Cerebral changes during exercise in the heat

Practical on-site measurement of heat strain with the use of a perceptual strain index

OBJECTIVES

There have been increased interests in research on quantifying heat strain of construction workers and formulating corresponding guidelines for working in hot weather. The aim of this study was to validate a subjective measurement tool, the perceptual strain index (PeSI), for measuring heat strain in real-work settings.

METHODS

A total of sixteen construction workers were invited to participate in the field surveys. Empiric-based human monitoring was carried out with simultaneous micrometeorological (wet-bulb globe temperature, WBGT), physiological (heart rate, HR), and perceptual (perceived exertion, RPE; thermal sensation, TS) measurements throughout the test. The relative heart rate (RHR), the physiological strain index (PSIHR), and the PeSI were then calculated accordingly.

RESULTS

The PeSI exhibited moderate correlations with WBGT and RHR (r = 0.42 and 0.40, respectively), which indicated the PeSI was sensitive to the variants of WBGT and RHR. The results of regression analysis indicated that the PeSI changed in the same general manner as the PSIHR, with a relatively large determination coefficient (R(2) = 0.67). The established perceptual strain zone illustrated that the PeSI ranging from 7 to 8 would be the exposure limit of construction workers in hot weather.

CONCLUSION

The PeSI is a simple, robust, reliable, and user-friendly tool for heat strain assessment in occupational settings. The perceptual strain zone will provide practical guidelines for on-site heat strain monitoring for construction workers.

The effects of temporal neck cooling on cognitive function during strenuous exercise in a hot environment: a pilot study

Background

Heat stress potentially has detrimental effects on brain function. Hence, cognitive function may be impaired during physical activity in a hot environment. Skin cooling is often applied in a hot environment to counteract heat stress. However, it is unclear to what extent neck cooling is effective for cognitive impairment during exercise in a hot environment. The purpose of this study was to examine the effects of temporal neck cooling on cognitive function during strenuous exercise in a hot environment.

Methods

Eight male young participants (mean ± SD, age = 26.1 ± 3.2 years; peak oxygen uptake = 45.6 ± 5.2 ml/kg/min) performed Spatial delayed response (DR) task (working memory) and Go/No-Go task (executive function) at rest and during exercise in the Hot and Hot + Cooling conditions. After the participants completed the cognitive tasks at rest, they cycled the ergometer until their heart rate (HR) reached 160 beats/min. Then, they cycled for 10 min while keeping their HR at 160 beats/min. The cognitive tasks were performed 3 min after their HR reached 160 beats/min. The air temperature was maintained at 35°C and the relative humidity was controlled at 70%. Neck cooling was applied to the backside of the neck by a wet towel and fanning. We used accuracy of the Spatial DR and Go/No-Go tasks and reaction time in the Go/No-Go task to assess cognitive function.

Results

Neck cooling temporarily decreased the skin temperature during exercise. The accuracy of the cognitive tasks was lower during exercise than that at rest in the Hot and Hot + Cooling condition (p < 0.05). There were no differences in the accuracy between the Hot and Hot + Cooling conditions (p = 0.98). Neither exercise (p = 0.40) nor cooling (p = 0.86) affected reaction time. These results indicate that temporal neck cooling did not alter cognitive function during strenuous exercise in a hot environment.

Conclusions

The present study suggests that temporal neck cooling with a wet towel and fanning is not effective for attenuating impairment of working memory and executive function during strenuous exercise with a short duration in a warm and humid environment.

Performance in the heat-physiological factors of importance for hyperthermia-induced fatigue

This article presents a historical overview and an up-to-date review of hyperthermia-induced fatigue during exercise in the heat. Exercise in the heat is associated with a thermoregulatory burden which mediates cardiovascular challenges and influence the cerebral function, increase the pulmonary ventilation, and alter muscle metabolism; which all potentially may contribute to fatigue and impair the ability to sustain power output during aerobic exercise. For maximal intensity exercise, the performance impairment is clearly influenced by cardiovascular limitations to simultaneously support thermoregulation and oxygen delivery to the active skeletal muscle. In contrast, during submaximal intensity exercise at a fixed intensity, muscle blood flow and oxygen consumption remain unchanged and the potential influence from cardiovascular stressing and/or high skin temperature is not related to decreased oxygen delivery to the skeletal muscles. Regardless, performance is markedly deteriorated and exercise-induced hyperthermia is associated with central fatigue as indicated by impaired ability to sustain maximal muscle activation during sustained contractions. The central fatigue appears to be influenced by neurotransmitter activity of the dopaminergic system, but inhibitory signals from thermoreceptors arising secondary to the elevated core, muscle and skin temperatures and augmented afferent feedback from the increased ventilation and the cardiovascular stressing (perhaps baroreceptor sensing of blood pressure stability) and metabolic alterations within the skeletal muscles are likely all factors of importance for afferent feedback to mediate hyperthermia-induced fatigue during submaximal intensity exercise. Taking all the potential factors into account, we propose an integrative model that may help understanding the interplay among factors, but also acknowledging that the influence from a given factor depends on the exercise hyperthermia situation.

Performance limitation and the role of core temperature when wearing light-weight workwear under moderate thermal conditions

The objective of this investigation was to achieve an understanding about the relationship between heat stress and performance limitation when wearing a two-layerfire-resistant light-weight workwear (full-clothed ensemble) compared to an one-layer short sports gear (semi-clothed ensemble) in an exhaustive, stressful situation under moderate thermal condition (25°C). Ten well trained male subjects performed a strenuous walking protocol with both clothing ensembles until exhaustion occurred in a climatic chamber. Wearing workwear reduced the endurance performance by 10% (p=0.007) and the evaporation by 21% (p=0.003), caused a more pronounced rise in core temperature during submaximal walking (0.7±0.3 vs. 1.2±0.4°C; p≤0.001) and from start till exhaustion (1.4±0.3 vs. 1.8±0.5°C; p=0.008), accelerated sweat loss (13±2 vs. 15±3gmin(-1); p=0.007), and led to a significant higher heart rate at the end of cool down (103±6 vs. 111±7bpm; p=0.004). Correlation analysis revealed that core temperature development during submaximal walking and evaporation may play important roles for endurance performance. However, a critical core temperature of 40°C, which is stated to be a crucial factor for central fatigue and performance limitation, was not reached either with the semi-clothed or the full-clothed ensemble (38.3±0.4 vs. 38.4±0.5°C). Additionally, perceived exertion did not increase to a higher extent parallel with the rising core temperature with workwear which would substantiate the critical core temperature theory. In conclusion, increased heat stress led to cardiovascular exercise limitation rather than central fatigue.

