Predicting successful draft outcome in Australian Rules football: Model sensitivity is superior in neural networks when compared to logistic regression.

Using logistic regression and neural networks, the aim of this study was to compare model performance when predicting player draft outcome during the 2021 AFL National Draft. Physical testing, in-game movement and technical involvements were collected from 708 elite-junior Australian Rules football players during consecutive seasons. Predictive models were generated using data from 465 players (2017 to 2020). Data from 243 players were then used to prospectively predict the 2021 AFL National Draft. Logistic regression and neural network models were compared for specificity, sensitivity and accuracy using relative cut-off thresholds from 5% to 50%. Using factored and unfactored data, and a range of relative cut-off thresholds, neural networks accounted for 73% of the 40 best performing models across positional groups and data configurations. Neural networks correctly classified more drafted players than logistic regression in 88% of cases at draft rate (15%) and convergence threshold (35%). Using individual variables across thresholds, neural networks (specificity = 79 ± 13%, sensitivity = 61 ± 24%, accuracy = 76 ± 8%) were consistently superior to logistic regression (specificity = 73 ± 15%, sensitivity = 29 ± 14%, accuracy = 66 ± 11%). Where the goal is to identify talented players with draft potential, model sensitivity is paramount, and neural networks were superior to logistic regression.

Habitual Physical Activity of People with or at Risk of Diabetes-Related Foot Complications.

Regular physical activity is an important component of diabetes management. However, there are limited data on the habitual physical activity of people with or at risk of diabetes-related foot complications. The aim of this study was to describe the habitual physical activity of people with or at risk of diabetes-related foot complications in regional Australia. Twenty-three participants with diabetes from regional Australia were recruited with twenty-two participants included in subsequent analyses: no history of ulcer (N = 11) and history of ulcer (N = 11). Each participant wore a triaxial accelerometer (GT3X+; ActiGraph LLC, Pensacola, FL, USA) on their non-dominant wrist for 14 days. There were no significant differences between groups according to both participant characteristics and physical activity outcomes. Median minutes per day of moderate-to-vigorous physical activity (MVPA) were 9.7 (IQR: 1.6-15.7) while participants recorded an average of 280 ± 78 min of low-intensity physical activity and 689 ± 114 min of sedentary behaviour. The sample accumulated on average 30 min of slow walking and 2 min of fast walking per day, respectively. Overall, participants spent very little time performing MVPA and were largely sedentary. It is important that strategies are put in place for people with or at risk of diabetes-related foot complications in order that they increase their physical activity significantly in accordance with established guidelines.

Position-Specific Running and Technical Demands During Male Elite-Junior and Elite-Senior Australian Rules Football Match-Play.

ABSTRACT: Jennings, J, Staka, Z, Wundersitz, DW, Sullivan, CJ, Cousins, SD, Custovic, E, and Kingsley, MI. Position-specific running and technical demands during male elite-junior and elite-senior Australian rules football match-play. J Strength Cond Res 37(7): 1449-1455, 2023-The aim of this study was to compare position-specific running and technical demands of elite-junior and elite-senior Australian rules football match-play to better inform practice and assist transition between the levels. Global positioning system and technical involvement data were collated from 12 Victorian U18 male NAB League ( n = 553) and 18 Australian Football League ( n = 702) teams competing in their respective 2019 seasons. Players were grouped by position as nomadic, fixed, or ruck, and data subsets were used for specific analyses. Relative total distance ( p = 0.635, trivial effect), high-speed running (HSR) distance ( p = 0.433, trivial effect), acceleration efforts ( p = 0.830, trivial effect), deceleration efforts ( p = 0.983, trivial effect), and efforts at >150 m·min -1 ( p = 0.229, trivial effect) and >200 m·min -1 ( p = 0.962, trivial effect) did not differ between elite-junior and elite-senior match-play. Elite juniors covered less total and HSR distance during peak periods (5 seconds-10 minutes) of demand ( p ≤ 0.022, small-moderate effects). Within both leagues, nomadic players had the greatest running demands followed by fixed position and then rucks. Relative disposals ( p = 0.330, trivial effect) and possessions ( p = 0.084, trivial effect) were comparable between the leagues. During peak periods (10 seconds to 2 minutes), elite juniors had less technical involvements than elite seniors ( p ≤ 0.001, small effects). Although relative running demands and positional differences were comparable between the leagues, elite juniors perform less running, HSR, and technical involvements during peak periods when compared with elite seniors. Therefore, coaching staff in elite-senior clubs should maintain intensity while progressively increasing the volume of training that recently drafted players undertake when they have transitioned from elite-junior leagues.

