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McKleroy W, Shing T, Anderson WH, Arjomandi M, Awan HA, Barjaktarevic I, Barr RG, Bleecker ER, Boscardin J, Bowler RP, Buhr RG, Criner GJ, Comellas AP, Curtis JL, Dransfield M, Doerschuk CM, Dolezal BA, Drummond MB, Han MK, Hansel NN, Helton K, Hoffman EA, Kaner RJ, Kanner RE, Krishnan JA, Lazarus SC, Martinez FJ, Ohar J, Ortega VE, Paine R, Peters SP, Reinhardt JM, Rennard S, Smith BM, Tashkin DP, Couper D, Cooper CB, Woodruff PG. Longitudinal Follow-Up of Participants With Tobacco Exposure and Preserved Spirometry. JAMA 2023; 330:442-453. [PMID: 37526720 PMCID: PMC10394572 DOI: 10.1001/jama.2023.11676] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 06/20/2023] [Indexed: 08/02/2023]
Abstract
Importance People who smoked cigarettes may experience respiratory symptoms without spirometric airflow obstruction. These individuals are typically excluded from chronic obstructive pulmonary disease (COPD) trials and lack evidence-based therapies. Objective To define the natural history of persons with tobacco exposure and preserved spirometry (TEPS) and symptoms (symptomatic TEPS). Design, Setting, and Participants SPIROMICS II was an extension of SPIROMICS I, a multicenter study of persons aged 40 to 80 years who smoked cigarettes (>20 pack-years) with or without COPD and controls without tobacco exposure or airflow obstruction. Participants were enrolled in SPIROMICS I and II from November 10, 2010, through July 31, 2015, and followed up through July 31, 2021. Exposures Participants in SPIROMICS I underwent spirometry, 6-minute walk distance testing, assessment of respiratory symptoms, and computed tomography of the chest at yearly visits for 3 to 4 years. Participants in SPIROMICS II had 1 additional in-person visit 5 to 7 years after enrollment in SPIROMICS I. Respiratory symptoms were assessed with the COPD Assessment Test (range, 0 to 40; higher scores indicate more severe symptoms). Participants with symptomatic TEPS had normal spirometry (postbronchodilator ratio of forced expiratory volume in the first second [FEV1] to forced vital capacity >0.70) and COPD Assessment Test scores of 10 or greater. Participants with asymptomatic TEPS had normal spirometry and COPD Assessment Test scores of less than 10. Patient-reported respiratory symptoms and exacerbations were assessed every 4 months via phone calls. Main Outcomes and Measures The primary outcome was assessment for accelerated decline in lung function (FEV1) in participants with symptomatic TEPS vs asymptomatic TEPS. Secondary outcomes included development of COPD defined by spirometry, respiratory symptoms, rates of respiratory exacerbations, and progression of computed tomographic-defined airway wall thickening or emphysema. Results Of 1397 study participants, 226 had symptomatic TEPS (mean age, 60.1 [SD, 9.8] years; 134 were women [59%]) and 269 had asymptomatic TEPS (mean age, 63.1 [SD, 9.1] years; 134 were women [50%]). At a median follow-up of 5.76 years, the decline in FEV1 was -31.3 mL/y for participants with symptomatic TEPS vs -38.8 mL/y for those with asymptomatic TEPS (between-group difference, -7.5 mL/y [95% CI, -16.6 to 1.6 mL/y]). The cumulative incidence of COPD was 33.0% among participants with symptomatic TEPS vs 31.6% among those with asymptomatic TEPS (hazard ratio, 1.05 [95% CI, 0.76 to 1.46]). Participants with symptomatic TEPS had significantly more respiratory exacerbations than those with asymptomatic TEPS (0.23 vs 0.08 exacerbations per person-year, respectively; rate ratio, 2.38 [95% CI, 1.71 to 3.31], P < .001). Conclusions and Relevance Participants with symptomatic TEPS did not have accelerated rates of decline in FEV1 or increased incidence of COPD vs those with asymptomatic TEPS, but participants with symptomatic TEPS did experience significantly more respiratory exacerbations over a median follow-up of 5.8 years.
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Affiliation(s)
- William McKleroy
- Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, School of Medicine, University of California, San Francisco
- Now with Department of Pulmonary and Critical Care Medicine, Kaiser Permanente San Francisco Medical Center, San Francisco, California
| | - Tracie Shing
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Wayne H Anderson
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill
| | - Mehrdad Arjomandi
- Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, School of Medicine, University of California, San Francisco
- Division of Pulmonary and Critical Care Medicine, Medical Service, San Francisco VA Medical Center, San Francisco, California
| | - Hira Anees Awan
- Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City
| | - Igor Barjaktarevic
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - R Graham Barr
- Divisions of General Medicine and Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University Medical Center, New York, New York
- Department of Epidemiology, Columbia University Medical Center, New York, New York
| | - Eugene R Bleecker
- Division of Genetics, Genomics, and Precision Medicine, Department of Medicine, College of Medicine, University of Arizona, Tucson
- Division of Pharmacogenomics, Center for Applied Genetics and Genomic Medicine, University of Arizona, Tucson
| | - John Boscardin
- Department of Medicine and Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco
| | - Russell P Bowler
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, Colorado
| | - Russell G Buhr
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Gerard J Criner
- Division of Thoracic Medicine and Surgery, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Alejandro P Comellas
- Division of Pulmonary, Critical Care, and Occupational Medicine, Department of Medicine, Carver College of Medicine, University of Iowa, Iowa City
| | - Jeffrey L Curtis
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Michigan, Ann Arbor
- Medical Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Mark Dransfield
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Alabama, Birmingham
| | - Claire M Doerschuk
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill
| | - Brett A Dolezal
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - M Bradley Drummond
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill
| | - MeiLan K Han
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Michigan, Ann Arbor
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Kinsey Helton
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Eric A Hoffman
- Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City
- Division of Pulmonary, Critical Care, and Occupational Medicine, Department of Medicine, Carver College of Medicine, University of Iowa, Iowa City
- Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City
| | - Robert J Kaner
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Richard E Kanner
- Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, Department of Medicine, School of Medicine, University of Utah, Salt Lake City
| | - Jerry A Krishnan
- Breathe Chicago Center, Division of Pulmonary, Critical Care, Sleep, and Allergy, University of Illinois, Chicago
| | - Stephen C Lazarus
- Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, School of Medicine, University of California, San Francisco
- Cardiovascular Research Institute, University of California, San Francisco
| | - Fernando J Martinez
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Jill Ohar
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Victor E Ortega
- Division of Pulmonary Medicine, Department of Medicine, Mayo Clinic, Phoenix, Arizona
| | - Robert Paine
- Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, Department of Medicine, School of Medicine, University of Utah, Salt Lake City
| | - Stephen P Peters
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Joseph M Reinhardt
- Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City
| | - Stephen Rennard
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, College of Medicine, University of Nebraska, Omaha
| | - Benjamin M Smith
- Divisions of General Medicine and Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University Medical Center, New York, New York
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - Donald P Tashkin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - David Couper
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Christopher B Cooper
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles
| | - Prescott G Woodruff
- Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, School of Medicine, University of California, San Francisco
- Cardiovascular Research Institute, University of California, San Francisco
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Yamamoto T, Pandit B, Viggiano M, Daniels K, Mologne MS, Gomez D, Dolezal BA. Efficacy of a 6-week Novel Exergaming Intervention Guided by Heart Rate Zones on Aerobic Performance in Children with Fetal Alcohol Spectrum Disorder and Attention-deficit/Hyperactivity Disorder: A Feasibility Study. Int J Exerc Sci 2023; 16:710-720. [PMID: 37649462 PMCID: PMC10464751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
The purpose of this study was to determine the feasibility of a novel exergaming intervention guided by heart rate zones for children and adolescents with fetal alcohol spectrum disorder (FASD) and attention-deficit/hyperactivity disorder (ADHD). Eight study participants (6 females, 2 males, mean age= 11.4±1.4 years old) participated twice weekly over six weeks to complete twelve multimodal exergaming sessions. Participants significantly improved 6MWT from baseline to week 6 (575.4±55.0 m to 732.8±58.9 m; P<0.01), which conferred a 31% improvement in estimated VO2max (31.5±5.5 ml/kg/min to 40.9±5.9 ml/kg/min), respectively. There was an upward trend of the mean percentage of time spent in the intermediate HR zones over the course of the 6-week intervention. These findings may provide value to the field as they support the clinical utility and promising effects of cardiovascular improvement in children who engage in a compelling exergaming intervention. In doing so, this establishes a preliminary understanding of how to augment routine physical exercise through exergaming using visually targeted heart rate zones.
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Affiliation(s)
- Trent Yamamoto
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Bilal Pandit
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Michael Viggiano
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Kristin Daniels
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Mitchell S Mologne
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - David Gomez
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Brett A Dolezal
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
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Fortis S, Quibrera PM, Comellas AP, Bhatt SP, Tashkin DP, Hoffman EA, Criner GJ, Han MK, Barr RG, Arjomandi M, Dransfield MB, Peters SP, Dolezal BA, Kim V, Putcha N, Rennard SI, Paine R, Kanner RE, Curtis JL, Bowler RP, Martinez FJ, Hansel NN, Krishnan JA, Woodruff PG, Barjaktarevic IZ, Couper D, Anderson WH, Cooper CB. Bronchodilator Responsiveness in Tobacco-Exposed People With or Without COPD. Chest 2023; 163:502-514. [PMID: 36395858 PMCID: PMC9993341 DOI: 10.1016/j.chest.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 11/04/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Bronchodilator responsiveness (BDR) in obstructive lung disease varies over time and may be associated with distinct clinical features. RESEARCH QUESTION Is consistent BDR over time (always present) differentially associated with obstructive lung disease features relative to inconsistent (sometimes present) or never (never present) BDR in tobacco-exposed people with or without COPD? STUDY DESIGN AND METHODS We retrospectively analyzed data from 2,269 tobacco-exposed participants in the Subpopulations and Intermediate Outcome Measures in COPD Study with or without COPD. We used various BDR definitions: change of ≥ 200 mL and ≥ 12% in FEV1 (FEV1-BDR), change in FVC (FVC-BDR), and change in in FEV1, FVC or both (ATS-BDR). Using generalized linear models adjusted for demographics, smoking history, FEV1 % predicted after bronchodilator administration, and number of visits that the participant completed, we assessed the association of BDR group: (1) consistent BDR, (2) inconsistent BDR, and (3) never BDR with asthma, CT scan features, blood eosinophil levels, and FEV1 decline in participants without COPD (Global Initiative for Chronic Obstructive Lung Disease [GOLD] stage 0) and the entire cohort (participants with or without COPD). RESULTS Both consistent and inconsistent ATS-BDR were associated with asthma history and greater small airways disease (%parametric response mapping functional small airways disease) relative to never ATS-BDR in participants with GOLD stage 0 disease and the entire cohort. We observed similar findings using FEV1-BDR and FVC-BDR definitions. Eosinophils did not vary consistently among BDR groups. Consistent BDR was associated with FEV1 decline over time relative to never BDR in the entire cohort. In participants with GOLD stage 0 disease, both the inconsistent ATS-BDR group (OR, 3.20; 95% CI, 2.21-4.66; P < .001) and consistent ATS-BDR group (OR, 9.48; 95% CI, 3.77-29.12; P < .001) were associated with progression to COPD relative to the never ATS-BDR group. INTERPRETATION Demonstration of BDR, even once, describes an obstructive lung disease phenotype with a history of asthma and greater small airways disease. Consistent demonstration of BDR indicated a high risk of lung function decline over time in the entire cohort and was associated with higher risk of progression to COPD in patients with GOLD stage 0 disease.
