Grad Research Day (UBC-O & UBC-V) – May 11 & 12

Joshua Bovard, Daniele A. Cardinale, Filip J. Larsen, Emma Reiter, Mads Jensen-Urstad, Erik Rullman, David Morales-Alamo, Bjorn Ekblom, Jose A. L. Calbet, Robert Boushel.
To determine their consequences on exercising hemodynamics with large (e.g., 2-leg cycling (BIKE)) vs. small (e.g., 1-leg knee extension (KE)) muscle mass.Healthy young subjects (4M, 3W) completed BIKE and KE exercise tests.
The femoral artery and vein were catheterized to measure leg blood flow (Q), CaO2, and mean arterial pressure (MAP). Vascular conductance (VC), O2delivery, and leg O2uptake (VO2) were calculated. Measures were normalized to right leg (BIKE) or quadriceps (KE) lean mass. Whole body VO2was measured with a metabolic cart. Men and women were compared at similar and maximal work rates. Body mass was greater in men (M: 80±6 vs. W: 59±12 kg, p=0.03). Although quadriceps mass (3.3±0.2 vs. 2.0±0.3 kg, p less than 0.001) and CaO2were lower, women had a higher mass-specific Q, VC (p=0.054), O2delivery, and leg VO2to maintain whole body VO2during similar KE (Table 1).
These differences were maintained during maximal KE, at which women tended to achieve a higher mass-specific work rate (21±2 vs. 25±3 W·kg-1, p=0.10). They were also apparent during similar BIKE despite a lower leg lean mass in women (8.7±0.3 vs. 5.3±0.7 kg, p less than 0.001). However, the differences were no longer present during maximal BIKE when mass-specific work rate was similar (21±2 vs. 20±2 W·kg-1, p=0.70) and whole body VO2was lower in women.These findings highlight a greaterhemodynamic capacity for women to overcome differences in CaO2and maintain whole body VO2at similar work rates during exercise. They also implicate the quantity of exercising muscle in facilitating the greater hemodynamic capacity and mass-specific workrate during maximal exercise with a small but not large muscle mass.

Kaela Cranston,TinekeDineen, Natalie Grieve, Mary Jung.
Small Steps for Big Changes (SSBC) is a diabetes prevention program that aims to empower individuals with prediabetes to make diet and exercise changes. Previously, SSBC coaches have been trained through a 3-day in-person workshop. In order to improve SSBC’s reach, an online platform is necessary to train coaches in a less resource-intensive manner. The creation of the SSBC online training platform was guided by the 5-phase analysis, design, development, implementation, and evaluation (ADDIE) model. The purpose of this project was to describe the analysis, design, and development phases of the SSBC online training platform. Methods.Focus groups with previously trained SSBC coaches were conducted to determinewhat skills, knowledge, and attitudes future coaches need to gain and how information should be delivered during the training. The research team worked with 3C Institute and SSBC coaches to determine learning objectives and the best way to deliver didactic and experiential components, develop scripts for the online modules, develop storyboard proofs, film the modules, develop a landing page, and finalize the online platform.Results.Recommendations from SSBC coaches were largely focussed on ensuring there were interactive components in the training and that SSBC content be better integrated with the motivational interviewing content. The final online training platform consisted of 7 modules and a resource centre. Conclusion.Using systematic methodology and engaging end-users and those with expertise in developing online learning platforms was necessary to develop a high-quality SSBC training platform for future scale-up.

Xueqing Zhou, Alison M.M. Williams (MSc), Tania Lam (PhD).
This systematic review aimed to investigate the feasibility (dropout rates, adverse events) and effects of exercise training as a treatment to improve urogenital function and quality of life (QoL) in individuals with spinal cord injury (SCI).Database searches were conducted on MEDLINE, EMBASE, and CINAHL for studies that examined the effects of any exercise intervention on urogenital function and/or QoL in adults with SCI. Quality of the included studies was assessed using the Joanna Briggs Institute critical evaluation tools. When possible, Hedges’ g was calculated for overall effect sizes. Descriptive subgroup analyses were conducted on sex and injury severity.Ten studies (228 participants) were included. Study interventions included pelvic floor muscle training (n=3) and locomotor training (LT) (n=7). The overall quality of evidence was low due to small sample sizes and non-randomized designs in most studies. Dropout rates ranged from 12% to 25%, and adverse events were reported only in some LT studies. For lower urinary tract (LUT) outcomes, urodynamic findings were mixed despite moderately positive changes in maximum bladder capacity (g=0.50) and bladder compliance (g=0.37). Fairly consistent but small improvements were observed in bladder awareness and incontinence. Fewer data were available for LUT QoL and sexual health outcomes, which presented mixed findings or minor improvements. Subgroup analyses based on sex and injury severity were inconclusive.There could be a potential benefit of exercise on urogenital outcomes in people with SCI, but the evidence is insufficient given the heterogeneity and relatively low quality of included studies.

Phuong L. Ha, Wendy B. Peters, Michael A. McGeehan, Brian H. Dalton.
The purpose was to determine whether vestibular control of standing balance is altered in older compared to younger females and whether the vestibular-evoked balance response is related to muscle power. Sixteen young (n=8; 22.6±1.8 years) and older (n=8; 69.7±6.7 years) females stood quietly on a force plate, while subjected to random, continuous electrical vestibular stimulation (EVS; 0-20Hz, root mean square amplitude: 1.13mA). Medial gastrocnemius (MG) and tibialis anterior (TA) surface electromyography (EMG) and anterior-posterior forces (FAP) were sampled and quantified using frequency and time domain correlations with the EVS. Knee extensor strength and power were evaluated using a Biodex System 3 dynamometer. The weaker (-34%; p less than 0.05) and less powerful (-39%; p less than 0.05) older females exhibited a greater medium-latency peak amplitude for the TA (-99%; p less than 0.05) and FAP(-42%; p less than 0.05), but no other differences were detected for short-and medium-latency peak amplitudes. The EVS-EMG coherence for the TA (less than 10Hz) and MG (less than 4Hz) and EVS-FAPcoherence (less than 2Hz) was greater at lower frequencies in older females than young. A strong correlation was detected for FAPmedium-latency peak amplitude with centre of pressure displacement variability (r=0.75; p less than 0.05) and TA medium-latency peak amplitude (r=0.86; p less than 0.05). Knee extensor power was negatively and moderately correlated with FAPmedium-latency peak amplitude (r=-0.47; p less than 0.05). The enhanced vestibular-evoked whole-body balance response (i.e., EVS-FAP) is related to muscle power capacity and greater sway variability. These findings indicate that an increased vestibular control of balance may compensate for an age-related reduction in power and accompanies greater postural instability in older females than young.