Residual neuromuscular fatigue influences subsequent on-court activity in basketball.

The aim of this study was to determine if residual neuromuscular fatigue influenced subsequent match and training activity in professional women's basketball. Prior to matches and training sessions throughout a season, players performed countermovement jumps while wearing a magnetic, angular rate and gravity (acceleration) sensor on their upper back. Flight time to contraction time ratio was used to determine neuromuscular performance and to identify neuromuscular fatigue. Average session intensity and volume, the proportion of live time spent in different intensity bands (matches), and absolute and relative time spent in different intensity bands (training) were quantified using accelerometry. Residual neuromuscular fatigue was deemed to be present when the decrement in neuromuscular performance relative to pre-season baseline was greater than the smallest worthwhile change. Players displayed residual neuromuscular fatigue before 16% of matches and 33% of training sessions. When players were fatigued prior to matches, the proportion of live time undertaking supramaximal activity was 5.7% less (p = 0.02) and moderate-vigorous activity was 3.7% more than when not fatigued (p = 0.02). When fatigued prior to training, the players displayed a 2.6% decrement in average intensity (p = 0.02), 2.8% decrement in absolute (p = 0.01) and 5.0% decrement in relative (p = 0.01) maximal activity, as well as 13.3% decrement in absolute (p < 0.01) and 6.8% decrement in relative (p < 0.01) supramaximal activity when compared to not being fatigued. These findings suggest that residual neuromuscular fatigue influences players' ability to perform supramaximal activity, which highlights the importance of monitoring neuromuscular performance throughout a professional season.Highlights Residual neuromuscular fatigue can influence the amount of supramaximal activity players perform in a subsequent training session or match.Practices should be implemented to minimise residual neuromuscular fatigue carried into matches while maintaining a sufficient training volume to elicit physiological adaptations.MARG sensors can be used as an affordable and time-efficient tool for regularly monitoring countermovement jump-derived neuromuscular fatigue.

Sympathovagal Balance Is a Strong Predictor of Post High-Volume Endurance Exercise Cardiac Arrhythmia.

Regular physical activity is important for cardiovascular health. However, high-volume endurance exercise has been associated with increased number of electrocardiogram (ECG) abnormalities, including disturbances in cardiac rhythm (arrhythmias) and abnormalities in ECG pattern. The aim of this study was to assess if heart rate variability (HRV) is associated with ECG abnormalities. Fifteen participants with previous cycling experience completed a 21-day high-volume endurance exercise cycle over 3,515 km. Participants wore a 5-lead Holter monitor for 24 h pre- and post-exercise, which was used to quantify ECG abnormalities and export sinus R-to-R intervals (NN) used to calculate HRV characteristics. As noise is prevalent in 24-h HRV recordings, both 24-h and heart rate collected during stable periods of time (i.e., deep sleep) were examined. Participants experienced significantly more arrhythmias post high-volume endurance exercise (median = 35) compared to pre (median = 12; p = 0.041). All 24-h and deep sleep HRV outcomes were not different pre-to-post high-volume endurance exercise (p > 0.05). Strong and significant associations with arrhythmia number post-exercise were found for total arrhythmia (total arrhythmia number pre-exercise, ρ = 0.79; age, ρ = 0.73), supraventricular arrhythmia (supraventricular arrhythmia number pre-exercise: ρ = 0.74; age: ρ = 0.66), and ventricular arrhythmia (age: ρ = 0.54). As a result, age and arrhythmia number pre-exercise were controlled for in hierarchical regression, which revealed that only deep sleep derived low frequency to high frequency (LF/HF) ratio post high-volume endurance exercise predicted post total arrhythmia number (B = 0.63, R 2Δ = 34%, p = 0.013) and supraventricular arrhythmia number (B = 0.77, R 2Δ = 69%, p < 0.001). In this study of recreationally active people, only deep sleep derived LF/HF ratio was associated with more total and supraventricular arrhythmias after high-volume endurance exercise. This finding suggests that measurement of sympathovagal balance during deep sleep might be useful to monitor arrhythmia risk after prolonged high-volume endurance exercise performance.

