Chapter 2: Historical Perspective on Canadian Exercise Physiology*

*Much of the material in this chapter previously appeared on the web-site of the Canadian Society of Exercise Physiology under the title: “The first 50 years: A personal perspective on the history of Canadian Exercise Physiology.” Ottawa, ON: Canadian Society of Exercise Physiology. (https://web.archive.org/web/20180412174251/http://www.csep.ca/view.asp?ccid=545). The material is reproduced with the kind permission of the Society.

 

 

Introduction

There are other sources that provide a general introduction on the history of exercise physiology, health and fitness; in particular texts authored by Dr. Charles Tipton of Arizona State University (Tipton, 2010) and myself (Shephard, 2015, 2018). The objectives of the present chapter are to suggest why Canada has played a major role in the development of this particular area of knowledge, to highlight certain Canadians who have gained outstanding national and international reputations as exercise scientists, and to provide a sampling of some of the major Canadian contributions to knowledge in this area.

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. 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 university physical education programs, the possibly related academic acceptance of exercise physiology in Canada, the hosting of seminal international conferences, the early establishment of opportunities for graduate education in the exercise sciences, and the willingness of Canadians to debate their current 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 this group he made some characteristically blunt comments on the perceived lack of fitness in Canadian youth. His warning words were noted and circulated in a Royal Bank newsletter, and the resulting furor quickly spread to the Federal parliament, where members urged the early establishment of a program to correct the perceived problem. Thus, in 1961, Bill C-131 (“An act to encourage fitness and amateur sport”) received the Royal Assent. The enactment of this legislation in turn led to the establishment of a Directorate of Fitness and Amateur Sport in Ottawa, with an annual operating budget of $5 million. One of their early initiatives was to propose the establishment of three university-based fitness research units (see below). In 1963, the Canadian Association for Health, Physical Education, and Recreation (CAHPER) also hosted its first fitness seminar in Saskatoon (Photo 2-2).

 

Photo 2-2  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), held in Saskatoon (1963).

The Fitness Research Units

Given the realities of Canadian politics, the Federal Directorate of Fitness and Amateur Sport decided that it was desirable to establish three fitness research units across the country, one located in central Canada, one on the Prairies, and one in French Canada. Dr. John Merriman (Photo 2-3), then a cardiologist at the University of Saskatoon, and President (1972-3) of the Canadian Association of Sport Sciences (CASS) assumed responsibility for peer review of the program, with an almost manic enthusiasm. The University of Toronto, the University of Alberta, and the University of Montreal were selected as appropriate locations for the three units, and Dr. Merriman paid searching and somewhat dreaded periodic site visits as investigators at each location initiated a five-year program of research in fitness and exercise physiology. The base budget of $50,000 per year per unit was, in the mid-1960s, sufficient to provide each unit with 2 academic staff, 2 technicians, a secretary and a modest quantity of supplies.

Photo 2-3  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, who had 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 Fitness Research Unit. This initiative led to the development of a doctoral program in Exercise Sciences at the University of Toronto, with an initial focus upon the limiting links in the oxygen transport chain. Other important events for the Toronto unit included: hosting a World Health Organization working group on the standardization of methodology for the measurement of maximal oxygen uptake, testing the current fitness level of various populations, and organizing an international conference on physical activity and cardiovascular disease (Photo 2-4). The University of Alberta unit focused largely on cellular aspects of exercise physiology, and Dr. Bert Taylor (CASS President 1974-75, Honour Award recipient in 1986, and recently retired from the University of Western Ontario), assumed a dominant role in these studies. The Montreal unit was dogged by problems of ill-health in its leadership, and its achievements were more limited, although it may have provided the initial stimulus towards development of the widely used shuttle-run test of Luc Léger.

Name Change of Former Physical Education Departments

Another possible influence has been a change in either the name of many programs, or (more probably) a change in the underlying curricular philosophy of university Schools and Faculties formerly identified as “Physical Education.” The emphasis of undergraduate teaching has 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 began in two of Canada’s newer universities, Simon Fraser and Waterloo, as in 1967 they each established Kinesiology programs. The term Kinesiology remains popular, although there have been other choices (for example Kinanthropology, initially in Ottawa, then in Sherbrooke), and Human Kinetics (at the University of Guelph and 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 apparently occurred more readily in Canada than in the U.S., where many schools were under heavy pressure to keep the name Physical Education, to sustain Alumni funding/support, primarily through the excellence of their sports teams.

Academic Acceptance of Exercise Physiology in Canada

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 by the change in name and philosophy of many faculties, as discussed above.

