Publications by year
Byrne C, Cosnefroy A, Eston R, Lee J, Noakes T (In Press). Continuous Thermoregulatory Responses to a Mass Participation 89 km Ultramarathon Road Race. International Journal of Sports Physiology and Performance
Byrne C (In Press). Small changes in thermal conditions hinder marathon running performance in the tropics. Temperature (Austin, Tex.)
Adams ST, Bedwani NH, Massey LH, Bhargava A, Byrne C, Jensen KK, Smart NJ, Walsh CJ
(2022). Physical activity recommendations pre and post abdominal wall reconstruction: a scoping review of the evidence. Hernia
Physical activity recommendations pre and post abdominal wall reconstruction: a scoping review of the evidence.
PURPOSE: There are no universally agreed guidelines regarding which types of physical activity are safe and/or recommended in the perioperative period for patients undergoing ventral hernia repair or abdominal wall reconstruction (AWR). This study is intended to identify and summarise the literature on this topic. METHODS: Database searches of PubMed, CINAHL, Allied & Complementary medicine database, PEDro and Web of Science were performed followed by a snowballing search using two papers identified by the database search and four hand-selected papers of the authors' choosing. Inclusion-cohort studies, randomized controlled trials, prospective or retrospective. Studies concerning complex incisional hernia repairs and AWRs including a "prehabilitation" and/or "rehabilitation" program targeting the abdominal wall muscles in which the interventions were of a physical exercise nature. RoB2 and Robins-I were used to assess risk of bias. Prospero CRD42021236745. No external funding. Data from the included studies were extracted using a table based on the Cochrane Consumers and Communication Review Group's data extraction template. RESULTS: the database search yielded 5423 records. After screening two titles were selected for inclusion in our study. The snowballing search identified 49 records. After screening one title was selected for inclusion in our study. Three total papers were included-two randomised studies and one cohort study (combined 423 patients). All three studies subjected their patients to varying types of physical activity preoperatively, one study also prescribed these activities postoperatively. The outcomes differed between the studies therefore meta-analysis was impossible-two studies measured hernia recurrence, one measured peak torque. All three studies showed improved outcomes in their study groups compared to controls however significant methodological flaws and confounding factors existed in all three studies. No adverse events were reported. CONCLUSIONS: the literature supporting the advice given to patients regarding recommended physical activity levels in the perioperative period for AWR patients is sparse. Further research is urgently required on this subject. Abstract
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Tan XR, Low ICC, Byrne C, Wang R, Lee JKW
(2021). Assessment of dehydration using body mass changes of elite marathoners in the tropics. Journal of Science and Medicine in Sport
Assessment of dehydration using body mass changes of elite marathoners in the tropics
Objectives: the ACSM recommends drinking to avoid loss of body mass >2% during exercise to avert compromised performance. Our study aimed to assess the level of dehydration in elite runners following a city marathon in a tropical environment. Design: Prospective cohort design. Methods: Twelve elite runners (6 males, 6 females; age 24–41 y) had body mass measured to the nearest 0.01 kg in their race attire immediately before and after the 2017 Standard Chartered Singapore Marathon 2017. Body mass change was corrected for respiratory water loss, gas exchange, and sweat retained in clothing, and expressed as % of pre-race mass (i.e. % dehydration). Results: Data are expressed as means ± SD (range). Dry bulb temperature and humidity were 27.9 ± 0.1 °C (27.4–28.3 °C) and 79 ± 2% (73–82%). Finish time was 155 ± 10 min (143−172 min). Male runners finishing positions ranged from 2–12 out of 7627 finishers, whilst female runners placed 1–8 out of 1754 finishers. Body mass change (loss) and % dehydration for all runners were 2.5 ± 0.5 kg (1.8–3.5 kg) and 4.6 ± 0.9% (3.6–6.8%). Male runners experienced body mass loss of 2.8 ± 0.5 kg and 4.9 ± 1.2% while females experienced body mass loss of 2.1 ± 0.2 kg and 4.3 ± 0.6%. Conclusions: Despite experiencing dehydration (4.6% body mass loss) two-fold higher than current fluid replacement guidelines recommend (≤2%), elite male and female runners performed successfully and without medical complication in a hot weather marathon. Abstract
Harrison P, Didembourg M, Wood A, Devi A, Dinsdale R, Hazeldine J, Alsousou J, Keene DJ, Hulley P, Wagland S, et al
(2021). Characteristics of L-PRP preparations for treating Achilles tendon rupture within the PATH-2 study. Platelets
Characteristics of L-PRP preparations for treating Achilles tendon rupture within the PATH-2 study.
Platelet-rich plasma (PRP) is an autologous preparation that has been claimed to improve healing and mechanobiological properties of tendons both in vitro and in vivo. In this sub-study from the PATH-2 (PRP in Achilles Tendon Healing-2) trial, we report the cellular and growth factor content and quality of the Leukocyte-rich PRP (L-PRP) (N = 103) prepared using a standardized commercial preparation method across 19 different UK centers. Baseline whole blood cell counts (red cells, leukocyte and platelets) demonstrated that the two groups were well-matched. L-PRP analysis gave a mean platelet count of 852.6 x 109/L (SD 438.96), a mean leukocyte cell count of 15.13 x 109/L (SD 10.28) and a mean red blood cell count of 0.91 x 1012/L (SD 1.49). The activation status of the L-PRP gave either low or high expression levels of the degranulation marker CD62p before and after ex-vivo platelet activation respectively. TGF-β, VEGF, PDGF, IGF and FGFb mean concentrations were 131.92 ng/ml, 0.98 ng/ml, 55.34 ng/ml, 78.2 ng/ml and 111.0 pg/ml respectively with expected correlations with both platelet and leukocyte counts. While PATH-2 results demonstrated that there was no evidence L-PRP is effective for improving clinical outcomes at 24 weeks after Achilles tendon rupture, our findings support that the majority of L-PRP properties were within the method specification and performance. Abstract
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Candy E, Bunn L, Virgo P, Byrne C, Bannigan K
(2021). Evaluating participants’ perceptions of a functional physical fitness assessment for those aged 60 years and over conducted in the community by student physiotherapists. International Journal of Therapy and Rehabilitation
Evaluating participants’ perceptions of a functional physical fitness assessment for those aged 60 years and over conducted in the community by student physiotherapists
Background/aims Physical fitness is crucial in preserving independence and quality of life for older adults. A functional physical fitness assessment has been designed specifically for those aged 60 years and over. This study explored older people’s perceptions of this assessment, conducted by student physiotherapists, and the feasibility of a larger study to evaluate the long-term effects of its use. Methods a total of five scheduled drop-in sessions were arranged. Participants aged 60 years and over were recruited. Physiotherapy students conducted the assessment and participants completed follow-up physical activity status and quality of life questionnaires as well as an evaluation of the session. Focus groups were conducted to explore participant’s perceptions and experiences. Data was analysed using descriptive statistics and thematic analysis. Results Overall, 91 adults (aged 60–93 years) participated, 75 (46 (61%) women and 10 (13%) men) completed questionnaires, and seven attended focus groups. In total, 100% of the 91 participants suggested that those aged 60 years and over would benefit from functional fitness assessment, and 79% perceived this would lead to increased physical activity. Focus group participants reported they enjoyed working with students and suggested that regular assessment would provide a yardstick for their level of fitness, that they would like to repeat their tests next year and that ‘they were mentally a positive thing’. conclusions Functional fitness assessments were perceived as useful and encouraged older adults to increase their activity levels. Students successfully completed the tests in non-healthcare settings. This study suggests that a large trial designed to assess the benefit of regular functional fitness assessment for the over 60s in community settings is feasible. Abstract
Candy E, Bunn L, Byrne C, Hornsby C, Virgo P, Bannigan K (2019). Evaluating the benefit of physical fitness MOTs for people aged over 60 with Devon AgeUK and Age Concern. Physiotherapy, 105, e128-e129.
