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Lee S, Quinn L, Fritschi C, Fink AM, Park C, Reutrakul S, Collins EG. Effects of daily sleep on physical activity after cardiac surgery. Heart Lung 2024; 65:47-53. [PMID: 38401358 DOI: 10.1016/j.hrtlng.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/06/2024] [Accepted: 02/18/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Maintaining physical activity is challenging after cardiac surgery. Postsurgical cardiac patients often experience sleep problems showing a reciprocal interaction with physical activity. As sleep and physical activity show day-to-day variations, their daily relationships need to be assessed. However, no studies have examined daily sleep-physical activity relationships in postsurgical cardiac patients. OBJECTIVES This study aimed to examine the effects of daily sleep factors on daily physical activity after cardiac surgery. METHODS Among 33 patients who underwent cardiac surgery at least 10 weeks earlier, 5 sleep and 4 physical activity variables were measured using a wrist-worn ActiGraph for 7 days. Mixed-effects models were applied for data analyses. RESULTS Most participants were male (57.6 %), non-Hispanic whites (63.6 %) who had coronary artery bypass graft surgery (54.6 %). Participants averaged 60.8 ± 10.1 years of age and 85.7 ± 91.2 months since surgery. They slept for an average of 385.6 ± 74.6 min (6.4 ± 1.2 h). Among sleep factors, greater number of awakenings (NOA) predicted lower next-day sedentary time. Higher sleep efficiency (SE) was associated with lower next-day sedentary time when not controlling for covariates. Among the psychosocial, demographic, and clinical covariates, higher comorbidity index was associated with fewer kcals expended, less daily moderate-to-vigorous physical activity, and more daily sedentary time. CONCLUSIONS Daily SE and NOA and individual health status, including comorbidity, should be assessed over time to support improvement of daily physical activity after cardiac surgery. Researchers should examine the relationship between NOA and next-day sedentary time with larger samples. Such research should address multiple psychosocial, demographic, and clinical factors and the potential mediating role of sleep.
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Affiliation(s)
- Sueyeon Lee
- Loyola University Chicago, Marcella Niehoff School of Nursing, 2160 S. 1st Ave., Maywood, IL 60153, USA.
| | - Lauretta Quinn
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
| | - Cynthia Fritschi
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
| | - Anne M Fink
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
| | - Chang Park
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
| | - Sirimon Reutrakul
- University of Illinois Chicago, Department of Medicine, 835 S. Wolcott, Chicago, IL 60612, USA
| | - Eileen G Collins
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
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Zhao H, Lu C, Yi C. Physical Activity and Sleep Quality Association in Different Populations: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1864. [PMID: 36767229 PMCID: PMC9914680 DOI: 10.3390/ijerph20031864] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/09/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
The meta-analysis statistical methodology was used to test the effect of physical activity intervention on sleep quality. According to the preliminary results of the meta-analysis, moderating variables (age stage and physical activity intensity) were included for further study. On this basis, measures and schemes to improve sleep quality through physical activity were put forward. A preliminary Endnote X9 search of relevant literature from six electronic databases (Web of Science, Medline, PubMed, CNKI, PsycINFO and Wanfang) was performed. The results showed the following: (1) The overall test effect of physical activity intervention on sleep quality was not significant (p = 0.15). (2) Moderate- and low-intensity physical activity had significant effects on sleep quality (moderate intensity d = 2.56, p = 0.015; low-intensity d = 1.38, p = 0.03), while high-intensity physical activity had no obvious effect on sleep quality (d = 1.12, p = 0.32). (3) There were differences in the effect of physical activity on sleep quality at different ages. The effect of physical activity on sleep quality was more obvious in children and middle-aged and elderly people (children d = 1.24, p = 0.03; middle-aged and elderly people d = 1.98, p = 0.037), but not in young people (d = 1.32, p = 0.11). Conclusion: The overall effect of physical activity on sleep quality was not significant. Physical activity had an obvious effect on the sleep quality of children and middle-aged and elderly people but had no obvious effect on young people. Moderate-intensity physical activity had a certain effect on sleep quality, but high-intensity physical activity had no obvious effect on sleep quality. Future studies need to confirm these findings with a good large sample and moderating variables.
