavior change, exercise 'dose' and prescription, integration with other on-campus services, and robust research and evaluation. These considerations may provide impetus for widespread program development and implementation, as well as informing research focused on protecting and improving student mental health.

Acute exercise affects dual-energy X-ray absorptiometry body composition estimates but not standardised ultrasound measurements of subcutaneous adipose tissue.

Ultrasound has been demonstrated to be a highly accurate and reliable tool for measuring subcutaneous adipose tissue thickness and is robust against changes in hydration status or acute food or fluid intake. However, the effect of prior acute exercise is unexamined. This study examined the impact of an acute endurance exercise and resistance exercise session on standardised brightness-mode ultrasound measurements of subcutaneous adipose tissue thickness compared to skinfolds and dual-energy X-ray absorptiometry body composition estimates. In a randomised cross-over design, 30 active adults (24.2 ± 4.9 years) undertook physique assessment via standardised brightness-mode ultrasound, skinfolds and dual-energy X-ray absorptiometry before, immediately and 45 min after an acute endurance or resistance exercise session. The mean sum of eight subcutaneous adipose tissue thickness measured via standardised brightness-mode ultrasound increased (0.6 mm, p = 0.04) immediately postendurance exercise but was not meaningful when evaluated against the technical error of measurement of the investigator. A significant (p = 0.01) but not meaningful decrease in the sum of eight skinfolds occurred immediately (-1.1 ± 0.4 mm) and 45 min (-1.3 ± 0.4 mm) postresistance exercise. Comparatively, endurance exercise elicited a meaningful decrease of total mass (460 ± 30 g) and trunk lean mass (680 ± 90 g) dual-energy X-ray absorptiometry estimates. Findings from this study indicate standardised client presentation may be unnecessary when employing either standardised brightness-mode ultrasound or skinfolds for body composition assessment unlike dual-energy X-ray absorptiometry.

Support needs and experiences of young people living in families with mental illness.

INTRODUCTION: Children and adolescents living in families affected by mental illness are at elevated risk of developing mental health problems. A range of interventions have been designed to help these young people; however, the effectiveness of these programs is, in some cases, mixed. Our aim was to understand in detail the support needs and experiences of a group of Australian children and adolescents living in families with mental illness. METHODS: Our study is a qualitative in nature. In 2020-2021, we interviewed 25 Australian young people (Mage = 13.60, SD = 2.26, 20 females and 5 males) living with family members affected by mental illness to understand their (the young people's) experiences, and to identify the types of support that these young people considered important or effective. We conducted reflexive thematic analyses of interview data, underpinned by interpretivist assumptions. RESULTS: We identified seven themes within two higher-order categories reflecting our aims to understand (1) lived experiences within families affected by mental illness (i.e., increased responsibilities, missing out, and stigmatization), and (2) support experiences, needs, and preferences (i.e., respite, shared experiences with like-minded others, education, and flexibility). CONCLUSIONS: Our findings hold substantial practical value by informing services, interventions, and conversations that better support young people living in families affected by mental illness.

Reliability of Fitness Assessments in Children With Emotional and Behavioral Difficulties.

PURPOSE: Examine the reliability of field-based fitness assessments in school-aged children with emotional or behavioral difficulties (EBD). Understanding the impact of fitness on physical activity participation for children with EBD is limited by our ability to reliably measure it. METHODS: Fifteen children aged 7-12 years with EBD completed 7 assessments-standing broad jump, overhead throw, grip strength, isometric plank hold, isometric wall squat, unilateral heel raise, and modified 6-minute walk test-in a random order on 2 separate occasions. Intraclass correlation coefficients (ICCs) were computed to evaluate reliability. RESULTS: ICCs ranged from .65 to .99 representing moderate to excellent reliability for all assessments. Shorter assessments requiring less attention and behavior regulation tended to demonstrate higher ICC values while assessments with greater attention or behavioral regulation demands tended to have lower ICC values. CONCLUSION: Results demonstrate varied reliability for fitness tests in children with EBD. Practitioners can use grip strength and standing broad jump assessments with confidence. Other assessments have good reliability but greater variability indicating they may be a challenge for some children with EBD.

Food and fluid intake and hydration status does not affect ultrasound measurements of subcutaneous adipose tissue in active adults.

