Anterior Cruciate Ligament Reconstruction – Semitendinosus Tendon Autograft Resistance Testing
The ACLR-START study is recruiting participants! We are looking for actively competing elite alpine ski racers who underwent an anterior cruciate ligament (ACL) reconstruction at least two years ago. This operation must have involved a semitendinosus tendon autograft procedure. Participants in ACLR-START can be male or female, between the ages of 15-30. Testing will occur at the University of Calgary and Winsport facilities. The two hour session will include a “DEXA” full body composition scan and comprehensive strength testing with a dynamometer. If you think you or anyone you know fits the description for participants provided above, please contact Mike Christie at:
Are you thinking about starting an exercise program and wish to gain valuable information about your body composition and aerobic fitness?
The Doyle-Baker Lab at the University of Calgary recruited participants for a study investigating the relationship between physical activity and gut bacteria composition. participants were:
- Between the ages of 18-55 yrs.,
- Considered: sedentary and unfit, i.e., sit for 12 hours a day and did participate in physical activity
- A BMI of 28 or higher
- Had no known chronic illness, cardiac disease, and not currently taking any medications
Participation involved providing information about physical activity and diet, a stool sample, as well as taking part in 1 hr of testing that involved a body composition scan (DXA) and a submaximal bike test. Upon completion the participant summary included: personal results (body composition, blood pressure, heart rate, aerobic fitness etc.)
Thank you for your interest in this study, please click the link below to fill out a prescreening survey to help us determine your eligibility to participate in this study. https://www.surveymonkey.com/r/foragestudy
In the first class of KNES 433 (Title: Physical Activity and Health), a course in the Exercise and Health Physiology route, Dr. Doyle-Baker asked us, “What are you going to die from?” This question took me by surprise as I’d never really considered my own death and dying before. During the next four months, this class changed my outlook on a number of areas in my life. Course material required me to examine my family tree for disease history, understand my blood lipid profile, take a reflective look at my dietary habits, and be honest with myself about different lifestyle choices I was making. All of this information meant that I had to stop and think about what I was doing for my health and wellbeing. As the saying goes, if you don’t make time for health now, you’ll make time for illness later. I had never fully considered how all the aspects of my life fully intertwined and contributed to the person that I was at that moment.
These reflections culminated in the Personal Health Report (PHR). For me, this paper was the cherry on top of an amazing university experience. At the University of Calgary, and specifically the faculty of Kinesiology (http://www.ucalgary.ca/knes/), there is a strong focus on integration between different disciplines. The PHR required me to synthesize all that I had learned over the last four years into one clear, concise paper where I could draw a conclusion about my health status.
We learned that the first step towards making a change is becoming aware of what is going on. Too often, I rush through each day without really stopping to think. I took this course in the last semester of my degree and was able to identify some negative habits and troubleshoot so that I could create solutions that would work for me as I left my cozy university bubble. One of the main things that I identified was my grocery shopping habits. I don’t own a car, which can make grocery shopping a struggle, especially in the winter. For example, I went one semester without grocery shopping for six weeks! While I could get food on campus, this food was definitely of a lesser quality, which would negatively impact my future health if these habits continued over time. I had been aware that this was a problem but I had never set about finding a solution. Since completing this report, I now try to go grocery shopping every 7-10 days, and for the most part I am successful. My diet has improved and I feel healthier and have more energy!
I believe that the PHR helped me develop as a kinesiologist. The course required that I review my family history and, because of this, I had many conversations with my family about what I was working on. The family tree of medical history definitely opened up the dialogue between myself and my parents. I am the only one in my family with this kind of the background; everyone else is an engineer or in a related field. This meant that I got a lot of practice explaining things in layman’s terms, which is something I now have to do every day for work.
Shortly after graduation, I started working in the Culos-Reed Health and Wellness Lab and for the lifestyle management program, TrymGym. Both of these jobs require me to have a solid understanding of the effect different lifestyle factors have on physiological and psychological outcomes. Without taking KNES 433 and completing the PHR, I would definitely be at a disadvantage in both of these settings. One of my favourite parts of my job with TrymGym is seeing the participants have similar realizations and making changes like I did during and after KNES 433.
So what am I going to die from? After completing KNES 433, I can tell you that the odds favour Type 2 Diabetes and Cardiovascular Disease. However, I am confident that I have gained skills in the realms of food and health literacy that will allow me to make positive decisions, ultimately decreasing my risk of disease and leading to an enhanced quality of life.