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Affiliation(s)
- Spyridon Fortis
- Center for Access & Delivery Research & Evaluation, Iowa City VA Health Care System, Iowa City, IA; Division of Pulmonary, Critical Care and Occupational Medicine, Department of Internal Medicine, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA.
| | - Pedro M Quibrera
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Alejandro P Comellas
- Division of Pulmonary, Critical Care and Occupational Medicine, Department of Internal Medicine, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA
| | - Surya P Bhatt
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham VA Medical Center, Birmingham, AL
| | - Donald P Tashkin
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA
| | - Eric A Hoffman
- Departments of Radiology, Biomedical Engineering and Medicine, University of Iowa, Iowa City, IA
| | - Gerard J Criner
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - MeiLan K Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI
| | - R Graham Barr
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Mehrdad Arjomandi
- Department of Medicine, University of California, San Francisco, CA; San Francisco Veterans Affairs Healthcare System, San Francisco, CA
| | - Mark B Dransfield
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham VA Medical Center, Birmingham, AL; Division of Pulmonary and Critical Care Medicine, Birmingham VA Medical Center, Birmingham, AL
| | - Stephen P Peters
- Section on Pulmonary, Critical Care, Allergy, and Immunologic Diseases, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Brett A Dolezal
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA
| | - Victor Kim
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Nirupama Putcha
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | - Stephen I Rennard
- Division of Pulmonary and Critical Care Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Robert Paine
- Division of Respiratory, Critical Care and Occupational Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Richard E Kanner
- Division of Respiratory, Critical Care and Occupational Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Jeffrey L Curtis
- Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI; Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Russell P Bowler
- Department of Medicine, National Jewish Medical and Research Center, Denver, CO
| | - Fernando J Martinez
- Departments of Medicine and Genetic Medicine, Weill Cornell Medicine, New York, NY
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | - Jerry A Krishnan
- Division of Pulmonary, Critical Care, Sleep, and Allergy, University of Illinois at Chicago, Chicago, IL
| | | | - Igor Z Barjaktarevic
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA
| | - David Couper
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Wayne H Anderson
- Division of Pulmonary and Critical Care Medicine, Marsico Lung Institute, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Christopher B Cooper
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA
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Mologne MS, Hu J, Carrillo E, Gomez D, Yamamoto T, Lu S, Browne JD, Dolezal BA. The Efficacy of an Immersive Virtual Reality Exergame Incorporating an Adaptive Cable Resistance System on Fitness and Cardiometabolic Measures: A 12-Week Randomized Controlled Trial. Int J Environ Res Public Health 2022; 20:210. [PMID: 36612530 PMCID: PMC9819410 DOI: 10.3390/ijerph20010210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Exergaming, combining elements of video game into the realm of exercise, has recently incorporated immersive virtual reality (IVR) with resistance training. Thirty-two participants (14 females, mean age = 24.3) were randomized to IVR or self-directed control group (SELF) and worked out thrice weekly for 12 weeks (for 36 sessions). The IVR group spent 14 fewer minutes per session (p < 0.001) while reporting the sessions “enjoyable’. Compared to SELF, the IVR group had significantly greater improvement in changes from baseline to post-training in upper-and-lower muscular strength (1-RM) and muscular endurance (85% 1-RM) (14.3 kg vs. 10.0 kg for 1-RM upper, 28.6 kg vs. 22.5 kg for 1-RM lower, 2.6 reps vs. 1.9 reps for 85% 1-RM of upper, 2.7 vs. 2.0 reps for 85% 1-RM of lower, all p < 0.001), peak leg power (1424 vs. 865 W, p < 0.001), body fat% (−3.7% vs. −1.9%, p < 0.001), heart rate variability (4.3 vs. 1.8 ms, p < 0.001), rVO2max (3.28 vs. 0.89 mL/min/kg, p < 0.001) with decreased systolic BP (−0.4 vs. −2.3 mmHg, p < 0.001), and level of perceived exertion during workouts (RPE 14 vs. 16, p < 0.001). With its high-paced and action-filled gaming coupled with superior fitness and cardiometabolic outcomes, this IVR exergaming platform should be considered as another exercise modality for performance and health-related training.
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Affiliation(s)
- Mitchell S Mologne
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Jonathan Hu
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
- John A Burns School of Medicine, University of Hawaii, Honolulu, HI 96813, USA
| | - Erik Carrillo
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - David Gomez
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Trent Yamamoto
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Stevin Lu
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
- Creighton School of Medicine, Omaha, NE 68178, USA
| | - Jonathan D Browne
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
- School of Medicine, California University of Science and Medicine, Colton, CA 92324, USA
| | - Brett A Dolezal
- Airway & UCFit Digital Health-Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
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Goldman P, Pandit B, Gomez D, Lu S, Mills C, Kull N, Ku R, Aramie A, Kim A, Alexandru A, Hu J, Neufeld EV, Dolezal BA. Effect of Real-Time Feedback on Power Output Using a Novel Smart-Resisted Sled Push. Int J Exerc Sci 2022; 15:1578-1586. [PMID: 36582967 PMCID: PMC9762164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Prior studies have demonstrated the beneficial effects of real-time data feedback (RTF) on athletic performance and motivation. Despite this evidence, the lack of practical means to implement RTF has hindered its widespread adoption. Recently, a smart-resisted sled push was developed to improve athletic power by utilizing electromagnetic motors as a resistance mechanism, coupled with an RTF display. Thirty healthy college-aged male football players were recruited in this randomized, crossover designed study to examine the efficacy of the RTF to improve power output. Participants were randomized into either group 1 (receiving RTF first then no RTF) or group 2 (receiving no RTF first then RTF) during six, 10-meter sled pushes with 3 min rest intervals. The first three pushes were set to an easier level (L1) and the last three were set to a resistance level twice that of the first three runs (L2). A one-month washout period was enforced. For trials 1-3 (L1) (p = 0.026, t = -2.34, ES = -0.428) and 4-6 (L2) (p = 0.035, t = -2.22, ES = -0.405), peak power output (the average peak power output over the course of trials 1-3 and 4-6) was greater in both groups when receiving RTF compared to no-RTF. These findings demonstrate the effectiveness of RTF in augmenting power output during performance training.
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Affiliation(s)
- Phillip Goldman
- Airway & UC Fit Digital Health – Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA,University of Colorado-Boulder, Boulder, CO, USA
| | - Bilal Pandit
- Airway & UC Fit Digital Health – Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - David Gomez
- Airway & UC Fit Digital Health – Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Stevin Lu
- Airway & UC Fit Digital Health – Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Cade Mills
- Airway & UC Fit Digital Health – Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Nick Kull
- Airway & UC Fit Digital Health – Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Richard Ku
- Airway & UC Fit Digital Health – Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Adrian Aramie
- Airway & UC Fit Digital Health – Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Alex Kim
- Airway & UC Fit Digital Health – Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Anka Alexandru
- Airway & UC Fit Digital Health – Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Jonathan Hu
- Airway & UC Fit Digital Health – Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Eric V. Neufeld
- Airway & UC Fit Digital Health – Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY, USA
| | - Brett A. Dolezal
- Airway & UC Fit Digital Health – Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
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Gomez D, Browne JD, Neufeld EV, Pandit B, Dolezal BA. Muscle Activity And User-perceived Exertion During Immersive Virtual Reality Exergaming Incorporating Adaptive Cable Resistance. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000877732.42096.e6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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7
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Buhr RG, Barjaktarevic IZ, Quibrera PM, Bateman LA, Bleecker ER, Couper DJ, Curtis JL, Dolezal BA, Han MK, Hansel NN, Krishnan JA, Martinez FJ, McKleroy W, Paine R, Rennard SI, Tashkin DP, Woodruff PG, Kanner RE, Cooper CB. Reversible Airflow Obstruction Predicts Future Chronic Obstructive Pulmonary Disease Development in the SPIROMICS Cohort: An Observational Cohort Study. Am J Respir Crit Care Med 2022; 206:554-562. [PMID: 35549640 PMCID: PMC9716898 DOI: 10.1164/rccm.202201-0094oc] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/10/2022] [Indexed: 12/14/2022] Open
Abstract
Rationale: Chronic obstructive pulmonary disease (COPD) is defined by fixed spirometric ratio, FEV1/FVC < 0.70 after inhaled bronchodilators. However, the implications of variable obstruction (VO), in which the prebronchodilator FEV1/FVC ratio is less than 0.70 but increases to 0.70 or more after inhaled bronchodilators, have not been determined. Objectives: We explored differences in physiology, exacerbations, and health status in participants with VO compared with reference participants without obstruction. Methods: Data from the SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) cohort were obtained. Participants with VO were compared with reference participants without obstruction. Measurements and Main Results: We assessed differences in baseline radiographic emphysema and small airway disease at study entry, baseline, and change in lung function by spirometry, functional capacity by 6-minute walk, health status using standard questionnaires, exacerbation rates, and progression to COPD between the two groups. All models were adjusted for participant characteristics, asthma history, and tobacco exposure. We assessed 175 participants with VO and 603 reference participants without obstruction. Participants with VO had 6.2 times the hazard of future development of COPD controlling for other factors (95% confidence interval, 4.6-8.3; P < 0.001). Compared with reference participants, the VO group had significantly lower baseline pre- and post-bronchodilator (BD) FEV1, and greater decline over time in post-BD FEV1, and pre- and post-BD FVC. There were no significant differences in exacerbations between groups. Conclusions: Significant risk for future COPD development exists for those with pre- but not post-BD airflow obstruction. These findings support consideration of expanding spirometric criteria defining COPD to include pre-BD obstruction. Clinical trial registered with www.clinicaltrials.gov (NCT01969344).
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Affiliation(s)
- Russell G. Buhr
- Division of Pulmonary and Critical Care Medicine, and
- Center for the Study of Healthcare Innovation, Implementation, and Policy, Health Services Research and Development, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California
| | | | - P. Miguel Quibrera
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Lori A. Bateman
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Eugene R. Bleecker
- Division of Genetics, Genomics, and Precision Medicine, University of Arizona, Tucson, Arizona
| | - David J. Couper
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Jeffrey L. Curtis
- Division of Pulmonary and Critical Care Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan
- Medical Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
| | | | - MeiLan K. Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan
| | - Nadia N. Hansel
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jerry A. Krishnan
- Breathe Chicago Center, Division of Pulmonary and Critical Care Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois
| | - Fernando J. Martinez
- Division of Pulmonary and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, New York
| | - William McKleroy
- Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, California
| | - Robert Paine
- Division of Respiratory, Critical Care, and Occupational Medicine, University of Utah School of Medicine, Salt Lake City, Utah
- Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah; and
| | - Stephen I. Rennard
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | | | - Prescott G. Woodruff
- Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, California
| | - Richard E. Kanner
- Division of Respiratory, Critical Care, and Occupational Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Christopher B. Cooper
- Division of Pulmonary and Critical Care Medicine, and
- Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, California
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Browne JD, Boland DM, Neufeld EV, Gomez D, Goldman P, Dolezal BA. Lifestyle Modification Using A Wearable Biometric Ring And Guided Feedback Improve Sleep And Exercise Behaviors. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000877740.34674.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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9
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Neufeld EV, Gomez D, Brown JD, Dolezal BA. Assessing The Feasibility And Characterizing The Energy Expenditure And Relative Intensity Of A High-intensity Functional Training Regimen For Obese Female Adults: A Feasibility Study. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000877816.64556.95] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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10
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Gomez D, Browne JD, Almalouhi A, Abundex M, Hu J, Nason S, Kull N, Mills C, Harris Q, Ku R, Neufeld EV, Dolezal BA. Muscle Activity During Immersive Virtual Reality Exergaming Incorporating an Adaptive Cable Resistance System. Int J Exerc Sci 2022; 15:261-275. [PMID: 36896022 PMCID: PMC9987444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The purpose of this exploratory study was to characterize muscle activation via surface electromyography (sEMG), user-perceived exertion, and enjoyment during a 30-minute session of immersive virtual reality (IVR) cable resistance exergaming. Ten healthy, college-aged males completed a signature 30-minute exergaming session using an IVR adaptive cable resistance system that incorporated six traditional compound exercises. Muscle activation (sEMG) was captured during the session with a wearable sEMG system. Rated of Perceived Exertion (RPE) and Physical Activity Enjoyment Scale (PACES) were recorded following the session. Pectoralis major showed the highest activation during chest press, deltoids showed the highest activation on overhead press, latissimus dorsi showed the highest activation during lat pulldown and row exercises, hamstrings were the most activated muscles during Romanian deadlift, and glutes showed the highest activity during squats. RPE and PACES mean scores were 14 (1) and 4.27 (0.38), respectively. IVR exergaming with resistance cable training provides an enjoyable experience and distracts practitioners from exertion while exercising at a high intensity. Results from this study suggest similar muscle activation responses compared to traditional resistance exercises as demonstrated with prior evidence. This novel form of exercise might have important repercussions for improving health outcomes among those who find it challenging to adhere to and enjoy exercise routines, as well as with little knowledge on how to progress in their resistance training. Further investigations are needed to explore long-term adaptations and to assess if IVR exergaming has additional benefits compared to traditional resistance training.
