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  • Staying Ready: A Real-World AED Response

    by Caitlin Kinser | Jan 03, 2023
    Staying Ready: A Real-World AED Response, Headshot of Tony Maloney

    You never know when you’ll need to use your emergency training. That’s what ACSM member and Noblesville, Indiana, Orangetheory Fitness Head Coach Tony Maloney was reminded of in late October when a patron visiting from out of state collapsed suddenly in a mid-morning strength class. 

    Maloney had just finished the five-minute warm-up and started the initial working block. He was walking another client through a movement when he heard the visitor, an active man over the age of 60, fall to the floor. The coach immediately moved to render assistance, first establishing that though the man wasn’t unconscious per se, he was seemingly unable to speak. 

    “My first thought was sugar,” Maloney said. But he also cleared the area in case the man was having a seizure. Then the client became unresponsive. 

    Maloney and a patron with a medical background both checked for a pulse — neither could find one. That’s when Maloney retrieved the automated external defibrillator (AED) that was on the wall a mere five feet away. After he’d set it up and run a diagnostic, the machine advised a shock. Maloney moved everyone away and administered one. Then he began chest compressions. 

    “It was strange,” Maloney said. “You really only see it in the movies, but he came to after about 90 seconds of delivering compressions.” 

    It was just then that EMS first responders arrived. 

    While Maloney was attending to the client, Orangetheory staff and patrons had been working concurrently to make sure emergency services were inbound. When EMS loaded the man into an ambulance, he was, by Maloney’s estimation, “halfway coherent.” Though for privacy reasons, the coach wasn’t able to get a full picture of the outcome, he later learned that the man had been released. 

    Maloney first earned an ACSM certification back in 2009. Since then, he has worked with the college in various capacities to advocate for certification, including photo and video shoots. He’s also the ACSM-EP committee chair. 

    He was subsequently recognized for his lifesaving efforts by both the fire department and the city, receiving the Noblesville Fire Department Civilian Certificate of Recognition from the fire chief and the City of Noblesville Partner in Progress from the mayor.  


    Still, Maloney remains humble: “It was a team effort.” 

    And critically, the studio had done its due diligence: All Orangetheory patrons, even those dropping in from other locations, fill out a form that includes a brief medical history before they’re allowed to participate in a workout. The EMS responders informed Maloney that this information was particularly helpful, allowing them to tailor their response and be better prepared to react to the situation they were arriving at. 

    “We had all the info they needed to know right in hand when they walked through the door,” Maloney said. “I give a lot of props to the team and my studio manager, Tori.” 

    Further, Maloney himself had reviewed the client’s intake documents — the man had had a prior heart attack but had been cleared for exercise by a physician — and had been keeping an eye on him. So though the fall was sudden, Maloney wasn’t taken completely by surprise. 

    The Orangetheory team also runs regular drills to prepare for just such an emergency, always working to speed up their response time and making sure to thoroughly document their efforts. They also stress the importance of ensuring the AED is online and ready. 

    “Come in, turn on the lights and check the AED,” Maloney said. 

    Still, he’s taken the time to assess and learn from this particular incident. He noted two improvements came to mind: One, he should have remained with the client and assigned someone else to bring him the AED rather than retrieving it himself. Fortunately, it was only a few feet away. Two, he would have preferred that he’d designated one person to make the 911 call. As it happened, three or four patrons as well as the front desk phoned them. 

    In this line of work, you never know what you might encounter during a class. Fortunately, there are ways to prepare. Run your emergency drills. Keep an AED on hand. Review your clients’ medical histories. 

    “Practice,” Maloney said. “And know your people.” 

    For more information on the importance of AEDs, check out ACSM's two pronouncements:

    American College of Sports Medicine Expert Consensus Statement to Update Recommendations for Screening, Staffing, and Emergency Policies to Prevent Cardiovascular Events at Health Fitness Facilities (CSMR, June 2020)

    Increasing the Availability of Automated External Defibrillators at Sporting Events: A Call to Action from the American College of Sports Medicine (CSMR, August 2021)

    Download and print this free AED poster to alert your employees and clients to the location of the AED in your facility. 

  • A New Way to Help Our Bones with Calcium?

    by Greg Margason | Dec 16, 2022
    A New Way to Help Our Bones with Calcium?

    Despite the broad benefits of exercise to bone health, athletes from some sports fare better than others.  Athletic training and performance can also be completely derailed by bone stress injuries, which have multifactorial contributors of which bone health is key. Energy availability, bone-loading exercise and vitamin D are known to influence bone health, but even with these optimized, bone issues can still remain. 

