Darren Warburton

Background: The monitoring of body composition together with training load provides an informative, comprehensive assessment of training effectiveness, adaptive responses, and physiological status to strengthen athlete management and development. Currently, this relationship has yet to be fully synthesized in team sport and warrants investigation.Objectives: The aim of this systematic review and meta-analysis was to synthesize the current literature regarding the effects of team sport and associated training loads on body composition changes.Methods: A systematic search was completed according to PRISMA guidelines in MEDLINE, EMBASE, CINAHL, and SPORTDiscus databases to identify articles that examine the relationship between team sport, training load, and changes in body composition. A random-effects meta-analysis was performed to analyze changes in body mass (kg), body fat (%, kg), and lean body mass (kg).Results: The database search yielded 4,594 studies, with six studies meeting all eligibility criteria for inclusion. Meta-analysis demonstrated that playing elite/professional level team sport is associated with small reductions in body fat percentage (SMD: -0.37, 95% CI [-0.74 to -0.01], p = 0.04). These changes appear to be associated with reductions in fat mass (SMD: -0.33, 95% CI [-0.68 to 0.02], p = 0.07), while body mass (SMD: -0.02 [95% CI -0.25 to 0.21], p = 0.87) and lean body mass (SMD: 0.02, 95% CI [-0.26 to 0.29], p = 0.91) tend to be maintained. Inconsistencies and diversity in training load methodologies and reporting resulted in unclear evidence depicting the moderating effect of training load; however, preliminary findings suggest that excessive volumes of high-speed running/sprinting loads may negatively impact body composition, while increasing accelerations/decelerations may provide an effective and efficient means to increase intensity, improve conditioning, and optimize adaptation.Conclusions: Findings from this work suggest that body composition changes as an effect of the cumulative factors and stimuli of elite/professional team sport. Further research is warranted to ascertain the effect of training loads on these changes, with an aim to standardize the quantification and reporting of these loads as well as improved nutritional reporting.

View record

Ensuring an athlete’s health while developing athletic performance is a key objective of coaches and training staff. Current literature supports the importance of monitoring training load and its effect on athletic performance; however, there is limited research examining the effects in female athletes. Therefore, we sought to examine the effects of training load on performance, cardiovascular function, anthropometry in female collegiate soccer players. Moreover, we aimed to examine the relationships between resting cardiovascular function and performance measures while controlling for anthropometry. The data was analyzed used a Pearson correlation coefficient (r) and multiple regression analysis (R²). Owing to the potential confounding effects of changes in anthropometric indices, body composition (body mass index & body fat percentage) indices were also used as covariates in separate analyses of resting cardiovascular function and physical performance measures. The results yielded several negative correlations between between training load and athletic performance, revealing that sprints had the biggest impact on performance for LRS at 5 metres (r = -0.53, p
View record

Background: A protein intake above the recommended dietary allowance (RDA) (i.e., 0.8 g∙kgˉ¹∙dayˉ¹) might benefit muscle strength (MS) and skeletal muscle mass (SMM). However, whether a higher protein intake would benefit MS and SMM (depending on sex, age group, and physical activity level) at younger ages is still to be determined. Objective: To examine whether a protein intake above the RDA is associated with a higher MS and SMM depending on sex, age group, and physical activity level in young and middle-aged adults. Methods: A secondary data analysis from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 was conducted. We analyzed data from participants aged 20 to 59, with dietary intake (24 h dietary recall), combined handgrip strength (HGS), dual-energy x-ray absorptiometry-derived appendicular lean soft tissue (ALST), accelerometer-assessed physical activity, among other variables (n = 3406). The protein intake was categorized as 1.0 g∙kgˉ¹∙dayˉ¹) was associated with a higher MS, while higher protein amounts (≥1.6 g∙kgˉ¹∙dayˉ¹) would be necessary to observe a higher SMM.

