David N. Borg

Can perceptual indices estimate physiological strain across a range of environments and metabolic workloads when wearing explosive ordnance disposal and chemical protective clothing

OBJECTIVE Explosive ordnance disposal (EOD) often requires technicians to wear multiple protective garments in challenging environmental conditions. The accumulative effect of increased metabolic cost coupled with decreased heat dissipation associated with these garments predisposes technicians to high levels of physiological strain. It has been proposed that a perceptual strain index (PeSI) using subjective ratings of thermal sensation and perceived exertion as surrogate measures of core body temperature and heart rate, may provide an accurate estimation of physiological strain. Therefore, this study aimed to determine if the PeSI could estimate the physiological strain index (PSI) across a range of metabolic workloads and environments while wearing heavy EOD and chemical protective clothing. METHODS Eleven healthy males wore an EOD and chemical protective ensemble while walking on a treadmill at 2.5, 4 and 5.5km·h(-1) at 1% grade in environmental conditions equivalent to wet bulb globe temperature (WBGT) 21, 30 and 37°C. WBGT conditions were randomly presented and a maximum of three randomised treadmill walking trials were completed in a single testing day. Trials were ceased at a maximum of 60-min or until the attainment of termination criteria. A Pearsons correlation coefficient, mixed linear model, absolute agreement and receiver operating characteristic (ROC) curves were used to determine the relationship between the PeSI and PSI. RESULTS A significant moderate relationship between the PeSI and the PSI was observed [r=0.77; p<0.001; mean difference=0.8±1.1a.u. (modified 95% limits of agreement -1.3 to 3.0)]. The ROC curves indicated that the PeSI had a good predictive power when used with two, single-threshold cut-offs to differentiate between low and high levels of physiological strain (area under curve: PSI three cut-off=0.936 and seven cut-off=0.841). CONCLUSIONS These findings support the use of the PeSI for monitoring physiological strain while wearing EOD and chemical protective clothing. However, future research is needed to confirm the validity of the PeSI for active EOD technicians operating in the field.

The Pandolf load carriage equation is a poor predictor of metabolic rate while wearing explosive ordnance disposal protective clothing

Abstract This investigation aimed to quantify metabolic rate when wearing an explosive ordnance disposal (EOD) ensemble (~33kg) during standing and locomotion; and determine whether the Pandolf load carriage equation accurately predicts metabolic rate when wearing an EOD ensemble during standing and locomotion. Ten males completed 8 trials with metabolic rate measured through indirect calorimetry. Walking in EOD at 2.5, 4.0 and 5.5km·h−1 was significantly (p < 0.05) greater than matched trials without the EOD ensemble by 49% (127W), 65% (213W) and 78% (345W), respectively. Mean bias (95% limits of agreement) between predicted and measured metabolism during standing, 2.5, 4 and 5.5km·h−1 were 47W (19 to 75W); −111W (−172 to −49W); −122W (−189 to −54W) and −158W (−245 to −72W), respectively. The Pandolf equation significantly underestimated measured metabolic rate during locomotion. These findings have practical implications for EOD technicians during training and operation and should be considered when developing maximum workload duration models and work-rest schedules. Practitioner Summary: Using a rigorous methodological design we quantified metabolic rate of wearing EOD clothing during locomotion. For the first time we demonstrated that metabolic rate when wearing this ensemble is greater than that predicted by the Pandolf equation. These original findings have significant implications for EOD training and operation.

Heat acclimation for protection from exertional heat stress

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of heat acclimation interventions aimed at protecting health and performance from exertional heat stress.