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Affiliation(s)
- David Gomez
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Jonathan D Browne
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
- School of Medicine, California University of Science and Medicine, Colton, CA, USA
| | - Abdulrahman Almalouhi
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Max Abundex
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Jonathan Hu
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Sally Nason
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Nicholas Kull
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Cade Mills
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Quincy Harris
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Richard Ku
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Eric V Neufeld
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY, USA
| | - Brett A Dolezal
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
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11
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Ronish BE, Couper DJ, Barjaktarevic IZ, Cooper CB, Kanner RE, Pirozzi CS, Kim V, Wells JM, Han MK, Woodruff PG, Ortega VE, Peters SP, Hoffman EA, Buhr RG, Dolezal BA, Tashkin DP, Liou TG, Bateman LA, Schroeder JD, Martinez FJ, Barr RG, Hansel NN, Comellas AP, Rennard SI, Arjomandi M, Paine III R. Forced Expiratory Flow at 25%-75% Links COPD Physiology to Emphysema and Disease Severity in the SPIROMICS Cohort. Chronic Obstr Pulm Dis 2022; 9:111-121. [PMID: 35114743 PMCID: PMC9166328 DOI: 10.15326/jcopdf.2021.0241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Forced expiratory volume in 1 second (FEV1) is central to the diagnosis of chronic obstructive pulmonary disease (COPD) but is imprecise in classifying disease burden. We examined the potential of the maximal mid-expiratory flow rate (forced expiratory flow rate between 25% and 75% [FEF25%-75%]) as an additional tool for characterizing pathophysiology in COPD. OBJECTIVE To determine whether FEF25%-75% helps predict clinical and radiographic abnormalities in COPD. STUDY DESIGN AND METHODS The SubPopulations and InteRediate Outcome Measures In COPD Study (SPIROMICS) enrolled a prospective cohort of 2978 nonsmokers and ever-smokers, with and without COPD, to identify phenotypes and intermediate markers of disease progression. We used baseline data from 2771 ever-smokers from the SPIROMICS cohort to identify associations between percent predicted FEF25%-75% (%predFEF25%-75%) and both clinical markers and computed tomography (CT) findings of smoking-related lung disease. RESULTS Lower %predFEF25-75% was associated with more severe disease, manifested radiographically by increased functional small airways disease, emphysema (most notably with homogeneous distribution), CT-measured residual volume, total lung capacity (TLC), and airway wall thickness, and clinically by increased symptoms, decreased 6-minute walk distance, and increased bronchodilator responsiveness (BDR). A lower %predFEF25-75% remained significantly associated with increased emphysema, functional small airways disease, TLC, and BDR after adjustment for FEV1 or forced vital capacity (FVC). INTERPRETATION The %predFEF25-75% provides additional information about disease manifestation beyond FEV1. These associations may reflect loss of elastic recoil and air trapping from emphysema and intrinsic small airways disease. Thus, %predFEF25-75% helps link the anatomic pathology and deranged physiology of COPD.
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Affiliation(s)
- Bonnie E. Ronish
- Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, University of Utah, Salt Lake City, Utah, United States
| | - David J. Couper
- Department of Biostatistics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Igor Z. Barjaktarevic
- Division of Pulmonary and Critical Care, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles,California, United States
| | - Christopher B. Cooper
- Division of Pulmonary and Critical Care, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles,California, United States,Department of Physiology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, United States
| | - Richard E. Kanner
- Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Cheryl S. Pirozzi
- Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Victor Kim
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania, United States
| | - James M. Wells
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - MeiLan K. Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, United States
| | - Prescott G. Woodruff
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Victor E. Ortega
- Division of Internal Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina, United States
| | - Stephen P. Peters
- Division of Internal Medicine, Wake Forest University Health Sciences, Winston-Salem, North Carolina, United States
| | - Eric A. Hoffman
- Division of Physiologic Imaging, Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
| | - Russell G. Buhr
- Division of Pulmonary and Critical Care, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles,California, United States,Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Health Services Research and Development, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, United States
| | - Brett A. Dolezal
- Division of Pulmonary and Critical Care, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles,California, United States
| | - Donald P. Tashkin
- Division of Pulmonary and Critical Care, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles,California, United States
| | - Theodore G. Liou
- Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Lori A. Bateman
- Department of Biostatistics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Joyce D. Schroeder
- Division of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, United States
| | - Fernando J. Martinez
- Division of Pulmonary and Critical Care, Weill Cornell Medicine, New York, New York, United States
| | - R. Graham Barr
- Department of Internal Medicine, Columbia University, New York, New York, United States
| | - Nadia N. Hansel
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Alejandro P. Comellas
- Division of Pulmonary, Critical Care and Occupational Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Stephen I. Rennard
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, United States
| | - Mehrdad Arjomandi
- Department of Medicine, University of California San Francisco, San Francisco, California, United States,San Francisco Veterans Affairs Healthcare System, San Francisco, California, United States
| | - Robert Paine III
- Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, University of Utah, Salt Lake City, Utah, United States
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12
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Browne JD, Boland DM, Baum JT, Ikemiya K, Harris Q, Phillips M, Neufeld EV, Gomez D, Goldman P, Dolezal BA. Lifestyle Modification Using a Wearable Biometric Ring and Guided Feedback Improve Sleep and Exercise Behaviors: A 12-Month Randomized, Placebo-Controlled Study. Front Physiol 2021; 12:777874. [PMID: 34899398 PMCID: PMC8656237 DOI: 10.3389/fphys.2021.777874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/29/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose: Wearable biometric monitoring devices (WBMD) show promise as a cutting edge means to improve health and prevent disease through increasing accountability. By regularly providing real-time quantitative data regarding activity, sleep quality, and recovery, users may become more aware of the impact that their lifestyle has on their health. The purpose of this study was to examine the efficacy of a biometric tracking ring on improving sleep quality and increasing physical fitness over a one-year period. Methods: Fifty-six participants received a biometric tracking ring and were placed in one of two groups. One group received a 3-month interactive behavioral modification intervention (INT) that was delivered virtually via a smartphone app with guided text message feedback (GTF). The other received a 3-month non-directive wellness education control (CON). After three months, the INT group was divided into a long-term feedback group (LT-GTF) that continued to receive GTF for another nine months or short-term feedback group (ST-GTF) that stopped receiving GTF. Weight, body composition, and VO2max were assessed at baseline, 3months, and 12months for all participants and additionally at 6 and 9months for the ST-GTF and LT-GTF groups. To establish baseline measurements, sleep and physical activity data were collected daily over a 30-day period. Daily measurements were also conducted throughout the 12-month duration of the study. Results: Over the first 3months, the INT group had significant (p<0.001) improvements in sleep onset latency, daily step count, % time jogging, VO2max, body fat percentage, and heart rate variability (rMSSD HRV) compared to the CON group. Over the next 9months, the LT-GTF group continued to improve significantly (p<0.001) in sleep onset latency, daily step count, % time jogging, VO2max, and rMSSD HRV. The ST-GTF group neither improved nor regressed over the latter 9months except for a small increase in sleep latency. Conclusion: Using a WBMD concomitantly with personalized education, encouragement, and feedback, elicits greater change than using a WBMD alone. Additionally, the improvements achieved from a short duration of personalized coaching are largely maintained with the continued use of a WBMD.
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Affiliation(s)
- Jonathan D. Browne
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- School of Medicine, California University of Science and Medicine, Colton, CA, United States
| | - David M. Boland
- Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, United States
| | - Jaxon T. Baum
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Kayla Ikemiya
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Quincy Harris
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Marin Phillips
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Eric V. Neufeld
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY, United States
| | - David Gomez
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Phillip Goldman
- College of Arts and Sciences, University of Colorado Boulder, Boulder, CO, United States
| | - Brett A. Dolezal
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
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Gomez D, Neufeld EV, Hicks JW, Dolezal BA. COVID-19 Lockdowns: Exacerbating the Silent Pandemic. Int J Exerc Sci 2021; 14:1256-1260. [PMID: 35096237 PMCID: PMC8758161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The global medical community has exalted the vaccine as the champion solution to end the violent toll inflicted by COVID-19. While the role of vaccines cannot be undervalued in wide-scale intervention, presenting them as the sole solution exonerates individuals of the importance of taking ownership over their lifestyle choices. This editorial focuses on the importance of physical activity as a crucial component of COVID-19 prevention programs and a long-term investment against chronic diseases.
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Affiliation(s)
- David Gomez
- Airway and Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Eric V Neufeld
- Airway and Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY, USA
| | - James W Hicks
- Center for Exercise Medicine and Sport Sciences, University of California-Irvine, Irvine, CA, USA
| | - Brett A Dolezal
- Airway and Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
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Hu J, Browne JD, Arnold MT, Robinson A, Heacock MF, Ku R, Mologne M, Baum GR, Ikemiya KA, Neufeld EV, Dolezal BA. Physiological and Metabolic Requirements, and User-Perceived Exertion of Immersive Virtual Reality Exergaming Incorporating an Adaptive Cable Resistance System: An Exploratory Study. Games Health J 2021; 10:361-369. [PMID: 34403592 DOI: 10.1089/g4h.2021.0031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: To measure metabolic and physiological demand, subjective fatigue, and enjoyment during a signature 30-minute immersive virtual reality (IVR) adaptive cable resistance exergaming session. Methods: Fourteen healthy college-aged individuals (seven females) were initially acquainted with the IVR equipment and gameplay dynamics. Participants then underwent a 30-minute IVR exergaming session performing six different cable resistance exercises. A portable metabolic gas exchange analyzer concurrently assessed energy expenditure (EE) through indirect calorimetry while a chest-worn monitor captured heart rate (HR). Participants subsequently completed questionnaires, including the Borg scale for rating of perceived exertion (RPE), Physical Activity Enjoyment Scale (PACES), and Simulator Sickness Questionnaire (SSQ). Results: The mean EE, mean metabolic equivalent, and average total calories expended during the 30-minute session were 14.7 (standard deviation [SD] 2.8) kcal/minute, 12.9 (SD 0.5), and 440 (SD 84) kcals respectively. The mean HR was 176 (SD 3.1) beats per minute (bpm) with a mean max HR of 188 SD (SD 2.9) bpm. The combined training volume among all participants was 16,102 kg (SD 4137). Participants classified the IVR training session to be "somewhat hard-to-hard" with a RPE score of 14 (SD 1) while indicating the session to be "enjoyable" with a PACES score of 4.31 (SD 0.36). The participants did not report any cybersickness symptoms, demonstrating an average total SSQ score of 24.04 (SD 24.13). Conclusions: IVR exergaming incorporating cable resistance training elicits high EE and physiological demand with high enjoyment scores while attenuating perceived fatigue. The potential for IVR to elicit these acute training effects over long-term training periods warrants further investigation into its contribution to fitness and health.