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Affiliation(s)
- Haitao Zhao
- Department of Sociology, School of Humanities and Social Sciences, Xi’an Jiaotong University, Xi’an 710049, China
- College of Physical Education, ShanXi Normal University, Taiyuan 030031, China
| | - Chuntian Lu
- Department of Sociology, School of Humanities and Social Sciences, Xi’an Jiaotong University, Xi’an 710049, China
| | - Cuixia Yi
- Department of Sociology, School of Humanities and Social Sciences, Xi’an Jiaotong University, Xi’an 710049, China
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Bianchim MS, McNarry MA, Holland A, Cox NS, Dreger J, Barker AR, Williams CA, Denford S, Mackintosh KA. A Compositional Analysis of Physical Activity, Sedentary Time, and Sleep and Associated Health Outcomes in Children and Adults with Cystic Fibrosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095155. [PMID: 35564550 PMCID: PMC9102111 DOI: 10.3390/ijerph19095155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 11/23/2022]
Abstract
This study sought to investigate the association of light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), sedentary time (SED), and sleep with lung function in children and adults with CF. In total, 86 children (41 females; 13.6 ± 2.8 years; FEV1%predicted: 86 ± 1%) and 43 adults (21 females; 24.6 ± 4.7 years; FEV1%predicted: 63 ± 21%) with CF participated in this study. Wrist-worn accelerometery was used to assess PA, SED and sleep. Compositional linear regression models were conducted following normalisation via isometric log-ratio transformations. Sequential binary partitioning was applied to investigate the impact of reallocating 10 to 30 min between each behaviour on FEV1%predicted. A decline in FEV1%predicted was predicted with the reallocation of 30 min from MVPA to SED or LPA or sleep to any other behaviour in children (−3.04–−0.005%) and adults (−3.58–−0.005%). Conversely, improvements in FEV1%predicted were predicted when 30 min was reallocated to MVPA from LPA or SED in children (0.12–1.59%) and adults (0.77–2.10%), or when 30 min was reallocated to sleep from any other behaviour in both children (0.23–2.56%) and adults (1.08–3.58%). This study supports the importance of MVPA and sleep for maintaining and promoting lung function in people with CF.
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Affiliation(s)
- Mayara S. Bianchim
- Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University Bay Campus, Swansea SA1 8EN, UK; (M.S.B.); (K.A.M.)
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling FK9 4LA, UK
| | - Melitta A. McNarry
- Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University Bay Campus, Swansea SA1 8EN, UK; (M.S.B.); (K.A.M.)
- Correspondence: ; Tel.: +44-(0)7971220327
| | - Anne Holland
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne 3004, Australia; (A.H.); (N.S.C.); (J.D.)
- Alfred Health, Australia Institute for Breathing and Sleep, Melbourne 3004, Australia
- Alfred Health, Physiotherapy Department, Melbourne 3004, Australia
| | - Narelle S. Cox
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne 3004, Australia; (A.H.); (N.S.C.); (J.D.)
- Alfred Health, Australia Institute for Breathing and Sleep, Melbourne 3004, Australia
| | - Julianna Dreger
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne 3004, Australia; (A.H.); (N.S.C.); (J.D.)
- Alfred Health, Physiotherapy Department, Melbourne 3004, Australia
| | - Alan R. Barker
- Children’s Health and Exercise Research Centre, University of Exeter, Exeter EX1 2LU, UK; (A.R.B.); (C.A.W.); (S.D.)
| | - Craig A. Williams
- Children’s Health and Exercise Research Centre, University of Exeter, Exeter EX1 2LU, UK; (A.R.B.); (C.A.W.); (S.D.)
| | - Sarah Denford
- Children’s Health and Exercise Research Centre, University of Exeter, Exeter EX1 2LU, UK; (A.R.B.); (C.A.W.); (S.D.)