Amanda Wurz & Dr. S. Nicole Culos-Reed
As it is now nearing the end of August, you should be convinced of the importance of physical activity during childhood, a key factor in the development of healthy children and eventually healthy adults. As Andrew mentioned in “How Much Physical Activity do Children Need?”, physical inactivity in our children and youth is alarming. We know that less than half of children are meeting the Canadian Society for Exercise Physiology (CSEP) Physical Activity Guidelines. And research suggests that childhood cancer patients and survivors are more sedentary than their healthy peers1,2,3. It may seem counterintuitive to focus on physical activity levels while a child is battling cancer, as we typically think children should be resting and recovering from their treatment. However, the research consistently stresses the importance of exercise throughout the childhood cancer trajectory4,5,6,7.
Tremendous advances in research and technology over the past 30 years have resulted in improved treatment and survival rates, with over 80% of childhood cancer patients becoming long-term survivors8,9. Unfortunately, survivorship is often accompanied by negative side-effects that develop both during and after treatments10. Physical early side-effects impact a range of body tissues and functions during or shortly after treatment (i.e., increased risk of infections, bleeding and clotting complications, nausea, vomiting, allergic reactions, skin changes, temporary hair loss, fatigue). Physical late side-effects occur months or years after treatment ends and include, reduced muscular strength, damage to nerves in the extremities, reduced cardiovascular functioning due to damage to the lungs and heart, persistent fatigue. Psychosocial early side-effects include a range of negative social and emotional states that would be expected to occur during or shortly after treatment (i.e., anxiety, fear, depression, social isolation) with many of the late side-effects occurring months or years after treatment ends (i.e., poor social functioning, withdrawal, decreased health related quality of life). Several resources outlining the array and degree of side-effects experienced can be accessed online11,12. Unfortunately, adding physical inactivity into this mix not only worsens the side-effects experienced, but it also increases the likelihood of childhood survivors developing diseases such as hypertension, diabetes, osteoporosis and cancer recurrence4,13,14.
Across childhood cancers, patients report lower amounts and intensity levels of physical activity than healthy children. Pain, fear, anxiety, fatigue, difficulty accessing programs, and the overprotective attitudes of parents and educators have been commonly cited in the literature as barriers to physical activity in this population15,16. Additionally, it is suggested that the low levels of physical activity typically seen in this population may be due to the fact that pediatric cancers peak in incidence between the ages of 2-5 years, a time when many children are introduced to leisure time physical activity4,17. Thus, their disease may impede their ability to play with their peers and establish healthy physical activity habits. Likely it is a culmination of disease timing, fatigue, limited programming, parental attitudes, and an array of personal and familial characteristics that result in lower than average physical activity levels.
Fortunately, researchers and clinicians are aware of the importance of early intervention in this population. The last 15 years have shown physical activity’s beneficial impact on many of the negative physical and psychosocial side-effects of treatment2,4,5,18.
Although the field is still young and the majority of findings are preliminary, the existing evidence consistently suggests that mild to moderate exercise is safe, beneficial and feasible for both childhood cancer patients and survivors. As the field grows it will be important to:
(i) Share the research information we have;
(ii) Create tailored guidelines. Our lab is currently working with an international team to put out the first Pediatric Oncology Exercise Manual – POEM – which will be distributed to physicians and parents at the Alberta Children’s Hospital, as well as across Canada, and through our colleagues worldwide); and,
(iii) Create safe, evidence-informed programs to offer patients and survivors a safe space to exercise (that takes into account their compromised immune systems, lower level of physical functioning etc.). We have developed Pediatric Survivors Engaging in Exercise for Recovery (PEER), and will be launching Yoga Thrive for Youth (YTY) an innovative yoga program for childhood and adolescent cancer patients and survivors in Fall 2013. These programs have a central goal: Provide childhood cancer patients and survivors safe, accessible, evidence-informed activity programming that will enhance and restore their levels of physical and psychosocial functioning. We need to continue reaching out to childhood cancer patients and survivors to ensure they are meeting physical activity guidelines.
A more in depth article expressing our teams vision for the future of physical activity and pediatric oncology can be found here: Chamorro-Vina, C, Wurz, AJ, & Culos-Reed, SN (2013). Promoting physical activity in pediatric oncology. Where do we go from here? Frontiers in Oncology, 3(173), 1-4. doi: 10.3389/fonc.2013.00173
- Ness, K.K., Leisenring, W.M., Huang, S., Hudson, M.M., Gurney, J.G., Whelan, K. et al. (2009). Predictors of inactive lifestyle among adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study. Cancer, 115(9), 1984-1994.
