HPHE 6710: Section 05 - Exercise Performance and Environmental Stress (Chapter 25,24,26,27)

Section 05: Exercise Performance and Environmental Stress
Chapter 25 Exercise and Thermal Stress Chapter 24 Exercise at High and Medium Altitude Chapter 26 Sport Diving Chapter 27 Microgravity: The Final Frontier
HPHE 6710 Exercise Physiology II Dr. Cheatham
Chapter 25
Exercise and Thermal Stress
Chapter Objectives
Understand the physiological mechanisms in response to heat and cold exposure Understand the physiological responses during exercise in the heat and the cold Understand heat and cold acclimatization Understand the different types of heat illness Understand factors that modify the responses to heat and cold
Introduction
Part 1
Mechanisms of Thermoregulation
Thermal Balance
S M CV Cd R - E
Hypothalamic Regulation of Temperature Hypothalamus

Central coordinating center for temperature regulation
Activation of bodys heat-regulating mechanisms

Thermal receptors in the skin Changes in blood temperature perfusing the hypothalamus
Hypothalamic Regulation of Temperature

0C, 32F
TCORE = 37.1C TSET = 37.5C
Im cold!
23C, 74F
36C, 97F
Im hot!
Skin Temp
Skin Temp
Thermoregulation in Cold Stress: Heat Conservation and Heat Production
Vascular adjustments
Cutaneous cold receptors constrict peripheral blood vessels.
250 mL/min at thermoneutral; approaches zero with severe cold stress Begins when skin temperature < 35C and is maximal when skin temperature < 31C
Skin temperature declines
Muscular activity
Shivering
Hormonal output
Maximal rates have been shown to be around 46% VO2max
Epinephrine and norepinephrine (short term) Thyroxine (long term)
Individual Factors Modifying Responses to Cold

Anthropometric Characteristics
Surface area to mass ratio Body Composition
Thermoregulation in Heat Stress: Heat Loss
Thermoregulation in Heat Stress: Heat Loss Radiation

Electromagnetic heat waves
Conduction
Direct contact between molecules
Convection
Movement of adjacent air or water molecules
Evaporation
Vaporizing water
Evaporative heat loss at high ambient temperatures Heat loss in high humidity
Thermoregulation in Heat Stress: Heat Loss Integration of Heat Dissipating Mechanisms

Circulation Body can control dry heat loss by varying skin blood flow and thus skin temperature After sweating has begun, skin blood flow serves primarily to deliver to the skin the heat that is being removed by sweat evaporation. Skin blood flow is affected by temperature in two ways:
Local effect on smooth muscle Reflexes operating through the SNS
36C (97F), 60% RH, 105 Watts
Thermoregulation in Heat Stress: Heat Loss Integration of Heat Dissipating Mechanisms

Evaporation
Sweating begins within several seconds of the start of vigorous exercise. The onset time of thermoregulatory sweating is influenced by skin temperature, acclimatization status, hydration status, and nonthermal stimuli. Sweating closely parallels increase in body temperature First, recruitment of sweat glands increases Second, sweat secretion per gland increases Chest and back sweat first, followed by limbs Cooled blood returns to core to absorb additional heat.
Hormonal adjustments
Vasopressin and aldosterone help maintain blood volume.

36C (97F), 60% RH, 105 Watts
Effects of Clothing on Thermoregulation

Clothing Insulation (CLO Units)
Index of thermal resistance A clo unit of 1 maintains a sedentary person at 1 MET indefinitely in an environment at 21C (68.8F) and 50% RH Factors:
Wind speed Body movements Chimney effect baggy clothes Bellows effect movement increases ventilation of air layers Water vapor transfer Permeation efficiency factor clothes absorb sweat
Cold-weather clothing
Layers trap air Moisture properties
Warm-weather clothing
Light in color Moisture properties
Part 2
Thermoregulation and Environmental Stress During Exercise
Exercise in the Heat

