The effects of hypothermia on submaximal and maximal work performance

Head-neck cooling effects on central and peripheral fatigue, motor accuracy, and blood markers of stress in men with multiple sclerosis and healthy men: A randomized crossover study

BACKGROUND

The present study aimed to investigate whether head and neck cooling (at 18 °C next to the skin) and fatiguing submaximal exercise at a thermoneutral ambient temperature can induce peripheral and central responses in healthy men and those with multiple sclerosis (MS).

METHODS

A local head-neck cooling (at 18 °C next to the skin) intervention in men with a relapsing-remitting form of MS (n = 18; age 30.9 ± 8.1 years) and healthy men (n = 22; age 26.7 ± 5.9 years) was assessed. Men in both groups performed 100 intermittent isometric knee extensions with 5 s contractions and 20 s of rest. The primary variables were measured before exercise, after 50 and 100 repetitions, and 1 h after recovery. The central activation ratio, maximal voluntary contraction, electrically induced force, electromyography, contractile properties, blood markers, muscle temperature, and perception of effort were measured.

RESULTS

Compared with noncooled conditions, head and neck cooling increased the central capacity to activate exercising muscles but resulted in greater exercise-induced peripheral fatigue in men with MS (p < 0.05). Local cooling did not affect motor accuracy or the amplitude of electromyography signals; however, these factors were related to the intensity of the motor task (p > 0.05). The changes in central and peripheral fatigability induced by local cooling during submaximal exercise were more pronounced in men with MS than in healthy men (p < 0.05).

CONCLUSION

Head and neck cooling enhances central activation of muscles during exercise, leading to improved exercise performance compared with noncooled conditions in men with MS.

Cold Stress Effects on Exposure Tolerance and Exercise Performance

Cold weather can have deleterious effects on health, tolerance, and performance. This paper will review the physiological responses and external factors that impact cold tolerance and physical performance. Tolerance is defined as the ability to withstand cold stress with minimal changes in physiological strain. Physiological and pathophysiological responses to short-term (cold shock) and long-term cold water and air exposure are presented. Factors (habituation, anthropometry, sex, race, and fitness) that influence cold tolerance are also reviewed. The impact of cold exposure on physical performance, especially aerobic performance, has not been thoroughly studied. The few studies that have been done suggest that aerobic performance is degraded in cold environments. Potential physiological mechanisms (decreases in deep body and muscle temperature, cardiovascular, and metabolism) are discussed. Likewise, strength and power are also degraded during cold exposure, primarily through a decline in muscle temperature. The review also discusses the concept of thermoregulatory fatigue, a reduction in the thermal effector responses of shivering and vasoconstriction, as a result of multistressor factors, including exhaustive exercise.

Exercise performance and body dimensions in anorexia nervosa before and after rehabilitation

The boys and five girls (mean age 15.0 y.) with anorexia nervosa (AN) were studied before and after a treatment which restored their body weight to normal. Before treatment the patients' average weight loss was 25% of their premorbid weight. The function and dimensions of the oxygen transport system were determined with heart (HV) and blood (BV) volumes, lean body mass (LBM) and exercise tests on a bicycle ergometer with determination of maximal aerobic power (VO2 max). Before treatment, the patients had bradycardia and hypotension. HV and BV decreased in proportion to the loss of body weight. During maximal exercise, attainable oxygen uptake and heart rate were low. VO2 max decreased out of proportion to the circulatory and body dimensions. After treatment, HV and BV increased in proportion to the rise in body weight. LBM increased significantly in all patients. Heart rates at rest and during exercise were within the range of normal and VO2 max increased. It is concluded that the circulatory system is highly adaptive to the low caloric intake in AN and is totally normalized after weight gain.

Neuromuscular performance limitations in cold

This review will focus on the effects of cooling on muscular performance and its variables, functional properties of the muscles and some neural aspects of muscle function. The changes are described in terms of different cold exposures with varying intensity, therefore also looking at the dose dependent relationship between cooling and performance decrement. In addition, relationship between rewarming exercise and performance enhancement is described. Future research needs are addressed.

Thermoregulation in homeotherms: central temperature results from optimization of energy transfers

In contrast to the classical homeostatic concept of the constancy of the central temperature, this study proposes an original model of thermoregulation based on the optimization of energy transfers. Exchange of the energy consumed or produced by the cell between the cell and the external medium has an associated energy cost. The different variables of the internal medium-flows, pressures, concentrations and also temperatures, since heat is but a particular form of energy--are continuously set at optimal values such that this cost is always minimal for the prevailing constraints with which the organism is faced. The proposed thermoregulatory model accounts for the physiological spatial and temporal variability of the body's temperatures. The predictive curves suggest a new approach to experimental studies concerned with thermal regulation and throw new light on their results.

