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Arthur L. Weltman

· Professor of Kinesiology Professor of MedicineVerified

University of Virginia · Kinesiology and Health Science

Active 1968–2025

h-index72
Citations15.2k
Papers57240 last 5y
Funding$38.7M
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About

Arthur L. Weltman is a Professor of Kinesiology and a Professor of Medicine at the University of Virginia. He earned his Ph.D. and M.A. from the University of Michigan-Ann Arbor in 1976 and 1974, respectively, and his B.A. from City University of New York-Queens College in 1973. His academic and professional focus includes exercise physiology, health and wellbeing, and applied physiology of exercise. He is associated with the Kinesiology department and the Center for Clinical Services Partnerships at UVA. Professor Weltman has been recognized for his contributions to sports medicine, earning a national award, and has been involved in research testing age-appropriate exercise for individuals with heart failure, supported by a significant NIH grant. His work emphasizes the importance of exercise and health sciences, contributing to the fields of education, health, and human development.

Research topics

  • Physical therapy
  • Internal medicine
  • Medicine
  • Surgery
  • Physical medicine and rehabilitation
  • Computer Science
  • Psychology
  • Endocrinology

Selected publications

  • Associations Between Oral Nitrate Reducing Capacity and Aerobic Fitness in Older Individuals with Heart Failure (HFrEF) and Healthy Controls

    Physiology · 2025-05-01

    article

    BACKGROUND: Nitric oxide (NO) is essential for cardiovascular health and is purported as an exercise ergogenic. Vascular endothelial dysfunction and a reduction in endogenous NO production is a hallmark of heart failure. Low NO bioavailability may also contribute to reduced exercise capacity in these populations. Oral inorganic nitrate supplementation has been shown to increase circulating plasma nitrite (NO2-) and consequently bioavailable NO. This occurs via reduction of nitrate by oral commensal bacteria. Patients with heart failure with reduced ejection fraction (HFrEF) display blunted increases in plasma NO2- and do not increase exercise tolerance following nitrate supplementation. Therefore, the purpose of this pilot study was to examine the associations between the bacterial oral nitrate reducing capacity (ONRC) and markers of exercise capacity [VO2peak and VO2 at ventilatory threshold (VT)] in patients with HFrEF versus age-matched healthy controls. HYPOTHESIS: We hypothesized that individuals with HFrEF would have decreased ONRC compared to healthy, age-matched controls, and that exercise capacity (VO2peak and VO2 at VT) would be positively associated with ONRC. METHODS: 6 individuals with HFrEF (Age: 77.50 ± 6.09yrs, VO2peak: 14.24 ± 4.45ml/kg/min) and 9 healthy controls (Age: 71.89 ± 4.23yrs, VO2peak: 24.25 ± 2.86ml/kg/min) completed a symptom-limited incremental VO2peak test on a cycle ergometer. VO2 at VT was determined as the VO2 just prior to the curvilinear increase in ventilation. ONRC was measured using a 5-min oral rinse of 10mL UltraPure Water containing 8.50mg NaNO3. Saliva samples were analyzed via ozone-based chemiluminescence using a Sievers NOA 280i. Comparisons between HFrEF and healthy controls for ONRC were assessed via a Mann Whitney U Test and differences in VO2peak, and VO2 at VT were examined via independent samples t-tests. Associations between ONRC and VO2 were explored through Spearman’s Rank correlations. RESULTS: ONRC was lower in HFrEF (NO2-: 452.3 ± 210.6µM) vs. controls (NO2-: 737.2 ± 302.9µM) (p = 0.035). ONRC for all participants was moderately to strongly correlated with VO2peak (r = 0.668; p = 0.007) and VO2 at VT (r = 0.775; p = 0.002). In individuals with HFrEF, ONRC was strongly correlated with VO2 at VT (r = 0.900; p = 0.037). CONCLUSIONS: This data is the first to suggest that ONRC may be dysfunctional in HFrEF in comparison to age-matched healthy participants. Furthermore, higher aerobic fitness improves ONRC in both healthy older individuals and those with HFrEF. This work was supported by the University of Virginia School of Education and Human Development and the National Institutes of Health (R01 AG075556). This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