- Kelly, A.K. (2011). Physical activity prescription for childhood cancer survivors. Current Sports Medicine Reports, 10(6), 352-359.
- Ness, K.K., Hudson, M.M., Ginsberg, J.P., Nagarajan, R., Kaste, S.C., Marina, M. et al. (2009). Physical performance limitations in the Childhood Cancer Survivor Study cohort. Journal of Clinical Oncology, 24(14), 2382-2389.
- San Juan, A.F., Wolin, K., & Lucia, A. (2011). Physical activity and pediatric cancer survivorship. In: Courneya K.S., & Friedenreich, C.M. (eds) Physical activity and cancer: Recent results in cancer research (pp.319-347). New York: Springer – Berlin Heidelberg.
- Huang, T-T., & Ness, K.K. (2011). Exercise interventions in children with cancer: A review. International Journal of Pediatrics, 1-11.
- Soares-Miranda, L., Fiuza-Luces, C., Lassaletta, A et al. (2013). Physical activity in pediatric cancer patients with solid tumors (PAPEC): Trial rationale and design. Contemporary Clinicial Trials, 5(1), 106-115.
- Winter, C., Muller, C., Brandes, M., Brinkmann, A., Hoffman, C., Hardes, J. et al. (2009). Level of activity in children undergoing cancer treatment. Pediatric Blood and Cancer, 53(3), 438-443.
- Jemal, A., Siegel, R., Ward, E., Hao, T., Xu, J., & Thun, M.J. (2009). Cancer statistics, 2009. CA – A Cancer Journal for Clinicians, 59(4), 225-229.
- Ellison, L.F., Prithwish, D., Mery, L.S., & Grundy, P.E. (2009). Canadian cancer statistics at a glance: Cancer in Children. Canadian Medical Association Journal, 180(4), 422-424.
- Oeffinger, K.C., Mertens, A.C., Sklar, C.A., Kawashima, T., Hudson, M.M., Meadows, A.T. et al. (2006). Chronic Health Conditions in Adult Survivors of Childhood Cancer. New England Journal of Medicine, 355, 1572-1582.
- Shad, A.T., Late Effects of Childhood Cancer and Treatment. (2010). http://emedicine.medscape.com/article/990815-overview.Retrieved August 28, 2013.
- American Cancer Society. (2012). Children diagnosed with cancer: Late effects of cancer treatment. http://www.cancer.org/treatment/childrenandcancer/whenyourchildhascancer/children-diagnosed-with-cancer-late-effects-of-cancer-treatment. Retrieved August 28, 2013.
- Finnegan, L., Wilkie, D.J., Wilbur, J., Campbell, R.T., Zong, S., & Katula, S. (2007). Correlates of physical activity in young adult survivors of childhood cancers. Oncology Nursing Forum, 34(5), E60-E69.
- Wolin, K.Y., Ruiz, J.R., Tuchman, H., & Lucia, A. (2010). Exercise in adult and pediatric hematological cancer survivors: An intervention review. Leukemia, 24(6), 1113-1120.
- Arroyave, W.D., Clipp, E.C., Miller, P.E., Jones, L.W., Ward, D.S., Bonner, M.J. et al. (2008). Childhood cancer survivors’ perceived barriers to improving exercise and dietary behavior. Oncology Nursing Forum, 35, 121-130.
- Aznar, S., Webster, A.L., San Juan, A.F., Chamorro-Vina, C., Mate-Munoz, J.L., Moral, S. et al. (2006). Physical activity during treatment in children with leukemia: A pilot study. Applied Physiology, Nutrition and Metabolism, 31, 407-413.
- Oeffinger, K.C., Buchanan, G.R., Eshelman, D.A., Denke, M.A., Andrews, T.C., Germak, J.A. et al. (2001). Cardiovascular risk factors in young adult survivors of childhood acute lymphoblastic leukemia. Journal of Pediatric Hematology/Oncology, 23(7), 424-430.
- Keats, M.R., & Culos-Reed, S.N. (2008). A community-based physical activity program for adolescents with cancer (project trek): Program feasibility and preliminary findings, Journal of Pediatric Hematology and Oncology, 30, 272-280.
