Maturity, athletic growth and anterior cruciate ligament injury
Anterior cruciate ligament (ACL) injuries typically occur during non-contact landing and change of direction manoeuvres commonly performed in netball. These injuries are devastating events, which are generally season-ending and in some cases career-ending. Epidemiological data indicate that females participating in team sports are around 4 times more likely to suffer an ACL injury than their male counterparts. Injury rates are similar amongst pre-pubescent girls and boys; however, these diverge considerably from the onset of puberty, with the peak rates occurring around the ages of 15 to 16 years in females. Sex-specific, maturation-related changes (such as anatomical, biomechanical, neuromuscular and hormonal) could conceivably contribute to the increased risk of ACL injury in post-pubescent females. For example, across adolescence, hip width, joint laxity and body fat are known to increase in post-pubescent females, who also exhibit increases in mass in the absence of the ‘neuromuscular spurt’ that males experience.
This PhD will explore the changes in physical capacity, anatomy and movement patterns experienced by adolescent female netball players and relate this to ACL injury risk. The broad aim of the project is to develop a multi-factorial approach to ACL injury risk screening that can help protect knee health in maturing netball players and inform training interventions.
Dr Steffi Colyer, Lecturer
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Effects of body size and morphology on nutritional interventions
A fundamental yet remarkably outstanding question in the field of nutrition and metabolism is whether the sheer size and proportions of the human body and its various organ systems are related to our dietary requirements and how we respond to specific foods. Advancing understanding in this area will be useful for wider society in order to better individualise nutritional recommendations but will be particularly important for many individuals for whom current recommendations based on an average person are inappropriate.
This project idea will provide this novel insight via targeted recruitment of populations who represent the extremes of the physiological range (for example, extremely small/large athletes and clinical populations with genetic, endocrine/pituitary conditions that result in extreme short/tall stature and bodily proportions). The proposed approach will be interdisciplinary, integrating whole body physiology (anthropometry, metabolic rate), behavioural outcomes (dietary analysis, physical activity and sleep monitoring), and the biochemical analysis of human tissue samples (skeletal muscle, adipose and blood metabolites, hormones and gene/protein expression). There are therefore many definite pre-stated research questions to address in this area, both from a basic science perspective and in terms of direct clinical application, but also with the flexibility for a doctoral student to shape the research programme according to their personal interests.
Conducting doctoral research on this topic within the Centre of Nutrition, Exercise and Metabolism at Bath will provide a unique and varied training opportunity that generates both world-class research outputs and a highly-qualified post-doctoral research scientist.
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How occupational stress impacts performance, health and wellbeing
Occupational stress is associated with 7 out of the 10 leading causes of death, and has been identified by the World Health Organisation as a 21st century global health epidemic. Furthermore, according to the Health and Safety Executive report (2016), occupational stress accounts for 37% of work-related ill health and 45% of lost working days. While stress is traditionally seen in a negative light due to such statistics, it is noticeable that not all individuals succumb to the high demands they encounter. Indeed, some individuals demonstrate grit, resilience, and even thrive in the face of stress.
This PhD aims to better understand such variability in response to occupational stress, and how stress influences the performance, well-being, and physical/mental health of individuals operating in a range of high-pressure contexts (such as medicine, education, and sport). To this end, this interdisciplinary PhD will use experimental methods and longitudinal designs to monitor underlying psychophysiological responses to stress, with the view of developing interventions that help individuals cope better during stressful encounters.
Dr Lee Moore, Lecturer
Dr Rachel Arnold, Senior Lecturer
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Personalisation of prosthetic care for lower limb amputees
Lower-limb amputation rates are rising each year and are associated with the global spread of perivascular diseases including type-2 diabetes mellitus.
In all lower limb amputees, the postoperative phase after amputation is characterised by big changes in the shape and size of the residual limb, causing many challenges for the amputees and the professional cares: several prosthesis replacements, secondary diseases (such as osteoporosis, osteoarthritis, back pain, risk of falling and fracture), increased wheelchair use and low quality of life.
Each patient has different requirements for a prosthesis and there is a strong need to move towards a personalised rehabilitation after the amputation.
The aim of this research is to provide new insights on the post-surgery amputees’ residuum and gait changes to optimise the early rehabilitation process of the lower limb amputees and to inform the design personalised prosthetic care solutions.