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1UD, UK
| | - Kelly A. Mackintosh
- Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University Bay Campus, Swansea SA1 8EN, UK; (M.S.B.); (K.A.M.)
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Curran M, Tierney AC, Button B, Collins L, Kennedy L, McDonnell C, Sheikhi A, Jurascheck A, Casserly B, Cahalan R. Physical Activity and Sedentary Behavior in Adults With Cystic Fibrosis: Association With Aerobic Capacity, Lung Function, Sleep, Well-Being, and Quality of Life. Respir Care 2022; 67:339-346. [PMID: 34815328 PMCID: PMC9993503 DOI: 10.4187/respcare.09270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Physical activity (PA) and sedentary behavior (SB) have marked impact on key prognostic indicators such as aerobic capacity and lung function in people with cystic fibrosis (CF) and may have associations with sleep, well-being, and health-related quality of life (HRQOL). METHODS This observational study assessed PA, SB, aerobic capacity, spirometry, sleep, well-being, and HRQOL in adults with CF at University Hospital Limerick. PA and SB were assessed using an accelerometer that was worn for 7 days. A cardiopulmonary exercise test assessed aerobic capacity. Spirometry was performed according to American Thoracic Society guidelines. Well-being was measured by the AWESCORE, sleep quality by the Pittsburgh Sleep Quality Index (PSQI), and HRQOL using the CF Questionnaire-Revised. RESULTS Thirty-three participants (13 males/20 females) were recruited. Mean age was 26.2 y (± 7.1 SD), with mean FEV1 72.9% of predicted (± 26.2 SD). Mean step count was 7,788 (± 3,583 SD). Over 75% of participants did not reach recommended PA targets (> 10,000 steps), with females being 25.5% less active than males. The PSQI indicated 48.5% of participants scored > 5, indicating poor sleep quality. Number of steps and SB demonstrated a moderate significant correlation with FEV1 (r = 0.45, P = .030; r = -0.37, P = .043, respectively) and sleep quality (r = -0.85, P < .001; r = 0.77, P < .001, respectively). [Formula: see text] peak expressed relative to body weight, and as a percentage of predicted, was significantly positively correlated with step count (r = 0.48, P = .007; r = 0.42, P = .02, respectively) but did not correlate with SB (P = .96). [Formula: see text] peak (L/min) strongly correlated with FEV1 (r = 0.75, P < .001). CONCLUSIONS Most participants did not meet PA targets. PA levels correlated to aerobic capacity, FEV1, and self-reported sleep quality, and this should be considered in longitudinal studies and in PA interventions.
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Affiliation(s)
- Máire Curran
- School of Allied Health, University of Limerick, Limerick, Ireland.