Alsousou J, Keene DJ, Harrison P, Hulley P, Wagland S, Thompson JY, Parsons SR, Byrne C, Schlüssel MM, O’Connor HM, et al
(2019). Platelet-rich plasma injection for adults with acute Achilles tendon rupture: the PATH-2 RCT. Efficacy and Mechanism Evaluation
Platelet-rich plasma injection for adults with acute Achilles tendon rupture: the PATH-2 RCT
BackgroundAchilles tendon rupture (ATR) has a long healing period, which is challenging for patients and clinicians. Platelet-rich plasma (PRP) is an autologous concentration of platelets thought to improve tendon function recovery. Although preliminary research has indicated positive effects, there is, as yet, no evidence of clinical efficacy from adequately powered robust clinical trials.ObjectivesThe objectives were to determine the clinical efficacy of PRP in patients with acute ATR using an objective mechanical muscle–tendon function measure and patient-reported outcome measures (PROMs), and to determine which PRP components contribute to its mechanism.DesignThis was a multicentre, parallel-group, participant- and outcome assessor-blinded randomised controlled trial (RCT) comparing PRP with placebo. Two embedded substudies investigated the PRP’s quality and composition and its effects on healing tendon tissues.SettingThis trial was set in trauma and orthopaedic surgery departments in 19 NHS hospitals in England and Wales.ParticipantsAdults with acute ATR presenting within 12 days of injury to be treated non-surgically were eligible. Patients with platelet dysfunction or leg functional deficiency were excluded.InterventionsParticipants were randomised 1 : 1 to the PRP injection group or the placebo group (dry needle in the rupture gap) by central computer-based randomisation using minimisation, stratified by centre and age.Main outcome measuresThe primary outcome measure was the Limb Symmetry Index (LSI) of work during the heel-rise endurance test at 24 weeks. Secondary outcomes measures, collected at 4, 7, 13 and 24 weeks, were repetitions, maximum heel-rise height, Achilles tendon Total Rupture Score (ATRS), quality of life (as measured using the Short Form questionnaire-12 items version 2), pain and participant goal attainment. Needle biopsies of the affected tendon zone were taken under ultrasound guidance at 6 weeks from 16 participants from one centre. Whole blood was analysed for cell count. PRP was analysed for cell count, platelet activation and growth factor concentration. The primary analysis was intention to treat.ResultsA total of 230 participants were randomised: 114 to the PRP group (103 treated) and 116 to the placebo group (all treated). One participant withdrew after randomisation but before the intervention. At 24 weeks, 201 out of 230 participants (87.4%) completed the primary outcome and 216 out of 230 participants (93.9%) completed the PROMs. The treatment groups had similar participant characteristics. At 24 weeks, there was no difference in work LSI (mean difference –3.872; 95% confidence interval –10.454 to 2.710;p = 0.231), ATRS, pain or goal attainment between PRP- and placebo-injected participants. There were no differences between the groups in any PROM at any time point or in complication rates, including re-rupture and deep-vein thrombosis. There was no correlation between work LSI and platelet activation in PRP, or erythrocyte, leucocyte or platelet counts in whole blood or PRP. Biopsies showed similar cellularity and vascularity between groups.ConclusionsThis trial design and standardised PRP preparation gives the first robust RCT evidence about PRP’s role in managing ATR, which suggests that PRP offers no patient benefit. Equally robust evidence to investigate PRP application in tendon and soft tissue injuries is required. The 24-month follow-up will be completed in April 2020.Trial registrationCurrent Controlled Trials ISRCTN54992179.FundingThis project was funded by the Efficacy and Mechanism Evaluation programme, a Medical Research Council and National Institute for Health Research (NIHR) partnership. The trial was supported by the NIHR Biomedical Research Centre, Oxford, and the NIHR Fellowship programme. Abstract
Byrne C, Lee JKW
(2019). The Physiological Strain Index Modified for Trained Heat-Acclimatized Individuals in Outdoor Heat. Int J Sports Physiol Perform
The Physiological Strain Index Modified for Trained Heat-Acclimatized Individuals in Outdoor Heat.
Purpose: to determine if the Physiological Strain Index (PSI), in original or modified form, can evaluate heat strain on a 0-10 scale, in trained and heat-acclimatized men undertaking a competitive half-marathon run in outdoor heat. Methods: Core (intestinal) temperature (TC) and heart rate (HR) were recorded continuously in 24 men (mean [SD] age = 26  y, VO2peak = 59  mL·kg·min-1). A total of 4 versions of the PSI were computed: original PSI with upper constraints of TC 39.5°C and HR 180 beats·min-1 (PSI39.5/180) and 3 modified versions of PSI with each having an age-predicted maximal HR constraint and graded TC constraints of 40.0°C (PSI40.0/PHRmax), 40.5°C (PSI40.5/PHRmax), and 41.0°C (PSI41.0/PHRmax). Results: in a warm (26.1-27.3°C) and humid (79-82%) environment, all runners finished the race asymptomatic in 107 (10) (91-137) min. Peak TC and HR were 39.7°C (0.5°C) (38.5-40.7°C) and 186 (6) (175-196) beats·min-1, respectively. In total, 63% exceeded TC 39.5°C, 71% exceeded HR 180 beats·min-1, and 50% exceeded both of the original PSI upper TC and HR constraints. The computed heat strain was significantly greater with PSI39.5/180 than all other methods (P 10 was observed in 63% of runners with PSI39.5/180, 25% for PSI40.0/PHRmax, 8% for PSI40.5/PHRmax, and 0% for PSI41.0/PHRmax. Conclusions: the PSI was able to quantify heat strain on a 0-10 scale in trained and heat-acclimatized men undertaking a half-marathon race in outdoor heat, but only when the upper TC and HR constraints were modified to 41.0°C and age-predicted maximal HR, respectively. Abstract
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Lamb SE, Sheehan B, Atherton N, Nichols V, Collins H, Mistry D, Dosanjh S, Slowther AM, Khan I, Petrou S, et al
(2018). Dementia and Physical Activity (DAPA) trial of moderate to high intensity exercise training for people with dementia: randomised controlled trial. BMJ
Dementia and Physical Activity (DAPA) trial of moderate to high intensity exercise training for people with dementia: randomised controlled trial.
