In the episode ‘Run Before You Can Walk’, Jenny and Frank discuss the physical activity tests that they undertook under the guidance of the HRI team when they visited the La Trobe University Flora Hill campus in September this year. Brett, Blake and Dan were able to provide Frank and Jenny with an overall assessment of their health and function after their body composition was examined, aerobic and anaerobic fitness measured and their muscular strength, endurance and power determined.

Using state of the art equipment within the La Trobe Rural Health School Exercise Physiology laboratory, Frank and Jenny undertook a Dual Energy X-Ray Absorptiometry (DEXA) scan, blood glucose test, isokinetic dynamometry, Wingate Anaerobic Test and Maximal Aerobic Test (V̇O₂ max). See below footage of Frank performing a Maximal Aerobic Test and listen to the podcast episode ‘Run Before You Can Walk’ in full on Spotify and Apple.

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Dr Blake Collins, the HRI Research Officer, had cause for celebration earlier this month graduating with a PhD in Exercise Science from Charles Sturt University. Blake’s research focus is on cardio-metabolic health among shift workers and the prognostic effect of exercise which perfectly aligns with the HRI Active Rural Individuals stream and the HRI research aims of optimising function and performance for all individuals and addressing the global challenges of inactivity and chronic disease. 

Blake joined the HRI in 2020 and quickly embedded himself within multiple HRI projects. In particular, Blake’s background lends itself to our Active Rural Individual projects investigating chronic disease and cardiac rehabilitation in rural adults. Blake has demonstrated a strong work ethic and broad knowledge base and has therefore, not surprisingly, become an invaluable member of the HRI team. Congratulations Blake!

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Brett Gordon researches how to prescribe safe, effective exercise for people with underlying health conditions, like diabetes and pre-diabetes, obesity and cardiac conditions. He wants to develop ways to help people manage their conditions through exercise, safely and effectively.

This is a research story all about movement, both metaphorically and literally. For a start, Brett moved a lot when he was young. His father was a bank manager in rural towns, and moved every few years. Brett reckons he had lived in ten small towns before he was eighteen.

On the move again

Brett’s research journey really started at the Austin Hospital building exercise prescriptions for people with cardiac disease. Cardiac disease is one of the major causes of mortality and morbidity in the world today yet only 20-30% of people who have a cardiac event attend rehab sessions. At the time, the beneficial effects of exercise-based cardiac rehabilitation were developing but the implementation was not consistent. He decided to research how to improve it, so people can get maximum benefit from their exercise, and reduce their risk of having another cardio-vascular event.

He went on to study how people with chronic fatigue syndrome and diabetes can best manage their condition with exercise, and found that resistance training was a safe method that actually reduced their fatigue and improved wellbeing.

La Trobe Bendigo teaching & research success

Meanwhile, Brett was ‘on the move’ in other ways. He was keen to return to the regions so took the opportunity to work with La Trobe Bendigo. Brett is proud of his department’s teaching success and how it interacts with La Trobe Rural Health School research.

Demographics show that people who live in regions are at higher risk of developing heart diseases and diabetes. It is vital to provide expert evidence-based exercise prescriptions for people living with chronic conditions in the regions. This will reduce heavier health problems like the cardiac consequences of diabetes.

With Bendigo’s exercise physiology teaching program, Brett feels La Trobe is building an expert workforce to help take the department’s research into the community and improve the health and well-being of regional people.

“Every year we have 20 to 30 students graduate as exercise physiologists from Bendigo campus and 80% of them work in the regions. That’s a huge contribution, every year, to regional health and well-being.”

Holsworth Research initiative aims

Brett is using the Holsworth Research Initiative funding to further his mission:

“We know exercise is a great help in managing cardiac and metabolic conditions but it is so hard to keep going. We want to make sure  that we can prescribe exercise so that people can exercise in safe and effective ways.”

We look forward to bringing you more updates on Brett’s research. Stay tuned to this space.

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She is working with Dr Jayden Hunter on a study of the impact of the COVID-19 lockdown on physical activity and workplace wellbeing. In particular she wants to explore people’s perceptions of barriers to exercise. As she explains:

We know that physical activity has a relationship with work productivity, and we want to look at how this relationship is effected by the COVID-19 lockdown.

Rebecca had published a prior study on the perceived impact of the COVID-19 lockdown on physical activity in New Zealand adults.