Relationships between Physical Activity, Work Ability, Absenteeism and Presenteeism in Australian and New Zealand Adults during COVID-19.

Public health movement and social restrictions imposed by the Australian and New Zealand governments in response to the COVID-19 pandemic influenced the working environment and may have affected health behaviours, work ability, and job performance. The aim of this study was to determine the associations between health behaviours and work ability and performance during COVID-19 restrictions and if health behaviours were related to demographic or population factors. A cross-sectional survey was used to gather responses from 433 adult employees in Australia and New Zealand between June and August 2020. The survey requested demographic information and used the International Physical Activity Questionnaire, Work Ability Index, and the World Health Organisation's Health and Work Performance Questionnaire. Multivariate regression models were used to explore relationships between the identified variables while controlling for several possible confounders. Being sufficiently physically active was associated with higher reported physical (aOR = 2.1; p = 0.001) and mental work abilities (aOR = 1.8; p = 0.007) and self-reported job performance (i.e., lower presenteeism) (median +7.42%; p = 0.03). Part-time employees were 56% less likely (p = 0.002) to report a good or very good mental work ability. Those with existing medical conditions were 14% less likely (p = 0.008) to be sufficiently active and 80% less likely (p = 0.002) to report rather good or very good physical work ability. Being sufficiently active was associated with higher physical and mental work abilities and better job performance during the COVID-19 pandemic. Employers should support opportunities for regular physical activity and provide specific support to individuals with medical conditions or in part-time employment.

Foot Strike Patterns During Overground Distance Running: A Systematic Review and Meta-Analysis.

BACKGROUND: Investigations of foot strike patterns during overground distance running have foci on prevalence, performance and change in foot strike pattern with increased distance. To date, synthesised analyses of these findings are scarce. OBJECTIVE: The key objectives of this review were to quantify the prevalence of foot strike patterns, assess the impact of increased running distance on foot strike pattern change and investigate the potential impact of foot strike pattern on performance. METHODS: Relevant peer-reviewed literature was obtained by searching EBSCOhost CINAHL, Ovid Medline, EMBASE and SPORTDiscus (inception-2021) for studies investigating foot strike patterns in overground distance running settings (> 10 km). Random effects meta-analyses of prevalence data were performed where possible. RESULTS: The initial search identified 2210 unique articles. After removal of duplicates and excluded articles, 12 articles were included in the review. Meta-analysis of prevalence data revealed that 79% of long-distance overground runners rearfoot strike early, with prevalence rising to 86% with increased distance. In total, 11% of runners changed foot strike pattern with increased distance and of those, the vast majority (84%) do so in one direction, being non-rearfoot strike to rearfoot strike. Analysis of the relationship between foot strike pattern and performance revealed that 5 studies reported a performance benefit to non-rearfoot strike, 1 study reported a performance benefit to non-rearfoot strike in women but not men, 4 studies reported no benefit to non-rearfoot strike or rearfoot strike, and no studies reported a performance benefit of rearfoot strike over non-rearfoot strike. CONCLUSION: Most overground distance runners rearfoot strike early, and the prevalence of this pattern increases with distance. Of those that do change foot strike pattern, the majority transition from non-rearfoot to rearfoot. The current literature provides inconclusive evidence of a competitive advantage being associated with long-distance runners who use a non-rearfoot strike pattern in favour of a rearfoot strike pattern.

Physical testing characteristics better explain draft outcome than in-game movement profile in junior elite Australian rules football players.