  • The interrelationship among exercise intensity, endothelial function, and ghrelin in healthy humans

    Physiological Reports · 2025-04-01

    articleOpen accessSenior author

    Abstract Ghrelin circulates in acylated (AG) and deacylated (DAG) isoforms and both may impact endothelial function (EF). Although acute exercise has been shown to modulate ghrelin levels and EF, data on the impact of exercise intensity on these parameters are scarce. To investigate the effect of exercise intensity and sex on EF and ghrelin levels, nine males (age: 43.8 ± 10.3 y; BMI: 22.5 ± 1.8 kg/m 2 ) and eight females (age: 33.75 ± 10.2 y; BMI: 22.4 ± 1.6 kg/m 2 ) completed a maximal cycle ergometer lactate threshold (LT)/VO 2peak test. This test determined the exercise intensity for three visits: (a) CON, no exercise; (b) MOD, the power output (PO) at LT; (c) HIGH, the PO associated with 75% of the difference between LT and VO 2peak . Ghrelin levels and EF [flow‐mediated dilation (FMD), shear rate (SR)] were measured at baseline and then 30–120 min post‐exercise. HIGH and MOD increased FMD ( p < 0.0001). Each ghrelin isoform was suppressed by HIGH; only females exhibited reduced DAG levels in HIGH compared to MOD and CON ( p < 0.0001–0.004). FMD was associated with ghrelin levels in females ( r = −0.26–0.47). High‐intensity exercise is key for ghrelin suppression and appears to only be weakly/moderately related to EF.

  • Exercise Intensity, Insulin Sensitivity and Sex, but not Obesity, Impact Ghrelin and Appetite Responses to Acute Exercise

    Physiology · 2025-05-01

    articleSenior author

    Background: The hormone ghrelin has 2 isoforms, acylated (AG) and deacylated (DAG), and has biological effects that include energy balance, appetite, and glucose homeostasis. Ghrelin dysregulation is common in adults with obesity and/or diabetes and exercise has been shown to influence its release. However, the relationship between obesity, insulin sensitivity status (IS), and appetite is understudied, especially in females. Thus, the purpose of this study was to investigate the effects of obesity (BMI≥30), IS (Matsuda Index > 4.3), and ghrelin (TG, AG, DAG) on appetite after acute exercise of differing intensity. HYPOTHESES: We hypothesized that high intensity exercise and obesity status would lead to a suppression of appetite and decreases in all ghrelin isoforms. Methods: Seventeen lean adults (11IS/9F; Age: 41.2.0±9.2 y.; BMI: 22.2±1.7 kg/m 2 ; VO 2peak : 32.5±6.3 ml/kg/min) and eleven adults with obesity (3IS/7F; Age: 35.1±11.2 y.; BMI: 32.2±2.6 kg/m 2 ; VO 2peak : 21.5±3.9 ml/kg/min) underwent maximal exercise testing on a cycle ergometer. The lactate threshold (LT) and VO 2peak from maximal testing were used to determine intensities for randomized, calorically matched exercise conditions – moderate intensity (MOD): power output at LT; high intensity (HIGH): power output at 75% of difference between VO 2peak and LT; and control (CON): rest. Plasma glucose and insulin values during an oral glucose tolerance test were used to determine IS via the Matsuda Index. Plasma blood samples were obtained from an indwelling catheter at baseline at 60, 90, 120, 150, and 180 mins during experimental visits and used to measure total ghrelin (TG), AG, and DAG. At the same timepoints, participants also completed a visual analog scale (VAS) to assess desired to eat (EAT), hunger (HUN), fullness (FULL), satisfaction (SAT), and appetite (APP). APP scores were calculated with the formula: APP = EAT + HUN + (100 – FULL) + (100 – SAT))/4. Total area under the curve (AUC) was calculated for AG, DAG, TG, and VAS variables using the trapezoidal method. Linear mixed models were used to determine the appetite response to exercise, with participant as the random factor and obesity status, IS, sex, and condition as fixed factors. F-tests of nested models were used to determine differences in fixed effects. Estimated marginal means were utilized to estimate the means that were adjusted for the factors in each model. Data are reported as mean ± SE. Results: For ghrelin, there was a main effect of condition in AG AUC and TG AUC models, with reduced levels in HIGH v. MOD ( p =0.017-0.033) and a main effect of IS, where participants with insulin resistance had reduced levels of AG AUC regardless of condition( p =0.033). There was also a main effect of condition in APP AUC (HIGH < MOD; p =0.017) and an interaction between condition and sex where females had suppressed APP AUC in HIGH v. MOD ( p =0.02) and CON ( p <0.001). There were no effects found in males or based on obesity status ( p >0.05). Conclusions: Ghrelin and appetite are suppressed with high intensity exercise, with sex and insulin sensitivity status impacting this response. Future research should investigate if short-to-long-term high intensity exercise interventions elicit consistently suppressed ghrelin and appetite in untrained adults. UVA School of Education and Human Development and NIH NIDDK (R01 DK129510). This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