Core Temperature During Exercise

36C (97F), 60% RH, 105 Watts

Circulatory Adjustments
Two competing cardiovascular demands:
Adequate muscle blood flow for metabolism Adequate peripheral blood flow for thermoregulation Also, maintenance of blood pressure

Cardiovascular Responses



Cardiovascular Drift

HR
Higher in heat
SV
Lower in heat
Q
At low intensity will increase At higher intensities usually maintained
a-vO2 difference Blood Pressure

Lower in heat
Usually higher in heat
TPR
Usually lower in heat

Exercise Performance Limitations
Performance Effects
VO2max is lower in hot compared to temperate environments
0.25 L/min lower in 49C compared to 21C
Why?
Decrease in muscle blood flow Decrease in central blood flow and thus maximal CO

Water Loss in the Heat: Dehydration
Magnitude of fluid loss
The more prolonged or intense the exercise, the greater the loss. Sweat rates can exceed 3 L/hour
Significant consequences
Dehydration may threaten health. Physiologic and performance decrements occur. For every liter of sweat loss, HR can increase by 8 b/min with a corresponding 1.0 L/min decrease in Q
Diuretics
Cause greater fluid loss from plasma than sweating

Water Loss in the Heat: Dehydration
Dehydration by more than 2% of body weight will negatively impact endurance exercise
Increased hyperthermia
Core temperature elevations ~ 0.2C for every 1% decrease in BW Lowers the core temperature that can be tolerated before heat exhaustion from heat strain Sweating is reduced
Increased cardiovascular strain Altered metabolic function Altered CNS function
Maintaining Fluid Balance
Maintaining Fluid Balance
Factors That Modify Heat Tolerance

Acclimatization
Physiologic changes that improve heat tolerance Optimal acclimatization requires adequate rehydration. Three classical signs:
Lower HR Lower core temperature Higher sweat rate
After acclimatization, the threshold for sweating occurs at a lower core temperature Lower skin temperatures decrease cutaneous BF requirements for heat balance

Training status
Increased sensitivity and capacity of sweating response Plasma volume increases Greater skin and GI blood flow Larger volumes of more dilute sweat
Age
Age-related differences in heat tolerance Some age-related factors affect thermoregulatory dynamics. Children
Lower sweating rate and higher core temperature Sweat is more concentrated.

Gender
When studies control for fitness level and relative exercise intensity, no gender differences are observed. Sweating Women
Sweat less prolifically than men despite having more heat-activated sweat glands Sweat smaller volumes Begin sweating at higher skin and core temperatures
Compared to men, women tend to cool faster. Menstrual cycle alters skin blood flow and sweating response. Body fat insulates body, retards heat dissipation, and adds to metabolic cost of weight-bearing activities.
Complications from Excessive Heat Stress Heat Cramps (Involuntary Muscle Spasms)
Core temperature typically in normal range Due to an imbalance in fluid levels and electrolyte concentrations Those at risk tend to have high sweat rate and high sweat sodium concentrations Prevention
Adequate fluid and electrolyte intake before and during exercise
Complications from Excessive Heat Stress

Heat Exhaustion
Ineffective circulatory adjustments, depletion of extracellular volume (especially PV) Peripheral pooling occurs, central blood volume decreases, cardiac output usually decreases
Symptoms:
Weak, rapid pulse Low blood pressure Dizziness, headache, overall weakness Possible decrease in sweat rate Core temperature is elevated but not to dangerous levels (i.e. > 40C or 104F)
Treatment
Move to cooler location, rapid body cooling, fluids (possibly intravenously)
Complications from Excessive Heat Stress Heat Stroke

The failure of the heat-regulating mechanisms from an excessively high core temperature Classic Form:
Environmental heat overloads the bodys heat dissipating mechanisms. Symptoms:
Core temp > 105F, altered mental status, absence of sweating, multisystem organ dysfunction.
Exertional Heat Stroke:

