Long-term effects of multiple concussions on prefrontal cortex oxygenation during a hypercapnic challenge in retired contact sport athletes.

This exploratory study aimed to investigate the long-term effects of multiple concussions on prefrontal cortex oxygenation during a five-minute hypercapnic challenge using Near Infrared Spectroscopy (NIRS). 55 physically active retired contact sport male athletes with three or more previous concussions (mTBI) were recruited along with 29 physically active males with no concussions history (CTRL). Participants completed five minutes of seated rest prior to the five-minute hypercapnic challenge (20-second breath-hold, 40-second recovery breathing; five times). NIRS measured right and left side oxygenated (O2Hb), deoxygenated (HHb), total (tHb) haemoglobin, and haemoglobin difference (HbDiff) with all parameters analysed through changes in average maximal and minimal values (ΔMAX), Z-scores, and standard deviations. Right prefrontal cortex HbDiff ΔMAX was significantly higher in the mTBI compared to CTRL (p = 0.045) group. Left prefrontal cortex O2Hb ΔMAX (p = 0.040), HHb Z-Scores (p = 0.008), and HbDiff ΔMAX(p = 0.014) were significantly higher in the mTBI group. Within-group right vs left analyses demonstrated significantly lower left HbDiff ΔMAX (p = 0.048) and HbDiff Z-scores (p = 0.002) in the mTBI group, while the CTRL group had significantly lower left HHb Z-scores (p = 0.003) and left tHb Z-scores (p = 0.042). This study provides preliminary evidence that athletes with a history of three or more concussions may have impaired prefrontal cortex oxygenation parameters during a hypercapnic challenge.

Examining the Canadian 24-Hour Movement Guidelines among Adults with Intellectual Disability: A Pilot Study.

The purpose of this pilot study was to investigate the extent to which adults with intellectual disability (ID) met the 2020 Canadian 24-Hour Movement Guidelines. Fifteen adults (six females and nine males) participated in this nine-day observational study (age = 20-64 years) in 2021-2022, during the COVID-19 pandemic. Moderate-to-vigorous physical activity (MVPA), sedentary time, and total sleep time were measured with a smartwatch to compare to the guidelines. A diary subjectively tracked physical activity. Of the 15 participants, 11 met the MVPA guidelines (73%), 4 met the sedentary behaviour guidelines (27%), 7 met the sleep guidelines (47%), and only 1 participant met all 3 of the guidelines (7%). There were no differences in physical activity or sleep between weekends and weekdays, or between males and females. Walking, cleaning dishes, and swimming were the most common types of physical activity performed by the participants. The findings of this pilot study indicate the need to improve sleep and reduce sedentary time in adults with ID. As most participants met the MVPA guidelines, few met the sedentary behaviour guidelines, and nearly half met the sleep guidelines, these data also demonstrate how important it is to assess all three aspects of the movement guidelines. All these behaviours have independent health benefits and risks, which interact to influence overall health.

An assessment of the validity and reliability of the P022-P version of e-Celsius core temperature capsules.

Core temperature monitoring is a research tool used in many studies, though most popularly, heat strain. Ingestible core temperature capsules are a non-invasive and increasingly popular choice for measuring core body temperature, particularly considering the well-established validation of capsule systems. A newer version of the e-Celsius ingestible core temperature capsule has been released since the preceding validation study resulting in a paucity of validated research for the current version of capsules, P022-P, used by researchers. Using a 1:1 ratio of propylene glycol to water in a circulating water bath, and a reference thermometer with resolution and uncertainty of 0.01 °C, we assessed the validity and reliability of 24 P022-P e-Celsius capsules in three groups of eight, at seven temperature plateaus between 35 °C, and 42 °C in a test-retest format. The systematic bias of these capsules across all 3360 measurements was found to be -0.038 °C ± 0.086 °C (p < .001), The TEST-RETEST evaluation revealed excellent reliability by way of a minute overall mean difference of 0.0095 °C ± 0.048 °C (p < .001), and an intraclass correlation coefficient of 1.00 for each of TEST and RETEST conditions. Although quite small, differences in systematic bias across temperature plateaus were observed for both the OVERALL bias-between 0.00066 °C and 0.041°C-and TEST/RETEST bias-between 0.00010 °C and 0.016 °C. We found that the new capsule version outperforms manufacturer guarantees, with half of the systematic bias observed in a validation study of the previous capsule version. Though these capsules tend to slightly underestimate temperature, we find they possess excellent validity and reliability between 35 °C and 42 °C.