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Affiliation(s)
- Jonathan Hu
- Airway and Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Jonathan D Browne
- Airway and Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,School of Medicine, California University of Science and Medicine, Colton, California, USA
| | - Michael T Arnold
- Airway and Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Anthony Robinson
- Airway and Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Marin F Heacock
- Airway and Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Richard Ku
- Airway and Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Mitchell Mologne
- Airway and Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Gracie R Baum
- Airway and Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Kayla A Ikemiya
- Airway and Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Eric V Neufeld
- Airway and Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, New York, USA
| | - Brett A Dolezal
- Airway and Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
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15
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Sirichana W, Neufeld EV, Wang X, Hu SB, Dolezal BA, Cooper CB. Response. Med Sci Sports Exerc 2021; 53:1316. [PMID: 33986233 DOI: 10.1249/mss.0000000000002651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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16
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Sirichana W, Neufeld EV, Wang X, Hu SB, Dolezal BA, Cooper CB. Reference Values for Chronotropic Index from 1280 Incremental Cycle Ergometry Tests. Med Sci Sports Exerc 2021; 52:2515-2521. [PMID: 32496367 DOI: 10.1249/mss.0000000000002417] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Clinical cardiopulmonary exercise testing can determine causes of exercise limitation. The slope of heart rate (fC) versus oxygen uptake (V˙O2), which we call the chronotropic index (CI), can help identify cardiovascular impairment. We aimed to develop a reference equation for CI based on a large number of subjects considered to have normal exercise responses. METHODS From a database of 13,728 incremental cycle ergometry exercise tests, we identified 1280 normal tests based on the absence of a clinical diagnosis, normal body mass index, and normal aerobic performance plus absence of cardiovascular disease, medications, or ventilatory limitation. A linear mixed-model approach was used to analyze the relationship between CI and other variables. RESULTS Subjects were age 18-84 yr, and 693 (54.1%) were men. Mean ± SD CI in men was lower than in women, 41.2 ± 9.3 beats per liter versus 63.4 ± 15.7 L. Age (in years), sex (0, male; 1, female), height (in centimeters), and weight (in kilograms) were significant predictors for CI:CIi = 106.9 + 0.16 × agei + 14.3 × sexi - 0.31 × heighti - 0.24 × weighti. The SE of estimates ranged from 10.6 to 11.2 L (median of 10.7 L). CONCLUSIONS We report a reference equation for CI derived from normal subjects. The CI can be used in conjunction with V˙O2max to interpret maximal cardiopulmonary exercise tests. We consider a high CI to be cardiovascular impairment and a low CI plus low V˙O2max to be chronotropic insufficiency.
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Affiliation(s)
| | - Eric V Neufeld
- Exercise Physiology Research Laboratory, Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
| | - Xiaoyan Wang
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
| | - Scott B Hu
- Exercise Physiology Research Laboratory, Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
| | - Brett A Dolezal
- Exercise Physiology Research Laboratory, Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
| | - Christopher B Cooper
- Exercise Physiology Research Laboratory, Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
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17
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Hu J, Browne JD, Baum JT, Robinson A, Arnold MT, Reid SP, Neufeld EV, Dolezal BA. Lower Limb Graduated Compression Garments Modulate Autonomic Nervous System and Improve Post-Training Recovery Measured via Heart Rate Variability. Int J Exerc Sci 2020; 13:1794-1806. [PMID: 33414888 PMCID: PMC7745918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Prior studies have examined the benefits of graduated compression garments (GCG) with regards to diverse exercise regimens; however, the relationship between GCG and the autonomic nervous system (ANS) has not been fully explored. The aim of this study was to examine Heart Rate Variability (HRV) trends-a proxy for ANS modulation-in response to donning GCG during a progressive overload training regimen designed to induce overtraining. Ten college-aged male novice runners were recruited for the 8-week crossover study. After three weeks of monitored free living, participants were randomized and blinded to an intervention group that donned a lower-body GCG during a two-week exercise regimen or a control group that donned a visually identical but non-compressive sham during identical training. No significant difference in HRV was calculated by the natural logarithm of the root mean square of successive RR-interval differences (lnRMSSD) between the 3-week free-living baseline and GCG intervention periods (P = 0.3040). The mean lnRMSSD was greater during the free-living phase and GCG intervention compared to the sham placebo (P < 0.001 and <0.001 respectively). With regard to the daily fluctuation of lnRMSSD, no significant differences were found between free-living and intervention (P = 1.000). Conversely, the intervention period demonstrated reduced daily fluctuation of lnRMSSD relative to the Sham placebo group (P = 0.010). These novel findings posit that post training use of a commercially available graduated compression garment in novice runners may be effective in counteracting some deleterious effects from overtraining while attenuating its effects on vagally-mediated HRV.
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Affiliation(s)
- Jonathan Hu
- Exercise Physiology Research Laboratory, Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Jonathan D Browne
- Exercise Physiology Research Laboratory, Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- School of Medicine, California University of Science and Medicine, Colton, CA, USA
| | - Jaxon T Baum
- Exercise Physiology Research Laboratory, Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- School of Medicine, Texas Tech University of Health Sciences, Lubbock, TX, USA
| | - Anthony Robinson
- Exercise Physiology Research Laboratory, Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Michael T Arnold
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Sean P Reid
- Exercise Physiology Research Laboratory, Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Eric V Neufeld
- Exercise Physiology Research Laboratory, Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY, USA
| | - Brett A Dolezal
- Exercise Physiology Research Laboratory, Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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18
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Robinson AJ, Carter RP, Browne JD, Hu J, Arnold MT, Baum JT, Neufeld EV, Dolezal BA. Energy Expenditure and Muscular Recruitment Patterns of Riding a Novel Electrically Powered Skateboard. Int J Exerc Sci 2020; 13:1783-1793. [PMID: 33414880 PMCID: PMC7745903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Analysis of metabolic gas exchange and muscular output measures have enabled researchers to index activity intensity and energy expenditure for a myriad of exercises. However, there is no current research that investigates the physiological demands of riding electrically powered skateboards. The aim of this study was to measure the energetic cost and muscular trends of riding a novel electrically powered skateboard engineered to emulate snowboarding on dry-land. While riding the skateboard, eight participants (aged 21-37 years, 1 female) donned a portable breath-by-breath gas analyzer to measure energy expenditure (mean = 12.5, SD = 2 kcal/min), maximum heart rate (mean = 158, SD = 27 bpm), and metabolic equivalent (mean = 10.5, SD = 2 kcal/kg/h). By comparison, snowboarding has a metabolic equivalent (MET) of 8.0. Per the Compendium of Physical Activities guidelines, the predicted MET values for riding an electrically powered skateboard qualifies as vigorous-intensity activity. Four participants additionally wore a surface EMG embedded garment to record the percentage of maximum voluntary contraction (%MVC) of lower limb muscle groups. The inner quadriceps had the most pronounced mean peak muscle activation of 145%MVC during frontside and 164%MVC during frontside turns. EMG recordings showed 11.7%MVC higher utilization during backside turns compared to frontside turns while riding the electrically powered skateboard, which is similar to trends observed in alpine snowboarders. Therefore, electrically powered skateboards may be a promising technology for snowboarders and non-snowboarders alike to burn calories and increase physical activity year-round.
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Affiliation(s)
- Anthony J Robinson
- Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Robert P Carter
- Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Jonathan D Browne
- Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- School of Medicine, California University of Science and Medicine, Colton, CA, USA
| | - Jonathan Hu
- Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Michael T Arnold
- Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Jaxon T Baum
- Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Eric V Neufeld
- Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY, USA
| | - Brett A Dolezal
- Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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19
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Neufeld EV, Seltzer RA, Sazzad T, Dolezal BA. A Multidomain Approach to Assessing the Convergent and Concurrent Validity of a Mobile Application When Compared to Conventional Methods of Determining Body Composition. Sensors (Basel) 2020; 20:s20216165. [PMID: 33138133 PMCID: PMC7663304 DOI: 10.3390/s20216165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022]
Abstract
Determining body composition via mobile application may circumvent limitations of conventional methods. However, the accuracy of many technologies remains unknown. This investigation assessed the convergent and concurrent validity of a mobile application (LS) that employs 2-dimensional digital photography (LS2D) and 3-dimensional photonic scanning (LS3D). Measures of body composition including circumferences, waist-to-hip ratio (WHR), and body fat percentage (BF%) were obtained from 240 healthy adults using LS and a diverse set of conventional methods-Gulick tape, bioelectrical impedance analysis (BIA), and skinfolds. Convergent validity was consistently high-indicating these methods vary proportionally and can thus reliably detect changes despite individual measurement differences. The span of the Limits of Agreement (LoA) using LS were comparable to the LoA between conventional methods. LS3D exhibited high agreement relative to Gulick tape in the measurement of WHR, despite poor agreement with individual waist and hip circumferences. In BF%, LS2D exhibited high agreement with BIA and skinfold methods, whereas LS3D demonstrated low agreement. Interestingly, the low inferred bias between LS3D and DXA using existing data suggests that LS3D may have high agreement with dual-energy x-ray absorptiometry. Overall, the suitability of LS2D and LS3D to replace conventional methods must be based on an individual user's criteria.
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Affiliation(s)
- Eric V. Neufeld
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, Los Angeles, CA 90095, USA; (E.V.N.); (T.S.); (B.A.D.)
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY 11549, USA
| | - Ryan A. Seltzer
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, Los Angeles, CA 90095, USA; (E.V.N.); (T.S.); (B.A.D.)
- School of Medicine, Stanford University, Stanford, CA 94305, USA
- Correspondence:
| | - Tasnim Sazzad
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, Los Angeles, CA 90095, USA; (E.V.N.); (T.S.); (B.A.D.)
| | - Brett A. Dolezal
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, Los Angeles, CA 90095, USA; (E.V.N.); (T.S.); (B.A.D.)
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20
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Browne JD, Carter R, Robinson A, Waldrup B, Zhang G, Carrillo E, Dinh M, Arnold MT, Hu J, Neufeld EV, Dolezal BA. Not All HIFT Classes Are Created Equal: Evaluating Energy Expenditure and Relative Intensity of a High-Intensity Functional Training Regimen. Int J Exerc Sci 2020; 13:1206-1216. [PMID: 33042371 PMCID: PMC7523891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The demand for efficient and effective exercises has grown in concert with increased attention to fitness as a determinant of overall health. While past studies have examined the benefits traditional conditioning exercises, there have been few investigations of high intensity functional training (HIFT). The aim of this study was to measure the energy expenditure and relative intensity from participation in a signature, 35-minute group-based HIFT regimen. During the HIFT session, 13 volunteers (aged 23-59 years, 6 females) donned a portable breath-by-breath gas analyzer and a heart rate monitor. Mean caloric expenditure (528 ± 62 kcal), maximum heart rate (172 ± 8 bpm), and metabolic equivalents (12.2 ± 1.4 kcal/kg/h) were characterized as a vigorous-intensity activity according to the Compendium of Physical Activities guidelines. Moreover, implementing this high energy expenditure session twice weekly may comport with Physical Activity Guidelines for Americans weekly physical activity recommendations. HIFT training may provide time-efficient exercise for those seeking exercise-related health benefits.