OBJECTIVES: To investigate the impact of acute food and fluid intake or hydration status on the standardised brightness-mode ultrasound measurement of subcutaneous adipose tissue thickness. DESIGN: Thirty active adults (female n = 10) participated in a randomised cross over study. METHODS: Participants completed three body composition assessment sessions via standardised brightness-mode ultrasound and Dual-energy X-ray absorptiometry. Participants were assessed under standardised presentation during 'food only' and 'food plus water' sessions at baseline and reassessed after their allotted intake. 'Hypohydration plus water' was undertaken in a hypohydrated state at baseline and reassessed after water intake. RESULTS: The sum of eight subcutaneous adipose tissue thickness was lower when measured after 'food only' or 'food plus water' compared to baseline (-0.1 to -0.9 mm; p < 0.01). However, these changes were less than the 95% confidence interval of the technical error of measurement of the investigator. Body mass, dual-energy x-ray absorptiometry total and trunk mass, lean mass and trunk lean mass estimates increased (p < 0.01) following 'food only' or 'food plus water', and decreased with hypohydration (p < 0.01). Total and regional fat mass estimates were not impacted. CONCLUSIONS: The sum of eight subcutaneous adipose tissue thickness measured via standardised brightness-mode ultrasound was unaffected by acute food and fluid consumption or hydration status changes. Comparatively, these interventions altered dual-energy x-ray absorptiometry body composition estimates, especially that of lean mass components. Standardised brightness-mode ultrasound can therefore be used to monitor changes in fat patterning when standardised client presentation is not practically achievable.

Measures of body composition via Dual-energy X-ray absorptiometry, ultrasound and skinfolds are not impacted by the menstrual cycle in active eumenorrheic females.

OBJECTIVES: (1) Compare changes in body composition estimates over the menstrual cycle in active females using Dual-energy X-ray absorptiometry, standardised brightness-mode ultrasound and skinfolds (2) Compare the predictability of Dual-energy X-ray absorptiometry fat mass estimate via standardised brightness-mode ultrasound versus skinfolds measurements. DESIGN: Thirty active females (27 ±â€¯5 y) with regularly occurring menstrual cycles participated in a cross sectional study. METHODS: Participants completed four assessment sessions scheduled according to each individual's menstrual cycle. These sessions took place during their (1) early follicular, (2) mid-to-late follicular, (3) mid-luteal and (4) second early follicular phases. Body composition estimates were acquired using Dual-energy X-ray absorptiometry, subcutaneous adipose tissue thickness was measured at eight sites using standardised brightness-mode ultrasound and skinfolds. RESULTS: The sum of eight subcutaneous adipose tissue thickness measured using standardised brightness-mode ultrasound and skinfolds were not different between the cycle phases (p > 0.05). Body mass and Dual-energy X-ray absorptiometry total mass estimate as well as Dual-energy X-ray absorptiometry estimates of total and regional lean and fat mass were also not different between cycle phases (p > 0.05) and any changes were within the 95% confidence intervals of their respective least significant change values. CONCLUSIONS: There were no true and meaningful changes in the sum of eight subcutaneous adipose tissue thickness measured via standardised brightness-mode ultrasound and skinfolds or Dual-energy X-ray absorptiometry total and regional tissue mass estimates across the menstrual cycle in active eumenorrheic females. Body composition may thus be assessed via these methods in this population at any cycle phase with standardised participant presentation.

Knee extensor strength, hop performance, patient-reported outcome and inter-test correlation in patients 9-12 months after anterior cruciate ligament reconstruction.

BACKGROUND: Hop performance and isokinetic knee extensor strength (IKES) asymmetry are associated with re-injury after anterior cruciate ligament reconstruction (ACLR). This study investigated deficits after ACLR, and which hop tests are most correlated with IKES and patient-reported outcome measures (PROMs). METHODS: 50 patients were assessed 9-12 months after ACLR using the International Knee Documentation Committee (IKDC) and ACL Return to Sport after Injury (ACL-RSI) scores. Peak IKES and eight hop tests were assessed: single (SHD), triple (THD) and triple crossover (TCHD) hop for distance, 6 m timed hop (6MTH), single medial (MHD) and single lateral (LHD) hop for distance, single countermovement jump (SLCMJ) and timed speedy hop (SHT). The percentage of patients with limb symmetry indices (LSIs) < 90% was reported. Pearson's correlations investigated the correlation between PROMs, IKES and hop LSIs. RESULTS: The majority (80%) of patients had IKES LSIs < 90%. While 12-14% of patients demonstrated LSIs < 90% for the SHD, 6MTH, THD and TCHD, 52-80% demonstrated LSIs < 90% for the other hop tests. The IKES LSI was significantly different (p < 0.05) from all hop LSIs, besides the SLCMJ (p = 0.638). Large correlations were only observed between the IKES LSI and the SLCMJ (r = 0.82), MHD (r = 0.71) and LHD (r = 0.53). The SLCMJ, MHD and IKES LSIs demonstrated the largest significant correlations with the IKDC (r = 0.51-0.53) and ACL-RSI (r = 0.38-0.40). CONCLUSIONS: Hop tests such as the MHD and SLCMJ may present a more practical alternative to quantifying peak IKES, especially in the absence of more sophisticated testing equipment. While not surrogates as such, these selective hop measures may better inform the clinician as to whether significant underlying quadriceps deficits are still present throughout the post-operative rehabilitation period.

