Public Health, Physiotherapy and Sports Science Theses

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This collection is made up of doctoral and master theses by research, which have been received in accordance with university regulations.

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Now showing 1 - 5 of 17
  • Publication
    Heart Rate Variability Monitoring in Athletes
    (University College Dublin. School of Public Health, Physiotherapy and Sports Science, 2022) ;
    0000-0003-2745-4072
    Introduction: Heart Rate Variability (HRV) is a popular assessment of the autonomic nervous system (ANS). It is a non-invasive measure commonly used in clinical settings to evaluate cardiovascular health and ANS function. In athletes/athletic populations it provides insight into recovery status and readiness for training. Although this assessment has been validated in clinical populations, the reliability of using HRV measurements in practical settings has not been comprehensively studied nor is there any universal guidelines dictating best practice for use with athletes. This thesis outlines some of the concerns pertaining to the reliability of this assessment and the steps in developing new guidelines to ensure best practice can be met, both for research and practical uses. The aim of this thesis is to investigate the reliability and practicality of using HRV to monitor athletes, (1) in a systematic review of studies examining the reliability of HRV in athletes and (2) through a test-retest reliability study of HRV. Methods: Elite or regularly active athletes of all sports, (including endurance, team sport and power-based sports) were eligible for inclusion in both the systematic review and research study. In the systematic review, the reliability of different HRV measurement protocols were examined. The systematic review included 11 papers and a total of 215 participants. In the test-retest reliability study participants were tested for HRV on 4 occasions determined from a 30 minute 3-lead ECG measurement. The research study included 16 athletes (5 male, 11 female). Results: The systematic review found that the 1996 guidelines created by the Electrophysiology Task Force of the European Society of Cardiology and the North American Society of Pacing for HRV measurements in athletes are underutilised and the reporting of methodologies was not consistent amongst studies. Reliability results were also not consistent among the studies investigated (CV ranging from 1.80 – 61.0% for lnRMSSD). The original research study conducted showed that the use of an average of two 30minute HRV measures within a one-week period is a reliable method to assess HRV (ICC = 0.798, CV = 5.88 +/- 4.34%). It also showed that shorter HRV measurements are as reliable as the 30minute reference measure when using this protocol. Conclusions: The current recommended guidelines for HRV measurements in the general population are both insufficient and under used in the testing of athletic populations. Care should be taken in future studies to ensure methodologies are appropriately reported. HRV can be a reliable tool for monitoring autonomic function in athletic populations if suitable protocols are followed.
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  • Publication
    An investigation into the physiological and genetic determinants of sarcopenia and the enhancing of current strategies for skeletal muscle screening
    (University College Dublin. School of Public Health, Physiotherapy and Sports Science, 2022) ;
    0000-0002-7410-078X
    The age-related deterioration of muscle strength and mass, known as ‘sarcopenia’, is a major public health burden, due to its high and increasing prevalence and association with several adverse health outcomes. Although decades of research have been dedicated to understanding its aetiology and developing preventative strategies, sarcopenia effects >40% of those aged =80 years. Thus, there is a clear need to further elucidate the mechanistic pathways underlying sarcopenia, and to enhance current screening and treatment measures. To date, barriers associated with attaining accurate muscle measurements have impeded a proficient implementation of preservative and diagnostic strategies in clinical practice. Correspondingly, the potential benefits of a blood-based sarcopenia assessment, incorporating markers indicative of its aetiological underpinnings, have gained credence. In this regard, although the clinical manifestation of sarcopenia is multifaceted, recent data suggest neural processes to be of principal importance, and so exploring markers of neural integrity is particularly relevant. In addition to barriers associated with muscle quantification, the paucity of suitable, high-quality normative data for certain populations presents further impediments to the clinical interpretation of muscle health across the lifespan. Consequently, the potential for an accurate and timely identification of those at risk of, or with poor muscle health is greatly reduced. In this regard, although sarcopenia is diagnosed as the simultaneous presence of low muscle strength and mass, muscle strength is recognised as the cardinal diagnostic