Hand and finger dexterity as a function of skin temperature, EMG, and ambient condition

Thermomechanical properties of bat and human red blood cells-Implications for hibernation

Hibernation is a widespread and highly efficient mechanism to save energy in mammals. However, one major challenge of hibernation is maintaining blood circulation at low body temperatures, which strongly depends on the viscoelastic properties of red blood cells (RBCs). Here, we examined at physiologically relevant timescales the thermomechanical properties of hundreds of thousands of individual RBCs from the hibernating common noctule bat (Nyctalus noctula), the nonhibernating Egyptian fruit bat (Rousettus aegyptiacus), and humans (Homo sapiens). We exposed RBCs to temperatures encountered during normothermia and hibernation and found a significant increase in elasticity and viscosity with decreasing temperatures. Our data demonstrate that temperature adjustment of RBCs is mainly driven by membrane properties and not the cytosol while viscous dissipation in the membrane of both bat species exceeds the one in humans by a factor of 15. Finally, our results show that RBCs from both bat species reveal a transition to a more viscous-like state when temperature decreases. This process on a minute timescale has an effect size that is comparable with fluctuations in RBC viscoelasticity over the course of the year, implying that environmental factors, such as diets, have a lower impact on the capability of RBCs to respond to different temperatures than general physical properties of the cell membrane. In summary, our findings suggest membrane viscoelasticity as a promising target for identifying mechanisms that could be manipulated to ensure blood circulation at low body temperatures in humans, which may be one first step toward safe synthetic torpor in medicine and space flight.

Energy expenditure during physical work in cold environments: physiology and performance considerations for military service members

Effective execution of military missions in cold environments requires highly trained, well-equipped, and operationally ready service members. Understanding the metabolic energetic demands of performing physical work in extreme cold conditions is critical for individual medical readiness of service members. In this narrative review, we describe 1) the extreme energy costs of performing militarily relevant physical work in cold environments, 2) key factors specific to cold environments that explain these additional energy costs, 3) additional environmental factors that modulate the metabolic burden, 4) medical readiness consequences associated with these circumstances, and 5) potential countermeasures to be developed to aid future military personnel. Key characteristics of the cold operational environment that cause excessive energy expenditure in military personnel include thermoregulatory mechanisms, winter apparel, inspiration of cold air, inclement weather, and activities specific to cold weather. The combination of cold temperatures with other environmental stressors, including altitude, wind, and wet environments, exacerbates the overall metabolic strain on military service members. The high energy cost of working in these environments increases the risk of undesirable consequences, including negative energy balance, dehydration, and subsequent decrements in physical and cognitive performance. Such consequences may be mitigated by the application of enhanced clothing and equipment design, wearable technologies for biomechanical assistance and localized heating, thermogenic pharmaceuticals, and cold habituation and training guidance. Altogether, the reduction in energy expenditure of modern military personnel during physical work in cold environments would promote desirable operational outcomes and optimize the health and performance of service members.

The effect of exposure to cold on dexterity and temperature of the skin and hands

Objectives. This study aimed to determine the impact of low temperature (-1 °C, +5 °C) on manual dexterity and hand skin temperature after 1 h of exposure when using two types of protective gloves. Methods. Ten male participants wore double gloves or single gloves, when spending 1 h in a climatic chamber at -1, +5 or +20 °C. Before and after the cold exposure, measurements of mean weighted body skin temperature, hand skin temperature, the Purdue Pegboard Test and hand grip strength were performed. Results. There were statistically significant differences in the values of mean weighted body skin temperature and left and right hand skin temperature between the study variants. Conclusion. No effect of cold exposure (-1 °C, +5 °C) on manual dexterity was observed, but there was an effect of -1 °C temperature change on weighted mean skin temperature and hand skin temperature during 1 h of exposure. The decrease in both right and left hand skin temperature after cold exposure was the largest for -1 °C while using single gloves, and differed significantly from the other variants.