Alanna Shwed, M.Sc., Femke Hoekstra, Ph.D., Kathryn M. Sibley, Ph.D., Shane N. Sweet, Ph.D., Peter Athanosopoulos, John Chernesky, Christopher B. McBride, Ph.D., W.Ben Mortenson, Ph.D., SCI Guiding Principles Panel, Heather L. Gainforth, Ph.D.
Integrated Knowledge Translation (IKT) Guiding Principles were co-developed by a multidisciplinary panel of spinal cord injury (SCI) researchers, research users, and funders to help address the gap between SCI research and practice. However, they will only be helpful if people are aware and choose to adopt them, both of which are dependent on exposure and engagement with the Principles. Therefore, the aim of this project is to evaluate and compare exposure and engagement with the IKT Guiding Principles after a passive diffusion approach versus a coordinated partnership approach to end-of-grant knowledge translation (KT).Passive diffusion of the IKT Guiding Principles and website began November 9th, 2020 and included uncoordinated tweets and Facebook posts. The coordinated partnership approach to end-of-grant KT began February 8th, 2021 and included tweets, a UBC press release, information emails, organization website postings, videos, and news articles. Exposure and engagement with the Principles are being tracked through Google Analytics of the IKT Guiding Principles website. For this study, exposure is defined as the number of new visitors tothe website and engagement is defined as the number of new user downloads of the Principles.Passive diffusion from November 9th, 2020 to February 7th, 2021 resulted in 198 new visitors to the website and 4 downloads of the Principles. The first month ofpartnered end-of-grant KT from February 8th, 2021 to March 8th, 2021 resulted in 569 new visitors to the website and 61 downloads of the Principles.Our initial findings suggest that a partnered approach to end-of-grant KT strategies of the IKT Guiding Principles increased exposure and engagement at a faster rate than passive diffusion efforts. This study demonstrates the potential value of using a coordinated partnership approach for end-of-grant KT.

Maya Sato-Klemm, Alison Williams, Ben Mortenson, Tania Lam.
Pelvic floor muscle training (PFMT) is a mainstay of rehabilitation treatment for urinary incontinencein able-bodied populations. A typical PFMT program includes repeated and sustained contractions of the pelvic floor muscles, with the intent to increase strength, endurance and coordination. So far, there has been little attention to rehabilitation-based approaches to manage urinary incontinence and other urogenital symptoms in people with spinal cord injury (SCI). Further, it is unknown the extent to which the SCI community is aware of the possibility for such exercise-based approaches for addressing urogenital symptoms. Thus, the goal of this study was to assess knowledge, attitudes and practice related to pelvic floor muscle training in people living with SCI. A web-based survey was created to capture current knowledge, attitudes, and practice related toPFMT. Feedback from an advisory group including a pelvic floor physiotherapist, a sexual health clinician, and two members of the local spinal cord injury community was solicited and incorporated before deployment. The survey was distributed via mailing lists of domestic (e.g. Spinal Cord Injury BC) and international (e.g. New Zealand Spinal Trust) organizations that provide support to the SCI community. Responses from 50 individuals with SCI have been received to-date. Descriptive statistics will be used to summarize the respondents’ level of knowledge, practice, and attitude towards PFMT. Survey responses will also be compared between males vs. females and people with complete vs. incomplete paralysis using Chi-square tests. Results from this work will help inform the development of PFMT interventions for people with SCI.

Hira Niazi, William Sheel & Meaghan MacNutt.
Sex and gender are interrelated but not interchangeable important determinants of health and wellbeing; therefore, both should be considered in research. Findings without this consideration cannot be extrapolated to everyone. Over the past few decades, efforts have been made to rectify the historic problem of overrepresentation of male participants in exercise physiology literature. To examine if this bias remains, this study describes and quantifies the participant pool in terms of sex. Six of the most relevant journals were searched for exercise physiology articles published in 2018-2020. After filtering through 1485 articles, a total of 613 original research articles with adult human participants were included in the final analysis. Of the 39,627 participants across 613 studies, 22,994 (58%) were described as male and 16,633 (42%) were described as female. There were 272 (44%) mixed studies, 293 (48%) male-only studies, and 48 (8%) female-only studies. Only 13% of male-only studies indicated this in the title, compared to 83% of female-only studies. There were zero reports of intersex, transgender, gender non-conforming, or gender non-binary participants. Of all mixed studies, 37% conducted a gender or sex analysis, and 41% were male-dominant with less than 40% female participants. Substantial sex and gender bias persists inthe recent exercise physiology literature. Females continue to be underrepresented, maleness is still centered as the default condition, and sex and gender are both described as binary.

Megan Trotman, Michael Kennefick, Scott Coughlin, Brian Dalton.
Research is limited regarding how whole-body balance adjustments are integrated with continuous voluntary reaching movements when a hand perturbation is encountered. When two tasks are performed simultaneously through a dual-task paradigm, performance of one or both tasks is often disrupted owing to attentional resources being divided. The purpose here was to assess the effects of increased cognitive processing via a working memory task on whole-body balance responses to perturbations of the hand during a continuous voluntary reaching task. Sixteen participants (8 females, 22.9 ± 4.5 years) stood and grasped the handle of a KINARM, a robotic-controlled manipulandum paired with an augmented visual display, and completed 10 trials of 100 continuous mediolateral arm movements at a consistent speed of one movement per second. Twenty anteroposterior hand perturbations were randomly interspersed throughout each trial (single-task). An auditory n-back task was performed during half of the trials (dual-task) and during quiet standing (cognitive-motor task). Peak centre of pressure (COP) displacement and velocity, time to COP displacement onset and peak, and hand displacement and velocity following the hand perturbation were evaluated. N-back performance for the dual-task was worse than the cognitive-motor task. Only peak COP displacement following posterior perturbations increased during dual-than single-task, with no other differences detected. Hand displacement decreased during dual-compared to single-task. The main findings likely indicate that with increased cognitive processing, attentional resources were allocated from the cognitive task towards upper limb movements, while attentional resources for balance seemed unaltered.