criterion, and so establishing muscle strength norms is particularly urgent. Accordingly, this thesis sought to: a) generate physiological and genetic data to illuminate the aetiological mechanisms underpinning sarcopenia development; b) identify promising blood-based markers that may enhance current screening strategies; and c) establish high-quality normative data and diagnostic thresholds for muscle strength. This thesis incorporated data from 9431 individuals aged 18-92 years (mean age: 44.8 ± 13.4 years; 57% females). Detailed phenotypic data (anthropometrics, body composition, muscle strength, cardiorespiratory fitness, blood sampling, health and lifestyle information) were collected for each participant, while plasma and genetic analyses were performed in subpopulations (n=300, aged 50-83 years; and n=6715, aged 18-83 years, respectively). Results confirmed the relevance of plasma C-terminal agrin fragment, a marker of neuromuscular junction (NMJ) stability, to sarcopenia, and illuminated novel associations between plasma neurofilament light chain, a marker of axonal integrity, and sarcopenia. Additional novel associations are highlighted between genes involved in regulating NMJ health (AGRN and PRSS12) and several phenotypes relevant to sarcopenia. Collectively, the physiological and genetic data provide strong evidence of the neural contribution to sarcopenia development, and suggest NMJ and axonal integrity to be of central importance. Finally, the normative data and diagnostic thresholds established in this thesis may help inform the clinical interpretation of muscle health across the entire adult age-span. Importantly, the diagnostic thresholds were proficient in identifying those with poor performance across a myriad of clinically relevant health domains, and suggest the cut-points currently in widespread use, may be too stringent.
      44
  • Publication
    Epidemiological analyses to support national control of SARS-CoV-2 in Ireland
    (University College Dublin. School of Public Health, Physiotherapy and Sports Science, 2022) ;
    0000-0002-4984-4031
    Pathogen emergence has been increasing in recent decades. In December 2019, an outbreak of atypical pneumonia emerged in Wuhan, central China. The cause of the disease, was subsequently identified as a novel coronavirus (SARS-CoV-2) and the disease named COVID-19. Over a short period of time SARS-CoV-2 rapidly spread throughout mainland China and surrounding countries in the western pacific before cases appeared in Europe in February of 2020. The first case in Ireland was documented in Ireland on the 29th of February 2020. In response, a series of epidemiological analyses were conducted to support decision making in the national control of the disease. The objective of this thesis was to provide regions-specific estimates of region-specific epidemiological parameters of interest, to aid in the accurate modelling of the disease in the country. The ultimate goal was to improve models so that more accurate information could be provided to decision makers. Chapter one proposed the use of the number of close contacts of infected cases over time as a metric for monitoring behaviour of infected contacts. The study found that the distribution of contacts per case was overdispersed, with a small proportion of cases reporting very large numbers of contacts. The study also provided an evidence basis for mathematical age-cohort compartmental models, by providing data on the social contacts of the Irish population under different levels of restriction. Chapter two estimated the serial interval of SARS-CoV-2 in Ireland using contact tracing data. The median serial interval was 4.0 days which was lower than estimates previously used for the statistical approximation of the serial interval in Ireland. Furthermore, the study also suggested that up to two thirds of transmission events were likely to have occurred prior to the onset of symptoms in the primary case. Finally, chapter three evaluated the potential use of Rapid Antigen Diagnostic Tests in screening individuals attending mass gatherings. The baseline risk of infection in the tested population is of key importance when interpreting the results of any imperfect diagnostic tests. This study provided a mechanism for estimating the baseline risk, as well as the uncertainty around that risk, using incidence data. The studies presented in this thesis demonstrate that secondary analyses of contact tracing data can yield meaningful and useful pieces of information that may be used to more accurately reflect transmission in the population of interest. However, it is also worth pointing out that certain opportunities were underutilized in the collection and analysis of contact tracing data. Given the apparent acceleration of pathogen emergence, evidenced in particular by the temporal proximity of repeated coronavirus outbreaks in the past 20 years, it is vital that Ireland take steps to develop infrastructure to deal with the current pandemic as well as the threat of future endemic diseases. Similar to work in other countries, this thesis demonstrates the strength of a OneHealth approach to the management of emerging infectious diseases.
