Collaborative Online International Learning in Physiology: A Case Study.

Internationalisation in higher education is essential, and although active learning methodologies are increasing and allow students to develop transversal skills, most still have a very local scope. In this context, the Collaborative Online International Learning (COIL) methodology is an interesting approach to benefit the students' development. It consists of an online program that involves creating multicultural teams to develop a specific learning project. Although this methodology is expanding, its use in physiology is still scarce. This paper aims to show an example of applying COIL methodology in physiology topics to enhance higher-education students' innovation and business skills. Our example project developed a sports-assessment service concept focused on physiology and biomechanics assessments. The program involved teams from Brazil, Germany, and Spain, comprising undergraduate and master students. Over seven weeks, these teams, mentored by professors and researchers, engaged in workshops covering COIL methodology, business model design, executive summary planning, economic analyses, and communication techniques. Key outcomes included learning new concepts, developing soft skills, building confidence in innovative solution proposals, and experiencing diverse cultures. Challenges faced were language barriers, scheduling, task complexity, and logistical issues. This experience confirms the effectiveness of incorporating programs using COIL methodology into educational curriculums. Doing so exposes physiology students to innovation, entrepreneurship, and business creation while strengthening their professional connections and opening up post-graduation opportunities.

A Preliminary Investigation about the Influence of WIMU PROTM Location on Heart Rate Accuracy: A Comparative Study in Cycle Ergometer.

Technological development has boosted the use of multi-sensor devices to monitor athletes' performance, but the location and connectivity between devices have been shown to affect data reliability. This preliminary study aimed to determine whether the placement of a multi-sensor device (WIMU PROTM) could affect the heart rate signal reception (GARMINTM chest strap) and, therefore, data accuracy. Thirty-two physical education students (20 men and 12 women) performed 20 min of exercise in a cycle ergometer based on the warm-up of the Function Threshold Power 20 test in laboratory conditions, carrying two WIMU PROTM devices (Back: inter-scapula; Bicycle: bicycle's handlebar-20 cm from the chest) and two GARMINTM chest straps. A one-dimensional statistical parametric mapping test found full agreement between the two situations (inter-scapula vs. bicycle's handlebar). Excellent intra-class correlation values were obtained during the warm-up (ICC = 0.99, [1.00-1.00], p < 0.001), the time trial test (ICC = 0.99, [1.00-1.00], p < 0.001) and the cool-down (ICC = 0.99, [1.00-1.00], p < 0.001). The Bland-Altman plots confirmed the total agreement with a bias value of 0.00 ± 0.1 bpm. The interscapular back placement of the WIMU PROTM device does not affect heart rate measurement accuracy with a GARMINTM chest strap during cycling exercise in laboratory conditions.

Acute physiological responses to a pyramidal exercise protocol and the associations with skin temperature variation in different body areas.

This study aimed to examine the skin temperature (Tsk) variations in five regions of interest (ROI) to assess whether possible disparities between the ROI's Tsk could be associated with specific acute physiological responses during cycling. Seventeen participants performed a pyramidal load protocol on a cycling ergometer. We synchronously measured Tsk in five ROI with three infrared cameras. We assessed internal load, sweat rate, and core temperature. Reported perceived exertion and calves' Tsk showed the highest correlation (r = -0.588; p < 0.01). Mixed regression models revealed that the heart rate and reported perceived exertion were inversely related to calves' Tsk. The exercise duration was directly associated with the nose tip and calf Tsk but inversely related to the forehead and forearm Tsk. The sweat rate was directly related to forehead and forearm Tsk. The association of Tsk with thermoregulatory or exercise load parameters depends on the ROI. The parallel observation of the face and calf Tsk could indicate simultaneously the observation of acute thermoregulatory needs and individual internal load. The separate Tsk analyses of individual ROI appear more suitable to examine specific physiological response than a mean Tsk of several ROI during cycling.

Acute effects of fatigue on internal and external load variables determining cyclists' power profile.

