INTRODUCTION: Postmenopausal women are at risk of sarcopenic obesity and metabolic dysfunction. While exercise has been proven to offer benefits to counter these risks, the efficacy of concurrent training (CT) in this population remains unclear. This study investigated the effects of a 10-week supervised CT program incorporating HIIT and resistance exercise training on body composition, muscular strength and glucose regulation in overweight postmenopausal women. METHODS: 12 postmenopausal women (age 58.4 ± 4.5 y; BMI 29.3 ± 2.3 kg/m²) completed a 10-week CT program with a frequency of 2 sessions per week. Sessions included progressive resistance training with 6 exercises targeting major muscle groups with 1-3 reps in reserve followed by stationary cycling with high-intensity interval training (HIIT) (10 x 60s at 70-90% peak power output interspersed with 60s active recovery). Pre- and post-intervention testing included whole body DEXA scans (lean mass, fat mass), 3-repetition maximum (3RM) strength tests (chest press and leg press) and 2-hour oral glucose tolerance test (OGTT). RESULTS: Adherence rate to the training program was 99%. There were significant increases in upper-body strength (51.0% ± 7.1%; p < 0.05) and lower-body strength (97.6% ± 9.7%; p < 0.05). Total lean mass increased significantly by 2.4% ± 0.5% (p < 0.05) while total fat mass did not change significantly (- 0.4% ± 1.2%; p = 0.6). Glucose AUC increased by 12.2% ± 5.1% after the intervention (p < 0.05). CONCLUSION: A 10-week, twice-weekly CT program incorporating HIIT is effective for improving muscular strength and lean mass in overweight postmenopausal women. However, as fat mass and glucose tolerance did not improve, the training program may be insufficient for metabolic changes without dietary changes. These findings support the utility of time-efficient CT as a viable intervention to mitigate menopause-related physiological decline.
A multidisciplinary prehabilitation approach may help to counter the negative physical, psychological and social impacts experienced during an allogeneic hematopoietic stem cell transplant (allo-HSCT) among Acute Myeloid Leukaemia (AML) and Myelodysplastic Syndrome (MDS) patients. This study investigated the feasibility, safety and preliminary efficacy of multidisciplinary prehabilitation in adults offered allo-HSCT. This single-group pilot study recruited patients (≥ 18 years) with AML or MDS scheduled for allo-HSCT between June 2023 and July 2024. The intervention integrated exercise physiology, physiotherapy, dietetics, occupational therapy, psychology, and social work. Feasibility outcomes included uptake, retention, adherence, and acceptability. Safety was evaluated by monitoring adverse events. Preliminary efficacy was assessed across functional (30-s sit-to-stand, grip strength, 2-min step test, Timed Up and Go), nutritional (PG-SGA), and patient-reported outcomes (EORTC QLQ-C30, HADS, NCCN Distress Thermometer). Of 27 patients approached, 19 (70.4%) enrolled; one withdrew due to medical deterioration. Eleven participants completed the full 8 weeks, and seven completed 3–7 weeks before transplant. Adherence was high (79.3%), and acceptability was positive across disciplines. No deaths or serious (grade ≥ 3) adverse events occurred. Four intervention-related adverse events were observed (three mild, one moderate), and 34 sessions were cancelled for safety reasons (haemodynamic abnormalities or cytopenias). Preliminary efficacy analyses showed moderate effect size improvements in lower body strength (sit-to-stand, d = 0.49), mobility (Timed Up and Go, d = 0.63), aerobic capacity (2-min step test, d = 0.60), and nutritional status (PG-SGA, d = 0.41). Small-to-moderate effects were observed for several QOL domains, with improvements in constipation but increases in nausea, dyspnoea, and financial concerns. Based on this study’s favourable safety, feasibility and preliminary efficacy results, future, larger-scale research is warranted to evaluate the efficacy of multidisciplinary prehabilitation more rigorously in this setting. The preliminary efficacy results provided by this study may be helpful to inform sample size calculations.
