Background Exercising at different levels of intensity is associated with an acute inflammatory response as a result of muscle damage, which consequently leads to delayed onset muscle soreness (DOMS). Cold-water immersion (CWI) has shown the potential to reverse exercise related muscle inflammation and enhance post-exercise recovery following sport activities. Several studies have investigated the effect of CWI on muscle recovery, however, their results are controversial. The purpose of the current study was to examine the physiological response of CWI on healthy participants and explore the physiological and psychological effect of CWI on athletes compared with controls. Methods Phase one observed the physiological response of 9 healthy active volunteers immersed in 12-13° for 15 minutes. Heart rate (HR), blood pressure (BP) and O2 consumption were measured and monitored. Inflammatory biomarkers and muscle strength were observed prior to immersion, 30 minute and 24 hour following CWI. Phase two used a randomized crossover trial to study the effectiveness of CWI [15 minutes of CWI at 12-13°C] compared to passive recovery [15 minutes sitting] post delayed onset muscle soreness in 8 elite male rugby players. Inflammatory biomarker, muscle strength, were measured prior to the intervention and 30 minutes, 24 and 48 hour post intervention. Muscle soreness [VAS and pain pressure threshold] was measured 20 minutes, 24 and 48 hours post intervention. Phase three explored the psychological effect of CWI using a focus group and self-administered questionnaire. Result In Phase one, CWI produced no significant changes in cardiovascular function, oxygen consumption, muscle strength and hormone concentration levels. In Phase two, CWI reduced immediate quadriceps muscle soreness by (5 unit) compare to passive group by (15 unit) (P=0.006). No effect on strength or inflammatory cytokines compared to passive recovery. In Phase three, athletes reported a perception of improved performance and reduction in pain when using CWI. Conclusion CWI has positive effects for the treatment of DOMS. Physiologically it reduces immediate muscle tenderness, but does not affect muscle strength. Psychologically athletes perceive an improvement in performance and reduction in pain.

The search for genes that influence human performance and health constitutes a popular topic of current research. One such genetic constituent that has caused much interest over the last 20 years is the angiotensin converting enzyme insertion/deletion polymorphism (ACE I/Dp). There is much controversy in the literature regarding the role (if any) of this polymorphism as effects and effect size vary between populations of different origin and training status. The aim of this thesis was to analyse at the whole organism level whether skeletal muscle plasticity explains the association of the ACE lfD polymorphism with metabolic fitness. Regular endurance exercise reduces the risk of a plethora of diseases, but the exact molecular mechanisms are not fully understood - the ability of muscle to adapt to exercise stimulus is key. Trained individuals demonstrated clear physiological differences of aerobic processes such as increased oxygen usage, greater power output and reduced body rat that would be expected (T-Test: p<O.OO l ). By contrast, when examining metabolite changes, at rest, in the local muscle there were few (n=6) nonpolar (lipid species) metabolite (assessed by mass spectrometry) differences between the trained and untrained. However, after an acute exercise bout working muscle in trained individuals displayed a significant up-regulation of (n=76) non-polar metabolites (Repeated ANOVA: p=O.0004) , illustrating that training produces significant adaptations in substrate metabolism at the local level Would there be a genetic component contributing towards these physiological and local muscle differences? Individuals with the ACE I-allele (insertion sequence) had increased capillary density, and there were significant differences in transcripts, together with both polar and non-polar metabolites in the untrained population at rest and following an acute exercise bout. These differences were lost in the trained population. In a different population (Swiss) capillary density was increased following a training programme in the absence of the I-allele - in contrast to the other population (British). However, gene expression response of important factors, to exercise was preserved. In conclusion, a trained population demonstrated enhanced non-polar metabolism in the working muscle after an exercise bout, and the dominant stimulus of regular exercise over-rides the influence of the ACE I/Dp. Nurture over-rides nature.

