Journal Articles

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    Acceptance and commitment therapy for mild traumatic brain injury (ACTion-mTBI): a quasiexperimental feasibility study
    (BMJ Publishing Group Ltd, 2025-02-16) Faulkner J; Prouty D; Devlin L; Appleton D; Roche M; Below K; Moffat J; Snell D; Williams MN; Barker-Collo S; Theadom A
    OBJECTIVES: This study aimed to determine the feasibility of recruiting, implementing and delivering an acceptance and commitment therapy (ACT) intervention for mild traumatic brain injury (mTBI) (ACTion-mTBI) within a multidisciplinary outpatient mTBI rehabilitation services. The study also aimed to conduct a preliminary investigation of group differences between ACTion-mTBI and an equivalent cognitive behavioural therapy (CBT) intervention on various outcome measures and psychological treatment targets. DESIGN: A two-arm quasiexperimental feasibility study. SETTING: Five mTBI rehabilitation clinics throughout New Zealand. INTERVENTION: Psychologists working in mTBI rehabilitation clinics throughout New Zealand were trained to deliver ACTion-mTBI or CBT. Eligible participants were assigned to either of these interventions based on the psychologist available at the clinic they were referred to. ACTion-mTBI is a five sessions intervention that incorporates all six components of the ACT model. The CBT intervention is an equivalent intervention and incorporating all four components of the CBT model. Both interventions are adapted for an mTBI context. PRIMARY OUTCOME MEASURES: The primary outcomes were related to the feasibility of ACTion-mTBI. This included recruitment, retention and treatment adherence of participants, study procedure and fidelity of treatment delivery. SECONDARY OUTCOME MEASURES: To explore group differences between ACTion-mTBI and CBT on functional disability, postconcussion symptoms, mental health, valued living and psychological flexibility. RESULTS: The intervention proved feasible to implement with community-based mTBI rehabilitation services. Attrition rates were comparable between the two psychological interventions and fidelity to the treatments was high. At post-treatment, when covarying pretreatment scores, ACTion-mTBI had a significantly greater improvement in functional disability than CBT (moderate effect). ACTion-mTBI also had a significantly greater reduction in postconcussion symptoms, anxiety and stress. Promisingly, significant improvements in psychological flexibility was also found post-treatment. There were no group differences on depressive symptoms and valued living. CONCLUSION: We conclude that a full clinical trial of ACTion-mTBI for individuals with mTBI is feasible and warranted. TRIAL REGISTRATION NUMBER: ACTRN1262100059482.
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    Physical Activity, Mental Health and Wellbeing during the First COVID-19 Containment in New Zealand: A Cross-Sectional Study
    (MDPI (Basel, Switzerland), 2021-11) O'Brien WJ; Badenhorst CE; Draper N; Basu A; Elliot CA; Hamlin MJ; Batten J; Lambrick D; Faulkner J
    Strategies implemented worldwide to contain COVID-19 outbreaks varied in severity across different countries, and established a new normal for work and school life (i.e., from home) for many people, reducing opportunities for physical activity. Positive relationships of physical activity with both mental and physical health are well recognised, and therefore the aim was to ascertain how New Zealand’s lockdown restrictions impacted physical activity, mental health and wellbeing. Participants (n = 4007; mean ± SD: age 46.5 ± 14.7 years, 72% female, 80.7% New Zealand European) completed (10–26 April 2020) an online amalgamated survey (Qualtrics): International Physical Activity Questionnaire: Short Form; Depression, Anxiety and Stress Scale-9; World Health Organisation-Five Well-Being Index; Stages of Change Scale. Positive dose–response relationships between physical activity levels and wellbeing scores were demonstrated for estimates that were unadjusted (moderate activity OR 3.79, CI 2.88–4.92; high activity OR 8.04, CI 6.07–10.7) and adjusted (confounding variables: age, gender, socioeconomic status, time sitting and co-morbidities) (moderate activity 1.57, CI 1.11–2.52; high activity 2.85, CI 1.97–4.14). The study results support previous research demonstrating beneficial effects of regular physical activity on mental health and wellbeing. Governments may use these results to promote meeting physical activity guidelines in order to protect mental health and wellbeing during the ongoing COVID-19 restrictions and future pandemics.
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    Adiposity in preadolescent children: Associations with cardiorespiratory fitness
    (Public Library of Science, 2022-10-26) Castro N; Bates LC; Zieff G; Pagan Lassalle P; Faulkner J; Lark S; Hamlin M; Skidmore P; Signal TL; Williams MA; Higgins S; Stoner L
    Lifestyle factors contribute to childhood obesity risk, however it is unclear which lifestyle factors are most strongly associated with childhood obesity. The purpose of this cross-sectional study was to simultaneously investigate the associations among dietary patterns, activity behaviors, and physical fitness with adiposity (body fat %, fat mass, body mass index [BMI], and waist to hip ratio) in preadolescent children. Preadolescent children (N = 392, 50% female, age: 9.5 ± 1.1year, BMI: 17.9 ± 3.3 kg/m2) were recruited. Body fat (%) and fat mass (kg) were measured with bioelectrical impedance analysis. Cardiorespiratory fitness (VO2 max), muscular strength (hand-grip strength), activity, sleep, and dietary pattern was assessed. Multivariable analysis revealed that cardiorespiratory fitness associated most strongly with all four indicators of adiposity (body fat (%) (β = -0.2; p < .001), fat mass (β = -0.2; p < .001), BMI (β = -0.1; p < .001) and waist to hip ratio (β = -0.2; p < .001). Additionally, fruit and vegetable consumption patterns were associated with body fat percentage, but the association was negligible (β = 0.1; p = 0.015). Therefore, future interventions should aim to promote the use of cardiorespiratory fitness as a means of reducing the obesity epidemic in children.