Which Hop Tests Can Best Identify Functional Limb Asymmetry in Patients 9-12 Months After Anterior Cruciate Ligament Reconstruction Employing a Hamstrings Tendon Autograft?

BACKGROUND: Hop tests are commonly employed to evaluate functional limb symmetry after anterior cruciate ligament reconstruction (ACLR). PURPOSE: To investigate the ability of eight hop tests to identify functional limb asymmetry in patients after ACLR. STUDY DESIGN: Prospective cohort. METHODS: Fifty patients were assessed 9-12 months following ACLR. Functional performance on both the operated and non-operated limb was assessed via eight hop tests, assessed in a randomised order. These included the: single (SHD), triple (THD) and triple crossover (TCHD) hop for distance, 6m timed hop (6MTH), single medial (MHD) and single lateral (LHD) hop for distance, single countermovement jump (SLCMJ) and timed speedy hop (TSHT). Differences in Limb Symmetry Indices (LSIs) across hop tests were compared, while Pearson's correlations were undertaken to investigate the significance and strength of the association between hop test LSIs. RESULTS: Significant differences were observed across hop LSIs (p<0.0001). Mean LSIs for the SHD (95.0%), 6MTH (95.0%), THD (96.1%) and TCHD (95.3%) were ≥90% and significantly greater (p<0.05) than the MHD (87.3%), LHD (87.5%), SLCMJ (83.4%) and TSHT (86.5%), which were all <90%. The LSI for the SLCMJ was significantly lower (p<0.05) than all other hop tests. While significant correlations existed across the majority of hop LSIs, the strongest correlations existed between the SHD, THD and TCHD (r=0.70-0.80), and lowest correlations between the TSHT and the other hop tests (r=0.26-0.49). CONCLUSIONS: The LHD, MHD and TSHT, as well as the SLCMJ in particular, were best able to demonstrate functional limb asymmetry in patients following ACLR. These hop measures should be incorporated into hop test batteries, if the purpose is to detect the presence of lingering functional deficits. LEVEL OF EVIDENCE: Level 3.

Move your mind: embedding accredited exercise physiology services within a hospital-based mental health service.

OBJECTIVE: Despite support for the role of exercise in improving physical and mental health for various psychiatric disorders, few service implementation evaluations within diverse hospital environments exist. This study presents the feasibility and implementation of a clinical exercise physiology service within a hospital mental health service. METHOD: Feasibility and service data were collected from databases and self-report (consumer and staff) for 6 months from the commencement of new exercise services (gym and group sessions) for community and inpatients (one secure and three open wards). RESULTS: One hundred and twenty consumers engaged with exercise services with 70 direct referrals over the 6-month audit period (mean age 40 ± 13 years (19-69); 41% male). The overwhelming reason for referral was related to weight loss/management (65.7%), with the majority of patients (51%) presenting with schizophrenia spectrum and other psychotic disorders. Further, 549 exercise service interactions were delivered and 78% gym attendees and 69% group session attendees rated the exercise sessions as 'Good' or 'Great', and intention to return ranged from 78% for inpatient gym sessions to 91% for community gym sessions. CONCLUSIONS: Embedding exercise physiology into a mental health service is feasible and well accepted and the evaluation of long-term consumer outcomes in 'real-world' will serve as a crucial step.

Exploring associations between neuromuscular performance, hypermobility, and children's motor competence.