Neuroscience of exercise: from neurobiology mechanisms to mental health

The neuroscience of exercise is a growing research area that is dedicated to furthering our understanding of the effects that exercise has on mental health and athletic performance. The present study examined three specific topics: (1) the relationship between exercise and mental disorders (e.g. major depressive disorder, dementia and Parkinson's disease), (2) the effects of exercise on the mood and mental health of athletes, and (3) the possible neurobiological mechanisms that mediate the effects of exercise. Positive responses to regular physical exercise, such as enhanced functional capacity, increased autonomy and improved self-esteem, are frequently described in the recent literature, and these responses are all good reasons for recommending regular exercise. In addition, physical exercise may improve both mood and adherence to an exercise program in healthy individuals and might modulate both the performance and mental health of athletes. Exercise is associated with the increased synthesis and release of both neurotransmitters and neurotrophic factors, and these increases may be associated with neurogenesis, angiogenesis and neuroplasticity. This review is a call-to-action that urges researchers to consider the importance of understanding the neuroscience of physical exercise and its contributions to sports science.

Power spectral analysis of two-channel EEG in very premature infants undergoing heat loss prevention

OBJECTIVE

To evaluate whether wearing a wool cap, a routine practice used to prevent heat loss in premature infants, affects interpretation of electroencephalogram spectral analysis.

METHODS

Eighteen premature infants (median gestational age 28 weeks, range 23-32) without neurological complications were randomized to two channel (C3, C4 referred to Cz) digital electroencephalogram recordings with (90 min) and without (90 min) wearing wool cap, at 4 days of life. Electroencephalogram was analyzed automatically by measurement of burst suppression ratio and asymmetry index and by Fast Fourier Transform to calculate total absolute spectral power; relative spectral power in the δ (0.5-3.5 Hz), θ (4-7.5 Hz), α (8-12.5 Hz), and β (13-30 Hz) frequency bands; spectral edge frequency; and mean dominant frequency.

RESULTS

The use of wool cap had no effect on all electroencephalogram parameters considered. Gestational age showed an effect on relative spectral power of all considered bands, spectral edge frequency and mean dominant frequency, while no effect was seen on burst suppression ratio and asymmetry index. Neonates born at gestational weeks lower than 28 had significantly higher relative power in the δ band and lower relative power in the α and β bands.

CONCLUSIONS

Heat loss prevention using wool cap does not affect interpretation of spectral electroencephalogram. Spectral values in our group of very premature infants without neurological complications correspond to normal data reported in the literature. Maturation changes consist of reduction of relative power of the δ band, spectral edge frequency and mean dominant frequency.

Altered topological patterns of large-scale brain functional networks during passive hyperthermia

In this study, we simulated environmental heat exposure to 18 participants, and obtained functional magnetic resonance image (fMRI) data during resting state. Brain functional networks were constructed over a wide range of sparsity threshold according to a prior atlas dividing the whole cerebrum into 90 regions. Results of graph theoretical approaches showed that although brain networks in both normal and hyperthermia conditions exhibited economical small-world property, significant alterations in both global and nodal network metrics were demonstrated during hyperthermia. Specifically, a lower clustering coefficient, maintained shortest path length, a lower small-worldness, a lower mean local efficiency were found, indicating a tendency shift to a randomized network. Additionally, significant alterations in nodal efficiency were found in bilateral gyrus rectus, bilateral parahippocampal gyrus, bilateral insula, right caudate nucleus, bilateral putamen, left temporal pole of middle temporal gyrus, right inferior temporal gyrus. In consideration of physiological system changes, we found that the alterations of normalized clustering coefficient, small-worldness, mean normalized local efficiency were significantly correlated with the rectal temperature alteration, but failed to obtain significant correlations with the weight loss. More importantly, behavioral attention network test (ANT) after MRI scanning showed that the ANT effects were altered and correlated with the alterations of some global metrics (normalized shortest path length and normalized global efficiency) and prefrontal nodal efficiency (right dorsolateral superior frontal gyrus, right middle frontal gyrus and left orbital inferior frontal gyrus), implying behavioral deficits in executive control effects and maintained alerting and orienting effects during passive hyperthermia. The present study provided the first evidence for human brain functional disorder during passive hyperthermia according to graph theoretical analysis using resting-state fMRI.