Her research is based on the New Zealand experience. New Zealand’s lockdown period was less stressful than the Australian experience, as it lasted 50 days in total. A contributing factor to the ability to maintain engagement in exercise in New Zealand could have been the government messaging – people were actively encouraged to engage in some exercise but stay within a certain distance of their home

Some other key findings included:

• The majority of respondents took part in regular physical activity prior to the lockdown period. Only half of those were able to maintain their current level of activity during the lockdown period.
• The main barrier to exercise was that their exercise facilities (e.g., gym) were closed, followed by being afraid to go out, and being unable to exercise in a social group or with their friends.
• Previous studies have also reported that a lack of time, cost, and not knowing what to do, are common barriers that prevent people from engaging in physical activity.

Rebecca is keen to emphasise a really important result:

Those people who continued to maintain their usual level of physical activity throughout the lockdown recognized the importance of exercise on their well-being, especially mental health.

A similar association was seen in adults in Australia, who reported that a decrease in physical activity levels was associated with an increase in depression, anxiety and stress.

The collaboration with Dr Hunter is an extension of that work. Their study specifically targeted white collar workers, who work at a desk and are sedentary for long periods of time.

The team are still analysing their results, but one of the key findings is that even though people who met the physical activity guidelines had a better work ability, job performance was lower. Rebecca found this reflected in her personal experience. She has two young children, so she found the lockdowns particularly challenging with the demands of work and child-care but actually found her activity went up as she needed to get out of the house for regular runs!

Rebecca is keen to research how the way we work and exercise changes in the post COVID-19 world.  As she says:

As exercise scientists who study the relationship between exercise, well-being and performance at work, our findings are applied in workplace wellbeing programs. If the way we are working is changing, these workplace wellbeing programs have to change as well.

Further questions remain as to whether there may be lingering anxiety in people wishing to take up exercise, especially those who fall within the vulnerable category for lifestyle disease.

Rebecca recommends that workplaces offer additional support for people with anxiety over returning to work, and people who stop exercising and do not resume after the lockdown period of the COVID-19.

Want to learn more?

Read:

The Effect of the COVID-19 Pandemic Movement Restrictions on Self-Reported Physical Activity and Health in New Zealand (2021)

Take 10 with Exercise Scientist, Rebecca Meiring (the University of Auckland)

Listen:

Ready, Steady Learn interview with Rebecca Meiring (2020)

This research supports the HRI aims to:

• optimise function and performance for all individuals, and
• address the global challenges of inactivity and chronic disease

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Daniel Wundersitz has always loved sport. Growing up he played football, basketball, netball, cricket and tennis, but when he left school he studied horticulture. His dad was an avid gardener and Daniel wanted to follow in his footsteps. It was only later that he realised that his real passion was sport.

Sports Scientist

Dan returned to study as a mature-age student to become a sports scientist. He discovered his research interest lay in bio-mechanics, learning how muscles, bones, tendons, and ligaments work together to create human movement.

Daniel worked with the Eastern Ranges football club as a fitness conditioning coach and researched the physical demands of team sports and looked at how wearable technology (like GPS and accelerometers) help athletes perform at their peak by monitoring physical demands during team sports. He dreamed of being a sports scientists with the AFL prescribing training to ensure the footballers were at peak fitness.

The Call to Research

But the call to research was too strong. Up north, medical staff at Bendigo Health Cardiology had noticed a worrying trend– a lot of cyclists from the Bendigo community were turning up in the cardio clinics with arrythmias – abnormal heart patterns. The cyclists were all ‘weekend warriors’, that is they enjoyed endurance cycling during their leisure time.

Professor Michael Kingsley thought this was a great research project for the Holsworth Research Initiative. He knew of Dan’s work and persuaded him to join the team. As Dan says:

‘It was definitely the right decision. Exercise physiology research into the health of the cardiovascular system gives me a real chance to make an impact on people’s lives.’

The Mad Ride

Daniel found that heart rate abnormalities were surprisingly common in endurance cyclists but he needed some real world data. One of his La Trobe Bendigo colleagues was helping plan an endurance charity ride (the Mad Ride 2019), so Daniel persuaded the cyclists to volunteer for a pilot study.

The findings from the field confirmed the research – the cyclists had a higher rate of heart irregularities during and after the multi-day ride.

What happens next?

Daniel plans to study the intensity and duration of exercise on the heart so he can find the right balance between ‘too much’ and ‘not enough’ allowing us to exercise in a way that keeps us healthy.

He wants to find out if there is a volume or amount of endurance exercise that leads to large increases in arrythmias. This way people know not to pass this threshold, as then that exercise is no longer safe for us to do.

He also wants to find out if the heart irregularities progress further to the point where they become life threatening. Finally, he wants to generalise his findings from cycling to other endurance sports.

As Daniel says,

“I really want to keep exercise safe and healthy for all of us to do. “

This research falls under all three HRI research aims, to optimize function and performance for all individuals, address the global challenge of inactivity, and enable athletes to perform better and compete more successfully.