You will be able to use cutting-edge technological tools in the field of computer aided design (3D scanners), imaging (MRI and fluoroscopy), and modelling, to create personalised healthcare solutions and monitor the residuum changes. These tools, together with established technologies in the field of biomechanics and human physiology will allow to characterise the biomechanical and physiological changes in the residual limb of lower limb amputees, to inform prosthetic fitting and design and rehabilitation.
The ultimate beneficiaries of this project will be the amputee population which could benefit on new rehabilitation programs and prosthetic solutions. To reach this goal, the project is designed to yield important multidisciplinary outcomes, allowing the collaboration between different research groups and rehabilitations centres. Also, an NHS partner will be involved for the patients recruitments.
Dr Elena Seminati, Lecturer
Dr Abby Tabor, Lecturer
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New biomarkers of insulin resistance and type 2 diabetes
Diabetes represents a global health, social and economic burden. Approximately 425 million people in the world suffer from diabetes and this will rise to 642 million by 2040. Of these, 90% have type 2 diabetes (T2D). The primary risk factor for developing T2D is the inability of tissues to respond appropriately to insulin; known as insulin resistance. This condition can remain undetected for a long time and ultimately will lead to T2D. In the UK it is estimated that 1 million people might have the condition and not know it.
We have discovered that a group of small GTPases in muscle and fat (Rab3 pathway) influence how glucose enter cells and could be a key factor in the development of T2D.
The aim of this PhD is to understand how the Rab3 pathway is regulated, and whether it can be used as an early diagnostic marker of insulin resistance and T2D. If successful, you will adopt a multidisciplinary approach:
- characterise the Rab3 pathway in skeletal muscle to provide solid basis for understanding its role in the development of T2D
- perform an intervention in pre-diabetic humans combining physical activity and diet to investigate how this pathway can be controlled
We welcome expression of interests if you're keen to develop a wide range of cross-disciplinary skills (biochemistry, cell biology, human physiology).
Dr Francoise Koumanov, Lecturer
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Public understanding of obesity: news and social media influences
Almost two thirds (63%) of adults and a third (34%) of children in England are overweight or living with obesity. Obesity-related illnesses cost the NHS £6 billion a year. Obesity is a complex, multifactorial disease, with genetic, behavioural, socioeconomic, and environmental determinants. However, a large proportion of the population still view obesity as an individual problem, related to overeating and laziness. This may, in part, be due to how the media portray, over-simplify, and/or misinterpret obesity-related research. News outlets use social media to share articles on obesity policies and research to the public. Yet, the rise of social media has meant that many adults use social media as their primary platform for learning about news and current affairs. Such exposure to news articles, and their associated content/comments, on social media may contribute to shaping an individual’s perspective on obesity.
This PhD project consists of a series of observational and experimental studies to systematically investigate how being exposed to social media news articles and their respective comments are associated with differing viewpoints on obesity. The PhD will incorporate mixed-methods (surveys, interviews, eye-tracking) to understand how different groups engage with news on social media and why this is associated with differing knowledge, attitudes, and views on obesity.
This innovative programme of work builds on research conducted in the Department for Health. The work offers important implications for how health topics are communicated online via social media, and the role that public comment forums play in shaping obesity-related perspectives.
Dr Emma Solomon-Moore, Lecturer
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Integrated Movement Behaviours for those with Multimorbidity
Multimorbidity (MM) is the co-existence of two or more mental and/or physical chronic conditions. MM places immense pressure on the NHS and represents a complex challenge for healthcare professionals, patients, and their families. Individuals classed as being ‘physically inactive’ are twice as likely to develop MM.
Extending beyond a sole focus on physical activity, the simultaneous consideration of multiple movement behaviours is required to better understand health and wellbeing (light-activity, MVPA, sedentary-time, and sleep). For many, an integrated approach that simultaneously considers daily movement may be more acceptable and useable than a sole focus on physical activity (attempting to initiate behaviours for which little, if any, motivation exists).
With the number of people diagnosed with MM set to double by 2035, interventions are required to decrease the progression of disease states as well as to improve the mental, social, physical and functional health of people living with MM. This mixed-methods programme of doctoral work will analyse existing data from over 100,000 participants who adhered to a 24-hour accelerometer protocol to gain robust and reliable insights into how the reallocation of different movement behaviours corresponds with various markers of health and wellbeing. Engagement with people living with MM, healthcare professionals, and stakeholders will provide rich insight into how best to present and frame lifestyle ‘time-use’ interventions. Having gained novel and rich insight into how best to present health messaging across full 24-hour cycles, intervention approaches based on motivation theory, personalised data, and informational feedback will be developed and tested.
