A previous animal study conducted in our lab showed that blueberry, a rich source of polyphenols, was able to increase whole-body BMD in ovariectomized (OVX) rat model. In addition, blueberry, as low as 5% in the diet, was able to suppress ovariectomy-induced rate of bone turnover. The present study was conducted to further investigate the anti-inflammatory properties of blueberry total polyphenols in MC3T3-E1 preosteoblast cells treated with tumor necrosis factor- and #945; (TNF- and #945;) and interleukin 1 (IL-1) on a molecular level. Cells were treated with blueberry (0, 10, 100 and #956;g/ml) for 24 h prior to the treatment of TNF- and #945; (10 ng/ml) or IL-1 (10 ng/ml) or combination of these two cytokines for 24 h and 48 h. Cell viability, nitric oxide (NO) production and expression of osteoclastogenesis and osteoblastogenesis factors mRNA were measured. The findings indicated that blueberry failed to significantly increase cell proliferation in the presence of proinflammatory cytokines, but blueberry polyphenols were able to significantly suppress NO production stimulated by either TNF- and #945; or IL-1. There was no inhibitory effect of blueberry on NO production in the presence of both TNF- and #945; and IL-1. On the molecular level, 10 and #956;g/ml of blueberry decreased osteoclastogenesis mediators, such as TNF- and #945;, TNF- and #945; receptor (TNFR), TNF- and #945; receptor associated factor (TRAF), macrophages-colony stimulating factor (M-CSF), receptor activator of nuclear factor and #954;B ligand (RANKL), IL-1, interleukin 6 (IL-6), and inducible NO synthase (NOS2) numerically but not significantly. However, blueberry promoted expression of osteoblastogenesis mRNA, such as osteoprotegerin (OPG), runt-related transcription factor 2 (RUNX2), and osterix (OSX), under the inflammatory condition induced by cytokine mixture. In conclusion, blueberry polyphenols significantly suppressed NO production, were beneficial for up regulating transcriptions of factors that promote MC3T3-E1 preosteoblasts formation and activation. However, blueberry did not have inhibitory effects on production of osteoclastogenesis mediators under inflammatory conditions. / A Thesis submitted to the Department of Nutrition, Food and Exercise Sciences in partial fulfillment of the requirements for the degree of Master of Arts. / Summer Semester, 2011. / June 28, 2011. / Includes bibliographical references. / Bahram H. Arjmandi, Professor Directing Thesis; Arturo Figueroa, Committee Member; P. Bryant Chase, Committee Member.

Approximately half of all cancer patients undergo cachexia, a paraneoplastic condition characterized by unintended weight loss, skeletal muscle atrophy, and impaired physical function. Using a pre-clinical mouse model, we compared the effects of high-tension muscle loading (i.e. resistance exercise) and low-tension muscle loading (i.e. aerobic exercise). We hypothesized that high tension exercise would: 1) ameliorate the adverse effects of cachexia on body composition, functional performance, and muscle size to a greater extent than low tension exercise; and 2) induce changes in gene expression profiles and muscle signaling events to favor protein synthesis and suppress protein degradation. Twelve-month old Balb/c mice were initially assigned to control (n=16), low tension exercise (Low Ex, n=16), or high tension exercise (High Ex, n=16). Mice in Low and High Ex groups performed wheel running and weighted ladder climbing, respectively. Wheel running was implemented using a motorized wheel at speeds increased progressively to 7 m/min for 60 min/d, 5 d/wk. To achieve resistance overload, mice were subjected to weighted ladder climbing 3 d/wk. The initial resistance was 50% of body weight with 10% increases bi-weekly. After 8 weeks of training, half of the mice in each initial group were given a subcutaneous injection of colon-26 (C26) tumor cells, followed by an additional 2.5 weeks of training. Overall, 6 groups were studied including: 1) Control (n=8), 2) C26 (n=8), 3) Low Ex (n=8), 4) Low Ex + C26 (n=8), 5) High Ex (n=8), and 6) High Ex + C26 (n=8). Body