This paper was prepared by longtime CSEP member Roy Shephard (CSEP president 1970-71). Originally published on csep.ca September 2013.
THE FIRST FIFTY YEARS: A PERSONAL PERSPECTIVE ON THE HISTORY OF CANADIAN EXERCISE PHYSIOLOGY
Roy J. Shephard
Faculty of Kinesiology & Physical Education,
University of Toronto,
Correspondence to: Roy J. Shephard, PO Box 521, Brackendale, BC V0N 1H0.
Phone: 604-898-5527. FAX: 604-898-5724.
There are other sources that provide a general introduction to the history of exercise physiology, in particular the text currently being prepared by Dr. Charles Tipton of Arizona State University (Tipton, 2013). However, there are certain features that are unique to CSEP/SCPE and the Canadian scene.
Interest in exercise physiology was already well-established in Europe during the early part of the 20th century, with the work August Krogh (1874-1949) and Johannes Lindhard (1970-1947), followed by Erik Hohwü-Christensen (1904-1996), Erling Asmussen (1907-1991) and Marius Nielsen (1903-2000) in Scandinavia, and A.V. Hill (1886-1977) in Great Britain. The Åstrands were also busy making their important contributions to this field during the 1950s. However, the Canadian story did not really begin until the early 1960s, coinciding approximately (although not causally!) with my period of employment by the University of Toronto; my very personal account of the first fifty years of Canadian exercise science is inevitably coloured by this association. My objectives are to suggest why Canada has played a major role in the development of Exercise Physiology, to highlight certain of the early group of Canadian investigators who gained national and international reputations as exercise scientists, and to provide a sampling of some of the major Canadian contributions to this area of knowledge.
Why has Canada played a major role in the development of Exercise Physiology?
There are many reasons why Canada has made an important contribution to the development of Exercise Physiology over the past 50 years. Among these influences, we may note some comments made by HRH the Duke of Edinburgh, the establishment of specific Fitness Research Units, the change in name of many former physical education programmes, the possibly related growth in academic acceptance of Exercise Physiology/Kinesiology across Canada, the hosting of several seminal international conferences, the establishment of opportunities for graduate education in the Exercise Sciences, and the willingness of Canadians to present and defend their new knowledge on the world stage.
The role of the Duke of Edinburgh. In 1959, HRH the Duke of Edinburgh became the first lay president of the Canadian Medical Association, and in his inaugural address to that body he made some characteristically blunt comments on the perceived lack of fitness among Canadian youth. His warning words were noted and circulated in a Royal Bank newsletter, and the resulting furor quickly spread to Ottawa, where members of the Federal Parliament urged the early establishment of a programme to correct the problem that he had identified. Thus, in 1961, Bill C-131 ("An act to encourage Fitness and Amateur Sport") received the Royal Assent. This in turn led to the establishment of a Directorate of Fitness and Amateur Sport, with an annual operating budget of $5 million. One of the early initiatives of the Directorate was to propose the establishment of three university-based Fitness Research Units. In 1963, the Canadian Association for Health, Physical Education, and Recreation (CAHPER) also hosted its first fitness seminar in Saskatoon (Fig.1).
Figure 1. One response to the Duke of Edinburgh's 1961 criticism of the fitness of Canadians was the organization of a fitness seminar by the Canadian Association for Health, Physical Education and Recreation (CAHPER) in Saskatoon (1963).
The Fitness Research Units. In allocating $150,000 of its Annual Budget to the Fitness Research Unit concept, it might have been thought advisable for Fitness & Amateur Sport to contemplate the establishment of a single institution. However, faced with the regional realities of Canadian politics, the Federal Agency decided that it would be necessary to establish three such Units, one in central Canada, one on the Prairies, and one in French Canada. The University of Toronto, the University of Alberta, and the University of Montreal were thus selected as appropriate locations for the Units. Dr. John Merriman, then a cardiologist at the University of Saskatoon, and subsequently President (1972-3) of the Canadian Association of Sport Sciences (CASS) assumed responsibility for peer review of the new Fitness Programme, promoting it with an almost manic enthusiasm (Fig. 2). He paid searching and somewhat dreaded periodic site visits to each of the Units as they initiated a five-year programme of applied research in Exercise Physiology and Physical Fitness within the constraints of a base budget of $50,000 per year.
Figure 2. Dr. John Merriman (left) in his Saskatoon Exercise Science laboratory in 1961. He is testing Dr. Don Bailey, and to the right of Dr. Bailey stands Dick Cobbald, Professor of Bioengineering at the University of Sakatchewan. Dr. Cobbald had recently, designed a telemetry unit, which weighed about 5 kg and had a range of maybe 50 m.
I was persuaded to emigrate to Canada as Director of the Toronto Unit in November of 1964. This was a period of rapid university expansion, and I was both surprised and flattered to receive the offer of an immediate Full Professorship with tenure at the age of 35! The Toronto Unit was offered somewhat antique laboratory space in what was then termed the School of Hygiene. The oaken benches had stood Dr. Charles Best in good stead for his studies of insulin many years previously, but the unsuspected persistence of a DC power supply quickly burnt out one or two pieces of expensive equipment! Nevertheless, the Unit quickly developed a doctoral programme in Exercise Science, focussing initially upon the limiting physiological links in the oxygen transport chain. By the summer of 1966, it was also asked to host a World Health Organization/International Biological Programme working group on the standardization of methodology for the measurement of maximal oxygen intake. It also tested the current fitness level of various populations, including those attending the Canadian National Exhibition of 1966.
Figure 3. In cooperation with the Ontario Heart Foundation and the Ontario and Canadian Medical Associations, the Fitness Unit at the University of Toronto organized an early International Symposium on Physical Activity and Cardiovascular Health. This was held at the "Inn on the Park," Toronto, in October 1966. The proceedings were published five months later as two special issues of the Canadian Medical Association Journal.the fall of 1966 it collaborated with the Ontario Heart Foundation and the Canadian Medical Association in organizing what was perhaps the first International Conference on Physical Activity and Cardiovascular disease (Fig. 3).
The University of Alberta Fitness Research Unit elected to focus largely on cellular aspects of Exercise Physiology, and Dr. Bert Taylor (CASS President 1974-75, Honour Award recipient in 1986, and now a faculty member at the University of Western Ontario), assumed a dominant role in these studies. The University of Alberta also conducted an ambitious, nation-wide survey of the cycle ergometer PWC170 on a representative sample of Canadian schoolchildren (Howell and Macnab, 1968) in an era when most laboratories gave little thought to population sampling.
The Montreal unit was dogged by problems of ill-health in its leadership, and its practical achievements were apparently more limited, although it may have provided the initial stimulus towards development of the widely used shuttle-run test of Dr. Luc Léger.
Name change of former departments of Physical Education. Another potent influence in the development of Exercise Science in Canada has been a change in the name of the academic programme and/or a change in the underlying curricular philosophy of Schools and Faculties which had formerly been identified as teachers of "Physical Education." Beginning in the 1960s, the emphasis of many undergraduate teaching programmes shifted from the practical preparation of coaches, trainers and physical education teachers to the preparation of students with a broad understanding of the science underlying human performance and health. The trend naturally began in two of Canada's newer universities, Simon Fraser and Waterloo, as in 1967 they each established Kinesiology programmes; other universities, with a longer history, progressively followed their example.
The term Kinesiology remains a popular descriptor for those faculties interested in the Exercise Sciences, although there have been other choices (for example Kinanthropology in Sherbrooke and initially in Ottawa), and Human Kinetics (at the University of Guelph, the University of Windsor, and currently in Ottawa). Some schools, like Ottawa and Guelph have undergone multiple name changes.
Many schools in the United States have now adopted a similar change in name and emphasis, but the shift from Physical Education to Kinesiology apparently occurred more readily in Canada than in the U.S., where many Schools of Athletics and Physical Education were under heavy pressure to sustain Alumni funding through the excellence of their sports teams.
Academic acceptance of Exercise Physiology in Canadian Universities. Exercise Physiology is a well-respected academic discipline in Canada, and has been so for many years. Acceptance of the discipline has probably been helped in part by the change in name and philosophy of many former Faculties of Physical Education, as discussed above.
In Britain and some other European countries applied research (including Human Exercise Physiology) was for long welcomed with less than open arms. My early training was as a classical Physiologist, and I can recall attending meetings of the British Physiological Society when leading members of the Society would pointedly walk out of a Society Meeting, rather than audit a paper on any aspect of Applied Physiology. Persistence of this attitude throughout much of the 20th century caused many scientists with interests in applied science to emigrate to Canada, the U.S. and Australia, severely hampering the research endeavours of those investigators who chose to remain in Britain. Acceptance of the need for studies of exercising humans, the provision of appropriate research funding, and the welcoming of those denied opportunity for such investigations in their countries of birth have all contributed to a strong growth of Exercise Physiology in Canada.
