The 15th National Rural and Remote Allied Health Conference was held in Mildura from the 21st to the 23rd of October on the banks of the iconic Murray River. 250 delegates attended the event including many staff and students from the La Trobe Rural Health School. Our very own Associate Professor Byron Perrin, Associate Professor Brett Gordon, Dr Daniel Wundersitz and Dr Blake Collins attended the event and presented their latest research findings as did Adjunct Research Fellow Dr Stephen Barrett and Senior Lecturer in Occupational Therapy and current PhD Candidate, Kylie Carra.

In what capped off a busy conference period for HRI affiliated staff and students, the 2024 Bendigo Health Research Showcase was held on Friday October 25th providing an opportunity to hear passionate clinicians present on how they are improving care and changing lives in our regional communities. A keynote presentation was given by Linda Brown, Director of Translational Research, Clinical Trials, Strategic Projects and Response at Safer Care Victoria, as well as interactive panel discussions and presentations showcasing the broad range of research currently being undertaken at Bendigo Health. Dr Daniel Wundersitz, Dr Blake Collins and Adjunct Research Fellow Dr Stephen Barrett represented the Holsworth Research Initiative in their presentations that described current findings in cycling and heart health, cardiac rehabilitation and behaviour change and physical activity, respectively.

With their return to the Bendigo campus, Holsworth Research Initiative staff and students are energised and inspired by the invaluable insights and connections gained over these recent months. The presentations and discussions have not only strengthened their commitment to advancing allied health research in rural and remote communities but also underscored the importance of collaboration across regional sectors. Now, with renewed focus, HRI staff are set to integrate the feedback, trends, and ideas encountered at these recent conferences into their ongoing projects. They look forward to sharing even more impactful research outcomes in the months ahead.

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Oral Presentations

Blake Collins | Investigating the role of motivational interviewing and cognitive behavioural therapy in telehealth delivered cardiac rehabilitation programs

Byron Perrin and Dimitri Diacogiorgis | A 3 Year retrospective audit of characteristics of the assessment, diagnosis and management of people with acute charcot neuroarthropathy attending a regional health service

Daniel Wundersitz | Does cardiac arrhythmia in recreational cyclists increase after high volume exercise?

Steve Barrett | Complexities and context in the scale-up of a physical activity coaching intervention: A process evaluation

Brett Gordon | Implementing exercise-based cardiac rehabilitation in regional Australia. Does it align with recommendations?

Poster Presentations

Jane McCaig, Brett Gordon, Carolyn Taylor | Exercise interventions on the acute medical ward: a systematic review and meta-analysis

Congratulations to Human Performance Co-Lead Dr Daniel Wundersitz and Holsworth Research Initiative Research Assistant Dr Blake Collins who achieved second place in the best presentation at the conference and the best early career researcher presentation, respectively.

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When we exercise too much

Nearly 20% of the population meet or exceed physical activity guidelines and the World Health Organisation suggests that we should be aiming to do more exercise for additional health benefit. While exercise is good for us, and great for the heart, sometimes too much exercise may lead to heart problems. As a result, we must understand what the impact of endurance exercise is on the heart.

Systematic review and meta-analysis results

Holsworth Research Initiative researcher, Dr Dan Wundersitz and his team of international and La Trobe Rural Health School researchers firstly investigated the effect of endurance cycling on the heart.

Dan and his team diligently sifted through the research and found that endurance cyclists have larger hearts relative to body size than non-athletes, and even when compared to participants in other active sports such as kayakers, canoeists, runners, swimmers, body builders and wrestlers this difference remained.

In addition, they found that endurance cyclists have an increased incidence of cardiac problems compared to non-athletes, but no more than other sport athletes.

MADRIDE results

When the team worked with participants in the MADRIDE, they found that recreational cyclists had a ten-fold increase in the rate of heart arrhythmias after this 21-day endurance cycling event.

Next they wanted to understand how endurance cycling influenced the heart and if this had any lasting effect (over multiple days).

Endurance exercise and abnormal arrhythmias

Recently, they completed a study assessing how heart arrhythmias change in response to a bout of high-volume exercise and to identify factors associated with abnormal arrhythmias.

This was the first study to monitor participants for nine days straight. Over this time they found 68% of participants displayed abnormal arrhythmias.

In addition, they found the proportion of participants with abnormal ventricular arrhythmias was higher on the exercise day (study under review). Now they want to understand how endurance exercise influences heart health by screening ~350 recreationally active adults. Once complete, they will look for ways to improve the hearts ability to handle the stress of endurance exercise so that people can perform physical activity safer.

You can read a promotional snippet about this work here Endurance exercise and heart health, News, La Trobe University

A call for volunteers

Dan and his team are recruiting volunteers for their next study. Are you a recreationally active adult who would like to have a FREE heart health assessment and VO2peak test as part of our next study? You will be asked to visit us once at the La Trobe University Flora Hill campus physiology clinic located in Bendigo Victoria. 