INTRODUCTION/ AIMS: Concurrent cognitive and physical training has shown beneficial effects for enhancing executive function at rest in older adults and athletes, and may offer a novel way to prepare individuals for roles which impose simultaneous cognitive and physical demands. However, its effects on cognition during and following exertion, remains unclear. This study investigated whether a 12-week concurrent training program improves cognitive performance during a combined cognitive and physical task, and whether these improvements extend to subsequent rested cognitive performance. METHODS: A randomised controlled trial included 107 adults (25 ± 6 yr; 58 females) assigned to one of three 12-week programs: physical training (two 60-minute moderate-intensity cycling sessions/week), concurrent training (cycling performed simultaneously with adaptive, multi-domain cognitive training), or separate training (cycling plus two rested cognitive training sessions/week). Pre- and post-testing involved: a ~45-minute weighted treadmill walk with embedded cognitive tasks; a rested cognitive battery; and subjective measures of perceived readiness and workload. Intervention effects were analysed using linear mixed-effects models. RESULTS: During the treadmill task, all groups improved verbal recall (p<0.001), but only the concurrent group improved response inhibition accuracy (p=0.018) with no change in reaction time across groups. This coincided with an increased challenge-oriented appraisal for the concurrent group (p=0.032). However, during the subsequent cognitive battery, this group showed post-intervention slowing on the psychomotor vigilance task (p=0.033), consistent with reduced attentional reserve following greater inhibitory engagement. All groups improved reaction time on the visual search, stroop and category switch tasks (all p<0.001). CONCLUSION: Concurrent training selectively enhanced inhibitory control during a combined cognitive and physical task and prompted a more adaptive psychological readiness state, both qualities relevant to cognitively demanding occupations. While these improvements did not extend to rested cognition, concurrent training shows promise as a task-specific tool for preparing individuals for cognitive performance under and after physical load.
INTRODUCTION AND AIMS: Falls are a major cause of injury in older adults, resulting in hospitalisation and high costs of medical care. Our study has shown that a Judo-based safe falling program can significantly improve older adults’ safe falling skills, thereby reducing the risk and severity of fall-related injury. However, widespread implementation is limited by workforce capacity. This study evaluated an innovative Train-the-Trainer program to build delivery capability by upskilling Allied Health Professionals and Judo Coaches to teach safe falling to older adults. METHODS: A repeated-measures study design was used, with assessments conducted at three timepoints: before (T1) and after (T2) a 2-day workshop, and after eight weekly practical sessions (T3). The 2-day workshop focused on teaching safe falling and working with older adults and was combined with practical experience by attending an 8-week Judo-based safe falling program. Outcomes included perceived competence and importance in teaching safe falling (Likert scale 1–6), objective knowledge, and trainees’ own safe falling skills measured using the Strömqvist-Bååthe Falling Competence Test. RESULTS: Sixteen trainees participated (n=8 Allied Health Professionals, n=8 Judo Coaches; mean age 50.4±11.4 years; 37.5% female). Perceived competence (p<.001), objective knowledge (p<.001), and safe falling skills (p<.001) improved significantly after the 2-day workshop, with gains maintained after the practical sessions. Perceived importance improved significantly after the full Train-the-Trainer program (p=.015). Judo Coaches demonstrated higher overall safe falling skills compared to Allied Health Professionals (p=.011). However, both groups showed similar improvements over time. CONCLUSION: This innovative Train-the-Trainer program improved perceived competence, objective knowledge, and safe falling skills among Allied Health Professionals and Judo Coaches, with most gains achieved after the 2-day workshop. Improvements in perceived importance required practical exposure, particularly among Allied Health Professionals. These findings support the feasibility and sustainability of upskilling a mixed workforce to scale safe falling programs for older Australians.