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Affiliation(s)
- Jonathan D Browne
- Exercise Physiology Research Laboratory, University of California Los Angeles, Los Angeles, CA, USA
- School of Medicine, California University of Science and Medicine, Colton, CA, USA
| | - Robert Carter
- Exercise Physiology Research Laboratory, University of California Los Angeles, Los Angeles, CA, USA
| | - Anthony Robinson
- Exercise Physiology Research Laboratory, University of California Los Angeles, Los Angeles, CA, USA
| | - Brigette Waldrup
- Exercise Physiology Research Laboratory, University of California Los Angeles, Los Angeles, CA, USA
| | - Geoffrey Zhang
- Exercise Physiology Research Laboratory, University of California Los Angeles, Los Angeles, CA, USA
| | - Erik Carrillo
- Exercise Physiology Research Laboratory, University of California Los Angeles, Los Angeles, CA, USA
| | - Minhsang Dinh
- Exercise Physiology Research Laboratory, University of California Los Angeles, Los Angeles, CA, USA
| | - Michael T Arnold
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Jonathan Hu
- Exercise Physiology Research Laboratory, University of California Los Angeles, Los Angeles, CA, USA
| | - Eric V Neufeld
- Exercise Physiology Research Laboratory, University of California Los Angeles, Los Angeles, CA, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY, USA
| | - Brett A Dolezal
- Exercise Physiology Research Laboratory, University of California Los Angeles, Los Angeles, CA, USA
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21
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Cooper CB, Sirichana W, Arnold MT, Neufeld EV, Taylor M, Wang X, Dolezal BA. Remote Patient Monitoring for the Detection of COPD Exacerbations. Int J Chron Obstruct Pulmon Dis 2020; 15:2005-2013. [PMID: 33061338 PMCID: PMC7519812 DOI: 10.2147/copd.s256907] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 07/15/2020] [Indexed: 12/13/2022] Open
Abstract
Background COPD exacerbations occur more frequently with disease progression and are associated with worse prognosis and higher healthcare expenditure. Purpose To utilize a networked system, optimized with statistical process control (SPC), for remote patient monitoring (RPM) and to identify potential predictors of COPD exacerbations. Methods Seventeen subjects, mean (SD) age of 69.7 (7.2) years, with moderate to severe COPD received RPM. Over 2618 patient-days (7.17 patient-years) of monitoring, we obtained daily symptom scores, treatment adherence, self-reported activity levels, daily spirometry (SVC, FEV1, FVC, PEF), inspiratory capacity (IC), and oxygenation (SpO2). These data were used to identify predictors of exacerbations defined using Anthonisen and other criteria. Results After implementation of SPC, concordance analysis showed substantial agreement between FVC (decrease below the 7-day rolling average minus 1.645 SD) and self-reported healthcare utilization events (κ=0.747, P<0.001) as well as between increased use of inhaled short-acting bronchodilators and exacerbations defined by two Anthonisen criteria (κ=0.611, P<0.001) or modified Anthonisen criteria (κ=0.622, P<0.001). There was a moderate agreement between FEV1 (decrease >1.645 SD below the 7-day rolling average) and self-reported healthcare utilization events (κ=0.475, P<0.001) and between SpO2 less than 90% and exacerbations defined by two Anthonisen criteria (κ=0.474, P<0.001) or modified Anthonisen criteria (κ=0.564, P<0.001). Conclusion Exacerbations were best predicted by FVC and FEV1 below the one-sided 95% confidence interval derived from SPC but also by increased use of inhaled short-acting bronchodilators and fall in oxygen saturation. An RPM program that captures these parameters may be used to guide appropriate interventions aimed at reducing healthcare utilization in COPD patients.
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Affiliation(s)
- Christopher B Cooper
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Worawan Sirichana
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michael T Arnold
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Eric V Neufeld
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | | | - Xiaoyan Wang
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Brett A Dolezal
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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22
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Arnold MT, Dolezal BA, Cooper CB. Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease: Highly Effective but Often Overlooked. Tuberc Respir Dis (Seoul) 2020; 83:257-267. [PMID: 32773722 PMCID: PMC7515680 DOI: 10.4046/trd.2020.0064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/06/2020] [Indexed: 12/16/2022] Open
Abstract
Patients with chronic obstructive pulmonary disease receive a range of treatments including but not limited to inhaled bronchodilators, inhaled and systemic corticosteroids, supplemental oxygen, and pulmonary rehabilitation. Pulmonary rehabilitation is a multidisciplinary intervention that seeks to combine patient education, exercise, and lifestyle changes into a comprehensive program. Programs 6 to 8 weeks in length have been shown to improve health, reduce dyspnea, increase exercise capacity, improve psychological well-being, and reduce healthcare utilization and hospitalization. Although the use of pulmonary rehabilitation is widely supported by the literature, controversy still exists regarding what should be included in the programs. The goal of this review was to summarize the evidence for pulmonary rehabilitation and identify the areas that hold promise in improving its utilization and effectiveness.
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Affiliation(s)
- Michael T Arnold
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Brett A Dolezal
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Christopher B Cooper
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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23
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Baum JT, Carter RP, Neufeld EV, Dolezal BA. Donning a Novel Lower-Limb Restrictive Compression Garment During Training Augments Muscle Power and Strength. Int J Exerc Sci 2020; 13:890-899. [PMID: 32922631 PMCID: PMC7449345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The popularity of graduated compression garments (GCG) in sport and exercise is largely driven by the abundance of anecdotal claims suggesting their efficacy. A new line of compression apparel, restrictive compression garments (RCG), integrate novel resistance technology into lower-limb compression garments designed to provide variable resistance to movement. This study aimed to investigate the effect of donning an RCG during a 4-week training program on selected performance variables. Twelve college-aged males were recruited for four weeks of lower-body strength-power resistance training. Participants were randomized 1:1 and blinded to (i) an intervention group (RCG; n = 6) that donned a lower-body RCG during training or (ii) a control group (SHAM; n = 6) that donned a sham during identical training. Both groups demonstrated significant increases in 1-repetition maximum (1-RM) on a seated leg press after 4 weeks (both p < 0.001), with RCG showing a significantly greater increase compared SHAM (p = 0.005, g = 3.35). Similarly, RCG demonstrated significantly greater increases in jump height, peak power, and average power compared to SHAM (p = 0.032, g = 3.44; p < 0.001, g = 4.40; p < 0.001, g = 4.50, respectively). Donning a RCG while engaging in lower-body strength-power training may augment increases 1-RM on a seated leg press, jump height, peak and average power, compared with same exercise training without an RCG.
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Affiliation(s)
- Jaxon T Baum
- Exercise Physiology Research Laboratory, Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Robert P Carter
- Exercise Physiology Research Laboratory, Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Eric V Neufeld
- Exercise Physiology Research Laboratory, Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY, USA
| | - Brett A Dolezal
- Exercise Physiology Research Laboratory, Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
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24
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Cooper CB, Sirichana W, Neufeld EV, Taylor M, Wang X, Dolezal BA. Statistical Process Control Improves The Feasibility Of Remote Physiological Monitoring In Patients With Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2019; 14:2485-2496. [PMID: 32009781 PMCID: PMC6859075 DOI: 10.2147/copd.s207626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 08/01/2019] [Indexed: 12/21/2022] Open
Abstract
Background Exacerbations of chronic obstructive pulmonary disease (COPD) occur with increasing frequency as the disease progresses and account for poor health status, worse prognosis, and higher healthcare expenditure. Methods We developed a networked system for remote physiological monitoring (RPM) at home and optimized it with statistical process control (SPC) with the goal of earlier detection of COPD exacerbations. We enrolled 17 patients with moderate to severe COPD with a mean (SD) age of 71.1 (7.2) years. We obtained daily symptom scores, treatment adherence and activity levels using a programmable device, and measured daily slow and forced spirometry (FEV1, FVC, PEF), inspiratory capacity (IC) and oxygenation (SpO2). To identify exacerbations, we developed rolling prediction intervals for FVC, FEV1, IC and SpO2 using SPC. Results The time taken to perform daily monitoring was reduced from 12.7 (5.4) minutes to 6.5 (2.6) minutes through software refinements during the study. Adherence to forced and slow spirometry was 62.6% and 62.4%, respectively. The within-subject coefficients of variation for FEV1, PEF and IC were 12.2%, 16.2%, and 13.1%, respectively. Event rates per patient-year for exacerbations were: self-reported 0.42, 2/3 Anthonisen Criteria (AC) 0.42, modified AC 2.23, systemic corticosteroid use 0.56, and antibiotic use 0.56. Conclusion We successfully implemented a networked system for RPM of symptoms, treatment adherence, and physiology at home in patients with COPD. We demonstrated that SPC improves the feasibility of RPM in COPD patients which may increase the likelihood of detecting COPD exacerbations.
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Affiliation(s)
- Christopher B Cooper
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Worawan Sirichana
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Eric V Neufeld
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | | | - Xiaoyan Wang
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Brett A Dolezal
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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25
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Dolezal BA, Boland DM, Neufeld EV, Martin JL, Cooper CB. Behavioral Modification Enhances the Benefits from Structured Aerobic and Resistance Training. Sports Med Int Open 2019; 3:E48-E57. [PMID: 31312715 PMCID: PMC6629998 DOI: 10.1055/a-0900-7501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/14/2019] [Accepted: 04/25/2019] [Indexed: 10/29/2022] Open
Abstract
Behavioral modification (BM) is a strategy designed to sustain or restore well-being through effects such as enhanced relaxation, reduced stress, and improved sleep. Few studies have explored the role of BM delivered in the context of fitness programs for healthy adults. Thus, the purpose of this investigation was to examine whether BM combined with aerobic and resistance training programs would improve health and fitness measures more than the exercise training alone. Thirty-two healthy fitness club members (19 men) were randomized to receive a BM program (n=15) or an equal-attention (EA) control (n=17). BM consisted of twelve, 10-min education sessions between a trained fitness professional and the participant, coupled with weekly, individualized relaxation, stress reduction, and sleep improvement assignments. All participants engaged in 1 h of coached resistance training and remotely guided aerobic exercise thrice weekly for 12 weeks. Fitness measures (aerobic performance, body composition, muscle strength and endurance, lower-body power), sleep characteristics, and heart rate variability (HRV) were obtained at baseline and after the 12-week program. BM resulted in greater improvements in aerobic performance (increased maximum oxygen uptake, metabolic (lactate) threshold, and percent of maximum oxygen uptake at which metabolic threshold occurred), peak and average lower-body power, and body composition (decreased body fat percentage and fat mass) compared to EA. BM also positively influenced parasympathetic tone through increased High-frequency HRV. BM resulted in greater improvements in fitness measures, body composition, and heart rate variability compared with EA. These findings have intriguing implications regarding the role of BM in augmenting health and physical performance.
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Affiliation(s)
- Brett A Dolezal
- David Geffen School of Medicine at UCLA, Medicine, Physiology, Los Angeles, United States
| | - David M Boland
- David Geffen School of Medicine at UCLA, Medicine, Physiology, Los Angeles, United States.,Army-Baylor University Doctoral Program, Physical Therapy, San Antonio, United States
| | - Eric V Neufeld
- David Geffen School of Medicine at UCLA, Medicine, Physiology, Los Angeles, United States
| | - Jennifer L Martin
- David Geffen School of Medicine at UCLA, Medicine, Los Angeles, United States.,VA Greater Los Angeles Healthcare System, Geriatric Research, Education and Clinical Center, Los Angeles, United States
| | - Christopher B Cooper
- David Geffen School of Medicine at UCLA, Medicine, Physiology, Los Angeles, United States
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26
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Cooper CB, Neufeld EV, Dolezal BA, Martin JL. Sleep deprivation and obesity in adults: a brief narrative review. BMJ Open Sport Exerc Med 2018; 4:e000392. [PMID: 30364557 PMCID: PMC6196958 DOI: 10.1136/bmjsem-2018-000392] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 06/25/2018] [Accepted: 08/06/2018] [Indexed: 12/18/2022] Open
Abstract
Background/aims Obesity and sleep deprivation are two epidemics that pervade developed nations. Their rates have been steadily rising worldwide, especially in the USA. This short communication will explore the link between the two conditions and outline the proposed mechanisms behind their relationship. Methods Studies on the topic of sleep and obesity were reviewed, and findings were used to develop a theoretical model for the biological link between short sleep duration and obesity. Results Individuals who regularly slept less than 7 hours per night were more likely to have higher average body mass indexes and develop obesity than those who slept more. Studies showed that experimental sleep restriction was associated with increased levels of ghrelin, salt retention and inflammatory markers as well as decreased levels of leptin and insulin sensitivity. Conclusions There may be a link between obesity and sleep deprivation. We recommend further investigations are to elucidate the potential mechanisms.