View record

Indigenous peoples throughout Canada have traditionally lived active lifestyles. However, due to the lasting effects of Colonization and its institutions (such as the Indian Residential School System and the Sixties Scoop), there has been a growing concern for marked health disparities, particularly surrounding wholistic health and wellness. Specifically, rural and remote Indigenous communities may experience greater health disparities due to several factors (such as the lack of available healthcare services). However, there is a lack of available literature examining the current aspirations (and potential barriers) related to maintaining connections to wholistic health and wellness within rural and remote Indigenous communities. In partnership with an Indigenous community partner organization, this work explores the current aspirations and perspectives of Indigenous peoples living in rural and remote Indigenous communities related to wholistic health and wellness. Indigenous community members were invited to participate in a virtual sharing circle workshop that was facilitated during the 9th Annual National Indigenous Physical Activity and Wellness (NIPAW) Virtual Conference. Participants were asked to complete an electronic survey (Likert-type scale) to further examine perspectives related to community health and wellness. A total of eight participants attended the virtual sharing circle workshop and seven participants completed the electronic survey. Using thematic analysis, five themes emerged from the virtual sharing circle workshop. Community voices were highlighted to further reflect the powerful discussions and teachings that were shared during the workshop. Using the Cronbach’s alpha, the electronic survey tool was determined to have high internal reliability (α = 0.84). The findings from the electronic survey indicate that Indigenous peoples living within rural and remote communities value highly traditional and cultural practices and ties, connections to wholistic health and wellness, and inclusion and diversity of all individuals in the community. A series of knowledge translation resources will be co-created with and for Indigenous peoples to highlight and reflect the perspectives, key findings, and recommendations stemming from the virtual sharing circle and survey. This research helped to identify the current aspirations of Indigenous peoples living within rural and remote Indigenous communities, to facilitate the co-creation of future wholistic health and wellness programs and initiatives.

View record

Background: Finding culturally relevant and safe ways to co-create health and fitness programs that support traditional ways to be physically active are important areas of strengths-based research with Indigenous communities in Canada. Indigenous communities are returning to traditional ways of being active on the land, and colonial perceptions of health and fitness are culturally inappropriate for Indigenous communities. As such, research methodologies should focus on empowering Indigenous community leaders to be the key advocates of health behaviour change within their own communities. Objectives: This study examined the impact of a community-based and Indigenous led healthy lifestyle intervention designed specifically to improve health-related physical fitness and healthy lifestyle behaviours (reducing sedentary activity time and increasing physical activity levels) in adults (n = 15). Methodology: In collaboration and consultation with a rural and remote Indigenous community, we co-created a 13-week Indigenous led intervention incorporating individualized western exercise prescriptions and knowledge sharing circles in a group-based walking program. Measures of physical activity and sedentary behaviour (self-report and 7-day accelerometry), predicted maximal aerobic power (VO2max; 6-minute walk test), resting heart rate and blood pressure, and other health-related physical fitness measures (musculoskeletal fitness and body composition) were taken pre- and post-intervention. Results: Significant and clinically relevant improvements in aerobic fitness, resting blood pressure, and resting heart rate were observed. Accelerometry-measured moderate-to-vigorous intensity physical activity minutes were above international recommendations (~275 min/week), and sedentary activity time in bouts of >60 min reduced significantly post-intervention. No significant changes were observed in weight, body mass index, waist circumference, percentage body fat, grip strength, and flexibility. Conclusion: This work demonstrates how an Indigenous designed and led, community-based healthy lifestyle intervention can provide a culturally relevant strategy to increase health-related physical fitness, increase physical activity participation, and reduce sedentary behaviours.

View record

Background: The majority of employed Canadians work forty hours per week, spending approximately seven hours per day at the workplace. Promoting and/or offering physical activity and proper nutrition at the workplace has been shown to increase activity and improve dietary choices both during and outside of work hours. Further, diet quality and activity levels together play major roles in a person's overall quality of life. Measuring quality of life, which includes physical, emotional, mental, and financial factors, is often conducted via survey, where results can be averaged to create an overall wellness score for each individual.Purpose: The aim of this study was to determine if nutrition and physical activity workplace wellness programs improve employee quality of life with the hypothesis that participants who participate will have higher overall wellness scores than those who do not. A systematic review with the same aim was also conducted.Methods: Twenty-eight employees at four Vancouver, BC companies with wellness programs were recruited to complete a survey. Data collection included the WellSuite® IV Health Risk Assessment for the Workforce (Non-U.S.) survey which contains 44 wellness-related questions. Employees who participated in their wellness program 25% or less of the time served as the control group. Data were described using descriptive statistics, contingency and frequency tables, ordinal logistic regression, one-way ANOVA, and independent samples T-tests.Results: The data suggests that those in the experimental group were more likely to have a higher Overall Wellness Score (p = 0.025), Fitness Score (p = 0.013), and to self-report higher life satisfaction and happiness than those in the control group. Nutrition Score increased with participation in the workplace wellness programs (p=0.035). Though limited by sample size and selection bias, this study supports the existing literature in the field and adds to the discussion on measuring quality of life outcomes of workplace wellness programs.Conclusion: The consistent and optimistic findings of this study are promising but inconclusive regarding the positive quality of life and overall health impact of workplace wellness programs that incorporate both PA and nutrition components. Future studies may benefit from aiming to limit confounding variables.