- University Hospital Limerick, Limerick, Ireland and Health Research Institute, University of Limerick, Limerick, Ireland
| | - Audrey C Tierney
- School of Allied Health, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland; Health Implementation Science and Technology Research Group, Health Research Institute, University of Limerick, Limerick, Ireland and Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, Australia
| | - Brenda Button
- Departments of Respiratory Medicine and Physiotherapy, The Alfred, Melbourne, Australia and Department of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | | | | | | | - Ali Sheikhi
- Health Research Institute, University of Limerick, Limerick, Ireland
| | | | | | - Roisin Cahalan
- School of Allied Health, University of Limerick, Limerick, Ireland; and Health Research Institute, University of Limerick, Limerick, Ireland
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Straßburg S, Linker CM, Brato S, Schöbel C, Taube C, Götze J, Stehling F, Sutharsan S, Welsner M, Weinreich G. Investigation of respiratory rate in patients with cystic fibrosis using a minimal-impact biomotion system. BMC Pulm Med 2022; 22:59. [PMID: 35148739 PMCID: PMC8832687 DOI: 10.1186/s12890-022-01855-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background In this study we tested the hypothesis that in patients with cystic fibrosis (pwCF) respiratory rate (RR) is associated with antibiotic treatment, exacerbation status, forced expiratory volume in one second (FEV1) and C-reactive protein (CRP). Methods Between June 2018 and May 2019, we consecutively enrolled pwCF who were referred to our hospital. We determined RR and heart rate (HR) by using the minimal-impact system VitaLog during the hospital stay. Furthermore, we performed spirometry and evaluated CRP. Results We included 47 patients: 20 with pulmonary exacerbation and 27 without. RR decreased in patients with exacerbation (27.5/min (6.0/min) vs. 24.4/min (6.0/min), p = 0.004) and in patients with non-exacerbation (22.5/min (5.0/min) vs. 20.9/min (3.5/min), p = 0.024). Patients with exacerbation showed higher RR than patients with non-exacerbation both at the beginning (p = 0.004) and at the end of their hospital stay (p = 0.023). During the hospital stay, HR did not change in the total cohort (66.8/min (11.0/min) vs. 66.6/min (12.0/min), p = 0.440). Furthermore, we did not find significant differences between patients with exacerbation and patients with non-exacerbation (67.0/min (12.5/min) vs. 66.5/min (10.8/min), p = 0.658). We observed a correlation of ρ = -0.36 between RR and FEV1. Moreover, we found a correlation of ρ = 0.52 between RR and CRP. Conclusion In pwCF requiring intravenous therapy, respiratory rate is higher at their hospital admittance and decreased by the time of discharge; it is also associated with C-reactive protein. Monitoring RR could provide important information about the overall clinical conditions of pwCF.
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Affiliation(s)
- Svenja Straßburg
- Department of Pneumology, University Medicine Essen - Ruhrlandklinik, University Duisburg-Essen, Tüschener Weg 40, 45239, Essen, Germany.
| | - Carolin-Maria Linker
- Department of Pneumology, University Medicine Essen - Ruhrlandklinik, University Duisburg-Essen, Tüschener Weg 40, 45239, Essen, Germany.,Information Processing Lab, Faculty of Electrical Engineering, Information Engineering - TU Dortmund, Dortmund, Germany
| | | | - Christoph Schöbel
- Center of Sleep and Telemedicine, University Medicine Essen - Ruhrlandklinik, University Duisburg-Essen, Essen, Germany
| | - Christian Taube
- Department of Pneumology, University Medicine Essen - Ruhrlandklinik, University Duisburg-Essen, Tüschener Weg 40, 45239, Essen, Germany
| | - Jürgen Götze
- Information Processing Lab, Faculty of Electrical Engineering, Information Engineering - TU Dortmund, Dortmund, Germany
| | - Florian Stehling
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children'S Hospital, University Duisburg-Essen, Essen, Germany
| | - Sivagurunathan Sutharsan
- Department of Pneumology, University Medicine Essen - Ruhrlandklinik, University Duisburg-Essen, Tüschener Weg 40, 45239, Essen, Germany
| | - Matthias Welsner
- Department of Pneumology, University Medicine Essen - Ruhrlandklinik, University Duisburg-Essen, Tüschener Weg 40, 45239, Essen, Germany
| | - Gerhard Weinreich
- Department of Pneumology, University Medicine Essen - Ruhrlandklinik, University Duisburg-Essen, Tüschener Weg 40, 45239, Essen, Germany
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Fauroux B, Waters K, MacLean JE. Sleep in children and young adults with cystic fibrosis. Paediatr Respir Rev 2021:S1526-0542(21)00094-4. [PMID: 34686437 DOI: 10.1016/j.prrv.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 10/20/2022]
Abstract
Large gains have been made in the management of respiratory diseases associated with cystic fibrosis (CF). Initial studies evaluating sleep issues in CF focused on respiratory problems of nocturnal hypoxia, alveolar hypoventilation and risk of airway obstruction from nasal polyps with treatment evaluations including long term oxygen therapy or noninvasive ventilation in case of nocturnal hypercapnia. More recent studies include patients whose lung function is better preserved, and have permitted more focus on sleep patterns and sleep quality. This literature identified that reduced sleep duration and poor sleep quality are common and may be explained by chronic pain and cough, frequent stools, gastro-oesophageal reflux, nasal obstruction or sinusitis, and drugs such as corticosteroids or beta-agonists. In the teenage years, poor sleep hygiene, sleep debt and poor sleep quality are associated with depression, poor academic performance, less physical activity, and a decrease in quality of life. Restless leg syndrome also seems to be common in adult patients with CF. These sleep problems seem more important in patients with a low lung function but may also be observed in patients with preserved lung function. The consequences of poor sleep may potentially exaggerate the multi-organ morbidity of CF, such as pain, inflammation, susceptibility to infection, and glucose intolerance, but these aspects are largely under-evaluated. Sleep should be evaluated on a routine basis in CF and prospective studies assessing the benefits of interventions aiming at improving sleep duration and sleep quality urgently needed.