However, in Britain and some other European countries applied research (including human exercise physiology) was welcomed with less 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 the lecture hall rather than audit a paper on any aspect of applied physiology. Persistence of this attitude throughout much of the last century caused many European scientists with interests in applied science to emigrate to Canada, severely hampering the research endeavors of those who remained in Europe. 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 the strength of exercise physiology in Canada.

Hosting of Seminal International Conferences

The hosting of four major international conferences, in the latter half of the 20^th century, contributed greatly to both the development of knowledge of exercise physiology within Canada, and to the global recognition of Canadian expertise in this area of research.

The first such conference was a three-day meeting at Toronto’s Inn on the Park in October of 1966 (Photo 2.4). It was sponsored jointly by the Toronto Fitness Research Unit, the Canadian Heart Foundation, and the Ontario and Canadian Medical Associations. Financial support was provided by the Canadian Life Insurance Association, and the Province of Ontario. The planning committee for this conference met at the noon hour 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 nominated commentators. After a few brushes with the chair of the session, this plan was well respected by participants. Evening visits were paid to local sites of interest, including the Toronto Rehabilitation Centre, and North York’s luxurious “Fitness Institute” (recently opened by Lloyd Percival); I recall my teaching assistant for 1966 at York University (the very young but dapper Norm Gledhill) efficiently marshaling delegates into a fleet of TTC buses.

Photo 2-4.   The Fitness Unit at the University of Toronto played a lead role in organizing the International Symposium on Physical Activity and Cardiovascular Health, held at the “Inn on the Park,” Toronto, in October 1966, in cooperation with the Ontario Heart Foundation, the Ontario Medical Association and the Canadian Medical Association. The proceedings were published five months later as two special issues of the Canadian Medical Association Journal.

The organizers of many such conferences have found themselves struggling to collect papers from speakers two years after such an event has been held, 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 span of four months (Shephard, 1967). One of the main reasons for the quick turn around 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 reimbursement! One speaker also argued that the CMAJ was not prestigious enough for his paper. He was politely reminded that he had agreed to publication, and 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 delay.

In 1988, a team of exercise physiologists headed by Claude Bouchard hosted a second major international conference at L’Hotel, and the Toronto Convention Centre. This conference lasted for four and a half days, and it was designed to develop a consensus 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 by a carefully selected panel of international experts, who had circulated written preprints of their presentations. At the conclusion of each public presentation a panel of some 70 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 Mighty 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 (Photo 2-5) were published as a major text in 1990 (Bouchard, et al., 1990).

Photo 2-5  The 1988 International Consensus Conference on Exercise, Fitness and Health was held in the Toronto Convention Centre, and the proceedings were 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 literature databases was used to identify the best-informed and most widely published investigators for each of 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 also submitted a detailed supporting document. This information was debated by the three editors of the final publication, with input where necessary from a panel of seven international advisors in exercise physiology. Thus, those attending the conference were able to review a carefully revised consensus statement that was near to its final format. In 1994, the conclusions were again published as a major scientific text (Bouchard, et al., 1994, Photo 2-6).

Photo 2-6  The second International Consensus Conference was held at the Skydome Hotel, Toronto, in 1992, and the proceedings were published by Human Kinetics in 1994.

At this stage, 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, but little was known about the optimal dose of exercise to prescribe for various conditions. Dr. Bouchard and his colleagues thus embarked on a further consensus conference that focused on a careful rating of “levels of evidence” concerning dose-response relationships. The selected panel of experts 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 through a substantial hike along the physically demanding Bruce Trail! The conference documented much new information, using processes developed from the previous conferences, although unfortunately there was still insufficient evidence to specify clear dose-response statements for many of the conditions that were considered. The findings from this 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 discipline, the bulk of the new information presented at these gatherings was not reaching those 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 scheduled for the resort of Whistler, B.C. in September of 2001, but because the terrorist attacks in that month caused a temporary fear of air travel, the conference was postponed until December of 2001. 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 the delegates reached Squamish, a heavy snowfall persuaded many of the group to make an ignominious return to the 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 papers presented at this meeting appeared in the American Journal of Preventive Medicine (Shephard, 2002).

Opportunities for Graduate Education

As noted throughout this chapter, a number of the early Canadian leaders in the activity sciences found it necessary to travel to the United States (frequently to Tom Cureton, at the University of Illinois) in order to complete their doctoral training. Nevertheless, with the impetus provided by the Fitness Research Units and the change in focus at other universities, Canada began to develop its own Ph.D. programs in the exercise sciences during the 1960s. The first candidates graduated from both the University of Toronto and the University of Alberta in 1966. The emphasis of these programs 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 programs. Some Scandinavian countries had at least equally good doctoral programs in clinical physiology during this era, but in other European countries, applied science was still held in low regard.