Pre-cooling and sports performance: a meta-analytical review

Pre-cooling is used by many athletes for the purpose of reducing body temperature prior to exercise and, consequently, decreasing heat stress and improving performance. Although there are a considerable number of studies showing beneficial effects of pre-cooling, definite conclusions on the effectiveness of pre-cooling on performance cannot yet be drawn. Moreover, detailed analyses of the specific conditions under which pre-cooling may be most promising are, so far, missing. Therefore, we conducted a literature search and located 27 peer-reviewed randomized controlled trials, which addressed the effects of pre-cooling on performance. These studies were analysed with regard to performance effects and several test circumstances (environmental temperature, test protocol, cooling method, aerobic capacity of the subjects). Eighteen studies were performed in a hot (>26°C) environment and eight in a moderate. The cooling protocols were water application (n = 12), cooling packs (n = 3), cold drinks (n = 2), cooling vest (n = 6) and a cooled room (n = 4). The following different performance tests were used: short-term, high-intensity sprints (n = 2), intermittent sprints (n = 6), time trials (n = 10), open-end tests (n = 7) and graded exercise tests (n = 2). If possible, subjects were grouped into different aerobic capacity levels according to their maximal oxygen consumption (VO(2max)): medium 55-65 mL/kg/min (n = 11) and high >65 mL/kg/min (n = 6). For all studies the relative changes of performance due to pre-cooling compared with a control condition, as well as effect sizes (Hedges' g) were calculated. Mean values were weighted according to the number of subjects in each study. Pre-cooling had a larger effect on performance in hot (+6.6%, g = 0.62) than in moderate temperatures (+1.4%, g = 0.004). The largest performance enhancements were found for endurance tests like open-end tests (+8.6%, g = 0.52), graded exercise tests (+6.0%, g = 0.44) and time trials (+4.2%, g = 0.44). A similar effect was observed for intermittent sprints (+3.3%, g = 0.43), whereas performance changes were smaller during short-term, high-intensity sprints (-0.5%, g = 0.03). The most promising cooling methods were cold drinks (+15.0%, g = 1.68), cooling packs (+5.6%, g = 0.70) and a cooled room (+10.7%, g = 0.49), whereas a cooling vest (+4.8%, g = 0.31) and water application (+1.2%, g = 0.21) showed only small effects. With respect to aerobic capacity, the best results were found in the subjects with the highest VO(2max) (high +7.7%, g = 0.65; medium +3.8%, g = 0.27). There were four studies analysing endurance-trained athletes under time-trial conditions, which, in a practical sense, seem to be most relevant. Those studies found an average effect on performance of 3.7% (g = 0.48). In summary, pre-cooling can effectively enhance endurance performance, particularly in hot environments, whereas sprint exercise is barely affected. In particular, well trained athletes may benefit in a typical competition setting with practical and relevant effects. With respect to feasibility, cold drinks, cooling packs and cooling vests can be regarded as best-practice methods.

Physiological responses and physical performance during football in the heat

PURPOSE

To examine the impact of hot ambient conditions on physical performance and physiological responses during football match-play.

METHODS

Two experimental games were completed in temperate (∼ 21°C; CON) and hot ambient conditions (∼ 43°C; HOT). Physical performance was assessed by match analysis in 17 male elite players during the games and a repeated sprint test was conducted after the two game trials. Core and muscle temperature were measured and blood samples were obtained, before and after the games.

RESULTS

Muscle and core temperatures were ∼ 1°C higher (P<0.05) in HOT (40.3 ± 0.1 and 39.5 ± 0.1°C, respectively) compared to CON (39.2 ± 0.1 and 38.3 ± 0.1°C). Average heart rate, plasma lactate concentration, body weight loss as well as post-game sprint performance were similar between the two conditions. Total game distance declined (P<0.05) by 7% and high intensity running (>14 km ⋅ h(-1)) by 26% in HOT compared to CON), but peak sprint speed was 4% higher (P<0.05) in HOT than in CON, while there were no differences in the quantity or length of sprints (>24 km ⋅ h(-1)) between CON and HOT. In HOT, success rates for passes and crosses were 8 and 9% higher (P<0.05), respectively, compared to CON. Delta increase in core temperature and absolute core temperature in HOT were correlated to total game distance in the heat (r = 0.85 and r = 0.53, respectively; P<0.05), whereas, total and high intensity distance deficit between CON and HOT were not correlated to absolute or delta changes in muscle or core temperature.

CONCLUSION

Total game distance and especially high intensity running were lower during a football game in the heat, but these changes were not directly related to the absolute or relative changes in core or muscle temperature. However, peak sprinting speed and execution of successful passes and crosses were improved in the HOT condition.

Differential blood flow responses to CO₂ in human internal and external carotid and vertebral arteries

Arterial CO2 serves as a mediator of cerebral blood flow(CBF), and its relative influence on the regulation of CBF is defined as cerebral CO2 reactivity. Our previous studies have demonstrated that there are differences in CBF responses to physiological stimuli (i.e. dynamic exercise and orthostatic stress) between arteries in humans. These findings suggest that dynamic CBF regulation and cerebral CO2 reactivity may be different in the anterior and posterior cerebral circulation. The aim of this study was to identify cerebral CO2 reactivity by measuring blood flow and examine potential differences in CO2 reactivity between the internal carotid artery (ICA), external carotid artery (ECA) and vertebral artery (VA). In 10 healthy young subjects, we evaluated the ICA, ECA, and VA blood flow responses by duplex ultrasonography (Vivid-e, GE Healthcare), and mean blood flow velocity in middle cerebral artery (MCA) and basilar artery (BA) by transcranial Doppler (Vivid-7, GE healthcare) during two levels of hypercapnia (3% and 6% CO2), normocapnia and hypocapnia to estimate CO2 reactivity. To characterize cerebrovascular reactivity to CO2,we used both exponential and linear regression analysis between CBF and estimated partial pressure of arterial CO2, calculated by end-tidal partial pressure of CO2. CO2 reactivity in VA was significantly lower than in ICA (coefficient of exponential regression 0.021 ± 0.008 vs. 0.030 ± 0.008; slope of linear regression 2.11 ± 0.84 vs. 3.18 ± 1.09% mmHg−1: VA vs. ICA, P <0.01). Lower CO2 reactivity in the posterior cerebral circulation was persistent in distal intracranial arteries (exponent 0.023 ± 0.006 vs. 0.037 ± 0.009; linear 2.29 ± 0.56 vs. 3.31 ± 0.87% mmHg−1: BA vs. MCA). In contrast, CO2 reactivity in ECA was markedly lower than in the intra-cerebral circulation (exponent 0.006 ± 0.007; linear 0.63 ± 0.64% mmHg−1, P <0.01). These findings indicate that vertebro-basilar circulation has lower CO2 reactivity than internal carotid circulation, and that CO2 reactivity of the external carotid circulation is markedly diminished compared to that of the cerebral circulation, which may explain different CBF responses to physiological stress.

