Exercise in hot environments decreases the temperature gradient for heat loss to the external environment increasing internal heat storage. Work completed decreases and exertional heat illness risk increases. Heat acclimation (HA) programmes which last between 7 -10 d improve heat tolerance by reducing rectal temperature (Tre) during exercise. Thermotolerance is also improved. These adaptations enable work to be maintained for longer periods of time. Exertional heat illness risk is also decreased. However, HA is not logistically feasible during rapid redeployment of military, athletic, occupational and emergency worker populations to hot environments. Therefore, developing an acute preconditioning trial to enhance heat tolerance and thermotolerance could be advantageous. This thesis first determined the effect of treadmill gradient (flat or downhill running) and environmental conditions (temperate~ 20oe, 50 % relative humidity (RH) or hot conditions; 30°C, 50 % RH) on heat shock protein 72 mRNA (Hsp72 mRNA), heat shock protein 90 alpha mRNA (Hsp90a mRNA), glucose regulated protein 78 mRNA, glucose regulate protein 94 mRNA, exercising Tre and HR, Study 2 investigated whether an acute trial combining downhill running and hot environmental conditions (Hot downhill) elevated basal HSP72 concentrations, attenuated exercising Tre• HR, vastus lateralis (VL) and leukocyte Hsp72 mRNA and Hsp90a mRNA responses during an identical trial 7 d later. Downhill running and hot environmental conditions increased leukocyte Hsp72 mRNA, leukocyte Hsp90a mRNA, exercising Trc and DOMS further than flat running and temperate environmental conditions. Increased Hsp72 mRNA and Hsp90a mRNA were mainly exercising Tre and metabolic strain dependent. Exercising Tn; (at 30 min) and DOMS were reduced during or following the second hot downhill trial. Attenuated Hsp72 mRNA and Hsp90a mRNA responses within the VL and leukocytes also occurred. Basal VL HSP72 increased after the second hot downhill trial In conclusion, an acute hot downhill trial decreases exercising Tn: and DOMS during an identical trial 7 d later but basal HSP72 concentrations are not affected. Leukocyte Hsp72 mRNA and Hsp90a mRNA are valid surrogates of the VL response.

Cycling efficiency is a measure of the ability to convert stored energy into power, and is considered a key determinant of cycling performance. Cycling efficiency has recently been manipulated with various techniques, but most prominently with high intensity training in habitual cyclists and using calorie restriction in sedentary obese participants. It was therefore the primary aim of this thesis to explore the efficacy of utilising a short- and medium-term calorie restriction intervention, to manipulate efficiency with participants accustomed to cycling. A secondary aim was to investigate the validity of measuring efficiency in a field-based environment. Male club level cyclists were recruited for the investigations, which comprised of a moderate -500 kcal.day-1 deficit, utilising portion control and measuring efficiency at both absolute and relative steady-state intensities. Seventeen participants completed the short-term, two-week intervention which utilised a randomised cross-over design. Although a significant reduction in body mass was attained, RMR, gross and net efficiency across all intensities and TT power remained stable. Field and laboratory comparisons indicated that prior to statistical correction absolute efficiency was significantly lower in the field, but after accounting for differences in power, cadence and environmental conditions, no differences were present. Twenty-nine participants conducted the medium-term study and were assigned either to calorie restriction or to no dietary intervention. Following a reduction in mass in the calorie restriction group and an increase in the group given no dietary intervention, a significant interaction between mass and efficiency was found across gross and net efficiency workloads. A six week follow-up period indicated that the process of calorie restriction and not absolute body mass reduction was the main mechanism for altering efficiency. This thesis suggests that efficiency can be manipulated both positively and negatively with calorie manipulation, and that these changes are linked to both laboratory and field based performance.

The aim of this Thesis was to further characterise and utilise an in vitro skeletal muscle (SkM) model, to investigate its potential use in further understanding the cellular and molecular adaptations to exercise in vivo. Candidate genes and proteins have been identified using in vivo, ex vivo and targeted in vitro experiments, however the complete picture of these molecular mechanisms are far from understood. Furthermore, the extent to which mechanical signals contribute to the intra-cellular mechanisms associated with exercise is also underinvesitgated. To this end, developing an in vitro model of SkM that can recapitulate in vivo SkM and respond to mechanical stimulation in a similar way to exercise will provide a means to begin to delineate the complex cellular and molecular regulation of SkM. The initial investigation (Chapter 3) characterised an optimal seeding density and culture period of C2C12 myoblasts within a 3 ml collagen gel. These data provided support for the use of collagen constructs seeded at 4 x 106 cells/ml, with no statistical differences observed in peak force, rate of force development and relative force compared to other seeding densities examined (table 3-2, all p > 0.05). However the use of 4 x 106 cells/ml supports previous data in a larger construct volume model, whilst the highest cell density possible in the system increases cell-cell contact required for fusion. Immunohistochemical and gene expression analyses provided evidence for the fusion of single seeded myoblasts into multinucleate myotubes, demonstrating an in vivo-like architecture. Chapter 4 presented data towards the characterisation and use of two distinct cyclical stretch regimens with respect to the acute biochemical and transcriptional responses. Data revealed increases in peak media lactate and reductions in peak media glucose, following cyclical stetch compared to control (p = 0.000 and p = 0.001 respectively, Fig. 4-2). Changes in mtDNA (Fig. 4-5) and associated mRNA transcriptional signals (Fig. 4-7) were mode dependent.