INTRODUCTION: The Low Energy Availability in Females Questionnaire (LEAF-Q) is a 25-question survey on the physical symptoms of insufficient energy intake across injuries, gastrointestinal function and menstrual dysfunction. There are currently limited studies using the LEAF-Q in footballers, with small sample size being a limitation of all previous studies and only one study in a national football team context. Aims: The aims of this study were (1) to describe LEAF-Q responses for female national team footballers and (2) to examine LEAF-Q responses based on player age and club location. METHODS: Players from female national teams (youth and senior teams) completed LEAF-Q surveys between 2019 and 2025. Descriptive statistics and linear mixed models were used to report the relationship between LEAF-Q outcomes, age and club location. RESULTS: 829 surveys were completed by 328 players (19.0 ± 4.3y), with a mean LEAF-Q total score of 6.97 ± 3.84 and subcategory scores of 2.57 ± 2.34 for injury, 1.74 ± 1.56 for gastrointestinal function and 2.66 ± 2.35 for menstrual function. A significant difference in injury subcomponent score and binary LEA risk was reported based on age (p < 0.05), where both increased with player age (estimate = 0.05 and 0.06 respectively). Further, senior national team players’ club location had a significant difference based on the menstrual subcomponent score (p < 0.05 for Australia compared to Europe). CONCLUSION: LEA risk was prevalent among a population of female national team footballers. Age had a significant association with the injury subcomponent score and binary LEA risk (p < 0.05), while players’ club location had a significant association with the menstrual function subcomponent (p < 0.05).
BACKGROUND & AIMS: Individuals living with chronic neurological and musculoskeletal conditions frequently experience impairments in gait, balance, strength and cardiorespiratory fitness, limiting physical activity participation and quality of life. Aquatic exercise is an established rehabilitation modality; however, evidence specific to underwater treadmill (UT) exercise remains limited, particularly regarding exercise prescription parameters. This review aimed to synthesise current evidence relating to UT-based exercise interventions and integrate clinician experience to inform evidence-based practice. METHODS: A structured literature review was conducted using PubMed, SPORTDiscus and Google Scholar to identify studies published between January 2014 and November 2024 examining UT-based exercise interventions in individuals with chronic disease or disability. Outcomes of interest included gait, strength, balance, functional capacity, cardiometabolic health and quality of life. Additionally, semi-structured interviews were conducted with senior exercise physiologists and physiotherapists working in a specialised disability exercise setting to explore clinical utilisation, exercise prescription and observed outcomes. RESULTS: Eleven studies met inclusion criteria, including randomised controlled trials, exploratory studies and pilot investigations. Most of the evidence related to neurological populations (stroke and spinal cord injury), with additional studies in knee osteoarthritis and type 2 diabetes mellitus. Across studies, UT exercise was associated with improvements in gait performance, lower-limb strength, balance, proprioception, walking endurance and selected cardiometabolic outcomes. Clinician perspectives aligned with the literature, highlighting the capacity of UT exercise to enable higher exercise volumes and task-specific gait training in individuals with reduced land-based capacity. Study heterogeneity and small sample sizes were common limitations. CONCLUSION: Underwater treadmill exercise represents a valuable modality within physical rehabilitation, particularly for individuals with neurological and musculoskeletal conditions. Integration of UT exercise with established land-based guidelines may enhance functional outcomes. Further research is required to establish UT-specific exercise prescription guidelines across distinct musculoskeletal and neurological client sub-groups and evaluate health related and functional outcomes.
INTRODUCTION AND AIMS: Goal setting, often delivered in conjunction with other therapies, is a core component of behavioural interventions for chronic musculoskeletal pain (CMP). This systematic review and meta-analysis aimed to assess the effect of embedded goal setting in behavioural interventions on pain intensity, disability, and physical activity in people with CMP. METHODS: We searched five electronic databases (PubMed, CENTRAL (Cochrane Library), PEDro, PsychINFO, CINAHL) and three clinical trial registers (clinicaltrials.gov, ANZCTR, and ISRCTN) from inception to August 2025 for randomised controlled trials of behavioural interventions with goal setting compared to matched interventions without goal setting, usual care, or no intervention. Screening, data extraction, risk of bias (RoB2), and certainty of evidence assessments (GRADE) were conducted in duplicate. We performed random effects meta-analyses to determine effects on pain intensity, disability, and physical activity. RESULTS: Thirty-eight trials involving 7,328 participants (mean age 56.5 ± 14.3 years; 61.2% female) were included. Compared to usual care, behavioural interventions with goal setting did not have clinically meaningful effects on pain intensity (0-100 scale, MD -5.46, 95%CI: -8.79 to -2.13; low certainty), disability (SMD -0.20, 95%CI: -0.27 to -0.13; moderate certainty), or physical activity (SMD -0.02, 95%CI: -0.08 to 0.12; moderate certainty). Comparisons to waitlist and matched controls also demonstrated no meaningful effects, however the evidence was of low to very low certainty. CONCLUSION: Based on mostly very low to low certainty evidence, behavioural interventions with goal setting may have no clinically meaningful effect on pain intensity, disability, or physical activity in adults with CMP compared to usual care, waitlist or matched controls. If clinicians choose to use goal setting, they should first consider how it could be best implemented to guide behaviour change by targeting potential mediators such as pain self-efficacy or kinesiophobia.