We are all exposed, but some are more exposed than others

This paper defines functional cold exposure zones that illustrate whether a person is at risk of developing physical performance loss or cold weather injuries. Individual variation in body characteristics, activity level, clothing and protective equipment all contribute to variation in the effective exposure. Nevertheless, with the right education, training, and cold-adapted behaviours the exposure differences might not necessarily lead to increased risk for cold injury. To support the preparation process for cold weather operations, this paper presents a biophysical analysis explaining how much cold exposure risk can vary between individuals in the same environment. The results suggest that smaller persons are prone to be underdressed for moderate activity levels and larger persons are prone to be overdressed. The consequences of these discrepancies place people at different risks for performance loss or cold weather injuries. Nonetheless, even if all are well-dressed at the whole-body level, variation in hand morphology is also expected to influence hand skin temperatures that can be maintained; with smaller hands being more prone to reach skin temperatures associated with dexterity loss or cold weather injuries. In conclusion, this work focusses on bringing cold science to the Arctic warrior, establishing that combating cold stress is not a one size fits all approach.

A 7-segment numerical hand-glove/mitten model for predicting thermophysiological responses of the human hand in extremely cold conditions

A 7-segment and 29-node numerical hand-glove/mitten model was developed to simulate human hand physiological responses in various cold environments. To validate the model, simulated skin temperatures were compared to data from published literature and human trials conducted at -20, -40, and -60 °C. Results demonstrated that the model could reasonably predict cold-induced vasodilation (CIVD) responses at 0 °C temperature. At -20 °C, the model predicted skin temperature with the root mean square deviation (RMSD) falling within the measurement standard deviation (SD) for both the entire and local hand except for the posterior hand. At -40 and -60 °C, the model could predict the trend of the skin temperatures of the whole/local hand, but the RMSD was larger than the SD for the majority of predictions. A parametric analysis revealed that the palm and posterior hand had higher skin temperatures than the fingers, while the thumb had the lowest skin temperature of the fingers in all simulated cases except the case with a 3.5 clo mitten at -60 °C. The proposed numerical hand-glove/mitten model could reasonably predict local hand physiological responses in three extremely cold environments and provides fundamental knowledge for cold stress prediction and protective glove development, thereby improving the safety and health of industrial workers, firefighters, first responders, and troops.

Duration limits for exposure for the whole body and extremities with a military extreme cold protection clothing ensemble at an ambient temperature of -40°C

Manual performance and body temperature responses were assessed in a 1-h trial at an ambient temperature (TAMB) of -40°C for 7 male participants (32 ± 14 (mean ± SD) years) wearing a typical military extreme cold protection clothing ensemble. The purpose was to establish duration limited exposure (DLIM) for these conditions, and it was hypothesized that (i) core temperature (TCORE) would remain normothermic, whereas extremity skin temperature (TSK) would decrease; (ii) decrements of manual performance would be in proportion to decreases of hand TSK; and (iii) DLIM would be determined by the hand or foot TSK responses. Linear regression was employed to assess associations of manual performance scores and body temperatures with DLIM assessed using the Required Clothing Insulation (IREQ) model and extremity temperatures in ISO 11079-2007. Results showed TCORE remained at ~37.3°C, whereas there were significant (0.0001 < p < 0.05) decreases in extremity TSK. Associations between manual performance and hand TSK showed coefficients of determination (R2) ranging from 0.48 < R2 < 0.98; 0.00005 ≤ p ≤ 0.08. The DLIM for the whole-body ensemble ranged from 2.2 h to > 8 h, whereas the DLIM for the extremities was 0.56 ± 0.20 h for TSK decreasing 15°C. In conclusion, the hypotheses of a stable core temperature and decreases of extremity skin temperature giving decrements in manual performance were accepted as was the hypothesis that duration limits for exposure would be determined by extremity skin temperatures of the hand and foot.