OBJECTIVES: The aim of this study was to investigate the extent to which Australian Football League (AFL) draft outcome is associated with physical performance and/or in-game movement profile. DESIGN: Observational cohort design. METHODS: Physical testing results and in-game global positioning system (GPS) data were collated from Victorian-based, draft-eligible participants in the under 18 boys NAB League competition (n = 450; age = 17.1 ±â€¯0.3 y). Players were grouped by position as nomadic, fixed-position or fixed&ruck. RESULTS: Individually, variables that best distinguish drafted and non-drafted players were: estimated V̇O2 max (all-position, nomadic, fixed&ruck: d = 0.60, 0.64, 0.53), standing vertical jump (d = 0.57, 0.58, 0.53), running vertical jump (d = 0.52, 0.51, 0.56), AFL agility (d = 0.49, 0.44, 0.67) and 20-m speed (all-position, nomadic: d = 0.50, 0.61). Factor analysis prior to binary logistic regression assessed the probability of factors influencing position-specific draft outcome. AFL agility (all-position, fixed&ruck: OR = 4.58, 15.86), anthropometry (all-position, nomadic, fixed, fixed&ruck: OR = 2.55, 2.06, 11.41, 7.99), and jumping (all-position, nomadic, fixed&ruck: OR = 1.75, 1.69, 2.68) were the factors most associated with positive draft outcome. More game involvement (fixed&ruck: OR = 2.22), sprinting (all-position, fixed&ruck: OR = 1.45, 2.06) and less non-sprinting activities (all-position, nomadic: OR = 0.64, 0.61) were associated with positive draft outcome. The fixed&ruck model was the best performing (χ2(115) = 30.59, p < 0.001, AUC = 84.7%). CONCLUSIONS: Physical testing-related factors were most likely to influence draft outcome, where larger and more agile players were desirable draft picks. In-game movement profile had some bearing on draft outcome in all positional groups with the exception of fixed.

Podiatrist-Delivered Health Coaching to Facilitate the Use of a Smart Insole to Support Foot Health Monitoring in People with Diabetes-Related Peripheral Neuropathy.

This trial evaluated the feasibility of podiatrist-led health coaching (HC) to facilitate smart-insole adoption and foot monitoring in adults with diabetes-related neuropathy. Adults aged 69.9 ± 5.6 years with diabetes for 13.7 ± 10.3 years participated in this 4-week explanatory sequential mixed-methods intervention. An HC training package was delivered to podiatrists, who used HC to issue a smart insole to support foot monitoring. Insole usage data monitored adoption. Changes in participant understanding of neuropathy, foot care behaviours, and intention to adopt the smart insole were measured. Focus group and in-depth interviews explored quantitative data. Initial HC appointments took a mean of 43.8 ± 8.8 min. HC fidelity was strong for empathy/rapport and knowledge provision but weak for assessing motivational elements. Mean smart-insole wear was 12.53 ± 3.46 h/day with 71.2 ± 13.9% alerts not effectively off-loaded, with no significant effect for time on usage F(3,6) = 1.194 (p = 0.389) or alert responses F(3,6) = 0.272 (p = 0.843). Improvements in post-trial questionnaire mean scores and focus group responses indicate podiatrist-led HC improved participants' understanding of neuropathy and implementation of footcare practices. Podiatrist-led HC is feasible, supporting smart-insole adoption and foot monitoring as evidenced by wear time, and improvements in self-reported footcare practices. However, podiatrists require additional feedback to better consolidate some unfamiliar health coaching skills. ACTRN12618002053202.

Exercise and COVID-19: reasons individuals sought coaching support to assist them to increase physical activity during COVID-19.

OBJECTIVE: This paper explores the experiences of individuals who reported substantially decreasing physical activity (PA) as a result of COVID-19 and sought coaching support to increase PA. METHODS: A qualitative study using phenomenological analysis. Eight individuals participated in semi-structured interviews that focused on their experiences of decreasing PA as a result of physical distancing measures, and why they sought PA coaching to overcome these issues. Responses were analysed thematically. RESULTS: The participants reported markedly decreasing their PA following the enactment of physical distancing measures. The inability to subsequently engage in regular PA was a source of frustration for participants. Interview analysis revealed two themes that contributed to the understanding of why these individuals felt they needed PA coaching to increase PA; namely, a desire for both listening support and PA self-regulation support. CONCLUSION: The individuals who decreased PA due to COVID-19 desired an autonomy-supportive counselling style, centred on listening support and self-regulatory support. Online PA interventions were not highlighted as strategies to overcome PA barriers. Implications for public health: The effect of physical distancing measures on the determinants of overall PA is important, particularly if prolonged physical distancing is required.