  • 45 (18A) The impact of exercise intensity on blood lactate in collegiate athletes with sport related concussion: a pilot study

    2025-05-01

    articleOpen access

    Purpose To examine the effect of calorically matched light (Rating of Perceived Exertion [RPE]-9) and moderate (RPE-13) daily exercise on Blood Lactate (La -) and days until symptom resolution (SRA) in collegiate athletes with concussion.Methods Participants (n=10,40% female) were randomly assigned to initiate a treadmill walking protocol at an RPE-13 (n=6, 33.3% female) or RPE-9 (n=4, 50% female) within 72 hours of concussion.Initial symptom severity was assessed with the Revised Head Injury Scale at Visit 1. Blood La - (mmol) was measured before and after exercise at Visit 1 and Visit 2(SRA).Initial symptom severity and days to SRA were compared using independent t-tests.An ANCOVA compared change in La -between Groups at Visits 1 and 2, controlling for initial total symptom severity.Analyses were performed with a= 0.05.Results Although underpowered, initial symptom severity was greater in RPE-13 (32.013.1)compared with RPE-9 (16.8 8.62).Average heart rate was similar between RPE-13 (116 14.0 bpm) and RPE-9 (1039.97bpm) groups at Visit 1. RPE-13 (1318.08bpm) was significantly higher than RPE-9 (10913.0 bpm [p=0.01]) at Visit 2. Days until SRA were similar between RPE-13 (9.04.29) and RPE-9 (6.254.99)groups (p>0.05).Though not significant, change in La - between RPE-13 (1.282.06;0.021.33)and RPE-9 (-2.20 2.89; 0.570.51)at Visits 1 and 2 showed differing patterns.Conclusions Though our study was underpowered to evaluate how exercise intensity influences La -responses in collegiate athletes with concussion, both RPE-13 and RPE-9 groups achieved SRA approximately three and four days sooner than collegiate athletes, with similar symptom severity, who received standard-of-care concussion management.

  • The acute effects of exercise intensity and inorganic nitrate supplementation on subendocardial viability ratio in postmenopausal females