    Research studies observing endurance training (running and cycling) have noted an acute drop in serum ionized calcium early in an exercise bout. This change is associated with an increased parathyroid hormone concentration and increases in the bone breakdown marker C-terminal telopeptide of type I collagen. This has given rise to the theory that bone is being used as a reservoir of calcium to maintain stable levels in the blood. It is thought that the calcium “borrowed” over time for this purpose may not be fully “paid back” and may contribute to bone health issues in these athletes.

    The theory is supported by a series of studies showing the drop in serum ionized calcium is attenuated by providing pre-exercise calcium intake, either intravenously or orally through a supplement or diet. This finding may provide an additional strategy for athletes to protect their bone health over and above adequate energy intake, overall daily calcium intake and vitamin D status. These studies, however, have focused on single exercise bouts of cycling or running and do not represent the more typical training pattern of athletes who may train two to three times each day. 

    In our study, published in Medicine & Science in Sports & Exercise®, we aimed to replicate a more typical training day by including more than one training session. We also chose a novel sport by using rowing, a non-weight-bearing sport where bone stress injuries have a negative effect on the ability to train and perform to potential. This is an issue from the sub-elite to the elite level within the sport. This study is unique in that top-caliber athletes from the Australian rowing team were able to participate. Unfortunately, due to COVID-19 travel restrictions at the time of the study, only male rowers were able to participate.

    The current study adds to the research by extending monitoring over two training session, representing a more typical training day. Dietary intake was standardized for the 24 hours prior to the test, and all food was provided on the testing days. Pre-exercise calcium intake was set at 1,000 mg for the high-calcium group and less than 10 mg for the control group, and was easily achieved and tolerated through diet. This was provided in the form of a bowl of Bircher muesli and a toasted ham-and-cheese sandwich. The low calcium intake was achieved using a nondairy milk and yogurt, and vegan cheese.

    The key findings were that, rather than the effect diminishing when multiple training sessions were undertaken, these changes are maintained through a training day and become potentially more important given the attenuation of bone breakdown over 7+ hours rather than 1-2. While the question remains as to whether this is ultimately beneficial to bone health over weeks and months, it adds a valuable step forward in our understanding and provides a safe new strategy for athletes to try. 

    Bronwen Lundy
    Bronwen Lundy, Ph.D.
    , is a sports dietitian who has been embedded in the Australian rowing team for the past 11 years. She has worked at the Australian Institute of Sport, the English Institute of Sport and with professional sports teams in the Australian rugby union and rugby league competitions. She is a member and previous director of Sports Dietitians Australia. She has recently completed a Ph.D. under the supervision of Louise Burke and John Hawley investigating nutrition factors relating to bone injury in rowing. 

    Louise BurkeLouise Burke, Ph.D., is a sports dietitian with 40 years of experience in the education and counselling of elite athletes. She was head of sports nutrition at the Australian Institute of Sport and the team dietitian for the Australian Olympic Teams (1996-2012). She is currently chair in sports nutrition in the Mary MacKillop Institute of Health Research at Australian Catholic University with over 350 papers in peer-reviewed journals and is an editor of the International Journal of Sport Nutrition and Exercise Metabolism. Louise was a founding member of the Executive of Sports Dietitians Australia and is a director of the IOC Diploma in Sports Nutrition and ACSM member. She was awarded a Medal of the Order of Australia in 2009 for her contribution to sports nutrition.

    Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily represent ACSM positions or policies. Active Voice authors who have received financial or other considerations from a commercial entity associated with their topic must disclose such relationships at the time they accept an invitation to write for SMB.

  • Tips for Inclusive Hiring Practices

    by Greg Margason | Dec 13, 2022
    Tips for Inclusive Hiring Practices

    In October, we celebrated National Disability Employment Month. We examined how far we have come as an industry and how far we still must go to ensure equal access for people with a disability in our field, particularly in our hiring practices. Inclusion in any space is not a one-time effort. It should be embedded in the core values, policies and culture of an organization for true success. Here are some steps you can take as an organization to ensure your employment opportunities are accessible and inclusive to disabled people. 

    Step 1:

    Be accessible. That may sound simple, but in reality, accessibility is all encompassing. It includes everything from the built environment to technology and services. In addition, accessibility has specific standards that all business and organizations must adhere to. Do your research on accessibility to ensure you are ADA compliant for both your staff and clients. You can even take access and inclusion one step further by meeting Universal Design Standards. If you are not sure where to begin, there are many resources available, including the ADA checklist, AIMFREE or the CHII that can provide an assessment. There are also tools that address website accessibility like WebAIM. While it’s important to receive staff feedback about accessibility, don’t rely on staff with disabilities to do your ADA work. There are accessibility and inclusion specialists you can work with to guide you along the way. Providing an accessible environment lets applicants know you welcome a diverse workforce and are willing to make an accommodation they may require. 