The Effect of Structured Exercise Compared with Education on Neuropathic Signs and Symptoms in People at Risk of Neuropathic Diabetic Foot Ulcers: A Randomized Clinical Trial.

Background and Objectives: Lifestyle interventions such as exercise prescription and education may play a role in the management of peripheral neuropathy in people with diabetes. The aim of this study was to determine the effect of undertaking an exercise program in comparison with an education program on the signs and symptoms of peripheral neuropathy in people with diabetes at risk of neuropathic foot ulceration. Materials and Methods: Twenty-four adult participants with diabetes and peripheral neuropathy were enrolled in this parallel-group, assessor blinded, randomised clinical trial. Participants were randomly allocated to one of two 8-week lifestyle interventions, exercise or education. The primary outcome measures were the two-part Michigan Neuropathy Screening Instrument (MNSI) and vibratory perception threshold (VPT). Secondary outcome measures included aerobic fitness, balance and lower limb muscular endurance. Results: Participants in both lifestyle interventions significantly improved over time for MNSI clinical signs (MD: -1.04, 95% CI: -1.68 to -0.40), MNSI symptoms (MD: -1.11, 95% CI: -1.89 to -0.33) and VPT (MD: -4.22, 95% CI: -8.04 to -0.40). Although the interaction effects did not reach significance, changes in values from pre to post intervention favoured exercise in comparison to control for MNSI clinical signs (MD -0.42, 95% CI -1.72 to 0.90), MNSI clinical symptoms (MD -0.38, 95% CI -1.96 to 1.2) and VPT (MD -4.22, 95% CI -12.09 to 3.65). Conclusions: Eight weeks of exercise training or lifestyle education can improve neuropathic signs and symptoms in people with diabetes and peripheral neuropathy. These findings support a role for lifestyle interventions in the management of peripheral neuropathy.

Criterion Validity of a MARG Sensor to Assess Countermovement Jump Performance in Elite Basketballers.

ABSTRACT: Staunton, CA, Stanger, JJ, Wundersitz, DW, Gordon, BA, Custovic, E, and Kingsley, MI. Criterion validity of a MARG sensor to assess countermovement jump performance in elite basketballers. J Strength Cond Res 35(3): 797-803, 2021-This study assessed the criterion validity of a magnetic, angular rate, and gravity (MARG) sensor to measure countermovement jump (CMJ) performance metrics, including CMJ kinetics before take-off, in elite basketballers. Fifty-four basketballers performed 2 CMJs on a force platform with data simultaneously recorded by a MARG sensor located centrally on the player's back. Vertical accelerations recorded from the MARG sensor were expressed relative to the direction of gravity. Jumps were analyzed by a blinded assessor and the best jump according to the force platform was used for comparison. Pearson correlation coefficients (r) and mean bias with 95% ratio limits of agreement (95% RLOA) were calculated between the MARG sensor and the force platform for jumps performed with correct technique (n = 44). The mean bias for all CMJ metrics was less than 3%. Ninety-five percent RLOA between MARG- and force platform-derived flight time and jump height were 1 ± 7% and 1 ± 15%, respectively. For CMJ performance metrics before takeoff, impulse displayed less random error (95% RLOA: 1 ± 13%) when compared with mean concentric power and time to maximum force displayed (95% RLOA: 0 ± 29% and 1 ± 34%, respectively). Correlations between MARG and force platform were significant for all CMJ metrics and ranged from large for jump height (r = 0.65) to nearly perfect for mean concentric power (r = 0.95). Strong relationships, low mean bias, and low random error between MARG and force platform suggest that MARG sensors can provide a practical and inexpensive tool to measure impulse and flight time-derived CMJ performance metrics.

Multiple short bouts of exercise are better than a single continuous bout for cardiometabolic health: a randomised crossover trial.