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Affiliation(s)
- Christopher B Cooper
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Eric V Neufeld
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Brett A Dolezal
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Jennifer L Martin
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California, USA.,VA Greater Los Angeles Healthcare System, Geriatric Research, Education and Clinical Center, Los Angeles, California, USA
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27
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Neufeld EV, Dolezal BA, Speier W, Cooper CB. Effect of altering breathing frequency on maximum voluntary ventilation in healthy adults. BMC Pulm Med 2018; 18:89. [PMID: 29793460 PMCID: PMC5968560 DOI: 10.1186/s12890-018-0650-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/14/2018] [Indexed: 12/02/2022] Open
Abstract
Background Compared to other pulmonary function tests, there is a lack of standardization regarding how a maximum voluntary ventilation (MVV) maneuver is performed. Specifically, little is known about the variation in breathing frequency (fR) and its potential impact on the accuracy of test results. This study examines the effect of several preselected values for fR and one self-selected fR (fRself) on MVV. Methods Ten participants performed MVV maneuvers at various fR values, ranging from 50 to 130 breaths·min− 1 in 10 breaths·min− 1 intervals and at one fRself. Three identical trials with 2-min rest periods were conducted at each fR, and the sequence in which fR was tested was randomized. Ventilation and related parameters were measured directly by gas exchange analysis via a metabolic measurement system. Results A third-order polynomial regression analysis showed that MVV = − 0.0001(fR)3 + 0.0258(fR)2–1.38(fR) + 96.9 at preselected fR and increased up to approximately 100 breaths·min− 1 (r2 = 0.982, P < 0.001). Paired t-tests indicated that average MVV values obtained at all preselected fR values, but not fRself, were significantly lower than the average maximum value across all participants. A linear regression analysis revealed that tidal volume (VT) = − 2.63(MVV) + 300.4 at preselected fR (r2 = 0.846, P < 0.001); however, this inverse relationship between VT and MVV did not remain true for the self-selected fR. The VT obtained at this fR (90.9 ± 19.1% of maximum) was significantly greater than the VT associated with the most similar MVV value (at a preselected fR of 100 breaths·min− 1, 62.0 ± 10.4% of maximum; 95% confidence interval of difference: (17.5, 40.4%), P < 0.001). Conclusions This study demonstrates the shortcomings of the current lack of standardization in MVV testing and establishes data-driven recommendations for optimal fR. The true MVV was obtained with a self-selected fR (mean ± SD: 69.9 ± 22.3 breaths·min− 1) or within a preselected fR range of 110–120 breaths·min− 1. Until a comprehensive reference equation is established, it is advised that MVV be measured directly using these guidelines. If an individual is unable to perform or performs the maneuver poorly at a self-selected fR, ventilating within a mandated fR range of 110–120 breaths·min− 1 may also be acceptable.
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Affiliation(s)
- Eric V Neufeld
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 37-131 CHS Building, Los Angeles, CA, 90095, USA
| | - Brett A Dolezal
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 37-131 CHS Building, Los Angeles, CA, 90095, USA.
| | - William Speier
- Medical Imaging Informatics, Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Christopher B Cooper
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 37-131 CHS Building, Los Angeles, CA, 90095, USA
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Neufeld EV, Dolezal BA, Boland DM, Martin JL, Cooper CB. Sleep Coaching Augments the Physiological Benefits of Exercise Training. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000535939.39508.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Dolezal BA, Storer TW, Neufeld EV, Smooke S, Tseng CH, Cooper CB. A Systematic Method to Detect the Metabolic Threshold from Gas Exchange during Incremental Exercise. J Sports Sci Med 2017; 16:396-406. [PMID: 28912658 PMCID: PMC5592292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 07/17/2017] [Indexed: 06/07/2023]
Abstract
Incremental exercise consists of three domains of exercise intensity demarcated by two thresholds. The first of these thresholds, derived from gas exchange measurements, is defined as the metabolic threshold (V̇O2θ) above which lactate accumulates. Correctly and reliably identified, V̇O2θ is a non-invasive, sub-maximal marker of aerobic function with practical value. This investigation compared variability in selection of V̇O2θ among interpreters with different levels of experience as well as from auto-detection algorithms employed by a commercially available metabolic cart (MC). Ten healthy young men performed three replicates of incremental cycle exercise during which gas exchange measurements were collected breath-by-breath. Two experienced interpreters (E) and four novice interpreters (N) determined V̇O2θ from plots of specific response variables. Interpreters noted methods used and confidence in their selections. V̇O2θ was automatically determined by the MC. Interclass correlations indicated that E agreed with each other (mean difference, 21 mL·min-1) and with the MC (23 mL·min-1), but not with N (-664 to 364 mL·min-1); N did not agree among themselves. Despite good overall agreement between E and MC, differences >500 mL·min-1 were seen in 50% of individual cases. N expressed unduly higher confidence and used different V̇O2θ selection strategies compared with E. Experience and use of a systematic approach is essential for correctly identifying V̇O2θ. Current guidelines for exercise testing and interpretation do not include recommendations for such an approach. Data from this study suggests that this may be a serious shortcoming. Until an alternative schema for V̇O2θ detection is developed prospectively, strategies based on the present study will give practitioners a systematic and consistent approach to threshold detection.
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Affiliation(s)
- Brett A Dolezal
- Exercise Physiology Research Laboratory, Departments of Physiology and Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA; USA
| | - Thomas W Storer
- Exercise Physiology Research Laboratory, Departments of Physiology and Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA; USA
| | - Eric V Neufeld
- Exercise Physiology Research Laboratory, Departments of Physiology and Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA; USA
| | - Stephanie Smooke
- Exercise Physiology Research Laboratory, Departments of Physiology and Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA; USA
| | - Chi-Hong Tseng
- Division of General Internal Medicine and Health Services Research David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Christopher B Cooper
- Exercise Physiology Research Laboratory, Departments of Physiology and Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA; USA
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Boland DM, Dolezal BA, Garfinkel A, Cooper CB. Correlation Of BDNF And Irisin With Aerobic Fitness And Cognition In Graduate Students. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000517424.41221.d1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sirichana W, Dolezal BA, Neufeld EV, Wang X, Cooper CB. Wrist-worn triaxial accelerometry predicts the energy expenditure of non-vigorous daily physical activities. J Sci Med Sport 2017; 20:761-765. [PMID: 28159535 DOI: 10.1016/j.jsams.2017.01.233] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 11/28/2016] [Accepted: 01/02/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Triaxial accelerometry is commonly used to estimate oxygen uptake (VO2) and energy expenditure in health and fitness studies. We tested the correlation of a triaxial accelerometer in terms of a summation of vector magnitudes with gravity subtracted (SVMgs) and measured VO2 for different daily physical activities. DESIGN Original research, cross-sectional. METHODS Twenty volunteers wore a triaxial accelerometer on both wrists while performing 12 assigned daily physical activities for 6min for each activity. The VO2 was determined by indirect calorimetry using a portable metabolic measurement system. The last 3min of each activity was assumed to represent steady-state. The VO2 measured during these periods was averaged and converted into metabolic equivalents (METs). RESULTS The range of VO2 for all activities was 0.18-3.2L/min (0.8-12.2 METs). Significant differences in SVMgs existed between accelerometer placements on the dominant (120.9±8.7gmin) versus non-dominant hand (99.9±6.8gmin; P=0.016) for the lowest levels of physical activity defined as <1.5 METs. Piecewise linear regression model using 6 METs as the transition point showed similar significant correlations for the non-dominant wrist (r2=0.85; P<0.001) and the dominant wrist (r2=0.86; P<0.001). Using the non-dominant wrist below 6 METs, the slope of the relationship between SVMgs and METs was 105.3±4.3 (95% CI 96.9 to 113.7) indicating an increase in SVMgs of approximately 100 units for every MET increase in oxygen uptake. CONCLUSIONS Wrist-worn triaxial accelerometry reliably predicted energy expenditure during common physical activities <6 METs. More consistent correlations were found when the accelerometer was worn on the non-dominant wrist rather than the dominant wrist.
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Affiliation(s)
- Worawan Sirichana
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California at Los Angeles, USA; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Thailand
| | - Brett A Dolezal
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California at Los Angeles, USA
| | - Eric V Neufeld
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California at Los Angeles, USA
| | - Xiaoyan Wang
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California at Los Angeles, USA
| | - Christopher B Cooper
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California at Los Angeles, USA.
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Boland DM, Neufeld EV, Ruddell J, Dolezal BA, Cooper CB. Inter- and intra-rater agreement of static posture analysis using a mobile application. J Phys Ther Sci 2016; 28:3398-3402. [PMID: 28174460 PMCID: PMC5276769 DOI: 10.1589/jpts.28.3398] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 08/20/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To determine the intra- and inter-rater agreement of a mobile application,
PostureScreen Mobile® (PSM), that assesses static standing posture. [Subjects
and Methods] Three examiners with different levels of experience of assessing posture, one
licensed physical therapist and two untrained undergraduate students, performed repeated
postural assessments of 10 subjects, fully clothed or minimally clothed, using PSM on two
nonconsecutive days. Anterior and right lateral images were captured and seventeen
landmarks were identified on them. Intraclass correlation coefficients (ICCs) were
calculated for each of 13 postural measures to evaluate inter-rater agreement on the first
visit (fully or minimally clothed), as well as intra-rater agreement between the first and
second visits (minimally clothed). [Results] Eleven postural measures were ultimately
analyzed for inter- and intra-rater agreement. Inter-rater agreement was almost perfect
(ICC≥0.81) for four measures and substantial (0.60<ICC≤0.80) for three measures during
the fully clothed exam. During the minimally clothed exam, inter-rater agreement was
almost perfect for four measures and substantial for four measures. Intra-rater agreement
between two minimally clothed exams was almost perfect for two measures and substantial
for five measures. [Conclusion] PSM is a widely available, inexpensive postural screening
tool that requires little formal training. To maximize inter- and intra-rater agreement,
postural screening using this mobile application should be conducted with subjects wearing
minimal clothing. Assessing static standing posture via PSM gives repeatable measures for
anatomical landmarks that were found to have substantial or almost perfect agreement. Our
data also suggest that this technology may also be useful for diagnosing forward head
posture.
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Affiliation(s)
- David M Boland
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine at the University of California, Los Angeles, USA
| | - Eric V Neufeld
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine at the University of California, Los Angeles, USA
| | - Jack Ruddell
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine at the University of California, Los Angeles, USA
| | - Brett A Dolezal
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine at the University of California, Los Angeles, USA
| | - Christopher B Cooper
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine at the University of California, Los Angeles, USA
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Cooper CB, Dolezal BA, Neufeld EV, Shieh P, Jenner JR, Riley M. Exercise responses in patients with chronically high creatine kinase levels. Muscle Nerve 2016; 56:264-270. [PMID: 27935086 DOI: 10.1002/mus.25508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 12/01/2016] [Accepted: 12/04/2016] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Elevated serum creatine kinase (CK) is often taken to reflect muscle disease, but many individuals have elevated CK without a specific diagnosis. How elevated CK reflects muscle metabolism during exercise is not known. METHODS Participants (46 men, 48 women) underwent incremental exercise testing to assess aerobic performance, cardiovascular response, and ventilatory response. Serum lactate, ammonia, and CK were measured at rest, 4 minutes into exercise, and 2 minutes into recovery. RESULTS High-CK and control subjects demonstrated similar aerobic capacities and cardiovascular responses to incremental exercise. Those with CK ≥ 300 U/L exhibited significantly higher lactate and ammonia levels after maximal exercise, together with increased ventilatory responses, whereas those with CK ≥200 U/L but ≤ 300 U/L did not. CONCLUSIONS We recommend measurement of lactate and ammonia profiles during a maximal incremental exercise protocol to help identify patients who warrant muscle biopsy to rule out myopathy. Muscle Nerve 56: 264-270, 2017.