It is possible to trace a pedagogic genealogy for some of the more outstanding programs, with students spreading 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.; 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 the University of New Brunswick, then Saskatoon and then Ottawa, Bill Montelpare to Lakehead University, 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 exceeded that of their more wealthy U.S. peers. For example, Don Bailey tells me that at the 10^th 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, as have other Canadians (John Faulkner and Jerome Dempsey).

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 have been key researchers, I shall omit one or more of the 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

William Robert Orban (Photo 2.7) 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. program in Canada at this period, so he completed a Ph.D. program 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 acknowledged 5-BX (5 basic exercises) exercise program (see below). 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. In 1966, he returned to Ottawa to become Dean of Physical Education (later renamed to Kinanthropology then Human Kinetics) at the University of Ottawa, and he continued studying optimal patterns of training until his death from cancer in 2003.

Photo 2-7   Dr. Bill Orban, world renowned for authorship of the 5-BX and 10-BX exercise programs.

Photo 2-8   The 5-BX and 10-BX exercise programs developed by Dr. Bill Orban.

Gordon Cumming

Dr. Gordon Cumming, a pediatric cardiologist practicing at the Children’s Hospital in Winnipeg, developed a strong interest in exercise physiology from the early 1960s, in part because of the involvement of his daughters in high-level skating competitions. He was an important player in organizing the 1967 Winnipeg Sports Science Meeting that accompanied the Pan American Games (Photo 2-9). It was here that CASS was founded. Dr. Cumming frequently took time out of his hospital practice to attend meetings of both CASS and the European Pediatric Work Physiology group. He quickly criticized the field performance tests that were widely used in the 1960s, underlining that a child’s score on such a test battery reflected body size and maturity as much as physical fitness. He argued for the replacement of such testing by objective measurements such as the Physical Work Capacity at a pulse rate of 170 beats/min (PWC₁₇₀). He was an early advocate of the careful calibration of cycle ergometers, and 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 underlined the apparent failure of the physical education programs of the 1970s to enhance the physical fitness of Canadian school children. His critical gaze 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 record 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 soon solved as the vinyl record was replaced, first by a tape and subsequently by a CD.

Photo 2-9   CASS was inaugurated at a meeting of Sports Scientists that accompanied the Pan American Games of 1967, held in Winnipeg.

A second important interest of Dr. Cumming was the use of the electrocardiogram in identifying exercise-induced myocardial ischaemia. This interest led him to accept a post as Medical Director of Great West Life 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 development of myocardial ischaemia during physically demanding employment.

Don Bailey

Dr. Don Bailey (Photo 2-10) 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 of the absence of graduate exercise science programs in Canada, and 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 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 (Photo 2-11). He also undertook a major community-wide fitness promotion initiative in the city of Saskatoon, in collaboration with the Crown Agency ParticipACTION (directed by Russ Kisby, and 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.

Photo 2-10   Dr. Don Bailey, for many years Director of the Longitudinal Study of Child Growth and Development in Saskatoon.

Photo 2-11  The Canadian Fit Kit, a package based on a long-playing record that allowed the population to test their cardiorespiratory fitness at home, and to choose an appropriate personal exercise program based on this information.

Don 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 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 a Professor Emeritus, his research studies are on-going both in Canada and in Australia.

John Faulkner

John Faulkner (Photo 2-12) 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), where he has continued for five decades.

Photo 2-12   Dr. John Faulkner, a Canadian-born physiologist who has for many years studied muscle function in health, disease and aging at the University of Michigan, Ann Arbor, MI.

His more recent research has focused specifically on the contractile properties of whole skeletal muscles, motor units, and single skeletal muscle fibres from mice and rats, and single fibres from muscle biopsies of humans. In particular, he and his associates have focused on muscle fibre-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 dystrophy. 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 the research team has been to elucidate underlying physiological mechanisms that lead to the substantial loss 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 been 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, a branch of the University of London (Photo 2.13), I 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. I was attracted to Canada in 1964 by the opportunity to serve as Director of the University of Toronto Fitness Research Unit, and establish a doctoral program in Exercise Sciences through the School of Hygiene, where I was initially quartered. Our first doctoral graduate, in 1966, was Dr. Terry Anderson; he examined various methods of measuring the pulmonary diffusing capacity during maximal exercise.

Photo 2-13   Dr. Roy Shephard, Director of the Toronto Fitness Research Unit, and for some 34 years Professor of Applied Physiology at the University of Toronto.