PURPOSE: To compare cardiometabolic responses to five consecutive days of daily postprandial exercise accumulated in three 10-min bouts or a single 30-min bout to a no-exercise control. METHODS: Ten insufficiently active adults completed three trials in a randomised order. Each trial comprised five consecutive days of 30 min of exercise either accumulated in three separate 10-min bouts (ACC) after main meals; a single 30-min bout after dinner (CONT); or a no-exercise control (NOEX). Glucose regulation was assessed from an oral glucose tolerance test. Applanation tonometry was used to assess pulse wave velocity approximately 12 h following completion of the final trial. RESULTS: Area under the 2-h glucose curve was similar for CONT (mean; 95% CI 917 mmol L-1 2 h-1; 815 to 1019) and ACC (931 mmol L-1 2 h-1; 794 to 1068, p = 0.671). Area under the 2-h insulin curve was greater following NOEX (70,328 pmol L-1 2 h-1; 30,962 to 109,693) than ACC (51,313 pmol L-1 2 h-1: 21,822 to 80,806, p = 0.007). Pulse wave velocity was lower for ACC (5.96 m s-1: 5.38 to 6.53) compared to CONT (6.93 m s-1: 5.92 to 7.94, p = 0.031) but not significantly lower for ACC compared to NOEX (6.52 m s-1: 5.70 to 7.34, p = 0.151). CONCLUSION: Accumulating 30 min of moderate-intensity walking in three bouts throughout the day is more effective at reducing markers of cardiometabolic health risk in insufficiently active, apparently healthy adults than a single daily bout. Both accumulated and single-bout walking were equally as effective at reducing postprandial glucose concentrations compared to a no-exercise control. Therefore, accumulating exercise in short bouts after each main meal might be more advantageous for overall cardiometabolic health.

Impact of endurance exercise on the heart of cyclists: A systematic review and meta-analysis.

OBJECTIVE: To compare heart structure and function in endurance athletes relative to participants of other sports and non-athletic controls in units relative to body size. A secondary objective was to assess the association between endurance cycling and cardiac abnormalities. PATIENTS AND METHODS: Five electronic databases (CINAHL, Cochrane Library, Medline, Scopus, and SPORTdiscus) were searched from the earliest record to 14 December 2019 to identify studies investigating cardiovascular structure and function in cyclists. Of the 4865 unique articles identified, 70 met inclusion criteria and of these, 22 articles presented 10 cardiovascular parameters in units relative to body size for meta-analysis and five presented data relating to incidence of cardiac abnormalities. Qualitative analysis was performed on remaining data. The overall quality of evidence was assessed using GRADE. Odds ratios were calculated to compare the incidence of cardiac abnormality. RESULTS: Heart structure was significantly larger in cyclists compared to non-athletic controls for left ventricular: mass; end-diastolic volume, interventricular septal diameter and internal diameter; posterior wall thickness, and end-systolic internal diameter. Compared to high static and high dynamic sports (e.g., kayaking and canoeing), low-to-moderate static and moderate-to-high dynamic sports (e.g., running and swimming) and moderate-to-high static and low-to-moderate dynamic sports (e.g., bodybuilding and wrestling), endurance cyclists end-diastolic left ventricular internal diameter was consistently larger (mean difference 1.2-3.2 mm/m2). Cardiac abnormalities were higher in cyclists compared to controls (odds ratio: 1.5, 95%CI 1.2-1.8), but the types of cardiac abnormalities in cyclists were not different to other athletes. CONCLUSION: Endurance cycling is associated with a larger heart relative to body size and an increased incidence of cardiac abnormalities relative to controls.

Factors influencing Australian podiatrists' behavioural intentions to adopt a smart insole into clinical practice: a mixed methods study.