Physical inactivity is a global phenomenon, with estimates of one in four adults not being active enough to achieve health benefits, thus heightening the risk of developing non-communicable diseases. In order to realise the health and wellbeing gains associated with physical activity the behaviour must be sustained. Community-based group exercise programmes (CBGEP) utilising social support have been shown to be one means of not only increasing activity levels for older people, but sustaining physical activity. A mixed-methods systematic review revealed a gap in the literature around older people’s long-term adherence to real-life CBGEP within a UK context. This study therefore sought to address this gap by understanding older people’s ongoing adherence to CBGEP with a view to gaining further insight about which factors contribute to enabling people to sustain their physical activity levels. A multiple case study research design was employed to understand older people’s (≥ 60 years, n=27) adherence (≥ 69%, for ≥ 1 year) to three current CBGEP in the South- West of England. Qualitative data (participant observation, focus groups, documents, and interviews) were collected and analysed using inductive thematic analysis followed by the analytic technique of explanation building. In order to gain deeper insights into adherence, the humanisation framework was utilised in an a priori manner to further understand adherence from a humanising perspective. Quantitative data were analysed using descriptive statistics and used to set the context of the study. This study found that older people’s adherence to CBGEP was mediated through six factors: factors relating to the individual, the instructor, programme design, social features, participant perceived benefits, and a humanised exercise environment. These all served to explain older people’s adherence to CBGEP. The humanising qualities of these CBGEP must be considered if we wish to support older people in sustaining a physically active lifestyle as they age. These findings are of interest to practitioners and policy makers in how CBGEP serve to aid older people in maintaining a physically active lifestyle with a view to preventing non-communicable diseases and in maintaining social connectivity.

Neuro-musculoskeletal impairments are a substantial burden on our health care system as a consequence of disease, injury or aging. A better understanding of how such impairments influence the skeletal system through muscle force production is needed. Clinical gait analysis lacks in a sufficient estimation of individual muscle forces. To date, joint moments and EMG measurements are used to deduce on the characteristics of muscle forces, however, known limitations restrain a satisfying analysis of muscle force production. Recent developed musculoskeletal models make it possible to estimate individual muscle forces using experimental kinematic and kinetic data as input, however, are not yet implemented into a clinical gait analysis due to a wide range of different methods and models and a lack of standardised protocols which could be easily applied by clinicians in a routine processing. This PhD thesis assessed the state of the art of mathematical modelling which enables the estimation of muscle force production during walking. This led into devising a standardised protocol which could be used to incorporate muscle force estimation into routine clinical practice. Especially the input of clinical science knowledge led to an improvement of the protocol. Static optimisation and computed muscle control, two mathematical models to estimate muscle forces, have been found to be the most suitable models for clinical purposes. OpenSim, a free available simulation tool, has been chosen as its musculoskeletal models have been already frequently used and tested. Furthermore, OpenSim provides a straight forward pipeline called SimTrack including both mathematical models. Minor and major adjustments were needed to adapt the standard pipeline for the purposes of a clinical gait analysis to be able to create a standardised protocol for gait analyses. The developed protocol was tested on ten healthy participants walking at five different walking speeds and captured by a standard motion capture system. Muscle forces were estimated and compared to surface EMG measurements regarding activation and shape as well as their dependence on walking speed. The results showed a general agreement between static optimisation, computed muscle control and the EMG excitations. Compared to the literature, these results show a good consistency between the modelling methods and surface EMG. However, some differences were shown between mathematical models and between models and EMG, especially fast walking speeds. Additionally, high estimated activation peaks and uncertainties within the estimation process point out that more research needs to be undertaken to understand the mechanisms of mathematical models and the influence of different modelling parameters better (e.g. characteristics of muscle-tendon units, uncertainties of dynamic inconsistency). In conclusion, muscle force estimation with mathematical models is not yet robust enough to be able to include the protocol into a clinical gait analysis routine. It is, however, on a good way, especially slow walking speeds showed reasonable good results. Understanding the limitations and influencing factors of these models, however, may make this possible. Further steps may be the inclusion of patients to see the influence of health conditions.