If you are interested in participating, please read this flyer to confirm your eligibility and to find out to get in touch with us.

Want to read more?

Endurance exercise and abnormal arrhythmias – Bendigo Advertiser and ABC News

Could too much cycling cause heart problems? A world-first study in Bendigo aims to find out – ABC News

Wundersitz, Gordon, Lavie, et al., Impact of endurance exercise on the heart of cyclists: A systematic review and meta-analysis, Progress in Cardiovascular Diseases (2020)

Wundersitz, Williamson, Nadurata, et al., The impact of a 21-day ultra-endurance ride on the heart in young, adult and older adult recreational cyclists, International Journal of Cardiology (2019)

Wundersitz, Nadurata, Lavie, et al., Response: Arrhythmias 72 hour post strenuous exercise at a time when cardiac troponin was not elevated, International Journal of Cardiology (2019)

Collins, Kingsley, Gordon, et al., Coagulation activity and thrombotic risk following high-volume endurance exercise in recreationally active cyclists. Journal of Applied Physiology (2024)

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Mr Price recently moved from Western Australia where he completed his Exercise Science Undergraduate and Honours degrees while working with both men’s and women’s teams in the Western Australian Football League (WAFL). Continuing on from Jake Jennings, who is set to submit his PhD thesis in the coming weeks, Lachlan will spend the next three years embedded in the La Trobe University Bendigo Pioneers team conducting research and improving player performance.

“I’m excited to work within the AFL Victoria system and the Coates Talent League. Some of Australia’s best AFL talent is being produced here along with some of the best coaches and medical teams”.

“I’m interested in learning more around how our physical and technical training approaches can influence performance, but also how they can improve development”.

PhD supervisor, Associate Brett Gordon, said La Trobe University in Bendigo is looking forward to strengthening its relationship with the Pioneers throughout the course of this PhD.

“We observed such great benefits for both organisations with the previous industry funded PhD, which saw Jake Jennings embedded with the Bendigo Pioneers for three years. We can only anticipate similar outcomes with Lachlan as we look to extend the work previously started”.

The Coates Talent League is the country’s premiere under-18 Australian rules football competition.

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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.

The post Holsworth Research Initiative Stream Leads feature in Spirit Levels Podcast appeared first on Holsworth Research Initiative.

Aims and Objectives

The first objective of Hugo’s PhD thesis is to comprehensively review the existing literature on methods and instruments used to identify barriers and facilitators to exercise-based rehabilitation in people with musculoskeletal conditions. By examining the current landscape of research, Hugo hopes to gain insights into the most effective ways to identify these crucial factors.

The second aim of Hugo’s research is to identify the barriers and facilitators that impact individual adherence to exercise-based rehabilitation programs. By analyzing the literature, Hugo will shed light on the multitude of factors that can either hinder or enhance an individual’s ability to commit to a rehabilitation regimen.

To gather first-hand data, Hugo plans to conduct a survey informed by the Theoretical Domain Framework. This survey will investigate the specific barriers and facilitators that individuals with knee or hip osteoarthritis face in adhering to exercise-based rehabilitation. By including participants from both metropolitan and regional/rural areas, Hugo aims to capture a diverse range of experiences and challenges.

With the insights gained from the survey, Hugo will then conduct a feasibility study. This study will explore the practicality of implementing a telehealth intervention based on motivational interviewing and cognitive behavioral therapy (MI-CBT) strategies. By integrating these evidence-based techniques into a telehealth framework, he hopes to minimize the identified barriers and enhance the facilitators, thereby improving adherence to exercise-based rehabilitation.

Are you an individual living with hip or knee osteoarthritis?

Your input and experiences are invaluable to Hugo’s research! We invite you to participate in a survey designed to identify barriers and facilitators to exercise-based rehabilitation in people with musculoskeletal conditions.

By completing this survey, you will not only contribute to scientific knowledge but also potentially pave the way for future improvements in the management of hip/knee osteoarthritis. Your insights and experiences could directly impact the development of strategies to overcome barriers and enhance facilitators, ultimately improving adherence to exercise-based rehabilitation.

To participate in the survey, please click on the following link: https://redcap.link/BarriersFacilitatorsSM

Your participation is completely voluntary, and all responses will be kept confidential. The survey should take approximately 20 minutes to complete.

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# How does sport participation contribute to total physical activity, health, function and wellbeing in regional Victoria?

