Staff Profiles

Modules taught

NUTR7008: Research Project

PSIO5044: Health, Wellbeing and Exercise

PSIO7011: Health, Wellbeing and Exercise

SPOR4012: Fitness and Assessment

SPOR4013: Health Promotion and Behaviour Change

SPOR5007: Independent Study 1

SPOR5009: Physical Activity & Health

SPOR5012: Applied Sport and Exercise Physiology

SPOR5016: Enhancing Physical Activity Across the Lifespan

SPOR5017: Determinants of Health

SPOR5018: Exercise Prescription in Clinical Populations

SPOR6004: Clinical Populations and Rehabilitation

SPOR6006: Independent Study 2

SPOR6008: Project \ Dissertation

SPOR6011: Alpine Fieldwork in Exercise Science

Andy's most recent research has focused on the impact of the Covid-19 pandemic on physical activity habits and mental health in a number of different countries. Previously, Andy has focused on the non-invasive measurement of aortic blood pressures in older populations and both acute and chronic stroke populations. Andy has also recently investigated the effects of sedentary time on the body after stroke and whether low intensity physical activity may mitigate the damage that extended sedentary time causes in sickness.

Research grants and awards

Journal articles

• Faulkner J, O'Brien WJ, Stuart B, Stoner L, Batten J, Wadsworth D, Askew CD, Badehorst CE, Byrd E, Draper N, Elliot C, Fryer S, Hamlin MJ, Jakeman JR, Mackintosh KA, McNarry MA, Mitchelmore A, Ryan-Stewart H, Saynoe Z, Schaumberg MA, Spiegelhalter E, Stone K, Lambrick D, 'Physical Activity, Mental Health and Wellbeing of Adults within and during the Easing of COVID-19 Restrictions, in the United Kingdom and New Zealand'
  International Journal of Environmental Research and Public Health 19 (3) (2022)
  ISSN: 1661-7827 eISSN: 1660-4601
  Abstract

  Physical activity (PA) participation was substantially reduced at the start of the COVID-19 pandemic. The purpose of this study was to assess the association between PA, mental health, and wellbeing during and following the easing of COVID-19 restrictions in the United Kingdom (UK) and New Zealand (NZ). In this study, 3363 adults completed online surveys within 2–6 weeks of initial COVID-19 restrictions (April/May 2020) and once restrictions to human movement had been eased. Outcome measures included the International Physical Activity Questionnaire Short-Form, Depression Anxiety and Stress Scale-9 (mental health) and World Health Organisation-5 Wellbeing Index. There were no differences in PA, mental health or wellbeing between timepoints (p > 0.05). Individuals engaging in moderate or high volume of PA had significantly better mental health (−1.1 and −1.7 units, respectively) and wellbeing (11.4 and 18.6 units, respectively) than individuals who engaged in low PA (p < 0.001). Mental health was better once COVID-19 restrictions were eased (p < 0.001). NZ had better mental health and wellbeing than the UK (p < 0.001). Participation in moderate-to-high volumes of PA was associated with better mental health and wellbeing, both during and following periods of COVID-19 containment, compared to participation in low volumes of PA. Where applicable, during the current or future pandemic(s), moderate-to-high volumes of PA should be encouraged.

  Website 
• James Faulkner, Wendy J. O’Brien, Bronagh McGrane, Daniel Wadsworth, John Batten, Christopher D. Askew, Claire Badenhorst, Erin Byrd, Maura Coulter, Nick Draper, Catherine Elliot, Simon Fryer, Michael J. Hamlin, John Jakeman, Kelly A. Mackintosh, Melitta A. McNarry, Andrew Mitchelmore, John Murphy, Helen Ryan-Stewart, Zoe Saynor, Mia Schaumberg, Keeron Stone, Lee Stoner, Beth Stuart, Danielle Lambrick, 'Physical activity, mental health and well-being of adults during initial COVID-19 containment strategies: A multi-country cross-sectional analysis'
  Journal of Science and Medicine in Sport 24 (4) (2020) pp.320-326
  ISSN: 1440-2440 eISSN: 1878-1861
  Abstract

  Objectives.
  To assess physical activity (PA), mental health and well-being of adults in the United Kingdom (UK), Ireland, New Zealand and Australia during the initial stages of National governments’ Coronavirus disease (COVID-19) containment responses.
  

  Design.
  Observational, cross-sectional.
  

  Methods.
  An online survey was disseminated to adults (n = 8,425; 44.5 ± 14.8y) residing in the UK, Ireland, New Zealand and Australia within the first 2-6 weeks of government-mandated COVID-19 restrictions. Main outcome measures included: Stages of Change scale for exercise behaviour change; International Physical Activity Questionnaire (short-form); World Health Organisation-5 Well-being Index; and the Depression Anxiety and Stress Scale-9.
  

