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The gene SMART (genes and the Skeletal Muscle Adaptive Response to Training) Study aims to identify genetic variants that predict the response to both a single session of High-Intensity Interval Exercise (HIIE) and to four weeks of High-Intensity Interval Training (HIIT). While the training and testing centre is located at Victoria University, Melbourne, three other centres have been launched at Bond University, Queensland University of Technology, Australia, and the University of Brighton, UK. Currently 39 participants have already completed the study and the overall aim is to recruit 200 moderately-trained, healthy Caucasians participants (all males 18–45 y, BMI < 30). Participants will undergo exercise testing and exercise training by an identical exercise program. Dietary habits will be assessed by questionnaire and dietitian consultation. Activity history is assessed by questionnaire and current activity level is assessed by an activity monitor. Skeletal muscle biopsies and blood samples will be collected before, immediately after and 3 h post HIIE, with the fourth resting biopsy and blood sample taken after four weeks of supervised HIIT (3 training sessions per week). Each session consists of eight to fourteen 2-min intervals performed at the pre-training lactate threshold (LT) power plus 40 to 70% of the difference between pre-training lactate threshold (LT) and peak aerobic power (Wpeak). A number of muscle and blood analyses will be performed, including (but not limited to) genotyping, mitochondrial respiration, transcriptomics, protein expression analyses, and enzyme activity. The participants serve as their own controls. Even though the gene SMART study is tightly controlled, our preliminary findings still indicate considerable individual variability in both performance (in-vivo) and muscle (in-situ) adaptations to similar training. More participants are required to allow us to better investigate potential underlying genetic and molecular mechanisms responsible for this individual variability.

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ABBREVIATIONS FMSFunctional Mobility Scale GPS Gait Profile Score SEMLS Single-event multilevel surgery AIM There are conflicting reports about the stability of the Gross Motor Function Classification System (GMFCS) in children with cerebral palsy (CP) after orthopaedic surgery. We studied the stability of the GMFCS in children with bilateral spastic CP after single-event multilevel surgery, using the Gait Profile Score (GPS) as the primary outcome measure.METHOD This was a retrospective cohort study of 107 children (46 females, 61 males) with bilateral spastic CP, classified as GMFCS level II or III, who underwent surgery at a single tertiary institution between 1997 and 2008. The mean age at surgery was 10 years 7 months (SD 2y 8mo). The primary outcome measure was the GPS. Changes in GMFCS level were studied at multiple time points before and after intervention.RESULTS Gait dysfunction was partially corrected, with a mean improvement of 28% in the GPS.The GMFCS remained stable and unchanged in 95% of children and improved by one level in 5% of children. The improvement in GPS was three times the minimal clinically important difference. The mean age at final postoperative GPS assessment was 11 years 10 months (SD 2y 10mo) and at final GMFCS assessment was 15 years 7 months (SD 3y 9mo).INTERPRETATION Stability of the GMFCS was confirmed in the majority of children with bilateral spastic CP after single-event multilevel surgery, despite statistically and clinically significant improvements in gait dysfunction and functional mobility. This information is important in realistic goal-setting and in counselling families.The Gross Motor Function Classification System (GMFCS) is a standardized method to classify gross motor function in children with cerebral palsy (CP) from 1 to 18 years of age. 1,2It is a five-level categorical grading system which classifies differences in gross motor function that are meaningful and significant to children with CP and their families.3 Distinctions between GMFCS levels are based on functional limitations with an emphasis on sitting and walking and the need for assistive devices and wheeled mobility. Children may be quickly and easily classified at any given time, such as during a clinic appointment or gait laboratory assessment, by determining which level best corresponds to the child's current gross motor function. A set of age-appropriate descriptive criteria are used and good correlations have been demonstrated between classifications assigned by parents and by health professionals. 1,2,4 Since the original description by Palisano et al. 1 in 1997, the GMFCS has become widely accepted, widely used, and is considered by many to be an essential tool to communicate about gross motor function in CP. 5,6The GMFCS is a valid and reliable classification tool which is expected to be relatively stable over time, with or without intervention. Palisano et al. 3 reported that 73% of 610 children with CP remained at the same GMFCS level at multiple ratings over time , and McCormick et ...

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