composition and function were evaluated before and after exercise training while the gastrocnemius and plantaris muscles were excised at sacrifice and analyzed by RT-PCR, western blotting, and histological techniques. Two mice from the High Ex + C26 group (25%) met the endpoints for early euthanasia while all other tumor bearing groups completed the study. For sensorimotor function, significant performance declines occurred in all groups except Low Ex + C26 (Control: -16%, p=0.006; C26: -13%, p=0.001; Low Ex + C26: -1%, p=0.769; High Ex + C26: -23%, p=0.003), with post-training values being greater in Low Ex + C26 compared to C26 (+12%, p=0.08) and High Ex + C26 (+20%, p=0.01). Significant absolute strength declines were observed in all groups (Control: -7%, p=0.021; C26: -23%, p=0.001; Low Ex + C26: -14%, p=0.003; High Ex + C26: -19%, p=0.002), with lower post-values in C26 (-19%, p=0.004) versus Control but not in Low Ex + C26 and High Ex + C26 when compared to Control (p>0.05). When strength was normalized to body mass, significant pre to post reductions were observed in all groups (Control: -7%, p=0.01; C26: -21%, p=0.005; High Ex + C26: -10%, p=0.004) except Low Ex + C26 (p>0.05), with lower post-measurements in C26 (-18%, p=0.02) but not Low Ex + C26 and High Ex + C26 when compared to Control (p>0.05). Gastrocnemius mass was significantly smaller in C26 (-13%, p=0.004), Low Ex + C26 (-14%, p=0.002), and High Ex + C26 (-19%, p<0.001) when compared to Control. There were no differences in gastrocnemius mass amongst the three tumor bearing groups (p>0.05). Similarly, myofiber cross-sectional area of the gastrocnemius was significantly lower (p<0.001) in C26 (1150.77 ± 82.85 µm2; -46%), Low Ex + C26 (1431.20 ± 132.24 µm2; -32%), and High Ex + C26 groups (1266.61 ± 114.86 µm2; -40%) when compared to Control (2118.15 ± 58.79 µm2). No significant differences were noted between the three tumor bearing groups (p>0.05). There was an enlargement of spleen mass in C26 (+195%, p<0.001), Low Ex + C26 (+114%, p<0.001), and High Ex + C26 (+203%, p<0.001) when compared to Control. However, spleen mass in Low Ex + C26 was significantly lower than the other tumor bearing groups including C26 (-27%, p=0.008) and High Ex + C26 (-29%, p=0.008). IGF-IEa mRNA abundance in the plantaris of High Ex + C26 significantly exceeded Control (+79%, p=0.016) while its expression in Low Ex + C26 (+62%, p=0.053) and C26 (+51%, p=0.066) tended to be greater than Control. Regarding the myogenic regulatory factors, transcript levels of myogenin in C26 mice were not different from Control (p>0.05); however, they were significantly greater in High Ex + C26 versus Control (+126%, p=0.036) and C26 (+150%, p=0.018). Overall, these findings refute the hypothesis that resistance loading would provide the greatest degree of protection against cancer cachexia. Given that 25% of High Ex + C26 mice became moribund before the end of the experiment, the possibility exists that high levels of muscle loading may contribute to declines in health. The induction of myogenin by High Ex + C26 only, coupled with increased IGF-I expression provides some degree of support for this notion as it suggests that cachectic muscle exposed to high forces may be activating compensatory mechanisms to cope with the dual stressors imposed by tumor and mechanical loads that ultimately ends up being futile. In contrast, low tension loading preserved physical function and possibly reduced inflammation, suggesting that aerobic exercise performed at a regular weekly frequency may contain therapeutic value for patients with cancer cachexia, albeit in the absence of muscle mass retention. / A Dissertation submitted to the Department of Nutrition, Food and Exercise Sciences in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester, 2014. / June 27, 2014. / Aerobic Exercise, Cachexia, Resistance Exercise, Skeletal Muscle / Includes bibliographical references. / Jeong-Su Kim, Professor Directing Dissertation; Robert J. Contreras, University Representative; Samuel C. Grant, Committee Member; Bahram H. Arjmandi, Committee Member.

