Michelle A. Cleary

Active dehydration impairs upper and lower body anaerobic muscular power

We examined the effects of active dehydration by exercise in a hot, humid environment on anaerobic muscular power using a test-retest (euhydrated and dehydrated) design. Seven subjects (age, 27.1 ± 4.6 years; mass, 86.4 ± 9.5 kg) performed upper and lower body Wingate anaerobic tests prior to and after a 1.5-hour recovery from a heat stress trial of treadmill exercise in a hot, humid environment (33.1 ± 3.1oC = 55.1 ± 8.9% relative humidity) until a 3.1 ± 0.3% body mass loss was achieved. Dehydration was confirmed by a significant body mass loss (P < 0.001), urine color increase (P = 0.004), and urine specific gravity increase (P = 0.041). Motivation ratings were not significantly different (P = 0.059), and fatigue severity was significantly (P = 0.009) increased 70% in the dehydrated compared to the euhydrated condition. Compared to the euhydrated condition, the dehydrated condition mean power was significantly (P = 0.014) decreased 7.17% in the upper body and 19.20% in the lower body. Compared to the euhydrated condition, the dehydrated condition peak power was significantly (P = 0.013) decreased 14.48% in the upper body and 18.36% in the lower body. No significant differences between the euhydrated and dehydrated conditions were found for decrease in power output (P = 0.219, power = 0.213). Our findings suggest that dehydration of 2.9% body mass decreases the ability to generate upper and lower body anaerobic power. Coaches and athletes must understand that sports performance requiring anaerobic strength and power can be impaired by inadequate hydration and may contribute to increased susceptibility to musculoskeletal injury.

Thermoregulatory Influence of a Cooling Vest on Hyperthermic Athletes

CONTEXT Athletic trainers must have sound evidence for the best practices in treating and preventing heat-related emergencies and potentially catastrophic events. OBJECTIVE To examine the effectiveness of a superficial cooling vest on core body temperature (T(c)) and skin temperature (T(sk)) in hypohydrated hyperthermic male participants. DESIGN A randomized control design with 2 experimental groups. SETTING Participants exercised by completing the heat-stress trial in a hot, humid environment (ambient temperature = 33.1 +/- 3.1 degrees C, relative humidity = 55.1 +/- 8.9%, wind speed = 2.1 +/- 1.1 km/hr) until a T(c) of 38.7 +/- 0.3 degrees C and a body mass loss of 3.27 +/- 0.1% were achieved. PATIENTS OR OTHER PARTICIPANTS Ten healthy males (age = 25.6 +/- 1.6 years, mass = 80.3 +/- 13.7 kg). INTERVENTION(S) Recovery in a thermoneutral environment wearing a cooling vest or without wearing a cooling vest until T(c) returned to baseline. MAIN OUTCOME MEASURE(S) Rectal T(c), arm T(sk), time to return to baseline T(c), and cooling rate. RESULTS During the heat-stress trial, T(c) significantly increased (3.6%) and, at 30 minutes of recovery, T(c) had decreased significantly (2.6%) for both groups. Although not significant, the time for return to baseline T(c) was 22.6% faster for the vest group (43.8 +/- 15.1 minutes) than for the no-vest group (56.6 +/- 18.0 minutes), and the cooling rate for the vest group (0.0298 +/- 0.0072 degrees C/min) was not significantly different from the cooling rate for the no-vest group (0.0280 +/- 0.0074 degrees C/min). The T(sk) during recovery was significantly higher (2.1%) in the vest group than in the no-vest group and was significantly lower (7.1%) at 30 minutes than at 0 minutes for both groups. CONCLUSIONS We do not recommend using the cooling vest to rapidly reduce elevated T(c). Ice-water immersion should remain the standard of care for rapidly cooling severely hyperthermic individuals.

Comparisons of Age-Predicted Maximum Heart Rate Equations in College-Aged Subjects