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Affiliation(s)
- Brigitte Fauroux
- Pediatric Noninvasive Ventilation and Sleep Unit, Necker University Hospital, AP-HP, Paris, France; Université de Paris, EA 7330 VIFASOM, F-75004 Paris, France.
| | - Karen Waters
- The Children's Hospital at Westmead, Sydney, Australia; Faculty of Medicine, University of Sydney, Australia
| | - Joanna E MacLean
- Division of Respiratory Medicine, Department of Pediatrics, University of Alberta, Edmonton, Canada
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McNarry MA, Stevens D, Stone M, Roberts S, Hall S, Mackintosh KA. Physical activity, sedentary time and sleep in cystic fibrosis youth: A bidirectional relationship? Pediatr Pulmonol 2021; 56:450-456. [PMID: 33236848 DOI: 10.1002/ppul.25185] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 11/11/2020] [Accepted: 11/14/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Physical activity (PA) and sleep are highly important for those with cystic fibrosis (CF), yet, despite this and suggestions of a bidirectional relationship between these factors in healthy children, their relationship is yet to be investigated. METHODS PA, sedentary time (SED), and sleep were objectively derived over seven days in 58 youth (11.9 ± 2.7 years; 29 CF). Generalized linear latent and mixed models with a random intercept and slope at child-level were adjusted for age, sex, wear-time, type of day, group and mean PA/SED and sleep. RESULTS Every additional 10 min sedentary was associated with 5.6 and 5.0 min less sleep and 10.6 and 12.0 min less wake after sleep onset (WASO) that night, in CF and healthy children, respectively. PA, regardless of intensity, was not associated with total sleep time but every additional 10 min of light PA (LPA) was associated with 3.0 min less WASO in healthy participants. Ten mins more sleep was associated with 3.1 and 1.7 min less SED in CF and healthy children, respectively. In CF, greater sleep time led to less LPA (3.6 min) the following day, whereas, in healthy children, poor sleep quality (greater WASO) was associated with more LPA (1.4 min) and moderate-to-vigorous PA (5.2 min) the following day. CONCLUSION A bidirectional relationship between SED and subsequent total sleep time was evident, irrespective of group, whereas the relationship between sleep and PA was group dependent. These findings have important implications regarding the reciprocal effects of promoting PA or sleep quantity or quality.
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Affiliation(s)
- Melitta A McNarry
- Applied Sports, Technology, Exercise and Medicine Research Center (A-STEM), College of Engineering, Swansea University, Swansea, Wales, UK
| | - Daniel Stevens
- Division of Kinesiology, Faculty of Health, School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.,IWK Health Center, Halifax, Nova Scotia, Canada
| | - Michelle Stone
- Division of Kinesiology, Faculty of Health, School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Spencer Roberts
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sarah Hall
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Kelly A Mackintosh
- Applied Sports, Technology, Exercise and Medicine Research Center (A-STEM), College of Engineering, Swansea University, Swansea, Wales, UK
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