Rowan R Smart, Anis Toumi, Owen Harris, Cydney M Richardson, Brian H Dalton, Daryl J Wile and Jennifer M Jakobi.
Persons with Parkinson’s disease (PD) have reduced balance compared to non-Parkinsonian individuals. In non-Parkinsonian persons, intermuscular coherence increases alongside balance task difficulty and has been associated with greater sway parameters. It is unknown if intermuscular coherence is a contributing factor to decreased balance control in persons with PD. We investigated intermuscular coherence during bipedal and single leg stance balance tasks for 9 persons with PD (70±5 yrs, 6 female, all on levodopa for symptom management, MDS-UPDRS motor score: 12±6) and 8 controls (71 ± 6 yrs, 5 female), and further challenged balance in no foam and foam conditions. Participants performed the balance tasks for as long as possible up to a maximum of 60 seconds, and EMG was recorded from the plantarflexors (agonists): medial and lateral gastrocnemeii, soleus; and from the primary dorsiflexor (antagonist): tibialis anterior. Sway increased from bipedal to singe-leg stances (p less than 0.05). During single-leg stance personswith PD had 20% and 12% greater SD of medio-lateral centre of pressure in no foam and foam conditions, respectively, compared to controls (p less than 0.05); and greater time-normalized sway area in no foam (101%) and foam (129%) conditions compared to controls (p less than 0.05). Agonist-agonist and agonist-antagonist coherence in the alpha (8-12Hz) and beta (15-35Hz) bands increased 38% from bipedal to single leg stance, but did not differ between groups. In a group of high-functioning PD individuals, SD of medio-lateral centre of pressure and time-normalized sway area are elevated in single-leg stance, but this is not due to group differences in intermuscular coherence.

Helena Neudorf, MSc,Michael Mindrum, MD, Christa Mindrum, MD, Cody Durrer, MSc, Jonathan Little, PhD.
Family physicians are the primary access point for care for the majority of Canadians living with T2D, and growing evidence suggests that carbohydrate restriction is an effective strategy to improve outcomes for patients with T2D. However, examples of successful implementation options for physician-led programs in primary care are limited. This retrospective secondary analysis of anonymized medical records assessed the impact of a very low-carbohydrate high-fat (VLCHF) ketogenic diet program on clinical outcomes in patients with T2D. This three-month diet program was delivered by a physician-led multi-disciplinary team in primary care, with follow-up visits at six-and 12-months. The primary outcomes assessed as markers of T2D management were HbA1c and glucose-lowering medication use. Secondary outcomes included blood pressure, blood lipids, and kidney and liver health.Compared to baseline, the VLCHF ketogenic diet program resulted in a clinically significant reduction in HbA1c at three-, six-, and 12-monthsof -0.8% (CI.95[-1.1, -0.5]; P less than 0.0001), -0.8% (CI.95[-1.1, -0.4]; P less than 0.0001), and -0.4% (CI.95[-0.7, 0.0]; P=0.042), respectively (N=27). This occurred in spite of simultaneously reduced glucose-lowering medication use as quantified by a significantly lower medication effect score at each timepoint (three-months: -1.7 (CI.95[-3, -1)]; six-months: -1.8 (CI.95[-3.2, 1.1]); 12-months: -1.7 (CI.95[-3.3, -1)]). Other markers of cardiometabolic health, including blood pressure, triglycerides, HDL-C, and liver health assessed via the hepatic steatosis index were also improved.A physician-led VLCHF ketogenic diet program using a multi-disciplinary team appears effective at improving markers of T2D management, cardiovascular health, and liver health in a community setting.

Matthew Fliss, Jordan Stevenons, Sobhan Mardan-Dezfouli, Donna Li, Cameron Mitchell.
Resistance exercise training (RET) is a potent stimulus for skeletal muscle hypertrophy. It was previously believed that moderate/heavier loads are superior to lighter loads when aiming to increase muscle size, but recent research has found that lighter load (LL) RET can lead tosimilar muscle hypertrophy as higher load (HL) RET when individuals train to volitional fatigue. While this result has been consistently shown in males, there are conflicting results when using female participants. The purpose of this study is to compare the muscle hypertrophic response to HL and LL RET in the upper and lower body of young adult females. The study used a repeated measures within-participant design wherein each participant had one arm and leg assigned to train with HL and the other arm and leg assigned to train with LL. HL training had participants reach volitional fatigue between 6-12 repetitions whereas LL RET had participants reach volitional fatigue between 20-30 repetitions. Participants performed thrice weekly training sessions over a 10-week training period where unilateral knee extension and unilateral dumbbell bicep preacher curls were performed for three sets each. Participants were also supplemented with 30-gram boluses of whey/vegan protein concentrate twice daily for the 10-week training period. Pre-RET testing occurred in the week immediately prior to the RET period and post-RET testing occurred in the week immediately following the RET period. The study is currently ongoing, and no results can be presented in this abstract but will be available on the presentation date.

Deana Kanagasingam.
From a social justice perspective, healthcare environments should be safe spaces that allow patients of all shapes and sizes to feel comfortable seeking support for a variety of health concerns, including weight (Puhl, 2010). However, a review of the existing literature reveals the presence of oppressive attitudes and behaviours directed at larger patients by a range of healthcare practitioners (Phelan et al., 2014). Despite the increased attention on such injustice, to-date there have been no empirical studies on 1) healthcare practitioners who practice social justice when treating larger patients for weight-related issues or 2) larger patients’ experiences of receiving social justice-informed care. I refer to social justice in practice as addressing intersecting macro-level inequities such as racism, sexism, and sizeism through micro-level practitioner-patient interactions (Mishler, 2005). My study fills a research gap by presenting an alternative to the dominant paradigm of obesity treatment and examining how social justice is understood, enacted, and experienced in weight-related clinical interventions. Using an intersectional lens, I present findings from in-depth one-on-one interviews with 22 healthcare practitioners from different disciplines who identify as social justice advocates and 20 patients who are served by such practitioners. I address five main questions: 1) What doessocial justice mean to practitioners? 2) How do practitioners translate principles of social justice into concrete practices? 3) What are the challenges of practicing social justice that practitioners encounter? 4) What does social justice mean to larger patients? 5) How does social justice-informed care shape larger patients’ experience in healthcare?