The effect of the menstrual cycle on the sense of touch, grip strength and manual dexterity of dental students

Objectives. This study aimed to evaluate through comparative tests the effect of the menstrual cycle on levels of depression, sleep quality and grip strength, fingertip touch and manual dexterity of students in the Dental Faculty. Methods. The study sample was formed from female students of the Dental Faculty. The total 70 participants comprised 31 from the first year and 39 from the final year. Evaluations were made in two different consecutive phases of the menstrual cycle. Data were collected using the Beck depression inventory (BDI), the Pittsburgh sleep quality index (PSQI), handgrip and lateral grip strength measurements, fingertip two-point discrimination sensory measurement, the Semmes-Weinstein monofilament test, the O'Connor tweezers skill test and the Purdue pegboard test. Results. A statistically significant difference was determined between the menstrual and ovulation phase measurements of the BDI, PSQI, Semmes-Weinstein monofilament test (right), the O'Connor tweezers skill test and Purdue pegboard test (right + left), and the Purdue Pegboard test (total and assembly) (p < 0.05). Conclusions. The menstrual cycle does not affect the sense of touch, grip strength and simple hand skills. However, task-focused skills requiring care and the manual dexterity needed for the use of instruments are affected.

Evaluating the thermal protection provided by a 2‒3 mm wet suit during fin diving in shallow water with a temperature of 16‒20°C

INTRODUCTION

The purpose of the study was to evaluate the thermal protection provided by a 2-3 mm surfing wet suit during at least two hours of fin diving in shallow water with a temperature of 16-20°C. We examined the effect of wearing the suit while diving in cold water on cognitive performance, muscle strength, and hand motor function.

METHODS

Subjects were six male well-trained rebreather divers, 19-23 years old, acclimatised to cold. They attended the laboratory on three separate occasions, when we conducted the experiment at one of three temperatures, 16, 18, and 20°C. Core temperature (gastrointestinal system), skin temperature, oxygen consumption, and cold perception were evaluated during the test. Before and immediately after the dives, subjects performed a series of cognitive, manual dexterity, and muscle strength tests.

RESULTS

Core temperature decreased by 0.35-0.81°C over the two hours at all three water temperatures. No subject reached a core temperature below 35°C. The decrease in upper body skin temperature during the two hour dive ranged between 5.97 and 8.41°C (P < 0.05). Two hours diving in 16-20°C water resulted in a significant increase in the time taken to perform the task of unlinking and reassembling four shackles (∼30% longer, P < 0.05). No effect was found on the cognitive or muscle strength tests.

CONCLUSIONS

A 2-3 mm wet suit provides adequate thermal protection in trained and cold-acclimatised young males engaged in active diving in shallow water with a temperature of 16°C and above.

Warm bodies, cool wings: regional heterothermy in flying bats

Many endothermic animals experience variable limb temperatures, even as they tightly regulate core temperature. The limbs are often cooler than the core at rest, but because the large locomotor muscles of the limbs produce heat during exercise, they are thought to operate at or above core temperature during activity. Bats, small-bodied flying mammals with greatly elongated forelimbs, possess wings with large surfaces lacking any insulating fur. We hypothesized that during flight the relatively small muscles that move the elbow and wrist operate below core body temperature because of elevated heat loss. We measured muscle temperature continuously in the small fruit bat Carollia perspicillata before and during wind tunnel flights, and discretely in diverse bats at rest in Belize. We found that bats maintained high rectal temperatures, but that there was a steep proximal-to-distal gradient in wing muscle temperature. Forearm muscles were 4-6°C cooler than rectal temperature at rest and approximately 12°C cooler during flights at an air temperature of 22°C. These findings invite further study into how bats and other endotherms maintain locomotor performance in variable environments, when some muscles may be operating at low temperatures that are expected to slow contractile properties.