Physical Inactivity (PI) is a leading risk factor for non-communicable diseases (NCDs), such as diabetes and coronary heart disease, therefore increasing population physical activity (PA) levels is a public health priority. This PhD considers two relatively new approaches being advocated to increase population-level PA- the policy approach and the environmental approach - both of which require further investigation (NICE, 2008). Firstly, it investigated local policy with respect to awareness and appreciation of PA by reviewing the nature and extent to which PA was acknowledged within NI government documents; it also discovered whether the use of health impact assessment in policy making was widespread. A second study comprised a review of qualitative research on the perceived impact of urban renewal on the PA of adults living in areas of socio-economic deprivation; it focused on the barriers and facilitators to engaging in and maintaining PA in areas of proposed or completed urban renewal. The main part of this PhD explored the views of residents, in an area of east Belfast that was earmarked for urban renewal, about their barriers and facilitators to PA, potential solutions to overcoming PI and their views on the use of urban renewal to change PA behaviour. Overall, the results suggested that environmental and policy approaches have the potential to impact positively on the PA levels of adults living in socio-economically deprived areas. The success of efforts to increase PA in the context of urban renewal, depends on conducting consultation exercises (incorporating qualitative research) with stakeholders particularly residents, to identify and address perceived barriers to PA as an integral part of the process. This contextual information can then be used to co-develop and implement multi-collaborative, multi-component interventions with residents, to increase PA, improve social capital and reinforce community capacity development. The PhD addresses the lack of research about lay views and provides a detailed bottom-up perspective of barriers, facilitators and potential solutions to increasing population-level physical activity.

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Whilst a significant gender gap in bicycle usage in the UK has been apparent for some time, the reasons why women are cycling less than men has not been comprehensively studied. Similarly, whilst we know that people influence each other's travel choices, social influence and cycling have been little studied. This qualitative research added to knowledge of this important health and transport policy area by providing new data on women's and men's experiences of cycling in two UK cities; Bristol and Cardiff. A reflexive sociological perspective, which combined influences from both critical realism and feminism, informed the research and shaped the research design and the data production and analysis. A total of 49 discussions were conducted with females and males who currently cycle, using a novel two-stage methodology, involving 42 semi-structured interviews and 7 linked social reference focus groups (SRFGs), with social contacts of the initial interviewee. This method was designed in order to detect social influence on (inward) and from (outward) research participants. The data were analysed using thematic analysis and presented using five key themes; affective barriers, affective enablers, instrumental barriers, instrumental enablers, and gendered aspects of the cycling experience. Key differences were identified around aggression and competitiveness in cycling, gendered norms on clothing and appearance and the continuation of gendered social roles. However, a large degree of commonality between men and women was also present, especially around the desire for a safer and more attractive cycling experience. Social influence was explored using 'social maps', which participants made to describe their key social influences related to cycling. Social influence was gendered, with women more likely to encourage other women, and men other men. Participants also portrayed their influence as largely positive, with no or few negative social influences, although instrumental influencers were sometimes viewed as negative. The research highlighted the need to encourage women to cycle by both providing better for their infrastructural needs, but also to recognise the often different ways in which they might approach cycling in policy initiatives. Further research could explore ways in which this could be achieved, and also provide a comparative analysis of men's and women's cycling experience between a UK location and a high-cycling country location, such as the Netherlands, Denmark or Germany.

The study is primarily concerned with the analysis of cinematographic records of human movement. Computational techniques for smoothing and differentiation of numerical data are examined and a suitable method is established as a computer programme. The programme accepts displacement data from cine film of a body action and produces inertia force components of the body segments. The equation of motion is expressed in terms of a sumation of segmental forces. The computed results are compared with the total reaction measured on a force platform and arc also used to indicate the segmental contributions in the sunmation. The analytical procedures are general, but are here applied to cimp2e athletic activities. Discussion of body motion and external force action is followed by estimation of the internal effects in muscles and joints in the lower limbs. During the course of the work, discussion of segmental models of the human body and of scum mechanical principles is undertaken. These sections range beyond the requirements of the central study and offer some broader considerations in movement analysis.

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