Hosting of seminal international conferences. The hosting of four major international conferences on physical activity, fitness and health has contributed greatly both to the developing understanding of Exercise Physiology within Canada, and to the recognition of Canadian expertise throughout the world.
The first of these conferences was a three-day meeting at Toronto's Inn on the Park, held in October of 1966 (Fig. 3). The event was sponsored jointly by the Toronto Fitness Research Unit, the Canadian Heart Foundation, and the Ontario and Canadian Medical Associations, and substantial financial support was provided by the Canadian Life Insurance Association, and the Province of Ontario. The planning committee held regular noon hour meetings in the former offices of the Ontario Heart Foundation (OHF, Davenport Rd., Toronto), and a light "healthy heart" lunch was usually served. The fare may have been adequate for the petite representative of the OHF, but I often left these meetings ravenously hungry! The meeting itself tackled the (then) novel topic of physical activity in the prevention and treatment of cardiovascular disease, and it attracted some 600 participants from many nations. The format was unusual, with a rigid time limit of 15 minutes for principal speakers, and a mere three minutes for commentators. After a few brushes with the Chair (the microphone was removed from the neck of one loquacious participant!), this schedule was well respected by participants. Evening visits were paid to local sites of interest, including the Toronto Rehabilitation Centre (where Dr. Terry Kavanagh had recently begun his Cardiac Rehabilitation Programme), and North York's luxurious "Fitness Institute" (recently opened by Lloyd Percival). I recall my York University teaching assistant for 1966 (a very young and dapper Norm Gledhill) efficiently marshaling delegates into a fleet of TTC buses, and making many other major contributions behind the scenes.
The organizers of many such conferences have found themselves struggling to collect papers from speakers two years after the event, but the full proceedings of the Inn on the Park meeting were published and distributed to some 25,000 physicians and physiologists as two special issues of the Canadian Medical Association Journal within the space of four months (Shephard, 1967). One of the main reasons for what was a very quick turn around in the pre-computer era was that speakers were not paid their traveling expenses until they had furnished a manuscript of appropriate quality! Typewriters were available to errant participants, and there were reports that at least one overseas delegate spent most of two nights typing in order to receive his travel reimbursement! One speaker also argued that the CMAJ was not a sufficiently prestigious venue for his paper. He was politely reminded that he had agreed to publication in the CMAJ, and he was given two options- immediate submission of his manuscript, or publication of a taped transcript of his somewhat garbled talk. One look at what he had said convinced him to forward the manuscript without further delay.
In 1988, a team of exercise physiologists headed by Claude Bouchard hosted a second major international conference in Toronto, using the well-appointed facilities of L'Hotel and the adjacent Toronto Convention Centre. This event lasted for four and a half days, and it was designed with the unique objective of developing a consensus among attendees on the mechanisms linking exercise, fitness, and health, both in healthy individuals and those with a variety of chronic conditions. More than 60 topics were considered. A carefully selected panel of international experts had each circulated written preprints of their individual presentations. At the conclusion of each public presentation a panel of speakers and consultants vigorously debated the conclusions that should be drawn, and a final consensus statement on each topic was approved by the entire conference of some 1000 participants. At the banquet, American delegates were somewhat bemused by a bilingual loyal toast, a multicultural grace that invoked the Might Manitou, and Selma, Great Mother of the sea-creatures, a selection of choice Ontario wines, and a spirited concert from the Canadian Brass. The findings from the meeting (Figure 4) were subsequently published as a major text in 1990 (Bouchard, Shephard, Stephens et al., 1990).
Figure 4. The 1988 International Consensus Conference on Exercise, Fitness and Health was held in the Toronto Convention centre, and was published by Human Kinetics in 1990.
Based on this experience, a somewhat similar event (again headed by Claude Bouchard) was held at Toronto's Skydome Hotel in 1992, On this occasion, a computer search of major data bases was used to identify the best informed and most widely published investigators for some 70 topics. Each of the individuals who were thus identified prepared a draft consensus statement on their assigned topic three months prior to the conference, and they submitted this along with a detailed supporting document. This information was vigorously debated by the three editors, with input where necessary from a panel of seven international advisors. Thus, those attending the conference itself were able to review a carefully revised consensus statement that was already near to its final format. In 1994, the conclusions were again published as a major scientific text (Bouchard, Shephard & Stephens, 1994, Fig.5).
Figure 5. The second International Consensus Conference, held at the Skydome Hotel, Toronto, in 1992, and published by Human Kinetics in 1994.
By this time, Exercise Physiologists had reached a fair degree of consensus on the merits of regular physical activity in the prevention and treatment of a multiplicity of chronic disorders. However, little was known about the optimal dose of exercise to prescribe. Dr. Bouchard and his colleagues thus embarked upon a further consensus conference that focused on a careful rating of "levels of evidence" concerning dose-response relationships between physical activity and the prevention and treatment of various diseases. The panel of experts selected for this event met in October of 2000, the venue on this occasion being the Hockley Valley Resort, to the north of Toronto. A few of the less fit American delegates were disturbed to find that the proceedings included an opportunity to enjoy the Fall colours during a substantial hike along the physically demanding Bruce Trail! This fourth conference documented much new information, using processes developed from the previous conferences. Unfortunately, there was still insufficient evidence to specify clear dose-response statements for many of the conditions that were considered. Nevertheless, the findings from the meeting were published as a special supplement of the journal Medicine & Science in Sports & Exercise (Kesaniemi et al., 2001).
The organizing committee recognized that although the consensus conferences had been very helpful to the development of Exercise Physiology as a scientific discipline, the bulk of the information presented at these gatherings was not reaching those who were working on the front lines of exercise testing and programming. Art Salmon of Fitness Ontario thus collaborated with Health Canada and the U.S. Centers for Disease Control in offering a more practically-oriented "translation" of the findings through a conference entitled "Communicating physical activity and health messages: science into practice." This meeting was initially scheduled for the resort municipality of Whistler, B.C. in September of 2001. However, fears aroused by the terrorist attacks on the World Trade Center caused a temporary reluctance for all types of travel, particularly among U.S. participants. The conference was thus postponed until December of 2001. On the designated day, a fleet of luxury coaches awaited delegates at Vancouver International Airport, but some delegates from sunnier climes elected to rent cars for the 130 km journey along the (subsequently much improved) mountain road to Whistler. Most of the rental vehicles were not equipped with snow tires, and by the time that delegates had reached Squamish, a heavy snowfall persuaded many of them to make an ignominious return to Vancouver airport in search of the official transport! Art Salmon, always the consummate booster of things Canadian, arranged for two RCMP officers in full dress uniform to greet participants. A summary of the papers presented at this meeting appeared in the American Journal of Preventive Medicine (Shephard, 2002).
Opportunities for Graduate Education. A number of early Canadian leaders in the Exercise Sciences found it necessary to travel to the United States (frequently to Dr. Tom Cureton, at the University of Illinois, in Champaign/Urbana) in order to complete their doctoral training. Nevertheless, with impetus provided by the Fitness Research Units and the change in academic focus at other universities, Canada began to develop its own Ph.D. programmes in Exercise Science during the 1960s. The first candidates graduated from both the University of Toronto and the University of Alberta in the summer of 1966. The emphasis of the new programmes was rigorously Physiological, backed by laboratory facilities and curricula that were in some respects superior to what was available in many U.S. Physical Education-centred Faculties. Some Scandinavian countries had at least equally good doctoral programmes in Clinical Physiology during this era, but this was not the case in many European countries (where Applied Science was still held in low regard).
It is possible to trace a pedagogic genealogy for some of the more outstanding programmes, as graduating students have spread the ideas and the reputation of Canadian universities around the world. I have watched this process at work in Toronto, where notable post-doctoral fellows have included the late Oded Bar-Or (previously at the Wingate Institute in Israel), Henri Vandevalle (Hôpital Pitié Salpetrière, Université de Paris VI), Dr. Vetencourt of Caracas, Venezuela, Dr. Dahong Zhuo (Ghuanzuo, China), several distinguished Japanese colleagues (Keiji Yamaji, Shoji Shinkai, Yuki Aoyaji and Masa Suzui), and members of the IBP Working Party on Exercise Testing (Drs. Bar-Or, Israel; Benade, South Africa; C.T.M. Davies, U.K.; Degré, Belgium; di Prampero, Italy; Hedman, Sweden; Ishii and Kaneko, Japan; LaCour, France; Myhre, Norway; and Seliger, Czechoslovakia). Doctoral graduates from the University of Toronto have also fanned out to academic appointments across Canada and the U.S. Specific names that I recall include Terry Anderson to the University of British Columbia, Don Paterson to the University of Western Ontario, Ken Sidney to Laurentian University, Veli Niinimaa to the University of New Brunswick, Gaston Godin and Luc Noreau to Laval University, Marc Tremblay to Saskatoon and then Ottawa, Bill Montelpare to Lakehead University and now Charlottetown, Greg Gannon to the University of Manitoba, Heather Evans to UBC and subsequently the University of Cincinnati, Jack Goodman continuing at the University of Toronto, Ingrid Brenner to Trent University, and Brent Faught to Brock University.