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Reducing fear of movement in people with ankylosing spondylitis
People with ankylosing spondylitis (AS) often avoid physical activity out of fear of pain and disease aggravation. Combined with the physical dysfunction caused by AS, this fear and avoidance of activity can lead to reduction in perceived and actual motor competence and subsequently decrease physical activity behaviour. Yet, physical activity is a core treatment strategy for AS with improvements evidenced in mobility, pain, physical function, psychological health and disease activity. The purpose of this project is to reduce this fear by enhancing self-perceptions of competence via the provision of personal biomechanical feedback.
Wearable sensors will be used to measure spinal movement and spinal muscle activations and biomechanical models to provide informational feedback to enhance patient autonomy, perceived competence, fear of pain, and actual motor competence. In this way it is possible, for the first time in a clinical setting, to clearly identify what phases of rehabilitation exercises are not performed correctly or which are the movements characterised by less motor competence for a specific individual. Demonstrating efficacy of this biomechanical protocol would represent a key step change, not just in AS care, but one that can be extrapolated to other clinical populations who avoid movement due to fear of pain or disease aggravation.
Dr Dario Cazzola, Senior Lecturer
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Injury surveillance and prevention in CrossFit
The importance of physical activity and exercise in the context of public health has been clearly outlined and is universally accepted. However, if physical activity and exercise are truly to be promoted as a 'medicine' for the treatment and prevention of lifestyle-related diseases, adverse effects and the need to mitigate them must also be considered. Injuries are of one of the unwelcome consequences of undertaking exercise, and have important health, performance, financial and legal consequences for all stakeholders.
CrossFit is a strength and conditioning programme that has gained widespread popularity since the launch of CrossFit.com in 2001, and is now practised by participants at over 12,000 affiliate gyms worldwide. However, at present little is known about the level of injury risk associated with this form of training. High quality injury data are the foundation of all injury prevention efforts. Accordingly, the overall aim of the proposed project is to improve our understanding of the injury risk associated with CrossFit training, to help inform injury prevention efforts.
To address the project aim, five main studies are proposed:
- A systematic review of injury risk in high-intensity training programmes.
- A pilot study to test and refine the methods used to collect injury surveillance data in this setting, and in particular to develop an understanding of how to maximise adherence to data input.
- A progressive roll-out of injury surveillance in a sample of CrossFit locations, in accordance with the knowledge gained from study two.
- Injury surveillance conducted at competitive CrossFit events.
- An exploration of training loads as an injury risk factor in competitive CrossFit athletes.
Dr Sean Williams, Lecturer
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A ‘coordinated’ response to concussion
The recognition and subsequent management of mild traumatic brain injuries (concussion) is challenging and the return to play process typically used in sport is based on athletes’ signs and symptoms. Currently, a wide variety of approaches to the recognition of concussion and management of recovery are being studied, including neuropsychological, oculomotor and biomarker tests. In addition, disturbances in motor control occur in response to concussion and these disturbances have been shown to persist beyond the typical time taken for an athlete to return to sport. Impaired motor control has even been implicated in an increased risk of injury for periods as long as two years subsequent to recovery from concussion.
This PhD will explore motor control in athletes in relation to concussion, with opportunities to focus on different phases of recovery in a range of different athletes. The ultimate goal will be to identify whether measures of motor control can aid in the recognition of concussion and the management of athletes during recovery. There may be opportunities to spend extended periods of time at the Rugby Football Union (RFU) and at international partner Institutions (such as Stellenbosch University or the University of Calgary) as part of this PhD.
Dr Cassie Wilson, Lecturer
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The role of the built environment in non-communicable diseases
The built environment shapes the way we live, from the homes we inhabit to the social interactions we engage in. Principally for protection, our cities are designed for safety and efficiency. Yet, with the dual trends of urbanisation (68% of the world’s population will live in cities by 2050) and increasing prevalence of non-communicable diseases (1 in 3 adults live with more than one chronic health condition), the role of the built environment as an intervention for health is coming under scrutiny.