# The effect of endurance exercise on cardiovascular function and movement efficiency in community level cycling

# Efficacy of e-Bike use for improving health and function

Efficacy of e-Bike use for improving health and function

The benefits of active travel, and cycling, on health have been well researched with a recent systematic review and meta-analysis demonstrating the lowest risk of CVD mortality with 130 minutes per week of cycling at an average, self-selected pace (Zhao et al., 2021). In terms of e-biking, studies have reported that e-biking enables people to achieve moderate levels of physical activity (Sperlich et al., 2012) in addition to reducing travel time when compared to push bikes (Fishman & Cherry, 2016) however, the impacts on health are less clear.

Led by Dr Rodrigo Bini, the E-biking for Human Health project incorporates three individual studies that aim to assess the efficacy of e-bike use for improving health and function in sedentary people. The project consists of an observational study identifying if current health and functional status impacts e-bike uptake in sedentary people as well as an intervention study that will assess changes in physical fitness following a short, unsupervised e-bike aerobic training program. A final randomised control study will build on these research outcomes by comparing the differences between e-bikes, walking and education in health and fitness outcomes of sedentary people.

Progress

Three e-bikes were purchased by the Holsworth Research Initiative for the project in mid-2022. This enabled pilot trials to commence followed by participant recruitment and subsequent data collection. Participants were required to attend La Trobe University Bendigo campus for physical fitness and health assessments as well as a series of familiarity trials before being provided with an e-bike for use for a period of four weeks. Data collection is almost complete with the remaining three participants currently completing their four-week block of unsupervised aerobic training. Following this, analysis of the data will take place and a draft manuscript will be prepared. The expected project completion date for both study one and two is January 2024. The final study in the E-biking for Human Health project is contingent on external funding with a projected start date of January 2024.

We are so pleased to be contributing to the literature on e-biking for human health and can’t wait to report on the findings of these studies in 2024.

Zhao, Y., Hu, F., Feng, Y., Yang, X., Li, Y., Guo, C., … & Hu, D. (2021). Association of Cycling with Risk of All-Cause and Cardiovascular Disease Mortality: A Systematic Review and Dose–Response Meta-analysis of Prospective Cohort Studies. Sports Medicine, 51, 1439-1448.

Fishman, E., and C. Cherry. 2016. E-bikes in the Mainstream: Reviewing a Decade of Research. Transport Reviews 36: 72–91.

Sperlich, B., C. Zinner, K. Hebert-Losier, D.P. Born, and H.C. Holmberg. 2012. Biomechanical, Cardiorespiratory, Metabolic and Perceived Responses to Electrically Assisted Cycling. European Journal of Applied Physiology 112: 4015–4025.

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Investigating the influence of caseload midwifery on physiological responsiveness to stress in mothers and midwives

Supervisors

Professor Michael Kingsley and Dr. Brad Wright              

Michael completed an Undergraduate degree in Psychological Sciences at La Trobe University, including an Honours year supervised by Dr Brad Wright in 2021 investigating how chronic workplace stress influences cognition. During his studies, Michael worked as a Behaviour Support Practitioner and Data Analyst at My Right 2 Voice, a NDIS provider of specialist disability services. It was here that Michael says he was inspired to undertake a PhD after experiencing how evidence-based practice, informed by quantitative knowledge, can make meaningful changes to the lives of those most vulnerable.

The physiological response to stress in mothers and midwives

A wealth of research links chronic and occupational stress with poor health outcomes. However, less is known about the relationship between physiological responsiveness to stress and chronic stress. This is particularly pertinent for vulnerable groups such as pregnant mothers and midwives who are ‘at-risk’ of experiencing negative health and behavioural outcomes related to chronic stress.

Looking towards the confirmation of candidature

Michael began his PhD in mid-2022 and has plans to meet the first milestone of the doctorate, confirmation of candidature, in May 2023. Over the next three months, Michael hopes to complete a draft manuscript of the first paper from his thesis as well as completing ethics applications for studies 2 and 3. By the end of 2023, Michael hopes to have completed data collection for all studies from his thesis and to have published his first study in a peer-reviewed journal.

Reflecting on his studies so far

Michael reports that the first year of his PhD has taught him about the research process, including research formulation, ethics applications, data collection and analysis techniques. He also credits his doctorate with improving his ability to critically appraise research and better formulate and articulate his views.

When thinking about his future career, Michael hopes that his studies equip him with the ability to produce high quality research so that he can continue to inform how health and well-being can be positively impacted for the most vulnerable groups within the community.

From the Bendigo Braves to winter discipline Olympic athletes, if you missed out last blog mini-series speaking with past research students you can find it here.

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Philip Lyristakis

Manipulating the resistance training prescription to optimally develop muscle strength

Supervisors

Dr. Stephen Cousins, Dr. Daniel Wundersitz, Dr. Emma Zadow and Associate Professor Brett Gordon

Prior to committing to the PhD program at La Trobe University, Philip completed Undergraduate and Masters degrees in Sport and Exercise Science while also working in the health and fitness industry. In addition to this, Philip also worked with both state and national level athletes as a strength and conditioning coach. Commencing in January 2020, Philip and his supervisory team which includes Holsworth Research Initiative Stream Leads Associate Brett Gordon and Dr Daniel Wundersitz developed a framework for a PhD that capitalises on Philips background in strength and conditioning.