Cleary, MA, Hetzler, RK, Wages, JJ, Lentz, MA, Stickley, CD, and Kimura, IF. Comparisons of age-predicted maximum heart rate equations in college-aged subjects. J Strength Cond Res 25(9): 2591-2597, 2011—This study investigated the accuracy of age-predicted equations to predict heart rate maximum (HRmax) in a college-age sample and establish efficacy of short-duration anaerobic capacity tests to determine the actual HRmax. A criterion HRmax (CHRmax) was obtained from 96 (52 men and 44 women, age = 22.0 ± 2.8 years, height = 163.9 ± 9.5 cm, 70.6 ± 14.7 kg, resting HR = 68.9 ± 11.2 b·min−1) healthy volunteers during 2 200-m sprint trials on a standard track. Maximal effort was confirmed via plasma lactate ≥7 mmol·L−1 and rating of perceived exertion ≥17 points. The CHRmax was compared to 7 age-predicted HRmax equations: Fox et al., 3 equations from Gellish et al., Tanaka et al., and gender-specific equations from Fairbarn et al., and Hossack et al. Descriptive statistics and standard errors of estimate (SEEs) were calculated. One-way analysis of variance was used to assess differences between the criterion HRmax and the age-predicted HRmax from the 7 equations. The predicted HRmax from the Fox equation and those of Gellish3, Tanaka, and Hossack were all significantly higher (p ≤ 0.05) than the CHRmax. The Fox equation resulted in overpredicting HRmax in 88.5% of the cases compared to the CHRmax. Compared to the CHRmax, the age-predicted HRmax equations resulted in the following percentages of the CHRmax: Fox = 104.8%, SEE = 12.7; Gellish1 = 95.2%, SEE = 12.2; Gellish2 = 99.6%, SEE = 8.3; Gellish3 = 101.8%, SEE = 9.1; Tanaka = 102.0%, SEE = 9.3; Fairbarn = 100.1%, SEE = 8.5; and Hossack = 105.2%, SEE = 13.9 of CHRmax. It was concluded that the Gellish2 and Fairbarn equations were the most accurate of the age-predicted HRmax equations in a college-age population. In practical application, 2 200-m sprint trials provide a reasonable estimate of HRmax compared to a graded exercise test.

Exertional Rhabdomyolysis in an Adolescent Athlete during Preseason Conditioning: A Perfect Storm

Cleary, MA, Sadowski, KA, Lee, SY-C, Miller, GL, and Nichols, AW. Exertional rhabdomyolysis in an adolescent athlete during preseason conditioning: a perfect storm. J Strength Cond Res 25(12): 3506-3513, 2011-The purpose of this brief review is to present a case of a healthy, male adolescent athlete (age = 16 years, body mass = 67.9 kg, height = 165.5 cm) who participated in a 3-day preseason wrestling camp which resulted in hospitalization for exertional rhabdomyolysis. As part of the preseason conditioning program directed by the coaches, the athlete completed 60 minutes of short, intense intervals of wall-sits, squats, sit-ups, push-ups, lunges, and plyometric jumps. The following day, the athlete continued his vigorous training consisting of running drills. That night he noticed voiding dark brown urine the color of cola. The day after the camp ended, the athlete reported to his Athletic Trainers with the chief complaint of severe bilateral leg pain in his quadriceps. Two days after the initial assessment, he was admitted to the hospital where he was diagnosed with exertional rhabdomyolysis based on creatine kinase (CK) levels that peaked at 146,000 IU·L, elevated far beyond normal (normal range = 58-280 IU·L). The athlete was hospitalized for 6 days where he received intravenous normal saline for rehydration, and his CK levels were assessed daily. Athletic Trainers, personal trainers, physical education teachers, and coaches should be aware that exertional rhabdomyolysis is the most common form of rhabdomyolysis and affects individuals who participate in novel and intense exercise to which they are unaccustomed. Stressful ambient conditions may lead to dehydration and exacerbation of the condition, particularly when the individual is not accustomed to the exercise intensity.

Hydration Behaviors Before and After an Educational and Prescribed Hydration Intervention in Adolescent Athletes

CONTEXT The effectiveness of education in modifying hydration behaviors in adolescent athletes is unclear. OBJECTIVE To assess the hydration status and behaviors of female athletes before and after a 1-time educational intervention and prescribed hydration intervention in a warm, humid, tropical environment. DESIGN Cohort study. SETTING Non-air-conditioned gymnasium in a tropical environment (indoor wet bulb globe temperature = 24.0 ± 0.2°C). Patient or Other Participants: Thirty-six female adolescent elite volleyball players (age = 14.8 ± 0.8 years, height = 168.2 ± 8.2 cm, mass = 60.8 ± 9.0 kg, body mass index = 21.7 ± 2.7, body surface area = 1.65 ± 0.14 m(2), body surface area to mass ratio = 2.71 ± 0.18 m(2)·kg(-1)·10(-2)) participated. INTERVENTION(S) Four observational periods consisting of 3 practices per observational period separated by 48 hours. The 4 periods included a control period, educational intervention, prescribed hydration intervention (PHI), and observational follow-up (OF-U). After the control period, an educational intervention consisting of a slide presentation was provided to the participants, followed by a week of observation. In the PHI, a precalculated volume of water based on individual sweat rate was consumed every 20 minutes during each 2-hour practice. During all other periods, participants consumed their fluid of choice ad libitum. The order of the treatment periods was not randomized and was the same for all participants. MAIN OUTCOME MEASURE(S) Prepractice to postpractice changes in body mass (ΔBM), percentage of body mass lost (%BML), urine specific gravity, urine color, urine osmolality, sweat rate, and volume of fluid consumed (F(vol)). RESULTS The PHI was the only period during which participants maintained body mass (ΔBM = 0.05 ± 1.3%); F(vol) consumed was greatest during this time (F(vol) = 1.3 ± 0.4 L; F(1,3) = 34.869, P ≤ .001). TheΔBM was less for the PHI (ΔBM = 0.05 ± 0.9 kg, %BML = 0.04 ± 1.3%) than the OF-U period (ΔBM = -0.7 ± 1.1 kg, %BML = -1.2 ± 1.9%; F(1,3) = 6.220, P = .01). The F(vol) (1.3 ± 0.4 L) and percentage of fluid consumed (143.7 ± 110.8%) to restore sweat loss for the PHI period were higher than for any other period (F(1,3) = 34.869, P ≤ .001). None of the participants experienced serious dehydration in any of the conditions. CONCLUSIONS A 1-time education session alone was not successful in changing hydration behaviors. However, prescribing individualized hydration protocols improved hydration for adolescents exercising in a warm, humid environment.