Cold water immersion recovery following intermittent-sprint exercise in the heat

This study examined the effects of cold water immersion (CWI) on recovery of neuromuscular function following simulated team-sport exercise in the heat. Ten male team-sport athletes performed two sessions of a 2 × 30-min intermittent-sprint exercise (ISE) in 32°C and 52% humidity, followed by a 20-min CWI intervention or passive recovery (CONT) in a randomized, crossover design. The ISE involved a 15-m sprint every minute separated by bouts of hard running, jogging and walking. Voluntary and evoked neuromuscular function, ratings of perceived muscle soreness (MS) and blood markers for muscle damage were measured pre- and post-exercise, immediately post-recovery, 2-h and 24-h post-recovery. Measures of core temperature (Tcore), heart rate (HR), capillary blood and perceptions of exertion, thermal strain and thirst were also recorded at the aforementioned time points. Post-exercise maximal voluntary contraction (MVC) and activation (VA) were reduced in both conditions and remained below pre-exercise values for the 24-h recovery (P < 0.05). Increased blood markers of muscle damage were observed post-exercise in both conditions and remained elevated for the 24-h recovery period (P < 0.05). Comparative to CONT, the post-recovery rate of reduction in Tcore, HR and MS was enhanced with CWI whilst increasing MVC and VA (P < 0.05). In contrast, 24-h post-recovery MVC and activation were significantly higher in CONT compared to CWI (P = 0.05). Following exercise in the heat, CWI accelerated the reduction in thermal and cardiovascular load, and improved MVC alongside increased central activation immediately and 2-h post-recovery. However, despite improved acute recovery CWI resulted in an attenuated MVC 24-h post-recovery.

Peripheral markers of central fatigue in trained and untrained during uncompensable heat stress

The development of fatigue is more pronounced in the heat than thermoneutral environments; however, it is unclear whether biomarkers of central fatigue are consistent with the higher core temperature (T (c)) tolerated by endurance trained (TR) versus untrained (UT) during exertional heat stress (EHS). The purpose of this study was to examine the indicators of central fatigue during EHS in TR versus UT. Twelve TR and 11 UT males (mean ± SE [Formula: see text] = 70 ± 2 and 50 ± 1 mL kg LBM(-1) min(-1), respectively) walked on a treadmill to exhaustion (EXH) in 40°C (dry) wearing protective clothing. Venous blood was obtained at PRE and 0.5°C T (c) increments from 38 to 40°C/EXH. Free tryptophan (f-TRP) decreased dramatically at 39.5°C for the TR. Branch chain amino acids decreased with T (c) and were greater for UT than TR at EXH. Tyrosine and phenylalanine remained unchanged. Serum S100β was undetectable (<5 pg mL(-1)). Albumin was greater for the UT from PRE to 39.0°C and at EXH. Prolactin (PRL) responded to relative thermal strain with similar EXH values despite higher T (c) tolerated for TR (39.7 ± 0.09°C) than UT (39.0 ± 0.09°C). The high EXH PRL values for both groups support its use as a biomarker of the serotonin and dopamine interplay within the brain during the development of central fatigue.

Brain temperature: heat production, elimination and clinical relevance

Neurological insults are a leading cause of morbidity and mortality, both in adults and especially in children. Among possible therapeutic strategies to limit clinical cerebral damage and improve outcomes, hypothermia remains a promising and beneficial approach. However, its advantages are still debated after decades of use. Studies in adults have generated conflicting results, whereas in children recent data even suggest that hypothermia may be detrimental. Is it because brain temperature physiology is not well understood and/or not applied properly, that hypothermia fails to convince clinicians of its potential benefits? Or is it because hypothermia is not, as believed, the optimal strategy to improve outcome in patients affected with an acute neurological insult? This review article should help to explain the fundamental physiological principles of brain heat production, distribution and elimination under normal conditions and discuss why hypothermia cannot yet be recommended routinely in the management of children affected with various neurological insults.

Neuromuscular fatigue in healthy muscle: underlying factors and adaptation mechanisms

OBJECTIVES

This review aims to define the concept of neuromuscular fatigue and to present the current knowledge of the central and peripheral factors at the origin of this phenomenon. This review also addresses the literature that focuses on the mechanisms responsible for the adaption to neuromuscular fatigue.

METHOD

One hundred and eighty-two articles indexed in PubMed (1954-2010) have been considered.

RESULTS

Neuromuscular fatigue has central and peripheral origins. Central fatigue, preponderant during long-duration, low-intensity exercises, may involve a drop in the central command (motor, cortex, motoneurons) elicited by the activity of cerebral neurotransmitters and muscular afferent fibers. Peripheral fatigue, associated with an impairment of the mechanisms from excitation to muscle contraction, may be induced by a perturbation of the calcium ion movements, an accumulation of phosphate, and/or a decrease of the adenosine triphosphate stores. To compensate for the consequent drop in force production, the organism develops several adaptation mechanisms notably implicating motor units.

CONCLUSION

Fatigue onset is associated with an alteration of the mechanisms involved in force production. Then, the interaction between central and peripheral mechanisms leads to a series of events that ultimately contribute to the observed decrease in force production.

Cycling in the heat: performance perspectives and cerebral challenges

Cycling performances require periods with high power output and consequently large endogenous heat production. During cycling in temperate or cold climates, heat is mainly released from the skin to the surroundings via convection, whereas evaporative heat loss becomes the dominant or only mechanism for heat dissipation when the environmental temperature increases. Accordingly, large sweat rates are required, which may challenge the cyclists' electrolyte and water balance. Furthermore, the cooling capacity of the environment may become a limiting factor for the ability to maintain heat balance, for example during cycling in very humid climates or when cycling up-hill as the wind speed decreases and reduces the maximal rate of evaporative heat loss. Hyperthermia may in itself hamper performance, but especially in combination with dehydration it may deteriorate the cyclist's ability to maintain power output. Fatigue mechanisms involve cardiovascular stressing, but it also appears that factors within the central nervous system are of major importance for motor performance during such exercise. However, the influence of the environmental temperature on cycling performance appears to vary markedly depending on the course, the air humidity and the cyclist ability to avoid dehydration. If hyperthermia becomes a major issue, it will deteriorate performance, but as long as temperature and water balance can be established, the high air temperature may actually benefit performance because air density and air resistance will decrease and lower the power output required to maintain a given velocity.