View record

Wildland firefighters are subject to prolonged and irregular shifts which can have detrimental effects on sleep and increase fatigue. Fatigue and sleep deprivation can reduce information-processing resulting in slower reaction times, poor decision-making, situational awareness, and hazard recognition. At present, current research on fatigue and sleep in firefighters is lacking and limited to laboratory studies. The main goal of this study was to provide insight and understanding into the impact the current wildland firefighting schedule has on the emergence of cognitive fatigue in an effort to guide future interventions that aim to improve occupational health and safety amongst wildland firefighters. This study aimed to objectively and subjectively measure sleep quantity, quality and fatigue throughout a 17-day firefighting deployment amongst firefighters in British Columbia, Canada during the fire season. During the deployment, 39 firefighters’ sleep was assessed using wrist actigraphy and subjective questionnaires. Fatigue was assessed using a cognitive performance test known as the psychomotor vigilance test. Our analysis revealed that sleep quantity was suboptimal during both fire and non-fire days. Total sleep time and sleep efficiency was less on fire days compared to non-fire days. Firefighters reported being significantly sleepier towards the end of their 14-day deployment. Our results also demonstrated that firefighters continued to report high levels of sleepiness and poor quality of sleep throughout their rest days immediately following their work deployment. Firefighters performed significantly poorer on cognitive performance tests and reported significantly higher levels of fatigue and decreased alertness near the end of their 14-day work deployment. Our results provide valuable insight into the development of fatigue across a 14-day work schedule and into the 3-day rest period for wildland firefighters. Our study highlights that firefighters may still be fatigued, sleep deprived and inadequately rested prior to their work deployment. Fire agencies and researchers should target future interventions and studies that aim to improve and manage sleep and fatigue during firefighters’ work and rest days.

View record

Background: Improving the health and well-being of Indigenous peoples is a priority in Canada. A high prevalence of chronic diseases (such as cardiovascular disease, type 2 diabetes and obesity) has been reported among Indigenous communities. Despite the growing awareness of the health disparities faced by Indigenous communities compared to the general population, limited research exists on how to improve the cardio-metabolic health of Indigenous communities in culturally appropriate ways. Physical activity and fitness is well known to be of benefit for health.Objective: To evaluate the effectiveness of a community-based walking and running physical activity program on improving health-related physical fitness and other risk factors for cardiovascular disease and type 2 diabetes.Methods: Six Indigenous communities participating in the program hosted a health screening. A total of 87 adults of varying ages (44.6 ± 14.9 yr), health status and previous physical activity levels were included in this study. A trained Indigenous community member delivered weekly running and walking sessions. Aerobic fitness, muscular strength, body composition, blood pressure, total cholesterol, high density lipoprotein cholesterol, glucose, glycosylated haemoglobin and physical activity behaviour were assessed pre-and post-training.Results: Improvements in cardiorespiratory fitness and muscular strength were observed after the program. Health-related outcomes including waist circumference and blood pressure were reduced.Conclusion: A community-based physical activity program, led by an Indigenous community member, was effective at improving the cardio-metabolic health of Indigenous adults. Future research should consider modelling the design and implementation of this physical activity program when working with Indigenous communities to reduce cardio-metabolic diseases.