Perceived exertion is as effective as the perceptual strain index in predicting physiological strain when wearing personal protective clothing

OBJECTIVE The perceptual strain index (PeSI) has been shown to overcome the limitations associated with the assessment of the physiological strain index (PSI), primarily the need to obtain a core body temperature measurement. The PeSI uses the subjective scales of thermal sensation and perceived exertion (RPE) to provide surrogate measures of core temperature and heart rate, respectively. Unfortunately, thermal sensation has shown large variability in providing an estimation of core body temperature. Therefore, the primary aim of this study was to determine if thermal comfort improved the ability of the PeSI to predict the PSI during exertional-heat stress. METHODS Eighteen healthy males (age: 23.5years; body mass: 79.4kg; maximal aerobic capacity: 57.2ml·kg-1·min-1) wore four different chemical/biological protective garments while walking on treadmill at a low (<325W) or moderate (326-499W) metabolic workload in environmental conditions equivalent to wet bulb globe temperatures 21, 30 or 37°C. Trials were terminated when heart rate exceeded 90% of maximum, when core body temperature reached 39°C, at 120min or due to volitional fatigue. Core body temperature, heart rate, thermal sensation, thermal comfort and RPE were recorded at 15min intervals and at termination. Multiple statistical methods were used to determine the most accurate perceptual predictor. RESULTS Significant moderate relationships were observed between the PeSI (r=0.74; p<0.001), the modified PeSI (r=0.73; p<0.001) and unexpectedly RPE (r=0.71; p<0.001) with the PSI, respectively. The PeSI (mean bias: -0.8±1.5 based on a 0-10 scale; area under the curve: 0.887), modified PeSI (mean bias: -0.5±1.4 based on 0-10 scale; area under the curve: 0.886) and RPE (mean bias: -0.7±1.4 based on a 0-10 scale; area under the curve: 0.883) displayed similar predictive performance when participants experienced high-to-very high levels of physiological strain. CONCLUSIONS Modifying the PeSI did not improve the subjective prediction of physiological strain. However, RPE provided an equally accurate prediction of physiological strain, particularly when high-to-very high levels of strain were observed. Therefore, given its predictive performance and user-friendliness, the evidence suggests that RPE in isolation is a practical and cost-effective tool able to estimate physiological strain during exertional-heat stress under these work conditions.

Intraocular pressure is a poor predictor of hydration status following intermittent exercise in the heat

Current hydration assessments involve biological fluids that are either compromised in dehydrated individuals or require laboratory equipment, making timely results unfeasible. The eye has been proposed as a potential site to provide a field-based hydration measure. The present study evaluated the efficacy and sensitivity of intraocular pressure (IOP) to assess hydration status. Twelve healthy males undertook two 150 min walking trials in 40°C 20% relative humidity. One trial matched fluid intake to body mass loss (control, CON) and the other had fluid restricted (dehydrated, DEH). IOP (rebound tonometry) and hydration status (nude body mass and serum osmolality) were determined every 30 min. Body mass and serum osmolality were significantly (p < 0.05) different between trials at all-time points following baseline. Body mass losses reached 2.5 ± 0.2% and serum osmolality 299 ± 5 mOsmol.kg−1 in DEH. A significant trial by time interaction was observed for IOP (p = 0.042), indicating that over the duration of the trials IOP declined to a greater extent in the DEH compared with the CON trial. Compared with baseline measurements IOP was reduced during DEH (150 min: −2.7 ± 1.9 mm Hg; p < 0.05) but remained stable in CON (150 min: −0.3 ± 2.4 mm Hg). However, using an IOP value of 13.2 mm Hg to predict a 2% body mass loss resulted in only 57% of the data being correctly classified (sensitivity 55% and specificity 57%). The use of ΔIOP (−2.4 mm Hg) marginally improved the predictive ability with 77% of the data correctly classified (sensitivity: 55%; specificity: 81%). The present study provides evidence that the large inter-individual variability in baseline IOP and in the IOP response to progressive dehydration, prevents the use of IOP as an acute single assessment marker of hydration status.

The impact of environmental temperature deception on perceived exertion during fixed-intensity exercise in the heat in trained-cyclists