OBJECTIVES: To evaluate if neuromuscular performance and hypermobility are factors associated with children's motor competence. DESIGN: Cross-sectional observation study. METHODS: Data was collected on 60 children aged 6-12 years; motor competence was determined using the Movement Assessment Battery for Children-2 test, with children classified into 3 groups (Typically Developing n=30; 'At Risk' of low motor competence (LMC) n=9; LMC n=21). Neuromuscular performance was determined utilising the Resistance Training Skills Battery for Children (RTSBc), 5-repetition maximum (5RM) leg press and Biodex dynamometry to assess isometric and isokinetic peak torque of the knee flexors and extensors. Hypermobility was measured using the Beighton and Lower Limb Assessment Score. RESULTS: Between-groups MANCOVA revealed typically developing children scored significantly higher on the RTSBc than those 'at risk' of LMC (p=0.021) and those in the LMC group (p<0.001). 5RM scores also differed between groups, with typically developing children achieving significantly higher scores than the LMC group. No differences were found between groups for isometric or isokinetic measures of strength. Sequential regression analysis revealed neuromuscular performance variables explained 44.7% of the variance in motor competence, with RTSBc (p<0.001) and 5RM (p=0.019) emerging as positive significant predictors. Hypermobility failed to explain significant variance in motor competence beyond that explained by neuromuscular performance. CONCLUSIONS: Neuromuscular performance of children varies according to levels of motor competence, with those with LMC performing poorly on tasks requiring multi-joint movement. Furthermore, neuromuscular performance predicted almost half the variance observed in motor competence and highlights a novel intervention strategy.

The effect of parental logistic support on physical activity in children with, or at risk of, movement difficulties.

OBJECTIVES: In a sample of children with, or at risk of, movement difficulties, (1) To test the direct effects of children's perceptions of parents' logistic support for physical activity on children's physical activity-related self-perceptions and on children's physical activity levels, and (2) To explore the indirect relationship between children's perceptions of parents' logistic support for physical activity and children's physical activity levels through children's physical activity-related self-perceptions. DESIGN: Cross-sectional observation study. METHODS: Data were collected from 120 children aged 6 to 12 years; movement proficiency levels were determined using the movement assessment battery for children-2 test. Children's perspectives of parental support for physical activity were captured using the Activity Support Scale for Multiple Groups child report. Children's self-perceptions towards physical activity were reported with the Children's Self- perceptions of Adequacy in and Predilections for physical activity, and time spent in physical activity were measured using accelerometers. RESULTS: There was no significant direct effect between perceived levels of parents' logistic support for physical activity and children's physical activity. A significant indirect relationship between these variables was discovered, with higher perceived levels of parent logistical support for physical activity predicting stronger perceptions of adequacy (i.e., confidence) toward physical activity participation among children, which in turn was associated with increased physical activity minutes. CONCLUSIONS: The results demonstrate that irrespective of a child's movement ability, children's perceptions of parents' logistic support for physical activity indirectly and positively predicts children's physical activity levels, via children's confidence for physical activity.

Study protocol for a multicentre, controlled non-randomised trial: benefits of exercise physiology services for type 2 diabetes (BEST).

INTRODUCTION: Controlled trials support the efficacy of exercise as a treatment modality for chronic conditions, yet effectiveness of real-world Exercise Physiology services is yet to be determined. This study will investigate the efficacy and cost-effectiveness of services provided by Accredited Exercise Physiologists (AEPs) for clients with type 2 diabetes (T2D) in clinical practice. METHODS AND ANALYSIS: A non-randomised, opportunistic control, longitudinal design trial will be conducted at ten Exercise Physiology Clinics. Participants will be individuals with T2D attending one of the Exercise Physiology Clinics for routine AEP services (exercise prescription and counselling) (intervention) or individuals with T2D not receiving AEP services (usual care) (control). The experimental period will be 6 months with measurements performed at baseline and at 6 months. Primary outcome measures will be glycosylated haemoglobin (HbA1c), resting brachial blood pressure (BP), body mass index, waist circumference, 6 min walk test, grip strength, 30 s sit to stand, Medical Outcomes Short-Form 36-Item Health Survey and Active Australia Questionnaire. Secondary outcomes will be medication usage, out-of-pocket expenses, incidental, billable and non-billable health professional encounters and work missed through ill health. Healthcare utilisation will be measured for 12 months prior to, during and 12 months after trial participation using linked data from Medicare Benefits Schedule and Pharmaceutical Benefits Scheme data. ETHICS AND DISSEMINATION: The study is a multicentre trial comprising: University of Tasmania, University of New South Wales Lifestyle Clinic, University of Canberra, Baker Heart and Diabetes Institute (covered under the ethics approval of University of Tasmania Health and Medical Ethics Committee H0015266), Deakin University (Approval number: 2016-187), Australian Catholic University (2016-304R), Queensland University of Technology (1600000049), University of South Australia (0000035306), University of Western Australia (RA/4/1/8282) and Canberra Hospital (ETH.8.17.170). The findings of this clinical trial will be communicated via peer-reviewed journal articles, conference presentations, social media and broadcast media. TRIAL REGISTRATION NUMBER: ACTRN12616000264482.