INTRODUCTION & AIM: Chest binding is a common practice in trans and gender diverse populations and is associated with many psychological benefits. Despite this, clinical and community guidance frequently cautions against chest binding during exercise due to perceived health risks, yet evidence supporting physiological risk or acute effects on performance is lacking. The aim of this study was to determine whether chest binding alters maximal aerobic and strength performance, respiratory function, range of motion (ROM), or perceptual responses to maximal exertion in binder-naive people. METHODS: A randomised counterbalanced crossover design evaluated acute responses to exercise performed in binder and non-binder conditions. The primary outcome was VO₂max, with secondary outcomes including maximal muscle strength (1RM bench press, lat pulldown), respiratory function (FEV1, maximal VT and VE), spine and shoulder flexion and perceptual ratings of comfort, dyspnoea, and exertion. Analyses examined within-participant differences across conditions and consistency of physiological and perceptual responses. RESULTS: Twenty-one participants (mean age 30.67± 5.41 years) completed all testing, with anthropometric diversity evident across chest girth, body composition, and binder size. No significant differences were found between conditions for VO₂max, 1RM bench press and lat pulldown strength, maximal VE and VT, FEV1, or ROM, and all effect sizes were small (d<0.3) with strong within-participant agreement for key physiological measures (r=0.89-0.95, p<0.001). Perceptual outcomes demonstrated no between-condition differences, with moderate to strong correlations across trials (r<0.5). CONCLUSION: Chest binding did not alter maximal aerobic or strength performance, respiratory function at rest or maximal exertion, ROM or perceptions during maximal exertion. Given the lack of change in physiological or perceptual function, chest binding, acutely, is unlikely to contribute to changes in risk profile associated with activity. These findings challenge the precautionary advice currently given, indicating it provides an unnecessary barrier to exercise participation.
INTRODUCTION & AIMS: Gender-affirming hormone therapy (GAHT) induces changes in body composition, which can influence cardiometabolic health and sport performance in transgender (trans) individuals. We aimed to assess the effects of estradiol- and testosterone-based GAHT on fat mass and fat free mass (FFM) over 24 months, compared to cisgender (cis) controls. METHODS: This was a 24-month prospective controlled study that enrolled trans individuals initiating GAHT (34 E-GAHT and 41 T-GAHT) and cis controls (50 women and 53 men). Body composition was measured via dual energy X-ray absorptiometry (DXA) at baseline, 6-, 12-, and 24-months. Linear mixed-effects models were used, and data are presented as between-group percentage change over time with 95% CI. RESULTS: Estrogen therapy over 24 months increased total fat mass by 20% [9, 32] (p<0.01), which remained significantly less than cis women at all time points (p=0.02). Total FFM reduced by 4% [-6, -2] (p<0.01) and was significantly less than cis women starting from 12 months (p=0.02). FFM in the arms was no different at all timepoints, and FFM in the legs was significantly less than cis women at 24 months (p<0.01). Testosterone therapy over 24 months reduced total fat mass by 18% [-29, -5] (p<0.01), which was no different to cis men at 24 months. Total FFM increased by 10% [7, 14] (p<0.01) and was significantly greater than cis men starting from 12 months (p<0.01). Regional FFM was significantly less at baseline in the arms (p<0.01) and legs (p<0.01), and both were no different starting from 6 months. CONCLUSION: Estrogen and testosterone therapies altered fat and FFM to distinct body composition profiles. Testosterone therapy increased FFM and may enhance physical performance. Estrogen therapy reduced FFM to levels that are less than cis women and may hinder physical performance, especially in lower-body dominant tasks.