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Affiliation(s)
- Christopher B Cooper
- UCLA Exercise Physiology Research Laboratory, Department of Medicine, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, 37-131 CHS, Los Angeles, 90095, USA.,Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Brett A Dolezal
- UCLA Exercise Physiology Research Laboratory, Department of Medicine, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, 37-131 CHS, Los Angeles, 90095, USA.,Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Eric V Neufeld
- UCLA Exercise Physiology Research Laboratory, Department of Medicine, David Geffen School of Medicine, University of California, 10833 Le Conte Avenue, 37-131 CHS, Los Angeles, 90095, USA.,Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Perry Shieh
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - John R Jenner
- Cambridge University Sports & Exercise Medicine Unit, Addenbrooke's Hospital, Cambridge, England
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Abstract
BACKGROUND Few studies have investigated the metabolic demands of functional exercise. We determined the oxygen cost, heart rate (HR) response, and energy expenditure (EE) both during and immediately following a loaded movement training (LMT) workout. METHODS Ten participants (5 male, age 23.5±3.7 years, VO2peak 53.3±6.4 mL/kg/min) completed baseline resting metabolic rate testing, a maximal oxygen uptake (VO2) test, and a familiarization trial. After 48 hours' rest, participants completed a 19-minute LMT protocol using functional exercise equipment, consisting of 10 x 60-second work intervals followed by 60 seconds of rest. VO2, HR, respiratory exchange ratio (RER), and EE were measured during the entire LMT protocol and for 45 minutes post-exercise. RESULTS Participants had a mean VO2 of 65.3±4.1% VO2peak, HR of 91.8±4.0% HRmax, RER of 1.06±0.06, EE of 13.0±3.0 kcal/min (0.176±0.021 kcal/kg/min), and rating of perceived exertion of 17.3±1.6. The mean overall caloric expenditure was 247 kcal. Post-exercise metabolic recovery data showed a mean overall excess post-exercise oxygen consumption (EPOC) of 7.89±3.78 L. EE remained elevated through 15 minutes, VO2 through 30 minutes, and HR through 45 minutes (P<0.05). RER remained depressed throughout the 45-minute collection (P<0.05). CONCLUSIONS LMT meets the American College of Sports Medicine's recommendations for improving cardiovascular fitness and achieving the daily caloric expenditure from exercise. It may be used to improve cardiovascular fitness and body composition in healthy adults.
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Affiliation(s)
| | | | - Eric V Neufeld
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Brett A Dolezal
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Daniel P Maclennan
- Department of Justice and Wellness, Mohawk College, Hamilton, ON, Canada
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Jo E, Lewis K, Directo D, Kim MJ, Dolezal BA. Validation of Biofeedback Wearables for Photoplethysmographic Heart Rate Tracking. J Sports Sci Med 2016; 15:540-547. [PMID: 27803634 PMCID: PMC4974868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 07/27/2016] [Indexed: 06/06/2023]
Abstract
The purpose of this study was to examine the validity of HR measurements by two commercial-use activity trackers in comparison to ECG. Twenty-four healthy participants underwent the same 77-minute protocol during a single visit. Each participant completed an initial rest period of 15 minutes followed by 5 minute periods of each of the following activities: 60W and 120W cycling, walking, jogging, running, resisted arm raises, resisted lunges, and isometric plank. In between each exercise task was a 5-minute rest period. Each subject wore a Basis Peak (BPk) on one wrist and a Fitbit Charge HR (FB) on the opposite wrist. Criterion measurement of HR was administered by 12-lead ECG. Time synced data from each device and ECG were concurrently and electronically acquired throughout the entire 77-minute protocol. When examining data in aggregate, there was a strong correlation between BPk and ECG for HR (r = 0.92, p < 0.001) with a mean bias of -2.5 bpm (95% LoA 19.3, -24.4). The FB demonstrated a moderately strong correlation with ECG for HR (r = 0.83, p < 0.001) with an average mean bias of -8.8 bpm (95% LoA 24.2, -41.8). During physical efforts eliciting ECG HR > 116 bpm, the BPk demonstrated an r = 0.77 and mean bias = -4.9 bpm (95% LoA 21.3, -31.0) while the FB demonstrated an r = 0.58 and mean bias = -12.7 bpm (95% LoA 28.6, -54.0). The BPk satisfied validity criteria for HR monitors, however showed a marginal decline in accuracy with increasing physical effort (ECG HR > 116 bpm). The FB failed to satisfy validity criteria and demonstrated a substantial decrease in accuracy during higher exercise intensities.
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Affiliation(s)
- Edward Jo
- Human Performance Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University Pomona , Pomona, CA, USA
| | - Kiana Lewis
- Human Performance Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University Pomona , Pomona, CA, USA
| | - Dean Directo
- Human Performance Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University Pomona , Pomona, CA, USA
| | - Michael J Kim
- Human Performance Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University Pomona , Pomona, CA, USA
| | - Brett A Dolezal
- Human Performance Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University Pomona, Pomona, CA, USA; Exercise Physiology Research Laboratory, David Geffen School of Medicine and Department of Physiology, University of California, Los Angeles, Los Angeles, CA, USA
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Neufeld EV, Carney JJ, Dolezal BA, Boland DM, Cooper CB. Exploratory Study of Heart Rate Variability and Sleep among Emergency Medical Services Shift Workers. PREHOSP EMERG CARE 2016; 21:18-23. [DOI: 10.1080/10903127.2016.1194928] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Boland DM, Uijtdehaage S, FitzGerald L, Macey P, Dolezal BA, Garfinkel A, Cooper CB. Correlation of Aerobic Fitness with Academic Performance in Medical and Nursing Students. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000485314.67618.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Dolezal BA, Boland DM, Waite JG, Martin JL, Cooper CB. Correlation of Aerobic Performance with Sleep Quality in Apparently Healthy Men and Women. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000485316.52371.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Robertson CL, Ishibashi K, Chudzynski J, Mooney LJ, Rawson RA, Dolezal BA, Cooper CB, Brown AK, Mandelkern MA, London ED. Effect of Exercise Training on Striatal Dopamine D2/D3 Receptors in Methamphetamine Users during Behavioral Treatment. Neuropsychopharmacology 2016; 41:1629-36. [PMID: 26503310 PMCID: PMC4832026 DOI: 10.1038/npp.2015.331] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 09/25/2015] [Accepted: 09/27/2015] [Indexed: 11/09/2022]
Abstract
Methamphetamine use disorder is associated with striatal dopaminergic deficits that have been linked to poor treatment outcomes, identifying these deficits as an important therapeutic target. Exercise attenuates methamphetamine-induced neurochemical damage in the rat brain, and a preliminary observation suggests that exercise increases striatal D2/D3 receptor availability (measured as nondisplaceable binding potential (BPND)) in patients with Parkinson's disease. The goal of this study was to evaluate whether adding an exercise training program to an inpatient behavioral intervention for methamphetamine use disorder reverses deficits in striatal D2/D3 receptors. Participants were adult men and women who met DSM-IV criteria for methamphetamine dependence and were enrolled in a residential facility, where they maintained abstinence from illicit drugs of abuse and received behavioral therapy for their addiction. They were randomized to a group that received 1 h supervised exercise training (n=10) or one that received equal-time health education training (n=9), 3 days/week for 8 weeks. They came to an academic research center for positron emission tomography (PET) using [(18)F]fallypride to determine the effects of the 8-week interventions on striatal D2/D3 receptor BPND. At baseline, striatal D2/D3 BPND did not differ between groups. However, after 8 weeks, participants in the exercise group displayed a significant increase in striatal D2/D3 BPND, whereas those in the education group did not. There were no changes in D2/D3 BPND in extrastriatal regions in either group. These findings suggest that structured exercise training can ameliorate striatal D2/D3 receptor deficits in methamphetamine users, and warrants further evaluation as an adjunctive treatment for stimulant dependence.
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Affiliation(s)
- Chelsea L Robertson
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA,Greater Los Angeles Veterans Affairs Hospital and Health Care System, Los Angeles, CA, USA
| | - Kenji Ishibashi
- Greater Los Angeles Veterans Affairs Hospital and Health Care System, Los Angeles, CA, USA,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Joy Chudzynski
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Larissa J Mooney
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Richard A Rawson
- Greater Los Angeles Veterans Affairs Hospital and Health Care System, Los Angeles, CA, USA
| | - Brett A Dolezal
- Department of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Christopher B Cooper
- Department of Medicine and Physiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Amira K Brown
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA,Greater Los Angeles Veterans Affairs Hospital and Health Care System, Los Angeles, CA, USA
| | - Mark A Mandelkern
- Greater Los Angeles Veterans Affairs Hospital and Health Care System, Los Angeles, CA, USA
| | - Edythe D London
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA,Greater Los Angeles Veterans Affairs Hospital and Health Care System, Los Angeles, CA, USA,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA,Semel Institute, University of California, Los Angeles, 760 Westwood Plaza, C8-831, Los Angeles, CA 90024, USA, Tel: +1 310 825 0606, Fax: +1 310 825 0812, E-mail:
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Haglund M, Ang A, Mooney L, Gonzales R, Chudzynski J, Cooper CB, Dolezal BA, Gitlin M, Rawson RA. Predictors of depression outcomes among abstinent methamphetamine-dependent individuals exposed to an exercise intervention. Am J Addict 2016; 24:246-251. [PMID: 25907813 DOI: 10.1111/ajad.12175] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 09/20/2014] [Accepted: 10/12/2014] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVES This paper expands on a study investigating depression outcomes in response to an 8-week exercise intervention among methamphetamine (MA) dependent individuals in early recovery. METHODS A total of 135 MA-dependent individuals enrolled in residential treatment were randomly assigned to either a structured exercise intervention or a structured health education control group. Both groups were similar in format: 60-minute sessions, offered three times a week over an 8-week study period. RESULTS Results showed that at the 8-week trial endpoint, participants randomized to the exercise intervention showed significantly greater reduction in depression symptom scores than participants randomized to the health education group, and that participants who attended the greatest number of exercise sessions derived the greatest benefit. This paper further analyzes study data to uncover individual predictors of depression response to exercise and finds that among participants randomized to exercise treatment, individuals with the most severe medical, psychiatric, and addiction disease burden at baseline showed the most significant improvement in depressive symptoms by study endpoint. CONCLUSIONS Our findings suggest that exercise in moderate dose is effective at treating depressive symptoms in individuals in early recovery from addiction, and furthermore, that treatment with exercise appears to be particularly beneficial to individuals who suffer from severe medical, psychiatric, and addictive disorders.
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Affiliation(s)
- Margaret Haglund
- Adult Division of Psychiatry, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Alfonso Ang
- Integrated Substance Abuse Programs, Department of Psychiatry, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Larissa Mooney
- Addiction Medicine Clinic, Department of Psychiatry, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Rachel Gonzales
- Azusa Pacific University, Azusa, California, and Integrated Substance Abuse Programs, Department of Psychiatry, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Joy Chudzynski
- Integrated Substance Abuse Programs, Department of Psychiatry, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Christopher B Cooper
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Brett A Dolezal
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Michael Gitlin
- Adult Division of Psychiatry, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Richard A Rawson
- Integrated Substance Abuse Programs, Department of Psychiatry, David Geffen School of Medicine, UCLA, Los Angeles, California
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Cooper CB, Dolezal BA, Riley M, Verity MA, Shieh PB. Reverse fiber type disproportion: A distinct metabolic myopathy. Muscle Nerve 2015; 54:86-93. [PMID: 26600317 DOI: 10.1002/mus.24984] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2015] [Indexed: 11/11/2022]
Abstract
INTRODUCTION In this investigation we characterized the physiological and metabolic responses to incremental exercise in 13 subjects with a predominance of type II fibers on muscle biopsy. METHODS Subjects underwent incremental exercise testing with measures of maximum oxygen uptake ( V˙O2 max), maximum heart rate (fc max), chronotropic index (fc / V˙O2 slope), maximum ventilation ( V˙emax), blood lactate, ammonia, and creatine kinase (CK) levels. Muscle fiber type was determined by myosin ATPase histochemistry. RESULTS Muscle biopsies showed more type II fibers (75%) in subjects compared with normal individuals (P < 0.01). Subjects exhibited normal V˙O2 max and end-exercise lactate, whereas ammonia and CK levels at maximum exercise were significantly higher. CONCLUSIONS Subjects with type II muscle fiber predominance exhibited exaggerated increases in ammonia and elevated CK levels during exercise. Predominance of type II fibers on muscle biopsy is the opposite finding of congenital fiber type disproportion; we suggest these patients be referred to as having "reverse fiber type disproportion." Muscle Nerve 54: 86-93, 2016.