Firefighter pre-frontal cortex oxygenation and hemodynamics during rapid heat stress.

This study evaluated the impact of rapid heat stress on prefrontal cortex (PFC) oxygenation and hemodynamics. Previous work has demonstrated that heat stress affects cerebral oxygenation and hemodynamics. Fourteen male subjects performed a graded exercise test to a termination criterion (volitional maximum, core temperature = 39.5 °C, or a 2-hour time cap) with (GEAR) and without (NOGEAR) firefighting gear in a laboratory with an ambient temperature of 25-26 °C. Changes in oxyhemoglobin (O2Hb), total hemoglobin (tHb), and tissue oxygen saturation index (TSI %) were monitored in the left and right PFC using near-infrared spectroscopy (NIRS). Significant NIRS results were a plateau in the left-side O2Hb and tHb at 80 % of the time to termination (TTT) in NOGEAR, and 60 % of TTT in GEAR. These TTT points were when the subject's core temperature (Tc) was equal to 38 °C. Additionally, there was higher left-side PFC activation during GEAR, as indicated by a significant decrease in TSI % from start to end of exercise and double the reduction in TSI % per minute in PPE compared to NOGEAR. There were no significant differences during the NOGEAR session. These data suggest that a rapid heat stress scenario (GEAR) causes altered cerebral oxygenation and hemodynamic response in the left-side PFC. The left PFC could be working harder to prevent fatigue in GEAR. This could affect cognitive processes during or following exercise in the heat while wearing personal protective equipment. Our results also support previous research demonstrating that NIRS is a sensitive metric of fatigue.

Long-term effects of multiple concussions on prefrontal cortex oxygenation during neurovascular coupling activation in retired male contact sport athletes.

Purpose: This study aimed to investigate the long-term effects of multiple concussions on prefrontal cortex oxygenation during a neurovascular coupling activating task using near infrared spectroscopy (NIRS). Methods: Self-reported physically active males who previously participated in contact team sports at various levels of competition and who previously had experienced at least 3 concussions (n = 55; mTBI) or had no history of concussions (n = 29; CTRL) were recruited. Participants completed a 5 min "Where's Waldo" object identification protocol which consisted of participants closing their eyes for 20-s followed by 40-s (repeated 5 times over 5-min) of searching a computer screen for "Waldo" hidden in a field of distractors. NIRS (µM) was used to measure right and left prefrontal cortex cerebral oxygenation. Oxygenated (O2Hb), deoxygenated (HHb), total (tHb) haemoglobin, and haemoglobin difference (HbDiff) were analysed through the change in average maximal and minimal values (ΔMAX), Z-scores, and standard deviations. Results: There were no significant differences in the relative change in cerebral oxygenation of the right prefrontal cortex between groups. In mTBI, left prefrontal cortex HHb ΔMAX (p = 0.031) and tHb ΔMAX (p = 0.044) were significantly lower than in the CTRL group. Within-group, right vs. left prefrontal cortex differences showed significantly lower values in left HbDiff Z-scores (p = 0.019) in only the mTBI group while the CTRL group showed significantly lower values in left HbDiff SD (p = 0.045). Conclusion: This preliminary study suggests that there are changes in prefrontal cortex oxygenation in males who had a history of experiencing multiple concussions in their past during a neurovascular coupling activating task. These changes may represent potential long-term effects in the brain's ability to adapt cerebral oxygenation during increased neural activity.

History of Brain Injury Alters Cerebral Haemodynamic Oscillations with Cardiac Influence.