BACKGROUND: Diabetes is the leading cause of lower limb amputation in Australia, costing the Australian health care system an estimated A$1.6 billion annually. Podiatrists are the primary foot health care provider in Australia. Research suggests that health professional attitudes can impact patient utilisation of e-health technologies, such as wearable foot monitoring devices aimed at preventing foot ulceration. The aim of this study was to explore factors that impact the intentions of Australian podiatrists to adopt smart insole foot monitoring technology. METHODS: A mixed methods explanatory sequential design was undertaken. One hundred and eleven Australian podiatrists completed an online version of the validated Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire. Multiple regression analysis was used to determine the strongest predictive model of podiatrists' behavioural intention to adopt technology. Additionally, two focus groups were conducted, and thematic analysis was performed to explore podiatrists' perceived barriers and enablers to smart insole adoption. RESULTS: One hundred and eleven Australian podiatrists completed the online UTAUT questionnaire. The majority of respondents practiced in the private sector (58.6%) and were female (50.5%), with Victoria the most common practice location (39.6%). Significant positive correlations existed between behavioural intention and six psychosocial domains including performance expectancy (r = 0.64, p < 0.001), effort expectancy (r = 0.47, p < 0.001), attitude (r = 0.55, p < 0.001), social influence (r = 0.45, p < 0.001), facilitating conditions (r = 0.36, p < 0.001), and self-efficacy (r = 0.30, p < 0.002). Multiple regression analysis determined that performance expectancy alone was most predictive of behavioural intention to adopt a smart insole into clinical practice (adjusted R2 = 42%, p < 0.001). Qualitative analyses revealed that podiatrists believed that the insole would increase patient knowledge, engagement and self-efficacy. However, concerns were raised about cost, footwear issues and the device's utility with elderly and remote populations. CONCLUSIONS: Performance expectancy was the most important psychosocial factor predicting the intentions of Australian podiatrists to adopt smart insole foot monitoring technologies. While Australian podiatrists are open to adopting smart insoles into clinical practice, evidence of the device's efficacy is a precursor to adoption. Other perceived barriers to adoption including device cost, compatibility with off-loading, footwear issues and patient age also need to be addressed prior to implementation and clinical adoption.

A comparison of acute glycaemic responses to accumulated or single bout walking exercise in apparently healthy, insufficiently active adults.

OBJECTIVES: To investigate the acute glyacaemic response to accumulated or single bout walking exercise in apparently healthy adults. DESIGN: Three arm, randomised crossover control study. METHODS: Ten adults (age: 50±12.6 y; BMI 29.0±5.4kgm-2) completed three separate trials comprising three 10-min walking bouts after breakfast, lunch, and dinner (APPW), a single 30-min walking bout after dinner only (CPPW), or a no-exercise control (NOEX). Participants walked on a treadmill at a moderate intensity of 55%-70% heart rate reserve. Two-hour postprandial glucose response was assessed using a continuous glucose monitor. RESULTS: There was a difference in the pattern of the glucose response between the trials during the two hours following dinner (p<0.001). Postprandial dinner glucose concentrations were not different between APPW and CPPW but were up to 1.01mmolL-1 lower than NOEX (partial eta2=0.21, p=0.041). CONCLUSIONS: Ten minutes of moderate intensity walking completed 30min after each meal lowers postprandial dinner glucose concentrations in comparison to no-exercise, and reduces glucose by a similar magnitude as a single 30-min bout after the evening meal. Short bouts of exercise after each meal may be recommended to minimise glucose elevations after dinner that might increase risk of cardiometabolic disease.

Change in foot strike patterns and performance in recreational runners during a road race: A cross-sectional study.

OBJECTIVES: To characterise foot strike and observe change in foot strike patterns with increasing distance during a 15km recreational running road race. To assess the impact of foot strike on running performance. DESIGN: Observational cross-sectional study. METHODS: Foot strike patterns were determined at the 3km and 13km checkpoints for 459 participants during the 2017 Melbourne City to Sea recreational running event. Foot strike patterns were categorised as either rearfoot strike (RFS) or non-rearfoot strike (NRFS) at both checkpoints and analyses were conducted on intra-individual change in foot strike as well as relationship to finishing time. RESULTS: The most prevalent foot strike pattern at 3km and 13km was RFS with 76.9% (95% CI: 73.2%-80.5%) and 91.0% (95% CI: 88.7%-93.1%) using this pattern, respectively. Of the 105 participants who ran with a NRFS at 3km, 61% changed to RFS at 13km. Race completion time differed by foot strike pattern, where mean time for consistent NRFS (62.64±11.20min) was significantly faster than consistent RFS (72.58±10.84min; p<0.001) and those who changed from NRFS to RFS between checkpoints (67.93±10.60min; p=0.040). CONCLUSIONS: While the majority of recreational distance runners RFS within race settings, the fastest runners were those who consistently ran with a NRFS. In runners that use a NRFS early, a large proportion change to RFS as distance increases. Further research is warranted to determine whether interventions aimed at reducing muscular fatigue can attenuate this change and enhance running performance.

Assessing the association of university stress and physiological reactivity with decision-making among students.