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Dr Rodrigo Rico Bini was always interested in cycling. When working in Rio de Janeiro he cycled to work and didn’t even own a car, because driving in Rio’s traffic jammed streets was ‘crazy’. Rio is a big city – the population of Melbourne in one third of the space – and challenging to get around.

He worked as a Lecturer in the Bachelor of Exercise Science at the Brazilian Army School of Physical Education which was in a beautiful location between the Sugarloaf mountain and the sea, but there were only two roads to the school and they were packed daily. Bicycles were in use everywhere – one day he saw a delivery man on a cargo bike ferrying a mattress alongside the Sugarloaf Mountain!

His interest served him well in his academic career when his knowledge of anatomy and the biomechanics of muscles led to his movement analysis lecturer asking him to help a Masters student who needed a muscle expert to help in a cycling project. So, as Rodrigo says, he was ‘hijacked into cycling’ although he is also interested in running and gait biomechanics. This cycling research led him to his academic journey, first a Masters and then a PhD.

The benefits of Bendigo

However he and his wife were also seeking a quieter city with better quality of life – and definitely less traffic. When Prof Michael Kingsley and his team were looking for someone to help them with their research with Bendigo Health into cycling in Bendigo, Rodrigo jumped at the chance.

He and his family are now happily living in Bendigo, having just bought their house, and revelling in the convenience of life in a rural city. However health, well-being and exercise continue to be at the forefront of Rodrigo’s mind. As he says:

Research shows that only 5% of regional and rural people ride a bike regularly. This figure needs to change!

A more active community

This is at the forefront of his work with the Holsworth Research Initiative Human Performance theme. He wants to advocate for cycling – not more ‘weekend warriors’, but a more active form of commuting and lifestyle for all the community.

While big cities like Rio, Melbourne and Auckland can be challenging to ride in, Rodrigo thinks that Bendigo has great potential as a place where a higher number of people use a bike as a commuter vehicle.  The city’s compact size is a great incentive. It is really only ever 10 or 15 kilometres to anywhere in town.

He acknowledges that the winter’s chill and summer heat can be a daunting, but suggests the increasing take-up of e-bikes can help commuters deal with climate extremes. Another issue is perception of cyclist safety on the road – but again smaller cities are more welcoming to cyclists. He advocates working with policy makers around improving safety and perception of safety on the road.

What can we do?

Rodrigo wants the researchers within the Holsworth Research Initiative to engage with the community and bring people together – on campus, in exercise and exercise advocacy, and within the research program. He wants to research how can we improve health and well-being, prevent lower limb pain and injury and get more cyclists on the roads.

For further news on Rodrigo’s research and advocacy for cycling and exercise, watch this space!

This research falls under all three HRI research aims:

to optimise function and performance for all individuals, address the global challenge of inactivity, and enable athletes to perform better and compete more successfully.

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Dr Gordon has received funding from the Holsworth Research Initiative in the La Trobe Rural Health School to investigate if dietary supplements containing caffeine and capsaicin (the active component of chili peppers) can help maintain weight loss. As he says:

It is important to identify potential treatments for obesity as we know that regional and rural areas have greater rates of obesity and more commonly poorer health outcomes. At the moment it is particularly important to manage conditions like obesity as that has been identified as a condition more commonly associated with worse outcomes if COVID-19 is contracted.

Obesity: a global challenge

This research addresses one of the key aims of the Holsworth Research Initiative:

to address the global challenges of inactivity and chronic disease

Adult weight gain and obesity are worldwide problems. Among developed countries, Australia has one of the highest proportions of overweight and obese people. Weight gain leads to an increased risk of cardiovascular disease, hypertension, type 2 diabetes, obesity-related cancers and osteoarthritis.

Can Caffeine and Capsaicin save the day?

Caffeine and capsaicin are two cost-effective and safe, natural supplements that show promise in assisting people to manage and maintain weight loss.

Further research is needed to discover the best ways that they can be used (alongside diet and exercise) to manage weight loss, maintain weight loss and ultimately reduce the risks of chronic disease.

Weight loss is hard and expensive

When people lose weight by calorie restriction and exercise the weight is almost always regained over time because the body is programmed to resist weight loss. Further, prescription weight loss drugs are expensive and can have negative side effects, so many people are turning to alternatives.

The research team hopes that this study will help understand how the body balances energy consumption and expenditure and identify the ways in which caffeine and capsaicin increase energy consumption. This will pave the way for more research in the future.

We look forward to providing regular updates on this project.

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Bendigo Health aims to improve the health of the community it serves with a preventive health program that encourages people with or at risk of chronic disease to exercise more.

However if they just encourage exercise they find that 50% of participants lapse back into inactivity when the intervention is over.