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    Effects of Whey Protein on Skeletal Muscle Microvascular and Mitochondrial Plasticity Following 10-Weeks of Exercise Training in Men with Type-2 Diabetes
    (Canadian Science Publishing, 2021-08) Gaffney K; Lucero A; Macartney-Coxson D; Clapham J; Whitfield P; Palmer BR; Wakefield S; Faulkner J; Stoner L; Rowlands DS
    Abstract Skeletal muscle microvascular dysfunction and mitochondrial rarefaction feature in type 2 diabetes mellitus (T2DM) linked to low tissue glucose disposal rate (GDR). Exercise training and milk protein supplementation independently promote microvascular and metabolic plasticity in muscle associated with improved nutrient delivery, but combined effects are unknown. In a randomised-controlled trial, 24 men (55.6 y, SD 5.7) with T2DM ingested whey protein drinks (protein/carbohydrate/fat: 20/10/3 g; WHEY) or placebo (carbohydrate/fat: 30/3 g; CON) before/after 45 mixed-mode intense exercise sessions over 10 weeks, to study effects on insulin-stimulated (hyperinsulinemic clamp) skeletal-muscle microvascular blood flow (mBF) and perfusion (near-infrared spectroscopy), and histological, genetic, and biochemical markers (biopsy) of microvascular and mitochondrial plasticity. WHEY enhanced insulin-stimulated perfusion (WHEY-CON 5.6%; 90% CI −0.1, 11.3), while mBF was not altered (3.5%; −17.5, 24.5); perfusion, but not mBF, associated (regression) with increased GDR. Exercise training increased mitochondrial (range of means: 40%–90%) and lipid density (20%–30%), enzyme activity (20%–70%), capillary:fibre ratio (∼25%), and lowered systolic (∼4%) and diastolic (4%–5%) blood pressure, but without WHEY effects. WHEY dampened PGC1α −2.9% (90% compatibility interval: −5.7, −0.2) and NOS3 −6.4% (−1.4, −0.2) expression, but other messenger RNA (mRNA) were unclear. Skeletal muscle microvascular and mitochondrial exercise adaptations were not accentuated by whey protein ingestion in men with T2DM. ANZCTR Registration Number: ACTRN12614001197628. Novelty: • Chronic whey ingestion in T2DM with exercise altered expression of several mitochondrial and angiogenic mRNA. • Whey added no additional benefit to muscle microvascular or mitochondrial adaptations to exercise. • Insulin-stimulated perfusion increased with whey but was without impact on glucose disposal. Résumé Le dysfonctionnement microvasculaire du muscle squelettique et la raréfaction mitochondriale caractérisant le diabète de type 2 (« T2DM ») sont liés à un faible taux d’élimination du glucose tissulaire (« GDR »). L’entraînement physique et la supplémentation en protéines du lait favorisent indépendamment la plasticité microvasculaire et métabolique dans le muscle; cette plasticité est associée à une amélioration de l’apport de nutriments, mais les effets combinés sont inconnus. Dans un essai contrôlé randomisé, 24 hommes (55,6 ans, SD 5,7) aux prises avec le T2DM consomment des boissons protéinées de lactosérum (protéines / glucides / lipides: 20/10/3 g; « WHEY ») ou un placebo (glucides / lipides: 30/3 g; « CON ») avant / après 45 séances d’exercice intense en mode mixte sur 10 semaines, et ce, pour examiner les effets sur le flux sanguin microvasculaire (« mBF ») et la perfusion (spectroscopie proche infrarouge) stimulés par l’insuline (clamp hyperinsulinémique), des variables histologiques, génétiques et des marqueurs biochimiques (biopsie) de la plasticité microvasculaire et mitochondriale. WHEY améliore la perfusion stimulée par l’insuline (WHEY-CON 5,6 %; IC 90 % −0,1, 11,3), tandis que le mBF n’est pas modifié (3,5 %; −17,5, 24,5); la perfusion, mais pas le mBF, est associée (régression) à une augmentation du GDR. L’entraînement à l’exercice augmente la densité mitochondriale (gamme de moyennes: 40-90 %) et lipidique (20−30 %), l’activité enzymatique (20−70 %), le ratio capillaire: fibre (∼25 %) et diminue les pressions systolique (∼4 %) et diastolique (4−5 %), mais sans effets de WHEY. WHEY amortit l’expression de PGC1α −2,9 % (intervalle de compatibilité de 90 % : −5,7, −0,2) et NOS3 −6,4 % (−1,4, −0,2), mais les autres ARN messager (ARNm) ne sont pas clairs. Les adaptations microvasculaires et mitochondriales des muscles squelettiques causées par l’entraînement physique ne sont pas accentuées par la consommation de protéines de lactosérum chez les hommes aux prises avec le T2DM. Numéro d’enregistrement ANXCTR : ACTRN12614001197628. [Traduit par la Rédaction] Les nouveautés: • La consommation prolongée de lactosérum en présence de T2DM combinée à l’entraînement physique modifie l’expression de plusieurs ARNm mitochondriaux et angiogéniques. • Le lactosérum n’ajoute aucun avantage supplémentaire aux adaptations microvasculaires ou mitochondriales musculaires à l’exercice physique. • La perfusion stimulée par l’insuline augmente avec le lactosérum mais n’a pas d’impact sur l’élimination du glucose.