OBJECTIVE: to estimate the effect of a moderate to high intensity aerobic and strength exercise training programme on cognitive impairment and other outcomes in people with mild to moderate dementia. DESIGN: Multicentre, pragmatic, investigator masked, randomised controlled trial. SETTING: National Health Service primary care, community and memory services, dementia research registers, and voluntary sector providers in 15 English regions. PARTICIPANTS: 494 people with dementia: 329 were assigned to an aerobic and strength exercise programme and 165 were assigned to usual care. Random allocation was 2:1 in favour of the exercise arm. INTERVENTIONS: Usual care plus four months of supervised exercise and support for ongoing physical activity, or usual care only. Interventions were delivered in community gym facilities and NHS premises. MAIN OUTCOME MEASURES: the primary outcome was score on the Alzheimer's disease assessment scale-cognitive subscale (ADAS-cog) at 12 months. Secondary outcomes included activities of daily living, neuropsychiatric symptoms, health related quality of life, and carer quality of life and burden. Physical fitness (including the six minute walk test) was measured in the exercise arm during the intervention. RESULTS: the average age of participants was 77 (SD 7.9) years and 301/494 (61%) were men. By 12 months the mean ADAS-cog score had increased to 25.2 (SD 12.3) in the exercise arm and 23.8 (SD 10.4) in the usual care arm (adjusted between group difference -1.4, 95% confidence interval -2.6 to -0.2, P=0.03). This indicates greater cognitive impairment in the exercise group, although the average difference is small and clinical relevance uncertain. No differences were found in secondary outcomes or preplanned subgroup analyses by dementia type (Alzheimer's disease or other), severity of cognitive impairment, sex, and mobility. Compliance with exercise was good. Over 65% of participants (214/329) attended more than three quarters of scheduled sessions. Six minute walking distance improved over six weeks (mean change 18.1 m, 95% confidence interval 11.6 m to 24.6 m). CONCLUSION: a moderate to high intensity aerobic and strength exercise training programme does not slow cognitive impairment in people with mild to moderate dementia. The exercise training programme improved physical fitness, but there were no noticeable improvements in other clinical outcomes. TRIAL REGISTRATION: Current Controlled Trials ISRCTN10416500. Abstract
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Schlussel MM, Keene DJ, Collins GS, Bostock J, Byrne C, Goodacre S, Gwilym S, Hagan DA, Haywood K, Thompson J, et al
(2018). Development and prospective external validation of a tool to predict poor recovery at 9 months after acute ankle sprain in UK emergency departments: the SPRAINED prognostic model. BMJ Open
Development and prospective external validation of a tool to predict poor recovery at 9 months after acute ankle sprain in UK emergency departments: the SPRAINED prognostic model.
OBJECTIVES: to develop and externally validate a prognostic model for poor recovery after ankle sprain. SETTING AND PARTICIPANTS: Model development used secondary data analysis of 584 participants from a UK multicentre randomised clinical trial. External validation used data from 682 participants recruited in 10 UK emergency departments for a prospective observational cohort. OUTCOME AND ANALYSIS: Poor recovery was defined as presence of pain, functional difficulty or lack of confidence in the ankle at 9 months after injury. Twenty-three baseline candidate predictors were included together in a multivariable logistic regression model to identify the best predictors of poor recovery. Relationships between continuous variables and the outcome were modelled using fractional polynomials. Regression parameters were combined over 50 imputed data sets using Rubin's rule. To minimise overfitting, regression coefficients were multiplied by a heuristic shrinkage factor and the intercept re-estimated. Incremental value of candidate predictors assessed at 4 weeks after injury was explored using decision curve analysis and the baseline model updated. The final models included predictors selected based on the Akaike information criterion (p Abstract
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Schlüssel MM, Keene DJ, Wagland S, Alsousou J, Lamb SE, Willett K, Dutton SJ, PATH-2 Trial Study Group
(2018). Platelet-rich plasma in Achilles tendon healing 2 (PATH-2) trial: statistical analysis plan for a multicentre, double-blinded, parallel-group, placebo-controlled randomised clinical trial. Trials
Platelet-rich plasma in Achilles tendon healing 2 (PATH-2) trial: statistical analysis plan for a multicentre, double-blinded, parallel-group, placebo-controlled randomised clinical trial.
BACKGROUND: There has been a recent steep growth in platelet-rich plasma (PRP) use for musculoskeletal conditions, but findings from high quality clinical trial data are lacking in the literature. Here, we describe the statistical analysis plan (SAP) for the Platelet-rich plasma in Achilles Tendon Healing 2 (PATH-2) trial. METHODS: PATH-2 is a pragmatic, parallel-group, multi-centre, double-blinded, randomised, placebo-controlled, superiority trial. The study aims to evaluate the clinical efficacy of PRP in acute Achilles tendon rupture in terms of muscle-tendon function. Patients are identified in the orthopaedic/trauma outpatient clinic. The primary outcome is muscle-tendon work capacity from the Heel Rise Endurance Test result, expressed as the Limb Symmetry Index (work, in joules), at 24 weeks post randomisation. Multivariate linear regression adjusting for the stratification factors (centre and age) and additional prognostic factors will be used to investigate the adjusted effect of the intervention. The analysis will be by modified intention-to-treat. Sensitivity analysis will assess the internal validity of the trial results by performing a per-protocol analysis. Safety will be summarised by treatment arm for all patients who started treatment. Secondary patient-reported outcome measures will be analysed using linear mixed effects models to allow all data collected at all follow-up points to be considered. Missing data will be summarised and reported by treatment arm. Missing data imputation will be performed, if appropriate. DISCUSSION: the PATH-2 trial will be reported in accordance with the CONSORT statement. This SAP publication will avoid bias arising from prior knowledge of the study results. Any changes or deviations from the current SAP will be described and justified in the final report. TRIAL REGISTRATION: ISRCTN registry: ISRCTN54992179 , assigned 12 January 2015. ClinicalTrials.gov: NCT02302664, received 18 November 2014. UK Clinical Research Network Study Portfolio Database: ID 17850. Abstract
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Keene DJ, Schlüssel MM, Thompson J, Hagan DA, Williams MA, Byrne C, Goodacre S, Cooke M, Gwilym S, Hormbrey P, et al
(2018). Prognostic models for identifying risk of poor outcome in people with acute ankle sprains: the SPRAINED development and external validation study. Health Technol Assess
Prognostic models for identifying risk of poor outcome in people with acute ankle sprains: the SPRAINED development and external validation study.