PURPOSE This study examined the effect of environmental temperature deception on the rating of perceived exertion (RPE) during 30 min of fixed-intensity cycling in the heat. METHODS Eleven trained male cyclists completed an incremental cycling test and four experimental trials. Trials consisted of 30 min cycling at 50% Pmax, once in 24 °C (CON) and three times in 33 °C. In the hot trials, participants were provided with accurate temperature feedback (HOT), or were deceived to believe the temperature was 28 °C (DECLOW) or 38 °C (DECHIGH). During cycling, RPE was recorded every 5 min. Rectal and skin temperature, heart rate and oxygen uptake were continuously measured. Data were analysed using linear mixed model methods in a Bayesian framework, magnitude-based inferences (Cohens d), and the probability that d exceeded the smallest worthwhile change. RESULTS RPE was higher in the heat compared to CON, but not statistically different between the hot conditions (mean [95% credible interval]; DECLOW: 13.0 [11.9, 14.1]; HOT: 13.0 [11.9, 14.1]; DECHIGH: 13.1 [12.0, 14.2]). Heart rate was significantly higher in DECHIGH (141 b·min-1 [132, 149]) compared to all other conditions (DECLOW: 138 b·min-1 [129, 146]; HOT: 138 b·min-1 [129, 145]) after 10 min; however, this did not alter RPE. All other physiological variables did not differ between the hot conditions. CONCLUSION Participants were under the impression they were cycling in different environments; however, this did not influence RPE. These data suggest that for trained cyclists, an awareness of environmental temperature does not contribute to the generation of RPE when exercising at a fixed intensity in the heat.

The reproducibility of 10 and 20 km time trial cycling performance in recreational cyclists, runners and team sport athletes

OBJECTIVES This study aimed to determine the reliability of 10 and 20km cycling time trial (TT) performance on the Velotron Pro in recreational cyclists, runners and intermittent-sprint based team sport athletes, with and without a familiarisation. DESIGN Thirty-one male, recreationally active athletes completed four 10 or 20km cycling TTs on different days. METHODS During cycling, power output, speed and cadence were recorded at 23Hz, and heart rate and rating of perceived exertion (RPE) were recorded every km. Multiple statistical methods were used to ensure a comprehensive assessment of reliability. Intraclass correlations, standard error of the measurement, minimum difference required for a worthwhile change and coefficient of variation were determined for completion time and mean trial variables (power output, speed, cadence, heart rate, RPE, session RPE). RESULTS A meaningful change in performance for cyclists, runners, team sport athletes would be represented by 7.5, 3.6 and 12.9% improvement for 10km and a 4.9, 4.0 and 5.6% for 20km completion time. After a familiarisation, a 4.0, 3.7 and 6.4% improvement for 10km and a 4.1, 3.0 and 4.4% would be required for 20km. CONCLUSIONS Data from this study suggest not all athletic subgroups require a familiarisation to produce substantially reliable 10 and 20km cycling performance. However, a familiarisation considerably improves the reliability of pacing strategy adopted by recreational runners and team sport athletes across these distances.

Predicting the metabolic cost of walking while wearing explosive ordnance disposal protective clothing.

The use of improvised explosive devices (IED) is becoming more prevalent in modern warfare, civil unrest and lone wolf terrorism. This has led to a greater role for explosive ordnance disposal (EOD) technicians to neutralise the threat of IED detonations. As such, the inherent risk to EOD technicians requires them to don a heavy (~34 kg) protective ensemble that subsequently increases the metabolic demand of tasks, such as locomotion. Previous research into the metabolic cost of protective clothing has focused primarily on chemical and fire ensembles [1]. Currently little is known about the metabolic cost of EOD protective clothing. The purpose of this investigation was 1) to quantify the metabolic demand when wearing an EOD ensemble at various speeds of locomotion and 2) establish whether the Pandolf predictive formula [2] is appropriate to estimate of EOD energy expenditure.

Can perceptual indices estimate physiological strain when wearing personal protective clothing in the heat

Explosive ordnance disposal (EOD) often requires technicians to wear multiple protective garments in challenging environmental conditions. The accumulative effect of increased metabolic cost coupled with decreased heat dissipation associated with these garments predisposes technicians to high levels of physiological strain. It has been proposed [1] that a perceptual strain index (PeSI) using subjective ratings of thermal sensation and perceived exertion as surrogate measures of core body temperature and heart rate, may provide an accurate estimation of physiological strain. Therefore, this study aimed to assess if the PeSI could estmate the physiological strain index (PSI) across a range [2] of metabolic workloads and environments while wearing heavy EOD and chemical protective clothing.