Tineke Dineen, CorlissBean, & Mary Jung.
With type two diabetes on the rise, there is a need for more prevention programs to reach the large number of at-risk individuals. This research examined the implementation process, strategies, and multilevel contextual factors as an evidence-based diabetes prevention program was implemented into two local community organization sites.Guided by a pragmatic epistemology, semi-structured interviews were conducted with community organization staff who delivered the program (n= 8), and a focus group was completed with implementation support staff (n= 5) from both sites. Interviews were transcribed verbatim and thematically analyzed using a template approach guided by the consolidated framework for implementation research (CFIR). Within the template approach, themes were first inductively identified to ensure all salient ideas were captured, then identified themes were deductively linked to CFIR constructs. Implementation strategies used were appropriate, well-received by staff and promoted successful implementation. Several CFIR constructs were identified from all five domains: (a) process, (b) intervention characteristics, (c) outer setting, (d) inner setting, and (e) individual characteristics. Specifically, results revealed the partnered one-year planning process, program components and structure, level of support, and synergy between program and context were important factors in the implementation.Successful implementation was supported by a fully engaged, partnered approach to planning, and subsequently executing, an implementation effort. The CFIR provided a thorough framework to identify and evaluate multilevel contextual factors impacting implementation. Results demonstrate a successful approach to working with a community partner to support implementation.

Kyle J. Missen, Lorenz Assländer, J. Timothy Inglis, Mark G. Carpenter.
Upright human stance is mechanically unstable. The central nervous system counters destabilizing effects of gravitational and inertial forces acting on the body by generating corrective torque. Some of the corrective torque required to stabilize the body is generated through active, closed-loop feedback control mechanisms; however, many aspects of the organizational structure of these feedback mechanisms are still unclear. Simulations using neuromechanical models of balance control suggest experimental data is more accurately reproduced when a torque-related positive feedback mechanism is included in the model. However, the existence of a torque feedback mechanism for standing balance remains speculative and has yet to be experimentally verified. The purpose of this study is to test the assumption of a positive torque feedback mechanism contributing to human upright stance. Participants will be positioned in a unique apparatus that restricts body motion while standing (and without participant awareness). Participants will complete a series of standing trials which will start with participants standing without stabilization (120s), followed by a locked period (120s) where participants will be systematically locked in a forward leaning position at various angles. Torque responses from a force plate will be compared across all leaning conditions and experimental data will be fit with existing computational models of standing balance. Positive torque feedback predicts that body lean away from the neutral upright position corresponds with increasing torque across time as the system attempts to restore the neutral position. It is hypothesized that greater deviations from the neutral position will correspond with greater increases in torque.

Jessica Liang.
The purpose of this study was to investigate how older women were represented in health and fitness magazines, paying particular attention to the ways that the depictions of older women reinforced or challenged cultural assumptions about gender, health, and aging.Over a six-month period, we collected monthly issues for three widely read, health and fitness magazines distributed in North America, namely Health, Prevention, and Yoga Journal. We examined the texts and images associated with the magazines’ advertisements and interest stories.Our thematic analysis revealed that older women were represented in three ways. To begin, ‘Fitness enthusiasts’ entailed stories about older women who had used physical activity to remain healthy and happy. ‘Active consumers’, referred to advertisements that featured older women as consumers of supplements and cosmetic interventions to treat the physical signs of aging. Finally, ‘Menopause warriors’ included interest stories and advertisements of older women discussing anddealing with the changes linked to menopause. Within each category, we report on the use of imagery and language to construct a deeper understanding of how older women are pressured to engage in consumer culture to stave off the signs of aging.The findings demonstrated that older women were depicted in favourable light. This study contributes to aging scholarship and highlights the ways that the dominant discourses about aging, gender, and health are either reinforced or challenged by health and fitness magazine texts and images.

Kelsey R. Wuerstl, M.Sc,Christopher B. McBride, Ph.D.3, & Heather L. Gainforth, Ph.D.
Compared to the general population, people with spinal cord injury (SCI) report higher smoking rates, a disproportionate burden of tobacco-related health disparities, and unique circumstances to smoking cessation. Theory-informed and rigorously developed smoking cessation interventions may reduce smoking rates and health inequities among persons with SCI.To establish a proof-of-concept of a tailored smoking cessation intervention for persons with SCI. This proof-of-concept aims to 1) prepare and test the intervention manual for fidelity monitoring and 2) assess preliminary evidence of the intervention's efficacy to determine whether the intervention merits more rigorous testing using a randomized design.Aligned with an integrated knowledge translation approach, a provincial SCI organization is meaningfully engaged throughout the research process. Using a treatment-only, pretest-posttest design, a small, accessible sample of persons with SCI who smoke will receive a 12-week tailored smoking cessation intervention. Participants will receive bi-weekly 20min sessions with a trained smoking cessation counsellor. Session topics may include SCI-specific tobacco-related health information, managing post-cessation weight gain, and coping with secondary health conditions. Self-reported smoking and carbon-monoxide verified abstinence will be assessed post-intervention and at 3-and 6-month follow-ups. All intervention sessions will be assessed for fidelity using gold-standard video-recording and behaviour change technique coding.This study will provide the groundwork for a future randomized-control trial through preliminary evidence about the intervention's efficacy to facilitate smoking cessation among persons with SCI. Additionally, it will enable us to refine and optimize theintervention manual and fidelity protocol, which may enhance feasibility and efficacy.