BACKGROUND: Ankle sprains are very common injuries. Although recovery can occur within weeks, around one-third of patients have longer-term problems. OBJECTIVES: to develop and externally validate a prognostic model for identifying people at increased risk of poor outcome after an acute ankle sprain. DESIGN: Development of a prognostic model in a clinical trial cohort data set and external validation in a prospective cohort study. SETTING: Emergency departments (EDs) in the UK. PARTICIPANTS: Adults with an acute ankle sprain (within 7 days of injury). SAMPLE SIZE: There were 584 clinical trial participants in the development data set and 682 recruited for the external validation study. PREDICTORS: Candidate predictor variables were chosen based on availability in the clinical data set, clinical consensus, face validity, a systematic review of the literature, data quality and plausibility of predictiveness of the outcomes. MAIN OUTCOME MEASURES: Models were developed to predict two composite outcomes representing poor outcome. Outcome 1 was the presence of at least one of the following symptoms at 9 months after injury: persistent pain, functional difficulty or lack of confidence. Outcome 2 included the same symptoms as outcome 1, with the addition of recurrence of injury. Rates of poor outcome in the external data set were lower than in the development data set, 7% versus 20% for outcome 1 and 16% versus 24% for outcome 2. ANALYSIS: Multiple imputation was used to handle missing data. Logistic regression models, together with multivariable fractional polynomials, were used to select variables and identify transformations of continuous predictors that best predicted the outcome based on a nominal alpha of 0.157, chosen to minimise overfitting. Predictive accuracy was evaluated by assessing model discrimination (c-statistic) and calibration (flexible calibration plot). RESULTS: (1) Performance of the prognostic models in development data set - the combined c-statistic for the outcome 1 model across the 50 imputed data sets was 0.74 [95% confidence interval (CI) 0.70 to 0.79], with good model calibration across the imputed data sets. The combined c-statistic for the outcome 2 model across the 50 imputed data sets was 0.70 (95% CI 0.65 to 0.74), with good model calibration across the imputed data sets. Updating these models, which used baseline data collected at the ED, with an additional variable at 4 weeks post injury (pain when bearing weight on the ankle) improved the discriminatory ability (c-statistic 0.77, 95% CI 0.73 to 0.82, for outcome 1 and 0.75, 95% CI 0.71 to 0.80, for outcome 2) and calibration of both models. (2) Performance of the models in the external data set - the combined c-statistic for the outcome 1 model across the 50 imputed data sets was 0.73 (95% CI 0.66 to 0.79), with a calibration plot intercept of -0.91 (95% CI -0.98 to 0.44) and slope of 1.13 (95% CI 0.76 to 1.50). The combined c-statistic for the outcome 2 model across the 50 imputed data sets was 0.63 (95% CI 0.58 to 0.69), with a calibration plot intercept of -0.25 (95% CI -0.27 to 0.11) and slope of 1.03 (95% CI 0.65 to 1.42). The updated models with the additional pain variable at 4 weeks had improved discriminatory ability over the baseline models but not better calibration. CONCLUSIONS: the SPRAINED (Synthesising a clinical Prognostic Rule for Ankle Injuries in the Emergency Department) prognostic models performed reasonably well, and showed benefit compared with not using any model; therefore, the models may assist clinical decision-making when managing and advising ankle sprain patients in the ED setting. The models use predictors that are simple to obtain. LIMITATIONS: the data used were from a randomised controlled trial and so were not originally intended to fulfil the aim of developing prognostic models. However, the data set was the best available, including data on the symptoms and clinical events of interest. FUTURE WORK: Further model refinement, including recalibration or identifying additional predictors, may be required. The effect of implementing and using either model in clinical practice, in terms of acceptability and uptake by clinicians and on patient outcomes, should be investigated. TRIAL REGISTRATION: Current Controlled Trials ISRCTN12726986. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 64. See the NIHR Journals Library website for further project information. Funding was also recieved from the NIHR Collaboration for Leadership in Applied Health Research, Care Oxford at Oxford Health NHS Foundation Trust, NIHR Biomedical Research Centre, Oxford, and the NIHR Fellowship programme. Abstract
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Keene DJ, Schlüssel MM, Hagan D, Thompson J, Williams MA, Byrne C, Gwilym SE, Goodacre S, Cooke MW, Hormbrey P, et al (2017). Development and external validation of a prognostic model for predicting poor outcome in patients with acute ankle sprains. Physiotherapy, 103, e32-e33.
Byrne C, Keene DJ, Lamb SE, Willett K
(2017). Intrarater reliability and agreement of linear encoder derived heel-rise endurance test outcome measures in healthy adults. J Electromyogr Kinesiol
Intrarater reliability and agreement of linear encoder derived heel-rise endurance test outcome measures in healthy adults.
A linear encoder measuring vertical displacement during the heel-rise endurance test (HRET) enables the assessment of work and maximum height in addition to the traditional repetitions measure. We aimed to compare the test-retest reliability and agreement of these three outcome measures. Thirty-eight healthy participants (20 females, 18 males) performed the HRET on two occasions separated by a minimum of seven days. Reliability was assessed by the intraclass correlation coefficient (ICC) and agreement by a range of measures including the standard error of measurement (SEM), coefficient of variation (CV), and 95% limits of agreement (LoA). Reliability for repetitions (ICC=0.77 (0.66, 0.85)) was equivalent to work (ICC=0.84 (95% CI 0.76, 0.89)) and maximum height (ICC=0.85 (0.77, 0.90)). Agreement for repetitions (SEM=6.7 (5.8, 7.9); CV=13.9% (11.9, 16.8%); LoA=-1.9±37.2%) was equivalent to work (SEM=419J (361, 499J); CV=13.1% (11.2, 15.8%); LoA=0.1±34.8%) with maximum height superior (SEM=0.8cm (0.6, 1.0cm); CV=6.6% (5.7, 7.9%); LoA=1.3±17.1%). Work and maximum height demonstrated acceptable reliability and agreement that was at least equivalent to the traditional repetitions measure. Abstract
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Alsousou J, Keene DJ, Hulley PA, Harrison P, Wagland S, Byrne C, Schlüssel MM, Dutton SJ, Lamb SE, Willett K, et al
(2017). Platelet rich Plasma in Achilles Tendon Healing 2 (PATH-2) trial: protocol for a multicentre, participant and assessor-blinded, parallel-group randomised clinical trial comparing platelet-rich plasma (PRP) injection versus placebo injection for Achilles tendon rupture. BMJ Open
Platelet rich Plasma in Achilles Tendon Healing 2 (PATH-2) trial: protocol for a multicentre, participant and assessor-blinded, parallel-group randomised clinical trial comparing platelet-rich plasma (PRP) injection versus placebo injection for Achilles tendon rupture.