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Affiliation(s)
- Christopher B Cooper
- Department of Medicine, UCLA Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Avenue, 37-131 CHS, Los Angeles, California, 90095, USA.,Department of Physiology, UCLA Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California, Department of Medicine, Los Angeles, Los Angeles, California, USA
| | - Brett A Dolezal
- Department of Medicine, UCLA Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Avenue, 37-131 CHS, Los Angeles, California, 90095, USA.,Department of Physiology, UCLA Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California, Department of Medicine, Los Angeles, Los Angeles, California, USA
| | | | - M Anthony Verity
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Perry B Shieh
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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Dolezal BA, Boland DM, Carney J, Chang A, Martin J, Cooper CB. Characterization of Sleep Quality and Heart Rate Variability in Emergency Medical Technicians. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000478986.14144.a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Boland D, Chang A, Lee J, Lee J, Dolezal BA, Cooper CB. Reliability of Standing Static Posture Analysis using a Mobile Application. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000477007.24664.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Storer TW, Dolezal BA, Berenc MN, Timmins JE, Cooper CB. Effect of supervised, periodized exercise training vs. self-directed training on lean body mass and other fitness variables in health club members. J Strength Cond Res 2015; 28:1995-2006. [PMID: 24276303 DOI: 10.1519/jsc.0000000000000331] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Conventional wisdom suggests that exercise training with a personal trainer (PTr) is more beneficial for improving health-related fitness than training alone. However, there are no published data that confirm whether fitness club members who exercise with a PTr in the fitness club setting obtain superior results compared with self-directed training. We hypothesized that club members randomized to receive an evidence-based training program would accrue greater improvements in lean body mass (LBM) and other fitness measures than members randomized to self-training. Men, aged 30-44 years, who were members of a single Southern California fitness club were randomized to exercise with a PTr administering a nonlinear periodized training program (TRAINED, N = 17) or to self-directed training (SELF, N = 17); both groups trained 3 days per week for 12 weeks. Lean body mass was determined by dual-energy x-ray absorptiometry. Secondary outcomes included muscle strength 1 repetition maximum (1RM), leg power (vertical jump), and aerobic capacity (V[Combining Dot Above]O2max). TRAINED individuals increased LBM by 1.3 (0.4) kg, mean (SEM) vs. no change in SELF, p = 0.029. Similarly, significantly greater improvements were seen for TRAINED vs. SELF in chest press strength (42 vs. 19%; p = 0.003), peak leg power (6 vs. 0.6%; p < 0.0001), and V[Combining Dot Above]O2max (7 vs. -0.3%; p = 0.01). Leg press strength improved 38 and 25% in TRAINED and SELF, respectively (p = 0.14). We have demonstrated for the first time in a fitness club setting that members whose training is directed by well-qualified PTrs administering evidence-based training regimens achieve significantly greater improvements in LBM and other dimensions of fitness than members who direct their own training.
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Affiliation(s)
- Thomas W Storer
- 1Division of Pulmonary Medicine, Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California; 2Equinox Fitness Clubs, Los Angeles, California; and 3Division of Endocrinology, Diabetes & Hypertension, Gonda (Goldschmied) Diabetes Center, University of California at Los Angeles, Los Angeles, California
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Abstract
BACKGROUND The Wellness-Fitness Initiative submaximal treadmill exercise test (WFI-TM) is recommended by the US National Fire Protection Agency to assess aerobic capacity (VO2 max) in firefighters. However, predicting VO2 max from submaximal tests can result in errors leading to erroneous conclusions about fitness. AIMS To investigate the level of agreement between VO2 max predicted from the WFI-TM against its direct measurement using exhaled gas analysis. METHODS The WFI-TM was performed to volitional fatigue. Differences between estimated VO2 max (derived from the WFI-TM equation) and direct measurement (exhaled gas analysis) were compared by paired t-test and agreement was determined using Pearson Product-Moment correlation and Bland-Altman analysis. Statistical significance was set at P < 0.05. RESULTS Fifty-nine men performed the WFI-TM. Mean (standard deviation) values for estimated and measured VO2 max were 44.6 (3.4) and 43.6 (7.9) ml/kg/min, respectively (P < 0.01). The mean bias by which WFI-TM overestimated VO2 max was 0.9ml/kg/min with a 95% prediction interval of ±13.1. Prediction errors for 22% of subjects were within ±5%; 36% had errors greater than or equal to ±15% and 7% had greater than ±30% errors. The correlation between predicted and measured VO2 max was r = 0.55 (standard error of the estimate = 2.8ml/kg/min). CONCLUSIONS WFI-TM predicts VO2 max with 11% error. There is a tendency to overestimate aerobic capacity in less fit individuals and to underestimate it in more fit individuals leading to a clustering of values around 42ml/kg/min, a criterion used by some fire departments to assess fitness for duty.
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Affiliation(s)
- B A Dolezal
- Department of Medicine and Physiology, Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA,
| | - D Barr
- Department of Health and Exercise Sciences, First Responder Health and Safety Laboratory, Skidmore College, Saratoga Springs, NY 12866, USA
| | - D M Boland
- Department of Medicine and Physiology, Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - D L Smith
- Department of Health and Exercise Sciences, First Responder Health and Safety Laboratory, Skidmore College, Saratoga Springs, NY 12866, USA
| | - C B Cooper
- Department of Medicine and Physiology, Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
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Storer TW, Dolezal BA, Abrazado ML, Smith DL, Batalin MA, Tseng CH, Cooper CB. Firefighter health and fitness assessment: a call to action. J Strength Cond Res 2014; 28:661-71. [PMID: 24566608 DOI: 10.1519/jsc.0b013e31829b54da] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Sudden cardiac deaths experienced by firefighters in the line of duty account for the largest proportion of deaths annually. Several fire service standards for fitness and wellness have been recommended but currently only 30% of U.S. fire departments are implementing programs for this purpose. The Department of Homeland Security Science and Technology Directorate has initiated the Physiological Health Assessment System for Emergency Responders (PHASER) program aiming to reduce these line-of-duty deaths through an integration of medical science and sensor technologies. Confirming previous reports, PHASER comprehensive risk assessment has identified lack of physical fitness with propensity for overexertion as a major modifiable risk factor. We sought to determine if current levels of fitness and cardiovascular disease (CVD) risk factors in a contemporary cohort of firefighters were better than those reported over the past 30 years. Fifty-one firefighters from a Southern California department were characterized for physical fitness and CVD risk factors using standard measures. Overall, physical fitness and risk factors were not different from previous reports of firefighter fitness and most subjects did not achieve recommended fitness standards. Considering the lack of widespread implementation of wellness/fitness programs in the U.S. fire service together with our findings that low physical fitness and the presence of CVD risk factors persist, we issue a call to action among health and fitness professionals to assist the fire service in implementing programs for firefighters that improve fitness and reduce CVD risk factors. Fitness professionals should be empowered to work with fire departments lending their expertise to guide programs that achieve these objectives, which may then lead to reduced incidence of sudden cardiac death or stroke.
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Affiliation(s)
- Thomas W Storer
- 1Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California; 2First Responder Health and Safety Laboratory, Department of Health and Exercise Sciences, Skidmore College, Saratoga Springs, New York; 3Institute for Technology Advancement, Henry Samueli School of Engineering and Applied Science, University of California-Los Angeles, Los Angeles, California; and 4Division of Biostatistics, Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California
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Dolezal BA, Abrazado M, Batalin MA, Smith D, Cooper CB. Deployment of remote advanced electrocardiography for improved cardiovascular risk assessment in career firefighters. Telemed J E Health 2014; 20:660-3. [PMID: 24796429 DOI: 10.1089/tmj.2013.0321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Firefighters perform strenuous muscular work while wearing heavy, encapsulating personal protective equipment in high temperature environments, under chaotic and emotionally stressful conditions. These factors can precipitate sudden cardiac events in firefighters with underlying cardiovascular disease. The purpose of this pilot study was to deploy and explore the feasibility of the resting "advanced" 12-lead electrocardiogram (A-ECG) as a remote firefighter risk assessment tool for improved assessment of cardiac risk. MATERIALS AND METHODS Conventional 12-lead resting electrocardiograms (ECGs) were collected for 5 min by using high-fidelity PC-based ECG hardware and software while subjects (n=21) rested comfortably. Raw data from the ECG system were securely transported via a secure network to a server where they were archived and processed. Authorized personnel performed both conventional ECG and A-ECG analyses from each digital recording, generating A-ECG "scores" in a blinded fashion. A separate cohort of firefighters (n=6) was trained to administer the A-ECG and rated the system's usability and frequency of technical problems. RESULTS Of the 21 uniformed personnel who completed testing, only 1 had a positive A-ECG score for coronary artery disease, which was subsequently confirmed by a cardiologist. All other subjects were classified as healthy by A-ECG. Firefighters trained to administer the A-ECG responded favorably in rating the usability of the system. CONCLUSIONS We have demonstrated that a new technology, A-ECG, can be deployed for remote firefighter risk assessment being performed by firefighters themselves and interpreted centrally. This simple, time- and cost-effective approach can help identify individuals potentially at increased risk for line-of-duty death due to underlying cardiovascular disease.
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Affiliation(s)
- Brett A Dolezal
- 1 Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, University of California , Los Angeles, Los Angeles, California
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Boland DM, Dolezal BA, Batalin M, Smith D, Cooper CB. Individualized Feedback to Firefighters via PHASER-Net Enhances Adherence and Benefits of Exercise Training. Med Sci Sports Exerc 2014. [DOI: 10.1249/01.mss.0000493526.77193.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Dolezal BA, Boland DM, Carney J, Cooper CB. Validation Of A Physiological Status Monitor-embedded Compression Shirt Derived Heart Rate Against 12-lead Ecg. Med Sci Sports Exerc 2014. [DOI: 10.1249/01.mss.0000496047.26160.86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Smith DL, Haller JM, Dolezal BA, Cooper CB, Fehling PC. Evaluation of a wearable physiological status monitor during simulated fire fighting activities. J Occup Environ Hyg 2014; 11:427-433. [PMID: 24433269 DOI: 10.1080/15459624.2013.875184] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A physiological status monitor (PSM) has been embedded in a fire-resistant shirt. The purpose of this research study was to examine the ability of the PSM-shirt to accurately detect heart rate (HR) and respiratory rate (RR) when worn under structural fire fighting personal protective equipment (PPE) during the performance of various activities relevant to fire fighting. Eleven healthy, college-aged men completed three activities (walking, searching/crawling, and ascending/descending stairs) that are routinely performed during fire fighting operations while wearing the PSM-shirt under structural fire fighting PPE. Heart rate and RR recorded by the PSM-shirt were compared to criterion values measured concurrently with an ECG and portable metabolic measurement system, respectively. For all activities combined (overall) and for each activity, small differences were found between the PSM-shirt and ECG (mean difference [95% CI]: overall: -0.4 beats/min [-0.8, -0.1]; treadmill: -0.4 beats/min [-0.7, -0.1]; search: -1.7 beats/min [-3.1, -.04]; stairs: 0.4 beats/min [0.04, 0.7]). Standard error of the estimate was 3.5 beats/min for all tasks combined and 1.9, 5.9, and 1.9 beats/min for the treadmill walk, search, and stair ascent/descent, respectively. Correlations between the PSM-shirt and criterion heart rates were high (r = 0.95 to r = 0.99). The mean difference between RR recorded by the PSM-shirt and criterion overall was 1.1 breaths/min (95% CI: -1.9 to -0.4). The standard error of the estimate for RR ranged from 4.2 breaths/min (treadmill) to 8.2 breaths/min (search), with an overall value of 6.2 breaths/min. These findings suggest that the PSM-shirt provides valid measures of HR and useful approximations of RR when worn during fire fighting duties.
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Affiliation(s)
- Denise L Smith
- a First Responder Health and Safety Laboratory, Health and Exercise Sciences Department, Skidmore College , Saratoga Springs , New York
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