Amateurism acted as the guiding principle for the many sporting clubs and governing bodies that were created and developed by the late Victorian middle-classes. While some forms of coaching and training were tolerated, many organisations, such as the Amateur Rowing Association, expressed a preference for amateur honorary coaches rather than professionals. Through the use of archival material, oral history interviews, and ongoing case studies in athletics and swimming, this thesis traces the trajectory of the less than harmonious relationship between amateurism and professional coaching in Britain throughout the twentieth century. In the pre and interwar period, a number of proposals for coaching schemes emerged, especially after poor Olympic performances, but continuing resistance within the amateur establishment meant that these initiatives were uncoordinated and experienced short life-spans. Even in the post-war period, characterised by an increasing number of centralised coaching schemes and the appointment of national coaches, amateur officials sought to maintain strict control over their appointments. A reluctance to accept advice from professional coaches, coupled with a struggling economy and a government determined to remain distant from sport, contributed to a further decline in international sporting performance. British athletes had long proved unable to compete with the Americans and the emergence of another sporting superpower at the 1952 Olympics, the Soviet Union, finally prompted a number of responses, including the 1960 Wolfenden Report. The government subsequently took a more active role in sport, resulting in an inevitable shift towards greater specialisation as centralised funding became inextricably linked with targets and results. Although this encouraged a more widespread utilisation of professional coaches and improved the integration of sports science, the ethos of amateurism proved farreaching, even at elite levels. The evidence suggests that, while it is no longer considered a guiding principle, its legacy continues to impact on the working lives of many British coaches.

Maximising strength and neurological adaptations to resistance training has long been sought to improve athletic performance and enhance clinical rehabilitation functional outcomes. In recent years, transcranial magnetic stimulation (TMS) and peripheral nerve stimulation (PNS) have been applied to investigate changes in the central nervous system (CNS). Conventional resistance training programmes consist of shortening and lengthening muscle contractions and have been shown to have uniquely different motor control strategies; how this neurological control is modified during specific muscle contraction resistance training is unknown. Additionally, understanding the detraining process will assist in designing tapers for elite athletes and improve our knowledge of detraining and inactivity in other populations. The overall aim of the thesis was to determine the TMS and PNS responses to, and following, shortening and lengthening resistance exercise and subsequent detraining.