In addition to studying links in the oxygen cascade from the atmosphere to the working muscle, assessing the fitness levels of various average and athletic Canadian populations, and writing a number of major textbooks addressing various aspects of exercise and fitness, early challenges included organization of the 1966 International Symposium on Physical Activity and Cardiovascular Health (above), hosting of the 1966 World Health Organization (WHO) working party on the measurement of oxygen uptake (below), and synthesizing information on the physical working capacity of world populations for the International Biological Programme, with personal responsibility for physiological studies of Inuit living in the Canadian arctic (1969-1990).

Collaboration with Dr. Hugues Lavallée of the University of Québec at Trois Rivières allowed the initiation of a large-scale controlled and quasi-experimental study of physical education in Québec primary school students (1970-present). Collaboration with Dr. Terence Kavanagh and the Toronto Rehabilitation Centre began in the early 1970s; this initiative led to involvement in a multicentre trial of exercise for post-coronary patients (Photo 2-14), participation of cardiac patients in the Boston Marathon (below), and the use of exercise testing to determine long-term prognosis in various cardiac conditions. I also shared with Dr. Don Bailey in the development and testing of the Canada Home Fitness Test (1973-74) (Photo 2-10), and (in collaboration with Dr. Art Salmon) undertook a quasi-experimental study of work-site fitness programs (1978-1990).

Photo 2-14  The multi-centre Ontario Exercise-Heart Trial was a randomized controlled trial examining the value of exercise following myocardial infarction. Participants included:  (front row) David Cunningham, Roy Shephard, Peter Rechnitzer, Norman Jones, Neil Lefcoe, John Sutton; (back row) Robin Campbell, Neil Oldridge, Mike Yuhasz, Terry Kavanagh, George Andrew, Sasha Sangal (statistician).

 

In 1979, I was appointed as Director of the School of Physical and Health Education at the University of Toronto, and moved my quarters to the newly constructed Warren Stevens complex. This move provided greatly expanded laboratory space, allowing the graduate program in Exercise Sciences to grow 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. This collaboration allowed an examination of exercise responses when combined with heat or cold stress, and permitted (in collaboration with Dr. Pang Shek) the development of the first major Canadian program in Exercise Immunology.

Throughout my career, I 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). I retired from the University of Toronto in 1994, but then served for a further four years as Canadian Tire Acceptance Distinguished Fellow in Exercise Physiology at Brock University. Since 1998, I have lived in the village of Brackendale (in rural British Columbia), but I continue writing and research through the magic of the internet and on-line journals. I was greatly honoured to receive the order of Canada in 2014, in recognition of my contributions to fitness and health in Canada.

Claude Bouchard

Dr. Claude Bouchard (Photo 2-15) is the most widely published of Canadian exercise physiologists, with data-bases such as HealthStar/Ovid listing 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 his M.Sc. degree in exercise physiology at the University of Oregon, and a doctorate in population genetics at the University of Texas at Austin. He 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 for his “Québec Family Study” that explored relationships between the 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 contributing to physical performance and conditioning. He also became a leading international Photo 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 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, if temporary, 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. However, Claude has now returned to Laval University, where he continues his work as professor Emeritus.

Photo 2-15  Dr. Claude Bouchard was for many years Director of the Exercise Research Program  and the Québec Family Study at Laval University, and a prominent player in the human genome project.   For a period, he became Executive Director of the Pennington Biomedical Research Center of the Louisiana State University System, at Baton Rouge, LA, but has now returned as professor Emeritus to Laval University.

David Cunningham

Dr. David Cunningham (Photo 2.16) was born and raised in Toronto. He received a B.A. from the University of Western Ontario in 1960, and his 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 the landmark Tecumseh Community Health Study at Ann Arbor. 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.

Photo 2-16  Dr. David Cunningham has pursued Exercise Physiology for many years at the University of Western Ontario. He is best known for his leadership in the Canadian Centre for Activity and Ageing.

Dr. Cunningham has made major contributions to many areas of research in exercise physiology, including the aerobic performance of young children, and the rehabilitation of cardiac patients (serving with Dr. Peter Rechnitzer, Norm Lefcoe, Mike Juhasz, and Sasha Sangal in the UWO component of the Ontario Multi-Centre Exercise Heart trial, Photo 2-14). However, perhaps his best-known contribution to the discipline has been in 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.