(1) Background: Cerebral autoregulation is altered during acute mild traumatic brain injury, or concussion. However, it is unknown how a history of concussion can impact cerebral haemodynamic activity during a task that elicits an autoregulatory response. (2) Methods: We assessed cerebral haemodynamic activity in those with a history of three or more concussions. The study included 44 retired athletes with concussion history and 25 control participants. We recorded participants' relative changes in right and left pre-frontal cortex oxygenation collected by near-infrared spectroscopy and continuous beat-to-beat blood pressure measured by finger photoplethysmography. Participants completed a 5-min seated rest followed by a 5-min repeated squat (10-s) stand (10-s) maneuver (0.05 Hz) to elicit a cerebral autoregulatory response. Wavelet transformation was applied to the collected signals, allowing separation into cardiac interval I (0.6 to 2 Hz), respiratory interval II (0.145 to 0.6 Hz), and smooth muscle cell interval III (0.052 to 0.145 Hz). (3) Results: Significant increases at cardiac interval I were found for the wavelet amplitude of oxy-haemoglobin and haemoglobin difference at the right pre-frontal cortex. No significant difference was found at the left pre-frontal cortex or the blood pressure wavelet amplitudes. (4) Conclusions: Contributions from cardiac activity to the pre-frontal cortex oxygenation are elevated when eliciting dynamic cerebral autoregulation in those with a history of three or more concussions.

Long-term effects of multiple concussions on prefrontal cortex oxygenation during repeated squat-stands in retired contact sport athletes.

BACKGROUND: This study investigated the long-term effects of multiple concussions on prefrontal cortex oxygenation using near-infrared spectroscopy (NIRS) during a squat-stand maneuver that activated dynamic cerebral autoregulation. METHODS: Active male retired contact sport athletes with a history of 3+ concussions (mTBI; n = 55), and active retired athletes with no concussion history (CTRL; n = 29) were recruited. Participants completed a 5-min squat-stand maneuve (10-s squat, 10-s stand, 0.05 Hz; 15 times). Oxygenated (O2Hb), deoxygenated (HHb), total (tHb) hemoglobin, and hemoglobin difference (HbDiff) were analyzed through the change in maximal and minimal values during the test (∆MAX), Z-scores, and standard deviations. RESULTS: mTBI group showed left prefrontal cortex O2Hb ∆MAX (p = 0.046) and HbDiff ∆MAX (p = 0.018) were significantly higher. Within-group analyses showed significantly higher left HHb ∆MAX (p = 0.003) and lower left HbDiff Z-scores (p = 0.010) only in the mTBI group. The CTRL group demonstrated significantly lower left HbDiff SD (p = 0.039), tHb Z-scores (p = 0.030), and HbDiff ∆MAX (p = 0.037) compared to right prefrontal cortex response. CONCLUSION: These preliminary results suggest changes in prefrontal cortex oxygenation potentially affecting the brain's ability to adapt to changing cerebral perfusion pressure after multiple previous concussions.

Firefighter salivary cortisol responses following rapid heat stress.

This research evaluated the impact of rapid heat stress on the rate of salivary cortisol appearance. We hypothesized that rapid heat stress would result in an increased rate of salivary cortisol appearance. Fourteen adult male participants performed an incremental exercise test to a termination criterion (volitional maximum, core temperature = 39.5 °C, or a 2-h time maximum time) with or without firefighting gear in a laboratory with an ambient temperature of 25-26 °C. Salivary cortisol was collected at each 0.5 °C increase in core temperature. We observed a significant increase (p ≤ 0.01) in the rate of cortisol appearance when the subjects were wearing the firefighting gear; no change was observed without firefighting gear. Our results demonstrate that rapid heat stress and the resulting physiological stress cause a rapid increase in the rate of salivary cortisol appearance. Our results also support previous research demonstrating that cortisol is a sensitive strain metric of heat intolerance.

A pilot study of the impact of an exercise intervention on brain structure, cognition, and psychosocial symptoms in individuals with relapsing-remitting multiple sclerosis.

BACKGROUND: Despite pharmacological treatment, many individuals with multiple sclerosis (MS) continue to experience symptoms and medication side effects. Exercise holds promise for MS, but changes in brain structure following exercise have not been thoroughly investigated, and important cognitive and psychosocial variables are rarely primary outcomes. The aim of this pilot study was to investigate whether a 12-week exercise intervention would improve white matter integrity in the brain, or cognition, symptoms of fatigue, and depressed mood for individuals with relapsing-remitting MS (RRMS). METHOD: Thirteen participants completed 12 weeks of speeded walking. Baseline and post-intervention testing included 3T diffusion tensor imaging (DTI) to assess white matter and neuropsychological testing to assess cognition, fatigue, and mood. Image pre-processing and analyses were performed in functional magnetic resonance imaging of the Brain Software Library. RESULTS: Post-intervention, there were no significant changes in white matter compared to baseline. Post-intervention, individuals with RRMS performed significantly better on the Symbol Digit Modalities Test (SDMT), reported fewer perceived memory problems, and endorsed less fatigue. Performance was not significantly different on Trails or Digit Span, and there were no significant changes in reports of mood. CONCLUSION: Although 12 weeks of speeded walking did not improve white matter integrity, exercise may hold promise for managing some symptoms of RRMS in the context of this study population.