    Step 2:

    Create a culture of inclusion. Make sure your diversity, equity and inclusion committees and initiatives actively include people with disability. Create awareness across your organization on your inclusion standards, and provide trainings on disability, allyship, advocacy, ableism and more. Make inclusion part of your core values and create policies around prioritizing the hiring of individuals with a disability as well as other inclusive practices. 

    Step 3:

    Ensure your marketing and recruitment efforts are accessible and inclusive. People with disabilities are vastly underrepresented in all aspects of life. Take inventory of your recruitment and marketing materials. Does the imagery and language include those with a disability? Are your print and digital materials accessible to people who use assistive technology or have low vision? If not, disabled people may not feel welcome or included, and you may miss out on highly qualified candidates. As a best practice, ensure one in four of your marketing materials or social media posts have disability-inclusive messaging or representation, reflecting the one in four Americans who have a disability. Check out these helpful tips from the National Center on Health, Physical Activity and Disability (NCHPAD) on more inclusive social marketing.  

    Step 4:

    Establish inclusive hiring practices. This might be the most important component of your plan to recruit individuals with a disability in your workplace. Review your hiring process and make sure all aspects are inclusive. This includes making sure your application is accessible, including the platform or website it is located on, and that the language in the job description does not exclude people with certain types of disabilities. Also, job interviews should be conducted in the least restrictive environment. Know the guidelines around inclusive interviews and practice them. Interviews are nerve racking enough. You don’t want to increase that anxiety by conducting it in a non-inclusive space. Check out Inclusively’s suggestions on what this includes.   

    Step 5:

    Partner with the disability community. The disability community has a wealth of knowledge, expertise and resources available. Partnering with disabled people helps you understand the real-life needs and barriers people with disabilities face working in our field or your facility. All disabilities are unique, and there is no one step that can be done to ensure access and inclusion. By partnering with the disability community, you can get a pulse on what unique characteristics exist in your community and how you can equip, hire or serve individuals with a disability in your fitness or wellness facility. They may also be able to provide you with qualified candidates for your organization.  

    Just like physical fitness, inclusion is a process. A one-time workout or heavy lift doesn’t make you fit. It might make you feel better in the moment, but it does not create long-term results. The same is true of inclusion. Simply adding a ramp or checking an accessibility box will do little to change the overall culture of your organization. So, commit to learning and practicing inclusion bit by bit each day. It will lead to a vibrant organization with a workforce that feels valued and supported. 

    Related Content: 
    Blog | Disability, Employment and Progress in the Fitness Space
    Certification | Become an ACSM/NCHPAD Certified Inclusive Fitness Trainer
    Book | ACSM's Exercise Management for Persons With Chronic Diseases and Disabilities

    Kelly BonnerKelly Bonner is the Director of Training and Operations at Lakeshore Foundation for the National Center on Health Physical Activity and Disability (NCHPAD). In her work with NCHPAD, she has conducted numerous trainings on Disability Education to organizations like the World Games, Encompass Health, and state health departments. She has also authored publications and blogs for organizations such as ACSM, CDC and NRPA. Mrs. Bonner manages NCHPAD’s training and education components including their on-line E-learning site. For the past 10 years Mrs. Bonner has overseen and delivered the trainings for the Certified Inclusive Fitness Trainer through ACSM. Mrs. Bonner is a certified fitness specialist and has worked at Lakeshore Foundation, an Olympic and Paralympic training center, working with disabled individuals across the lifespan in the fitness center as well as coaching adapted track and field.

  • Exercise and Sports Sciences Reviews Unveils New Cover Art

    by Caitlin Kinser | Dec 12, 2022

    ESSR unveils new cover artACSM is excited to announce a fresh new look for Exercise and Sport Sciences Reviews (ESSR), thanks to the diligent work of the publication team and longtime ACSM designer Dave Brewer. The new cover made its debut on the January 2023 issue.

    ESSR had its start in 1972 as annual hardcover volume and in 2000 transitioned to a quarterly journal, a publication schedule it retains to this day. The latest redesign took into account extensive reader surveys and competitor analyses.

    Then came the brainstorming: “The first step was to deconstruct the old cover down to the basic elements and then experimenting with different groupings/positions with the journal title,” Dave says.