Kinetics of oxygen consumption during maximal exercise at different muscle temperatures

The aim of this study was to test at maximal exercise the hypothesis of the temperature-dependence of the kinetics of O2 consumption (VO2), which predicts a greater O2 deficit as muscle temperature is decreased. Six male subjects underwent 3 min exercise bouts at the minimum power eliciting maximum O2 consumption (VO2max), at normal temperature (A) and after cooling the thigh muscles by water immersion (C). Breath-by-breath VO2 was measured together with muscle blood flow (Qm), blood lactate accumulation ("early lactate", eLa), heart rate and muscle temperature (Tm). The O2 deficit was calculated by standard procedure. Net VO2max was 2.92 +/- 0.85 (SD) and 3.19 +/- 0.71 l center dot min-1 in C and A respectively (P < 0.05). Correspondingly, maximum power was 20 W lower in C than in A. At exercise start, Tm was 35.0 +/- 1.2 and 27.5 +/- 1.8 degrees C in A and C respectively. O2 deficit was 2.25 +/- 0.53 and 3.05 +/- 1.12 l in A and C respectively. The corresponding eLa was 7.7 +/- 2.5 and 13.8 +/- 2.5 mM, (P < 0.05) while Qm was 376 +/- 92 and 290 +/- 50 ml center dot kg-1 center dot min-1 (P < 0.05) in A and C, respectively. The eLa increase in C is associated with an impaired muscle blood flow and decreased muscle O2 unloading, and does not completely explain the greater O2 deficit in C. The unexplained fraction of the latter is perhaps accounted for by a greater net alactic O2 deficit, in agreement with a temperature-dependent decrease of the velocity constants of oxidative reactions, as suggested by the tested hypothesis.

Comparison in men of physiological responses to exercise of increasing intensity at low and moderate ambient temperatures

In six male subjects the sweating thresholds, heart rate (fc), as well as the metabolic responses to exercise of different intensities [40%, 60% and 80% maximal oxygen uptake (VO2max)], were compared at ambient temperatures (Ta) of 5 degrees C (LT) and 24 degrees C (MT). Each period of exercise was preceded by a rest period at the same temperature. In LT experiments, the subjects rested until shivering occurred and in MT experiments the rest period was made to be of exactly equivalent length. Oxygen uptake (VO2) at the end of each rest period was higher in LT than MT (P less than 0.05). During 20-min exercise at 40% VO2max performed in the cold no sweating was recorded, while at higher exercise intensities sweating occurred at similar rectal temperatures (Tre) but at lower mean skin (Tsk) and mean body temperatures (Tb) in LT than MT experiments (P less than 0.001). The exercise induced VO2 increase was greater only at the end of the light (40% VO2max) exercise in the cold in comparison with MT (P less than 0.001). Both fc and blood lactate concentration [1a]b were lower at the end of LT than MT for moderate (60% VO2max) and heavy (80% VO2max) exercises. It was concluded that the sweating threshold during exercise in the cold environment had shifted towards lower Tb and Tsk. It was also found that subjects exposed to cold possessed a potentially greater ability to exercise at moderate and high intensities than those at 24 degrees C since the increases in Tre, fc and [1a]b were lower at the lower Ta.

Thermoregulatory responses to exercise at low ambient temperature performed after precooling or preheating procedures

Seven male skiers exercised for 30 min on a cycle ergometer at 50% of maximal oxygen uptake and an ambient temperature of 5 degrees C. The exercise was preceded either by cold exposure (PREC) or active warming-up (PREH). The data were compared with control exercise (CONT) performed immediately after entering the thermal chamber from a thermoneutral environment. Cold exposure resulted in negative heat storage (96.1 kJ.m-2, SE 5.9) leading to significantly lower rectal, mean body and mean skin temperatures at the onset of exercise in PREC, as compared to PREH and CONT. The PREC-PREH temperature differences were still significant at the end of the exercise period. During exercise in the PREC test, oxygen uptake was higher than in PREH test (32.8 ml.kg-1.min-1, SE 1.5 vs 30.5 ml.kg-1.min-1, SE 1.3, respectively). Heart rate showed only a tendency to be higher in PREC than in PREH and CONT tests. In the PREH test skin and body temperatures as well as sweat rate were already elevated at the beginning of exercise. Exercise-induced changes in these variables were minimal. Heat storage decreased with the duration of the exercise. Exercise at low ambient temperature preceded by a 30-min rest in a cold environment requires more energy than the same exercise performed after PREH.