As Steve says:

People living in rural areas are less likely to do enough exercise for health benefits, placing them at risk of preventable chronic diseases. 

Clearly, the team needed to engage not only the muscles but also the mind. They asked Steve to look at ways to encourage a positive mindset to exercise.

Healthy 4 U

In 2018 Bendigo Health ran the Healthy 4 U trial, where people visiting their hospital clinics signed up with preventative health specialists to improve their exercise routines.

Rather than “prescribing” exercise plans for patients to follow, the team used behaviour change techniques to allow the participants to develop a positive attitude towards exercise, with eight face-to-face meetings with specialists over six months.

“Why do you want to change and what do you want to do?”

The Health 4 U trial was so successful that in 2019 Bendigo Health embarked on Healthy 4U-2, to find out if the intervention could benefit a wider range of participants at a lower cost. They:

• recruited doctors to spread the message to their patients rather than relying on patients to make the initial contact themselves.
• used a low-cost, low-contact method by reducing the number of sessions to five, delivered over the phone, and
• directed participants towards community services like walking groups and strength training groups rather than setting up additional resources in the hospital.

Healthy 4 U 2

The good news is that the intervention was just as successful – participants increased their amount of daily activity, lost weight, and reported improved quality of life (when compared to a control group).

This shows that low-contact and low-cost interventions can produce lasting change – and the use of phone support is particularly important in the COVID-19 world.

We look forward to hearing more success stories with this initiative!

Stephen Barrett is a PhD candidate in the La Trobe Rural Health School, investigating the role of preventive health interventions in non-admitted secondary hospital care. Stephen is undertaking his PhD part-time, and works full time in the Health Promotion team at Bendigo Health. Stephen completed his physiotherapy undergrad at University College Dublin, and completed a Masters in Public Health at Melbourne University. His favorite sport is golf and you can follow him on Twitter: @barrettstephen1

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Dr Rodrigo Bini has received funding from the Holsworth Research Initiative in the La Trobe Rural Health School to investigate how to improve athletes’ performance as they move between the cycling and running stages of a triathlon – this is the stage where athletes cycle into the transition zone, change from their bike shoes to their running shoes, and then commence their run.

The cycle-to-run transition

How badly is athletic performance affected in this time? According to the Peak Performance website, French researchers found that 70% of national-level triathletes remained up to 10% below their average running velocity over the first kilometre of the run phase. This means an athlete who can maintain performance during this time will gain a crucial edge over their competitors!

Evidence not anecdote

There is a wealth of advice available for athletes and coaches on how to move between these stages, but much of this advice is based on anecdotal evidence and personal experience. It is unclear whether these performance issues are due to  muscle fatigue, oxygen or glycogen dips, blood redistribution or ‘neural catch up’.  There is a lack of evidence-based research in this area.

As Dr Bini explains:

This review will help triathletes and coaches base their strategies on research-based evidence rather than anecdotal evidence and personal experience.

Enabling sports people to perform better

As a first step, Dr Bini will review the existing studies on pedaling cadence, intensity, drafting, shoe-cleat position, training, and bike fitting, and use this body of research to make recommendations for triathletes and their coaches.

This research is a result of the Holsworth Research Institute aim:

Optimising function and performance for individuals and enabling sports people to perform better and compete more successfully.

We look forward to providing updates on this research in a future post.

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Dr Daniel Wundersitz has received funding from the Holsworth Research Initiative in the La Trobe Rural Health School to identify changes in blood clotting before, during and after endurance exercise. The project is part of an international research collaboration with 19 researchers from five different institutions. They seek to understand the impact of endurance exercise on the heart.

Heart health and exercise

Dr Wundersitz is working with Professor Lavie from the John Ochsner Heart and Vascular Institute (Ochsner Clinical School-the University of Queensland) and a team from Bendigo Health. They are looking at how endurance exercise causes alterations in the heart’s electrical activity (known as cardiac arrhythmias). Arrhythmias increase the risk of heart attack (and in a small percentage of cases, sudden death) in healthy and active adults.

Call for study participants

The researchers are looking for study participants. Does this sound like you? You need to be a recreationally active adult living in Bendigo. You will be tested over a three-week period before, during and after endurance cycling on an exercise bicycle at the La Trobe Flora Hill campus physiology clinic.

Safeguarding the health of cyclists 

Increasing numbers of people around the world are performing endurance exercise, so this research has real impact. The goals are to:

• provide evidence for the best time to screen recreational and professional athletes for health issues.
• reduce the financial and health burdens for people with exercise-induced heart complaints, and
• promote physical activity guidelines to enable people to safely perform strenuous endurance exercise.

We look forward to providing more updates on this research in the future.

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