Norman Jones

Norman Jones (Photo 2-17) 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 along 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. He focused particularly on individuals with cardiorespiratory disease and disturbances of acid-base balance, linking acid/base changes to lactate levels, and exploring mechanisms of dyspnea. A second area where he made major contributions was in the estimation of cardiac output from the exchange of carbon dioxide, using the rebreathing method. In association with Lydia Makrides he worked towards the establishment of normal standards for maximal power output, heart rate, and ventilation. Collaboration with Tony Sergeant explored interactions between oxygen uptake and strength. With John Sutton (below), he also directed the McMaster component of the Ontario Multi-Centre Exercise-Heart trial (Photo 2.14). He made a particularly important contribution to CASS by insisting on the standardization of laboratory methodology in Exercise Science, so that measurements of maximal oxygen intake and related variables could be compared reliably between 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 often led to athletes being tested in different laboratories at different times.

Photo 2-17  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, Ontario.

Image from http://fhs.mcmaster.ca/medicine/respirology/images/photo_faculty_jonesn.jpg

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 (Photo 2-18) 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 during the WHO 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, which is perhaps best known for development of the “Wingate Test” of power and work capacity.

Photo 2-18  The late Dr. Oded Bar-Or, Director of the Chedoke-McMaster Children’s Exercise and Nutrition Centre, and known world-wide for his expertise in the exercise responses of children.

From http://www.uwo.ca/actage/rechnitzer/lecture7.html

In 1981, Oded moved to McMaster University, becoming the founder and director of the Children’s Exercise and Nutrition Centre, located 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.

Bar-Or focused his research and clinical attention particularly on overweight children, being one of the first to express concern about the growing epidemic of obesity. He developed a multi-disciplinary team of researchers who created and delivered effective individualized nutrition and physical activity programs for children, at the same time spearheading many research investigations of obesity in childhood. He is also well known for his studies of 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 (Photo 2-19) graduated from the physical education program 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 program 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, 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 changes occurring in skeletal muscle in response to disturbances of energy homeostasis. 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 area of research, most notably with Dr. Dirk Pette and his German colleagues at the University of Konstanz in Southern Germany. 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 sarcoplasmic reticulum calcium handling.

Photo 2-19  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.

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 (Photo 2-20) 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, underlining that participants in fun runs were vulnerable to heat stroke, and exploring the hormonal changes associated with endurance exercise. In 1972, he was awarded the Royal Australian College of Physicians Overseas Fellowship; this accolade 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 exercise physiology is marked in perpetuity by the prestigious biennial International Hypoxia Symposia that began in 1979, and the annual CSEP John Sutton Memorial Lecture.

Photo 2-20  The late Dr. John Sutton, faculty member of McMaster University best known for his contributions to Environmental Physiology, and the 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 exercise physiology in Canada when Dr. Sutton (in 1989) decided to return to Australia, 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.

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 well-trained specialists in exercise physiology.

History of CSEP

The Canadian Society for Exercise Physiology (originally known as the Canadian Association of Sport Sciences) is a voluntary organization composed of both professionals involved in fitness and physical activity programs across the country and academics involved in the scientific study of exercise physiology, exercise biochemistry, physical fitness and health. Following preliminary discussions between representatives of the CMA (Sam Landa, John Merriman, and Max Avren), and CAHPER (Don Bailey, Howard Nixon, and John Leicester), it was formally established at a scientific meeting that accompanied the Winnipeg Pan American Games of 1967. The primary objective seen at that time was to achieve a rapprochement of the interests in physical activity and health represented by the CMA and CAHPER.

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 I 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 (Photo 2.21). I negotiated an agreement that the registration fees of participants 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 agreement proved a very advantageous arrangement for our 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 produced a mixture of amusement and consternation!

Photo 2-21  Programme of the only joint meeting between CASS and ACSM, held at the Inn on the Park, Toronto, in 1971.

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 quite limited, and almost all of those who attended the CASS sessions spoke excellent English. Speakers were occasionally disconcerted to see a group of Francophones at the rear of the room laughing helplessly at attempts of the translator to express scientific terms in acceptable French. I argued that we should expect Canadian academics to show reasonable fluency in both Canada’s official languages, and myself presented some papers in French at a meeting in Saskatoon; eventually it was decided that attempts to provide simultaneous translation of the proceedings were an unwarranted expense. However, the official documents of CSEP are still made available in both the official languages of Canada.

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 a 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 also permit the development of examinations that would allow certification of Sport Medicine as a distinct specialty recognized by the Canadian Medical Association. As knowledge of the exercise sciences increased, other members of CASS with interests in Biomechanics, Sociology, Psychology, and Psychomotor Learning also began organizing their own specialized conferences, further fragmenting Canadian sport 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 human movement.