Christine Zing-Ting Hsin*, Jennifer Boughner*,Alison Michelle McLean Williams, Andrea Bundon, and Tania Lam.
To understand how adaptive kayaking may improving sitting balance and the perceived ability to complete activities of daily living (ADLs) in individuals with spinal cord injury.Five subjects with spinal cord injury completed approximately 10 adaptive kayaking sessions over 12-weeks. Laboratory and clinical measures of seated balance, self-efficacy, and independence in completing ADLs were taken prior to and following the kayaking intervention. Semi-structured interviews were also completed following the intervention to explore self-perceived changes in self-efficacy and ability to complete ADLs, as well as the overall kayaking experience.On average, participants improved in functional balance measures, and seated balance measures when eyes were open. Qualitative interviews revealed that participants experienced an increase or maintenance of self-efficacy and perceived ability to complete ADLs. All participants reported that kayaking was a positive experience as a result of high confidence in safety of the activity, the outdoor environment, and the ability to choose the pacing of their exertion.Findings indicate that adaptive kayaking has potential as a recreational and rehabilitative tool to provide quality experiences in physical activity for individuals with spinal cord injury, while also improving their balance and independence in ADLs. In particular, accessible equipment, knowledgeable staff, and allowing for the self selection of exertion appear to be critical for success in adaptive kayaking programs.

Liam Stewart, Liisa Wainman, Mehdi Ahmadian, Christopher R. West.
Individuals with spinal cord injury (SCI) are predisposed to orthostatic intolerance stemming from disruptions to the sympathetic nervous system which impairs the arterial baroreflex. Whilst the vascular arm of the arterial baroreflex has been well studied, the cardiac-contractile arm has not. The first step in investigating the cardiac-contractile arm of the baroreflex is to develop an in-vivo model that permits the unloading of baroreceptors while simultaneously measuring left ventricle (LV) contractility.To develop an in-vivo neuro-cardiac testing platform in rodents that enables the measurement of LV contractility during baroreceptor unloading.Nine rats were instrumented with a LV pressure-volume catheter to measure LV contractility (Pmax-EDV and dP/dtmax-EDV). Rats were also outfitted with an arterial pressure catheter, and placed in a lower body negative pressure (LBNP) chamber and exposed to vacuum pressures to reducemean arterial pressure (MAP) by 10 (MAP-10) and 20 (MAP-20) mmHg to mechanically unload baroreceptors and stimulate the baroreflex.LBNP elicited mild increases in LV contractility at MAP-10 (Pmax-EDV: 0.42 ± 0.08 vs. 0.46 ± 0.08 mmHg μl−1, P=0.137; dp/dtmax-EDV: 37.0 ± 7.1 vs. 40.4 ± 8.8 mmHg s−1 μl−1, P=0.224). At MAP-20, Pmax-EDV and dp/dtmax-EDV were higher vs. baseline (0.50 ± 0.08 mmHg μl−1and 43.2 ± 8.2 mmHg s−1 μl−1, both p less than 0.009).We now have an in-vivo neuro-cardiac testing platform to interrogate the LV contractile response to unloading of the baroreflex. We will utilize this preparation to assess baroreflex function following SCI to better understand the mechanisms of orthostatic tolerance.

Mehdi Ahmadian, Liisa Wainman, Ryan L Hoiland, Erin Erskin, Glen E Foster, Christopher R West.
End-systolic elastance (Ees(IVC)) derived from inferior vena cava occlusion (IVCO) is the reference for quantification of cardiac contractility. However, such assessments require complex surgical procedures that make it practically impossible to use this method to assess longitudinal changes in cardiac inotropic function within the same animal. Consequently, there is an immediate need for developing methods that require less complex surgical procedures. Here, we tested the agreement of a novel Ees(RES) derived from respiratory-induced changes in cardiac preload during mechanical ventilation against Ees(IVC). Thirty-eight Wistar rats (300-350g; aged 10 wks) were used. Once anesthetized and ventilated, animals were instrumented with 1) a LV pressure-volume (PV) catheter and 2) a femoral arterial catheter to record basal systemic hemodynamics.Ees(IVC)was measured as the slope of end-systolic PV relationship (ESPVR) obtained during an IVCO. Measurement of Ees(RES) was analogous to Ees(IVC) however, respiratory-induced oscillations in cardiac preload, rather than an IVCO, was used to calculate the slope of the ESPVR. Correlations and agreements between metrics of interest were examined using Pearson’s and intraclass correlation coefficients (ICC). We found high positive correlation (r = 0.88, P less than 0.001) and excellent agreement (ICC = 0.934, P less than 0.001) between Ees(RES) and Ees(IVC). Our findings suggest that respiratory-derived Ees(RES)appears to be a reliable surrogate for Ees(IVC). With the advent of advanced preclinical tools to track changesin cardiac pressures and volumes (telemetry) over time, our findings provide a relatively straightforward method by which longitudinal changes in cardiac inotropic function can be tracked within an animal.

Jinelle C.M.Gelinas, Stephen P. Wright, Megan I. Harper, John P. Sasso, Gloria Agar, Bernie Melzer, Gregory R. duManoir, Jordan A. Guenette,J. Douglass Rolf, Neil D. Eves.
Utilizingthe power-duration relationship may help identify the optimal intensity for sustainable exercise in patients with COPD who have different exercise limitation phenotypes. We aimed to compare differences in critical power (CP) and W’ between patients with different exercise limitations, and to assess the efficacy of this methodology to predict exercise tolerance in COPD.Individuals with COPD (n=30, FEV1:31-111%pred) were classified as having a ventilatory, cardiovascular or combined phenotype using an incremental cardiopulmonary cycling exercise test. Three constant-load cycling exercise tests were performed at 50-80%Wmax to construct individual power-duration relationships, determine CP and W’, and to calculate the highest power output that could be maintained for 30-minutes (CP30). A verification trial was performed at CP30. CP was lower in the ventilatory phenotype compared to both other phenotypes (p less than 0.01), however W’ was not different between phenotypes (p=0.98). CP30 was higher in the cardiovascular (61±7%Wmax) and combined (57±6%Wmax)phenotypes versus ventilatory (44±8%Wmax) (both p less than 0.01). Throughout exercise at CP30, HR, VO2and blood lactate were higher in the cardiovascular and combined phenotypes versus ventilatory (all comparisons p less than 0.05). No differences were found in the proportion of patients who achieved 30-minutes at CP30 between the ventilatory and cardiovascular (p=0.07) or combined (p=0.51) phenotypes. Patients with a cardiovascular or combined phenotype can exercise continuously for 30-minutes at a higher intensity and metabolic load compared to those with a ventilatory phenotype. This novel finding demonstrates the importance of identifying phenotypes of exercise limitation when prescribing exercise intensity for sustainable exercise in COPD.