Introduction: Compression garments utilisation is very popular among runners despite the relative lack of consensus in the literature regarding a beneficial impact. Methods: A randomised controlled experimental study was conducted in healthy, uninjured endurance runners (n=41) participating in the Old Mutual Two Oceans 56km race. The experimental group (n=20) trained for six weeks and participated in the race wearing below knee compression garments while the control group (n=21) did not. Participants were tested on four occasions for various markers of exercise induced muscle damage (EIMD) and running performance. Six weeks prior to the race, ultrasound scans of the medial gastrocnemius, mid-calf and figure-of-8 ankle circumference baseline measurements were performed. Shortly prior to the race, these measurements were repeated in addition to a countermovement jump (CMJ) test. Immediately following the race, circumference measurements and CMJ testing were repeated in addition to pain ratings on the visual analogue scale (VAS). Race performance times were also obtained. Two days following the race, the ultrasound scans, circumference measurements and VAS pain ratings were repeated. Results: Ankle circumferences measurements increased significantly less (p=0.01, Cohen's d=0.9) in the experimental group from immediately after the race until two days post-race compared to the control group. There were no further statistically significant changes over time in any other objective outcome measure (i.e. mean mid-calf circumference, medial gastrocnemius mean muscle thickness and mean pennation angle, mean CMJ height and estimated peak power output nor in race performance) between the experimental and control groups. Selected pain ratings were statistically significantly worse in the experimental group. Muscle thickness and pennation angles were significantly greater in the control group compared to the experimental group two days following the race. Conclusion: There were limited indications of a beneficial impact of compression garments with minor improvements in ankle circumference measurements, but no further significant effects related to EIMD were detected. Furthermore, no ergogenic impact was detected. Based on the results of the study, there is limited evidence to support the continued utilisation of commercially available below knee compression garments during running.

Background: Participation in physical activity is a cost effective way to reduce the risks of over 25 chronic diseases. Despite the many dangers of physical inactivity, more than a quarter of the South African population remains inactive. One initiative aimed at increasing engagement in physical activity is parkrun, a free weekly 5 km running/walking based activity. There has been an increase in the number of parkrun participants in South Africa since its inception. An understanding of the motivation for participation and health related behaviour change is important for organisers and public health professionals to increase participation in this weekly mass participation event. Aim: The aim of this study was to describe the motivations for participation in parkrun and physical activity related behaviour changes among parkrun participants registered in the Western Cape Province of South Africa. Specific objectives The specific objectives of this study were: to identify demographic characteristics of parkrun participants in the Western Cape Province of South Africa; to describe the motivations for participating in parkrun runs in the Western Cape Province of South Africa; and to investigate physical activity related behaviour changes as a result of participating in parkruns in South Africa's Western Cape Province based on pre and post participation physical activity levels Methods: A cross sectional study was performed on 1787 parkrun participants registered at 40 parkrun sites in the Western Cape Province of South Africa. Participants from 37 of these sites were invited to participate via the parkrun South Africa mailing list in an online survey. Participants from the remaining three parkrun sites responded on paper-based questionnaires at the parkrun sites. The questionnaire included sections on demographic characteristics including employment status, gym membership and educational level; physical activity programmes before joining parkrun and changes in physical activity after joining parkrun. Results: The median age of participants was 50 (IQR:38-59). Female participants formed 53.3% of the sample. Approximately 80% of participants were educated to diploma or degree level (Technikons/College/University); and participants reported high employment rates (71%). Fifty-one percent of the sample were gym members. A total of 64.8% reported having very good to excellent health. A total of 86.1% reported health/fitness as the biggest motivation for participation in parkrun. Another 71.8% of the sample were motivated by enjoyment. Safe environment (58.7%), earning Discovery Health Vitality Points (46.4%), stress relief (40.8%), cost (40.4%) and socialisation (39.4%) were other common motivations among the sample. After joining parkrun, 24% of participants took up new physical activity programmes, with a further 24% of participant increasing their weekly volume of physical activity. More female participants (50.9%) than male participants (44.7%) increased their physical activity levels or took up new physical activity programmes (χ² =7.331, p=0.007). Running was the widely adopted physical activity attracting 18.2% of the sample as new runners. Conclusion: In conclusion, we found that parkrun in the Western Cape is mostly taken up by participants in their sixth decade of life with half of them being overweight. Most participants are physically active before joining parkrun with more than half exceeding recommended global physical activity levels. These results were described in previous studies in Australia and the UK. We also found health/fitness to be the biggest motivation for parkrun participation followed by enjoyment and the safe environment provided at parkrun sites. Running and walking are the common activities that are taken up by participants after joining parkrun. Further prospective studies are recommended to determine cause and effect models and describe health related physical activity behaviour changes in detail.

