Search

Context: Skeletal muscle plays a crucial role in daily motion, athletic performance, health, and longevity. However, aging- or disuse-induced muscle loss can lead to functional disorders, vulnerability to injury, and increased risks of chronic diseases if left unattended. Resistance training, a type of physical exercise where skeletal muscle contracts against an external resistance to improve function and aesthetics, has been widely considered the most effective extraneous means to increase muscle mass and prevent the health-related risk of muscle atrophy. Recent evidence suggests that a muscle could increase its anatomical cross-sectional area and muscle thickness of a particular region to a greater degree than others, referred to as regional muscle hypertrophy (RMH). Objective: This study examined the change in muscle thickness (MT) at three regions of elbow flexors (EF) and its RMH pattern to eight-week standing dumbbell curl (SDC) training. Method: 22 untrained individuals (age: 23.4±3.9 years) were recruited to participate in the study. Participants completed 24 sessions (eight weeks, 3 sessions/week) of unilateral SDC training with a dumbbell equivalent to 70% of their one repetition maximum. MT of the proximal, middle, and distal elbow flexor of each participant was assessed before and after training using B-mode ultrasonography. A paired sample t-test was used to assess the pre-post MT changes of each of the three regions. A one-way repeated measure analysis of variance was conducted to compare the percent change in MT between regions. Result: Paired sample t-tests found significant differences between pre- and post-MT of all three regions (Proximal: p<0.001, d=1.63, Middle: p<0.001, d=1.21, Distal: p<0.001, d=2.06). No significant differences were found among regions. Conclusion: The current study showed significant increases in MT of all three regions of the EF in untrained participants in response to eight weeks of SDC RT. Further, no significant differen

Introduction: Firefighters operating in hot environments face challenges from protective garments that restrict heat dissipation, resulting in increased core temperature, thermal discomfort, and performance decline. Cooling vests represent a viable solution. The study aim was to compare effectiveness of the same amount of cooling power to the upper body (UB) or whole body (WB) in alleviating thermoregulatory and physiological stress, enhancing cognitive function, and reducing ratings of thermal discomfort and exertion, during 60 min of exercise in a hot environment (40°C, 40% relative humidity) while wearing firefighter turnout gear. Methods: Eight healthy individuals (27.5±3 y) participated in three conditions with either no cooling (Control) or active cooling with a liquid perfused shirt (UB cooling), or with a liquid perfused shirt and pants (WB cooling). In each trial, participants performed three sets of 15 min of stepping (20 steps/min) and 5 min of rest. Results: Both cooling strategies were beneficial compared to having no cooling at all. Participants could only complete two exercise bouts during Control, but they completed all three bouts with active cooling. WB cooling provided an advantage over UB cooling for core and skin temperature, and thermal comfort and sensation. The advantage in minimizing the increase in core temperature was only evident during the third exercise bout. Conclusion: Active cooling is advantageous under these conditions. WB cooling provided some benefits versus UB cooling during heavy intensity exercise; however, it is uncertain whether these benefits would be observed during light-to-moderate exercise, which more likely reflects an actual firefighting scenario.

Exercise is positively related to aspects of brain health through mechanisms involving blood-based neurotrophins released in the brain and from skeletal muscle. Neurotrophins are neuroprotective, promoting the growth and plasticity of neurons in the brain. However, the differences and/or similarities of exercise type on neurotrophic release in the cardiovascular system have yet to be established. We evaluated the acute effects of moderate-intensity continuous exercise, high-intensity interval exercise, and resistance exercise on Brain Derived Neurotrophic Factor, a protein involved in promoting neuroplasticity along with secondary measures of brain health: heart rate variability (HRV), self-reported positive and negative affect, and grip strength. In a repeated measures cross-over design, 12 participants over 5 weeks underwent all three exercise types while phlebotomy, cardiac, affect and grip strength measures were taken pre-, immediately post-, 30-minutes, and 60-minutes post-exercise. Results showed a significant change in plasma BDNF concentrations across all exercise types from immediately post-exercise to the 60-minute post-exercise time interval. Cardiac measures showed a decrease in heart rate variability immediately post-exercise, followed by a gradual increase to above pre-exercise levels at 60-minutes post exercise. A decrease in negative affect following exercise was also observed from immediately post- to 60-minutes post-exercise. No significant changes in grip strength were observed. Taken together, the results suggest that although exercise type did not differentially affect BDNF, HRV, or negative affect, all three measures suggested a consistent trend of physiological and psychological improvement or recovery trend at 60-minutes post exercise, highlighting the potential widespread benefits of various forms of exercise on aspects of brain health.