Extreme hyperthermia from:
Metabolic heat load in exercise Challenge in heat dissipation from a hot-humid environment
Complications from Excessive Heat Stress Heat Stroke (contd)

Exertional Heat Stroke (contd):
Symptoms:
Core temp > 41.5C Sweating diminishes, skin becomes dry and hot Inordinate strain on the CV system Rapid breathing Altered mental status
Treatment:
Rapid cooling: ice packs, alcohol rubs, whole-body immersion in cold water or ice, intravenous fluids, EMS medical attention, drug treatment (endotoxins)
Complications from Excessive Heat Stress
Exercise in the Cold

At Rest:
Higher Q Higher SV No change in HR Higher BP and TPR a-vO2 diff
Lower if muscle temp decreases Similar between cold and neutral if muscle temp remains the same

During Exercise:
Increased Q Increased SV No change or slight decrease in HR Increased BP and TPR
Note to self: Get better figure for this slide

Oxygen Uptake and Systemic Oxygen Transport
Man in the cold is not necessarily a cold man If cold stress is sufficient to decrease core temperature or muscle temperature, then:
VO2max may be reduced Impairment of myocardial contractility

VO2max in the Cold
Matsui et al. (1978)
Acute exposures to 5C, 18C, and 35C No differences in VO2max
Astrand and Saltin (1961)

20C and -5C No difference in VO2max
Bergh (1980)
5 to 6% decrease for every 1C drop in core Probably related to decrease in max HR and thus maximum Q

Individual Factors Modifying Responses to Cold
Anthropometric Characteristics
Surface area to mass ratio Body Composition
Acclimatization to Cold
Chapter 24
Exercise at Medium and High Altitude
Chapter Objectives
Fill in
The Stress of Altitude

Reduced PO2 creates a metabolic challenge. Oxygen transport cascade
Progressive change in environments oxygen pressure and in various body areas
Acclimatization
Adaptations occurring due to a change in the natural environment
Acclimation
Adaptations produced in a controlled laboratory setting

159 Sea Level 94 4300 m
149
104 40 25
84
53
40
96
40
23

Oxygen Loading at Altitude
No meaningful change in Hb saturation until an elevation of 3048 m
Examples
At 1981 m (6500 feet) Mexico City Olympics (1968) (2300 m, 7546 feet)
PaO2 = 120 mmHg (80% saturated) Performance decrement
PAO2 at sea level = 100 mmHg (97.2% saturated) PAO2 at 6500 feet = 78 mmHg (~ 94% saturated)
Sudden exposure to 4300 m Mt. Everest

VO2max decreases by 32% VO2max decrease of 70%
Acclimatization
Acclimatization
Immediate Response to Altitude
Increase in respiratory drive to produce hyperventilation Increase in blood flow during rest and submaximal exercise
Hyperventilation
Low PaO2 sensed by peripheral chemoreceptors When PIO2 drops below 110 (normal = 150) or PaO2 is less than 60 (normal = 96) ventilation increases Beyond these levels, ventilation increases in proportion to level of hypoxia Increase in ventilation increases PAO2 and decreases PACO2 What happens during rapid exposure to low O2
First few minutes = dramatic increase in VE After initial minutes = slight blunting of VE but still more than normal Why? Ventilation induced hypocapnia
Acclimatization
Acclimatization
Immediate Response to Altitude (contd)
Increased cardiovascular response
Resting SBP increases Submaximal exercise heart rate and cardiac output can rise to 50% above sea level values (no change in SV) At a given absolute workload:
Q is increased at altitude HR is increased at altitude SV is the same Compensation for lower a-vO2 difference
However, a given absolute workload is a greater relative workload because VO2max is reduced at altitude If same relative workload is performed, no difference between normoxia and hypoxia
Acclimatization
Acclimatization
Catecholamine Response
Plasma and urine catecholamines are higher at altitude
Mostly due to increase in NE not E
During first few minutes, no difference in NE

Production is increased, but removal is also increased
Within 14-18 hours, an increase in NE is observed