BACKGROUND: Achilles tendon injuries give rise to substantial long-lasting morbidity and pose considerable challenges for clinicians and patients during the lengthy healing period. Current treatment strategies struggle to curb the burden of this injury on health systems and society due to lengthy rehabilitation, work absence and reinjury risk. Platelet-rich plasma (PRP) is an autologous preparation that has been shown to improve the mechanobiological properties of tendons in laboratory and animal studies. The use of PRP in musculoskeletal injuries is on the increase despite the lack of adequately powered clinical studies. METHODS AND DESIGN: This is a multicentre randomised controlled trial to evaluate the efficacy and mechanism of PRP in patients with acute Achilles tendon rupture (ATR). All adults with acute ATR presenting within 12 days of the injury who are to be treated non-operatively are eligible. A total of 230 consenting patients will be randomly allocated via a remote web-based service to receive PRP injection or placebo injection to the site of the injury. All participants will be blinded to the intervention and will receive standardised rehabilitation to reduce efficacy interference.Participants will be followed up with blinded assessments of muscle-tendon function, quality of life, pain and overall patient's functional goals at 4, 7, 13, 24 weeks and 24 months post-treatment. The primary outcome is the heel-rise endurance test (HRET), which will be supervised by a blinded assessor at 24 weeks. A subgroup of 16 participants in one centre will have needle biopsy under ultrasound guidance at 6 weeks. Blood and PRP will be analysed for cell count, platelet activation and growth factor concentrations. ETHICS AND DISSEMINATION: the protocol has been approved by the Oxfordshire Research Ethics Committee (Oxfordshire Research Ethics Committee A, reference no 14/SC/1333). The trial will be reported in accordance with the CONSORT statement and published in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER: ISRCTN: 54992179, assigned 12 January 2015. ClinicalTrials.gov: NCT02302664, received 18 November 2014. UK Clinical Research Network Study Portfolio Database: ID 17850. Abstract
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Thompson J, Byrne C, Williams M, Keene D, Schlussel M, Lamb S, Group SS (2017). Prognostic factors for outcome following acute lateral ankle ligament sprain: a systematic review. Physiotherapy, 103, e44-e45.
Thompson JY, Byrne C, Williams MA, Keene DJ, Schlussel MM, Lamb SE
(2017). Prognostic factors for recovery following acute lateral ankle ligament sprain: a systematic review. BMC Musculoskelet Disord
Prognostic factors for recovery following acute lateral ankle ligament sprain: a systematic review.
BACKGROUND: One-third of individuals who sustain an acute lateral ankle ligament sprain suffer significant disability due to pain, functional instability, mechanical instability or recurrent sprain after recovery plateaus at 1 to 5 years post injury. The identification of early prognostic factors associated with poor recovery may provide an opportunity for early-targeted intervention and improve outcome. METHODS: We performed a comprehensive search of AMED, EMBASE, Psych Info, CINAHL, SportDiscus, PubMed, CENTRAL, PEDro, OpenGrey, abstracts and conference proceedings from inception to September 2016. Prospective studies investigating the association between baseline prognostic factors and recovery over time were included. Two independent assessors performed the study selection, data extraction and quality assessment of the studies. A narrative synthesis is presented due to inability to meta-analyse results due to clinical and statistical heterogeneity. RESULTS: the search strategy yielded 3396 titles/abstracts after duplicates were removed. Thirty-six full text articles were then assessed, nine of which met the study inclusion criteria. Six were prospective cohorts, and three were secondary analyses of randomised controlled trials. Results are presented for nine studies that presented baseline prognostic factors for recovery after an acute ankle sprain. Age, female gender, swelling, restricted range of motion, limited weight bearing ability, pain (at the medial joint line and on weight-bearing dorsi-flexion at 4 weeks, and pain at rest at 3 months), higher injury severity rating, palpation/stress score, non-inversion mechanism injury, lower self-reported recovery, re-sprain within 3 months, MRI determined number of sprained ligaments, severity and bone bruise were found to be independent predictors of poor recovery. Age was one prognostic factor that demonstrated a consistent association with outcome in three studies, however cautious interpretation is advised. CONCLUSIONS: the associations between prognostic factors and poor recovery after an acute lateral ankle sprain are largely inconclusive. At present, there is insufficient evidence to recommend any factor as an independent predictor of outcome. There is a need for well-conducted prospective cohort studies with adequate sample size and long-term follow-up to provide robust evidence on prognostic factors of recovery following an acute lateral ankle sprain. TRIAL REGISTRATION: Prospero registration: CRD42014014471. Abstract
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Byrne C, Faure C, Keene DJ, Lamb SE
(2016). Ageing, Muscle Power and Physical Function: a Systematic Review and Implications for Pragmatic Training Interventions. Sports Med
Ageing, Muscle Power and Physical Function: a Systematic Review and Implications for Pragmatic Training Interventions.
BACKGROUND: the physiological impairments most strongly associated with functional performance in older people are logically the most efficient therapeutic targets for exercise training interventions aimed at improving function and maintaining independence in later life. OBJECTIVES: the objectives of this review were to (1) systematically review the relationship between muscle power and functional performance in older people; (2) systematically review the effect of power training (PT) interventions on functional performance in older people; and (3) identify components of successful PT interventions relevant to pragmatic trials by scoping the literature. METHODS: Our approach involved three stages. First, we systematically reviewed evidence on the relationship between muscle power, muscle strength and functional performance and, second, we systematically reviewed PT intervention studies that included both muscle power and at least one index of functional performance as outcome measures. Finally, taking a strong pragmatic perspective, we conducted a scoping review of the PT evidence to identify the successful components of training interventions needed to provide a minimally effective training dose to improve physical function. RESULTS: Evidence from 44 studies revealed a positive association between muscle power and indices of physical function, and that muscle power is a marginally superior predictor of functional performance than muscle strength. Nine studies revealed maximal angular velocity of movement, an important component of muscle power, to be positively associated with functional performance and a better predictor of functional performance than muscle strength. We identified 31 PT studies, characterised by small sample sizes and incomplete reporting of interventions, resulting in less than one-in-five studies judged as having a low risk of bias. Thirteen studies compared traditional resistance training with PT, with ten studies reporting the superiority of PT for either muscle power or functional performance. Further studies demonstrated the efficacy of various methods of resistance and functional task PT on muscle power and functional performance, including low-load PT and low-volume interventions. CONCLUSIONS: Maximal intended movement velocity, low training load, simple training methods, low-volume training and low-frequency training were revealed as components offering potential for the development of a pragmatic intervention. Additionally, the research area is dominated by short-term interventions producing short-term gains with little consideration of the long-term maintenance of functional performance. We believe the area would benefit from larger and higher-quality studies and consideration of optimal long-term strategies to develop and maintain muscle power and physical function over years rather than weeks. Abstract
