Craig Anthony Williams

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Verified

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• PhD, MSc, BEd(Hons)
• Professor at University of Exeter

Background Cardiopulmonary exercise testing (CPET) is feasible, valid, reliable, and clinically useful in interstitial lung disease (ILD). However, maximal CPET values are often presented relative to body mass, whereas fat-free mass (FFM) may better reflect metabolically active muscle during exercise. Moreover, despite the value of maximal paramete...

Aim To assess the effectiveness and safety of strength training (ST) interventions in people with congenital heart disease (ConHD). Methods Participants included people of all ages diagnosed with all complexity of ConHD. Interventions included strength training or inspiratory muscle training (IMT) which were delivered in whole or as part of a more...

Background New approaches involving adolescents in designing and implementing interventions are an opportunity to improve healthy lifestyles. This study aims to describe and analyse the differences and similarities between the four country-specific (Greece, Spain, The Netherlands and the United Kingdom) co-created interventions through a Makeathon...

Background Exercise stress echocardiography (ESE) provides a non-invasive estimation of diastolic function during exercise and can provide insight into systolic-diastolic coupling response. Current protocols are confounded by individual variation in fitness and exercise tolerance, which in turn leads to ESE normative data being difficult to define....

Background Pulmonary artery pressure (PAP) response to exercise is frequently investigated in a wide range of heart disease. Yet, there remains a grey area, especially in special groups such as athletes, where normal PAP response to exercise is not well defined. This is mainly due to how current ESE protocols do not account for individual variabili...

Background Peak oxygen consumption (peak V ̇ $$ \dot{\mathrm{V}} $$ O 2 ) is traditionally scaled by body mass, but it is most appropriately scaled by fat‐free mass. However, it is unknown whether peak V ̇ $$ \dot{\mathrm{V}} $$ O 2 scaled by fat‐free mass is associated with mortality and morbidity in people with a Fontan circulation. The aim of th...

Background Pulmonary rehabilitation (PR) is recommended for the management of interstitial lung disease (ILD), although a ‘one size fits all’ approach may not benefit every patient due to a multitude of unique characteristics, subsets and phenotypes. No ILD-specific personalised PR guidelines exist and exercise programme development is lacking, whi...

Background: Respiratory and musculoskeletal impairments in cystic fibrosis (CF) may affect balance. However, the relationship between these impairments and balance is poorly understood in children with CF. Aim: The aim of this study was to assess the balance of children with CF and investigate the relationship between balance, exercise capacity, a...

Introduction High-intensity interval training (HIIT) is an effective strategy for improving a variety of health and fitness outcomes within school settings. Incorporating HIIT into existing physical activity opportunities appears practically feasible, yet the process evaluation and effectiveness of this strategy needs to be further evaluated. There...

Background Functional exercise stress echocardiography (ESE) is used to quantify changes in cardiac reserve and can improve early cardiac dysfunction diagnosis and follow-up.[1.2] Current ESE protocols do not account for individual variations in fitness and heart rate response, leading to difficulties in defining normal reference values.[2,3] Physi...

Advances in development of cystic fibrosis transmembrane conductance regulator modulator (CFTRm) therapies mean that now people who are heterozygous (instead of having to be homozygous) for the common F508del variant can benefit from these therapies. Recent economic estimates suggest only approximately 15% of the global population have CFTRm access...

Background This review aims to identify which cardiopulmonary exercise test (CPET) derived variables can be used to personalise pulmonary rehabilitation for people with interstitial lung diseases. A ‘one size fits all’ approach does not benefit every patient due to a multitude of unique characteristics, subsets and phenotypes. No condition specific...

Background Peak oxygen consumption (peak V ̇ O 2 $$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ ) is routinely measured in people who have congenital heart disease and is reported as a percentage of predicted value, based upon age‐ and sex‐matched normative reference values (NRVs). This study aimed to identify which NRVs are being used, assess whether NRVs a...

Background: The literature is scarce about virtual reality (VR) use and its integration into clinical practice. Given the growing interest toward using VR in healthcare in the UK, the aims of this survey were to explore its current use by paediatric physiotherapists in clinical practice in the UK, identify the facilitators and barriers to VR imple...

Objectives This study aimed to assess and compare the effect of an 8-week high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT) programme on body composition and cardiovascular metabolic outcomes of sedentary adolescents in China. Methods Eighteen sedentary normal-weight adolescents (age: 18.5 ± 0.3 years, 11 fem...

Background Barth syndrome is a rare, life-threatening X-linked recessive mitochondrial disorder of lipid metabolism primarily affecting males. Previous research suggests that bezafibrate may ameliorate cellular lipid abnormalities and reduce cardiac dysfunction in an animal model. Objectives Estimate the effect of bezafibrate on clinical, biochemi...

Despite exercise intolerance being predictive of outcomes in pulmonary arterial hypertension (PAH), its underlying cardiac mechanisms are not well described. The aim of the study was to explore the biventricular response to exercise and its associations with cardiorespiratory fitness in children with PAH. Participants underwent incremental cardio-p...

Background Obesity in adolescence has increased in the last decades. Adolescents fail to meet the recommended guidelines for physical activity (PA) and healthy diet. Adolescents with a low socioeconomic status (SES) particularly seem to have fewer healthy lifestyle behaviours. The European Science Engagement to Empower aDolescentS (SEEDS) project u...

Introduction High-intensity interval training (HIIT) is an effective strategy for improving a variety of health and fitness outcomes within the school settings. Incorporating HIIT into existing physical activity opportunities appears practically feasible, yet the process evaluation and effectiveness of this strategy needs to be further evaluated. T...

Purpose : To examine the effect of normobaric hypoxia on pulmonary oxygen uptake ( ) and muscle oxygenation kinetics during incremental and moderate-intensity exercise in children. Methods : Eight prepubertal boys (9–11 y) performed incremental cycle tests to exhaustion in both normoxia and hypoxia (fraction of inspired O 2 of 15%) followed by repe...

Over the last five years, virtual reality (VR) has become more popular in pediatric physiotherapy. In this study, we assessed the feasibility and acceptability of measuring upper-limb movements in typically-developing children and adolescents using an immersive virtual reality (iVR) headset. Thirty-six typically-developing children (age: 12 ± 2.1 y...

Background: Routine physical activity (PA) and exercise form a cornerstone of the management of cystic fibrosis (CF), a genetically inherited pulmonary and digestive condition – whereby telehealth platforms have been proposed as a mechanism to engage remotely people with CF in PA and exercise. Methods: To test this, in early 2020, the ‘ActivOnline...

Aims The value of cardiopulmonary exercise testing (CPET) and exercise stress echocardiography (ESE) in managing cardiac disease is well known, but no standard CPET-ESE protocol is currently recommended. This pilot study aims to compare feasibility and cardiac function responses between a new high intensity single stage combined test (CPET-hiESE) a...

Background Several systematic reviews have been published to investigate the effectiveness of high-intensity interval training (HIIT) in schools. However, there has been limited attention given to understanding the functioning of the intervention processes, which is of paramount importance for interpreting and translating the intervention effective...

The study aims to examine the effect of the world’s largest school-feeding programme, the Mid-Day Meal (MDM) programme, on the changes in the underweight prevalence among school-children in India. Data from the Indian Human Development Survey (IHDS) Rounds 1 (2004–05) and 2 (2011–12) were utilized. The sample included individual-level information o...

Purpose : Rating of perceived exertion (RPE) is a convenient and cost-effective tool that can be used to monitor high-intensity interval exercise (HIIE). However, no methodological study has demonstrated the validity of RPE in this context. Therefore, the aim of this study was to validate and calibrate RPE for monitoring HIIE in adolescents. Method...

The interventions aimed at improving the levels of physical activity (PA) in children and adolescents diagnosed with heart disease did not produce the expected outcomes. Safe participation in sport activities proposed based on actual recommendations could be a solution to promote PA in this population. The aims of this study were to discover a caus...

Introduction Cardiopulmonary exercise testing (CPET) is a feasible, valid, repeatable, and prognostically important tool in the management of interstitial lung disease (ILD). However, due to the progressive nature of declining pulmonary function in ILD, it is unclear if clinical status has an underlying affect upon ventilatory dynamics during CPET....

https://youtu.be/EpABCWL0glE https://youtu.be/Cvh2GU2GxOY

INTRODUCTION: Patients with congenital heart disease (CHD) typically exhibit reduced exercise capacity and life quality, even after their structural heart defects have been clinically corrected. However, little is known about the interactions between physical activity (PA), sedentary time (ST), exercise capacity (peak VO2) and health-related qualit...

Rationale Cardiopulmonary exercise testing (CPET) provides prognostic information in cystic fibrosis (CF); however, its prognostic value for patients with advanced CF lung disease is unknown. Objectives To determine the prognostic value of CPET on the risk of death or lung transplant (LTX) within 2 years. Methods We retrospectively collected data...

Background Children and young people with CHD benefit from regular physical activity. Parents are reported as facilitators and barriers to their children’s physical activity. The aim of this study was to explore parental factors, child factors, and their clinical experience on physical activity participation in young people with CHD. Methods An on...

Background: Children and young people with CHD benefit from regular physical activity. Parents are reported as facilitators and barriers to their children's physical activity. The aim of this study was to explore parental factors, child factors, and their clinical experience on physical activity participation in young people with CHD. Methods: An o...

Introduction: The near-infrared spectroscopy (NIRS)-derived reperfusion rate of tissue oxygen saturation (slope 2 StO2) may provide a surrogate measure of vascular function, however, this has yet to be examined in a paediatric population. This study investigated in adolescents: 1) the between-day reliability of NIRS-derived measurements; 2) the rel...

INTRODUCTION: Young-people with congenital heart disease (ConHD) have reduced cardiorespiratory fitness (CRF), which has been associated with mortality and morbidity. Previous studies have explored the determinants of CRF using inappropriate ratio-scaling techniques and have not accounted for physical activity (PA). The aims of this study were to i...

High-intensity interval training (HIIT) has been for the last decade one of the most popular modes of training. While it has its origins in athletic training, it is also now appearing in public health and clinical exercise sciences for patients with chronic diseases. More recently, youth athlete studies have been conducted to evaluate the benefit f...

This book presents an integrated, research-driven, collection of 54 evidence-based chapters. Chapters are founded on the research and practical experience of 104 internationally renowned scientists and clinicians, from 25 countries. Each extensively referenced chapter concludes with a bulleted summary and where appropriate is cross-referenced to co...

Background Several systematic reviews have been published to investigate the effectiveness of high-intensity interval training (HIIT) in schools. However, there has been limited attention given to understanding the functioning of the intervention processes, which is of paramount importance for interpreting and translating the intervention effective...

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): UK Research and Innovation Medical Research Council Doctoral Training Programme Grant Work supported as part of a research partnership between the University of Bristol and Canon Medical Systems UK that determines the independence of th...

Objective To enable evidence-based public health policy and guidelines for 24-hour health behaviours in infants and toddlers, by demonstrating the feasibility and acceptability of using valid, objective, longitudinal measures of everyday health behaviour and physiology in infants and toddlers. Methods We are currently recruiting, through non-NHS c...

Background Increased maximal oxygen uptake (V̇O2max) is beneficial in children with cystic fibrosis (CF) but remains lower compared to healthy peers. Intrinsic metabolic deficiencies within skeletal muscle (muscle “quality”) and skeletal muscle size (muscle “quantity”) are both proposed as potential causes for the lower V̇O2max, although exact mech...

Background and Aim: Young people with congenital heart disease (CHD) are less active than their healthy peers negatively affecting quality of life and long-term outcomes. Despite no specific guidelines, a commonly used measure of physical activity (PA) is moderate- to-vigorous PA (MVPA), which has the disadvantage of neglecting light-intensity acti...