Sarah V. C. Lawrason, Jennifer R. Tomasone, Kenedy Olsen and Kathleen A. Martin Ginis.
Ambulators with SCI participate in less leisure-time physical activity (LTPA) than wheelchair-users with SCI. Although some research has been undertaken to explore strategies for increasing the quantity of LTPA, no studies have been conducted to examine subjective experiences of LTPA (i.e., the quality of LTPA) among ambulators with SCI. Thus, the purpose of this study was to explore (a) conditions that influence perceptions of LTPA experiences and (b) elements involved in quality LTPA experiences. Semi-structured interviews were conducted with 23 ambulators with SCI. Using a philosophically pragmatic approach, the data were thematically analyzed using both inductive and deductive coding. The Quality Parasport Participation Framework was employed for deductively coding the elements and conditions associated with LTPA experiences. Three principal themes were identified which provide broad insights for LTPA among ambulators with SCI: (a) ableism, (b) sidelined from participation and (c) invisibility. These themes capture conditions that fostered a positive or negative quality PA experience, including: three intrapersonal, five social, four program, and one physical condition(s). Elements identified in the Quality Participation Framework (i.e., belongingness, meaning, mastery,engagement, challenge, autonomy) were also related to both positive and negative quality LTPA experiences. This study provides insight on how LTPA is uniquely experienced by ambulators with SCI, including conditions and elements that influence quality participation. Importantly, ableism, feeling sidelined, and invisibility can undermine LTPA experiences. Interventions should make use of program conditions (e.g., peer support) and elements (e.g., autonomy) that could help improve the quality of LTPA participation for ambulators with SCI.

Ben Stothers, Michael Koehle, Andy Hung, Patric Oliveira Goçalves.
As the world’s population continues to increase andbecome more industrialised more people are being exposed to ambient air pollution. Concurrently, an emphasis is being put on the importance of physical activity in a healthy lifestyle. This raises concerns for people with asthma and/or exercise induced bronchoconstriction (EIB) who’s airways are more sensitive to respiratory irritants. One irritant in air pollution that effects this population is ozone (O3) generated in photochemical smog. Salbutamol (SAL) is a bronchodilator commonly prescribed to people with EIB and/or asthma. SAL use in O3pollution may be contradicted because it increases the O3exposure in the airways of individuals that are prone to inflammation. This has been shown previously in rodent studies.Salbutamol use will increase the amountof airway inflammation experienced in people with asthma and/or EIB exercising in ozone air pollution. In a double-blinded crossover design people with EIB and/or asthma will complete four 30-minute bouts of exercise at 60% of their VO2MAXon four separate days: [100]ppb O3+ SAL, [100]ppb O3+ placebo SAL, filtered air + SAL, filtered air + placebo SAL. A eucapnic voluntary hyperpnoea test will be done to confirm the presence of EIB in addition to a VO2MAX test. Lung inflammation will be measured before and after exercise using FeNO in addition to pulmonary function measured by spirometry. Post-exercise FeNO and spirometry measurements will be analyzed using linear regression. Baseline adjustments will be made taking pre-exercise values as covariates in the regression models.

Gevorg Eginyan, Alison MM Williams, Mason Chow, Tania Lam.
Urinary incontinence negatively impacts quality of life for over420 million people worldwide. The pelvic floor muscles (PFM) are crucial for maintaining urinary continence in humans. Transcutaneous tibial nerve stimulation (TcTNS) is used to manage urinary incontinence. However, the mechanisms of this treatment remainunclear. There is compelling evidence from upper and lower limb studies that peripheral nerve stimulation alone can trigger neuroplastic changes in primary motor cortex in the absence of motor training. Since the tibial nerve (L4-S3) shares segmental innervation with the pudendal nerve (S2-S4), which supplies the PFM, we hypothesize that TcTNS may lead to neuromodulation of the corticospinal projections to the PFM as well as Adductor Hallucis (AH) (innervated by tibial nerve). Thus, the purpose of this study is to evaluate whether TcTNS may alter corticospinal excitability of the PFM and AH when delivered at two different patterns on stimulation in neurologically intact individuals. We will show the preliminary results from two individuals who completed thestudy protocol. TcTNS was delivered either intermittently (trains of square wave pulses at 30Hz, 50% on/off duty cycle), or continuously at 30Hz. Stimulation conditions were randomized and tested on separate days. Surface electromyography will be used to record motor evoked potentials (MEPs) from PFM and AH before and after the 2-hr stimulation period. MEPs in the PFM and AH were elicited by transcranial magnetic stimulation (TMS) over the motor cortical areas controlling these muscles before and after TcTNS to compare the corticomotor excitability of these muscles.

Garry McCracken, Jennifer Jakobi.
Canadians are living longer and spending more years in retirement.This demographicshift has prompted significant growth in sport participation by older adults.The purpose of this research was to explore the principles of Physical Literacy (physical activity, motivation and engagement) within the Masters Athlete community in the Okanagan, and to determine how this group of older active adults put principles into practice in their lives.Of the 35 Masters Athletes who consented and completed an online survey of sport participation in a pre-COVID19 scenario, more than half declared themselves to be lifelong athletes, while almost a quarter could be considered “late bloomers” coming to competitive sport later in life.The survey also showed that while most Masters Athletes were unaware of Physical Literacy, they embodied its principles in their practice of physical activity and sport to maintain a healthy lifestyle for life. Following the survey, 8 participants were selected to participate in semi-structured interviews.The interviews showed that when presented with the Physical Literacy definition, Masters Athletes felt that it had little relevance for them and failed to see how it could be adapted to address the needs of older adults.The importance of social connection in sport was prominent in the interviews.Several commented about how sport had replaced the socialization previously found in the workplace.These data suggest that although Masters Athletes are unaware of the construct of Physical Literacy they are engaged in its principles and sought to share their active lifestyle with other older adults.