      27
  • Publication
    An investigation of professional practice and practitioner development in applied sports performance analysis
    (University College Dublin. School of Public Health, Physiotherapy and Sports Science, 2022) ;
    0000-0002-3044-7626
    Applied Performance Analysts (PAs) are increasingly seen as professional practitioners in the sports performance industry, providing stakeholders with support in the collection, analysis, interpretation, and translation of performance data. The role is relatively new and evolving at a pace which is not supported by the ‘normal’ trappings of professional practice such as demonstrable theoretical and practical expertise, guides for practice, organisation and regulation. This thesis leverages the learning accrued from the literature in applied PA, interactions with elite applied practitioners and academics in the field, and from the design of a practitioner development pathway to conceptualise the role of an applied PA and consider how best to support the development of the profession. The aim of the thesis was to understand professional practice in applied PA and explore how best to support practitioners in their professional development. A dual approach was applied to the investigative process. The first was a traditional research approach as a framework analysis of nearly twenty years of applied PA literature was employed to identify the components of professional practice and expertise which underpinned these. This framework was validated through a series of focus group interviews with elite applied PAs and experienced academics and additionally captured their perspectives on applied practice and the profession. The second approach was of participatory action research which saw the design, implementation and evaluation of an accreditation and practitioner development programme delivered in partnership with the Gaelic Athletic Association (GAA). This research conceptualises and defines the applied PA role, identifying the components of practice and the expertise required at a level of minutia which can act as a guide, an audit tool and a platform for further research. It is the first comprehensive discussion of applied PA as a profession, focusing on the challenges it faces in the absence of robust professional infrastructure, and the opportunity to reimagine and rebrand the role. It also reports how action research can support the development of an applied PA community of practice and accreditation process, through a practitioner development pathway.
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  • Publication
    The acute responses to resisted sled sprinting (RSS)
    (University College Dublin. School of Public Health, Physiotherapy and Sports Science, 2022) ;
    0000-0001-7480-8086
    Various sprint and resistance training methods are used to achieve improvements in sprint performance. Resisted sled sprinting (RSS) is a commonly used training method to improve sprint performance. Despite extensive investigation regarding the long-term training benefits of RSS, the acute external (mechanical load) and internal (psychophysiological load) stresses, elicited by RSS training stimuli in athletic populations remains unclear. Therefore, to elucidate the acute impact of RSS and inform RSS training prescription, this thesis examined, the acute responses to RSS in sprint trained field sport athletes. In introduction chapter 1 relays the background and rationale for this thesis, and the subsequent research questions developed, further to the aims, objective and methodological approaches set for each investigation. Chapter 2 discusses findings for a review of published literature pertaining to the acute effects of RSS. Assessment of physiological and perceived exertion, during both a relatively heavy and light RSS training bout in chapter 3 supplied a description of the acute psychophysiological effect and internal training load incurred from such training bouts. Findings described that relatively heavy loads inferred a greater physiological and perceived impact in lieu of comparable larger decline in subsequent URS or neuromuscular performance. The acute alterations in sprint kinetics to different RSS loads relative to unresisted sprint (URS) kinetics were assessed as in chapter 4. This generated detailed profiles of kinetic outputs during 20m RSS sprints at a spectrum of loads, describing the mechanical overload imposed, proposed efficacy and training stimulus targeted by each load-intensity. Finally, a priming protocol described in chapter 5, showed little evidence or efficacy for use of either heavy or very heavy RSS as a mechanism to acutely enhance URS performance. Together this body of evidence demonstrated that the acute responses elicited by RSS are sled load-intensity specific, that these responses are transient in nature, and that subsequent immediate and short-term URS performance is largely unaffected by execution of prior RSS efforts provided sufficient inter repetition recovery is supplied. However larger inter-individual variation in responses was evident as sled load-intensity exceeds 55 % velocity decrement. This load- intensity is proposed as a likely limit for accruing further training benefit. Furthermore, this thesis offered evidence that, when sled load-intensity is prescribed relative to measure of athletic ability, no sex-based differences in the acute effect of RSS occurs. In summary to attain a desired sprint training stimulus and ensure appropriate implementation of RSS in the context of athlete development, training load management and wider training regimes, RSS load prescription should be made on individual athlete basis and guided by load response relationship.
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