Physiological characteristics, self-perceptions, and parental support of physical activity in children with, or at risk of, developmental coordination disorder.

Children with low movement proficiency have been identified as having poorer physiological and psychosocial outcomes; however, the varied measurement approaches used to assess these outcomes have varied resulting in conflicting evidence regarding the presence and magnitude of differences compared to Typically Developing (TD) children. Additionally, there has been limited research into the role of parental support for physical activity (PA) in this group. We compared children with varying levels of movement proficiency on physiological characteristics and self-perceptions regarding PA. In addition, these children's parents were compared on physiological characteristics and support of their children's PA. Children (N = 117) aged 6 to 12 years, along with their parent/guardian, participated in this study. Children were classified according to the Movement Assessment Battery for Children-2 test (Typically Developing (TD) = 60; At Risk = 19; Developmental Coordination Disorder (DCD) = 38). Children's PA, muscle strength, cardio-respiratory fitness (CRF), body composition, and self-perceptions regarding PA were assessed, with parents assessed on CRF, body composition, and PA support. Compared to TD children, children with DCD had lower PA (p = 0.036), predilection (p ≤0.001) and adequacy (p ≤0.001) regarding PA, higher body fat percentage (p = 0.019), and received less logistic support (i.e., transportation) from their parents (p = 0.012). TD children had increased muscle strength compared to the DCD (p ≤ 0.001) and At Risk (p ≤ 0.001) groups. Results indicated that, relative to TD children, children with DCD have multiple physiological deficits, receive less parental logistic support for PA involvement, and report lower scores on psychological constructs that are predictive of PA involvement.

Reliability and validity of the adapted Resistance Training Skills Battery for Children.

OBJECTIVES: Resistance training (RT) is emerging as a training modality to improve motor function and facilitate physical activity participation in children across the motor proficiency spectrum. Although RT competency assessments have been established and validated among adolescent cohorts, the extent to which these methods are suitable for assessing children's RT skills is unknown. This project aimed to assess the psychometric properties of the adapted Resistance Training Skills Battery for Children (RTSBc), in children with varying motor proficiency. DESIGN: Repeated measures design with 40 participants (M age=8.2±1.7years) displaying varying levels of motor proficiency. METHODS: Participants performed the adapted RTSBc on two occasions, receiving a score for their execution of each component, in addition to an overall RT skill quotient child (RTSQc). Cronbach's alpha, intra-class correlation (ICC), Bland-Altman analysis, and typical error were used to assess test-retest reliability. To examine construct validity, exploratory factor analysis was performed alongside computing correlations between participants' muscle strength, motor proficiency, age, lean muscle mass, and RTSQc. RESULTS: The RTSBc displayed an acceptable level of internal consistency (alpha=0.86) and test-retest reliability (ICC range=0.86-0.99). Exploratory factor analysis supported internal test structure, with all six RT skills loading strongly on a single factor (range 0.56-0.89). Analyses of structural validity revealed positive correlations for RTSQc in relation to motor proficiency (r=0.52, p<0.001) and strength scores (r=0.61, p<0.001). CONCLUSIONS: Analyses revealed support for the construct validity and test-retest reliability of the RTSBc, providing preliminary evidence that the RTSBc is appropriate for use in the assessment of children's RT competency.

Exercise in the Treatment of Youth Substance Use Disorders: Review and Recommendations.

Substance use disorders among youth represent a significant public health concern. It is well established that regular exercise provides important physical and mental health benefits; however, evidence for the role of exercise as an adjunct component within substance use disorder treatment is scarce. In this review, we identify factors associated with the development and persistence of substance use disorders among youth, identify current treatment modalities, and present evidence to support the efficacy of incorporating exercise participation during rehabilitation. We also provide a series of recommendations for future research that explores the feasibility and effectiveness of exercise participation as a complement to substance use disorder treatment among youth.

Adaptation of the Resistance Training Skills Battery for Use in Children Across the Motor Proficiency Spectrum.