    Physiology · 2025-05-01

    article

    Background: Menopause elevates coronary heart disease (CHD) risk partly due to reduced estrogen-derived nitric oxide (NO) bioavailability. Coronary artery perfusion is a predictor of CHD and subendocardial viability ratio (SEVR) reflects the balance of myocardial oxygen supply and demand as an indicator of myocardial perfusion. Postmenopausal females (PMF) exhibit a lower SEVR and impaired myocardial perfusion compared to age-matched males. Although exercise can benefit myocardial perfusion, there appears to be a transient reduction in SEVR following acute exercise and endothelial-training adaptations are blunted in PMF. We recently reported that acute high-intensity exercise with inorganic nitrate (NO 3 - ) supplementation increased NO bioavailability and improved post-exercise endothelial function in PMF, but the impact of acute exercise and NO 3 - on myocardial O 2 supply and demand (SEVR) remains unexplored. Hypothesis: Following acute exercise, SEVR in PMF will be reduced in an exercise-intensity dependent manner and will be attenuated with NO 3 - supplementation. Methods: In a double-blinded, randomized design, 24 PMF (60±5 years, 27.5±5.9 kg/m 2 , 10±5 years since menopause, VO 2 peak=1.7±0.3 L/min) were randomized to consume 13 mmol of NO 3 - in the form of beetroot juice (BRJ; n=12) or placebo (PL; n=12) for 2 days with the last dose 2h before testing. SEVR was noninvasively measured via pulse wave analysis (SphymoCor, AtCor Medical) before (T0) and at 30 min intervals after (T60, T90, T120, T150, and T180) calorically matched high-intensity exercise (HIE), moderate-intensity exercise (MIE), and a non-exercise control (CON). Venous blood was sampled prior to supplementation and at rest 2h after the last supplementation dose for plasma NO 3 - and nitrite (NO 2 - ) concentrations. The area under the curve (SEVR AUC) was calculated for treatment group and exercise intensity. Mixed-model ANOVAs were performed to compare post-exercise SEVR across intensities and treatments. Results: BRJ supplementation significantly increased plasma NO 3 - (BRJ: 999±207mM; PL: 48±20mM; p<0.001) and plasma NO 2 - (BRJ: 544±241nM; PL: 200±132nM; p <0.001). Post-exercise SEVR AUC was significantly decreased compared to CON in an intensity dependent manner (intensity effect: p <0.0001). The BRJ treatment group had a significant attenuation in the post-exercise SEVR AUC decline compared to PL (treatment effect: p =0.009). Post hoc analysis showed the BRJ-induced attenuation in post-exercise SEVR AUC was significant following HIE (PL: 21,938±993 AU vs BRJ: 24,437±1,367AU, p<0.0001). Conclusions: Acute exercise suppresses SEVR for several hours in PMF in an intensity dependent manner, suggesting impaired myocardial O 2 supply to demand. NO 3 - supplementation attenuated the decline in post-exercise SEVR in healthy PMF. This work was supported by the UVA School of Education and Human Development Inclusion Diversity Equity Access (IDEA) and the UVA Department of Kinesiology (AW). This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

  • Oral nitrate-reducing capacity and aerobic fitness are impaired in older individuals with heart failure with reduced ejection fraction

    American Journal of Physiology-Heart and Circulatory Physiology · 2025-09-08 · 3 citations

    articleOpen access

    Although the link between cardiovascular disease and oral health has been established, the mechanisms underlying this relationship are not fully understood. These data are the first to suggest that the nitrate-reducing capacity of oral microbiota is lower in individuals with heart failure with reduced ejection fraction compared with healthy individuals, indicating that strategies to positively modulate the oral microbiome may improve the therapeutic potential of oral inorganic nitrate supplementation in heart failure.

  • Increased Endogenous Interleukin-1 Receptor Antagonist Levels after High Intensity Exercise in Healthy Adults

    Physiology · 2025-05-01

    article

    Introduction: Exercise triggers an inflammatory response in healthy adults which is followed by an anti-inflammatory response, including an increase in circulating levels of IL-1 receptor antagonist (IL-1Ra). Determining an optimal exercise prescription that can increase IL-1Ra and subsequently decrease inflammation may have therapeutic implications. Hypothesis: We hypothesized that calorically-equivalent high-intensity exercise (HIE) will induce a greater IL-1Ra response than moderate-intensity exercise (MIE). Aims: We aim to compare the changes in circulating IL-1Ra levels after moderate versus high-intensity exercise. Methods: Participants aged 18-55 years with a BMI between 18-40 kg/m 2 , without any known cardiovascular or rheumatologic disorders were included. Subjects underwent a standardized cycle ergometer protocol to measure lactate threshold (LT) and peak oxygen consumption (pVO 2 ) before three experimental visits in a random order: 1) control (CON); 2) HIE (75% delta between LT and pVO 2 ); and 3) MIE (at LT). Exercise was matched for energy expenditure within subjects. Venous blood was drawn pre-exercise/control, and every 30 minutes up to 180 min. Plasma IL-1Ra was measured using enzyme-linked immunosorbent assay (ELISA). Data are median [IQR] and compared between intensities using mixed models, with change over time (delta) compared using Wilcoxon signed-rank test. Results: We studied 14 adults (36 [26-45] years, 43% female, 64% white, BMI 33 [23-36], pVO 2 23.7 [19.8-34.5] ml/kg/min and 90 [77-102] % of predicted pVO 2 based on the Wasserman/Hansen formula). Baseline IL-1Ra levels were similar each visit ( p = 0.83). Energy expenditure was well-matched between intensities (HIE 272 [200 - 286] kcal, MIE 255 [197-292] kcal, p = 0.99). IL-1Ra was significantly different across exercise intensity ( p = 0.02), and time ( p = 0.03), with a trend for an interaction ( p = 0.06). Delta IL-1Ra at 180min was not significantly different during CON ( p = 0.54) or MIE ( p = 0.28), but was significantly higher after HIE ( p = 0.002). Conclusion: The anti-inflammatory cytokine IL-1Ra is increased after an individualized high intensity exercise bout, but not after moderate intensity exercise matched for energy expenditure. National Institute of Diabetes and Digestive and Kidney Diseases (5R01DK129510-02). This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