Distinguished lecturers in disciplines other than exercise physiology were thus invited to give major presentations at our annual meetings, 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 interested 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 an official journal (below), 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, and a final day when more general topics are communicated to certified exercise physiologists working in community rather than university settings.

Applied Physiology, Nutrition & Metabolism

When CASS was founded, my hope was that we might publish a scientific journal jointly with ACSM. I attended several committee meetings of ACMS, mostly in Chicago, but despite my strong pleas to the first editor-designate (Dr. Bruno Balke), the loudest of the U.S voices on the committee expressed confidence in their ability to publish a journal without any Canadian collaboration. As a small reward for my efforts, I was appointed a section editor of Medicine & Science in Sports (as it was then termed) for the first five years of its publication.

CASS continued to press for a 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 journal was self-published, 1976-86, then published by the University of Toronto Press, 1987-1990, under the shortened title of Canadian Journal of Sport Sciences. The first editor was Bert Taylor (1975-79). He was succeeded by Eric Bannister (1980-84), David Cunningham (1985-1989), and myself (1989-1991). At this stage, CASS still hoped to attract disciplines other than exercise physiology, and the articles covered a correspondingly wide range of interests. In an attempt to introduce members to a broader spectrum of the exercise sciences, I took the initiative of commissioning short editorials to accompany submissions. Some members 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 name changed again (Canadian Journal of Applied Physiology) and the page size was reduced from quarto to octavo format (as used in most Human Kinetics journals); this change certainly did not increase the popularity of our journal with librarians! Editors during this period were David Cunningham (1992-94), and Phil Gardiner with François Perronet (1995-1999). Difficulty was experienced in negotiating increases of page length with Human Kinetics, and in 2006 the decision was made to transfer publication once again, this time to the Canadian 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 it now appeared bimonthly, with a considerable increase in page allowance. Under the guidance of Dr. Terry Graham (editor 2000 – to 2019), the journal gained international contributors an improved their impact factor. Dr. Wendy Ward became co-Editor-in-Chief in April, 2019 and Phil Chillibeck joined Dr. Ward in Jan 2020). The journal is currently attracting considerable international attention, and high-quality articles are published from many corners of the globe.

CSEP currently has four position stands, published in APNM.

• resistance training in children and adolescents
• instability training of the core
• benefits and risks of physical activity in children
• getting the most out of your stretching routine

Certification of Physiologists

Professional certification of exercise physiologists was developed by the Health and Fitness Programme of CSEP in 1981, under the professional 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 for fitness professionals, and to give appropriate recognition to professionals with appropriate advanced qualifications.

There are two levels of certification, based on a candidate’s academic background and work experience; Level 1 is introductory, and Level 2 (the advanced level) requires a university degree. Level 1 candidates earn the CSEP Certified Personal Trainer™ (CSEP CPT) qualification; they are required to complete successfully two modules covering Canadian Physical Activity, Fitness and Lifestyle Applications (CPAFLA) Fitness Assessment Protocols and Exercise Prescription. Level 2 candidates earn the CSEP Certified Exercise Physiologist™ (CSEP CEP) qualification. They must complete a 4-year university degree in Kinesiology/Human Kinetics/Exercise Sciences; such certification is intended 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 5-BX and 10-BX exercise program,
• hosting of the WHO Working Party on the Standardization of Maximal Oxygen Intake Measurements,
• International Biological Program (IBP) studies of the Inuit,
• the nation-wide testing of PWC₁₇₀ in schoolchildren, by the Canadian Association of Health, Physical Education and Dance
• 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.

5-BX and 10-BX Exercise Program

The five and ten basic exercise plans 5-BX and 10-BX were created for Royal Canadian Air Force pilots by Dr. Bill Orban (Photo 2.7). These exercises offered an attractive approach to the enhancement of personal physical fitness in that no specialized equipment was required, and programs could be completed in as little as 11 minutes per day. The underlying concept was developed by Bill 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 were sold, and it has been translated into 13 different languages.

Standardization of Maximal Oxygen Intake Testing

The International Biological Program (IBP), initiated by Dr. J. S. Weiner of the London School of Hygiene during the late 1960s, included 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 uptake values found in such disparate groups as very sedentary populations and elite endurance athletes. Data contributing to the IBP program were necessarily collected by scientists drawn from a wide range of countries, and for meaningful comparisons between samples, it was vital to standardize methods of measuring maximal oxygen uptake and other indices of human physiological work capacity. In collaboration with the World Health Organization, the IBP thus convened a bench-level working group that met in our Toronto laboratories; participants included exercise physiologists drawn from the main centers involved in such measurements around the world. In order to test various potential protocols, a panel of 24 highly motivated subjects each completed measurements of maximal oxygen intake on each weekday 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 science gained considerable recognition as a result of both this working party, and two resulting publications (Shephard, 1968; Shephard, 1978).

