The relationship between stress and disease, in particular cardiovascular disease, has long been recognized, whereas the study of the physiological mechanisms that explain this link has only more recently received attention. The acute response to stress is generally thought to be a critically important adaptation designed to activate the system in preparation to cope with the stressor. However, prolonged stimulation of the system (acute and chronic) can lead to deleterious adaptations including the release of inflammatory cytokines (small proteins important in cell signaling) that play a critical role in the development of atherosclerosis. Scientists have therefore used a breadth of protocols and methods to identify the complexity of our fight-or-flight response and demonstrate the synergy between perception, the stress response, physical activity, and health. In addition, the critical assessment of cellular health, the gut microbiome, and genetic polymorphisms have further advanced our understanding of additional therapeutic targets against CVD.
Edmund O. Acevedo and Aaron L. Slusher
Douglas J. Casa, Yuri Hosokawa, Luke N. Belval, William M. Adams, and Rebecca L. Stearns
Exertional heat stroke (EHS) is among the leading causes of sudden death during sport and physical activity. However, previous research has shown that EHS is 100% survivable when rapidly recognized and appropriate treatment is provided. Establishing policies to address issues related to the prevention and treatment of EHS, including heat acclimatization, environment-based activity modification, body temperature assessment using rectal thermometry, and immediate, onsite treatment using cold-water immersion attenuates the risk of EHS mortality and morbidity. This article provides an overview of the current evidence regarding EHS prevention and management. The transfer of scientific knowledge to clinical practice has shown great success for saving EHS patients. Further efforts are needed to implement evidence-based policies to not only mitigate EHS fatality but also to reduce the overall incidence of EHS.
Daniel P. Ferris and Bryan R. Schlink
Robotic exoskeletons and bionic prostheses have moved from science fiction to science reality in the last decade. These robotic devices for assisting human movement are now technically feasible given recent advancements in robotic actuators, sensors, and computer processors. However, despite the ability to build robotic hardware that is wearable by humans, we still do not have optimal controllers to allow humans to move with coordination and grace in synergy with the robotic devices. We consider the history of robotic exoskeletons and bionic limb prostheses to provide a better assessment of the roadblocks that have been overcome and to gauge the roadblocks that still remain. There is a strong need for kinesiologists to work with engineers to better assess the performance of robotic movement assistance devices. In addition, the identification of new performance metrics that can objectively assess multiple dimensions of human performance with robotic exoskeletons and bionic prostheses would aid in moving the field forward. We discuss potential control approaches for these robotic devices, with a preference for incorporating feedforward neural signals from human users to provide a wider repertoire of discrete and adaptive rhythmic movements.
Charles H. Hillman, Kirk I. Erickson, and Bradley D. Hatfield
The past two decades have uncovered the beneficial relation of physical activity and other health behaviors on brain and cognition, with the majority of data emerging from older adult populations. More recently, a similar research thread has emerged in school-aged children, which offers insight into the relation of physical activity to scholastic performance, providing a real-world application of the benefits observed in the laboratory. Technological advances have similarly furthered our understanding of physical activity effects on cognitive and brain health. Given this emerging body of work, this manuscript reviews the basic findings within the field, but more importantly suggests triggers or signals from the emerging literature that will shape the field in the near future. The overall goal of this body of research is to increase cognitive and brain health to promote effective functioning of individuals across the lifespan.
Monica A.F. Lounsbery
For children, schools play an important role in providing and promoting physical activity, yet growing school pressure to produce academic achievement gains have limited the priority of physical activity producing programs. The Institute of Medicine, the Centers for Disease Control and Prevention, the American Heart Association, and others have developed recommendations for school physical activity policy and there is growing interest in examining the relationship between existing school physical activity policies, school practices, and physical activity. Given that research on school physical activity policy is in its infancy, my goal in writing this paper is to introduce readers to key aspects of school physical activity policy while simultaneously outlining existing research efforts and highlighting the many critical research gaps that still exist. I conclude the paper by linking policy to advocacy and outlining considerations for formulating effective advocacy efforts while emphasizing the need for advocacy research.
Nancy I. Williams, Clara V. Etter, and Jay L. Lieberman
An understanding of the health consequences of abnormal menstrual function is an important consideration for all exercising women. Menstrual disturbances in exercising women are quite common and range in severity from mild to severe and are often associated with bone loss, low energy availability, stress fractures, eating disorders, and poor performance. The key factor that causes menstrual disturbances is low energy availability created by an imbalance of energy intake and energy expenditure that leads to an energy deficit and compensatory metabolic adaptations to maintain energy balance. Practical guidelines for preventing and treating amenorrhea in exercising women include evidence-based dietary practices designed to achieve optimal energy availability. Other factors such as gynecological age, genetics, and one’s susceptibility to psychological stress can modify an individual’s susceptibility to menstrual disturbances caused by low energy availability. Future research should explore the magnitude of these effects in an effort to move toward more individualized prevention and treatment approaches.