The high prevalence of running related injury, particularly in novice runners has prompted the investigation into interventions to mitigate the risk of injury. This dissertation set out to investigate the effects of a progressive 12-week running intervention in novice runners wearing footwear with reduced cushioning. The aim was to understand how intrinsic characteristics of novice runners, namely body composition, strength and flexibility, influence running biomechanics and ultimately injury outcome, and whether footwear structure effects this relationship. Prior to the intervention, participants were assigned to wearing footwear with reduced cushioning (RC) or footwear with traditional cushioning (TC). Three-dimensional running biomechanics were collected during over ground running at 3.0 meters per second in their prescribed footwear. Other measured variables included lower limb strength, by means of an isokinetic dynamometer, lower limb flexibility, full body composition by means of Duel Energy X-Ray Absorptiometry and lower leg bone oedema by means of magnetic resonance imaging. Throughout the intervention, pain or discomfort was assessed. All variables were reassessed after the intervention. The programme used in this thesis resulted in a 11.1 % prevalence of injury, which is considerably lower than other studies. No differences in injury incidence, bone oedema or pain or discomfort prevalence were found between footwear groups, however the RC group experienced pain or discomfort more frequently. Footwear with reduced cushioning was found to promote kinematic strategies, including a lower foot strike angle (FSA), more flexed knee angle at foot strike and reduced knee range of motion during stance phase to compensate for the lack of cushioning. Whilst most novice runners adopted a rear foot strike pattern throughout the intervention, the RC group were four times more likely to reduce FSA. Intrinsic characteristics of novice runners may not be indicative of injury, however the intervention resulted in changes to these variables. These included improvements in movement-specific strength, increased passive hip flexor flexibility and weight loss. Footwear had no effect on these variables. Greater mass characteristics resulted in kinematic adaptations in the knee. This dissertation highlighted the importance of a conservative training structure to mitigate injury risk in novice runners. Additionally, footwear has limited effect on injury risk and thus should not be prescribed to promote biomechanical change, but rather to compliment a runner's current biomechanics and intrinsic characteristics.

Background: Developing tackle and ruck technique is important to improve performance in matches and reduce the risk of injury. Little is known regarding valid tools to assess tackle and ruck technique in rugby union. The aims of this thesis were (1) to assess the validity and representativeness of the contact assessment tool, and (2) to identify factors which may affect the degree to which contact technique developed in training transfers to matches. Methods: Tackle, ball-carry and ruck technique of players competing at different levels of play were assessed in a two-on-two training drill using standardised technical criteria. Technique scores between levels of play were compared to assess the validity of the contact assessment tool, and contact technique scores assessed in training and matches were compared to assess the representativeness of the tool. Physical qualities and questionnaire data on the importance of technique to improve performance and reduce injuries were compared to contact technique scores assessed in training, to determine the effect of physical conditioning and player's knowledge on contact technique proficiency. Finally, tackle and ruck technique scores assessed in training and matches were compared to measures of match performance and contact related injuries. Results: Senior players scored significantly higher in the tackle, ball-carrier and ruck assessment than academy 1st and 2nd level players, demonstrating the good construct validity of the assessment tool. Contact technique scores were associated with performance outcomes in training and in matches, although technique scores in matches were lower than technique scores in training. There were no significant relationships between player's knowledge of the importance of contact technique and their contact technique proficiency. There were moderate to large associations between various physical qualities and tackle, ball-carry and ruck technique scores assessed in training. Players with better contact technique in matches performed better in matches, however, there were no meaningful correlations between contact technique in training and match performance or match related contact injuries. Conclusions: These findings demonstrate the validity of a tool to assess contact technique in rugby union with good representative learning design, however progressing the drill into less structured environments is recommended to further improve the representativeness of the assessment environment. Furthermore, the findings highlight the importance of contact skill training and physical conditioning to ensure skills developed in training are transferred to match performance.