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Keene DJ, Williams MA, Segar AH, Byrne C, Lamb SE
(2016). Immobilisation versus early ankle movement for treating acute lateral ankle ligament injuries in adults. Cochrane Database of Systematic Reviews
Immobilisation versus early ankle movement for treating acute lateral ankle ligament injuries in adults
This is the protocol for a review and there is no abstract. The objectives are as follows: to assess the effects (benefits and harms) of immobilisation compared with early movement protocols for acute lateral ankle ligament injuries. Abstract
Lee JKW, Yeo ZW, Nio AQX, Koh ACH, Teo YS, Goh LF, Tan PMS, Byrne C
(2013). Cold drink attenuates heat strain during work-rest cycles. International Journal of Sports Medicine
Cold drink attenuates heat strain during work-rest cycles
There is limited information on the ingestion of cold drinks after exercise. We investigated the thermoregulatory effects of ingesting drinks at 4°C (COLD) or 28°C (WARM) during work-rest cycles in the heat. On 2 separate occasions, 8 healthy males walked on the treadmill for 2 cycles (45 min work; 15 min rest) at 5.5 km/h with 7.5% gradient. Two aliquots of 400 mL of plain water at either 4°C or 28°C were consumed during each rest period. Rectal temperature (T re ), skin temperature (T sk), heart rate and subjective ratings were measured. Mean decrease in T re at the end of the final work-rest cycle was greater after the ingestion of COLD drinks (0.5±0.2°C) than WARM drinks (0.3±0.2°C; P Abstract
Yeo ZW, Fan PWP, Nio AQX, Byrne C, Lee JKW
(2012). Ice slurry on outdoor running performance in heat. International Journal of Sports Medicine
Ice slurry on outdoor running performance in heat
The efficacy of ingestion of ice slurry on actual outdoor endurance performance is unknown. This study aimed to investigate ice slurry ingestion as a cooling intervention before a 10km outdoor running time-trial. Twelve participants ingested 8g·kg -1 of either ice slurry (1.4°C; ICE) or ambient temperature drink (30.9°C; CON) and performed a 15-min warm-up prior to a 10km outdoor running time-trial (Wet Bulb Globe Temperature: 28.2±0.8°C). Mean performance time was faster with ICE (2715±396s) than CON (2730±385s; P=0.023). Gastrointestinal temperature (T gi) reduced by 0.5±0.2°C after ICE ingestion compared with 0.1±0.1°C (P Abstract
Street B, Byrne C, Eston R
(2011). GLUTAMINE SUPPLEMENTATION IN RECOVERY FROM ECCENTRIC EXERCISE ATTENUATES STRENGTH LOSS AND MUSCLE SORENESS. JOURNAL OF EXERCISE SCIENCE & FITNESS
(2), 116-122. Author URL
Byrne C, Owen C, Cosnefroy A, Lee JKW
(2011). Self-paced exercise performance in the heat after pre-exercise cold-fluid ingestion. Journal of Athletic Training
Self-paced exercise performance in the heat after pre-exercise cold-fluid ingestion
Context: Precooling is the pre-exercise reduction of body temperature and is an effective method of improving physiologic function and exercise performance in environmental heat. A practical and effective method of precooling suitable for application at athletic venues has not been demonstrated. Objective: to confirm the effectiveness of pre-exercise ingestion of cold fluid without fluid ingestion during exercise on pre-exercise core temperature and to determine whether pre-exercise ingestion of cold fluid alone without continued provision of cold fluid during exercise can improve exercise performance in the heat. Design: Randomized controlled clinical trial. Setting: Environmental chamber at an exercise physiology laboratory that was maintained at 32°C, 60% relative humidity, and 3.2 m/s facing air velocity. Patients or Other Participants: Seven male recreational cyclists (age = 21 ±1.5 years, height = 1.81 ±0.07 m, mass = 78.4 ±9.2 kg) participated. Intervention(s): Participants ingested 900 mL of cold (2°C) or control (37°C) flavored water in 3 300-mL aliquots over 35 minutes of pre-exercise rest. Main Outcome Measure(s): Rectal temperature and thermal comfort before exercise and distance cycled, power output, pacing, rectal temperature, mean skin temperature, heart rate, blood lactate, thermal comfort, perceived exertion, and sweat loss during exercise. Results: During rest, a greater decrease in rectal temperature was observed with ingestion of the cold fluid (0.41 ±0.16°C) than the control fluid (0.17 ±0.17°C) over 35 to 5 minutes before exercise (t6 = -3.47, P =. 01). During exercise, rectal temperature was lower after ingestion of the cold fluid at 5 to 25 minutes (t6 range, 2.53-3.38, P ?. 05). Distance cycled was greater after ingestion of the cold fluid (19.26 ±2.91 km) than after ingestion of the control fluid (18.72 ±2.59 km; t6 = -2.80, P =. 03). Mean power output also was greater after ingestion of the cold fluid (275 ±27 W) than the control fluid (261 ±22 W; t6 = -2.13, P =. 05). No differences were observed for pacing, mean skin temperature, heart rate, blood lactate, thermal comfort, perceived exertion, and sweat loss (P >. 05). Conclusions: We demonstrated that pre-exercise ingestion of cold fluid is a simple, effective precooling method suitable for field-based application. © by the National Athletic Trainers' Association. Abstract
Jakeman J, Byrne C, Eston RG
(2010). Efficacy of Lower Limb Compression and Combined Treatment of Manual Massage and Lower Limb Compression on Symptoms of Exercise-Induced Muscle Damage in Women. Journal of Strength and Conditioning Research
Efficacy of Lower Limb Compression and Combined Treatment of Manual Massage and Lower Limb Compression on Symptoms of Exercise-Induced Muscle Damage in Women
Strategies to manage the symptoms of exercise-induced muscle damage are widespread, though are often based on anecdotal evidence. The aim of this study was to determine the efficacy of a combination of manual massage and compressive clothing and compressive clothing individually as recovery strategies following muscle damage. Thirty-two female volunteers completed 100 plyometric drop jumps, and were randomly assigned to a passive recovery (n = 17), combined treatment (n = 7) or compression treatment group (n = 8). Indices of muscle damage (perceived soreness, creatine kinase activity, isokinetic muscle strength, squat jump and countermovement jump performance) were assessed immediately before, and 1, 24, 48, 72, and 96 h following plyometric exercise. The compression treatment group wore compressive tights for 12 h following damage and the combined treatment group received a 30-min massage immediately after damaging exercise, and wore compression stockings for the following 11.5 h. Plyometric exercise had a significant effect on all indices of muscle damage (p < 0.05). The treatments significantly reduced decrements in isokinetic muscle strength, squat jump performance and countermovement jump performance, and reduced the level of perceived soreness in comparison with the passive recovery group (p < 0.05). The addition of sports massage to compression following muscle damage did not improve performance recovery, with recovery trends being similar in both treatment groups. The treatment combination of massage and compression significantly moderated perceived soreness at 48 and 72 h following plyometric exercise (p < 0.05) in comparison with the passive recovery or compression alone treatment. The results indicate that the use of lower limb compression and a combined treatment of manual massage with lower limb compression are effective recovery strategies following exercise-induced muscle damage. Minimal performance differences between treatments were observed, although the combination treatment may be beneficial in controlling perceived soreness. Abstract
Jakeman JR, Byrne C, Eston RG
(2010). Lower limb compression garment improves recovery from exercise-induced muscle damage in young, active females. European Journal of Applied Physiology