The aim of the present study was to determine whether fatigue affects internal and external load variables determining power profile in cyclists. Ten cyclists performed outdoor power profile tests (lasting 1-, 5 and 20-min) on two consecutive days, subject either to a fatigued condition or not. Fatigue was induced by undertaking an effort (10-min at 95% of average power output obtained in a 20-min effort followed by 1-min maximum effort) until the power output decreased by 20% compared to the 1-min power output. Fatigued condition decreased power output (p < 0.05, 1-min: 9.0 ± 3.8%; 5-min: 5.9 ± 2.5%; 20-min: 4.1 ± 1.9%) and cadence in all test durations, without differences in torque. Lactate decreased in longer efforts when a fatigue protocol had previously been conducted (e.g., 20-min: 8.6 ± 3.0 vs. 10.9 ± 2.7, p < 0.05). Regression models (r2 ≥ 0.95, p < 0.001) indicated that a lower variation in load variables of 20-min in fatigued condition compared with the non-fatigued state resulted in a lower decrease in critical power after the fatigue protocol. The results suggest that fatigued condition on power was more evident in shorter efforts and seemed to rely more on a decrease in cadence than on torque.

Can infrared thermography serve as an alternative to assess cumulative fatigue in women?

Muscle fatigue can limit performance both in sports and daily life activities. Consecutive days of exercise without a proper recovery time may elicit cumulative fatigue. Although it has been speculated that skin temperature could serve as an indirect indicator of exercise-induced adaptations, it is unclear if skin temperature measured by infrared thermography (IRT) could be an outcome related to the effects of cumulative fatigue. In this study, we recruited 21 untrained women and induced cumulative fatigue in biceps brachii over two consecutive days of exercise. We measured delayed onset muscle soreness (DOMS, using a numeric rate scale), maximal strength (using a dynamometer), and skin temperature (using IRT) in exercise and non-exercise muscles. Cumulative fatigue reduced muscle strength and increased DOMS. Skin temperature in the arm submitted to cumulative fatigue was higher for minimum and mean temperature, being asymmetrical in relation to the control arm. We also observed that the variations in the minimum and mean temperatures correlated with the strength losses. In summary, skin temperature measured by IRT seems promising to help detect cumulative fatigue in untrained women, being useful to explain strength losses. Future studies should provide additional evidence for the potential applications not only in trained participants but also in patients that may not be able to report outcomes of scales or precisely report DOMS.

Application of machine learning algorithms in thermal images for an automatic classification of lumbar sympathetic blocks.

PURPOSE: There are no previous studies developing machine learning algorithms in the classification of lumbar sympathetic blocks (LSBs) performance using infrared thermography data. The objective was to assess the performance of different machine learning algorithms to classify LSBs carried out in patients diagnosed with lower limbs Complex Regional Pain Syndrome as successful or failed based on the evaluation of thermal predictors. METHODS: 66 LSBs previously performed and classified by the medical team were evaluated in 24 patients. 11 regions of interest on each plantar foot were selected within the thermal images acquired in the clinical setting. From every region of interest, different thermal predictors were extracted and analysed in three different moments (minutes 4, 5, and 6) along with the baseline time (just after the injection of a local anaesthetic around the sympathetic ganglia). Among them, the thermal variation of the ipsilateral foot and the thermal asymmetry variation between feet at each minute assessed and the starting time for each region of interest, were fed into 4 different machine learning classifiers: an Artificial Neuronal Network, K-Nearest Neighbours, Random Forest, and a Support Vector Machine. RESULTS: All classifiers presented an accuracy and specificity higher than 70%, sensitivity higher than 67%, and AUC higher than 0.73, and the Artificial Neuronal Network classifier performed the best with a maximum accuracy of 88%, sensitivity of 100%, specificity of 84% and AUC of 0.92, using 3 predictors. CONCLUSION: These results suggest thermal data retrieved from plantar feet combined with a machine learning-based methodology can be an effective tool to automatically classify LSBs performance.