Presence of Canadian investigators on the world stage. A final factor contributing to the rapid development of Exercise Physiology in Canada has been the consistent attendance of Exercise Scientists at major international gatherings throughout the world. On a per capita basis, Canadian attendance at international (and often American) meetings has typically exceeded that of their more wealthy U.S. peers. For example, Don Bailey tells me that at the 10th Annual meeting of the American College of Sports Medicine (ACSM, held in Minneapolis in 1963) 40 papers were presented, of which 5 came from Canada. Possibly the scattered population of Canada has accustomed its scientists to the rigours of international travel. Moreover, many Canadians possess fluency in one or more foreign languages, giving them an important advantage over their American counterparts. Canada has contributed three presidents to the ACSM (Claude Bouchard, John Sutton and myself), and Claude and I have also received the Honour Award of ACSM.
Key Researchers in Canadian Exercise Physiology
It is somewhat invidious to single out a few people from the long list of investigators who have contributed to the development of Exercise Physiology in Canada. Indeed, there is a real danger that in pin-pointing a few of those who were key researchers during the early years, I shall omit one or more of any given reader's favourite personae. My short list would certainly include Bill Orban, Gordon Cumming, Don Bailey, John Faulkner, Roy Shephard, Claude Bouchard, David Cunningham, Norman Jones, Oded Bar-Or, Howie Green, and John Sutton.
Bill Orban. Dr. William Robert Orban (Fig. 6) was perhaps the best known of Canadian exercise scientists during the mid-1950s. Born in Regina in 1922, he gained a hockey scholarship to the University of California at Berkeley, and after a brief period in the Faculty of Engineering, he switched to Physical Education. There was no exercise science Ph.D. programme in Canada at this period, so he completed a Ph.D. programme with Dr. Tom Cureton at the University of Illinois. In 1956, he accepted an appointment with the Canadian Department of National Defence, where he developed the widely selected acknowledged 5BX exercise programme. In 1958, Dr. Orban became the first Dean of Physical Education in the University of Saskatchewan, and he initiated a landmark longitudinal study of physical development in boys aged 7 to 17 years of age, subsequently continued and expanded by Dr. Don Bailey. In 1966, he returned to Ontario to become Dean of Human Kinetics at the University of Ottawa, and he continued studying optimal patterns of training until his death from cancer in 2003.
Figure 6. Dr. Bill Orban, a Canadian exercise scientists world-renowned for his authorship of the 5-BX and 10-BX exercise programmes (Fig. 7).
Figure 7. The 5-BX and 10-BX exercise programmes developed by Dr. Bill Orban.
Gordon Cumming. Dr. Gordon Cumming began his career as a pediatric cardiologist, practising at the Children's Hospital in Winnipeg. He developed a strong interest in Exercise Physiology from the early 1960s, in part because of the involvement of his daughters in high level ice-skating competition. He played an important role in organizing the 1967 Winnipeg Sports Science Meeting that accompanied the Pan
American Games (Fig. 8). It was here that CASS was founded.
Figure 8. The Canadian Association of Sports Sciences (CASS) was the forerunner of CSEP/SCPE. CASS was officially inaugurated at a meeting of Sports Scientists in Winnipeg that accompanied the Pan American Games of 1967. The published account of the meeting bears the title "Environmental effects of work performance."
Dr. Cumming frequently took unpaid leave from his hospital practice to attend meetings of both CASS and the European Pediatric Work Physiology group (a group of Clinical Exercise Physiologists interested in promoting the health of children and adolescents). Dr. Cumming quickly criticized the field performance tests that were widely used by Physical Educators during the 1960s, underlining that a child's scores on such a test battery reflected the individual's body size and maturity as much as his or her physical fitness.
He argued for the replacement of such field testing by objective measurements such as the Physical Work Capacity at a pulse rate of 170 beats/min (PWC170). Perhaps in consequence of this, he was an early advocate of the careful calibration of cycle ergometers, and he made frequent surveys of PWC170 in healthy subjects and in children with congenital heart disease. He also highlighted urban/rural and seasonal differences of PWC170, and he underlined the apparent failure of the physical education programmes of the 1970s to enhance the physical fitness of Canadian school children. His critical gaze also rested on the Canadian Home Fitness Test (CHFT, see below), as he noted that the rhythm of the long-playing record setting the stepping cadence apparently differed from the intended beat frequency by a margin as large as 10 percent. I traced the problem to a tendency of cheap turntables to slow as the centre of a recording was approached, and humorous suggestions were made that we should set up a fund to buy Dr. Cumming a quality home stereo system. Nevertheless, Dr. Cumming's criticism of popular use of the CHFT recording was valid, since in that era most households were not using high quality turntables. Fortunately, the problem was solved, as the vinyl record was replaced, first by a tape-recording, and subsequently by a CD.
Another important interest of Dr. Cumming was the use of the electrocardiogram in identifying patients with exercise-induced myocardial ischaemia. This interest led him to accept a post as Medical Director of Great West Life Insurance in 1981. He became Vice-President of this company, and his further involvement in Exercise Physiology research was necessarily curtailed, although he continued to serve as an expert witness in Human Rights enquiries involving the possible development of myocardial ischaemia when older workers engaged in physically demanding employment.
Don Bailey. Dr. Don Bailey (Fig. 9) was born in Saskatchewan, and obtained a B.A. in Mathematics from the University of Saskatchewan in 1955. Like other Canadians of his generation, he faced the problem that graduate Exercise Science programmes were lacking in Canada, so he travelled to Ohio and Indiana where he obtained a doctorate in Physical Education. In 1959, he returned to the College of Kinesiology at the University of Saskatchewan, and with the departure of Dr. Bill Orban for Ottawa, he assumed responsibility for the Longitudinal Study of Child Growth and Physical Development. With Roy Shephard (below), he developed the Canadian Home Fitness Test (Fig. 10). He also undertook a major community-wide fitness promotion initiative in the city of Saskatoon, in collaboration with ParticipACTION (a Crown Agency directed by Russ Kisby that was charged to increase popular interest in physical activity). Don's expertise led to several prestigious appointments as Visiting Fellow, notably at the Institute of Child Health in London, at San Diego State University, and at the Universities of Queensland and Western Australia. In 1991, his interests shifted somewhat to the interactions between physical activity and bone health, and he initiated an innovative and widely acclaimed longitudinal study of bone mineral accrual in children and young women.
Figure 9. Dr. Don Bailey, for many years Director of the Longitudinal Study of Child Growth and Development in Saskatoon.
Dr. Bailey was one of an elite group of six individuals who saw the need to found CASS as a group that would marry the concerns and interests of Physicians and Physical Educators. Representatives from the Canadian Medical Association were Sam Landa, John Merriman and Max Avren, and from CAHPER Don Bailey, Howard Nixon, and John Leicester. In 1991, Dr. Bailey received the Honor Award of CASS (now the Canadian Society for Exercise Physiology, CSEP). He also received an Honor Award from CAHPER. As Professor Emeritus, his research studies are on-going, both in Canada and in Australia.
Figure 10. The Canadian Fit Kit was a fitness promotional package introduced by the Directorate of Fitness & Amateur Sport. Among other items, it included the PAR-Q and a long-playing record that allowed the population to estimate their cardio-respiratory fitness at home, and to chose an appropriate exercise programme based on this information.
John Faulkner. John Faulkner (Fig. 11) is a Canadian-born investigator who has made major contributions to our understanding of Exercise Physiology. He served as a fighter pilot in the RCAF from 1942-1945, and on his discharge from the Air Force pursued studies at the University of New Brunswick, Queens University and the Ontario College of Education. He then taught high school for five years, pursuing graduate education during the summer months. After gaining his M.Sc. degree, he became an Assistant Professor and swim coach in the Department of Physical Education at the University of Western Ontario. In 1960, he moved to the University of Michigan (Ann Arbor), and he has continued to serve this university for almost five decades.
Figure 11. Dr. John Faulkner is a Canadian-born Exercise Physiologist who has for many years studied muscle function in health, disease and aging at the University of Michigan, Ann Arbor, MI.
Dr. Faulkner's more recent research has focused specifically on the contractile properties of whole skeletal muscles, motor units, and single skeletal muscle fibers from mice and rats, and single fibers from muscle biopsies of humans. In particular, he and his associates have focussed on muscle typing, and the role of satellite cells. They have explored the changes that occur in the contractile properties of skeletal muscle during and following injuries caused by strong muscular contractions, denervation, reactive oxygen species, aging, and Duchenne and upper-limb girdle muscular dystrophies. Regardless of the cause of injury, skeletal muscle regeneration has been shown to involve the activation and division of satellite cells. Depending on the magnitude of injury to the muscle and its related vasculature, transient or permanent functional deficits develop in maximum force, rate and magnitude of length change, and consequently in power output. The long-term objective of Dr. Faulkner's research team has been to elucidate the physiological mechanisms underlying the decrease of peak force in aging muscle fibres, and thus to devise methods of reducing the functional losses associated with injury, aging and muscular dystrophies.