  • Gait Biomechanics Among Female Endurance Runners: Comparing Days With and Without Menstrual Cycle–Related Symptoms

    Journal of Athletic Training · 2025-05-29 · 1 citations

    articleOpen access

    OBJECTIVE: Determine differences in running biomechanics in female endurance runners between days when they did and did not report menstrual cycle-related symptoms. METHODS: Observational study. Subjects were provided RunScribe sensors to attach to their shoes to collect biomechanical data when running. Daily during the study period, subjects were sent a text message to complete a survey asking about their wellness, menstrual status, and training status. Descriptive measures (mean ± SD) were generated for whether runners reported being asymptomatic or symptomatic during runs and run workout details. Paired sample t-tests were executed to identify differences in impact Gs, braking Gs, pronation excursion, maximum pronation velocity, foot strike type, and gait speed between runs on days participants reported having menstrual-related symptoms (symptomatic) or not (asymptomatic). Participants needed to have recorded runs spanning the entire data collection window to be included for comparative analyses. RESULTS: Twenty-seven university club runners (age 20.5 ± 1.5) participated in the study. All runners (n = 27) experienced at least one menstrual cycle-related symptom during data collection. The average number of asymptomatic runs was 22.3 ± 17.1 and symptomatic runs was 9.1 ± 7.5. Daily mileage averaged 4.3 ± 1.9 miles and total mileage was 154.2 ± 115.4 miles. Fourteen runners had run data viable for pairwise sampling. There was no significant difference in biomechanical measures between symptomatic or asymptomatic days (p > .05). CONCLUSION: This study prospectively monitored distance runners' activity while simultaneously recording symptoms related to the menstrual cycle. While runners reported fewer days running when symptomatic, we did not identify a difference in objective biomechanical measures between asymptomatic or symptomatic runs. Perceived symptom burden was present in this sport population and may warrant further exploration of perceived expectations of the menstrual cycle to athletic performance.

  • Impact Of Obesity, Insulin Sensitivity, Exercise Intensity, And Sex On Ghrelin Release With Acute Exercise

    Medicine & Science in Sports & Exercise · 2025-09-16

    articleSenior author

    The hormone ghrelin exists in 2 isoforms, acylated (AG) and deacylated (DAG), and has systemic metabolic effects, including regulation of body weight and glucose metabolism. Ghrelin dysregulation is common in adults with obesity and/or diabetes and exercise has been shown to influence its release. However, few data examine the relationship among obesity, insulin sensitivity (IS), and acute exercise of differing intensity in untrained males and females. PURPOSE: To examine the effects of obesity (BMI > 30) and IS (Masuda Index >4.3) on ghrelin during acute exercise. METHODS: Sixteen lean adults (14IS/9F; Age: 38.4 ± 11.2 y.; BMI: 22.4 ± 1.7 kg/m2; VO2peak: 31.2 ± 6.0 ml/kg/min) and 13 adults with obesity (4IS/8F; Age: 37.9 ± 9.8 y.; BMI: 33.7 ± 2.3 kg/m2; VO2peak: 21.7 ± 4.4 ml/kg/min) completed a maximal exercise test on a cycle ergometer. Lactate threshold (LT) and VO2peak were used to set intensities for randomized, calorically matched exercise conditions – moderate intensity (MOD): power output at LT; high intensity (HIGH): power output at 75% of difference between VO2peak and LT; and control (CON): rest. IS was determined by an oral glucose tolerance test. Blood samples obtained from an indwelling catheter every 10 min for the first hr, and every 30 min for last 2 hr during experimental visits were used to measure total ghrelin (TG), AG, and DAG. Linear mixed models were used to determine ghrelin response to exercise, with participant as the random factor and obesity status, IS, sex, time, and condition as fixed factors. RESULTS: Overall, ghrelin (TG, AG, DAG) was decreased in HIGH v CON (p < 0.001), and there was an interaction effect for obesity, sex, and condition (p < 0.001-0.027). In IS subjects, ghrelin (TG, AG, DAG) was decreased during HIGH v CON (p < 0.001), regardless of sex and obesity. Females, regardless of obesity status, had decreased AG and TG in HIGH v CON (p < 0.001-0.0162). Lean males had reduced DAG and TG in HIGH v CON (p < 0.001). CONCLUSIONS: Obesity, IS, exercise intensity, and sex influence ghrelin responses to acute exercise, with lean adults and females having suppressed ghrelin release with high intensity exercise. Moreover, IS individuals, regardless of obesity status, appear to have reduced ghrelin levels with high intensity exercise.

