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The impact of the research by Professor Gleeson on immune responses to exercise and predictors of infection risk in athletes has altered practice of sport science support personnel, coaches and athletes in several areas including: immunoendocrine monitoring procedures, training prescription and the use of nutritional interventions to reduce exercise stress responses and minimize risk of infection. In this way, the research conducted during 2008-2013 at Loughborough University has impacted internationally upon the ways in which sports scientists operate, and athletes and games players are prepared for competition.
In this case study we describe an interrelated collection of impacts on healthcare in the NHS; these are summarised in the Table below.
It is important that valid outcome measures are used to assess clinical services and interventions to demonstrate that services are effective. Additionally, outcomes of interventions need to be meaningful to the patients reporting them, as this adds value to the outcome of trials over and above the statistically significant difference derived mathematically. Singh and colleagues explored the minimum clinically important difference of the incremental shuttle walking test for individuals with chronic respiratory disease. As a result of Singh's research, this threshold is now included in international guidelines for pulmonary rehabilitation and has also been introduced into research and practice among people attending cardiac rehabilitation over the last 5 years.
Prof Doherty's research is themed around `safe and effective exercise for patients with complex cardiac disease' where, until his leading research had been carried out, thousands of patients were denied access to such services. Prof Doherty implemented the first prospective randomised control trial (RCT) in this population which has: benefitted patients directly by enabling more programmes to offer rehabilitation to this group of patients; impacted on clinical guidance nationally and internationally; contributed to Department of Health policy; and influenced the public and clinical populations through the NHS, British Heart Foundation, Arrhythmia Alliance and professional clinical groups.
The Physical Activity in Ageing, Rehabilitation and Health Research Group at Aberystwyth University has designed, implemented and evaluated rural Community Exercise Schemes (CESs), including GP referral of sub-clinical populations, and more specialised schemes, such as cardiac rehabilitation and falls prevention. This research has made a distinct and material contribution to the provision of CESs in the region by providing evidence to inform service planning and delivery, increase access to and engagement with services, improve health and influence professional standards, guidelines and training.
High intensity training: Impact can be evidenced on multiple levels ranging from adding to the public debate on exercise duration and providing information to the sports industry. This includes publication of the findings/applied recommendations of this research in lay magazines (e.g. Men's Health), books (e.g. The High Intensity Workout Dundee University Press 2012) and television shows (e.g. Horizon). In addition, the research has informed coaches (ice hockey and rugby union) and people working in the fitness industry (personnel trainers), and has contributed to the debate on exercise for health (Scottish Government).
The modified shuttle test (MST), developed at the University of Ulster by Professor Bradley and colleagues, is an evidence-based exercise test that is having the following impacts: