Craig Anthony Williams

University of Exeter | UoE · Children's Health and Exercise Research Centre, Sport and Health Sciences

Aims The role of cardiopulmonary exercise testing (CPET) in predicting major adverse cardiovascular events (MACE) in people with congenital heart disease (ConHD) is unknown. A systematic review with meta-analysis was conducted to report the associations between CPET parameters and MACE in people with ConHD. Methods and results Electronic databases...

This study aimed to examine the reliability and validity of Global School-based Student Health Survey(GSHS) to measure 24-hour movement behaviours (moderate-to-vigorous physical activity - MVPA;sedentary behaviour in the form of recreational screen time - ST; and sleep) in Saudi Arabian youths. Atotal of 120 (50% female) participants aged 12–15 yea...

The aim of this study was to compare the use of generic and cystic fibrosis (CF)-specific cut-points to assess movement behaviours in children and adolescents with CF. Physical activity (PA) was assessed for seven consecutive days using a non-dominant wrist-worn ActiGraph GT9X in 71 children and adolescents (36 girls; 13.5 ± 2.9 years) with mild CF...

ABSTRACT Purpose: Cerebral palsy (CP) is the commonest motor disability affecting children. This study reviewed the evidence for virtual reality (VR) intervention compared with conventional physiotherapy in upper limb function of children with CP. Methods: Searches were undertaken in MEDLINE, EMBASE, PEDro, CENTRAL, Web of Science, CINAHL, ERIC, I...

Magnetic Resonance Imaging (MRI) is well‐suited for imaging peripheral blood flow due to its non‐invasive nature and excellent spatial resolution. Although MRI is routinely used in adults to assess physiological changes in chronic diseases, there are currently no MRI‐based data quantifying arterial flow in pediatric or adolescent populations during...

This study sought to investigate the association of light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), sedentary time (SED), and sleep with lung function in children and adults with CF. In total, 86 children (41 females; 13.6 ± 2.8 years; FEV1%predicted: 86 ± 1%) and 43 adults (21 females; 24.6 ± 4.7 years; FEV1%predicted...

Cross-sectional studies have reported lower pulmonary and aerobic function during exercise in people with cystic fibrosis-related diabetes (CFRD) compared to non-CFRD counterparts. However, this association has yet to be longitudinally investigated. Therefore, this study examines these differences over time between people with cystic fibrosis (CF)...

Objectives: The COVID-19 pandemic has resulted in unprecedent changes to clinical practice, and as the impact upon delivery of exercise services for people with cystic fibrosis (CF) in the United Kingdom was unknown, this was characterised via a national survey. Methods: An electronic survey was distributed to healthcare professionals involved i...

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): UK Research and Innovation - Medical Research Council GW4 Studentship Background Right ventricle inflow (RV) dilation is a common adaptation to training in professional athletes, but how this impacts myocardial mechanics is yet unclear. Previous studie...

Athlete preparticipation screening focuses on preventing sudden cardiac death (SCD) by detecting diseases such as arrhythmogenic ventricular cardiomyopathy (AVC), which affects primarily the right ventricular myocardium. Diagnosis may be obscured by physiological remodeling of the athlete heart. Healthy athletes may meet the 2010 Task Force Criteri...

Exercise intolerance is common in people with CF (pwCF), but not universal among all individuals. While associated with disease prognosis, exercise intolerance is not simply a reflection of the degree of lung disease. In people with severe CF, respiratory limitations may contribute more significantly to impaired exercise capacity than in those with...

Physical activity (PA), sedentary behaviour (SB) in the form of recreational screen time, and sleep time (ST), are associated with cardiometabolic disease risk in adolescents. The Canadian 24-Hour Movement Guidelines for children and youth has emphasised the integration of these three movement behaviours rather than in isolation (PA ≥60 min/day, SB...

Background Distance running is one of the most popular sports among children and adolescents around the world. Previous adult- and adolescent-based research indicates that injury is prevalent when participating in distance running. While knowledge related to the extent of the injury problem is important, an understanding of athletes’ psychosocial r...

Background Little is known about the overall health of adolescent distance runners. Objective To describe all health problems (injuries and illnesses) in relation to type, location, incidence, prevalence, time loss, severity, and burden, in competitive adolescent distance runners in England. Design Prospective observational study monitoring all h...

Exercise and physical activity (PA) have been shown to be effective, safe and feasible in both healthy children and children with congenital heart disease (CHD). However, implementing exercise training as an intervention is still not routine in children with CHD despite considerable evidence of health benefits and well-being. Understanding how chil...

Introduction: Countermovement jump (CMJ) and perceived wellness measures are useful for monitoring fatigue. Fatigue indicators should simultaneously show sensitivity to previous load and demonstrate influence on subsequent physical output; however, this has not been examined. This study examined the efficacy of CMJ and wellness measures to both de...

The 12-lead electrocardiogram is a key component of cardiac screening in elite adolescent footballers. Current technology hampers mobile electrocardiogram monitoring that could reduce the time-to-diagnosis in symptomatic athletes. Recently, a 22-lead mobile electrocardiogram monitor, CardioSecur (Personal MedSystems GmbH), has been approved for use...

Purpose: In a sample of healthy adolescents, the authors aimed to investigate the effects of high-intensity interval exercise (HIIE) training and detraining on baroreflex sensitivity (BRS) and it's vascular and autonomic components at rest. Methods: Nineteen volunteers were randomly allocated to (1) 4 weeks HIIE training performed 3 times per we...

EXERCISE TESTING USING SUPRAMAXIMAL VERIFICATION IN CYSTIC FIBROSIS Craig Anthony Williams1,2, Owen William Tomlinson1,2 1. Children’s Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, United Kingdom 2. Royal Devon and Exeter NHS Foundation Trust Hospital, Exeter, United Kingdom Objectives Annual exerc...

Objectives Aerobic fitness (represented by peak oxygen uptake,VO2peak) is a clinically important parameter in cystic fibrosis (CF), predicting mortality and hospitalisation risk. People with CF-related diabetes (CFRD) have reduced VO2peak relative to those with normal glucose tolerance (NGT). It is unclear how VO2peak changes over time in relation...

Background: Distance running is one of the most popular sports around the world. The epidemiology of running-related injury (RRI) has been investigated in adults, but few studies have focused on adolescent distance runners. Objectives: (1) To provide descriptive epidemiology of RRI (risks, rates, body regions/areas, and severity) and examine the tr...

The COVID-19 pandemic has resulted in unprecedent change to clinical practice. As the impact upon delivery of exercise services for people with cystic fibrosis (CF) in the UK was unknown, this was characterised via a national survey. In total, 31 CF centres participated. Principal findings included a significant reduction in exercise testing, and w...

Speckle tracking echocardiography (STE) has gained importance in the evaluation of adult inherited cardiomyopathies, but its utility in children is not well characterized. We conducted a systematic review to evaluate the role of STE in pediatric inherited cardiomyopathies. PubMed, EMBASE, Web of Science, Scopus, CENTRAL and CINAHL databases were se...

Introduction Cardiopulmonary exercise testing (CPET) provides a series of biomarkers, such as peak oxygen uptake, which could assess the development of disease status in interstitial lung disease (ILD). However, despite use in research and clinical settings, the feasibility of CPET in this patient group has yet to be established. Methods Twenty-si...

Background Cystic fibrosis (CF) is a genetically inherited, life-limiting condition, affecting ~90,000 people globally. Physical activity (PA) and exercise form an integral component of CF management, and have been highlighted by the CF community as an area of interest for future research. Previous reviews have solely focused on PA or structured ex...

Funding Acknowledgements Type of funding sources: Other. Main funding source(s): The study was support by a contractual research partnership between the University of Bristol and Canon Medical Systems UK. Background Arrhytmogenic cardiomyopathy (ACM) is a major cause of sudden cardiac death among young athletes. Screening these individuals can be...

Funding Acknowledgements Type of funding sources: Other. Main funding source(s): The study was support by a contractual research partnership between the University of Bristol and Canon Medical Systems UK Background Left ventricular non-compaction (LVNC) is a rare cardiomyopathy, with hypertrabeculation often observed in athletes. In confirmed LVNC...

Introduction Previous cross-sectional studies have reported lower ventilatory and aerobic function (peak oxygen uptake, VO2peak) during exercise in people with cystic fibrosis related diabetes (CFRD), compared to non-CFRD counterparts. Given that VO2peak is highly predictive of mortality, and the pancreas is one of the earliest affected organs in C...

Introduction Aerobic fitness (represented by VO2peak), derived from cardiopulmonary exercise testing (CPET), is a biomarker predictive of mortality in interstitial lung disease (ILD). However, CPET requires elicitation of maximal responses, which may not be feasible for some patients due to clinical contraindications. Therefore, suitable submaximal...

To describe all health problems (injuries and illnesses) in relation to type, location, incidence, prevalence, time loss, severity, and burden, in competitive adolescent distance runners in England. Prospective observational study. 136 competitive adolescent distance runners (73 female athletes) self-reported all health problems for 24-weeks betwee...

Purpose Few data exist on the descriptions of LV myocardial mechanics and reserve during dynamic exercise of adolescent athletes. The aim of this study was to describe the LV myocardial and cardiopulmonary changes during exercise using 2-D strain deformation imaging. Methods Elite adolescent male football players (n = 42) completed simultaneous ca...

New findings: What is the central question of this study? What is the effect of high-intensity and moderate-intensity interval running on macro- and microvascular function in a fasted state and following a glucose challenge in adolescents? What is the main finding and its importance? Both macro- and microvascular function were improved after inter...

In an attempt to facilitate more appropriate levels of challenge, a common practice in academy football is to play-up talented youth players with chronologically older peers. However, the context of playing-up in academy football is yet to be empirically explored. Thus, the purpose of this study was to examine the multidimensional factors that diff...

Technical ability is recognised as a fundamental prerequisite to achieve senior professional status in football. However, research is yet to investigate what technical attributes contribute to greater coach perceived potential within an academy environment. Therefore, the aim of this study was to examine technical ability and skill behaviour as con...

The reliability of handgrip strength (HGS) measurement has been confirmed in adults but has been sparsely addressed in pediatric populations. The aims of this study are twofold: to determine whether sex, age and/or hand-dominance influence the test-retest differences and to establish the reliability level of the HGS measurement in typical developin...

Background Congenital heart disease (ConHD) affects approximately 1% of all live births. People with ConHD are living longer due to improved medical intervention and are at risk of developing non‐communicable diseases. Cardiorespiratory fitness (CRF) is reduced in people with ConHD, who deteriorate faster compared to healthy people. CRF is known to...

The world’s greatest professional football players are able to execute effective tactical decisions as well as fulfil various physical demands. However, the degree to which both are associated with greater potential in a football academy is unknown. Therefore, the aim of this study was to investigate decision-making skill and physical performance a...

Background: The benefits of physical activity (PA) for people with cystic fibrosis (pwCF) are widely accepted, yet how PA is promoted and utilised by pwCF is unclear. Method: An online questionnaire to explore attitudes, practices and promotion of PA in cystic fibrosis was completed by healthcare providers (HCP), pwCF and parents/caregivers. Re...

Background Numerous studies have measured the prognostic associations between cardiorespiratory fitness and patient outcomes in congenital heart disease, but no systematic review has assessed these associations for all types of congenital heart disease. It is therefore a timely opportunity to syntheses all available data using a systematic review m...

Background: Distance running is one of the most popular sports around the world. The epidemiology of running-related injuries (RRI) has been examined in adults, but only a few studies have focused on adolescent distance runners. Therefore, the purpose of this study was 1) to examine the training practices (frequency, volume, and intensity) and desc...

To establish the test–retest reliability of pulmonary oxygen uptake (V̇O2), muscle deoxygenation (deoxy[haem]) and tissue oxygen saturation (StO2) kinetics in youth elite-cyclists. From baseline pedalling, 15 youth cyclists completed 6-min step transitions to a moderate- and heavy-intensity work rate separated by 8 min of baseline cycling. The prot...

Talent identification and development in male youth soccer are complex and multidimensional processes. The English Football Association “4 Corner Model” is often adopted by academies to support coaches and practitioners to implement a multidisciplinary approach to their talent identification and development framework. This holistic approach is char...

Regular physical activity is associated with physiological and psychosocial benefits in both healthy and clinical populations. However, little is known about tailoring the analysis of physical activity using accelerometers to the specific characteristics of chronic conditions. Whilst accelerometry is broadly used to assess physical activity, recomm...

Cardiac autonomic dysfunction has been reported in patients with cerebral palsy (CP). The aim of this study was to assess the existing literature on heart rate variability (HRV) in pediatric patients with CP and a special attention was paid to the compliance of the studies with the current HRV assessment and interpretation guidelines. A systematic...

Background: Distance running is one of the most popular sports around the world. The epidemiology of running-related injuries (RRI) has been examined in adults, but only a few studies have focused on adolescent distance runners. Objectives: To examine the training practices (frequency, volume, and intensity) and epidemiology of RRI (rates, sites, s...

Background: Bone Marrow Oedema (BMO), seen on magnetic resonance imaging (MRI), can be associated with various injuries to the knee but may also occur in asymptomatic athletes. The prevalence and causal factors for these observations are not well understood. The aim of this study was to determine the prevalence of BMO in asymptomatic knees of athle...

Background: The Cystic Fibrosis Trust recently published a standards of care document which stated that patients should be given a physical activity (PA) programme based on their motivations, fitness, and willingness to be active. However, there remains much debate regarding the roles and responsibilities for PA promotion, as well as “optimal” reco...

Cardiopulmonary exercise testing (CPET) is viewed by many as the gold standard for assessing exercise capacity in CF, being recommended on an annual basis. However, not all patients undergo CPET for varying reasons. This service evaluation retrospectively reviewed data from 179 (92 male) patients in a single CF centre in the UK to identify such rea...

Objectives Physical activity is widely recommended in the treatment and management of cystic fibrosis (CF). Despite the numerous physical and psychological benefits, many young people with CF are not achieving the recommended levels of physical activity. The aim of this systematic review was to identify and synthesise available qualitative investig...

Inter-individual cognitive factors have been shown to be related to the changes in affect evaluations during continuous high-intensity exercise in adolescents, but the role of cognitive factors on affect during high-intensity interval exercise (HIIE) is currently unknown. This study evaluated the influence of personality traits (behavioural activat...