Precooling's Effect on American Football Skills

Bradley, LJ, Miller, KC, Wiese, BW, and Novak, JR. Precooling's effect on American football skills. J Strength Cond Res 33(10): 2616-2621, 2019-Precooling (i.e., cooling before exercise) may reduce the risk of exertional heatstroke (EHS) in American football athletes. However, implementation of precooling by coaches or medical staff would likely be poor if it impaired performance. We investigated whether precooling impacted American football skill performance in this randomized, crossover, counterbalanced study. Twelve men (24 ± 2 years, mass = 85.5 ± 6.3 kg, height = 181.8 ± 8.1 cm) completed a familiarization day to practice each skill and then 2 testing days. On testing days (wet-bulb globe temperature = 19.3 ± 4.1° C), subjects were either precooled for 15 minutes using cold-water immersion (10.1 ± 0.3° C) or not (control). Then, they donned an American football uniform and completed several bouts of 8 different football skills. Rectal temperature (Trec) was measured before, during, and after skill testing. Precooling did not affect vertical jump, broad jump, agility, dynamic or stationary catching, or maximum throwing distance (p ≥ 0.13). Precooling impaired 40-yard dash time (precooling = 5.72 ± 0.53 seconds, control = 5.31 ± 0.34 seconds; p = 0.03, effect size = 1.2) and throwing accuracy (precooling = 4 ± 1 points, control = 7 ± 2 points; p = 0.001, effect size = 1.4). On average, Trec was 0.58 ± 0.35° C lower during skills testing after precooling and statistically differed from control from minute 10 to the end of testing (∼35 minutes; p < 0.05, effect size ≥ 1.2). Precooling may be a useful EHS prevention strategy in American football players because it lowered Trec without impacting most skills. By lowering Trec, precooling would prolong the time it would take for an athlete's Trec to become dangerous (i.e., >40.5° C). If precooling is implemented, coaches should alter practice so that throwing accuracy and speed drills occur after an athlete's Trec returns to normal (i.e., >35 minutes).

Effects of Sleep Deprivation on Surgeons Dexterity

Sleep deprivation is an ordinary aspect in the global society and its prevalence is increasing. Chronic and acute sleep deprivation have been linked to diabetes and heart diseases as well as depression and enhanced impulsive behaviors. Surgeons are often exposed to long hour on call and few hours of sleep in the previous days. Nevertheless, few studies have focused their attention on the effects of sleep deprivation on surgeons and more specifically on the effects of sleep deprivation on surgical dexterity, often relying on virtual surgical simulators. A better understanding of the consequences of sleep loss on the key surgical skill of dexterity can shed light on the possible risks associated to a sleepy surgeon. In this paper, the authors aim to provide a comprehensive review of the relationship between sleep deprivation and surgical dexterity.

The Combined Effect of Cold and Moisture on Manual Performance

Objective The aim of this study was to investigate the combined effect of cold and moisture on manual performance and tactile sensitivity. Background People working in the ocean environment often perform manual work in cold and wet conditions. Although the independent effects of cold and moisture on hand function are known, their combined effect has not been investigated. Method Participants completed sensory (Touch-Test, two-point discrimination) and motor (Purdue Pegboard, Grooved Pegboard, reef knot untying) tests in the following conditions: dry hand, wet hand, cold hand, and cold and wet hand. Results For the Purdue Pegboard and knot untying tasks, the greatest decrement in performance was observed in the cold-and-wet-hand condition, whereas the decrements seen in the cold-hand and wet-hand conditions were similar. In the Grooved Pegboard task, the performance decrements exhibited in the cold-and-wet-hand condition and the cold-hand condition were similar, whereas no decrement was observed in the wet-hand condition. Tactile sensitivity was reduced in the cold conditions for the Touch-Test but not the two-point discrimination test.

CONCLUSION

The combined effect of cold and moisture led to the largest performance decrements except when intrinsic object properties helped with grasp maintenance. The independent effects of cold and moisture on manual performance were comparable. Application Tools and equipment for use in the cold ocean environment should be designed to minimize the effects of cold and moisture on manual performance by including object properties that enhance grasp maintenance and minimize the fine-dexterity requirements.