Social factors and psychological characteristics can influence participation and development in talent pathways. However, the interaction between these two factors is relatively unknown. The aim of this study was to investigate the implications of socioeconomic status and psychological characteristics in English academy soccer players (n=58; aged 1...

Introduction Improving healthy lifestyles of adolescents is challenging. Citizen Science is a way to engage them in the design and delivery of interventions, and may also increase their interest in science, technology, engineering and mathematics (STEM). The Science Engagement to Empower aDolescentS (SEEDS) project aims to use an equity-lens, and e...

Objectives Regular exercise testing is recommended for people with cystic fibrosis (pwCF), as is the provision and regular review of exercise training programmes. A previous survey on exercise testing and training for pwCF in the UK was conducted over a decade ago. With the landscape of CF changing considerably during this time, this survey aimed t...

Aims: Echocardiographic assessment of adolescent athletes for arrhythmogenic cardiomyopathy (ACM) can be challenging owing to right ventricular (RV) exercise-related remodelling, particularly RV outflow tract (RVOT) dilation. The aim of this study is to evaluate the role of RV 2-D speckle tracking echocardiography (STE) in comparing healthy adoles...

Research has shown that there is a lack of confidence and understanding in how to use exercise for managing cystic fibrosis. This editorial discusses the key points of a consensus statement that highlights what is and is not known about the relationship between cystic fibrosis and exercise.

The project is related to the use of exercise echo cardiography and young athletes, as part fo an on-going heart health of yougn athletes.

High‐intensity interval training (HIIT) represents an effective method to improve cardiometabolic health in adolescents. This study aimed to investigate the effect of 4 weeks of HIIT followed by 2 weeks of detraining on vascular function and traditional cardiovascular disease (CVD) risk factors in adolescent boys. Nineteen male adolescents (13.3 ±...

Background: Increasing evidence suggests that vitamin D is associated with pulmonary health, which may benefit children and young people diagnosed with Cystic Fibrosis (cypCF). Therefore, the aim of this systematic review was to evaluate primary research to establish associations between 25OHD and pulmonary health in cypCF. Methods: Electronic data...

Background Increased physical activity has been shown to result in improved physical fitness, quality of life, self-confidence, and reduced anxiety in adults with congenital heart disease (CHD). In comparison to adults there are relatively few data on the benefit of physical activity for children and adolescents with CHD. It is clear that increasin...

Individuals with Down syndrome (DS) present similar heart rate variability (HRV) parameters at rest but different responses to selected movement maneuvers in comparison to individuals without DS, which indicates reduced vagal regulation. The present study undertakes a scoping review of research on HRV in individuals with DS, with special attention...

Background Cardiopulmonary exercise testing (CPET), and its primary outcome of peak oxygen uptake (VO 2peak ), are acknowledged as biomarkers in the diagnostic and prognostic management of interstitial lung disease (ILD). However, the validity and repeatability of CPET in those with ILD has yet to be fully characterised, and this study fills this e...

BACKGROUND: Peak oxygen consumption (peak V̇ O2) is traditionally divided (“ratio-scaled”) by body mass (BM) for clinical interpretation. Yet, it is unknown whether ratio-scaling to BM can produce a valid size-independent expression of peak V̇O2 in people with a Fontan circulation. Furthermore, people with a Fontan circulation have deficits in lean...

Objective The importance of aerobic fitness (VO 2peak ) in cystic fibrosis (CF) is well established, and regular exercise testing is recommended. To standardise VO 2peak , a ‘percentage of predicted’ (% pred ) derived from normative reference values (NRV), as promoted by the 2015 European Cystic Fibrosis Society Exercise Working Group (ECFS EWG), c...

Repeated maximal breath‐holds have been demonstrated to induce bradycardia, increase haematocrit and haemoglobin and prolong subsequent breath‐hold duration by 20%. Freedivers use non‐maximal breath‐hold techniques (BHTs) to improve breath‐hold duration. The aim of this study was to investigate the cardiorespiratory and haematological responses to...