Clinical results of lumbar sympathetic blocks in lower limb complex regional pain syndrome using infrared thermography as a support tool.

AIM: To describe the clinical outcomes for a group of complex regional pain syndrome patients using infrared thermography as an intraprocedural support tool when undertaking fluoroscopy-guided lumbar sympathetic blocks. SUBJECTS: 27 patients with lower limb complex regional pain syndrome accompanied by severe pain and persistent functional impairment. METHODS: A series of three fluoroscopic-guided lumbar sympathetic blocks with local anesthetic and corticoids using infrared thermography as an intraprocedural support tool were performed. Clinical variables were collected at baseline, prior to each block, and one, three, and six months after blocks in a standardized checklist assessing each of the clinical categories of complex regional pain syndrome stipulated in the Budapest criteria. RESULTS: 23.75% of the blocks required more than one chance to achieve the desired thermal pattern and therefore to be considered as successful. A decrease in pain measured on a visual analogic scale was observed at all time points compared to pre-blockade data, but only 37% of the cases were categorized as responders, representing a ≥ 30% decrease in VAS, with the disappearance of pain at rest. An improvement of most of the clinical variables recorded was observed, such as tingling, edema, perception of thermal asymmetry, difference in coloring and sweating. There was a significant decrease of neuropathic pain and improvement of functional limitation. Logistic regression analysis showed the main variable to explain the probability of being a responder was immobilization time (odds ratio of 0.89). CONCLUSION: A series of fluoroscopy-guided lumbar sympathetic blocks controlled by infrared thermography in the treatment of lower limb CRPS showed a responder rate of 37%.

Does Nordic Walking technique influence the ground reaction forces?

BACKGROUND: Nordic Walking (NW) practice has increased during the last decade, generating great benefits related to the reduction of ground reaction forces (GRF). However, there is still limited evidence regarding how the NW technique could affect GRF. RESEARCH QUESTION: To analyze the effect of the speed and the differences in ground reaction forces (GRF) between NW with Diagonal technique (DT) versus Alpha technique (AT) and compare them with normal walking (W) METHODS: 29 male physically active sport science students were randomly assigned to one of the training groups: AT (n = 15) or DT (n = 14). After 5 technique familiarization sessions, participants performed 5 experimental trials on a walkway for both NW and W at two different walking speeds, previously randomized. A two-way repeated measures ANOVA analysis was carried out to find differences between speeds (preferred, fast) and gait (NW, W) as within-subject factors and NW techniques (DT vs AT) as between-subject factor. RESULTS: During NW, both technique groups (AT, DT) showed an increase in GRF variables compared to W, such as in stance time (2.9 % mean increment, p < 0.01, ES = 0.3; 95 %IC[-0.027, -0.008]), vertical force impact or vertical heel strike variables (4.9 % mean increment, p < 0.01, ES = 0.4; 95 %IC[0.101, 0.036]; 7.3 % mean increment, p < 0.01, ES = 0.8; 95 %IC[-0.133, -0.081] respectively). Moreover, AT group experienced significant lower forces at vertical force at midstance (10.1 % mean descent, p = 0.036, ES = 0.3; 95 %IC[-0.083, -0.009]) and higher forces at AP propulsive forces (23.7 % mean increment, p < 0.001, ES = 0.6; 95 %IC[0.078, 0.202) and ML max force (14.0 % mean increment, p = 0.045, ES = 0.3; 95 %IC[0.002, 0.026]) compared to DT group. Walking speed was significantly higher during NW (Preferred: 1.89 ± 0.18 m/s; Fast: 2.17 ± 0.21 m/s) compared to W (Preferred: 1.76 ± 0.15 m/s; Fast: 2.04 ± 0.19 m/s) in both speed conditions. SIGNIFICANCE: NW favours an increase in GRF and speed in comparison with Walking, independently of the technique, with no evidence that justifies the use of one technique or another.

Duration Effects on Wingate and Functional Power Threshold Test Outputs in Female Cyclists.