Mechanisms of aerobic performance impairment with heat stress and dehydration

Environmental heat stress can challenge the limits of human cardiovascular and temperature regulation, body fluid balance, and thus aerobic performance. This minireview proposes that the cardiovascular adjustments accompanying high skin temperatures (Tsk), alone or in combination with high core body temperatures (Tc), provide a primary explanation for impaired aerobic exercise performance in warm-hot environments. The independent (Tsk) and combined (Tsk + Tc) effects of hyperthermia reduce maximal oxygen uptake (V̇o2max), which leads to higher relative exercise intensity and an exponential decline in aerobic performance at any given exercise workload. Greater relative exercise intensity increases cardiovascular strain, which is a prominent mediator of rated perceived exertion. As a consequence, incremental or constant-rate exercise is more difficult to sustain (earlier fatigue) or requires a slowing of self-paced exercise to achieve a similar sensation of effort. It is proposed that high Tsk and Tc impair aerobic performance in tandem primarily through elevated cardiovascular strain, rather than a deterioration in central nervous system (CNS) function or skeletal muscle metabolism. Evaporative sweating is the principal means of heat loss in warm-hot environments where sweat losses frequently exceed fluid intakes. When dehydration exceeds 3% of total body water (2% of body mass) then aerobic performance is consistently impaired independent and additive to heat stress. Dehydration augments hyperthermia and plasma volume reductions, which combine to accentuate cardiovascular strain and reduce V̇o2max. Importantly, the negative performance consequences of dehydration worsen as Tsk increases.

Changes in EEG activity before and after exhaustive exercise in sedentary women in neutral and hot environments

This study examined the effect of hyperthermia on brain electrical activity measured with encephalography during prolonged exhaustive exercise in a group of sedentary women (VO(2)max = 35 +/- 4 mL kg min(-1)). Two strenuous cycling exercises were performed either in neutral (N-Ex) or in heat (H-Ex) conditions. Tympanic temperature (Tty), heart rate (HR), body mass loss (BML), plasma volume decrease, and brain electrical activity [EEG: alpha (8-13 Hz) and beta(13-30 Hz)-band and alpha/beta index of fatigue: the ratio between EEG activity in the alpha band and beta-band] were recorded throughout the cycling sessions. The Tty increase 1.0 degrees C in the N-Ex and 1.8 degrees C in H-Ex. HR increased in both sessions but with significantly higher values during the H-Ex session when compared with the N-Ex session (p < 0.001) (from 85 +/- 4 beats min(-1) to 164 +/- 6 beats min(-1) and from 83 +/- 6 beats min(-1) to 181 +/- 8 beats min(-1), respectively in N-Ex and in H-Ex). This was associated with a significantly higher BML (p < 0.05) and a higher plasma volume decrease in the H-Ex session (p < 0.01). The alpha/beta index increased significantly during both trials particularly during the H-Ex session (p < 0.05). This was associated with a significant decrease of time to exhaustion (-34%). We suggest that exhausting work in the heat induced a change in gross brain activity (alpha/beta ratio) compared to a longer, less thermally demanding exposure. Fatigue in the heat could be attributed to central factors as well as thermal, cardiac and hydro-electrolytic impairment.

Prior heat stress: effect on subsequent 15-min time trial performance in the heat

The impact of prior heat stress on subsequent aerobic exercise-heat performance has not been studied.

PURPOSE

To determine whether prior heat stress degrades subsequent aerobic exercise performance in the heat.

METHODS

Eighteen nonheat acclimated males were trained (four practice trials) on an aerobic exercise performance test in 22 degrees C and then divided into two (n = 8) groups. One group (EUHPH; (.)VO2peak = 44 +/- 7 mL x kg x min(-1)) was tested after 90 min of recovery (in 22 degrees C) from 3 h of intermittent light-intensity (<30% (.)VO2peak) exercise-heat (50 degrees C) stress, where sweat losses were matched with fluid intake (3.5 +/- 0.5 L) to maintain euhydration. The other group (EUH; (.)VO2peak = 45 +/- 5 mL x kg x min(-1)) was tested while euhydrated without prior exercise-heat stress. Aerobic performance was determined from a 30-min cycling preload (50% (.)VO2peak) followed by a 15-min time trial in 40 degrees C. Total work during the 15-min performance time trial in EUH and EUHPH was compared, as were the percent changes from the best practice trials.

RESULTS

Volunteers were euhydrated (plasma osmolality < 290 mOsm x kg(-1)) and normothermic before each exercise-heat trial. Heart rate and core temperature were not different (P > 0.05) between groups at any time point during exercise. Total work was not different (P > 0.05) at baseline or between EUH (150.5 +/- 28.3 kJ; 2.0 +/- 0.3 kJ x kg(-1)) and EUHPH (160.3 +/- 24.0 kJ; 1.8 +/- 0.2 kJ x kg(-1)). The percent change in total work relative to baseline was not different (P > 0.05) between EUH (-18.7% +/- 9.2%) and EUHPH (-15.0% +/- 7.8%).

CONCLUSIONS

If hydration and body temperatures recover, prior exercise-heat stress does not result in a greater degradation in aerobic time trial performance in the heat compared with heat exposure alone.

Bedside-to-Bench conference: research agenda for idiopathic fatigue and aging

The American Geriatrics Society, with support from the National Institute on Aging and the John A. Hartford Foundation, held its fifth Bedside-to-Bench research conference, "Idiopathic Fatigue and Aging," to provide participants with opportunities to learn about cutting-edge research developments, draft recommendations for future research, and network with colleagues and leaders in the field. Fatigue is a symptom that older persons, especially by those with chronic diseases, frequently experience. Definitions and prevalence of fatigue may vary across studies, across diseases, and even between investigators and patients. The focus of this review is on physical fatigue, recognizing that there are other related domains of fatigue (such as cognitive fatigue). Many definitions of fatigue involve a sensation of "low" energy, suggesting that fatigue could be a disorder of energy balance. Poor energy utilization efficiency has not been considered in previous studies but is likely to be one of the most important determinants of fatigue in older individuals. Relationships between activity level, capacity for activity, a tolerable rate of activity, and a tolerable fatigue threshold or ceiling underlie a notion of fatiguability. Mechanisms probably contributing to fatigue in older adults include decline in mitochondrial function, alterations in brain neurotransmitters, oxidative stress, and inflammation. The relationships between muscle function and fatigue are complex. A number of diseases (such as cancer) are known to cause fatigue and may serve as models for how underlying impaired physiological processes contribute to fatigue, particularly those in which energy utilization may be an important factor. A further understanding of fatigue will require two key strategies: to develop and refine fatigue definitions and measurement tools and to explore underlying mechanisms using animal and human models.