Introduction: Frailty is a syndrome characterized by loss of muscle mass, strength, and difficulty completing activities of daily living. It’s presence in patients undergoing major surgical procedure is associated with prolonged postoperative recovery, resulting in functional decline and increased rates of morbidity and mortality. Methods: A prospective, quasi-experimental study was conducted on pre-frail and frail patients undergoing cardiac surgery at St. Boniface Hospital. Patient’s with an estimated wait time of ≥ 3 weeks for their surgical procedure and who scored ≤ 60 on the short form 36 physical functioning scale were approached to participate in a 100% virtually delivered preoperative home-based exercise intervention. Participants were assessed and prescribed standardized exercises over Zoom and monitored via weekly Zoom conferencing with a physiotherapist (4 sessions over 3 weeks). The program focused on balance and strengthening exercises 3 x/week at a moderate intensity. The primary outcome was the feasibility and practicality of the intervention, defined as a consent rate of ≥ 30% of eligible patients as well as an adherence rate of ≥ 65% to the prescribed exercise program. Secondary outcomes evaluated safety and exploratory efficacy of the home-based program. Results: Among 209 screened patients, only 27 met the eligibility criteria. Nine of the 27 consented to participate, 2 were lost due to early surgical dates and 1 dropped out. Visit data of 6 participants were analyzed and their adherence to exercise was > 75%, with proper exercise technique demonstrated 88% of the time. No safety events occurred and clinically meaningful change in the SPPB score was demonstrated with an effect size of d = -0.99. Gait speed also improved clinically and statistically with a p = 0.026, and effect size of d = -1.57. Conclusion: Feasibility was demonstrated with a consent rate of 33% and an adherence to the exercise protocol of > 75%. Participants safely completed the

Introduction: With an ever-growing prevalence, diabetes is a significant burden on the health care system and primary care which is where most diabetes care takes place. Physical activity is an effective and underutilized intervention in diabetes prevention and management. However, exercise specialists like physiotherapists and kinesiologists are not commonly members of diabetes care teams. Effective interprofessional collaboration with exercise specialists for diabetes care requires role clarity. Purpose: To promote effective interprofessional collaboration in primary care settings for diabetes care and physical activity by, (a) establishing the competencies of entry-level physiotherapists and kinesiologists for physical activity as an intervention for diabetes in primary care settings and (b) developing a referral pathway for physical activity interventions based on the distinct discipline-specific competencies for use by interprofessional primary care teams. Methods: Eleven physiotherapy and three kinesiology subject matter experts participated in two rounds of Delphi surveys to develop discipline and context specific competencies. These competencies were used to draft clinical tools (competency profiles and referral pathway), that were member-checked and modified based on focus group findings. Descriptive statistics and content analysis were used to analyze quantitative and qualitative data respectively. Results: There was consensus on 38 physiotherapy and 27 kinesiology competencies that highlighted the complexity of physical activity interventions for diabetes and the distinct roles of physiotherapists and kinesiologists in this practice area. Physiotherapy competencies highlight their unique role in supporting people with all types of diabetes to engage in physical activity despite complex medical or physical barriers. Focus group feedback resulted in modifications to the layout of the referral pathway to reflect that both professions can provide physical act