The response of female cyclists depending on the functional test duration has not been studied. This study aims to analyse the effect of modification of the duration of two different functional tests: Wingate (WAnT) and Functional Power Threshold (FTP) in female cyclists. Fourteen cyclists (27±8 years, 1,66±0,08 m, and 60,6±7,2 kg) performed 2 test days with a 24-hour break between days, varying the test duration (WAnT 20- or 30-sec, and FTP 8- or 10-min). Relative power output, cadence, heart rate, local oxygen saturation, lactate, and rating of perceived exertion were measured in each test. Time duration did not affect the power output outcomes in both tests (p>0,05). However, WAnT of 20 sec, compared with the test of 30 sec, resulted in a lower cadence decrease in the last 5 sec (p<0,01, ES=1,3), lower heart rate variables (peak, average and variation; p<0,01, ES>0,5), and higher execution inclination of local oxygen saturation (p<0,05 and ES=1,0). In conclusion, the time variations assessed do not alters power outcomes in female cyclists. However, higher acute fatigue can be observed in the WAnT of 30 sec, which suggests the use of the test of 20 sec to allow continue training afterwards.

Reproducibility of skin temperature analyses by novice and experienced evaluators using infrared thermography.

Infrared thermography (IRT) has become popular in several areas of knowledge. However, the analyses of thermal images often request manual actions, and little is known about the effect of the evaluator's experience on analysis thermal images. Here, we determine the reproducibility of IRT images analysis performed by evaluators with different levels of experience. Eight evaluators (GE, group experienced, n = 4; GN, group novice, n = 4) analyzed thermograms from 40 healthy participants recorded before and after exercise to determine the mean, minimum, maximum, standard deviation, and range of skin temperature in the anterior thigh and posterior leg. Before and after exercise, mean temperature showed excellent reproducibility for both groups for the anterior thigh (ICC >0.98) and posterior leg (ICC >0.94), and maximum temperature showed excellent reproducibility for both groups in the posterior leg (ICC >0.91). The influence of experience level was not significant considering the anterior thigh. Similarly, experience level did not affect the mean, maximum, and standard deviation temperature determined for the posterior leg. For the posterior leg, minimum temperature presented lower values and the range was higher among novice evaluators. Mean skin temperature showed narrower 95% limits of agreement than minimum and maximum for both regions and moments. Caution is advised when temperature ranges and minimums are determined by different evaluators. We conclude that for IRT analysis by evaluators with different levels of experience, the mean and maximum temperatures should be prioritized due to their better reproducibility.

Chronic and Acute Effects on Skin Temperature from a Sport Consisting of Repetitive Impacts from Hitting a Ball with the Hands.

Valencian handball consists in hitting the ball with the hands and it may contribute to injury development on the hands. This study aimed to analyze skin temperature asymmetries and recovery after a cold stress test (CST) in professional players of Valencian handball before and after a competition. Thirteen professional athletes and a control group of ten physically active participants were measured. For both groups, infrared images were taken at the baseline condition; later they underwent a thermal stress test (pressing for 2 min with the palm of the hand on a metal plate) and then recovery images were taken. In athletes, the images were also taken after their competition. Athletes at baseline condition presented lower temperatures (p < 0.05) in the dominant hand compared with the non-dominant hand. There were asymmetries in all regions after their match (p < 0.05). After CST, a higher recovery rate was found after the game. The regions with the most significant differences in variation, asymmetries and recovery patterns were the index, middle and ring fingers, and the palm of the dominant hand. Taking into account that lower temperatures and the absence of temperature variation may be the consequence of a vascular adaptation, thermography could be used as a method to prevent injuries in athletes from Valencian handball.

New Advances in Human Thermophysiology.

Human thermoregulation is the integrative physiological responses of the body used to maintain a core temperature with values close to 37 °C, even in a wide range of activities and environments [...].

Effects of different hydration supports on stride kinematics, comfort, and impact accelerations during running.