Fat energy use and plasma lipid changes associated with exercise intensity and temperature

The effect of 60 min of exercise at two intensities (50 and 60% VO2max) and temperatures (0 and 22 degrees C) on changes (delta) in plasma lipids [triglycerides (TG), glycerol (GLY), total cholesterol (TC), and HDL-cholesterol (HDL-C)] was examined. Subjects were 10 men aged 27 +/- 7 years (VO2max = 3.81 +/- 0.45 1 min, % fat = 12.2% +/- 7.1%). VO2 and respiratory exchange ratio results indicated that total energy and fat energy use were similar at the two temperatures. Changes in plasma volume (%delta PV) were different (P less than 0.05) at the two temperatures (22 degrees C: -2.3% vs 0 degrees C: 1.1%). Combining the data at each temperature revealed that the increases in concentrations were greater (P less than 0.05) at 22 degrees C (delta TG = 0.22, delta GLY = 0.20, delta TC = 0.14, delta HDL-C = 0.05 mmol l-1) vs 0 degrees C (delta TG = 0.10, delta GLY = 0.12, delta TC = 0.05, delta HDL-C = 0.02 mmol l-1). Combining the data for each intensity revealed that the increases in concentration were greater (P less than 0.05) at 60% VO2max for delta TG and delta HDL-C. The 60% VO2max/22 degrees C bout produced greater changes (P less than 0.05) than all other bouts for delta TC and delta HDL-C (0.21 and 0.08 mmol l-1, respectively). Only delta TG and delta GLY were greater at 22 degrees C when adjusted for %delta PV. These metabolic and plasma lipid results indicate that cold exposure does not act synergistically with exercise to further stimulate fat metabolism.

Adaptation to exercise in the cold

The winter athlete has several potential tactics for sustaining body temperature in the face of severe cold. An increase in the intensity of physical activity may be counter-productive because of increased respiratory heat loss, increased air or water movement over the body surface, and a pumping of air or water beneath the clothing. Shivering can generate heat at a rate of 10 to 15 kJ/min, but it impairs skilled performance, while the resultant glycogen usage hastens the onset of fatigue and mental confusion. Non-shivering thermogenesis could arise in either brown adipose tissue or white fat. Brown adipose tissue generates heat by the action of free fatty acids in uncoupling mitochondrial electron transport, and by noradrenaline-induced membrane depolarisation and sodium pumping. The existence of brown adipose tissue in human adults is controversial, and although there are theoretical mechanisms of heat production in white fat, their contribution to the maintenance of body temperature is small. Acclimatisation to cold develops over the course of about 10 days, and in humans the primary change is an insulative, hypothermic type of response; this reflects the intermittent nature of most occupational and athletic exposures to cold. Nevertheless, with more sustained exposure to cold air or water, humans can apparently develop the humoral type of acclimatisation described in small mammals, with an increased output of noradrenaline and/or thyroxine. The associated mobilisation of free fatty acids suggests the possibility of using winter sport as a pleasant method of treating obesity. In men, a combination of moderate exercise and facial cooling induces a substantial fat loss over a 1- to 2-week period, with an associated ketonuria, proteinuria, and increase of body mass. Possible factors contributing to this fat loss include: (a) a small energy deficit; (b) the energy cost of synthesising new lean tissue; (c) energy loss through the storage and excretion of ketone bodies; (d) catecholamine-induced 'futile' metabolic cycles with increased resting metabolism; and (e) a specific reaction to cold dehydration. Current limitations for the clinical application of such treatment include uncertainty regarding optimal environmental conditions, concern over possible pathological reactions to cold, and suggestions of a less satisfactory fat mobilisation in female patients. Possible interactions between physical fitness and metabolic reactions to cold remain controversial.(ABSTRACT TRUNCATED AT 400 WORDS)

Influence of low muscle temperature on muscle metabolism during intense dynamic exercise

Eight males performed intense leg cycle exercise at a constant rate of work averaging 350 W, according to three different protocols: 1) "Cold exhaustive" exercise (initial muscle temperature (Tm) = 29 degrees C), 2) "Warm non-exhaustive" exercise (initial Tm = 34 degrees C) for the same period of time as in 1), and 3) "Warm exhaustive" (initial Tm = 34 degrees C). In five subjects the concentration of various muscle metabolites was determined before and immediately, 1 min, and 5 min after exercise. Blood lactate concentration was determined before and repeatedly after exercise. At low Tm maximal work time was considerably shorter for all subjects compared to normal Tm, 1.3 and 2.1 min, respectively. Comparing conditions 1) and 2) oxygen deficit and the decrease in ATP and CP content were the same in the two experiments. There was a significantly higher concentration of glucose-6-phosphate 17.6 +/- 10.1 and 8.0 +/- 6.2 mmol X kg dw-1, respectively, and a tendency to higher lactate concentration 60 +/- 36 and 33 +/- 14 mmol X kg dw-1, respectively, immediately after exercise in the "cold exhaustive exercise". Peak blood lactate concentration appeared significantly later after "cold exhaustive" exercise indicating a slower elimination rate of lactate from the muscle compared to "warm non-exhaustive" exercise. The reduction in performance observed at low Tm may partially be explained by an increased accumulation rate of lactate in four of five subjects.