Jay Carr, Emmanuel Katsogridakis, Matt Bown, Ronney B. Panerai, Emma M.L. Chung, Phil N. Ainslie, Jatinder S. Minhas.
Cerebrovascular diseases are preceded by -and associated with -endothelial dysfunction in the cerebral vasculature. However, clinical assessments of cerebrovascular function currently lack specificity for extra-cranial artery endothelium-dependent function. In particular, typical measures of cerebrovascular function assess a number of overlapping and redundant vasodilator pathways, and do not hold strong predictive value in populations other than those with overt steno-occlusive disease. The extent of cerebral endothelium-dependent shear mediated vasodilation within patients with various categories of carotid stenoses and atherosclerotic burden are largely unknown.In 50 carotid stenosis patients we will evaluate large cerebral extra-cranial artery vasoreactivity using three common and integrative assessments (cerebral flow-mediated dilatation, cFMD; CVR; and common carotid artery cold pressorreactivity, CAR). cFMD will be assessed during transientlyelevated shear stress caused by increased inspired carbon dioxide using the Douglas bag following protocols based on similar previous studies. CVR will be assessed during steady-state elevation of CO2. Assess large extra-cranial artery endothelium-dependent shear-mediated vasodilation across severities of carotid stenosis, using a comprehensive evaluation of arterial vasomotor function. Extra-cranial artery endothelium dependent shear-mediated vasodilation will be associated with volume of carotid stenosis. Shear-mediated vasodilation and sympathetic vasodilation responses will be associated with risk of negative outcome.Differentiation of cerebral endothelial function across a range of impairments, and in the presence of atherosclerotic burden/risk but absence of manifest carotid stenoses, will inform future clinical diagnoses of carotid and systemic atherosclerotic risk to the cerebral vascular tree.

Robert B Shaw,Sarah VC Lawrason, Kendra R Todd, Katheen A Martin Ginis.
Peer mentorship is beneficial for people with disabilities and yet little is known about characteristics of the mentor-mentee relationship that contribute to the observed positive outcomes. To date, no review has examined characteristics of peer mentorship (i.e. interaction modality, interaction frequency) that could impact the quality and effectiveness of this service. The purpose of this project was to synthesize the peer mentorship literature for people with disabilities and report on the interaction modality and frequencyemployed in each study.Six databases were searched for articles that employed one-to-one peer mentorship interventions for people with spinal cord injury, cerebral palsy, multiple sclerosis, amyotrophic later sclerosis, stroke, spina bifida, spinal stenosis, amputee, muscular dystrophy, or fibromyalgia. A total of 2105 articles were screened, with 13 meeting the review inclusion criteria.Five different forms of interaction modalities were reported across the 13 included studies (i.e., face-to-face, telephone, text, email, video chat). Most studies (n=12) included telephone interactions and ten studies incorporated several interaction modalities. Intervention length varied greatly (range=6-104 weeks) as did the average number of weekly interactions between mentors and mentees (range=0.17-2.16). Only five studies allowed participants to self-select their interaction frequency.Peer mentorship research interventions have been delivered through various interaction modalities and at varying frequencies. Further research is needed to investigate the impact that interaction modality and frequency have on the quality of peer mentorship interactions for people with disabilities and the effect this could have on outcomes for both mentors and mentees.

Donna Li and Cam Mitchell.
Skeletal muscles responds to unaccustomed exercise by orchestrating an adaptive response to attenuate damage by future bouts of same or similar exercise. This intrinsic protective phenomenon is known as the repeated bout effect (RBE). Currently, the mechanisms underlying RBE has yet to be elucidated. There is evidence to suggest that the protective effect can be elicited by submaximal, nondamaging exercises. However, to our knowledge, no study has identified whether conventional resistance training (RT) can confer a similar magnitude of protective effect. Moreover, the role of extracellular matrix (ECM) remodeling has been identified as one potential mechanism in the adaptation of the musculature and its microenvironment to mechanical stimuli. Considering the lack of knowledge underpinning the mechanisms behind RBE and recent discoveries emphasizing the importance of ECM dynamics in dictating this niche muscle environment, we hypothesize that conventional RT preceding a damaging bout of exercise will mitigate indirect damage markers (e.g., Soreness and strength) and induce a RBE. Importantly, markers of ECM adaptations will be evident with an increase in growth factors (e.g., TGFβ), collagen synthesis and degradation (e.g., MMPs), as well as glycoprotein levels (e.g., TN, FN). Using a unilateral design, 24 young healthy subjects (12 men and 12 women) will complete: 3 weeks of conventional RT on the training leg(CRT) [3 sets of 12 rep leg extensions twice a week, totalling 6 sessions], followed by two eccentric bouts separated by 21 days on both the trained and untrained (CON) leg. The trained and control leg will be randomized. Following exercise, immunohistochemistry (e.g., FN, TN), magnetic bead multiplex (e.g., TGFβ) and qPCR (e.g., Collagen, MMP-2 and -9) will be used to characterize differences in ECM expression. These findings will provide insights into how the ECM interacts to manifest RBE following exercise.

Naomi Maldonado-Rodriguez, Jon Smirl, Colin Wallace, Cheryl Wellington & Paul van Donkelaar.
One in three women will experience intimate partner violence (IPV) in their lifetime and up to 92% may report symptoms that are consistent with brain injury (BI). Although neuropsychological and neurophysiological deficits related to IPV-related BI have been described, little is known about the physiological sequalae of IPV-related BI. In the case of IPV-related BI where injury is often chronic and repetitive, blood biomarkers may provide insight into potential pathophysiological mechanisms underlying chronic symptoms.The purposeof this exploratory study was to examine the relationship between IPV-related BI and blood-based biomarkers of neurological injury and inflammation.Women who have experienced IPV were recruited from various community women-serving organizations. BI load,PTSD, anxiety, depression, substance use, and history of abuse were assessed. Biomarkers of inflammation and neurological injury were quantified using an ultrasensitive immunoassay. Stepwise multiple regression was undertaken to explore the relationship between BI load and biomarker concentration while accounting for comorbid psychopathologies.In 24 participants assessed between 2 months and 12 years after BI, no biomarker concentration was predicted by BI load. Interleukin-10 and tumor necrosis factor-α concentrations were associated with PTSD severity. Interleukin-6 concentration was negatively associated with history of abuse.Our findings suggest IPV survivors may experience chronic low-grade systemic inflammation. This may be related to PTSD severity, reflecting ongoing stress in participants’ lives. Small sample size and large range in time since last BI may partly account for the lack of association of BI load with biomarkers of neurological injury.
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Michael G. Leahy, Shalaya Kipp, Dr. Nisha Charkoudian, Dr. Glen E. Foster, Dr. Michael S. Koehle & Dr. A. William Sheel.
The metaboreflexis a metabolically stimulated reflex originating in skeletal muscle that causes a sympathetically driven pressor response, increasing; heart rate, peripheral vascular resistance, and mean arterial pressure. The respiratory muscles can evoke the same reflex through high-intensity inspiratory work. Women have an attenuated blood pressure and heart rate response to intense respiratory muscle contractions compared to men. There are a number of possible reasons for sex-based differences, but some are thought tobe due to the protective qualities of circulating sex hormones (i.e. estrogen and progesterone) on cardiovascular regulation. Additionally, the effect of aging on the respiratory metaboreflex response remains largely unclear. The purpose of this ongoing study is to observe the effect of age and sex on the respiratory muscle metaboreflex. The comparison of in pre-and post-menopausal women to age-matched men can help us understand possible effects of circulating estrogen on muscle based pressor reflexes.

Gabriel Dix, Garett Jackson, Kendra Todd, Jonathan Little, Kathleen Martin Ginis.
No research has explored the relationships between cardiorespiratory (CR) fitness, cortisol, perceived stress, and leisure time physical activity (LTPA) in adults with a spinal cord injury (SCI). This study examined the relationships between LTPA, CR fitness and psychological (i.e., perceived) and physiological (i.e.,cortisol) stress in adults with chronic SCI. It was hypothesized that LTPA and CR fitness would negatively correlate with 1) perceived stress,and 2) circulating cortisol.Nine men with chronic (>1-year post injury) traumatic SCI (M=18.4 years post-injury) participated in this cross-sectional study. Fasted blood samples were taken, and participants completed the Perceived Stress Scale and a self-report LTPA measure prior to performing a V̇O2peaktest.Cortisol concentration was assessed using a cortisol ELISA.Hypothesis 1 received partial support as CR fitness was trivially negatively correlated with perceived stress (r=-.076), whereas a small negative correlation was observed between total LTPA and perceived stress (r=-.187). Hypothesis 2 was supported as both V̇O2peak(r=-.306) and total LTPA (r=-.475) demonstrated a medium-large negative correlation with levels of cortisol. Forced regression analysis indicated V̇O2peakand LTPA together explained 23.2% of the variance in cortisol (R2adj=.232,F[2,5]=0.755,p=.517) and 3.5% of the variance in perceived stress (R2adj=.035,F[2,5]=0.091,p=.914).Results suggest that as physical activity and fitness increase, cortisol levels decrease. Regression results suggest that a combination of physiological adaptation and behaviour may play a role in cortisol secretion. Interestingly, our regressions suggest that additional factors not examined in the present study likely contribute to variations in perceived stress.

Emma Reiter,Rocio Hollman, Minh John Luu, Sarah de Faye, Mark Hollands, Mark CarpenterSchool of Kinesiology, University of British Columbia, Vancouver, BC.
Vision has an important role in postural control in concert with other sensory systems. Aspects of sensorimotor control of posture have been investigated with height-related threat, however, eye-movement has not been extensively explored. Less exploratory gaze behaviour has been demonstrated in individuals with visual height intolerance (vHI) compared to controls [1] however visual exploration was not compared to ground level. Therefore, this study aimed to investigate changes in eye-movement between low and high heights. We hypothesized less exploratory eye-movements under conditions of postural threat.Twenty healthy young adults (8 female; mean age=26) stood on a forceplate at low (0.8m) and high (3.2 m) heights facing a blank canvas. Eye-movements were measured with a Dikablis eye-tracking system and normalized to participant eye level (horizon) and center of view. Repeated measures ANOVAs revealed significant changes in postural and emotional-cognitive outcomes, indicating a successful threat manipulation. No significant changes in average eyelocation or vertical exploration were found, but there was a significant reduction in horizontal exploration at height (p=0.051, d=0.80). Five participants (25%) reported having vHI, aligning with current estimates of vHI prevalence [2]. Descriptively, atheight these participants fixed their gaze further above their respective horizons compared to the overall group and showed more vertical exploration, in contrast to findings of horizon fixation previously reported in this population [1]. Further analysisin this project will investigate location and duration of gaze fixations to gather a more detailed understanding of gaze patterns under these conditions.

Kara Crampton, Dr. Barbara Oliveira & Dr. Jonathan Little.
Type 2 Diabetes is a chronic condition characterized by increased blood glucose, or hyperglycemia. One of the complications associated with this condition is a decrease in cognitive function. Consumption of carotenoids, specifically lutein and zeaxanthin, found in fruits and vegetables as well as eggs has been found to increase visual and spatial memory and learning. Lutein and zeaxanthin are the only two carotenoids that have been found to specifically accumulate within the macula of the eye and play a protective role for both eye and brain health. The purpose of my research will be to compare the effect of regularly consuming an egg-based breakfast on cognitive function in participants with T2D. This 3-month trial will have approximately 50 participants randomized into either a high-carbohydrate/low fat (control) or low-carbohydrate/high fat egg-based (experimental) breakfast condition. Participants will consume their assigned breakfasts everyday over the course of the trial and will complete cognitive assessments at three time points (baseline, middle, end) during the study. Dried blood spots will also be collected at baseline and conclusion of the study to be analyzed for blood carotenoid levels. At this time, 8 participants completed the study. Preliminary results will be presented. My research will test whether a relatively straightforward dietary strategy of consuming more eggs will help increase blood carotenoid levels and ultimately offset cognitive dysfunction in people with T2D.