Compared with age-matched employees, university students report higher levels of chronic stress and this may affect their decision-making. The impact of chronic stress and physiological reactivity upon cognitive function is receiving more attention, but few studies have empirically assessed the associations of these variables concurrently. Our aim was to investigate if chronic student stress, as assessed by effort-reward imbalance (ERI) and overcommitment, and physiological reactivity, were related to decision-making. As measures of physiological reactivity, we collected salivary alpha-amylase (sAA) and continuously recorded heart rate variability (HRV) data from male students (n = 79) at pretest and immediately after some computerized decision-making tasks (simple and choice- reaction times). Our findings suggest that students who are higher in overcommitment and who are more physiologically reactive (sAA and HRV indices) at the pretest stage may be more "at-risk" of poor decision-making than others. If others can replicate our findings in more diverse samples, this will contribute to an evidence base for interventions targeted at reducing overcommitment, ERI, and dysregulated autonomic reactivity to improve decision-making.

Factors influencing behavioural intention to use a smart shoe insole in regionally based adults with diabetes: a mixed methods study.

BACKGROUND: Smart insole technologies that provide biofeedback on foot health can support foot-care in adults with diabetes. However, the factors that influence patient uptake and acceptance of this technology are unclear. Therefore, the aim of this mixed-methods study was to use an established theoretical framework to determine a model of psychosocial factors that best predicts participant intention to use smart insoles. METHODS: Fifty-three adults with diabetes from regional Australia completed the validated Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire. Multiple regression analysis was used to determine the psychosocial factors that best predict behavioural intention to adopt a smart insole. Additionally, a focus group was conducted and thematic analysis was performed to explore barriers and enablers to adopting this technology. RESULTS: The multiple regression model that best predicted intention to adopt the smart insole (adjusted R2 = 0.51, p < 0.001) identified that self-efficacy (ß = 0.67, p = 0.001) and attitude (ß = 0.72, p < 0.001) were significant predictors of behavioural intention, while effort expectancy (ß = - 0.52, p = 0.003) and performance expectancy (ß = - 0.40, p = 0.040) were moderating factors. Thematic analysis illustrates the importance of attitude and self-efficacy on participants' behavioural intentions, influenced by participant's belief in the device's clinical efficacy and anticipated effort expectancy. CONCLUSIONS: This mixed-methods study demonstrates that attitude, self-efficacy, performance expectancy and effort expectancy combine to predict intention to adopt smart insole technology. Clinicians should consider these psychosocial factors when they prescribe and implement smart soles with patients at high risk of foot ulceration.

Wrist-specific accelerometry methods for estimating free-living physical activity.

OBJECTIVES: To compare accelerometry-derived estimates of physical activity from 9 wrist-specific predictive models and a reference hip-specific method. DESIGN: Prospective cohort repeated measures study. METHODS: 110 participants wore an accelerometer at wrist and hip locations for 1 week of free-living. Accelerometer data from three axes were used to calculate physical activity estimates using existing wrist-specific models (3 linear and 6 artificial neural network models) and a reference hip-specific method. Estimates of physical activity were compared to reference values at both epoch (≤60-s) and weekly levels. RESULTS: 9044h were analysed. Physical activity ranged from 7 to 96min per day of moderate-to-vigorous physical activity (MVPA). Method of analysis influenced determination of sedentary behaviour (<1.5 METs), light physical activity (1.5 to <3 METs) and MVPA (>3 METs) (p<0.001, respectively). All wrist-specific models produced total weekly MVPA values that were different to the reference method. At the epoch level, Hildebrand et al. (2014) produced the strongest correlation (r=0.69, 95%CI: 0.67-0.71) with tightest ratio limits of agreement (95%CI: 0.53-1.30) for MVPA, and highest agreement to predict MVPA (94.1%, 95%CI: 94.0-94.1%) with sensitivity of 63.1% (95%CI: 62.6-63.7%) and specificity of 96.0% (95%CI: 95.9-96.0%). CONCLUSIONS: Caution is required when comparing results from studies that use inconsistent analysis methods. Although a wrist-specific linear model produced results that were most similar to the hip-specific reference method when estimating total weekly MVPA, modest absolute and relative agreement at the epoch level suggest that additional analysis methods are required to improve estimates of physical activity derived from wrist-worn accelerometers.