Almost 1.2million Australian adults (4.6% of the adult population) have type 2 diabetes (T2D), with ~45,700 newly diagnosed cases annually. It is a leading contributor to long-term health complications and is implicated in 11% of deaths nationwide. This is an update of the 2012 Exercise and Sports Science Australia (ESSA) position statement. The objective of this position statement is to provide exercise practitioners with a summary of the current evidence, and an update of the exercise prescription recommendations and practical guidance for people with T2D. Research evidence shows exercise can improve glycaemic control, reduce central adiposity, manage cardiovascular health, increase aerobic and neuromuscular fitness, and improve patient-reported outcomes measures. A client-centred, culturally responsive, stepped approach to exercise prescription should be utilised. Initially, sedentary time should be limited and regular movement incorporated throughout the day. Then, exercise professionals should collaborate with the client to co-develop an exercise prescription that reflects their needs, preferences and context, with gradual progression toward meeting the guidelines in this statement by incorporating both aerobic (continuous and/or interval) and progressive resistance training. Mind-body exercise (i.e., tai chi, yoga, qigong) has also been shown to provide numerous benefits and may be included as an adjunctive therapy. This statement provides targeted exercise recommendations to improve specific outcomes (e.g., HbA1c, bodyweight, blood pressure). Recommendations for successful implementation are discussed, including screening and assessments, special considerations in the presence of comorbidities and medications, barriers to and facilitators of exercise, behaviour change, and addressing potential inequities that limit exercise access and adoption.
INTRODUCTION: Cognitive impairment is a commonly reported clinical concern among men with prostate cancer undergoing androgen deprivation therapy (ADT). In older adults, moderate to high intensity physical activity and cardiorespiratory fitness are consistently associated with better cognitive function; however, these relationships remain underexplored in men receiving ADT, limiting evidence-informed exercise strategies to support cognitive health. AIM: Assess correlations between fitness and self-reported physical activity with cognitive function in men with prostate cancer undergoing ADT. METHODS: Men diagnosed with prostate cancer receiving ADT were included (n=20). Fitness was predicted from an Astrand Rhyming test on a recumbent bike. Self-reported physical activity was obtained from the International Physical Activity Questionnaire with moderate, vigorous and total metabolic minute equivalents per week recorded. Cognitive performance (executive function, spatial awareness, memory and reaction time) was assessed via a computerised cognitive battery. Spearman’s rho (ρ) assessed correlation direction and magnitude with 90% bootstrapped confidence intervals. RESULTS: Higher fitness was associated with faster reaction times (large effect ρ=0.51, CI [-0.18, 0.74]; p=0.02) as well as accuracy in executive function (moderate effect ρ=0.40, [0.03, 0.69], p=0.08) and spatial awareness tasks (moderate effect ρ=0.41, [0.04, 0.70], p=0.07). Self-reported moderate to vigorous physical activity is moderately associated with reaction time in an executive function assessment involving task switching (ρ=0.37, CI [-0.06, 0.69], p=0.11) and non-switching elements (ρ=0.33, [−0.08, 0.65], p=0.16). No other associations reached significance and at least a moderate effect size between fitness or self-reported physical activity at any intensity and cognition. CONCLUSION: Cross-sectionally, higher fitness and greater engagement in moderate to higher-intensity physical activity may be linked to better cognitive performance, in particular reaction time, in men with prostate cancer receiving ADT. These results support the growing role of exercise professionals in addressing cancer-related cognitive concerns, highlighting the need for further targeted and longitudinal research in this area.