Production is increased, but removal is decreased Splanchnic removal is proportional to arterial concentration
Acclimatization
Acclimatization
Acclimatization
Longer-Term Adjustments to Altitude
Regulation of acid-base balance altered by hyperventilation Synthesis of hemoglobin and red blood cells Elevated sympathetic neurohormonal activity
Acid-Base Readjustment
Hyperventilation causes a decrease in PCO2
Increase in pH Kidneys begin to excrete bicarbonate
Acclimatization
Longer-Term Adjustments to Altitude (contd)
Hematologic Changes
Initial plasma volume decrease
Shift from intravascular space to interstitial and intracellular space Increases red blood cell and hemoglobin concentration Diuresis Maintains fluid balance between the compartments even though total body water is reduced
Red blood cell mass increases
Acclimatization
Acclimatization
Longer-Term Adjustments to Altitude (contd)
Cellular Changes
Capillary adjustments Increased myoglobin Increased mitochondrial density Increased 2,3-DPG levels
Altitude Training and Sea-Level Performance

Performance upon return is not improved if using VO2max as the criteria Altitude acclimatization improves ability to perform at altitude. Decrement in absolute training level at altitude
Athletes cannot train as intensely while at altitude.
Altitude Training and Sea-Level Performance
Combine Altitude Stay with Low-Altitude Training
Live hightrain low appears to be the best scenario for improving performance.
Capitalize on stress of altitude and acclimatization Train lower so intensity can be maintained
At-Home Acclimatization
Methods of simulating hypobaric conditions
Cause altitude-induced physiologic adaptations
Gamow hypobaric chamber Wallace altitude tent
Simulated Altitude
Simulated Altitude
http://www.youtube.com/watch?v=RRCBbAKW1DU&feature=player_embedded
Simulated Altitude
http://www.youtube.com/watch?v=izuDBEu4BhY&feature=player_embedded
Simulated Altitude
http://www.youtube.com/watch?v=p6WHPd7yHdk
Chapter 26
Sport Diving (Hyperbaria)
Chapter Objectives
Fill in
Introduction
Pressure-Volume Relationships and Diving Depth
Diving Depth and Pressure

Hyperbaria Water is noncompressible. As a diver descends, the pressure increases. Two forces produce this external pressure
Weight of the column of water above the diver Weight of the atmosphere at the waters surface
Every 33 feet of sea water represents another atmosphere of pressure.
Diving Depth and Gas Volume

Boyles law At a given temperature, the volume of a gas varies inversely with its pressure.
P1V1 = P2V2
Greater pressure compresses the gas into a smaller volume.
So, volume of air underwater is less than that same amount of air measured at sea level
Diving Depth and Gas Volume (contd)

Example:
What is the volume of 1 liter of gas (measured at sea level) at a depth of 100 feet (4 ATM)? (1)(1) = (4)(X) X = 1/4 Liter

If a rigid container was submersed underwater, the pressure in the container would not change But, the human body is not a rigid container Therefore, the contents of the human body will compress as the pressure increases as water depth increases Water cannot compress (but the pressure of water can increase), so the air spaces within the body will compress

Which air spaces are susceptible to damage?
Natural Air Spaces
Lungs Middle Ear Sinuses Gastrointestinal Tract
Artificial Spaces
Cavities within teeth Face Mask Air spaces within diving suit

What happens to the lungs?
A breath hold diver with a TLC of 6L and a RV of 1.5L takes a full inspiration and dives downward At 100 feet, pressure equals 4 ATM and lung volume equals: (6L)(1ATM) = (X)(4ATM) X = 1.5 L Residual volume has been reached and lung volume can decrease no further

What happens if the diver goes deeper?
Pulmonary capillary and venous congestion displaces air in thorax decreasing RV and equalizing pressure Problem with this:
The increase in vascular pressures may lead to ruptures of the microvasculature Pulmonary edema and hemorrhage

What happens to diver during ascent?
At 100 feet, diver is running out of air He fills his lungs with air from the tank As he ascends, pressure decreases Volume of air expands because pressure is decreasing Volume of air is too large to occupy lung space Lung bursts Only happens if breath holding during ascent
Snorkeling and Breath-Hold Diving

Limits to Snorkel Size
Inspiratory capacity and diving depth
Pressure of water reduces lung expansion
Snorkel size and pulmonary dead space

The snorkel adds to the dead space. Larger snorkel sizes are not effective due to too much dead space, which limits alveolar ventilation.