Beneficial effects of ice ingestion as a precooling strategy on 40-km cycling time-trial performance

PURPOSE

The effect of crushed ice ingestion as a precooling method on 40-km cycling time trial (CTT) performance was investigated.

METHODS

Seven trained male subjects underwent a familiarization trial and two experimental CTT which were preceded by 30 min of either crushed ice ingestion (ICE) or tap water (CON) consumption amounting to 6.8 g x kg(-1) body mass. The CTT required athletes to complete 1200 kJ of work on a wind-braked cycle ergometer. During the CTT, gastrointestinal (Tgi) and skin (Tsk) temperatures, cycling time, power output, heart rate (HR), blood lactate (BLa), ratings of perceived exertion (RPE) and thermal sensation (RPTS) were measured at set intervals of work.

RESULTS

Precooling lowered the Tgi after ICE significantly more than CON (36.74 +/- 0.67 degrees C vs 37.27 +/- 0.24 degrees C, P < .05). This difference remained evident until 200 kJ of work was completed on the bike (37.43 +/- 0.42 degrees C vs 37.64 +/- 0.21 degrees C). No significant differences existed between conditions at any time point for Tsk, RPE or HR (P > .05). The CTT completion time was 6.5% faster in ICE when compared with CON (ICE: 5011 +/- 810 s, CON: 5359 +/- 820 s, P < .05).

CONCLUSIONS

Crushed ice ingestion was effective in lowering Tgi and improving subsequent 40-km cycling time trial performance. The mechanisms for this enhanced exercise performance remain to be clarified.

Effect of hot versus cold climates on power output, muscle activation, and perceived fatigue during a dynamic 100-km cycling trial

The purpose of this study was to examine the influence of environmental temperature on power output, muscle activation, body temperature, and perceived physical strain during a dynamic self-paced 100-km cycling trial. Nine endurance-trained male cyclists (mean + or - s: age 31 + or - 6 years; VO(2max) 62.1 + or - 8.5 ml x kg(-1) x min(-1)) completed two 100-km experimental trials, interspersed with five 1-km and four 4-km high-intensity epochs, in hot (34 degrees C) and cold (10 degrees C) environments. Measurements consisted of power output, rectal and skin temperature, muscle activation of vastus lateralis, biceps femoris and soleus, ratings of perceived exertion, thermal sensation and pain intensity in the quadriceps. Power output and muscle activation of the biceps femoris and soleus were lower in the hot trial (22 km; P < 0.05) prior to significant (P < 0.05) differences in rectal temperature [38.8 degrees C (cold) vs. 39.1 degrees C (hot)] at 42 km. Muscle activation of the vastus lateralis, biceps femoris, and soleus was significantly (P < 0.001) correlated with power output and thermal sensation (r > 0.68) but not with perceived pain or exertion. Thus, a hyperthermic-induced anticipatory reduction of muscle activation may have occurred during the hot exercise trials only. Fatigue and pacing during prolonged dynamic exercise in the cold appears to be influenced by factors dissociated from hyperthermic-induced stress.

Gastrointestinal temperature increases and hypohydration exists after collegiate men's ice hockey participation

The cold environments in which ice hockey players participate are counterintuitive to the predisposing factors of heat- and hypohydration-related illnesses. This population has received little consideration in hypohydration-related illness risk assessments. Protective equipment, multiple clothing layers, and performance intensity may predispose these athletes to significant decreases in hydration and increases in core temperature. The purpose of this study was to measure hydration status and gastrointestinal temperature (T(GI)) in male ice hockey players during practice sessions that focused on pre-season skill development and cardiovascular conditioning. The study used a repeated measures design. Data were collected in a collegiate ice hockey rink (ambient temperature = 6.03 +/- 1.65 degrees C; relative humidity = 40.4 +/- 11.89%). Seventeen ice hockey players (age = 20.6 +/- 1.1, height = 180 +/- 5 cm, mass = 85.04 +/- 7.9 kg) volunteered for this study. Urine-specific gravity (USG) and body weight were measured before and after two 110-minute practice sessions. Urine reagent strips measured USG. Calibrated CorTemp (HQ, Inc., Palmetto, FL, USA) radiofrequency telemetered thermometers collected T(GI) before, during, and after two 110-minute practice sessions. Individual participant sweat rates were calculated. Data from both sessions were pooled. T(GI) (p < 0.0001), and USG (p < 0.0001) increased over the 110-minute session. Post-exercise body weight (83.9 +/- 7.6 kg) was statistically lower (p < 0.001) than the pre-exercise weight (85.0 +/- 7.9 kg). Sweat rates were calculated to be 0.83 +/- 0.50 L.h(-1). These male ice hockey players become hypohydrated during participation potentially predisposing them to dehydration-related illnesses. This change in hydration status resulted in a gastrointestinal temperature increase and significant weight loss during activity. Prevention and rehydration strategies such as those developed by the American College of Sports Medicine and National Athletic Trainers' Association should be implemented to reduce the possibility of heat-related illness for this population.

Evidence against a 40 degrees C core temperature threshold for fatigue in humans

Evidence suggests that core temperatures of approximately 40 degrees C can induce fatigue, although this may be confounded by coincident elevations in skin temperatures and maximal cardiovascular strain. In an observational field study to examine core temperature threshold for fatigue, we investigated whether running performance is impaired when rectal temperature (T(re)) is >40 degrees C and skin temperature remains modest. Seventeen competitive runners (7/10 women/men: 8 km best 1,759 +/- 78/1,531 +/- 60 s) completed 8-km track time trials in cool (WBGT approximately 13 degrees C; n = 6), warm (WBGT approximately 27 degrees C; n = 4), or both (n = 7) conditions. T(re), chest skin temperature, and heart rate were logged continuously; elapsed time was recorded every 200 m. Running velocity for T(re) >40 degrees C was compared with that for T(re) <40 degrees C for each runner. Changes in running velocity over the last 600 m were compared between runners with T(re) >40 degrees C and <40 degrees C. Twelve runners achieved T(re) >40.0 degrees C with >or=600 m remaining (range 600-3,400 m). Average running velocity for T(re) <40 degrees C (282 +/- 27 m/min) was not different from that for T(re) >40 degrees C (279 +/- 28 m/min; P = 0.82). There were no differences in running velocity during the final 600 m between runners with final T(re) >40 degrees C or <40 degrees C (P = 0.16). Chest skin temperature ranged from 30 to 34 degrees C, and heart rate was >95% of age-predicted maximum. Our observation that runners were able to sustain running velocity despite T(re) >40 degrees C is evidence against 40 degrees C representing a "critical" core temperature limit to performance.