Cardiovascular disease is the primary cause of global mortality (Naghavi, 2015). Given the global health issues associated with poor cardiovascular function, interventions that help reduce the severity and prevalence of these diseases would not only have economic implications, but would also improve health, wellbeing and quality of life. Epidemiological studies have suggested that polyphenol-rich foods can exert positive cardiovascular health benefits and as a result could reduce the severity of the primary pathology and increase the capacity to stay physically and mentally active (Joshipura et al., 1999; Bazzano et al., 2002; Hung et al., 2004). One of most studied polyphenol-rich, functional foods in recent years, in both the clinical and exercise domains, has been tart cherries. Tart cherries and their derivatives are high in numerous polyphenols (Wang et al., 1999; Seeram et al., 2001; Seymour et al., 2014; Bell et al., 2014) that include the flavonoids isorhamnetin, kaempferol, quercetin, catechin, epicatechin, procyanidins, and anthocyanins (Kim et al., 2005; Kirakosyan et al., 2009). Indeed, there has been an enormous research effort over the past decade to delineate the physiological and biochemical effects that tart cherries (and its constituents) might afford, and how these effects could be exploited to improve health outcomes. There is now strong evidence that tart cherries attenuate inflammation (Wang et al., 1999), oxidative stress (Howatson et al., 2010; Bell et al., 2014) and accelerate exercise recovery (Howatson et al., 2010; Bowtell et al., 2011; Bell et al., 2014; 2016). Furthermore, cherry extracts have been shown, in cell and animal models, to exert a range of cardioprotective effects that include increasing nitric oxide production and antioxidant (AOX) status, reducing lipid oxidation and inhibiting inflammatory pathways (Wang et al., 1999; Seeram et al., 2001). However, data from human trials are not always consistent. Furthermore, it is yet to be explored whether MC concentrate can be used for performance enhancement. Thus, the overarching aim of this thesis was to elucidate the effects of Montmorency, a specific cultivar of tart cherry, (MC) supplementation on vascular function and exercise performance in humans. The series of investigations that set out to address this aim have led to many novel and interesting findings. To begin, study 1 was the first to show that protocatechuic and vanillic acid were identified in the plasma post MC consumption. Furthermore, a combination of PCA and VA increased cell migration, but had no effect on the proliferation of vascular smooth muscle cells. Secondly, and perhaps the most novel finding of this thesis was that MC supplementation showed promise as an effective adjuvant in the management of hypertension. This was a consistent finding throughout the thesis; in all instances MC supplementation was able to significantly reduce systolic blood pressure. Another important finding was that MC supplementation resulted in an acute modulation of cerebral blood flow parameters in the front cortex during task performance with no changes in cognition or mood. Finally, the final study of this thesis demonstrated that MC supplementation can improve aspects of exercise performance with no changes in V̇O2 kinetics, NO2- concentrations or muscle oxygenation. All of these findings suggest that circulating phenolic metabolites derived from MC juice are at least partly responsible for these effects. Collectively, findings of this thesis provide novel information to literature surrounding the application of MC in health maintenance and exercise performance. In addition to identifying and quantifying some of the primary downstream metabolites of the principal anthocyanins contained in the concentrate, this research is the first to provide efficacy for the use of MC supplementation to acutely modulate various aspects of vascular function including systolic blood pressure, total and oxy-Hb during a cognitively challenging task. The underlying mechanisms that govern these effects remain elusive, although data from study 1, 2 and 4 would suggest that it is not likely to be attributed to NO, at least systemically. A more likely idea by which MC supplementation improves factors associated with CVD is based on the uptake of polyphenols that possess cardio-protective properties. To conclude, this thesis highlights the ability of MC to improve aspects of cardiovascular function and exercise performance. Circulating phenolic metabolites derived from MC are at least partly responsible for these acute improvements. Further work is required to; fully elucidate the mechanisms by which MC exerts its protective effects, determine whether the effects reported would be amplified using chronic supplementation and demonstrate effects of MC supplementation within habitual dietary practices.

The major theme of the current thesis was the definition, measurement, and development of perfectionism in elite junior sport. The first purpose was to examine the psychometric properties associated with Hewitt and Flett’s (1991) Multidimensional Perfectionism Scale (MPS-HF) when complete by a sample of elite junior athletes. In study one, a confirmatory factor analysis failed to support the original structure of 45-item MPS-HF. Subsequent exploratory and confirmatory factor analyses revealed a more parsimonious 15-item factor structure representing self-oriented (SOP), socially prescribed (SPP), and other-oriented perfectionism (OOP). Having established a reconstituted version of the MPS-HF, a second purpose of the research programme was to consider the origins of perfectionism in elite junior athletes using a cross-sectional design. Initially, in study two a social learning model was supported, with 18%-26% of variance in athletes’ perfectionism predicted by parents’ perfectionism. Building upon this finding in study three, a structural equation model revealed that parenting styles, including empathy and psychological control, mediated the parent-athletic child SPP relationship. In study four, a significant pathway emerged between parents’ achievement goals and athletes’ dispositional perfectionism, offering support for a social expectations model of perfectionism development. Specifically, parents’ task and ego orientations were positively associated with athletes’ SOP. In contrast, athletes’ SPP was predicted by parents’ ego orientation. Study four also demonstrated the nature and form of motivational regulation associated with athletes’ SOP and SPP. That is, a pathway emerged between athletes’ SPP and controlled forms of regulation, while athletes’ SOP was correlated with self-determined and controlled motivation. Finally, in study five, the coach-created motivational climate accounted for approximately 19% of variance in athletes’ perfectionistic cognitions, highlighting the role of additional social agents in the development of athletes’ perfectionism. The results of this research programme contribute to existing knowledge of perfectionism by forwarding reliable measures of SOP and SPP for employment in sport, and revealing a complex array of pathways that underpin the development of perfectionism in elite junior athletes. Ultimately, by preventing the occurrence of such pathways, athletic children may be protected from the perils of perfectionism.