INTRODUCTION: Men with prostate cancer undergoing hormone treatment commonly report poorer cognitive performance than their age-matched controls. Within other populations, cognitive and physical activity can independently provide cognitive benefits, however, greater benefits may be achieved by combining stimuli simultaneously (concurrently). Initial feasibility and acceptability of this approach are yet to be demonstrated in men affected by prostate cancer. AIM: To assess the feasibility and acceptability of a concurrent cognitive and physical training intervention for men with prostate cancer undergoing hormone treatment. METHODS: Men diagnosed with prostate cancer receiving androgen deprivation therapy were randomly allocated to either a physical training (n=7), cognitive training (n=2), concurrent training (n=6) intervention or waitlist control (n=5). Feasibility of the intervention was determined by recruitment success (target n=76), intervention adherence (aiming for >65%), occurrence of adverse events, and benefit likelihood for cognitive health. Acceptability was assessed qualitatively using reflexive thematic analysis of participant experience. All outcomes were considered against a pre-determined criteria to indicate appropriateness of progression to a larger clinical trial. RESULTS: Although only 26% of the target recruitment was met, other feasibility measures were favourable, including overall study adherence (95%, no withdrawals), compliance with intervention parameters (≥90%) and no serious adverse events. Further, the concurrent intervention appeared to offer overall cognitive benefits (Hedge’s g≥0.5 - medium effect - relative to wait-list control). Subjective acceptability indicated overall enjoyment and high satisfaction (including professionalism and quality) with the concurrent intervention. Key insights for future trial design were also offered. CONCLUSION: This novel intervention is feasible and acceptable given the high adherence, positive study and intervention compliance and favourable subjective acceptability, provided improved participant recruitment can be addressed. Concurrent cognitive and physical interventions could provide a time-efficient means of supporting those on hormone treatment with cognitive side effects and warrants further exploration in a larger clinical trial.
INTRODUCTION: Passive heating can enhance acute muscle function and demonstrate some exercise-like adaptations. This study investigated whether hot-water immersion (HWI) during detraining mitigates losses in muscle strength and performance compared with controls. METHODS: Twenty-nine untrained adults (14 males, 15 females; 22.0 ± 3.1 years) completed 4 weeks of concurrent training followed by 4 weeks of detraining. Fourteen participants underwent HWI to waist level (42 °C) for 60 min, three times weekly during detraining. Heart rate and rectal temperature were recorded during immersion. Muscle thickness (vastus lateralis, vastus medialis, rectus femoris) was assessed via ultrasound. Strength was measured at baseline, 4, and 8 weeks using maximum voluntary contraction (MVC) and six-repetition maximum (6RM) for leg press, leg curl, and leg extension. Data were analysed using linear mixed models, and significance was accepted where p<0.05. RESULTS: HWI reduced immersion heart rate by 11 bpm (p = 0.0034) and attenuated core temperature rise by 0.5 °C (p = 0.0002). Both groups showed substantial strength gains during training (0–4 weeks): leg press increased by 29% in controls and 46% in HWI, leg extension by 63% and 59%, and leg curl by 21% and 28%, respectively. From 4 to 8 weeks, changes were minimal, indicating maintenance: leg press (+0.6% vs −3.4%), leg extension (−6.6% vs +10.4%), and leg curl (+2.9% vs −2.0%). Strength gains were preserved in both groups (p = 1.00), while MVC, quadriceps thickness, and mid-thigh circumference did not change significantly (p ≥ 0.05). CONCLUSION: Chronic passive heating did not confer additional benefits for muscle size or strength during detraining, contrasting prior evidence that repeated passive heating can induce hypertrophy and strength gains under higher-dose protocols. These findings suggest that short-term HWI may reduce physiological strain without influencing muscular adaptations, highlighting the importance of heat dose and duration for exercise-mimetic effects.
Introduction Trauma Informed Practice (TIP) recognises the prevalence and impact of trauma and seeks to create safe, trustworthy, and empowering environments for service users. Adoption of this approach is growing, alongside an increasing body of literature evaluating its application and benefits within primary healthcare, social work, and psychology. However, little is known about how TIP is understood and applied in specific allied health roles, such as the exercise professions. This paper explores how exercise professionals understand and apply TIP in their practices. Methods This study employed a qualitative design, using semi-structured interviews to explore participants' perspectives. Exercise professionals were recruited using purposive sampling and Braun and Clarke's six steps of inductive thematic analysis were used to analyse the data. Results 13 exercise professionals completed an interview; from their responses, three themes emerged: (1) cultivating therapeutic relationships through psychological safety and mutual partnership, (2) trauma informed exercise becomes a vehicle for experiencing empowerment and agency, and (3) exercise professionals need to turn inward to sustain TIP and a gap in training leaves exercise professionals to piece together TIP on their own. These themes demonstrate how TIP is currently understood and being applied in practice. Conclusions This study sheds light on the importance of the therapeutic relationship as a foundational element of TIP in exercise settings and its influence on exercise delivery. Currently, exercise professionals feel responsible for sustaining this approach individually, which points to the need to develop training and support structures to sustain its implementation.