A word from the DBL:
Many thanks to our guest contributors, Amanda Wurz and Dr. S. Nicole Culos-Reed. Dr. Culos-Reed is the director of the Health & Wellness Lab, University of Calgary, Faculty of Kinesiology. She is an Associate Professor in Health and Exercise Psychology in the Faculty of Kinesiology and Adjunct Associate Professor in the Department of Oncology in the Faculty of Medicine at the University of Calgary. She also holds a Research Associate appointment with the Department of Psychosocial Resources in the Tom Baker Cancer Centre. Her research is focused on the benefits of physical activity throughout the cancer trajectory. Amanda Wurz holds a BA in Psychology and is currently a MSc student at the University of Calgary, in the Health & Wellness Lab. Her research is exploring the effects of a 12-week yoga intervention in childhood cancer out-patients. Additionally, she assists with both the PEER and YTY programs.
By: Lisa Campkin Published August 28, 2013
The notion of physical activity and exercise can be daunting for adults over the age of 65, especially for those living with a chronic condition or those who have never felt comfortable with being physically active previously. Fear not, older adults! There is plenty of evidence to show that becoming more active is within your reach and well worth the effort.
This article outlines why it is important to get active and how you can do so. Not only will a daily dose of activity improve your health today, it can contribute to your increased quality and life over time as well as decrease the risk of premature death .
Let’s outline the ways you can get active. There are a few broad categories to understand regarding fitness and physical activity:
- Aerobic Activity to get the heart beating faster and increase overall cardiovascular fitness 
- Flexibility and Balance to keep motion in the joints and help to prevent falls 
- Strengthening Activity to keep bones strong, maintain muscle mass and strength for daily activities 
By maintaining a mixture of these three activities, the preventative and therapeutic effects of physical activity can also improve your health in the following ways:
- Improve balance 
- Maintain independence further into life 
- Prevent a number of diseases such as heart disease, type II diabetes, osteoporosis & some forms of cancer 
- Improvements in cognition 
- Reduce the incidence of dementia 
Specifically, how should you go about creating this lifestyle-based physical activity plan? Generally, it is best to look to Canadian Physical Activity Guidelines  for suggestions on how much activity is needed for health benefits as well as useful tips on how to incorporate activity into your life. Take these suggestions for example:
|Mow the lawn||Gardening & yard work (digging, lifting etc.)|
|Walk to the store||Carrying groceries|
|Cross-country skiing||Climbing stairs|
Overall, the activity should make you…
|BE IN CONTINUOUS MOVEMENT – INCREASE HEART RATE – BREATHE HARDER||PUSH OR PULL AGAINST A WEIGHTED OBJECT (could be your own body weight)|
Finally, how much and how often should you be enjoying activities such as the ones described above?
Take part in at least 2.5 hours of moderate- to vigorous-intensity aerobic activity each week. This time can be spread into sessions as low as 10 minutes each, and you will still obtain health benefits . Moderate intensity can be best described as a brisk walk while vigorous activity causes further heart rate and breathing rate increases over a moderate level; this intensity would closely resemble jogging for most people . Muscular strength activities should be performed at least two days per week . Inspire others to get off the couch – include friends and family in your efforts to become active and look into joining a community fitness class  Make the activity social and fun and you’re more likely to stay engaged longer. These are the minimum current standards to maintain health and prevent illness, so to exceed these amounts could result in further risk reduction of disease and disability . Talk to your health professional if you have any activity-based questions or health concerns regarding these recommendations .
The key to becoming more active lies in your motivation to do so and enjoyment in the journey. Start by finding an activity you truly enjoy, and do it often enough to reap the health benefits associated with it. Only a few older adults are currently meeting basic physical activity guidelines . Be a positive role model for others and get out there!
- Nelson, M.E., Rejeski, W.J., Blair, S.N., Duncan, P.W., Judge, J.O., King, A.C., Macera, C.A. & Castaneda-Sceppa, C. (2007). Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Medicine and Science in Sports and Exercise, 39(8), 1435-45.
- Public Health Agency of Canada (2012, April 25). Physical activity tips for older adults (65 years and older). Retrieved August 21, 2013, from http://www.phac-aspc.gc.ca/hp-ps/hl-mvs/pa-ap/08paap-eng.php
- Haskell, W.L., Lee, I.M., Pate, R.R., Powell, K.E., Blair, S.N., Franklin, B.A., Macera, C.A., Heath, G.W., Thompson, P.D. & Bauman, A. (2007). Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Medicine and Science in Sports and Exercise, 39(8), 1423-34.
- King, A.C. (2001). Interventions to promote physical activity by older adults. The Journals of Gerontology: Series A: Biological Sciences and Medical Sciences, 56 (2), 36-46.
- Lautenschlager, N.T. Cox, K.L., Flicker, L., Foster, J.K., van Bockxmeer, F.M., Xiao, J., Greenop, K.R. & Almeida, O.P. (2008). Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial. The Journal of the American Medical Association, 300(9), 1027-1037.