Seasonality in physical activity and walking of healthy older adults

BACKGROUND

An increasing number of older adults require improvements in their quality of life. Physical activities, particularly walking ability, are of primary importance for older adults. The influence of season on physical activity has not been sufficiently studied among older adults. Therefore, this report compared the physical activity and walking of older individuals between summer and winter seasons using a longitudinal study design in a community in a mid-latitude area.

METHODS

Participants in the study comprised 39 healthy community-dwelling adults ranging in age from 65 to 80 years. Physical parameters and activities as well as the preferred speed of walking were measured at half-year intervals.

RESULTS

Significant seasonal differences from summer to winter and from winter to summer were detected. Specifically, body fat percentage, single-leg stance, walking speed, cadence, stride length, and trunk and head-trunk pitch ranges were greater in winter than in summer, whereas grip strength and steps per day were greater in summer. Temperature and total activity level were considered to be related to body fat percentage. Grip strength was thought to be affected by outdoor temperature. The possibility of relationships between increased activity per unit time in older adults and increased preferred walking speed, cadence, and stride length in winter temperatures was discussed.

CONCLUSION

The seasonal climatic environment of the geographic area of this study affected the activity level of the participants. These results indicate that seasonality should be considered when analyzing physical activity and walking in older adults.

The influence of cooling forearm/hand and gender on estimation of handgrip strength

Handgrip strength is essential in manual operations and activities of daily life, but the influence of forearm/hand skin temperature on estimation of handgrip strength is not well documented. Therefore, the present study intended to investigate the effect of local cooling of the forearm/hand on estimation of handgrip strength at various target force levels (TFLs, in percentage of MVC) for both genders. A cold pressor test was used to lower and maintain the hand skin temperature at 14°C for comparison with the uncooled condition. A total of 10 male and 10 female participants were recruited. The results indicated that females had greater absolute estimation deviations. In addition, both genders had greater absolute deviations in the middle range of TFLs. Cooling caused an underestimation of grip strength. Furthermore, a power function is recommended for establishing the relationship between actual and estimated handgrip force. Statement of relevance: Manipulation with grip strength is essential in daily life and the workplace, so it is important to understand the influence of lowering the forearm/hand skin temperature on grip-strength estimation. Females and the middle range of TFL had greater deviations. Cooling the forearm/hand tended to cause underestimation, and a power function is recommended for establishing the relationship between actual and estimated handgrip force. Practitioner Summary: It is important to understand the effect of lowering the forearm/hand skin temperature on grip-strength estimation. A cold pressor was used to cool the hand. The cooling caused underestimation, and a power function is recommended for establishing the relationship between actual and estimated handgrip force.

STATEMENT OF RELEVANCE

Manipulation with grip strength is essential in daily life and the workplace, so it is important to understand the influence of lowering the forearm/hand skin temperature on grip-strength estimation. Females and the middle range of TFL had greater deviations. Cooling the forearm/hand tended to cause underestimation, and a power function is recommended for establishing the relationship between actual and estimated handgrip force.

PRACTITIONER SUMMARY

It is important to understand the effect of lowering the forearm/hand skin temperature on grip-strength estimation. A cold pressor was used to cool the hand. The cooling caused underestimation, and a power function is recommended for establishing the relationship between actual and estimated handgrip force

[Measuring the handgrip strength of geriatric patients]

The handgrip strength of geriatric patients can be measured when the patient is hospitalized. This article elaborates on the intrinsic and extrinsic factors which have a direct or indirect influence on handgrip strength. For the best results the tests need to be taken in the best circumstances with attention to individual differences and the age of the patient. Handgrip strength as determination of biological vitality is a key concept. Besides the physical characteristics there are many psychological factors (cognition, psyching-up, test attitude…) influencing the results. These are barely mentioned or not mentioned at all in the usual procedures. Research of handgrip strength testing theories is mostly focused on young, healthy adults and less on elderly patients. The main goal of this article is stimulating experimental research on the measurement of handgrip strength with elderly people and involving them more actively with the procedure. It is not enough to acquire insight in function and predicting characteristics of handgrip strength. Next to the aiming for the best test performance is 'working interactively with elderly patients' a goal on itself in the modern vision of health care.