Most of Dr. Faulkner's professional career has evolved within the context of ACSM rather than CASS/CSEP, and in 1992 his contributions were recognized through the Honour Award of that College.
Roy Shephard. After completing doctoral studies in Physiology and in Cardiology at Guy's Hospital (Fig. 12), a branch of the University of London, Dr. Shephard worked as an Applied Physiologist at the Royal Air Force Institute of Aviation Medicine, the Department of Preventive Medicine in the University of Cincinnati, and the U.K. Chemical Defence Experimental Establishment at Porton Down, Wiltshire. He was attracted to Canada in 1964 by the opportunity to serve as Director of the University of Toronto Fitness Research Unit, where he established a doctoral programme in Exercise Sciences through the School of Hygiene. The first graduate of that programme, in 1966, was Dr. Terry Anderson. His thesis examined various methods of measuring the pulmonary diffusing capacity during maximal exercise.
Figure 12. Dr. Roy Shephard was appointed as Director of the Toronto Fitness Research Unit, and has been associated with the University of Toronto for some 50 years.
He studied limiting segments in the oxygen transport chain from the atmosphere to the working muscle, assessed the fitness levels of ordinary and athletic Canadian populations, and wrote a number of texts on various aspects of exercise and physical fitness. Other early challenges included organization of the 1966 International Symposium on Physical Activity and Cardiovascular Health (above), hosting of the 1966 World Health Organisation/International Biological Programme working party on the measurement of maximal oxygen intake (below), and synthesizing information on the physical working capacity of world populations for the International Biological Programme. In conjunction with students Andris Rode and Gaetan Godin, he assumed responsibility for the Canadian contribution to the IBP Human Adaptability Project, initiating longitudinal studies on the fitness and working capacity of Inuit living in the Igloolik and the Melville Peninsula (1969-1990).
Collaboration with Dr. Hugues Lavallée of the University of Québec at Trois Rivières allowed initiation of a large scale controlled quasi-experimental study of physical education in Québec primary school students (1970-present). Collaboration with Dr. Terence Kavanagh and the Toronto Rehabilitation Centre began around 1965. This subsequently led to involvement in a multicentre trial of exercise for post-coronary patients led by Dr. Peter Rechnitzer (Fig. 13), participation of cardiac patients in the Boston Marathon (below), and the use of exercise testing to determine long-term prognosis in various cardiac conditions. Other cooperative ventures included development and evaluation of the Canada Home Fitness Test with Dr. Don Bailey at the University of Saskatchewan (1973-74)(Fig. 10), and (in collaboration with Dr. Art Salmon of Fitness Ontario) a quasi-experimental study of work-site fitness programmes at the Canada Life and North American Life Insurance Companies (1978-1990).
Figure 13. The multi-centre Ontario Exercise-Heart Trial was a randomized controlled trial examining the value of exercise following myocardial infarction organized by Dr. Peter Rechnitzer, of the University of Western Ontario. Study participants included:
Front Row: David Cunningham, Roy Shephard, Peter Rechnitzer, Norman Jones, Neil Lefcoe, John Sutton
Second Row: Robin Campbell, Neil Oldridge, Mike Yuhasz, Terry Kavanagh, George Andrew, Sasha Sangal (statistician)
In 1979, Dr. Shephard became Director of the School of Physical and Health Education at the University of Toronto, and his laboratories were moved to the newly constructed Warren Stevens complex. This provided greatly expanded research space, and it allowed the graduate programme in Exercise Sciences to expand from a small handful of students to 40-50 candidates, often with several post-doctoral fellows also working in the laboratory. A close collaboration developed with the (then) Defence and Civil Institute of Environmental Medicine at Downsview, ON, with many of the government scientists becoming cross-appointed to the graduate programme in Exercise Sciences. This allowed students to examine exercise responses when combined with exposure to heat or cold stress, and permitted (in collaboration with Dr. Pang Shek) emergence of the first human programme in Exercise Immunology at a Canadian university.
Throughout his career, Dr. Shephard was closely associated with both CASS/CSEP (President 1970-71, first recipient of an Honour Award in 1985), and ACSM (President, 1974-75, Honour Award recipient 2001). He retired from the University of Toronto in 1994, but served for a further four years as Canadian Tire Acceptance Distinguished Fellow in Exercise Physiology at Brock University. Since 1998, he has lived in the village of Brackendale (in rural British Columbia), but continues writing and research through the magic of the internet and on-line journals.
Claude Bouchard. Dr. Claude Bouchard (Fig. 14) is the most widely published of Canadian Exercise Physiologists. Data-bases such as HealthStar/Ovid credit him with more than 800 peer-reviewed publications. After completing a bachelor's degree at Laval University in 1962, he faced the problem common to his generation of the need to travel to the United States for graduate training. He completed an M.Sc. degree in Exercise Physiology at the University of Oregon, and a doctorate in Population Genetics at the University of Texas at Austin.
Figure 14. Dr. Claude Bouchard was for many years Director of the Exercise Research Programme and the Québec Family Study at Université Laval, Québec City, and he subsequently became a prominent player in the human genome project. He then served as Executive Director of the Pennington Biomedical Research Center of the Louisiana State University System, at Baton Rouge, LA, before returning to Laval as professor Emeritus..
He then returned to Laval University, in Québec City, where he directed the Exercise Research Programme for many years. His interests spanned an impressively wide range of topics, but he attracted particular international attention by the "Québec Family Study." This investigation explored relationships between genetic and environmental components of an individual's inheritance, and many facets of human performance and the training response. The quality of his research attracted Honour Awards from both CASS (1988), and ACSM (2002), the Order of Canada (2001) and L'Ordre National du Québec (2005), along with prestigious awards from a number of other professional societies in both Europe and North America. With the emergence of the human genome project, his laboratory played a leading role in identifying components of the genome associated with physical performance and conditioning response. He also became a leading international figure in research on obesity, the metabolic syndrome, and diabetes. He carefully examined the contribution of genetic factors to development of these conditions, and served as president of both the North American Association for the Study of Obesity, and the International Association for the Study of Obesity. He was also a prominent member of CASS, serving as its president (1985-86), and he played a leading role in organizing the international consensus conferences of 1988, 1992, and 2000 (see below). It was a great loss to Canadian exercise physiology when he decided to accept the George A. Bray, Jr. Chair in Nutrition and serve as the Executive Director of the Pennington Biomedical Research Centre, a campus of the Louisiana State University System, in Baton Rouge. Happily, he has now returned to Laval University as Professor Emeritus.
David Cunningham. Dr. David Cunningham (Fig. 15) was born and raised in Toronto. He received a B.A. from the University of Western Ontario in 1960, and an M.Sc. from the University of Alberta in 1963, but like many of his contemporaries, he found it necessary to travel to the U.S. for his Ph.D, which he completed in 1966. He became involved in in the landmark Tecumseh Community Health Study. In 1969, he returned to the University of Western Ontario (UWO), accepting joint appointments in Physiology and Physical Education; he continued in this role until 2001, and is now a Professor Emeritus of that institution.
Figure 15. Dr. David Cunningham has pursued Exercise Physiology for many years at the University of Western Ontario. He is perhaps best known for his leadership in the Canadian Centre for Activity and Ageing.
Dr. Cunningham has made major contributions to many areas of Exercise Physiology, including the aerobic performance of young children, and the rehabilitation of cardiac patients (he served with Dr. Peter Rechnitzer, Norm Lefcoe, Mike Juhasz, and Sasha Sangal in operating the UWO component of the Ontario Multi-Centre Exercise Heart trial, Fig. 13). However, perhaps his best-known contributions to the discipline have come through his systematic studies of exercise and ageing. He was the driving force behind formation of the Centre for Activity and Ageing (now the Canadian Centre for Activity and Ageing) at UWO, and in collaboration with Don Paterson he has completed important longitudinal studies showing the importance of regular physical activity to the maintenance of health and independence in advanced old age. Dr. Cunningham has been a consistent supporter of CASS, serving two terms as Editor-in-Chief of the Canadian Journal of Sport Sciences, and receiving the Honour Award of the Association in 1995. He also founded the Ontario Exercise Physiology group, which has in essence served as a regional chapter of CSEP/SCPE.
Norman Jones. Dr. Norman Jones (Fig, 16) is another physician and exercise scientist who was attracted to Canada from Great Britain during the 1960s. He began his career at the Hammersmith (London) Post-graduate Medical School in the Department of Dr. Moran Campbell, in 1961. He emigrated to St. Joseph's Hospital in Hamilton with Dr. Campbell when the new Medical School was established at McMaster University in 1968. Both scientists served in the Clinical Department of Respirology; Norman Jones continued and expanded his studies of the human exercise response when in Hamilton.