Breath-Hold Diving
Duration depends on
Time to CO2 build-up reaches breath-hold breakpoint (PCO2 ~ 50 mmHg) Relationship between divers TLC and RLV
Hyperventilation
Decreases PCO2, increases breath-hold time Increases susceptibility to blackout
Thoracic squeeze
Limits depth of breath-hold diving to about 100 FSW

A Diving Reflex in Humans?
Physiologic responses to water immersion
Bradycardia Decreased cardiac output Increased peripheral vasoconstriction Lactate accumulation
Scuba Diving
Open vs. Closed Circuit Scuba
Special Problems With Breathing Gases at High Pressure
Henrys law
Gas dissolved in a liquid at a given temperature depends upon pressure differences between the gas and liquid and gas solubility in the liquid. Air must be delivered at sufficient pressure to overcome force of water against divers thorax.
The Bends
At high pressures, the partial pressure of all gases increases The partial pressure of Nitrogen especially increases Nitrogen is fat soluble and thus enters the fatty tissues Upon ascent, the pressure decreases and thus the gases must be released The lungs cannot get rid of the nitrogen quickly enough Thus, the nitrogen begins to bubble out of the tissues and the nitrogen content of the body increases
The Bends (contd)

Treatment
Recompression allows the nitrogen to enter into solution again The pressure is then gradually decreased
This allows time for the nitrogen to escape through the respiratory system
Oxygen Poisoning
Exposure to a high partial pressure of oxygen can have severe effects on the lungs and the CNS
A high PO2 causes much oxygen to be dissolved in solution The O2 dissolved in solution is the first O2 to be used by the tissues Because the dissolved O2 is high, it is sufficient to supply the tissues with O2
Oxygen Poisoning (contd)

Thus, O2 does not have to dissociate from hemoglobin
Hemoglobin in venous blood contains high amount of O2 What problem does this cause?
Hemoglobin normally binds CO2 in the venous circulation
CO2 builds up since it cannot bind to hemoglobin
Oxygen Poisoning (contd)

Symptoms of O2 poisoning
The high PO2 can cause cerebral blood vessels to constrict Visual distortion Rapid and shallow breathing Convulsions Irritation of the respiratory tract leading to pneumonia
Nitrogen Narcosis
Nitrogen is not metabolically active Can act like an anesthetic gas Diver develops symptoms similar to alcohol intoxication
Every 15 meter descent is equal to the consumption of one martini on an empty stomach Impairment of judgment and diver may not recognize a problem exists
Divers who dive below 30 meters will use a helium mixture
Chapter 27
Microgravity: The Last Fronteir
Chapter Objectives
Fill in
Introduction
Microgravity and Weightlessness
Microgravity: Gravitational forces acting on the long axis of the body are minimized. Gravity depends on the:
Persons mass, earth mass, and distance from the center of the earth (increases 5% during spaceflight) So, gravity is only slightly decreased in space
Weightlessness:
Caused in space due to the fact that the spacecraft is in free fall.
The crafts centrifugal force counterbalances the force of gravity. Therefore, the perception is weightlessness
Introduction
Introduction
Space Flight
Microgravity unloads body tissues and redistributes body fluids Light and dark cycles are altered Very little ultraviolet radiation Carbon dioxide levels are elevated Psychological stress Vigorous physical activity
Introduction
Simulated Microgravity
Bed Rest
Loss of muscle mass and strength within 2 weeks Decrease in bone mineral density (~12 weeks) Decrease in cardiac mass (~6 weeks) Exercise impairment (~ few days) Decrease in maximal exercise capacity (~ few weeks)
Immersion Suspension and Immobilization
Introduction
Physiologic Adaptations to Microgravity Cardiovascular System

