Journal Entry Week 6

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Feb 20, 2024

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Hello class, For my post this week I chose a 2019 article from the journal Respiratory Physiology & Neurobiology examining cold environment exercise and Exercise Induced Bronchoconstriction (EIB) in cold weather athletes. The study was performed at the University of Alberta in Edmonton, Alberta, Canada between the months of February and March so you can imagine it was a bit cold outside. The study was performed in two different environments. First, day one of the testing was completed indoors in the university lab where the participants completed a Eucapnic Voluntary Hyperpnea (EVH) test. This is essentially a breathing machine providing a dry gas mixture to participants who were to keep a respiratory rate of 30 breath cycles per minute and a tidal volume equal to their previously recorded baseline of one second Force Expiratory Volume (FEV1), which is the volume measured in the first second of a forceful exhale (Kennedy et al., 2019). This indoor test lasted six minutes and is considered the standard for EIB screening. The second environment for the study was performed outside the university lab where the athletes completed a five-kilometer run at race pace in -15 degrees Celsius, which is a temperature known to induce bronchoconstriction. The results of the study showed that of the 16 participants, five were found to be positive for EIB with the EVH test versus seven with cold air test (CAT). It was also documented that CAT seemed to be more sensitive for EIB identification due to being performed in the common training and competition environment. Another finding of the study was that a FEV1 to Forced Vital Capacity (FVC) ratio of <0.75 may also be indicative of EIB (Kennedy et al., 2019). When compared, the EVH test and the cold air test (CAT) were not in agreement 50% of the time when came to identifying EIB in the 16 winter athletes. This may be due to the lack of

environmental exposure in the lab tests. Also, participants took longer to return to baseline respiratory measurements after the CAT. This may support the need to increase the tidal velocity used for the study beyond the 85% of maximal velocity ventilation. Another disparity I noted was that the lab tests were strictly controlled exertion compared to participants using the Rate of Perceived Exertion (RPE) for the CAT (Kennedy et al., 2019). For a follow up study, I would like to see this same study performed at high altitude with a larger group of male and female athletes that have been acclimated to the high altitude, the physiological adaptations to the cardiovascular and respiratory systems like increased blood hemoglobin concentration and increased ventilation of the lungs would add an interesting variable (Sutton & Gregg, 1994). Dave References Kennedy, M. D., Steele, A. R., Parent, E. C., & Steinback, C. D. (2019). Cold air exercise screening for exercise induced bronchoconstriction in cold weather athletes. Respiratory Physiology & Neurobiology , 269 , 103262. https://doi.org/10.1016/j.resp.2019.103262 Sutton, J., & Gregg, S. (1994). Exercise training at high altitude. Swimming Technique , 30 (4). https://web-b-ebscohost-com.ezproxy2.apus.edu/ehost/detail/detail? vid=0&sid=cb93a3e6-3b8c-4604-b31f- 7bbc0f3b6ce0%40sessionmgr101&bdata=JkF1dGhUeXBlPWlwJnNpdGU9ZWhvc3Qtb Gl2ZSZzY29wZT1zaXRl#AN=9709080199&db=s3h

Reply 1: Marie Darnell Marie, Great post this week, that was a cool study. This reminds me of passing through Qatar in the Middle East a few times enroute to the mountains and being hit with the wall of humidity out there in the summer. Some days it was 120 degrees Fahrenheit and 100% humidity! We used to joke about never needing to hydrate because we were basically swimming every time we went for a run. I would have liked to know the hydration levels post training for both groups, but the study states that they were unable to collect urine from the subjects. Do you think the participants should have been directed to ingest a set amount of water during the test sessions to increase the possibility of a urine sample at the end? Dave Reply 2: Leslie Bolton Les, That was an interesting study. I would agree with that first key finding about the feasibility of performing a large cohort study on Mount Everest, that is an amazing accomplishment. I also noticed the study noted acclimatization climbs between base camp and camp two, but I must have missed the reason for the climb down between expedition days 40 and 50. Was that part of the acclimatization process for the higher altitudes? Have you ever done any altitude training yourself? I trained for about a month and a half in Colorado doing a lot of hiking, rock climbing and white-water rafting and experienced an improvement in my aerobic capacity when I returned home to Las Vegas (I was stationed at Nellis AFB at that time). However, running and training in the heat of a Las Vegas summer presented its own challenges. Dave

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Reply 3: Dr. Reiss Dr. Reiss, Exercise Induced Bronchoconstriction (EIB) is caused by prolonged high ventilation combined with chronic exposure to cold dry air (Kennedy et al., 2019). This constriction of the airway can affect performance in both asthmatic and non-asthmatic athletes and may be harmful to lung health in the long-term causing asthma and airway remodeling. Even indoor athletes like hockey players and figure skaters are susceptible to EIB due to the pollutants expelled from the ice resurfacing machines (Rundell et al., 2015). Therefore, EIB is a significant issue for all winter athletes, no matter what the sport. Dave References Kennedy, M. D., Steele, A. R., Parent, E. C., & Steinback, C. D. (2019). Cold air exercise screening for exercise induced bronchoconstriction in cold weather athletes. Respiratory Physiology & Neurobiology , 269 , 103262. https://doi.org/10.1016/j.resp.2019.103262 Rundell, K. W., Anderson, S. D., Sue-Chu, M., Bougault, V., & Boulet, L.-P. (2015). Air Quality and Temperature Effects on Exercise-Induced Bronchoconstriction. Comprehensive Physiology , 5 (2), 579–610. https://doi.org/10.1002/cphy.c130013

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