Thermoregulatory, Cardiovascular, and Perceptual Responses to Intermittent Cooling During Exercise in a Hot, Humid Outdoor Environment

Abstract Cleary, MA, Toy, MG, and Lopez, RM. Thermoregulatory, cardiovascular, and perceptual responses to intermittent cooling during exercise in a hot, humid outdoor environment. J Strength Cond Res 28(3): 792–806, 2014—Decreasing core body temperature during exercise may improve exercise tolerance, facilitate acclimatization, and prevent heat illness during summer training. We sought to evaluate the effectiveness of intermittent superficial cooling on thermoregulatory, cardiovascular, and perceptual responses during exercise in a hot humid environment. We used a randomized, counterbalanced, repeated measures investigation with 2 conditions (control and cooling) during exercise and recovery outdoors on artificial turf in a hot, humid tropical climate in the sun (wet bulb globe temperature outdoors [WBGTo], 27.0 ± 0.8° C; range, 25.8–28.1° C) and in the shade (WBGTo, 25.4 ± 0.9° C; range, 24.3–26.8° C). Participants were 10 healthy males (age, 22.6 ± 1.6 years; height, 176.0 ± 6.9 cm; mass, 76.5 ± 7.8 kg; body fat, 15.6 ± 5.4%) who wore shorts and T-shirt (control) or “phase change cooling” vest (cooling) during 5-minute rest breaks during 60 minutes of intense American football training and conditioning exercises in the heat and 30 minutes of recovery in the shade. Throughout, we measured core (Tgi) and skin (Tchest) temperature, heart rate (HR), thermal and thirst sensations, and rating of perceived exertion. We found significant (p ⩽ 0.001) hypohydration (−2.1%); for Tgi, we found no significant differences between conditions (p = 0.674) during exercise and progressive decreases during recovery (p < 0.001). For [INCREMENT]Tg,i we found no significant (p = 0.090) differences. For Tchest, we found significantly (p < 0.001) decreased skin temperature in the cooling condition (Tchest, 31.85 ± 0.43° C) compared with the control condition (Tchest, 34.38 ± 0.43° C) during exercise and significantly (p < 0.001) lower skin temperature in the cooling condition (Tchest, 31.24 ± 0.47° C) compared with the control condition (Tchest, 33.48 ± 0.47° C) during recovery. For HR, we found no significant difference (p = 0.586) between the conditions during exercise; however, we did find significantly (p < 0.001) lower HR during recovery. Thermal sensations were significantly (p = 0.026) decreased in the cooling (4.4 ± 0.2 points) compared with the control (5.0 ± 0.2 points) condition but not for other perceptual responses. The cooling effects of “phase change cooling” material were effective in reducing skin temperature but did not sufficiently reduce core body temperature or cardiovascular strain.

Superficial cooling does not decrease core body temperature before, during, or after exercise in an American football uniform.

Abstract Lopez, RM, Eberman, LE, and Cleary, MA. Superficial cooling does not decrease core body temperature before, during, or after exercise in an American football uniform. J Strength Cond Res 26(12): 3432–3440, 2012—The purpose of this study was to identify the effects of superficial cooling on thermoregulatory responses while exercising in a hot humid environment while wearing an American football uniform. Nine male and female subjects wore a superficial cooling garment while in a cooling (CS) experimental condition or a no cooling (NCS) control condition during an exercise task consisting of warm-up (WU), exercise (EX), and recovery (R). The exercise task simulated an American football conditioning session with subjects wearing a full American football uniform and performing anaerobic and aerobic exercises in a hot humid environment. Subjects were allowed to drink water ad libitum during rest breaks. During the WU, EX, and R periods, core body temperature (Tc) was measured to assess the effect of the cooling garment. Neither baseline resting before warm-up Tc nor after warm-up Tc was significantly different between trials. No significant differences in exercise Tc between conditions were found. Time to return to baseline Tc revealed no significant differences between the experimental and control conditions. The authors found that the volume of fluid consumed was 34% less in the experimental condition (711.1 ± 188.0 ml) compared with the control condition (1,077.8 ± 204.8 ml). The findings indicate that the cooling garment was not effective in blunting the rise in Tc during warm-up, attenuating a rise in Tc during intermittent exercise, or in increasing a return to baseline Tc during a resting recovery period in a hot humid environment while wearing an American football uniform.