Background: The majority of patients undergoing cardiac surgery (CS) are older, more vulnerable malnourished adults, which increases the risk of postoperative complications due to poor energy and protein intakes. The goal of this research study was to determine if a virtual nutrition intervention preoperative protein program (VIP) would be supported by CS patients and positively impact CS patient nutrition literacy and knowledge retention and protein intakes. Methods: A convenience sample size of 20 participants undergoing non-urgent elective CS received the VIP intervention consisting of four 25-minute sessions provided preoperatively. Each session focused on an overarching CS protein theme that built upon the previous session. Feasibility was measured by participants completed patient satisfaction surveys at 1-month post-CS, and nutrition literacy questionnaires and 3-day food records at baseline, within 2 weeks before CS and 1-month post-CS. Health outcomes were measured by analyzing medical chart data on patient length of stay (LOS) until discharge post-CS. Results: All participants reported taking part in the VIP intervention as beneficial and their nutrition literacy and knowledge increased as a result. All participants supported the intervention being delivered remotely preoperatively using a virtual platform. No participants reported regretting taking part in the VIP study or a preference for an alternate delivery platform. Participant 3-day protein intake mean score increased from 6.67 ±0.42 (Mean ± SD) protein servings at baseline to 9.33 ±0.57 protein servings before CS after receiving the VIP protein intervention. Conclusion: The findings indicate that the VIP intervention is supported by CS patients and that it can have a positive impact on patient nutrition literacy and knowledge retention and improve pre-surgery protein intakes.

High-intensity aerobic exercise is associated with various health benefits. Unfortunately, high-intensity exercises can be contraindicated and has barriers to participation depending on health conditions. These drawbacks could be mitigated using neuromuscular electrical stimulation (NMES). Current literature has shown that the addition of NMES to upper leg skeletal musculature during moderate-intensity aerobic exercise can increase the physiological responses associated with exercise intensity. It has been suggested that NMES can be used to assist the elevation of cardiovascular responses to help people reach cardiovascular responses similar to high-intensity exercise. Unfortunately, it’s unknown if the effects of NMES are the same or different between the biological sexes. The purpose of this research was to explore the acute cardiovascular responses between two conditions which included: 1) moderate-intensity cycle ergometer exercise; and 2) moderate-intensity cycle ergometer exercise with NMES. Mean values of respiratory exchange ratio, oxygen consumption, carbon dioxide production, heart rate, kilocalories utilized, substrate utilization and rating of perceived exertion were all collected. The data was compared across conditions and biological sexes. It was hypothesized that NMES with moderate-intensity aerobic exercise would have significantly higher cardiovascular responses than moderate-intensity aerobic exercise without NMES in both biological sexes. Results of the present study (n=20) went against the hypotheses with no statistically significant differences between the two conditions on acute cardiovascular responses (p > 0.05). No significant interactions between biological sex and condition in acute cardiovascular responses were noted (p > 0.05). Potential reasons for this are NMES intensity, study design, and antagonist muscle stimulation. In conclusion, in a young, healthy, physically active population there were no significant interactions between the

The high-altitude environment, which is characterized by low ambient temperature, precipitation (rain and snowfall), increased windchill, and hypoxia [low partial pressure of inspired oxygen (PiO2)] caused by decreased barometric pressure poses several challenges for athletes, industrial/commercial workers, military personnel, and researchers. All these factors decrease performance and survival. One famous example of the deleterious impacts of altitude on performance and survival, is human experiences on Mount Everest. The British experienced 30 years of failure in attempting to reach the summit of Everest. However, on the 29th of May, 1953 Everest was successfully climbed. Success on Everest may not have been possible without the indefatigable scientific recommendations and contributions of Dr. Griffith Pugh (pioneer Everest physiologist) who was a major contributor to the field of altitude science in general. The purpose of this review project was to investigate the scientific contributions of Dr. Pugh to the understanding of physiology of performance and injury treatment related to cold and altitude by systematically reviewing all his publications on these topics. We searched Medline database and Web of Science for publications by Lewis Griffith Pugh which revealed 61 and 75 articles respectively. Two reviewers independently screened for all articles that met the inclusion criteria (articles related to altitude, and/or cold physiology, and/or exercise physiology). At the end of the screening process, 61 papers (peer reviewed, n=52; and gray literature, n=9) met the inclusion criteria which were analysed. This narrative review revealed that Pugh was a model of a dedicated researcher who has contributed immensely to the field of high-altitude medicine and environmental physiology by conducting several physiological studies which have earned him significant academic recognition. Pugh had a long storied career among notable researchers. Interestingly, some of his sci