Bibliography: leaves 93-106.

Includes bibliographical references (leaves 121-128). / Background: Previous clinical research of football players participating in international tournaments has mainly focussed on documentation of injuries and risk factors for injury. However, despite anecdotal evidence that medical symptomatology, illness and medical complaints are common during travel to international competitions, the epidemiology of medical conditions before, during or after elite level football tournaments, has not been well documented. Objective: The aims of the research presented in this dissertation were: 1) to determine the prevalence of medical conditions in elite football players 2) to determine the incidence and nature of medical conditions and illness in the elite football players participating in an international tournament (2009 FIFA Confederations Cup tournament) and 3) to provide data for the medical planning and management of elite football players during future events. Methods: The first component of this dissertation consisted of a comprehensive review of the current literature describing the prevalence and incidence of medical conditions and illness in athletes. The original research component of this dissertation consisted of two parts, and both studies were conducted during the FIFA Confederations Cup tournament, which was held in South Africa in June 2009. All the players in the 8 participating teams (23 players per team – a total of 184 players) were approached by the FIFA Medical Assessment and Research Centre (F-MARC) through their team physicians and invited to participate as research subjects in the studies. Part 1 (descriptive cross-sectional study): Prior to the tournament, all the players completed a previously validated medical history and illness questionnaire. Furthermore, the questionnaire contained sections on player demographics, training history, medication and supplement use, life-style history, family history of atopy, current and past history of medical conditions and detailed sections pertaining to upper respiratory tract infections (URTI), allergies, asthma, exercise associated muscle cramping (EAMC) and history of previous surgery. Part 2 (prospective cohort study): During the 15 days of the tournament each team physician was requested to complete a daily injury, medical illness and treatment log for each player. Finally, data on the environmental conditions at each venue were collected, as recorded by the South African Weather Service. Results: The main findings in part 1 of this study were: 1) exercise associated muscle cramping (EAMC) was the most prevalent medical condition reported, with 64 (46%) of the players reporting a history of EAMC, 2) the prevalence of allergy was 27 (20%) and asthma 6 (4%), 3) the prevalence of dermatological conditions was 16 (12%), 4) the prevalence of gastro-intestinal conditions was 10 (7%) and central nervous system conditions was 6 (4%), 5) URTI one week before the tournament was reported by 7 (5%) of the players, 6) 68 (49%) of the players reported a history of previous surgery and 7) 72 (52%) of the players reported the use of supplements or vitamins and 11 (8%) the use of medication. Knee surgery was the most common anatomical area operated with 33 (24%) of the players reporting previous knee surgery. This was followed by a much lower prevalence of ankle surgery, 8 (6%). In part 2 of the study, a total of 56 injuries and 35 illnesses were recorded during the tournament. The main findings in this study were: 1) an overall injury rate of 64.4 injuries per 1000 match hours or 2.1 injuries per match, 2) an overall rate of 2.7 injuries and 1.7 illnesses per 100 player days, 3) that 0.88 days were lost per injury and 0.46 days were lost per illness, 4) the lower limb was the most commonly injured body part, 5) 11 (20%) of the injuries reported were to the thigh, 6) 15 (44%) of the injuries reported were due to a contusion, 6) 13 (37%) of the illnesses reported were due to ENT conditions, and 7) 7 (20%) were due to respiratory tract symptoms. Summary and conclusion: Illness and injury are common during an international football tournament. The pattern of injury was similar to that previously reported. However, the novel finding of this dissertation was that illness is a significant component to the medical care to a travelling team and needs to be considered by team physicians managing the medical needs of elite football teams.