Figure 16. Dr. Norman Jones has made many notable contributions to cardiac and respiratory exercise physiology since accepting academic appointments at McMaster University Medical School and St. Joseph's Hospital in Hamilton, ON.
Dr. Jones focussed particularly on individuals with cardio-respiratory disease and resulting disturbances of acid-base balance, linking acid/base changes to lactate levels, and exploring mechanisms of dyspnea. A second area where he made a major scientific contribution was in the estimation of cardiac output from the exchange of carbon dioxide, using a rebreathing method. In association with Lydia Makrides, he also worked towards the establishment of normal standards for maximal power output, heart rate, and ventilation. Collaborating with Dr. Tony Sergeant, he explored interactions between maximal oxygen uptake and muscle strength. With John Sutton (below), he also directed the McMaster component of the Ontario Multi-Centre Exercise-Heart trial (Fig. 13). He made a particularly important contribution to CASS by insisting on the standardization of methodology in Canadian Exercise Science laboratories; in consequence, measurements of maximal oxygen intake and related variables could be compared with confidence between different university laboratories. Previously, measurements on the same individual had sometimes shown inter-laboratory differences as large as 25 percent, a particularly important consideration in Canada, where problems of distance led to athletes being tested in many different laboratories at different times.
Dr. Jones' scientific contributions were recognized by the Award of a Citation by ACSM in 1986. He currently continues as Professor Emeritus within the Department of Respirology at McMaster Medical School in Hamilton.
Oded Bar-Or. Dr. Oded Bar-Or (Fig. 17) graduated in Medicine from the Hadassah Medical School in Jerusalem. He then undertook post-graduate training in Exercise Physiology with Elsworth Buskirk at Penn State University, visiting the University of Toronto as a member of the WHO/IBP Working Party on the Standardization of Fitness Testing (see below). He returned to Israel, and established an outstanding Exercise Physiology laboratory at the Wingate Institute in Netanya; this is perhaps best known for development of the "Wingate Test" of anaerobic power and capacity.
Figure 17. The late Dr. Oded Bar-Or, Director of the Chedokee-McMaster Children's Exercise and Nutrition Centre,, and known world-wide for his expertise in the exercise responses of children.
In 1981, Dr. Bar-Or moved to McMaster University, founding the Children's Exercise and Nutrition Centre at Chedoke Hospital in Hamilton. He became an acknowledged world expert in Pediatric Work Physiology, serving as a prominent member of the European Work Physiology Group, and writing what has become a standard text of Pediatric Sports Medicine. His contribution to ACSM was recognized by the award of a Citation (1992). He was also strongly committed to CASS/CSEP, serving as its President (1987-88), and receiving the Honour Award in 2005.
Dr. Bar-Or focussed both his research and his clinical attention on overweight children, being one of the first of the scientific community to express concern about the growing epidemic of obesity. While in Hamilton, he developed a multi-disciplinary team of researchers who created and delivered effective individualized nutrition and physical activity programmes for children, at the same time spearheading many research investigations of childhood obesity. He is also well known for his studies of heat tolerance in children. He retired from McMaster University in 2003. Unfortunately his career as an Emeritus professor and world-wide lecturer was cut short by his death from cancer in 2005.
Howie Green. Dr. Howard Green (Fig. 18) graduated from the Physical Education programme at Queen's University, Kingston, ON in 1962, and completed an M.A. degree in Physical Education/Physiology at the University of Alberta before travelling to the University of Wisconsin, where he completed his Doctoral training in 1972. He played an important role in establishing the Kinesiology programme at the University of Waterloo, beginning as a lecturer in 1965, and rising to the rank of Full Professor in 1983. His research has spanned a variety of aspects of Exercise Physiology and Biochemistry, including the effects of hypoxia, ischemia, and hypervolaemia on oxygen transport, and various aspects of performance in ice-hockey. However, his main focus of interest has been the acute and chronic cellular and molecular changes occurring in skeletal muscle in response to disturbances of energy homeostasis.
Figure 18. Dr. Howie Green, currently Distinguished Professor Emeritus at the University of Waterloo, has worked in many areas of exercise physiology, including studies of ice hockey and hypervolaemia, but is best known for his investigations of the cellular physiology of muscle in health and disease.
With Bert Taylor, he played an important part in introducing the Cellular Physiology of Exercise to Canadian investigators, and he has collaborated successfully with a number of renowned international laboratories in this same area of research, most notably with Dr. Dirk Pette and his German colleagues at the University of Konstanz in Bavaria. He has also made significant contributions to our understanding of skeletal muscle in such disease states as chronic heart failure and chronic obstructive pulmonary disease. His observations have challenged a number of long-held beliefs concerning metabolic regulation. In particular, he has demonstrated that adaptations designed to protect energy homeostasis occur soon after the onset of regular exercise, independently of any increases in mitochondrial potential, but closely integrated with sodium and potassium trans-membrane regulation, and the handling of calcium by the sarcoplasmic reticulum.
Dr. Green's scientific contributions were recognized by an Honour Award from CASS/CSEP (1987), and a Citation from ACSM (2002). His career has continued as a Distinguished Professor Emeritus at the University of Waterloo following his formal retirement in 2005.
John Sutton. The late Dr. John Sutton (Fig. 19) was another distinguished migrant to Canada, After graduating in Medicine from the University of Sydney in 1965, he established the Sydney Human Performance laboratory, and (as a marathon runner himself), he showed a keen interest in the physiology of distance running. He underlinied that participants in fun runs were vulnerable to heat stroke, and explored various hormonal changes associated with participation in endurance exercise. In 1972, he was awarded the Royal Australian College of Physicians Overseas Fellowship. This brought him to McMaster University in Hamilton, Ontario. Here, he taught and conducted research on many aspects of exercise physiology, most notably studying hypoxia and altitude sickness both on Mount Logan and in high altitude chambers. Every summer between 1973 and 1980, John and his collaborators travelled to the Yukon, conducting rigorous experiments at altitudes of some 6,000 m. On at least one occasion, he had to run repeatedly over this rugged terrain to flatten a small snow-covered landing strip so that an aircraft could convey the research team back to Hamilton! His commitment to this topic is marked in perpetuity by the prestigious biennial International Hypoxia Symposia that began in 1979, and by the annual CSEP/SCPE John Sutton Memorial Lecture.
Figure 19. The late Dr. John Sutton, faculty member of McMaster University, is best known for his contributions to Environmental Exercise Physiology, and the Banff International Hypoxia Symposium.
Dr. Sutton played an important role in the McMaster component of the Ontario Multi-Centre Exercise-Heart study, and he served as a president of ACSM. It was a considerable loss to Canadian Exercise Physiology in Canada when he decided to return to Australia (1989), accepting senior academic appointments at the then Cumberland College of Health Sciences, and the Medical Faculty of the University of Sydney. Exercise Physiology suffered an even greater loss when he died in 1996, at the early age of 55 years.
The Canadian Society For Exercise Physiology
This section considers the history of the Canadian Society for Exercise Physiology (CSEP) and two of its more important contributions- the publication of an internationally respected peer-reviewed journal (currently entitled Applied Physiology, Nutrition and Metabolism) and the certification of several categories of well-trained specialists in Exercise Physiology.
History of CSEP/SCPE. The Canadian Society for Exercise Physiology (originally known as the Canadian Association of Sport Sciences, CASS) is a voluntary organization composed of both professionals involved in fitness and physical activity programming across Canada and Academics engaged in the scientific study of Exercise Physiology, Exercise Biochemistry, Exercise Immunology, Physical Fitness and Health. Following preliminary discussions between three representatives of the Canadian Medical Association (CMA) (Sam Landa, John Merriman, and Max Avren), and an equal number from CAHPER (Don Bailey, Howard Nixon, and John Leicester), CASS was formally established at a scientific meeting that accompanied the Winnipeg Pan American Games of 1967, The primary objective of the organization, as seen at that time, was to achieve a rapprochement of the divergent interests in Physical Activity and Health represented by the CMA and CAHPER.
Fig. 20. Programme of the only joint meeting between CASS and ACSM, held at the Inn on the Park, Toronto, in 1971.
Two of the first three presidents of the newly formed association were physicians who cared for athletes (Drs. Sam Landa, and Max Avren). Although excellent clinicians, they had only a limited interest in the finer points of Exercise Physiology. The organization took a stronger physiological stance when Dr. Shephard became its fourth president (1970-1971), and the only joint meeting of CASS and the American College of Sports Medicine was hosted at Toronto's Inn on the Park in May of 1971 (Fig. 20). Dr. Shephard negotiated an agreement with ACSM stipulating that the registration fees of those attending the meeting would be distributed on the basis of nationality, and since many Canadians normally attended the ACSM annual meeting, but relatively few Americans participated in Canadian meetings, this proved a very advantageous arrangement for Canadian coffers. The meeting followed shortly after the FLQ (Front de Libération de Québec) crisis of October 1970, and the decision of the hotel chef to process a "bombe flambé" into the annual dinner of the Society produced a mixture of amusement and consternation!