  • The Pharmacokinetics of Saliva and Plasma N-Oxides Following a Single Administration of a Plant-Based Bioequivalent Inorganic Nitrate Oral Supplement in an Open-Label, Phase 1, Single-Arm Study

    Journal of Clinical Medicine · 2025-06-27 · 1 citations

    articleOpen accessSenior authorCorresponding

    Background/Objective: Hypertension and other modifiable risk factors for cardiovascular disease are characterized by a dysfunctional vascular endothelium and decreased nitric oxide (NO) bioavailability. The oral supplementation of inorganic nitrate (NO3−) has been shown to increase the salivary and plasma nitrite (NO2−), a precursor to NO, though there may be significant variation in the pharmacokinetics of this process between different supplements. The purpose of this open-label, phase 1, single-arm study was to investigate the pharmacokinetic profile of the plasma and salivary NO3− and NO2− concentrations following the administration of a single serving of a plant-based bioequivalent inorganic nitrate oral supplement (“Berkeley Life Nitric Oxide Foundation Capsules”, Chicago, IL, USA). Methods: Nine males and three females (age: 33 ± 15 years; BP: 129 ± 6 mmHg; BMI: 27.58 ± 4.27 kg/m2) participated in the protocol. Following the baseline collection of saliva and plasma samples, the participants consumed 314 mg (two capsules) of the supplement. Saliva and plasma samples were collected at 2 h, 4 h, 8 h, and 24 h post consumption. Results: The peak salivary NO3− (13,326.12 ± 4926.60 µM), salivary NO2− (1375.27 ± 679.28 µM), plasma NO3− (498.37 ± 168.89 µM), and plasma NO2− (231.66 ± 97.26 nM) were observed at 2 h post-supplementation (p &lt; 0.01 vs. the baseline). The concentrations of the salivary and plasma NO2− remained elevated at 8 h after administration (220% and 50% above the baseline, respectively), and the concentrations of the salivary and plasma NO3− remained elevated at 24 h after administration (22% and 50% above the baseline, respectively). Conclusions: These data suggest that a single serving of “Berkeley Life Nitric Oxide Foundation Capsules” taken once to twice per day is a viable strategy to provide sustained salivary and plasma NO3− and NO2− availability over 24 h and therefore may provide a viable approach for long-term blood pressure maintenance.

Recent grants

Frequent coauthors

  • Judy Y. Weltman

    University of Virginia

    123 shared
  • Glenn A. Gaesser

    Arizona State University

    97 shared
  • Alan D. Rogol

    88 shared
  • James T. Patrie

    University of Virginia

    78 shared
  • Laurie Wideman

    University of North Carolina at Greensboro

    74 shared
  • Johannes D. Veldhuis

    Mayo Clinic in Florida

    74 shared
  • Mark L. Hartman

    Eli Lilly (United States)

    70 shared
  • Eugene J. Barrett

    University of Virginia

    66 shared

Education

  • PhD, Kinesiology

    University of Michigan

    1976

Awards & honors

  • National Sports Medicine Award
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