Hyperthermia increases the cytotoxicity of many exogenous compounds

Cytotoxicity testing of extracts from medical device materials is typically conducted at 37 degrees C. It may be more relevant to screen extracts from device materials for in vitro cytotoxicity at temperatures found in febrile patients. To address this, the cytotoxicity of selected chemicals, drugs, and medical device extracts was evaluated in vitro following incubation at normothermic (37 degrees C) and hyperthermic (39 degrees C) conditions. In L929 cells, the percentage of cell death increased from 2-fold to more than 4-fold after chemical exposure when cells were maintained at 39 degrees C. Extracts of some medical devices and materials showed a 10-fold increase in cytotoxicity when cells were maintained at 39 degrees C as compared to 37 degrees C. For many of the substances in this study, exogenous compounds that are toxic at normothermic conditions (37 degrees C) are more cytotoxic under hyperthermic conditions (39 degrees C). The toxicity of compounds was more readily discernable at the higher incubation temperature, even at lower concentrations. In vitro cytotoxicity testing of chemicals and extracts at febrile temperatures can provide more sensitive and relevant biocompatibility tests than under normothermic conditions alone.

Brain serotonin and dopamine modulators, perceptual responses and endurance performance during exercise in the heat following creatine supplementation

BACKGROUND

The present experiment examined the responses of peripheral modulators and indices of brain serotonin (5-HT) and dopamine (DA) function and their association with perception of effort during prolonged exercise in the heat after creatine (Cr) supplementation.

METHODS

Twenty one endurance-trained males performed, in a double-blind fashion, two constant-load exercise tests to exhaustion at 63 +/- 5% V(O2) max in the heat (ambient temperature: 30.3 +/- 0.5 degrees C, relative humidity: 70 +/- 2%) before and after 7 days of Cr (20 g.d-1 Cr + 140 g.d-1 glucose polymer) or placebo (Plc) (160 g.d-1 glucose polymer) supplementation.

RESULTS

3-way interaction has shown that Cr supplementation reduced rectal temperature, heart rate, ratings of perceived leg fatigue (P < 0.05), plasma free-tryptophan (Trp) (P < 0.01) and free-Trp:tyrosine ratio (P < 0.01) but did not influence the ratio of free-Trp:large neutral amino acids or contribute in improving endurance performance (Plc group, n = 10: 50.4 +/- 8.4 min vs. 51.2 +/- 8.0 min, P > 0.05; Cr group, n = 11: 47.0 +/- 4.7 min vs. 49.7 +/- 7.5 min, P > 0.05). However, after dividing the participants into "responders" and "non-responders" to Cr, based on their intramuscular Cr uptake, performance was higher in the "responders" relative to "non-responders" group (51.7 +/- 7.4 min vs.47.3 +/- 4.9 min, p < 0.05).

CONCLUSION

Although Cr influenced key modulators of brain 5-HT and DA function and reduced various thermophysiological parameters which all may have contributed to the reduced effort perception during exercise in the heat, performance was improved only in the "responders" to Cr supplementation. The present results may also suggest the demanding of the pre-experimental identification of the participants into "responders" and "non-responders" to Cr supplementation before performing the main experimentation. Otherwise, the possibility of the type II error may be enhanced.

Somatosensory feedback from the limbs exerts inhibitory influences on central neural drive during whole body endurance exercise

We investigated whether somatosensory feedback from contracting limb muscles exerts an inhibitory influence on the determination of central command during closed-loop cycling exercise in which the subject voluntarily determines his second-by-second central motor drive. Eight trained cyclists performed two 5-km time trials either without (5K(Ctrl)) or with lumbar epidural anesthesia (5K(Epi); 24 ml of 0.5% lidocaine, vertebral interspace L(3)-L(4)). Percent voluntary quadriceps muscle activation was determined at rest using a superimposed twitch technique. Epidural lidocaine reduced pretime trial maximal voluntary quadriceps strength (553 +/- 45 N) by 22 +/- 3%. Percent voluntary quadriceps activation was also reduced from 97 +/- 1% to 81 +/- 3% via epidural lidocaine, and this was unchanged following the 5K(Epi), indicating the presence of a sustained level of neural impairment throughout the trial. Power output was reduced by 9 +/- 2% throughout the race (P < 0.05). We found three types of significant effects of epidural lidocaine that supported a substantial role for somatosensory feedback from the exercising limbs as a determinant of central command throughout high-intensity closed-loop cycling exercise: 1) significantly increased relative integrated EMG of the vastus lateralis; 2) similar pedal forces despite the reduced number of fast-twitch muscle fibers available for activation; 3) and increased ventilation out of proportion to a reduced carbon dioxide production and heart rate and increased blood pressure out of proportion to power output and oxygen consumption. These findings demonstrate the inhibitory influence of somatosensory feedback from contracting locomotor muscles on the conscious and/or subconscious determination of the magnitude of central motor drive during high intensity closed-loop endurance exercise.

Unlocking the Energy Dynamics of Executive Functioning: Linking Executive Functioning to Brain Glycogen

Past work suggests that executive functioning relies on glucose as a depletable energy, such that executive functioning uses a relatively large amount of glucose and is impaired when glucose is low. Glucose from the bloodstream is one energy source for the brain, and glucose stored in the brain as glycogen is another. A review of the literature on glycogen suggests that executive functioning uses it in much the same way as glucose, such that executive functioning uses glycogen and is impaired when glycogen is low. Findings on stress, physical persistence, glucose tolerance, diabetes, sleep, heat, and other topics provide general support for this view.