  Results.
  Participants who reported a negative change in exercise behaviour from before initial COVID-19 restrictions to during the initial COVID-19 restrictions demonstrated poorer mental health and well-being compared to those demonstrating either a positive-or no change in their exercise behaviour (p < 0.001). Whilst women reported more positive changes in exercise behaviour, young people (18-29y) reported more negative changes (both p < 0.001). Individuals who had more positive exercise behaviours reported better mental health and well-being (p < 0.001). Although there were no differences in PA between countries, individuals in New Zealand reported better mental health and well-being (p < 0.001).
  

  Conclusion.
  The initial COVID-19 restrictions have differentially impacted upon PA habits of individuals based upon their age and sex, and therefore have important implications for international policy and guideline recommendations. Public health interventions that encourage PA should target specific groups (e.g., men, young adults) who are most vulnerable to the negative effects of physical distancing and/or self-isolation.
  

  Website 
• Mitchelmore A, Lambrick D, Jobson S, Stoner L, Faulkner J, 'Effects of a heel raise programme on central haemodynamics and cognitive performance in chronic stroke: study protocol for a randomized, controlled, crossover trial'
  Clinical Trials in Degenerative Diseases 3 (4) (2019) pp.130-134
  ISSN: 2542-3975 eISSN: 2542-3983
  Abstract

  Background and objectives. As survival rates after incident stroke increase, the burden caused by secondary stroke and pressure placed on rehabilitation centers also rises. Lifestyle interventions have the potential to drive secondary-prevention treatments. Low-intensity interventions, such as heel raises, may offer a simple method of improving cardiovascular health and cognitive ability in chronic stroke. Here we present a protocol which attempts to determine whether a heel raise training program can improve markers of vascular health and cognitive function. Design. A randomized, controlled, crossover trial. Methods. Fifteen participants (> 3 months post-stroke diagnosis) will be randomly assigned to an intervention-first group (n = 8) or a control-first group (n = 7). In the intervention period, participants will complete 170 heel raises per day for 10 weeks. Heel raises will be completed in sets of ten, within a period of 170 minutes, from a seated position. In the control period, participants will go about their normal lives for 10 weeks. On completion of each program, participants will have a 4-week washout before commencing the alterative arm. Outcome measures. The primary outcomes (pre- and post-measures of peripheral and central blood pressure and pulse wave velocity) will be recorded, as these variables are strongly linked to vascular health after stroke. Secondary outcomes (cognitive function and maximal voluntary contractions) will be assessed using the Stroop task and electromyography respectively. A mixed-model analysis of variance will identify whether a heel raise intervention has a significant effect on the proposed primary and secondary outcome variables. Discussion. The potential improvements in vascular health may demonstrate that lower-limb heel raise exercise is a beneficial exercise stimulus for this population group. 

  Website 
• Mitchelmore A, Stoner L, Lambrick D, Jobson S, Faulkner J, 'Reliability of oscillometric central blood pressure and central systolic loading in individuals over 50 years: Effects of posture and fasting'
  Atherosclerosis 13 (11) (2018)
  ISSN: 0021-9150 eISSN: 1879-1484
  Abstract

  Background. This study examined the short-term reproducibility of non-invasive estimates of central and peripheral blood pressure and markers of central systolic loading (augmentation index [AIx; a measure of central systolic loading] and AIx75 [AIx standardised to 75 b·min-1 heart rate]) and the effect of posture and fasting state on these variables in patients with acute stroke. Methods. Twenty-two acute stroke patients (72 ± 10y) had blood pressure measured using the SphygmoCor XCEL in supine and seated postures and whilst fasted and non-fasted. Results. Acceptable short-term reproducibility (ICC >0.75) was reported for all peripheral and central variables in all conditions (ICC = 0.77–0.90) and for AIx and AIx75 in both fasted postures (ICC = 0.78–0.81). Food consumption significantly lowered all blood pressures (p <0.05; η2p = 0.20–0.55). The seated posture resulted in a significantly greater AIx than supine (p <0.05; η2p = 0.22). Fasting state had significant main effects on AIx and AIx75 (p <0.05; η2p = 0.14–0.22). Conslusions. Oscillometric estimates of central blood pressure have high short-term reproducibility in different postures and fasting states but markers of systolic load should be assessed whilst fasted. Fasting state has a large effect on central and peripheral blood pressures and on measures of systolic loading. It is important for clinicians to be aware of optimal assessment conditions without this impacting on patient wellbeing.

  Website 
• Mitchelmore A, Stoner L, Lambrick D, Sykes L, Eglinton C, Jobson S, Faulkner J, 'Oscillometric central blood pressure and central systolic loading in stroke patients: Short-term reproducibility and effects of posture and fasting state'
  PLoS ONE 13 (11) (2018)
  ISSN: 1932-6203
  Abstract