Image: “Balance” by applecorekevin (©2006-2013)
Image: “Cogs” by suedollin (©2007-2013)
Image: “walking” by Ciaran-Brennan (©2004-2013)
by Jodi Nettleton
Published August 14, 2013
The previous blog indicated the amount of physical activity that is recommended for adults between the ages of 18-64 years according to the Centres for Disease Control and Prevention (CDC). The amount of spent in physical activity was based on the exercise intensity that is being performed.
Well, what is exercise intensity?
The World Health Organization (WHO) describes intensity as “the rate at which the activity is being performed or the magnitude of effort required to perform an activity or exercise”. In other words, how hard a person has to work to perform an activity or a specific exercise.
There are many ways to measure intensity, however we will only focus on two that we believe is easiest to measure for the general population. Other methods are generally performed in a laboratory with trained professionals. The two I will focus on may be done on your own with little to no extra gadgets required.
1. Heart Rate:
Heart rate is the number of heartbeats per unit of time – in this case, per minute.
To monitor intensity, one must first determine the maximum amount of heartbeats they can sustain per minute. Sounds intimidating, right?
Well, there is a simple and validated equation that requires nothing else than simple math to determine this value. No exercise required figuring this out.
220 – age = Maximum heart rate (HRmax)
For example: if you are 35 years old, your HRmax would be (220 – 35) = 185
According to the CDC, moderate physical activity is within the range of 50% to 70% of your HRmax.
To calculate the lower end of this range:
50% of HRmax = HRmax (which is 220 – age) x 0.5
The upper end of this range:
70% of HRmax = HRmax x 0.7
Therefore, a 35 year old individual have moderate exercise intensity between 93 – 130 beats per minute.
Vigorous intensity is considered to be within the range of 70% to 85% of HRmax.
To calculate the lower end of this range:
70% of HRmax = HRmax x 0.7
The upper end of this range:
85% of HRmax = HRmax x 0.85
Monitoring your heart rate does not require you to personally count your heartbeats while exercising – that would be too much work!! There are wonderful gadgets called heart rate monitors that will do the job for you. Generally they include a belt consisting of the monitor that wraps around your chest and a watch that will show you how hard your heart is working by recording the amount of beats per minute.
Heart rate monitors range in price, from around $30 to $300. They may be found at most running and sport stores.
2. Rating of Perceived Exertion (RPE) Scale:
The RPE scale is a subjective measure of exercise intensity. Originally created by Gunnar Borg in the 1980’s, intensity was measure on a scale of 6 – 20, based on inferred heart rates that would correspond. For example, a rating of 12 on the scale would represent a heart rate of 120. It has been modified to a scale of 1 – 10, that many people may find conceptually easier, with 0 = when the body is at rest and 10 = maximum heart rate.
However, I have posted the Borg scale from values 6 – 20 because this scale has had more research determining its validity, and is used primarily in the exercise physiology labs for undergraduate kinesiologystudents when performing exercise testing.
The rating of 6 corresponds to “no exertion at all” where 20 correspond to “maximal exertion”.
Rating between 11 – 12 are considered moderate intensity, where 13 and higher is considered vigorous.
The Borg Scale:
Centres for Disease Control and Prevention. (2011, December 1). How much physical activity do adults need? Retrieved August 10, 2013, from http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html
Mayo Clinic. (2011, March 5). Exercise intensity: why it matters, how it’s measured. Retrieved August 12, 2013, from http://www.mayoclinic.com/health/exercise-intensity/SM00113
McArdle, W. D., Katch, F. I. & Katch, V. L. (2010). Exercise physiology: nutrition, energy, and human performance, 7th. ed. Baltimore, MD: Lippincott Williams & Wilkins.
Public Health Agency of Canada. (2012, April 25). Physical activity tips for adults (18-64 years). Retrieved August 10, 2013, from http://www.phac-aspc.gc.ca/hp-ps/hl-mvs/pa-ap/07paap-eng.php
Scherr, J., Wolfarth, B., Christle, J. W., Pressler, A., Wagenpfeil, S. & Halle, M. (2013). Associations between Borg’s rating of perceived exertion and physiological measure of exercise intensity. European Journal of Applied Physiology, 113, 147-155.
World Health Organization. (2013). What is moderate-intensity and vigorous-intensity physical activity? Retrieved August 13, 2013 from http://www.who.int/dietphysicalactivity/physical_activity_intensity/en/