Because of travel costs, attendance at early meetings of CASS was relatively sparse. The economics of the annual meetings were further compromised by the decision to offer simultaneous translation of proceedings, even in strongly Anglophone cities such as Vancouver and Saskatoon. The Francophone attendance at meetings was usually quite limited, and almost all of those who attended the CASS sessions spoke excellent English. Speakers were occasionally disconcerted to see a group at the rear of the room laughing helplessly at attempts of the commercial translator to express scientific terms in an acceptable French. Dr. Shephard argued that we should expect Canadian academics to show reasonable fluency in both Canada's official languages, and eventually it was decided that attempts to translate the proceedings were an unwarranted expense. However, the official documents of CSEP are still made available in both official languages.
Although the initial intent of CASS was to bridge the gap between physical educators and physicians, as early as 1969 the physicians had established a steering committee to develop an independent Canadian Academy of Sport Medicine. From the viewpoint of the physicians, an organization specific to medical practitioners would give a stronger clinical focus to presentations; further, it would permit the development of examinations that would allow certification of Sport Medicine as a distinct specialty recognized by the Canadian Medical Association. As the knowledge of Exercise Science increased, other members of CASS with interests in Biomechanics, Sociology, Psychology, and Psychomotor Learning began organizing their own specialized conferences, further fragmenting Canadian Sports Science expertise. The issue of "separatism" was debated vigorously at a number of annual meetings of CASS, and the hope was frequently expressed that it might serve as an umbrella organization, bringing together all who were interested in the scholarly study of Exercise and Health. Distinguished lecturers in disciplines other than Exercise Physiology were invited to give major presentations at the annual meetings of CASS, but sadly, they were sometimes greeted by an audience of only three or four people.
Finally, Exercise Physiologists recognized that they were the only people strongly committed to CASS, and in recognition of this situation the name was changed from CASS to the Canadian Society for Exercise Physiology in 1992. The new organizational format proved effective. Meetings began to attract a growing attendance, including Exercise Scientists with interests in Biochemistry and Nutrition, and there was a growing participation of investigators from northern U.S. States. The reformatted Society also began a liaison with the Canadian Federation of Biological Societies, starting in 2000.
Important initiatives of CASS and CSEP have included the publication of two journals (below), the development of position stands on key issues in exercise physiology, and the Certification of Professional Exercise Physiologists. Currently, the annual meeting includes two or three days of scientific papers (including the John Sutton Memorial Lecture), and a final day when more general topics are communicated to Certified Exercise Physiologists working in community rather than university settings.
Scientific Journals. When CASS was founded, there was hope of publishing a scientific journal jointly with ACSM. Dr. Shephard attended several meetings of the ACSM, Board of Directors, mostly in Chicago, but despite strong pleas to the first editor-designate (Dr. Bruno Balke), the loudest of the U.S voices on the ACSM Board expressed confidence in their ability to publish a journal without any Canadian participation. As a small sop to the Canadian overtures, Dr.Shephard was appointed a section editor of Medicine & Science in Sports (as it was then termed) for the first five years of its publication.
The Board of CASS continued to press for a scientific journal that could be distributed to its members as a component of annual dues, and in 1976 it was decided to launch what was initially termed the Canadian Journal of Applied Sport Sciences. This was self-published from 1976 to 1986, and was then published by the University of Toronto Press (under the shortened title of Canadian Journal of Sport Sciences). The first editor was Dr. Bert Taylor (1975-79). He was succeeded by Dr. Eric Bannister (1980-84), Dr. David Cunningham (1985-1988), and Dr. Roy Shephard (1988-1991), At this stage, CASS still hoped to attract investigators from disciplines other than Exercise Physiology, and the published articles covered a correspondingly wide range of interests. In an attempt to introduce members to a broader spectrum of the Exercise Sciences, Dr. Shephard took the initiative of commissioning short editorials to accompany submissions.
Some members of the CASS Board thought that Human Kinetics might offer a better deal than the University of Toronto Press in terms of printing costs, and production of the journal was transferred to Human Kinetics in 1990. In 1992, the page size was reduced from quarto to octavo format (typical of most Human Kinetics journals); this change certainly did not increase the popularity of the journal with librarians! Editors during this period were Dr. David Cunningham (1992-94), and Dr. Phil Gardiner with Dr. François Perronet (1995-1999). Submissions continued to rise, but great difficulty was experienced in negotiating any increases of page length with Human Kinetics, and in 2006 the decision was made to transfer publication once again, this time to the National Research Council Press, under the new title of Applied Physiology, Nutrition & Metabolism (APNM). The new publisher proved a happy choice. The journal reverted to a quarto format, and with a considerably increased page allowance, it appeared at first bimonthly, and starting in 2013, monthly. An electronic, on-line version also became available. Under the guidance of Dr. Terry Graham (editor 2000 – to date), the journal is currently attracting considerable international attention, and high quality articles are published from many corners of the globe. By 2007, the impact factor had reached a very creditable 1.57, and in 2013 the journal web-site indicated a 5-year average value of 2.40. CSEP currently has three position stands, on resistance training in children and adolescents, exercise in pregnancy and post-partum, and the use of instability to train the core in athletic and non-athletic conditioning. All have been published in APNM.
The orientation of Applied Physiology, Nutrition & Metabolism has shifted progressively towards the "pure" science of Exercise and Nutrition, and some members of CSEP, particularly those involved in the delivery of clinical fitness and health programmes, felt a need for a second journal that addressed their applied interests more specifically. In 2008, the open-access, on-line Health & Fitness Journal of Canada was thus born under the very capable leadership of Dr. Shannon Bredin. Its stated mission is to publish information that "can be applied directly to improve the health and well-being of Canadian Society." It is currently appearing 3-4 issues per year, with articles that cover a wide range of interests in Health and Physical Activity.
Certification of Professional Physiologists. The Health and Fitness Programme of CSEP introduced the Professional Certification of Exercise Physiologists in 1981, under the able leadership of Dr. Norm Gledhill of York University (CASS President 1981-82, Honour Award Recipient 1999). The Certification has twin objectives: to protect consumers by regulating standards of practice for Fitness Professionals, and to give appropriate recognition to those Professionals with appropriate advanced qualifications.
There are currently two levels of certification, based on a candidate's academic background and work experience. Level 1 is introductory, and Level 2 (the advanced level) is only open to candidates with a university degree. Level 1 candidates earn the title of CSEP Certified Personal Trainer® (CSEP CPT) qualification. They are required to complete successfully two modules covering CPAFLA Fitness Assessment Protocols and Exercise Prescription. Level 2 candidates earn the CSEP Certified Exercise Physiologist® (CSEP CEP) qualification. They must first complete a 4-year university degree in Kinesiology/Human Kinetics/Health Sciences. The Level 2 certification is intended primarily for Kinesiologists who wish to specialize in the Health, Fitness, and Rehabilitation industry.
A sampling of unique Canadian contributions to exercise physiology
As with the listing of prominent exercise physiologists, it is controversial to pick out for more detailed discussion a few of the many unique Canadian contributions to the exercise sciences. I have chosen to consider the following:
- the 5BX/10BX exercise programme,
- hosting of the WHO Working Party on the Standardization of Maximal Oxygen Intake Measurements,
- International Biological Programme (IBP) studies of the Inuit,
- the nation-wide CAHPERD testing of PWC170 in schoolchildren,
- development of the Canadian Home Fitness Test
- related exercise clearance procedures (PAR-Q and PAR-MED-X),
- nation-wide surveys of physical fitness conducted by the Canadian Fitness and Lifestyle Research Institute (CFLRI),
- the Trois Rivières quasi-experimental study of physical activity in primary school students,
- the participation of post-coronary patients in the Boston Marathon, and
- the development of evidence-based guidelines for physical activity at various ages, and in various clinical conditions.
5BX and 10 BX exercise programme. Dr. Bill Orban originally created the five and ten basic exercise plans (5BX and 10 BX) were created for Royal Canadian Air Force pilots (Fig. 7). These simple and straight-forward exercise plans offered an attractive approach to the enhancement of personal physical fitness in that no specialized equipment was required, and participants could complete their programmes in as little as 11 minutes per day. The system was developed by Dr. Orban while studying at the University of Illinois. He had noted that long periods of exercise did not necessarily enhance performance more than shorter training sessions, provided that subjects adopted an adequate intensity of exercise. His conclusions were not universally accepted, but nevertheless the 5BX pamphlet in particular proved very popular; 23 million copies have been sold, and it has been translated into 13 different languages.