Decrease in plasma volume Lower resting heart volume Cardiac atrophy
May actually be negative caloric balance and body weight
Cardiac contractility probably not affected Increases in cardiac compliance

But, these decrease after two weeks of bed rest
Increased venous compliance (decrease VR) Decreased PNS, increased HR, increased SNS
Physiologic Adaptations to Microgravity
Physiologic Adaptations to Microgravity Musculoskeletal adaptations

Increased calcium loss
Skeletal muscle adaptations

Concentric and eccentric strength Muscle ultrastructural changes
Altered muscular coordination Delayed-onset muscle soreness General weakness and fatigue Max explosive leg power decreases.

HPHE 6710: Section 05 - Exercise Performance and Environmental Stress (Chapter 25,24,26,27)

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HPHE 6710: Section 05 - Exercise Performance and Environmental Stress (Chapter 25,24,26,27)

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Section 05: Exercise Performance and Environmental Stress

HPHE 6710 Exercise Physiology II Dr. Cheatham

Hypothalamic Regulation of Temperature Hypothalamus

Activation of bodys heat-regulating mechanisms

Hypothalamic Regulation of Temperature

Hypothalamic Regulation of Temperature

Hypothalamic Regulation of Temperature

Hypothalamic Regulation of Temperature

Hypothalamic Regulation of Temperature

Hypothalamic Regulation of Temperature

Thermoregulation in Cold Stress: Heat Conservation and Heat Production

Thermoregulation in Cold Stress: Heat Conservation and Heat Production

Thermoregulation in Cold Stress: Heat Conservation and Heat Production

Thermoregulation in Cold Stress: Heat Conservation and Heat Production

Skin temperature declines

Maximal rates have been shown to be around 46% VO2max

Epinephrine and norepinephrine (short term) Thyroxine (long term)

Thermoregulation in Cold Stress: Heat Conservation and Heat Production

Thermoregulation in Cold Stress: Heat Conservation and Heat Production

Individual Factors Modifying Responses to Cold

Thermoregulation in Heat Stress: Heat Loss

Thermoregulation in Heat Stress: Heat Loss Radiation

Thermoregulation in Heat Stress: Heat Loss

Thermoregulation in Heat Stress: Heat Loss

Thermoregulation in Heat Stress: Heat Loss

Thermoregulation in Heat Stress: Heat Loss Integration of Heat Dissipating Mechanisms

Thermoregulation in Heat Stress: Heat Loss

36C (97F), 60% RH, 105 Watts

Thermoregulation in Heat Stress: Heat Loss

Thermoregulation in Heat Stress: Heat Loss Integration of Heat Dissipating Mechanisms

Thermoregulation in Heat Stress: Heat Loss

Effects of Clothing on Thermoregulation

Effects of Clothing on Thermoregulation

Effects of Clothing on Thermoregulation

Effects of Clothing on Thermoregulation

Exercise in the Heat

Exercise in the Heat

Exercise in the Heat

Exercise in the Heat

Exercise in the Heat

Exercise in the Heat

Exercise in the Heat

Exercise in the Heat

Exercise in the Heat

Exercise in the Heat

Exercise in the Heat

Exercise in the Heat

Exercise in the Heat

a-vO2 difference Blood Pressure

Usually higher in heat

Exercise in the Heat

Exercise in the Heat

Exercise in the Heat

Exercise in the Heat

Increased cardiovascular strain Altered metabolic function Altered CNS function

Maintaining Fluid Balance

Maintaining Fluid Balance

Factors That Modify Heat Tolerance

Factors That Modify Heat Tolerance

Factors That Modify Heat Tolerance

Factors That Modify Heat Tolerance

Factors That Modify Heat Tolerance