  Background. This study examined the short-term reproducibility of non-invasive estimates of central and peripheral blood pressure and markers of central systolic loading (augmentation index [AIx; a measure of central systolic loading] and AIx75 [AIx standardised to 75 b·min-1 heart rate]) and the effect of posture and fasting state on these variables in patients with acute stroke. Methods. Twenty-two acute stroke patients (72 ± 10y) had blood pressure measured using the SphygmoCor XCEL in supine and seated postures and whilst fasted and non-fasted. Results. Acceptable short-term reproducibility (ICC >0.75) was reported for all peripheral and central variables in all conditions (ICC = 0.77–0.90) and for AIx and AIx75 in both fasted postures (ICC = 0.78–0.81). Food consumption significantly lowered all blood pressures (p <0.05; η2p = 0.20–0.55). The seated posture resulted in a significantly greater AIx than supine (p <0.05; η2p = 0.22). Fasting state had significant main effects on AIx and AIx75 (p <0.05; η2p = 0.14–0.22). Conslusions. Oscillometric estimates of central blood pressure have high short-term reproducibility in different postures and fasting states but markers of systolic load should be assessed whilst fasted. Fasting state has a large effect on central and peripheral blood pressures and on measures of systolic loading. It is important for clinicians to be aware of optimal assessment conditions without this impacting on patient wellbeing.

  Website 
• Faulkner J, Stoner L, Lanford J, Joliffe E, Mitchelmore A, Lambrick D, 'Long-term effect of participation in an early exercise and education program on clinical outcomes and cost implications, in patients with TIA and minor, non-disabling stroke'
  Translational Stroke Research 8 (2016) pp.220-227
  ISSN: 1868-4483 eISSN: 1868-601X
  Abstract

  Participation in exercise and education programs following transient ischemic attack (TIA) or minor stroke may decrease cardiovascular disease risk. The purpose of this study was to assess the long-term effect (3.5 years) of an exercise and education program administered soon after TIA or minor stroke diagnosis on clinical outcome measures (stroke classification and number, patient deaths, hospital/emergency department admission) and cost implications obtained from standard hospital records. Hospital records were screened for 60 adults (male, n = 31; 71 ± 10 years), diagnosed with TIA or non-disabling stroke, who had previously been randomised and completed either an 8-week exercise and education program, or usual care control. Follow-up clinical outcomes and cost implications were obtained 3.5 ± 0.3 years post-exercise. Participants randomised to the exercise and education program had significantly fewer recurrent stroke/TIAs (n = 3 vs. n = 13, Cohen’s d = 0.79) than the control group (P ≤ 0.003). Similar finding were reported for patient deaths (n = 0 vs. n = 4, d = 0.53), and hospital admissions (n = 48 vs. n = 102, d = 0.54), although these findings were only approaching statistical significance. The relative risk (mean; 95%CI) of death, stroke/TIAs and hospital admissions were 0.11 (0.01 to 1.98), 0.23 (0.07 to 0.72) and 0.79 (0.57 to 1.09), respectively. Hospital admission costs were significantly lower for the exercise group ($9041 ± 15,080 NZD [~$6000 ± 10,000 USD]) than the control group ($21,750 ± 22,973 NZD [~$14,000 ± 15,000 USD]) during the follow-up period (P < 0.05, d = 0.69). The present study demonstrates the long-term patient benefit and economic importance of providing secondary prevention, exercise and education programs for patients with TIA and minor stroke.
  

  Website 

Book chapters

• Mitchelmore A, 'Qualitative methods to optimise design and conduct of randomised controlled trials with clinical populations' in Locke R, Lees A (ed.), Mixed-Methods Research in Wellbeing and Health, Routledge (2021)
  ISBN: 9780367207762 eISBN: 9780429263484
  Abstract

  Quantitative clinical research is based on clearly defined protocols as to how study procedures, processes and measurements will be conducted in a uniform manner for all participants. With reference to ongoing doctoral research, this chapter challenges this reductionist view of clinical research and highlights the sensitive, relational and responsive approach that is required to recruit and work with frail and vulnerable stroke patients in hospital settings. Linking personal experience with existing research on the challenges of recruiting to stroke trials, this chapter argues the case for a mixed-methods approach to enhancing the recruitment and retention of patients.

  Website 

Areas of expertise

Covid-19 pandemic and mental health, cardiovascular disease and neurological conditions, heart rate variability, peripheral and central blood pressures and their circadian rhythms, physical activity and chronic disease, non-communicable disease risk factors, sedentary time.

Membership of professional bodies

Fellow of the Higher Education Academy

Member of the British Association of Sport and Exercise Sciences

Member of the Physiological Society

Reviewer for the Journal of Clinical Nursing

Reviewer for the European Journal of Applied Physiology and Journal of Sports Sciences with Dr James Faulkner

Consultancy

Collaborator of the Health Enhancing Lifestyle Programme (HELP) Hampshire Stroke Clinic

Previous work involving the University of Winchester Sport and Exercise Consultancy Unit (SECU) including work with Portsmouth FC, The Atlantic Drifters (Talisker Whisky Atlantic Challenge Rowers), various schools and colleges in the community.

Conferences

Other experience

Andy's previous place of employment was the University of Winchester, where he was employed as an Associate Lecturer in Sport and Exercise Science. In this role, Andy taught and supervised on a range of degree programmes involving health and exercise physiology, and coaching sciences. He also taught on a number of research methods modules across the undergraduate programmes.