Evaluation of the effects of low temperature on performance of standard non-electric medical equipment at -21.5°C (-6.7°F) - a descriptive study on a real life challenge in the prehospital setting

AIM OF THE STUDY

To our knowledge, there are no previous reports on the performance of medical equipment in cold conditions. The aim of this study was to evaluate the performance of several plastic, single-use medical equipment exposed to cold outdoor temperature.

METHODS

Medical equipment such as endotracheal tubes, suction catheters and intravenous lines were exposed to outdoor temperature of -21.5°C (-6.7°F) for 15 min. After 15 min the equipment underwent a manual stress test resembling normal prehospital use.

RESULTS

After 15 min in -21.5°C (-6.7°F) during the stress test several equipment exhibited significant changes in properties as compared to room temperature. Mainly, loss of flexibility and connectivity was observed. Examples of these were fractures of endotracheal tubes and suction catheters, and permanent airway adapter loosening from a respirator breathing circuit.

CONCLUSION

Plastic medical equipment has poor tolerance of cold conditions. Loss of equipment performance and properties could result in relevant harm to the patient. Retaining the equipment, e.g. in a closed backpack slows the rate of temperature decrease.

Should athletes return to sport after applying ice? A systematic review of the effect of local cooling on functional performance

Applying ice or other forms of topical cooling is a popular method of treating sports injuries. It is commonplace for athletes to return to competitive activity, shortly or immediately after the application of a cold treatment. In this article, we examine the effect of local tissue cooling on outcomes relating to functional performance and to discuss their relevance to the sporting environment. A computerized literature search, citation tracking and hand search was performed up to April, 2011. Eligible studies were trials involving healthy human participants, describing the effects of cooling on outcomes relating to functional performance. Two reviewers independently assessed the validity of included trials and calculated effect sizes. Thirty five trials met the inclusion criteria; all had a high risk of bias. The mean sample size was 19. Meta-analyses were not undertaken due to clinical heterogeneity. The majority of studies used cooling durations > 20 minutes. Strength (peak torque/force) was reported by 25 studies with approximately 75% recording a decrease in strength immediately following cooling. There was evidence from six studies that cooling adversely affected speed, power and agility-based running tasks; two studies found this was negated with a short rewarming period. There was conflicting evidence on the effect of cooling on isolated muscular endurance. A small number of studies found that cooling decreased upper limb dexterity and accuracy. The current evidence base suggests that athletes will probably be at a performance disadvantage if they return to activity immediately after cooling. This is based on cooling for longer than 20 minutes, which may exceed the durations employed in some sporting environments. In addition, some of the reported changes were clinically small and may only be relevant in elite sport. Until better evidence is available, practitioners should use short cooling applications and/or undertake a progressive warm up prior to returning to play.

Test-retest reliability of Purdue Pegboard performance in thermoneutral and cold ambient conditions

In the cold, Purdue Pegboard (PP) performance declines. The purpose of this study was to determine if this cold-induced impairment is consistent across days (i.e. test-retest reliability) in 5°C. In thermoneutral air (25°C), 14 men were familiarised to the dominant hand (PPa) and bimanual (PPb) PP tasks. They then experienced two 90-min cold exposures (Day 1, Day 2) while wearing ∼1 clo. Bare hands were maintained throughout. Performance on both tasks showed high reliability from day to day (intraclass correlations >0.700) in both thermoneutral and cold conditions. However for both tasks, room temperature performance did not predict performance in the cold (intraclass correlations <0.450). When screening applicants for manual labour in the cold, one must consider that room temperature dexterity does not correlate with dexterity in the cold. It is recommended that a 60-min period of cold exposure be employed to assess manual dexterity in these workers. STATEMENT OF RELEVANCE: This study shows that PP performance in room temperature does not predict performance in the cold but performance in the cold is consistent from day to day. When screening applicants for manual labour in the cold, it is recommended that dexterity tests be conducted in the same ambient conditions.