Standardization of Maximal Oxygen Intake Testing. The Human Adaptability Project of the International Biological Programme (IBP), initiated by Dr. J. S. Weiner of the London School of Hygiene during the late 1960s, contemplated a concerted attempt to document the range of biological characteristics then existing in various small and geographically isolated tribes that had adapted culturally and genetically to challenging habitats, but had not yet been "contaminated" by modern civilization.
One issue of particular interest was to assess the range of maximal oxygen intake values found in such disparate groups as very sedentary populations and elite endurance athletes. Data contributing to the IBP programme were necessarily collected by scientists drawn from a wide range of countries, and (as in the cross-Canada data standardization discussed above), it was vital to obtain international agreement on standardized methods of measuring maximal oxygen intake and other indices of human physiological work capacity. In collaboration with the World Health Organisation, the IBP thus convened a bench-level working group that met in the laboratories of the Toronto Fitness Research Unit. Participants in this "bench-level" initiative included Exercise Physiologists drawn from many of the main centres that were then involved in such measurements around the world. In order to test various potential protocols, a panel of 24 highly motivated subjects committed themselves to a very demanding schedule, completing measurements of maximal oxygen intake five times per week for a total of five weeks. Direct measurements of maximal oxygen intake and a range of cognate variables were also made for the first time on a representative sample of Toronto schoolchildren. Canadian Exercise sScience gained considerable recognition as a result of this working party and resulting publications (Shephard, 1968 ; Shephard, 1978).
IBP studies of Inuit. It was agreed with Dr. Wiener that one of the North American contributions to the IBP Human Adaptability Project would be a systematic study of adaptations to the arctic environment, as seen among three differing Inuit populations. The U.S. made some measurements of maximal oxygen intake at Fort Wainwright, Alaska, and Scandinavian investigators also completed limited observations on a Greenlandic population, but the most comprehensive study was undertaken at a field station in the community of Igloolik, at the tip of the Melville Peninsula (Fig. 21). Much modern laboratory equipment was flown to the arctic, allowing a full range of sophisticated tests of health and fitness to be completed on all willing villagers from primary school to old age. The uniqueness of the Canadian study is that investigators continued to visit the village over the next 20 years, thus allowing documentation of a progressive deterioration in the PhysicaL Fitness of the community as it became acculturated to a southern Canadian lifestyle (Shephard and Rode, 1996). Members of the research team also accompanied the Inuit on traditional hunting expeditions, obtaining unique data on the very high energy cost of such activities, and allowing an economic analysis of relationships between the energy expended in hunting and its yield in terms of foodstuffs.
Figure 21. IBP Study of the Canadian Inuit living at Igloolik, conducted largely by the University of Toronto.
CAHPER National Testing of PWC170 in Canadian schoolchildren. During the 1960s, most Exercise Physiologists paid remarkably little attention to issues of population sampling. Observations were commonly made on the principal investigator, immediate colleagues and a few laboratory technicians. Physical Educators also were mainly content to infer levels of Physical Fitness from simple field tests of performance that were vulnerable to issues of motivation, environment and the body size of participants. However, in 1966, the Canadian Association for Health, Physical Education, and Recreation (CAHPER) under the leadership of Dr. Max Howell (Fig. 22) and the University of Alberta embarked upon a unique and innovative programme, taking Monark ergometers into schools to measure the PWC170 on a large sample of children aged 10 to 17 years, using a sample that was statistically representative of Canadian students in this age range (Howell & MacNab, 1968). This allowed them to develop norms for the entire Canadian population.
Figure 22. Max Howell led the CAHPER study of PWC170 in a representative sample of Canadian schoolchildren aged 10-17 years during the summer of 1966. He is here wearing the recently awarded Order of Australia.
Development of the Canadian Home Fitness Test. One of the interesting findings from the Toronto IBP Working Party on the Standardization of Fitness Testing (above) was that subjects could be brought to within 3-4 percent of their treadmill maximal oxygen intake using a simple double step (total height of 0.457 m, climbed and descended by taking three paces in each direction). Previous authors had tended to dismiss the effectiveness of step testing, perhaps because many of them had used taller steps that many subjects found difficult to climb. However, an effective step test offered a valuable alternative to the treadmill, particularly when testing people in their own homes or in the more remote parts of Canada. Igloolik, for example, lacked the 30 ampere power supply needed for a treadmill, and even if this difficulty could have been circumvented, it is doubtful if most types of treadmill could have been loaded onto the small de Havilland Dash-6 and Dash-7 aircraft serving that community. Thus, the IBP team substituted the 0.457 m double step. In order to ensure that Inuit subjects maintained an appropriate stepping cadence, the Inuit equivalent of 1-2-3 was chanted on a rising and then on a descending scale throughout the progressive, multi-stage test.
This approach was tested further on a large sample of the Saskatoon population. Groups of sixteen subjects of similar age and sex climbed and descended long benches to an appropriate rhythm that was set by metronome (Bailey, Shephard & Mirwald, 1976; Fig. 23). This study suggested that large-scale home fitness testing would be possible, using a similar type of step, if a long-playing gramophone record was provided to set an age and sex appropriate rhythm for the individual subject. The idea seemed to have commercial potential, but neither Don Bailey nor I had any experience in the marketing of long-playing records, so we decided to "sell" the idea to the Crown Corporation which had recently been set up to promote the fitness of the Canadian population (ParicipACTION, established in 1971). The contract specified that Dr. Bailey and I would each be paid one third of a cent for exclusive rights to the concept, although we have yet to receive this unique coinage!
Figure 23. The concept for the Canadian Home Fitness Test was evaluated on a large population sample in Saskatoon in 1973. Groups of 16 age and sex-matched subjects performing the test simultaneously to a rhythm set by a metronome.
Under government sponsorship, the concept of home fitness testing faced the inevitable bureaucratic hiccups. A band was hired to provide suitable martial music, but only after it had been delivered to the government did it occur to some Ottawa civil servant that the music should have been written in ¾ rather than 4/4 time. However, a suitable package was eventually assembled for mass use. This included the PAR-Q clearance sheet (below), the LP recording that set age and sex specific climbing rhythms, instructions for carrying out a sub-maximal exercise test, and some simple exercises that subjects could perform based on their test results (Fig. 10).
As noted above, Dr. Cumming pointed out that if a cheap turn-table was used to play the music, a problem of cadence developed as the needle approached the centre of the recording, but this difficulty was quickly resolved by the change to taped and then CD versions of the same music. The Canadian Home Fitness Test recording never achieved "platinum" sales, although a substantial volume of the test package was eventually sold through the unlikely outlet of official government book-stores. I suspect that with more aggressive commercial marketing, distribution could have been increased by at an order of magnitude.
Development of simple exercise clearance procedures. When planning the Saskatoon evaluation of the Home Fitness Test concept, Bailey and Shephard had an extensive preliminary discussion of test safety. They recognized that the test was essentially self-limited, and was carried to no more than 70-75 per cent of the individual's maximal oxygen intake, so that any risks of cardiac arrest or sudden cardiac death were very low for healthy subjects. Nevertheless, it was thought important to develop a simple and brief questionnaire that would identify those individuals who should consult a physician before engaging in the test.
Figure 24. The PAR-Q (Physical Activity Readiness Questionnaire) form, as currently used for exercise clearance.
The idea of a screening questionnaire was used successfully in Saskatoon, and was tested more formally in Vancouver by Dr. David Chisholm and his associates. They applied what were essentially the questions that we had used in Saskatoon to people attending the Pacific National Exhibition in Vancouver (Chisholm, Collis, Kulak et al., 1975), comparing findings with a physician's evaluation fo the same individuals. Based on this research, the standard PAR-Q form was developed (Fig. 24). The PAR-Q has since found widespread acceptance, both in Canada and around the world. Experience has suggested that it offers a safe clearance procedure both for exercise testing and for those contemplating a moderate exercise programme. The main practical objection to the
PAR-Q has been that a rather high proportion of the general population (about 20 per cent) are advised to seek further guidance from a physician. Minor modifications of the questionnaire have already been introduced in an attempt to correct unnecessary referrals, and a detailed restructuring has now been completed through the enthusiastic activity of a team led by Drs. Norman Gledhill, Darren Warburton, Veronica Jamnik and Sharon Bredin. (see below).(Warburton et al., 2011 a, b)
Attempts to develop a similar screening form for use by physicians (the PAR-MED-X) met less wide acceptance. Most physicians found the documents too complicated and time-consuming to complete. The PAR-MED-X has now been revised also, with the intent that it can be used by either Physicians or qualified Clinical Exercise Physiologists, using an electronic decision tree to speed progress throough a comprehensive screening process (Warburton et al., 2011c).
Figure 25. Dr. Cora Craig, Director of the Canadian Fitness and Lifestyle Research Institute, has directed several samples testing the Fitness and Physical Activity of large and representative samples of the Canadian population of all ages from 7 to 65 years.