PURPOSE: The study aim was to adapt the Resistance Training Skills Battery for use in children and assess its interrater and intrarater reliability. The RTSBc provides an assessment of resistance training (RT) skill competency and an indication of readiness to perform RT. The RTSBc includes 6 basic RT skills. Scoring for individual RT skills is based on the number of performance criteria correctly demonstrated and a gross resistance training skills quotient for children (RTSQc) is calculated by summing the individual skill scores. METHODS: Twenty participants (mean age = 8.2 ± 1.8 years) were assessed while performing the RTSBc on 2 occasions. The 3 raters completing the assessments had varying levels of movement analysis and RT experience and received training in how to appraise RT skill competency using the RTSBc. RESULTS: Interrater reliability for the 3 raters was very good for the RTSQc (ICC = 0.92) and individual RT skills (ICC range = 0.82-0.94). Intrarater reliability of the live rater was also very good for the RTSQc (ICC = 0.97) and individual RT skills (ICC range = 0.87-0.95). CONCLUSION: This study has demonstrated the interrater and intrarater reliability of the RTSBc for children with varying levels of motor proficiency. The RTSBc can be used reliably within and between-raters to assess the RT skill competency of children.

A randomised controlled trial comparing the effects of a 12-week supervised exercise versus usual care on outcomes in haematological cancer patients.

PURPOSE: Following treatment, haematological cancer (HEM) patients exhibit significant physical deconditioning and psychological distress. Exercise has been shown as a clinically effective and safe intervention for cancer patients, with the potential to reverse the deleterious effects following treatment. Our aim was to investigate the efficacy of a 12-week exercise rehabilitation on cancer-related fatigue (CRF) and associated outcomes in HEM patients post-treatment. METHODS: Patients with a HEM were recruited to participate in a 12-week exercise rehabilitation intervention post-treatment. Pre-, post- and follow-up assessments were conducted on outcome measures including CRF, quality of life (QoL), psychological distress, cardiovascular fitness, muscle strength (MS) and body composition. Patients were given tailored exercise programmes comprising aerobic and resistance exercises, carried out three times per week for 12 weeks in local gyms and clinics. Usual-care participants were offered a delayed, tailored 12-week exercise intervention after the initial study period. RESULTS: Thirty-seven patients (49 % recruitment rate) were randomly assigned to the 12-week exercise rehabilitation (n = 18) or usual care (n = 19) with a 91 % adherence to the exercise intervention. Following the exercise programme, significant improvements were seen in CRF (p = 0.01), cardiovascular fitness (p ≤ 0.001), QoL (p ≤ 0.001), MS (p ≤ 0.001) and body composition (p = 0.001), with moderate to large effects for all primary outcomes. Patient follow-up at 24 weeks demonstrated outcome maintenance in the exercise rehabilitation group and significant improvements in outcomes in usual-care patients following participation in a delayed exercise programme. There were no adverse reactions or study withdrawals. CONCLUSIONS: A 12-week exercise rehabilitation programme resulted in significant statistical (p ≤ 0.05) and clinical improvements in CRF and additional outcomes in HEM patients following treatment. Additionally, a 12-week delayed exercise programme showed similar significant improvements in patient outcomes. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12609000450213.

Positive patient experiences in an Australian integrative oncology centre.

BACKGROUND: The purpose of this study was to explore the experiences of cancer patients' utilising complementary and integrative therapies (CIT) within integrative oncology centres across Western Australia. METHODS: Across four locations 135 patients accessed CIT services whilst undergoing outpatient medical treatment for cancer. Of the 135 patients, 66 (61±12 y; female n=45; male n=21) agreed to complete a personal accounts questionnaire consisting of open-ended questions designed to explore patients' perceptions of CIT. All results were transcribed into nVivo (v9) and using thematic analysis, key themes were identified. RESULTS: Of the 66 participants, 100% indicated they would "recommend complementary therapies to other patients" and 92% stated "CIT would play a significant role in their future lifestyle". A mean score of 8±1 indicated an improvement in participants' perception of wellbeing following a CIT session. Three central themes were identified: empowerment, support and relaxation. Fourteen sub-themes were identified, with all themes clustered into a framework of multifaceted views held by cancer patients in relation to wellbeing, role of significant others and control. CONCLUSIONS: Exploration of patients' experiences reveals uniformly positive results. One of the key merits of the environment created within the centres is patients are able to work through their cancer journey with an increased sense of empowerment, without placing them in opposition to conventional medical treatment. In order to effectively target integrative support services it is crucial to explore the experiences of patients in their own words and use those forms of expression to drive service delivery.