Movement disorders are the hallmark of Parkinson’s disease (PD) and can severely compromise an individual’s ability to perform well-learned motor skills such as walking, writing, turning around and transferring in and out of bed. The first symptoms of PD typically do not appear until a critical threshold of 70-80% loss of the striatal neurotransmitter called Dopamine (DA) is exceeded. The loss of DA compromises the connection between the striatum and the Substania Nigra (SN); this connection is essential for the control of body movement. The lifelong management of individuals with PD needs a multidisciplinary approach, which includes coordination of pharmacological and non-pharmacological interventions. The use of prescribed exercise as a non-invasive PD symptom management tool is well recognized. What needs further research and development is an evidence-base for the type, frequency, intensity, duration etc. of exercise bouts. It is however ethically, socially and morally challenging to put unknown physical demands on PD sufferers, therefore in vivo and in vitro studies will be essential in delineating and targeting appropriate interventions. Additionally, in order to establish whether the various interventions are effective will also require a simple measure, preferably one that can be detected following exercise. Ca2+ plays an important role in the synthesis of DA via the Ca2+ calmodulin system and its increase in exercise coincidences with the reported positive effects of exercise on dopamenirgic neuron activity. The aim of this thesis was therefore to use in vivo, in vitro and human methodologies to establish a role for physical exercise in the amelioration of the symptoms of PD. The in vivo study comprised of four groups of experimental animals (rats): a control group (C), a training exercise group (E), a group in which Parkinson’s was induced via systemic injections of PD toxin MPTP (PD) and a group where PD-induced animals were trained/exercised (PDE). (E) and (PDE) groups were trained with 8 weeks of endurance exercise at 90% of the lactate threshold (LT), 5 times a week with each bout lasting for 45 min using a custom-built rodent treadmill. After 8 weeks, all animals were sacrificed and brain samples were collected for immunohistochemistry and western blot analysis. Ca2+ calmodulin kinases I (CaMK-1) and IV (CaMK-4) were investigated as indicators of the activity of the Ca2+ calmodulin pathway. Immunohistochemical analysis of SN region indicated that in the PD group, CaMK-1 and CaMK-4 expression was suppressed when compared with control (C) animals. This phenotype was apparently rescued by endurance exercise as those animals. The western blot results also showed quantitative differences in CaMK-1 and CaMK-4 proteins in the studied brain regions in the (PDE) and (E) groups compared with the PD group. It was concluded from this data that endurance exercise could up regulate the expression of both CaMK-1 and CaMK-4 in the brain of PD sufferers. It was postulated that changes in Ca2+ levels might therefore drive the neuroprotective effect of exercise. The in vitro study was designed to test the hypothesis generated from the in vivo work that Ca2+ is a main effector of the neuroprotective effect of exercise. The SH-SY5Y human neuroblastoma cell line is used as a model of DA neurons as it has DA activity and can synthesize DA. PD was simulated in these cells by exposure to the toxin 6-OHDA whilst addition of Ca2+ was used as an “exercise mimic”. Results showed differences in the survival of SH-SY5Y cells after exposure to specific concentration of Ca2+ following treatment with 6-OHDA. Finally, in order to assess the importance of this data to the clinical population and to further develop the concept that Ca2+ is a major effector of the positive effect of exercise, the effect of moderate-level exercise on the levels of blood Ca2+ in subjects with PD was investigated. Measures of cardiovascular physiology and blood biochemistry (total blood Ca2+) were obtained during cycling exercise at an intensity of 90% of the lactate threshold. Results indicated exercise to be beneficial in alleviating motor symptoms of PD.