Lower limb compression garment improves recovery from exercise-induced muscle damage in young, active females
This study aimed to investigate the efficacy of lower limb compression as a recovery strategy following exercise-induced muscle damage (EIMD). Seventeen female volunteers completed 10 × 10 plyometric drop jumps from a 0.6-m box to induce muscle damage. Participants were randomly allocated to a passive recovery (n = 9) or a compression treatment (n = 8) group. Treatment group volunteers wore full leg compression stockings for 12 h immediately following damaging exercise. Passive recovery group participants had no intervention. Indirect indices of muscle damage (muscle soreness, creatine kinase activity, knee extensor concentric strength, and vertical jump performance) were assessed prior to and 1, 24, 48, 72, and 96 h following plyometric exercise. Plyometric exercise had a significant effect (p ≤ 0.05) on all indices of muscle damage. The compression treatment reduced decrements in countermovement jump performance (passive recovery 88.1 ± 2.8% vs. treatment 95.2 ± 2.9% of pre-exercise), squat jump performance (82.3 ± 1.9% vs. 94.5 ± 2%), and knee extensor strength loss (81.6 ± 3% vs. 93 ± 3.2%), and reduced muscle soreness (4.0 ± 0.23 vs. 2.4 ± 0.24), but had no significant effect on creatine kinase activity. The results indicate that compression clothing is an effective recovery strategy following exercise-induced muscle damage. © Springer-Verlag 2010. Abstract
Al-Rahamneh HQ, Faulkner JA, Byrne C, Eston RG (2010). Prediction of peak oxygen uptake from ratings of perceived exertion during arm exercise in able-bodied and persons with poliomyelitis. Spinal Cord
Al-Rahamneh H, Faulkner JA, Byrne C, Eston R
(2010). The Relationship Between Perceived Exertion and Physiologic Markers During Arm Exercise with Able-Bodied Participants and Participants with Poliomyelitis. Archives of Physical Medicine and Rehabilitation
The Relationship Between Perceived Exertion and Physiologic Markers During Arm Exercise with Able-Bodied Participants and Participants with Poliomyelitis
OBJECTIVE: to investigate the strength of the relationship between ratings of perceived exertion (RPE) and oxygen uptake (Vo(2)), heart rate, ventilation (Ve) and power output (PO) during an arm-crank ramped exercise test to volitional exhaustion in men and women who differed in physical status. DESIGN: Each participant completed an arm-crank ramp exercise test to volitional exhaustion. PO was increased by 15 W.min(-1) and 6 W.min(-1) for men and women able-bodied participants, respectively; for the poliomyelitis participants, 9 W.min(-1) and 6 W.min(-1) increments were used for men and women, respectively. SETTING: Laboratory facilities at a university. PARTICIPANTS: Able-bodied participants (n=16; 9 men, 7 women) and participants with poliomyelitis (n=15, 8 men, 7 women) volunteered for the study. MAIN OUTCOME MEASURES: Strength of the relationship (R(2) values) between RPE and Vo(2), heart rate, Ve and PO. RESULTS: There were significantly higher values for maximum Vo(2) and maximum PO for able-bodied men compared with their counterparts with poliomyelitis (P.05). Similar results were observed for the women who were able-bodied as well as for the women who had poliomyelitis (P>.05). The relationships between heart rate and RPE and Ve and RPE for able-bodied patients and patients with poliomyelitis were similar (R(2)>.87). The relationship between Vo(2) and RPE was stronger in the able-bodied participants compared wih the participants with poliomyelitis, regardless of sex (P.05). CONCLUSIONS: RPE is strongly related to physiologic markers of exercise intensity during arm exercise, irrespective of sex or participant's poliomyelitis status. Abstract
Lee JKW, Nio AQX, Lim CL, Teo EYN, Byrne C
(2010). Thermoregulation, pacing and fluid balance during mass participation distance running in a warm and humid environment. Eur J Appl Physiol
Thermoregulation, pacing and fluid balance during mass participation distance running in a warm and humid environment.
Deep body temperature (T(c)), pacing strategy and fluid balance were investigated during a 21-km road race in a warm and humid environment. Thirty-one males (age 25.3 +/- 3.2 years; maximal oxygen uptake 59.1 +/- 4.2 ml kg(-1) min(-1)) volunteered for this study. Continuous T(c) responses were obtained in 25 runners. Research stations at approximately 3-km intervals permitted accurate assessment of split times and fluid intake. Environmental conditions averaged 26.4 degrees C dry bulb temperature and 81% relative humidity. Peak T(c) was 39.8 +/- 0.5 (38.5-40.7) degrees C with 24 runners achieving T(c) > 39.0 degrees C, 17 runners > or = 39.5 degrees C, and 10 runners > or = 40.0 degrees C. In 12 runners attaining peak T(c) > or = 39.8 degrees C, running speed did not differ significantly when T(c) was below or above this threshold (208 +/- 15 cf. 205 +/- 24 m min(-1); P = 0.532). Running velocity was the main significant predictor variable of T(c) at 21 km (R(2) = 0.42, P < 0.001) and was the main discriminating variable between hyperthermic (T(c) > or = 39.8 degrees C) and normothermic runners (T(c) < 39.8 degrees C) up to 11.8 km. A reverse J-shaped pacing profile characterised by a marked reduction in running speed after 6.9 km and evidence of an end-spurt in 16 runners was observed. Variables relating to fluid balance were not associated with any T(c) parameters or pacing. We conclude that hyperthermia, defined by a deep body temperature greater than 39.5 degrees C, is common in trained individuals undertaking outdoor distance running in environmental heat, without evidence of fatigue or heat illness. Abstract
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Lim CL, Byrne C, Lee JK
(2008). Human thermoregulation and measurement of body temperature in exercise and clinical settings. Ann Acad Med Singap
Human thermoregulation and measurement of body temperature in exercise and clinical settings.
This review discusses human thermoregulation during exercise and the measurement of body temperature in clinical and exercise settings. The thermoregulatory mechanisms play important roles in maintaining physiological homeostasis during rest and physical exercise. Physical exertion poses a challenge to thermoregulation by causing a substantial increase in metabolic heat production. However, within a non-thermolytic range, the thermoregulatory mechanisms are capable of adapting to sustain physiological functions under these conditions. The central nervous system may also rely on hyperthermia to protect the body from "overheating." Hyperthermia may serve as a self-limiting signal that triggers central inhibition of exercise performance when a temperature threshold is achieved. Exposure to sub-lethal heat stress may also confer tolerance against higher doses of heat stress by inducing the production of heat shock proteins, which protect cells against the thermolytic effects of heat. Advances in body temperature measurement also contribute to research in thermoregulation. Current evidence supports the use of oral temperature measurement in the clinical setting, although it may not be as convenient as tympanic temperature measurement using the infrared temperature scanner. Rectal and oesophagus temperatures are widely accepted surrogate measurements of core temperature (Tc), but they cause discomfort and are less likely to be accepted by users. Gastrointestinal temperature measurement using the ingestible temperature sensor provides an acceptable level of accuracy as a surrogate measure of Tc without causing discomfort to the user. This form of Tc measurement also allows Tc to be measured continuously in the field and has gained wider acceptance in the last decade. Abstract
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Ng QY, Lee KW, Byrne C, Ho TF, Lim CL
(2008). Plasma endotoxin and immune responses during a 21-km road race under a warm and humid environment. Ann Acad Med Singap
Plasma endotoxin and immune responses during a 21-km road race under a warm and humid environment.