A dose-response function to muscle strength

There is a significant body of research that has investigated how different weight training programs and their training variables influence muscle strength. However, the available literature is yet to demonstrate the relationship between a training variable (i.e. sets, and repetitions) and muscle strength adaptations. One of the aims of Philips PhD is to identify a dose-response function to muscle strength, which is essentially the amount of work performed in a training program and improvements in strength as a result of that work. Philip has so far published one manuscript from his PhD titled The influence of considering individual resistance training variables as a whole on muscle strength: A systematic review and meta-analysis protocol.

Looking towards the pre-submission presentation

Philip is on the home stretch of his PhD journey having completed his confirmation of candidature in 2021 and his mid-candidature presentation in 2022. The final milestone before submission is a pre-submission presentation which Philip is hoping to complete in December of this year. To achieve that milestone, Philip reports that he needs to analyse data for the systematic review and meta-analysis and write manuscripts for the remaining studies within his thesis. Philip hopes to have two manuscripts accepted for publication by December of this year with the final manuscript accepted or submitted for publication and awaiting feedback.

Reflecting on his studies so far

Reflecting on his studies, Philip reports significant improvements in his time-management, project management, organisation, and communication skills over the last three years. These are all qualities that will serve Philip well in his ambition to work domestically at a Sport Institute or internationally as a Strength and Conditioning Coach. We look forward to Philips pre-submission presentation and reporting his research outcomes from published papers in the near future.

Join us next month as we hear from Michael Matyevich, a HDR student supervised by HRI Director Professor Michael Kingsley.

From the Bendigo Braves to winter discipline Olympic athletes, if you missed out last blog mini-series speaking with past research students you can find it here.

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Hugo Eduardo De Amorim

Barriers and facilitators for exercise-based rehabilitation in the management of knee/hip osteoarthritis

Supervisors

Dr. Marcos de Noronha, Dr Jayden Hunter, Prof. Michael Kingsley

Hugo came to La Trobe University, Bendigo in 2021 after being successful in his application for a PhD scholarship with the Holsworth Research Initiative. Shortly after arriving, Hugo and his supervisors worked together to develop a framework for a suite of investigations that would both align with Hugo’s background in physiotherapy and meet the key aims of the Holsworth Research Initiative in exercise, physical activity, and rehabilitation. What evolved from those discussions was a thesis that would investigate barriers and facilitators for exercise-based rehabilitation in the management of knee/hip osteoarthritis.

The first-line treatment for osteoarthritis

Globally, the prevalence of osteoarthritis is rising, and increasing with the ageing of the population. There is no question that exercise-based rehabilitation has an important place in knee and hip osteoarthritis treatment, however the adherence to exercise programs is low. This is despite the clear recommendation in most clinical guidelines that exercise-based rehabilitation be the first-line treatment for osteoarthritis to assist with pain, physical function, symptoms of anxiety and depression, social activities and quality of life. Hugo and his supervisors aim to understand why people do not take-up or adhere to exercise-based rehabilitation and how it can be modified to improve sustained participation. An important component to Hugo’s research is the identification of barriers and facilitators to exercise-based rehabilitation in the management of knee/hip osteoarthritis for people from both metropolitan and regional/rural areas.

Looking towards the mid-candidature review

Hugo was successful in his confirmation of candidature at the end of 2022 which is a significant milestone in the first year of a Doctoral Candidature. A presentation is made by the Higher Degree by Research Student to an Academic Panel who must decide if the outlined project will result in a high-quality thesis and that it will be completed in the required time. Hugo is now working towards his mid-candidature review in May 2023 and hopes to present the findings from his systematic review at an international conference in 2023. In the meantime, Hugo is forging ahead with his research creating a survey about barriers and facilitators for people with knee/hip osteoarthritis to exercise-based rehabilitation. Following this, Hugo and his supervisors will develop an intervention to improve sustained participation in exercise programs with the aim to help clinicians to implement clinical guidelines and patients to adhere to treatment.

Reflecting on his studies so far

Reflecting on his studies, Hugo expects that the time management skills, patience, and resilience that has been required so far will serve him well in his future career. We have no doubt that Hugo will be successful and look forward to reporting his research outcomes.

Join us next month as we hear from Philip Lyristakis, a HDR student supervised by Active Rural Individuals Stream Lead, Associate Professor Brett Gordon.

From the Bendigo Braves to winter discipline Olympic athletes, if you missed out last blog mini series speaking with past research students you can find it here.

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