Background: Exercise induced muscle damage collectively describes the response to strenuous or unaccustomed exercise. It is well - established that endurance running causes muscle damage. Indirect indicators of muscle damage include the loss of muscle strength, increased levels of muscle proteins, such as creatine kinase, in the blood and delayed onset of muscle soreness. Magnetic resonance imaging has been used to gain insight in to the underlying mechanisms associated with exercise induced muscle damage. The most common approach has focused on changes in transverse (T2) relaxation times after exercise. Given that inflammation and oedema are proposed as reasons for the changes in T2 times, there may be changes in morphological measurements such as muscle volume and peak cross sectional area. Few studies have utilised MRI morphological measurements to assess the effects of exercise induced muscle damage, and there is a lack of evidence regarding changes in muscle morphology after endurance running. Aim: The aim of this study was to investigate changes in transverse (T2) relaxation times and muscle morphology in endurance runners after a 90 km ultramarathon race. Specific objectives: (a) To determine the time course of recovery of muscle pain and plasma creatine kinase activity after a 90km ultramarathon race; (b) to determine changes in 5km time trial performance in an experimental group of endurance runners that took part in a 90 km ultramarathon race compared to a control group of endurance runners that did not take part in a 90 km ultramarathon race; (c) to compare changes in muscle morphology (volume and average cross sectional area) and T2 relaxation times of the quadriceps and hamstrings in an experimental group of endurance runners that took part in a 90 km ultramarathon race and a control group of endurance runners that did not take part in a 90 km ultramarathon race; and (d) to evaluate potential relationships between indicators of muscle damage (plasma creatine kinase levels and muscle pain measurements), morphological muscle changes, and T2 relaxation times in an experimental group of endurance runners that took part in a 90 km ultramarathon race and a control group of endurance runners that did not take part in a 90 km ultramarathon race. Methods: This was a descriptive, correlational study that involved secondary analysis of previously collected data. No new participants were recruited for the study. Participants were allocated to groups, based on whether they took part in a 90 km ultramarathon. The experimental group (n = 11) completed a 90 km ultramarathon. The control group (n = 11) consisted of endurance runners, who ran a minimum of 60 km.wk-1, but did not take part in the ultramarathon. Magnetic resonance images were taken seven days before and 10 - 15 days after an ultramarathon as part of an earlier study. The magnetic resonance images analysis included the digital segmentation and reconstruction of the rectus femoris, combined quadriceps and combined hamstrings muscle groups. Muscle volume and peak cross sectional area was calculated as well as T2 relaxation times. These measurements were correlated with muscle pain and plasma creatine kinase activity measurements obtained during the initial study. Results: There was a significant difference in hamstrings muscle volume between the experimental and control groups. The experimental group had a significantly lower muscle volume compared to the control group (p = 0.03). There was also a significant positive relationship between the T2 relaxation time and plasma CK activity. (r = 0.74; p = 0.04) Conclusion: Changes in muscle morphology in endurance runners are evident after a 90 km ultramarathon. The significant relationship between T2 relaxation times and plasma creatine kinase activity confirms that T2 relaxation time may be used as a non-invasive direct indicator of exercise induced muscle damage.

The purpose of this study was to determine the effect of high intensity interval training (HIIT) on post traumatic stress disorder (PTSD) and to compare the results of HIIT to a short, deep breathing session (BRTH) that is commonly used to manage PTSD symptoms. Previous research has demonstrated a positive effect of exercise on PTSD and related mental health concerns. Seven volunteers (six females and one male) participated in this study. All participants completed two groups of sessions, one comprised of three HIIT sessions and one of three BRTH sessions. Each group of sessions took place over approximately ten days, with a 4-week washout period between the two protocols. The HIIT sessions each involved eight sets of a work rest ratio of 20-second exercise to 10-second rest, with a 60-second break between the fourth and the fifth set for a total of 5 minutes. The BRTH sessions involved the use of an established 5-minute deep breathing PTSD therapy protocol. PTSD symptoms were measured using the PTSD Checklist (PCL). PCL measures were taken before (pre-test) and after (post-test) the intervention. Within the HIIT intervention, mean post-test Total PCL scores were significantly reduced compared to pre-test scores (p < 0.005), while BRTH scores did not significantly change. Two subscales in the PCL, Intrusion and Avoidance were also significantly reduced (p < 0.0005) following HIIT but not BRTH. All other subscales scores were lower following both HIIT and BRTH, though were not statistically significant different from pre-test values. No statistical between-intervention differences were detected. The preliminary results from this research provide evidence that acute use of HIIT exercise provides similar or better positive effects on PTSD symptoms as BRTH and that HIIT exercise can be used as a symptom management tool for PTSD. / Graduate