INTRODUCTION: This study investigated the responses of plasma endotoxin and pro- and antiinflammatory cytokines during a 21-km road race in warm and humid conditions. The influence of carbohydrate-electrolyte (CE)-water (WA) drink mix ingested on leukocyte subset responses and the association between plasma lipopolysaccharide (LPS) concentration and fluid balance, exercise intensity, and body core temperature (Tc) were also studied. MATERIALS AND METHODS: Thirty runners provided blood samples before and after the half-marathon for leukocyte, LPS and cytokine analyses. Tc was measured by the ingestible telemetric temperature sensor and fluid intake and split-times were recorded at 3 km intervals. Exercise intensity was determined by matching running speed and heart rate during the race with the corresponding speed-oxygen uptake relationship and heart rate measured in the laboratory 2 to 6 weeks before the race. RESULTS: Plasma LPS concentration increased from 1.9 +/- 1.9 pg/mL before, to 2.5 +/- 1.9 pg/mL after running (P Abstract
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(2007). Accuracy of radiopill telemetry during distance running in the heat - Response. MEDICINE AND SCIENCE IN SPORTS AND EXERCISE
(2), 394-394. Author URL
Byrne C, Lee J
(2007). Important insight from the 2003 Singapore half-marathon - Respose. MEDICINE AND SCIENCE IN SPORTS AND EXERCISE
(10), 1884-1884. Author URL
Byrne C, Lee J (2007). Response . Medicine and Science in Sports and Exercise, 39(10).
(2007). Study findings challenge core components of a current model of exercise thermoregulation - Response. MEDICINE AND SCIENCE IN SPORTS AND EXERCISE
(4), 744-744. Author URL
Byrne C, Lim CL (2007). The ingestible telemetric body core temperature sensor: a review of validity and exercise applications. British Journal of Sports Medicine, 41(3), 126-133.
Byrne C, Chew SAN, Lee KW, Lim CL (2006). Continuous thermoregulatory responses to mass-participation distance running in heat. Medicine & Science in Sports & Exercise, 38(5), 803-810.
Byrne C, Chew SAN, Lim CL, Mackinnon LT (2005). Leukocyte subset responses during exercise under heat stress with carbohydrate or water intake. Aviation, Space and Environmental Medicine, 76(8), 726-732.
Byrne C, Lim CL, Chew SAN (2005). Water versus carbohydrate-electrolyte fluid replacement during loaded marching under heat stress. Military Medicine, 170(8), 715-721.
Byrne C, Twist C, Eston R (2004). Neuromuscular function after exercise-induced muscle damage: Theoretical and applied implications. Sports Medicine, 34(1), 49-69.
Zhao B, Moochala SM, Tham S, Lu J, Chia M, Byrne C, Hu Q, Lee LKH (2003). Relationship between angiotensin-converting enzyme ID polymorphism and VO2max of Chinese males. Life Sciences, 73(20), 2625-2630.
Byrne C, Eston RG (2002). EFFECT OF ECCENTRIC EXERCISE-INDUCED MUSCLE DAMAGE ON ISOMETRIC LEG STRENGTH AND WINGATE PEAK POWER. Medicine & Science in Sports & Exercise, 34(5).
Byrne C, Eston R (2002). Maximal-intensity isometric and dynamic exercise performance following eccentric muscle actions. Journal of Sports Sciences, 20(12), 951-959.
Byrne C, Eston R
(2002). The effect of exercise-induced muscle damage on isometric and dynamic knee extensor strength and vertical jump performance. J Sports Sci
The effect of exercise-induced muscle damage on isometric and dynamic knee extensor strength and vertical jump performance.
In this study, we assessed the effect of exercise-induced muscle damage on knee extensor muscle strength during isometric, concentric and eccentric actions at 1.57 rad x s(-1) and vertical jump performance under conditions of squat jump, countermovement jump and drop jump. The eight participants (5 males, 3 females) were aged 29.5+/-7.1 years (mean +/- s). These variables, together with plasma creatine kinase (CK), were measured before, 1 h after and 1, 2, 3, 4 and 7 days after a bout of muscle damaging exercise: 100 barbell squats (10 sets x 10 repetitions at 70% body mass load). Strength was reduced for 4 days (P< 0.05) but no significant differences (P> 0.05) were apparent in the magnitude or rate of recovery of strength between isometric, concentric and eccentric muscle actions. The overall decline in vertical jump performance was dependent on jump method: squat jump performance was affected to a greater extent than countermovement (91.6+/-1.1% vs 95.2+/-1.3% of pre-exercise values, P< 0.05) and drop jump (95.2+/-1.4%, P< 0.05) performance. Creatine kinase was elevated (P < 0.05) above baseline 1 h after exercise, peaked on day 1 and remained significantly elevated on days 2 and 3. Strength loss after exercise-induced muscle damage was independent of the muscle action being performed. However, the impairment of muscle function was attenuated when the stretch-shortening cycle was used in vertical jumping performance. Abstract
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Byrne C, Edwards RHT, Eston RG (2001). Characteristics of isometric and dynamic strength loss following eccentric exercise-induced muscle damage. Scandinavian Journal of Medicine and Science in Sports, 11(3), 134-140.
Eston RG, Lemmey AB, McHugh P, Byrne C, Walsh SE
(2000). Effect of stride length on symptoms of exercise-induced muscle damage during a repeated bout of downhill running. Scand J Med Sci Sports
Effect of stride length on symptoms of exercise-induced muscle damage during a repeated bout of downhill running.
The purpose of this study was to assess the effects of changes in stride length on the symptoms of exercise-induced muscle damage (EIMD) during a repeated bout of downhill running in a group of 18 men and women. Muscle tenderness, plasma creatine kinase activity (CK) and maximal voluntary isometric force were measured before and after two downhill runs, with each run separated by 5 weeks. The first downhill run was at the preferred stride frequency (PSF). Participants were then randomly allocated to one of three sex-balanced groups with equal numbers of men and women: overstride (-8% PSF), understride (+8% PSF) and normal stride frequency for the second downhill run. Stride length had no effect (P>0.05) on muscle tenderness, CK or isometric peak force. Increases in muscle tenderness (P Abstract
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Byrne C, Eston RG, Edwards RHT (2000). Effects of eccentric exercise-induced muscle injury on isometric torque at short and optimal muscle lengths and isokinetic torque.
Byrne C, Eston RG, Edwards RHT (2000). The effects of eccentric exercise-induced muscle injury on isometric knee extensor torque at short and optimal muscle length.
Byrne C, Eston RG
(1998). Exercise, muscle damage and delayed onset muscle soreness. SPORTS EXERC INJURY
Exercise, muscle damage and delayed onset muscle soreness
Delayed-onset muscle soreness (DOMS) is a common sensation following unaccustomed exercise, and especially eccentric exercise. The term DOMS is used to denote not only muscle soreness, but also stiffness, tenderness and pain on active movement. An inherent loss of force-generating capacity and reductions in range of motion are typical functional consequences that accompany DOMS. The symptoms of DOMS are commonly believed to be caused by damage to the muscle; yet DOMS and muscle damage share a poor temporal relationship. This review focuses on empirical research relating to the phenomenon of DOMS, potential underlying mechanisms, functional consequences, and also preventative and treatment strategies. Abstract
Byrne C, Eston RG (1998). Use of ratings of perceived exertion to regulate exercise intensity: a study using effort estimation and effort production procedures.