IBP Studies of Inuit

It was decided that one of the North American contributions to the IBP program should be a systematic study of adaptations to the arctic environment, as seen among three Inuit populations. The U.S. made some measurements of maximal oxygen uptake at Fort Wainwright, Alaska, and Scandinavian investigators also completed limited observations on a Greenlandic population, but the most comprehensive study was undertaken by our Toronto laboratory, operating a field station in the community of Igloolik, at the tip of the Melville Peninsula. 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. Investigators visited the village over the course of more than 20 years, thus allowing documentation of a progressive deterioration in fitness as the community became acculturated to a southern Canadian lifestyle (Shephard and Rode, 1996, Photo 2-22). Members of our research team also accompanied the Inuit on traditional hunting expeditions, obtaining unique data on the very high energy cost of such activities.

Photo 2-22  20-year 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 little attention to issues of population sampling; observations were commonly made on the principal investigator, immediate colleagues and a few laboratory technicians. However, in 1966, the Canadian Association for Health, Physical Education, and Recreation (CAHPER) under the leadership of Max Howell (Photo 2-23) took the innovative step of measuring the PWC₁₇₀ of schoolchildren aged 7-17 years, using a sample that was statistically representative of Canadian students in this age range (Howell & MacNab, 1968).

Photo 2-23  Max Howell led the CAHPER study of PWC₁₇₀ in a representative sample of Canadian schoolchildren in the summer of 1966. He is here wearing the 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 uptake using a simple double step (total height of 0.457 m, climbed and descended with 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 were difficult to climb. However, an effective step test offered a valuable alternative to the treadmill, particularly when testing people living in remote areas. In Igloolik, we lacked the 30 ampere power supply that a treadmill would have required, and it is doubtful if we would have been able to load most types of treadmill into a de Havilland Dash aircraft, so we substituted the 0.457 m double step for our exercise testing. In order to ensure that our subjects maintained an appropriate stepping cadence, we chanted the Inuit equivalent of 1-2-3 on rising and descending scales throughout a progressive, multi-stage test.

Don Bailey and I tested this approach 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 set by metronome (Bailey, Shephard & Mirwald, 1976; Photo 2-24). It occurred to us that large-scale home fitness testing would be possible, using a similar type of step, and a long-playing gramophone record to set age and sex appropriate rhythms. The idea seemed to have commercial potential, but neither Don Bailey nor I had much experience in the marketing of long-playing records, so we sold the idea to the crown corporation recently established to promote the fitness of the Canadian population (ParticipACTION, established in 1971). The contract specified that we would each be paid one third of a cent for exclusive rights to the concept, although we have yet to receive this unique coinage!

Photo 2-24  The idea for the Canadian Home Fitness Test was field-tested in Saskatoon in 1973, with groups of 16 age and sex-matched subjects performing the test simultaneously.

Under government sponsorship, the concept faced the usual bureaucratic hiccups. A high-priced band was hired to provide martial music, and only when it was delivered to the government did it occur to some civil servant that the music should be written in 3/4 rather than 4/4 time. However, a suitable package was eventually assembled that included the PAR-Q clearance sheet (below), the LP recording, instructions for submaximal exercise testing, and some simple exercises that subjects could perform based on their test results (Photo 2.10). As noted above, Dr. Cumming pointed out that if a cheap turn-table was used, a problem of cadence developed at the centre of the recording, but this difficulty was quickly resolved by the popularity of taped versions of the same music. The Canadian Home Fitness Test recording never achieved platinum sales, but a substantial number of copies were 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 least one order of magnitude.

Development of Simple Exercise Clearance Procedures

When planning the Saskatoon evaluation of the Canadian Home Fitness Test, Don Bailey and I had an extensive discussion of test safety. We 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 uptake, so that risks were quite low for healthy subjects. However, we thought it important to develop a simple and brief questionnaire that would identify individuals who should consult a physician before engaging in the test.

The idea was developed further 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). Based on this assessment, the PAR-Q form was developed (Photo 2-25), and it has found widespread use both in Canada and around the world. Experience has suggested that it offers a safe clearance procedure for both exercise testing, and the prescription of moderate intensity exercise; the main complaint has been that a rather high proportion of the general population (about 20 per cent) are advised to seek further guidance. Minor modifications of the questionnaire were introduced in an attempt to correct unnecessary referrals, and a detailed restructuring by Dr. Darren Warburton led to the development of an evidence-based electronic version of the test, with probing questions exploring areas of uncertainty; this version of the test has been up-dated annually.