View record

With the majority of Canadians waking hours spent at the workplace place, the financial effects of absenteeism and presenteeism due to chronic disease is increasing. Healthy lifestyle behaviours (such as physical activity, proper nutrition, smoking and alcohol reduction, and mental health management) play in reducing absenteeism and presenteeim rates is crucial. A comprehensive multi-faceted 12 week wellness program (i.e., ACCELERATION) was implemented within a workplace setting to determine its effects on absenteeism and presenteeism. One hour education sessions covered a range of topics from physical activity, proper nutrition, smoking and alcohol cessation to mental health management and stress coping. Weekly one hr exercise sessions conducted with exercise logs to monitor activity/exercise levels at home. The specialized workplace wellness program was designed to examine changes healthy lifestyle behaviours in relation to employee health status, as well as absenteeism and presenteeism costs. An economic evaluation of the ACCELERATION program was created via the distribution of online questionnaires at both baseline and a 3 month follow up. A total of 50 participants, 35 females (43.4 ± 11.5 yr) and 15 males (44.9 ± 10.5 yr) completed the 12 week program. The monetary results from the evaluation reported a reduction in absence days by 54.0% from 1.40 to 0.64 per employee and a cost savings average of $155.79 per employee. Presenteeism was reduced by 17.0% from 29.0% to 12.0% equating to an average cost savings of $420.12 per employee. These results indicate that the ACCELERATION program had a positive effect on employee health costs and is a beneficial health program for the workplace.

View record

Background: Individuals living with schizophrenia have consistently demonstrated impaired cardiovascular fitness. It is of particular interest whether antipsychotic medications significantly contribute to the reduced cardiovascular fitness in these individuals. A comprehensive review of the literature and meta-analysis was performed to examine the overall dose-dependent effect of antipsychotics on cardiovascular fitness. Also, it was tested in our participants with schizophrenia whether this dose-dependent effect might be independent of body mass index (BMI) and whether cardiovascular fitness might be further reduced in those exposed primarily to clozapine versus other antipsychotics. Methods: For our comprehensive review and meta-analysis, an electronic search of the literature was performed to identify studies that examined the effects of antipsychotics on cardiovascular fitness. For our original research investigation, 30 participants with schizophrenia or schizoaffective disorder stabilized on antipsychotics were recruited. The patients were divided into the clozapine (n = 15) and non-clozapine (n = 15) groups, and a group of healthy age- and sex-matched controls (n = 15) was included. All current antipsychotic doses were converted to chlorpromazine equivalents (CPZE). Each participant completed maximal symptom-limited exercise testing on a cycle ergometer for the assessment of peak aerobic power (VO₂peak). Results: The meta-analysis revealed an overall significant dose-dependent effect of antipsychotics on cardiovascular fitness in a total of 294 participants (correlation coefficient: -0.29, 95% CI: -0.43 to -0.14, p
View record

Background: Recovery strategies aim to reduce the inflammatory response that occurs following exercise induced muscle damage (EIMD) via increased venous return. Available research is contradictory regarding whether recovery strategies are effective in reducing recovery time and improving subsequent athletic performance. As a result, further research is warranted.Purpose: To determine which application is effective in accelerating recovery for athletes following eccentric exercise, and maintaining performance.Hypothesis: We hypothesized that the VIP and CWT will be more effective compared to placebo and NormaTec conditions in facilitating recovery.Methods: 24 highly trained participants were tested over five test sessions. Participants underwent measures of VJ, 10m/30m sprints, HRV, VAS and Leg Girth. Participants underwent 100 repetitions of a plyometric drop jump and were then randomly assigned into four conditions: 1) Contrast water therapy (CWT, n=6), 2) Variable intermittent pressure (VIP, n=6), 3) NormaTec IPC (NormaTec, n= 6), 4) Passive Recovery/ Placebo (Placebo, n=6). Perception of recovery was analyzed using a Likert recovery questionnaire. Follow-up measures of outcome variables occurred at 24, 48 and 72 hr.Statistics: Two-way mixed model ANOVA was used to assess between groups and repeated measures. Tukey’s HSD was used when necessary.Results: CWT demonstrated 4.4% increase in mean VJ @ 72 hr (p > 0.05). VIP demonstrated performance maintenance for VJ and sprint measures (p > 0.05). VIP demonstrated significantly (p 0.05) occurred between groups at any time point for any other outcome measures. Conclusion: CWT and VIP appear to be beneficial in facilitating recovery and the maintenance of performance following strenuous exercise compared to placebo and NormaTec conditions. There appear to be differences in subjective perceptions of muscle soreness reflecting the differences in recovery strategy methodologies. Further research is warranted to determine the underlying mechanisms responsible for facilitating recovery and maintaining physical performance.