Heading in the Right Direction: A Critical Review of Studies Examining the Effects of Heading in Soccer Players.

The practice of heading in soccer has become a public concern because of the potential for subconcussive impacts to cause cumulative concussive-like effects; however, experimental evidence for this hypothesis has been mixed. This systematic review used pre-defined search parameters to assess primary literature that examined changes in cognitive, behavioral, structural, and/or biological processes after acute heading exposure in youth and young adult soccer players. The findings were synthesized into a concise and comprehensive summary of the research following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) format, and suggestions for standardization of acute heading protocols are described. A total of 1189 articles were considered for this review, with 19 articles meeting all of the inclusion criteria for full analysis. An attempt was made to identify methods with significant sensitivity and reliability by grouping studies based on their outcome measures. Because of lack of standardization across intervention types and data collection protocols, no sensitive and reliable methods could be identified conclusively to assess the effects of acute heading exposure in soccer players. Based on this review, there is not enough evidence to either support or refute the potential of effects of subconcussive events from acute soccer heading exposure. Recommendations for standardization of acute heading exposure studies based on the included literature are discussed. Standardization is required to better understand the impact of acute heading exposure in soccer players, while allowing for the development of guidelines that mitigate any potential risks and allowing athletes to remain active and develop their skills.

The Six-Minute Walk Test for adults with intellectual disability: a study of validity and reliability.

BACKGROUND: The Six-Minute Walk Test (6MWT) has been used with clinical and healthy populations to assess functional capacity and cardiovascular fitness. The aim of this study was to determine the test-retest reliability of a modified-6MWT as well as concurrent validity of walk distance with peak oxygen uptake (VO2 peak). METHOD: Participants were 13 adults (males = 7) with intellectual disability aged 18-44 years recruited from Special Olympics, and with no medical contraindications to exercise. The 6MWT was modified to include familiarisation, a 1:1 pacer, and encouragement every 15 s. Each participant performed the graded maximal treadmill test and the modified-6MWT twice. RESULTS: Test-retest reliability of the modified-6MWT was ICC = .98, and linear regression revealed that the modified- 6MWT distance was significantly related to VO2 peak (R = .84, p < .001). CONCLUSIONS: The modified-6MWT is easy to administer and score and shows acceptable validity and excellent reliability for assessing cardiovascular fitness in adults with intellectual disability.

Hydration status and fluid and sodium balance in elite Canadian junior women's soccer players in a cool environment.

Dehydration can impair mental and on-field performance in soccer athletes; however, there is little data available from the female adolescent player. There is a lack of research investigating fluid and electrolyte losses in cool temperatures. Therefore, the purpose of this study was to investigate the pretraining hydration status, fluid balance, and sweat sodium loss in 34 female Canadian junior elite soccer athletes (mean age ± SD, 15.7 ± 0.7 years) in a cool environment. Data were collected during two 90 min on-field training sessions (9.8 ± 3.3 °C, 63% ± 12% relative humidity). Prepractice urine specific gravity (USG), sweat loss (pre- and post-training body mass), and sweat sodium concentration (regional sweat patch method) were measured at each session. Paired t tests were used to identify significant differences between training sessions and Pearson's product moment correlation analysis was used to assess any relationships between selected variables (p ≤ 0.05). We found that 45% of players presented to practice in a hypohydrated state (USG > 1.020). Mean percent body mass loss was 0.84% ± 0.07% and sweat loss was 0.69 ± 0.54 L. Although available during each training session, fluid intake was low (63.6% of players consumed <250 mL). Mean sweat sodium concentration was 48 ± 12 mmol·L⁻¹. Despite low sweat and moderate sodium losses, players did not drink enough to avoid mild fluid and sodium deficits during training. The findings from this study highlights the individual variations that occur in hydration management in athletes and thus the need for personalized hydration guidelines.