Photo 2-25  A version of the PAR-Q  (Physical Activity Readiness) form used for exercise clearance.

Attempts to develop a similar screening form for use by physicians (the PAR-MED-X) have met less wide acceptance, but Dr. Warburton has now developed electronic versions of these forms.

Canadian Fitness Sur veys; CLFRI

Having devised a readily portable test of aerobic fitness (the double step test, above), and an appropriate screening procedure (the PAR-Q  test), Health Canada decided to undertake the ambitious project of measuring 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 CFLRI was established in September of 1980 under the effective direction of Dr. Cora Craig (Photo 2-26), and the first such 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 measures was revived with the Canadian Health Measures Survey sponsored by Statistics Canada and the Public Health Agency of Canada.

Photo 2-26  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.

Trois Rivières Quasi-experimental Study of Primary School Students

The Trois Rivières study, led by Dr. Hugues Lavallée (Photo 2-27), was designed to examine the effects of incorporating five hours per week of professionally taught physical education into the primary school curriculum. The study was unique in many respects; similar experiments in the United States had a duration of only one or two years, but the Trois Rivières intervention continued throughout primary school, grades 1-6. Unlike other studies, a quasi-experimental design was adopted, with students in preceding and succeeding classes at the same school serving as controls. The intervention was carefully monitored to ensure that the five hours of supervised exercise per week were of adequate intensity, and it was demonstrated that there was no substantial compensatory reduction in leisure activity. The sample was large (546 students), and all attended an exercise physiology laboratory annually for a sophisticated range of investigations. Measures of academic attainments demonstrated that experimental students performed at least as well as the controls (although the latter spent 14 percent more time learning academic material). Finally, because of the low mobility of the population in this region, it was possible to make follow-up observations on the same subjects when they reached the age of 30-35 years and older; these follow-up studies showed a modest persistence of the intervention in terms of both physical activity habits and avoidance of cigarette smoking (Shephard & Trudeau, 2005).

Photo 2-27  Dr. Hugues Lavallée. Medical Director of the Trois Rivières study of physical education for primary school students.

Quasi-experimental Study of Worksite Fitness Programs

Another important first for Canada was a quasi-experimental trial of work-site fitness programs. 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 short-term changes induced by al fitness program, and so were vulnerable to “Hawthorne” effects. However, the Toronto study compared responses between an experimental site (a large assurance company, Canada Life, Photo 2-28) and a control site (a nearby rival life assurance company, North American Life). A detailed analysis of potential economic benefits was undertaken in terms of productivity, absenteeism, and employee turnover, and a unique feature of the study was a direct comparison of OHIP Medicare billings between the two companies before and after institution of the program (Shephard, 1986).

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 to offer vigorous rehabilitation programs for individuals who had sustained a myocardial infarction (and subsequently for those who had chronic cardiac failure or who had received a cardiac transplant). Through a close association with the University of Toronto graduate program in exercise sciences that began around 1970, detailed physiological data were obtained on all patients, including direct measurements of peak oxygen uptake. One noteworthy early episode was the participation (under close medical supervision) of eight post-coronary patients in the 1973 Boston Marathon. A carefully planned program of progressive aerobic training had increased the peak oxygen intake of these patients from an initial 24-27 ml∙kg^-1∙min^-1 to a peak of 53 ml∙kg^-1∙min^-1 in one subject; he 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) was very upset to find himself upstaged in this way, declaring the run to be “criminal folly.” Nevertheless, he at the same time claimed that he had persuaded a patient to run the marathon distance prior to the Canadian exploit! The Toronto investigators made careful studies of fluid and mineral balance over several marathons, and (at a time when proprietary drinks were becoming popular among runners), it was established that in most situations, the best replacement fluid was simply water.

Development of Evidence-based Physical Activity Guidelines

The last, but by no means the least important Canadian contribution has been the development of evidence-based guidelines for activity in the general population, the elderly and youth (Health Canada/CSEP, 1998; 1999; 2002a, b, Photo 2-29). Canada has been in a unique position to develop such advice, given the series of major consensus conferences on physical fitness and health, noted above. It is interesting that at an early stage Canadian physiologists were urging that the volume of physical activity recommended in other countries such as the U.S. was insufficient to counter some of society’s current health problems, particularly the obesity epidemic, a view that is now widely accepted.

Photo 2-29   CSEP has been at the forefront internationally in developing physical activity recommendations for adults, children and the elderly.