Canadian Fitness Surveys; CLFRI. Having devised a readily portable test of aerobic fitness (the double step test, above), and an appropriate preliminary screening procedure (the PAR-Q test), Health Canada decided to undertake the ambitious project of making repeated measurements of multiple components of Health and Physical Fitness on a large and representative sample of the Canadian population at all ages between 7 and 65 years. The Canadian Fitness and Lifestyle Research Institute was established in September of 1980 under the very effective direction of Dr. Cora Craig (Fig. 25), and their first nation-wide survey was completed in 1982 (Canada Fitness Survey, 1983). Partly because of the large costs involved in this endeavour, most subsequent surveys have used questionnaires rather than direct physiological measurements to track on-going levels of physical activity and fitness in the Canadian population. However, the use of direct pedometer/accelerometer measures of physical activity patterns has recently been introduced as a part of the Canadian Health Measures Survey, sponsored by Statistics Canada and the Public Health Agency of Canada.
The Trois Rivières quasi-experimental study of primary school students. The Trois Rivières study, led by Dr. Hugues Lavallée (Fig. 26), was designed to examine the effects of incorporating five hours per week of professionally taught physical education into the primary school curriculum.
Figure 26. Dr. Hugues Lavallée. Medical Director of the Trois Rivières quasi-experimental study of physical education for primary school students.
The study was unique in many respects. Similar experiments in the United States continued for only one or two years, but the Trois Rivières intervention continued throughout primary school, grades 1-6. Moreover, and unlike other such studies, a quasi-experimental design was adopted; students in preceding and succeeding classes at the same school and under the same teachers served as the control group. The intervention was carefully monitored by telemetry to ensure that the five hours of exercise per week were of adequate intensity, and it was also demonstrated by diary records that there was no substantial compensatory reduction in leisure activity away from the school. The sample was large (546 students), and all attended an Exercise Physiology laboratory annually for a sophisticated range of investigations. Measures of Academic Attainment were also obtained from school and Provincial records; these demonstrated that experimental students had at least as good an academic performance as the controls (although they spent 14 percent less time learning academic material). Finally, because of the low population mobility in this region of Québec, Dr. François Trudeau and his associates at the Université de Québec à Trois Rivières found it possible to make exceptionally long-term follow-up observations on the same subjects when they had reached the ages of 30-35 years and 40-45 years. These unique long-term studies studies showed a modest persistence of the effects of the intervention in terms of both physical activity habits and avoidance of cigarette smoking (Shephard & Trudeau, 2005).
Quasi-experimental study of work-site fitness programmes. Another important first for Canada was a quasi-experimental trial of work-site fitness programmes. This was initiated by the University of Toronto, with the enthusiastic support of Art Salmon and his colleagues at Fitness Ontario. Most previous work-site studies had simply reported the observed short-term changes associated with introduction of a work-site fitness programme, and apparent responses were vulnerable to "Hawthorne" effects. However, the Toronto study compared changes in fitness and health between an experimental site (a large assurance company, Canada Life, Fig. 27) and a closely comparable control site (a nearby rival assurance company, North American Life). A detailed analysis of potential economic benefits was undertaken in terms of productivity, absenteeism, and employee turnover, and a particularly unique feature of the study was a direct comparison of OHIP Medicare billings between the two companies before and after institution of the programme (Shephard, 1986).
Figure 27. The first quasi-experimental study of the health and economic benefits of employee fitness programmes was conducted at the Canada Life Assurance Company in Toronto. The nearby North American Life Assurance Company served as the control site.
Participation of post-coronary patients in the Boston Marathon. The Toronto Rehabilitation Centre, under its former Director, Terry Kavanagh, was one of the first institutions in North America to offer vigorous rehabilitation programmes for individuals who had sustained a myocardial infarction, beginning in the mid-1960s. Dr. Kavanagh went on subsequently to include those who had developed compensated cardiac failure and those who had received a cardiac transplant. Through a close association with the University of Toronto graduate programme in Exercise Sciences, detailed physiological data were obtained on all patients, including direct measurements of peak oxygen intake.
One noteworthy early episode was the participation (under close medical supervision) of eight post-coronary patients in the 1973 Boston Marathon. A carefully planned programme of progressive aerobic training had increased the peak oxygen intake of participants from an initial 24-27 ml/[kg.min] to a peak of 53 ml/[kg.min] in one subject; this individual was able to complete the marathon in the very respectable time of 3 hours 17 minutes (Kavanagh et al., 1974). Another early proponent of cardiac rehabilitation (Dr. Herman Hellerstein, of Cleveland, Ohio) was very upset to find himself upstaged in this way, declaring the involvement of cardiac patients as "criminal folly." Nevertheless, he rather undermined his condemnation by claiming that he had persuaded one of his patients to run the marathon distance prior to the Canadian exploit! Dr.Kavanagh's team made careful studies of fluid and mineral balance over the course of several marathons, and (at a time when proprietary drinks were becoming popular among runners), it was established that the best replacement fluid was pure water.
The development of evidence-based physical activity guidelines. The last, but by no means the least important Canadian contribution to Exercise Science has been the development of clear evidence-based guidelines for physical activity in the general population, the elderly and youth (Health Canada/CSEP, 1998; 1999; 2002a, b, Fig. 28).
Figure 28. CSEP has been at the forefront internationally in developing physical activity recommendations for Adults, Children and the Elderly.
Canada has been in a unique position to develop such advice, given the series of major consensus conferences on Physical Fitness and Health that it has hosted. It is interesting to note that at an early stage Canadian physiologists were urging that the volume and intensity of physical activity recommended in other countries such as the U.S. was probably insufficient to counter some of society's current health problems, particularly the obesity epidemic.
What does the future hold for Canadian Exercise Physiology?
Despite the major contributions that Canadian scientists have made to the development of Exercise Physiology and Sports Science over the past fifty years, there remain many important challenges where further leadership can and will be contributed. Better information is needed on the safety of exercise testing and prescription both in health and disease, and the development of reliable statistics will require the establishment of a Canada-wide registry where all critical incidents occurring during exercise testing and programming can be recorded and evaluated.
Although many Canadian exercise programmes have now been operating with apparent success for many years, there is still a need for more precise information on both safety and an appropriate dosage of exercise. The PAR-Q clearance process (and its medical counterpart) are currently undergoing extensive review and revision. It is hoped that in future, a much larger fraction of those who wish to exercise will receive appropriate clearance, using a suitable modification of the PAR-Q process. Modern computer technology will allow a rapid and detailed interaction between the client and the computer programme, often without the need for referral to a Certified Exercise Physiologist or a Physician. Further, it should become possible to extend the clearance process currently designed for healthy individuals to include versions of the PAR-Q programme that are applicable to those affected by a variety of chronic medical conditions. This will probably require an extension of the responsibilities of Certified Exercise Physiologists, and possibly some extension of their training. Finally, definitive information may become available on that most elusive of goals, the optimal frequency, intensity, and duration of exercise to prescribe in both healthy individuals, and in those with various clinical conditions.
To date, most assessments of the costs and benefits of regular physical activity have been made in terms of overall mortality, but from the viewpoint of the patient, the critical issue is any resulting change in the quality of life. Analyses of costs and benefits will thus need repeating, with the quality-adjusted lifespan as the appropriate outcome measure. Finally, Applied Scientists will need to develop more effective ways of persuading the general public to accept their recommendations for a healthy lifestyle.
Beyond these pragmatic and applied goals, there remain many more fundamental challenges. The basic outlines of Exercise Physiology are now well-established, but global warming will force greater attention upon changes in the exercise response occurring at high ambient temperatures. A desire to exploit the resources of the Canadian north will also encourage a re-examination of interactions between cold and exercise. Molecular Chemists will continue to explore the determinants of many aspects of personal fitness, looking not only at the human genome, but also at epigenetic phenomena. As the population ages, ever greater attention will be focused upon the biological causes of aging, and the ways in which these processes can be slowed or halted by appropriate doses of physical activity. Finally, exercise immunologists will contribute more effectively to this challenge, boosted in their endeavours by clearer markers of impending cell migration and apoptosis.
A brief account is given of reasons why Canada has made major contributions to the development of Exercise Physiology. Description is given of key figures leading this process, and noteworthy landmarks along the journey are highlighted. Canadian journals have a much smaller circulation than their U.S. counterparts, but many Canadian investigators have loyally communicated very important findings through the Canadian literature. Major strides in knowledge made north of the U.S. border have not always received the recognition that they merit. However, an objective review of the past 50 years points to many Canadian firsts in Exercise Physiology. There remains much for the Exercise Scientist to discover, both in terms of fundamental research and its application to exercise prescription in Health and Disease, but Canadian laboratories currently seem well positioned to continue their leadership role in this endeavour.
Acknowledgment: I would like to thank many of my contemporaries who have contributed photographs and have helped me in recalling some of the exciting experiences that we have shared over the past 40 years. in particular, Dr. Don Bailey very kindly provided me with a wealth of historic photographs.
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