Nutrition status of junior elite Canadian female soccer athletes.

CONTEXT: Adolescent female team-sport athletes are faced with the challenge of meeting nutrition requirements for growth and development, as well as sport performance. There is a paucity of evidence describing the dietary adequacy of this population in respect to these physiological demands. Therefore, the aim of this study was to comprehensively evaluate the nutrition status of junior elite female soccer athletes. METHOD: A total of 33 athletes (15.7 ± 0.7 yr) completed anthropometric assessment, 4-day food records analyzed for macro- and micronutrient intake, and hematological analysis. Energy expenditure was estimated using predictive equations. RESULTS: Mean sum of 7 skinfolds was 103.1 ± 35.2 mm, and body-mass index was 22.7 ± 2.7. Mean energy intake was 2,079 ± 460 kcal/day, and estimated energy expenditure was 2,546 ± 190 kcal/day. Of the athletes, 51.5% consumed <5g/kg carbohydrate, 27.3% consumed <1.2g/kg protein, and 21.2% consumed <25% of energy intake from fat. A large proportion of athletes did not meet Dietary Reference Intakes for pantothenic acid (54.5%), vitamin D (100%), folate (69.7%), vitamin E (100%), and calcium (66.7%). Compared with recommendations for athletes, 89.3% and 50.0% of participants had depleted iron and 25-hydroxyvitamin D, respectively. CONCLUSION: A high proportion of players were not in energy balance, failed to meet carbohydrate and micronutrient recommendations, and presented with depleted iron and vitamin D status. Suboptimal nutrition status may affect soccer performance and physiological growth and development. More research is needed to understand the unique nutrition needs of this population and inform sport nutrition practice and research.

The effects of caffeine during exercise in fire protective ensemble.

To examine the effects of caffeine during exercise in fire protective ensemble (FPE), 10 healthy males completed 3 x 10 min bouts of treadmill exercise on two separate days. Sixty minutes prior to exercise either 6 mg/kg of caffeine (CAFF) or dextrose placebo (PLA) capsules were ingested (randomly assigned, double blind). End-exercise gastrointestinal temperature (T(gi)) was higher in CAFF compared to PLA (38.80 +/- 0.08 degrees C vs. 38.43 +/- 0.11 degrees C, p < or = 0.01). Ventilation (V(E)) and tidal volume (V(t)) were also significantly higher in CAFF, which resulted in higher consumption of air from the self-contained breathing apparatus. While perceived exertion in the caffeine condition was decreased (p < or = 0.05) compared to placebo, the higher T(gi) values increased calculated physiological strain index in CAFF (p < or = 0.01). Caffeine appears to alter the physiological and psycho-physical responses to exercise in FPE and may influence factors related to work tolerance in firefighting. These findings are relevant to occupations such as firefighting where workers are encapsulated during exposure to heavy physical work and/or environmental heat. The results indicate that workers may be more susceptible to heat-related fatigue, illness or injury with ingestion of significant amounts of caffeine. To the authors' knowledge this is the first study involving humans and exercise to detect an increase in body temperature with caffeine ingestion.

Hypervolemia and blood alkalinity: effect on physiological strain in a warm environment.

PURPOSE: To evaluate the influence of acute hypervolemia, achieved through the ingestion of a sodium citrate-rich beverage, on cardiovascular strain and thermoregulatory function, during moderate-intensity aerobic exercise in a warm environment. Sodium citrate's ability to increase buffering capacity was also assessed. METHODS: Twelve endurance-trained athletes completed two blind randomized treatment trials, separated by a minimum of seven days, on a cycle ergometer under heat stress (30.9 degrees C, 64% RH). The subjects ingested 12 mL.kg(-1) of (1) Gatorade, the control (CNT), or (2) sodium-citrate plus Gatorade (NaCIT: 170 mmol Na+L(-1)) before cycling at 15% below ventilatory threshold (VT) for 62 minutes. Core and skin temperature, expired gas samples, heart rate, and perceived exertion were measured throughout exercise. Blood samples were taken before drinking each beverage, before commencing exercise, and throughout the exercise bout. RESULTS: Plasma volume (PV) was significantly expanded in the NaCIT trial (3.6+/-5.5%) and remained significantly higher throughout exercise in the NaCIT trial compared with the CNT trial (P