Sarcopenic obesity is the co-existence of low muscle mass and excess fat mass and can place frail individuals at increased risk of disability, chronic diseases, and mortality. Due to a lack of standardized criteria, the prevalence of sarcopenic obesity varies across definitions. The purpose of this cross-sectional study is to determine the prevalence of sarcopenic obesity using different published diagnostic criteria and its association with frailty in a population of Manitoba females, aged 55 years and older. Further, the prevalence of sarcopenic obesity and its association with frailty with the addition of handgrip strength (HGS) stratified by Body Mass Index (BMI) to sarcopenic obesity diagnostic criteria was examined to determine if the inclusion of HGS as part of existing diagnostic criteria strengthens the association between sarcopenic obesity and frailty. Finally, the relationship between BMI, waist circumference (WC) and frailty were explored to determine if a U-shaped relationship was observed in the study cohort. The relationship between Percentage Body Fat (%BF), WC, and frailty was also explored to determine if %BF exhibits a similar relationship with frailty compared to BMI. Diagnostic criteria were selected for analysis if body composition was measured using Bioelectric impedance analysis (BIA) and sex-specific (female) cut-off values were included. 20 diagnostic criteria were considered for analysis. The association between frailty and sarcopenic obesity was determined using a Spearman’s correlation. An unpaired t-test was performed in any models that were correlated in order to compare the frailty index scores between sarcopenic obesity levels. The prevalence of sarcopenic obesity ranged from 0% - 39%. Sarcopenic obesity was only significantly associated with frailty when using weight-adjusted or unadjusted diagnostic criteria, whereas there was no difference in frailty index scores in height-adjusted definitions. The addition of HGS lowered the pre

There are many discussions about the occurrence of hamstring injury, especially in running dominant sports such as Canadian rules football. Many interventions exist to decrease the risk and/or occurrence of hamstring injury, with the Nordic Curl being among one of the most studied interventions. The Nordic Curl is commonly implemented as part of a preventative injury program, often alongside various other methods of injury prevention exercises. Limited research exists on the implementation of a “more difficult” variation of the conventional Nordic Curl, which involves keeping the concentric portion in the exercise, as opposed to only completing the eccentric portion. This modified Nordic Curl (mNC) exercise was completed in one professional football team over the duration of four competitive seasons, post practice in a progressive manner to an upper limit of 5 reps per practice. Hamstring injury data collected during the four years of implementing the mNC was compared to the prior four years of hamstring injury data in three categories: rate of hamstring injuries per 4 years; average calendar days lost due to injury; and a comparison of total hamstring injuries per timeframe of the season. Independent t-tests were calculated to analyze for differences between rate of hamstring injuries in the two time periods (intervention vs non-intervention), and average time lost due to hamstring injury between the two time periods. Four Mann Whitney U tests were conducted to examine temporal differences in number of injuries between the intervention and non-intervention periods using four separate timeframes within the competitive season. No significant differences were found with any analyses, but large effect sizes were observed for differences between the groups for rate of hamstring injuries and the number of injuries that occurred in the first 6 weeks of the season. The results suggest the mNC does not significantly affect hamstring injury rates, time lost due to injury or