Cardio-respiratory physical training in water and on land

Fifteen unconditioned young men, who were similar in maximal aerobic power (VO2 max), were divided into three groups (n = 5 each) and physically trained for one month on a cycle ergometer either on land (I) or immersed to the neck in water of either 32 degrees C (II) or 20 degrees C (III) to determine if physical training (PT) in water and air differ. PT consisted of one-hour daily exercise, 5 times/wk, with exercise intensity readjusted each week to maintain a constant training stimulus of approximately 75% VO2 max (determined on land). Throughout the training period, heart rates (fc) of III averaged 20 and 10 beats . min-1 less than I and II, respectively, despite working at the same VO2 and % VO2 max. Training elicited a 16% increase in VO2 max in I compared to increases of 13 and 15% for II and III, respectively. It was concluded that PT in water produces similar physiological adaptations as does training on land. In cold water, VO2 max is improved despite training with fc significantly lower than that on land.

The effect of the environment of human performance

The performance of man, for a given level of ability, will be affected by his hygro-thermal, electro-ionic, visual and psychological microclimates. This paper presents the results of studies which demonstrate the effect of the hygro-thermal micro-climate on worker performance. The effects of the other micro-climates on worker performance are also discussed. For tasks with mainly physical activity performance depends upon metabolic heat. For tasks with mainly psychological activities there have, until now, been no specified criteria for determining the effects of the environment on performance. Consideration of the results of studies conducted in working environments clearly shows that environmental conditions can effect the efficiency of workers and hence that there are sound economic arguments for optimising working conditions.

Exercise heart rate response to facial cooling

The heart rate responses of physically untrained men to exercise with and without facial cooling were determined. Cold wind (10 degrees C, 6.5 m x s-1, or 2 degrees C, 6.5 m x s-1) was directed at the faces of the subjects during a 16 min bout of progressively intense exercise. The 10 degrees C wind resulted in a significantly (p less than 0.05) lowering of heart rate that appeared to be associated with a decline in forehead temperature at 4, 6, and 8 min of exercise. No differences were observed for blood pressure or rectal temperature. The significant (p less than 0.05) reduction in heart rate with the 2 degrees C cold wind did not appear to be associated with changes in facial temperature. The 2 degrees C wind also resulted in a persistent peripheral vasoconstriction (p less than 0.05). The results suggest that the heart rate response to facial cooling during exercise is mediated not through a reflex associated with increased stroke volume but rather via a central thermoregulatory response.

Influence of muscle temperature on maximal muscle strength and power output in human skeletal muscles

The influence of muscle temperature (Tm) on maximal muscle strength, power output, jumping, and sprinting performance was evaluated in four male subjects. In one of the subjects the electromyogram (EMG) was recorded from M. vastus lateralis, M. biceps femoris, and M. semitendinosus. Tm ranged from 30.0 degrees C to 39 degrees C. Maximal dynamic strength, power output, jumping, and sprinting performance were positively related to Tm. The changes were in the same order of magnitude for all these parameters (4-6% x degrees C-1) Maximal isometric strength decreased by 2% x degrees C-1 with decreasing Tm. The force-velocity relationship was shifted to the left at subnormal Tm. Thus in short term exercises, such as jumping and sprinting, performance is reduced at low Tm and enhanced at Tm above normal, primarily as a result of a variation in maximal dynamic strength.

Function and dimensions of the circulatory system in anorexia nervosa

The functional and dimensional components of the oxygen transporting system was studied in 17 female and 11 male patients suffering from anorexia nervosa. Both groups were 14.9 years old, on average, and had lost about 25% of their weight. Measurements at rest included blood and heart volume, heart rate, blood pressure, oxygen uptake (VO2), RQ, blood lactate (LA) and in 6 of the patients cardiac output. During bicycle ergometry the determinations of heart rate, blood pressure, LA, VO2 and cardiac output were repeated and maximal aerobic power was determined. A low metabolic rate with bradycardia and hypotension was apparent at rest. Blood and heart volume was decreased proportionally to the weight loss. On a given work load VO2 was lowered to the same extent as the resting metabolic rate. At maximal effort VO2 was reduced out of proportion to the circulatory dimensions and maximal heart rate was low. During exercise cardiac output was normally related to VO2 and stroke volume was maintained, indicating a normokinetic circulation and an unimpaired myocardial function. The main cause of the low maximal aerobic power seems to be the reduced muscle mass.