View record

Background: Trastuzumab, a HER2 antagonist, has been shown to improve rates of overall survival in patients with HER2-positive breast cancer. However, cardiotoxic effects associated with treatment limits these benefits. Due to an increase in survival years, women with a history of HER2-positive breast cancer might be at increased risk of developing cardiotoxicity (i.e., LVEF
View record

The role left ventricular (LV) twisting mechanics play in the stroke volume response to incremental exercise is unknown. Furthermore, the influences of aerobic fitness and venous return on LV twisting mechanics during vigorous exercise have not been investigated previously. To examine this issue, LV twisting mechanics and haemodynamics were assessed in eight endurance-trained (VO₂ max = 68.1 ± 5.6 mL∙kg⁻¹∙min⁻¹) and eight normally active (VO₂ max = 50.1 ± 5 mL∙kg⁻¹∙min⁻¹) males during incremental upright and supine exercise at rest and during heart rates of 110, 130, 150, and 170 bpm. LV twisting mechanics were measured via echocardiography, while haemodynamic measures were collected using impedance cardiography. During both incremental protocols, cardiac output increased continuously in both groups. Stroke volume (SV) and end-diastolic volume increased to a greater extent in endurance-trained athletes compared to normally active individuals during exercise in both postural positions (e.g., SV at 170 bpm supine: ET, 45%; NA, 30.5%; SV at 170 upright: ET, 44.7%; NA, 33.8%; p
View record

Despite an exceptionally high prevalence of overuse injury among elite volleyball players, very little is known about the aetiology of these conditions. Fundamental movement patterns have been found to be predictive of serious acute athletic injury, however the relationship between fundamental movement patterns and overuse injury has yet to be determined. Sport-specific jumping biomechanics have been shown to play an additional role in the development of overuse injuries in sport, and it is likely that combining fundamental and sport-specific movement assessment may possess greater predictive power than either alone. The purpose of this investigation was to evaluate how volleyball-related overuse injuries are related to fundamental movement patterns and volleyball spike jump technique. We hypothesized that volleyball players with a history of overuse injury would exhibit more dysfunctional fundamental and sport-specific movement than players without a history of injury. Fifty-seven male and female collegiate volleyball players took part in Functional Movement Screen testing, and athletes free of lower body pain (n=31) took part in a 2-dimensional kinematic analysis of spike jump technique using Dartfish video analysis software. Volleyball players with a history of overuse low back injury had significantly lower Active Straight Leg Raise scores compared to healthy players (p=0.011). Various aspects of hip mechanics during the spike jump were significantly related to a history of shoulder, low back, and knee pain (p
View record

Introduction: Aboriginal individuals continue to experience greater levels of cardiovascular disease (CVD) and diabetes than the Canadian general population, though these diseases were historically rare. Increasing evidence indicates rising sedentary behaviours from the traditional healthy and active lifestyles of this population. Various interventions have been implemented to address the health inequities in Aboriginal peoples with mixed results. Unfortunately, limited research has taken a culturally appropriate community approach to improve the health and well-being of Aboriginal peoples. By implementing a community-based and participatory physical activity (PA) and healthy living program, health and wellness can be improved in a culturally relevant context.Purposes: The primary purpose of this investigation was to examine the health benefits of a community-based PA and healthy living intervention program for Aboriginal Canadians.Methods: Participants were recruited through local Aboriginal offices representing male and female participants of wide ranging ages and CVD risk profiles. Each participant completed identical testing days pre- and post-training including a variety of CVD risk factors and four CVD risk scoring systems. Participants were self-assigned to three different community-based PA interventions including walking, walk/running, or running.Results: Significant improvements in health measures and CVD risk scores were observed for both male and female participants of all age groups. The three PA programs produce similar improvements in health measures and risk scores. Individuals of high, moderate and low CVD risk also experienced similar improvements.Discussion: High program compliance indicated success for improving PA of this population. Improvements among both genders and a variety of age groups support this program as a successful intervention for males and females of all ages. The similar changes in health status with each of the programs suggest that Aboriginal adults successfully self-select an appropriate PA intervention for health benefits. Moreover, the similarity in improvements among participants of a variety of CVD risk classifications indicates this individualized program was appropriate for improving the health status of individuals of a range of CVD risk profiles.Conclusion: The self-selected intensities Hearts inTraining program was successful in improving health status and increasing PA for Aboriginal adults of all ages, genders and risk categories.

View record