Exercise tolerance and thermoregulatory responses during cycling in boys and men

PURPOSE

Physiological responses to exercise in the heat differ between prepubertal children and young adults. Whether these maturity-related variations imply lower exercise tolerance, inferior thermoregulation, and greater risk for heat injury in the child is uncertain. This study directly compared thermoregulatory and cardiovascular responses as well as endurance performance between prepubertal boys and adult males during steady-load cycling in moderately hot and cool ambient conditions with moderate humidity.

METHODS

Eight prepubertal boys (age 11.7 +/- 0.4 yr) and eight adult men (age 31.8 +/- 2.0 yr) performed steady-load cycling to exhaustion at an intensity equivalent to approximately 65% peak V O2 in both hot (approximately 31 degrees C) and cool (approximately 19 degrees C) environments, with fluid intake ad libitum.

RESULTS

Exercise duration in the heat was shorter for both groups (hot: men 30.46 +/- 8.84 min, boys 29.30 +/- 6.19 min; cold: men 42.88 +/- 11.79 min, boys 41.38 +/- 6.30 min), with no significant difference between men and boys (P > 0.05). Increases in rectal temperature, heart rate, and cardiac index were similar between groups and conditions. Stroke index, mean arterial pressure, and arterial venous oxygen difference were stable and similar in both conditions, without group differences. No significant dehydration was observed in men or boys.

CONCLUSIONS

This study failed to reveal differences in exercise tolerance, thermoregulatory adaptation, or cardiovascular response to exercise in the heat between euhydrated prepubertal boys and adult men.

Human Thermoregulation and Measurement of Body Temperature in Exercise and Clinical Settings

This review discusses human thermoregulation during exercise and the measurement of body temperature in clinical and exercise settings. The thermoregulatory mechanisms play important roles in maintaining physiological homeostasis during rest and physical exercise. Physical exertion poses a challenge to thermoregulation by causing a substantial increase in metabolic heat production. However, within a non-thermolytic range, the thermoregulatory mechanisms are capable of adapting to sustain physiological functions under these conditions. The central nervous system may also rely on hyperthermia to protect the body from “overheating.” Hyperthermia may serve as a self-limiting signal that triggers central inhibition of exercise performance when a temperature threshold is achieved. Exposure to sub-lethal heat stress may also confer tolerance against higher doses of heat stress by inducing the production of heat shock proteins, which protect cells against the thermolytic effects of heat. Advances in body temperature measurement also contribute to research in thermoregulation. Current evidence supports the use of oral temperature measurement in the clinical setting, although it may not be as convenient as tympanic temperature measurement using the infrared temperature scanner. Rectal and oesophagus temperatures are widely accepted surrogate measurements of core temperature (Tc), but they cause discomfort and are less likely to be accepted by users. Gastrointestinal temperature measurement using the ingestible temperature sensor provides an acceptable level of accuracy as a surrogate measure of Tc without causing discomfort to the user. This form of Tc measurement also allows Tc to be measured continuously in the field and has gained wider acceptance in the last decade. Key words: Core temperature, Gastrointestinal temperature, Ingestible temperature sensor, Thermoregulation

Exercise-induced homeostatic perturbations provoked by singles tennis match play with reference to development of fatigue

This review addresses metabolic, neural, mechanical and thermal alterations during tennis match play with special focus on associations with fatigue. Several studies have provided a link between fatigue and the impairment of tennis skills proficiency. A tennis player's ability to maintain skilled on-court performance and/or optimal muscle function during a demanding match can be compromised as a result of several homeostatic perturbations, for example hypoglycaemia, muscle damage and hyperthermia. Accordingly, an important physiological requirement to succeed at competitive level might be the player's ability to resist fatigue. However, research evidence on this topic is limited and it is unclear to what extent players experience fatigue during high-level tennis match play and what the physiological mechanisms are that are likely to contribute to the deterioration in performance.

The limits of human performance

Human performance, defined by mechanical resistance and distance per time, includes human, task and environmental factors, all interrelated. It requires metabolic energy provided by anaerobic and aerobic metabolic energy sources. These sources have specific limitations in the capacity and rate to provide re-phosphorylation energy, which determines individual ratios of aerobic and anaerobic metabolic power and their sustainability. In healthy athletes, limits to provide and utilize metabolic energy are multifactorial, carefully matched and include a safety margin imposed in order to protect the integrity of the human organism under maximal effort. Perception of afferent input associated with effort leads to conscious or unconscious decisions to modulate or terminate performance; however, the underlying mechanisms of cerebral control are not fully understood. The idea to move borders of performance with the help of biochemicals is two millennia old. Biochemical findings resulted in highly effective substances widely used to increase performance in daily life, during preparation for sport events and during competition, but many of them must be considered as doping and therefore illegal. Supplements and food have ergogenic potential; however, numerous concepts are controversially discussed with respect to legality and particularly evidence in terms of usefulness and risks. The effect of evidence-based nutritional strategies on adaptations in terms of gene and protein expression that occur in skeletal muscle during and after exercise training sessions is widely unknown. Biochemical research is essential for better understanding of the basic mechanisms causing fatigue and the regulation of the dynamic adaptation to physical and mental training.

Physiological limits to exercise performance in the heat

Exercise in the heat results in major alterations in cardiovascular, thermoregulatory, metabolic and neuromuscular function. Hyperthermia appears to be the key determinant of exercise performance in the heat. Thus, strategies that attenuate the rise in core temperature contribute to enhanced exercise performance. These include heat acclimatization, pre-exercise cooling and fluid ingestion which have all been shown to result in reduced physiological and psychophysical strain during exercise in the heat and improved performance.

The cardiovascular challenge of exercising in the heat

Exercise in the heat can pose a severe challenge to human cardiovascular control, and thus the provision of oxygen to exercising muscles and vital organs, because of enhanced thermoregulatory demand for skin blood flow coupled with dehydration and hyperthermia. Cardiovascular strain, typified by reductions in cardiac output, skin and locomotor muscle blood flow and systemic and muscle oxygen delivery accompanies marked dehydration and hyperthermia during prolonged and intense exercise characteristic of many summer Olympic events. This review focuses on how the cardiovascular system is regulated when exercising in the heat and how restrictions in locomotor skeletal muscle and/or skin perfusion might limit athletic performance in hot environments.