BACKGROUND TO THE STUDY: Recruitment is key for any organisation. Admission onto health education programmes must balance the requirements of a degree with preparation for a specific professional role. Additionally, gate keeping demands recruitment of those with potential to uphold the values and standards of the NHS constitution, the chosen profession, who can work with, and for, vulnerable people. Evidence indicates a relationship between prior academic attainment and future academic performance. However, the importance of personal characteristics for those entering healthcare education is unclear. RESEARCH QUESTION: Do students learning journey experiences illustrate personal characteristics influencing progression through their physiotherapy degree? STUDY AIM: To investigate a physiotherapy year group's journey through their degree programme, from pre-admission to graduation and identify personal characteristics influencing progression, professional registration and employability. METHODOLOGY: A qualitative approach, built on a thematic model of personal, social and professional identity, utilised an applied social policy research data handling and analysis Framework approach, underpinned by a pragmatic worldview. METHOD: Following ethical clearance, a physiotherapy cohort from a North East of England university consented to admissions and progression data being analysed. A purposive sample of nine students consented to attend semi-structured interviews exploring their learning journey. Interviews explored pre-admission through year 1, year 2 to year 3 and year 3 plus overview of their degree. Progression was analysed by consideration of secondary data, including grade point average (GPA), placement formative feedback & degree classification. RESULTS: Analysis of the interviews and secondary data suggested all learning journeys present challenges. Six personal characteristics emerged as important facilitators, conscientiousness, resilience, reflection, caring, interpersonal relationships and attitude to learning. The strength of affinity for the intended physiotherapy identity emerged as a key motivating factor along the learning journey. CONCLUSION: Learning journeys are challenging. Frustrations and disappointments transpire as a natural consequence of academic and professional development. They may also coincide with major life-events creating additional stressors. Personal characteristics appear vital protectors against such stressors and additionally facilitate the learning journey. No single key characteristic emerged; rather several appear to interact to facilitate the learning journey. When one characteristic is overwhelmed, successful individuals draw on others as resources. Characteristics themselves are not simple expressions of behaviour but nuanced, with certain facets more or less important depending on context. It is too simplistic to view struggling, or failing students as lacking certain characteristics, as unique contextual issues may inhibit utility of a normally present characteristic. Managing challenges appears related to the strength of affinity for the physiotherapy identity. If strong, individuals appear highly motivated to persevere even in the face of significant stressors. When weak or the proto-physiotherapy identity fails to match the reality encountered through the degree, the ability to manage is diminished, resulting in a challenged and likely unsuccessful outcome. ACADEMIC CONTRIBUTION: The results have led to better understandings of the role of personal characteristics in the development of students through their professional education. It is envisaged this will not only contribute to more focused admissions strategy and processes locally, but will contribute knowledge to the national debate on values based recruitment (VBR) in the NHS.

The action of overtraining may lead to the different states of overreaching or the overtraining syndrome (OTS). Chronic maladaptation in endocrine and immune mechanisms, and performance decrements occur with the incidence of these states. Circulating cortisol and testosterone have been proposed as endocrine markers of overreaching/OTS. Salivary measurements of these hormones have been used as a non-invasive surrogate for circulating levels. Chapter 4 (study 1) on this Thesis examined the influence of consuming water 10 min, 5 min and 1 min before providing a saliva sample in diluting saliva and consequently providing invalid salivary cortisol and testosterone concentration levels. No trial effect was found. However, exercise-induced salivary cortisol and testosterone significantly elevated in response to the 10 min and 5 min trials only, with lower absolute-changes observed in the 1 min trial. No differences were found in the resting samples. It was suggested that consuming water up to 5 min before providing a saliva sample does not appear to influence the hormone concentrations at rest and during exercise. However, the recommended guidelines for saliva collection have been followed in the subsequent studies. Chapter 5 (study 2) examined the reproducibility of salivary cortisol and testosterone responses to a 30-min cycle named as the 55/80. This test has been proposed as a suitable indicator of hormonal alterations associated with overreaching/OTS. Reproducibility of salivary cortisol and testosterone to the 55/80 was confirmed by determining intra-individual coefficients of variation (CVi). However, the 55/80 is a cycle test and therefore, may not be appropriate for runners. Chapter 6 (study 3) focused on designing a 30-min, running bout (i.e. the RPEtreadmill) to reproduce the effects of the 55/80. The RPEtreadmill is a self-paced test and therefore, will not require aVO2maxtest to determine exercise intensities. An acute elevation of plasma and salivary testosterone, but not cortisol was observed in response to the RPEtreadmill. These responses have been shown to be reproducible. The data from Chapter 6 suggest that the RPEtreadmill may be a suitable tool to indicate hormonal alterations associated with overreaching/OTS. This led to the design of study 4 (Chapter 7). Plasma and salivary cortisol and testosterone responses were examined before and after a 12-day intensified-training period. Immunity markers (specifically salivary immunoglobulin A (SIgA), leucocyte subset proliferation and phagocytic activity) were examined before and after training. Plasma and salivary cortisol were unaffected by acute exercise and training. However, testosterone elevated to the RPEtreadmill Pre-Training, and these responses were reduced Post-Training. Total leucocytes and mucosal immunity were unaffected by exercise and training. However, increased upper respiratory tract infection symptoms were found Post-Training. Baseline phagocytic function was 47% lower Post-Training. This Thesis suggests that testosterone may be a more reliable exercise-stress marker. Moreover, the RPEtreadmill may be a suitable tool to highlight alterations in testosterone when in an overreached state in an attempt to avoid the incidence of OTS, and that this tool may be practically applied in the field of exercise science. Additionally, this Thesis shows that a 12-day intensified-training period induced a marked decrease in phagocytic responses, and therefore using the RPEtreadmill to highlight overreaching may be important to also prevent further impairments in immunity status.