    After much ideating and iterating, Dave came up with a series of conceptual designs that he shared with the team. Once these were narrowed down to a few top picks, and after incorporating further feedback, he shared them with a wider group of constituents for final approval.

    The design the team landed on has been well-received within the ACSM community.

    “I’m thrilled with the new and contemporary cover of Exercise and Sport Sciences Reviews,” says ESSR Editor-in-Chief Sandra Hunter, Ph.D., FACSM. “The design team did a fabulous job … resulting in a strong cover redesign that appropriately houses the cutting-edge and forward-thinking review articles in sports medicine and exercise science. It’s an exciting time to be a contributor to the high-quality journals of ACSM.”

    ACSM Publications Committee Chair Karyn Hamilton, Ph.D., R.D., FACSM, agrees.

    “What an exciting time for ACSM Membership!” she says. “Exercise and Sport Sciences Reviews has a brand new look, a talented new editor-in-chief with outstanding new ideas for the journal, and a continued commitment to publishing the most relevant scientific, medical and research-based topics emerging in the field.”

    ESSR Cover Evolution

    Read the New Issue

  • Pedaling toward Activity-Supportive Workplace Environments

    by Greg Margason | Dec 12, 2022
    Pedaling toward Activity-Supportive Workplace Environments

    Approximately 80% of jobs in the United States are predominantly sedentary. Sedentary work time is also increasing worldwide. National and global policy guidelines recommend breaking up sedentary work time to improve population health and reduce premature mortality. However, policies and job demands requiring workers to remain at their desks, along with limited funds and space for exercise equipment, can impede efforts to break up sedentary work time. Under-desk pedaling devices could help address these impediments as they can be used without leaving one’s desk, and their cost and space requirements are similar to office chairs. However, the optimal under-desk pedaling intensity level to enable concurrent office work among physically inactive adults has not been well explored.

    In our study, published in Medicine & Science in Sports & Exercise®, we tested if physically inactive adults could perform office work tasks while concurrently using an under-desk pedaling device at low intensity levels. To help understand if under-desk pedaling is feasible for diverse workers, we recruited equal numbers of men and women, older and younger working-aged adults, and normal weight and overweight/obese adults. Ninety-six adults completed the study in a controlled laboratory setting over a two-hour period. We measured the adults’ performance on typing, reading, logical reasoning and phone tasks while engaged in seated pedaling at two intensity settings (17 and 25 watts) and while seated without pedaling. We also measured adults’ perceived comfort while pedaling and working.

    We found that physically inactive adults obtained equivalent work performance scores on typing, reading, logical reasoning and phone tasks across all pedaling and non-pedaling conditions. Differences in adults’ age, sex and body mass index did not modify the pattern of equivalent work performance we observed across the pedaling and non-pedaling conditions. Pedaling at both intensity settings appeared feasible for most physically inactive adults, as adherence to the 17 and 25 watt pedaling intensities exceeded 95%. Adults reported greater comfort while completing work tasks during the lower intensity setting of 17 watts.

    Our findings suggest that physically inactive adults can productively perform work tasks while using an under-desk pedaling device at low intensity levels. As adults reported more comfort completing work tasks during the lower intensity condition, future desk-pedaling programs may benefit from recommending a starting intensity level of about 17 watts.

    We hope our findings contribute to efforts to implement and evaluate under-desk pedaling devices on a larger scale over extended time periods. Many under-desk pedaling devices provide real-time tracking of pedaling duration and speed — enabling these devices to simultaneously provide feedback for employees and data for program evaluation. These dynamic measurement features of under-desk pedaling devices could help inform next steps to optimize their implementation and use. For instance, ongoing pedaling tracking could provide data on the volume of pedaling that predicts optimal productivity and health outcomes, or the effects of praise and/or incentives on pedaling volume. Continued efforts to implement and evaluate under-desk pedaling devices could reduce health risks of sedentary work time and contribute toward building activity-supportive workplace environments and cultures. 

    Liza Rovniak
    Liza S. Rovniak, Ph.D., MPH, is an associate professor of medicine and public health sciences at the Pennsylvania State University College of 
    Medicine. Her research focuses on designing environments and policies to sustain physical activity, healthy eating and other behaviors. Using an ecological framework and emphasizing interdisciplinary collaborations, Dr. Rovniak conducts clinical trials and epidemiological research across diverse populations and settings to explore how to facilitate long-term health behavior change. Dr. Rovniak is an ACSM member.

    Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily represent ACSM positions or policies. Active Voice authors who have received financial or other considerations from a commercial entity associated with their topic must disclose such relationships at the time they accept an invitation to write for SMB.