This project will draw together information about the built environment (such as access to green space, exposure to pollutants and stressors), human activity (GPS tracking) and symptom reporting (fatigue, pain and breathlessness), to better understand the relationship between human health and the cities in which we exist. Through an improved understanding of the interplay between the external world and the symptoms we experience, it is proposed that we can use the design of our cities as a means for preventative health strategies. This project seeks to build this health agenda.
Dr Abby Tabor, Lecturer
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Overfeeding, inactivity and exercise impact on metabolic health
The proposed project will investigate how overeating combined with physical inactivity impairs human health, whilst elucidating the protective effects of vigorous exercise.
Few studies have investigated the effects of sedentary behaviours and energy surplus upon health. Our previous research demonstrated that one week of overfeeding (50%) combined with reduced step count (less than 4,000 steps/day) impaired insulin sensitivity and altered the expression of key molecules within adipose tissue. Exercise counteracted these effects, even in the face of a standardised energy surplus.
This thesis will firstly include two randomised controlled trials using the same protocol to impair insulin sensitivity in order to examine whether vigorous exercise can counteract the effects of either a high-carbohydrate diet (Study 1) or a high-fat diet (Study 2) combined with physical inactivity. Critically, all groups will experience the same degree of overfeeding, enabling isolation of the benefits of exercise independent of its impact on energy balance.
Primary outcomes will include glucose control and insulin sensitivity, as well as mRNA and protein expression of key molecules in fat and muscle. Incorporation of dual tracers into glucose tolerance tests will allow inference about the site of impaired glucose control (muscle or liver). Secondary outcomes will include changes in biomarkers of metabolic syndrome (plasma lipids and inflammatory markers), visceral adiposity and endothelial function.
Study 3 will be designed following completion of these two studies, where results will inform a diet/exercise intervention in a prediabetic population, aiming to improve their glucose control and insulin sensitivity, ultimately reversing their condition.
Dr Jean-Philippe Walhin, Lecturer
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Promotion of positive parental responses to their child's weight
Childhood obesity rates are continuing to rise. Working with whole families to try and prevent and reverse the development of excess weight in children while maintaining their wellbeing is considered an important part of any public health response. However, the first step in this process – providing feedback to parents when a child is overweight – is challenging to do in a way that leads to effective action rather than distress.
Uptake of weight management services for families and children are rare, and uptake low, in part due to the stigma associated with obesity. Parents can be reluctant to talk to children about their weight for fear of harming their wellbeing. This project takes as a starting point the need to help parents to feel confident that they can safely have conversations with their children about weight, and to be open to support that may better enable them to take the small steps that could lead to big changes for their child.
Bringing together the disciplines of health communication theory and behavioural science, this project will involve a series of studies including the design and pilot evaluation of an intervention to promote positive action from parents in response to feedback that their child is overweight. It will be embedded in existing childhood obesity policy, primarily by aligning with the delivery and timing of the National Child Measurement Programme. It will draw on existing materials and evidence developed within the research group at Bath, and in partnership with Public Health England.
Dr Fiona Gillison, Senior Lecturer
Dr Tania Griffin, Lecturer
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Promoting activity for people with depression and low back pain
Depression is three to four times more common in people with chronic low back pain (LBP) than in the general population. People with both depression and LBP experience higher levels of pain, lower health-related quality of life than people with LBP alone. Furthermore, people with both depression and LBP more frequently access healthcare providers and have higher rates of absenteeism and presenteeism, costing the UK economy around £12.3 billion per year. Effectively treating depression in people with LBP, has the potential to reduce the overall burden on health care services, improve people’s overall quality of life and benefit the economy.
Physical activity has shown to be effective in both reducing symptoms of depression and LBP. However, low mood, pain, fear, self-efficacy and motivation are significant obstacles to engagement in physical activity for people with depression and LBP. Such barriers to physical activity may be overcome with adequate behavioural and psychological support. Web-based behavioural interventions represent an accessible, flexible and scalable approach to support people with depression and LBP in the community. The importance of web-based approaches has been further recognised as a result of Covid-19.
This PhD aims to develop and evaluate a novel web-based intervention that supports both the physical and mental health needs of people with depression and LBP. If shown to be effective, this PhD will provide a cost-effective way of supporting and improving the quality of life for many people with LBP and depression leading to patient, social and economic benefits.
Dr Jeff Lambert, Lecturer
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