INTRODUCTION & AIMS: Workplace exercise programs can improve employee wellbeing, but the impact of supervision type on psychosocial outcomes remains unclear. This study compared personal and non-personal exercise supervision and examined associations between aerobic and resistance training volumes and psychosocial well-being. METHODS: Eighty-five university employees (mean age 43.2±9.8 years; 62 females) were randomised to personal supervision (SUP, n=28), non-personal supervision (NPS, n=28), or no supervision (CON, n=29) for a 16-week aerobic and resistance exercise program prescribed at moderate-to-vigorous intensity using progressive overload principles. Programs were tailored to individual capacity for all groups and delivered onsite for SUP and NPS groups to maximise accessibility. Psychosocial outcomes were assessed at baseline, 8- and 16-weeks using SF-36, Ewart’s Self-Efficacy Scale, and BREQ-2 questionnaires. Non-parametric tests evaluated changes over time, while Spearman’s correlations examined associations between aerobic and resistance training volumes and psychosocial wellbeing at 16 weeks. RESULTS: Seventy-six participants (89%) completed the intervention. Group × time interactions were not significant. Within-group analyses showed improvements in SF-36 components, including general health (SUP, p<0.001; NPS, p<0.05; CON, p<0.001), emotional well-being and social functioning (CON, p<0.05). Self-efficacy gains were most consistent in SUP (lifting, climbing stairs, push-ups), with smaller improvements in NPS (jogging) and CON (push-ups). Identified (p<0.01) and intrinsic regulation (p<0.05) increased in both supervised groups. Resistance training volume correlated positively with post-intervention self-efficacy (SUP & NPS, p<0.05) and perceived health (SUP, p<0.05). CONCLUSION: Although interaction effects were not significant, personal supervision delivered the broadest psychosocial benefits. Both types of supervision enhanced identified and intrinsic (i.e. self-determined) regulation. Positive correlations between resistance training volume, self-efficacy, and perceived health, together with increases in identified and intrinsic regulation, suggest supervision may promote self-determined exercise behaviour. Such behaviour supports long-term adherence and psychological well-being, whereas inactivity is linked to greater perceived work demands and lower self-efficacy, undermining motivation.
INTRODUCTION: Asymmetries in lower-limb biomechanical measures are typically oriented towards clinical populations. However, there is emerging relevance for athletes given possible links to injury risk and performance. Traditionally, laboratory-based assessments have quantified asymmetry, however, wearable inertial sensors may overcome logistical limitations and enable scalable, longitudinal tracking in ecologically valid settings. The aim of this systematic review was to evaluate the utilisation and suitability of inertial sensors, different running protocols, data processing methods and asymmetry calculations in asymmetry-based running assessments in healthy active adults. METHODS: Following PRISMA-Scoping Reviews, seven databases were searched with Boolean terms for inertial sensors, asymmetry, and athletic movement. Study and participant characteristics, sensor specifications, running protocols, processing methods, and asymmetry metrics were extracted. RESULTS: From 8,778 identified records (4,349 after de-duplication), 40 studies met inclusion criteria. Samples averaged 24±14 participants, with cohorts mainly elite (n=13) or recreational athletes (n=12). 22 studies addressed validity/reliability, however few used criterion-standard comparators. 30 described asymmetry measures in specific populations, and 13 sufficiently justified sensor suitability. Protocols were heterogeneous with 36 unique sensor implementation methods, and environments were predominantly treadmill based (n=29). Accelerometers were most common (n=20), followed by combination inertial sensors (n=14); and sampling frequencies spanned 30–2000 Hz. Most studies used one or two sensors, typically midline or bilateral lower-limb placements. Terminology for limbs and metrics lacked consistency. Asymmetry was commonly computed using Zifchock’s symmetry index (n=14), alongside ratio/difference, waveform-based, or symmetry angle methods. CONCLUSION: The evidence of heterogeneous protocols, inconsistent terminology/indices, variable sampling and placement positions, and inconsistent validation techniques suggest that current inertial sensor approaches do not appear to be sufficiently accurate or reliable for individual asymmetry assessment. Standardised definitions, validated data processing practices (including reliability and criterion-standard comparisons), more comprehensive datasets are required before translating asymmetry magnitudes into individual performance or injury decisions.