BACKGROUND: Different supports for hydration can influence total body mass and affect running biomechanics. RESEARCH QUESTION: Do different hydration supports affect the perceived exertion and comfort, stride kinematics, and impact accelerations during running? METHODS: This was a crossover study design. Thirteen trail runners completed a treadmill running test divided into four different durations and randomized hydration supports conditions, lasting 8 min each at moderate intensity: A) waist bag (0.84 kg); B) medium load backpack (0.84 kg); C) full load backpack (3.40 kg); and D) a control condition without water support. Impact accelerations were measured for 30 s in 4, 6, and 8 min. The rate of perceived exertion and heart rate were registered on minutes 4 and 8. At the last minute of each condition, comfort perception was registered RESULTS AND SIGNIFICANCE: No condition affected the stride kinematics. Full load backpack condition reduced head acceleration peak (-0.21 g; p = 0.04; ES=0.4) and head acceleration magnitude (-0.23 g; p = 0.03; ES=0.4), and increased shock attenuation (3.08 g; p = 0.04; ES=0.3). It also elicited higher perceived exertion (p < 0.05; ES>0.8) being considered heavier (p < 0.01; ES > 1.1). The waist bag condition was more comfortable in terms of noise (p = 0.006; ES=1.3) and humidity/heat (p = 0.001; ES=0.8). The waist bag was the most comfortable support. On the other hand, the full backpack elicited lower comfort and was the only generating compensatory adjustments. These results may help to improve design of full load backpack aiming at comfort for runners.

Consistency of pacing profile according to performance level in three different editions of the Chicago, London, and Tokyo marathons.

Running pacing has become a focus of interest over recent years due to its relationship with performance, however, it is still unknown the consistency of each race in different editions. The aim of this study is to analyze the consistency of pacing profile in three consecutive editions of three marathon races. A database of 282,808 runners, compiled from three different races (Chicago, London, and Tokyo Marathon) and three editions (2017, 2018, and 2019) was analyzed. Participants were categorized according to their time performance in the marathon, every 30 min from 2:30 h to sub-6 h. The relative speed of each section for each runner was calculated as a percentage of the average speed for the entire race. The intraclass correlation coefficients (ICC) of relative speed at the different pacing section, taking into account the runner time categories, was excellent over the three marathon editions (ICC > 0.93). The artificial intelligence model showed an accuracy of 86.8% to classify the runners' data in three marathons, suggesting a consistency between editions with identifiable differences between races. In conclusion, although some differences have been observed between editions in certain sections and marathon runner categories, excellent consistency of the pacing profile was observed. The study of pacing profile in a specific marathon can, therefore, be helpful for runners, coaches and marathon organizers for planning the race and improving its organization.

Skin temperature measurement in individuals with spinal cord injury during and after exercise: Systematic review.

BACKGROUND: Athletes with spinal cord injury (SCI) have difficulties in maintaining thermal homeostasis during exercise due to their lower sweat capacity and skin vasodilation. Skin temperature (Tsk) assessment, as opposed to core temperature, has become more widely accepted due to its non-invasive nature. The aims of this systematic review was to collate research studies that measured Tsk of individuals with SCI during or after exercise, study their Tsk response, taking into account the method employed, the environmental and exercise conditions, and to identify the different cooling strategies and their effect during exercise. METHODS: Pubmed, Web of Science and Scopus databases were searched to identify the articles published since year 2000. Two reviewers working independently extracted data and assessed the quality of the articles included. If they disagreed, a third reviewer was consulted. ROBINS-I scale was used to assess the quality of the articles, and the review has been conducted in agreement with PRISMA guidelines. RESULTS: Twenty studies were included in this review. 84% of them presented moderate, serious or critical risk of bias. The entire of the studies assessed Tsk during exercise, but only seven studies measured it during rest or after exercise. Eighteen studies used contact thermometry to assess Tsk and the two remaining studies employed non-contact techniques. Seven studies were conducted in warm conditions (>31.5°C) and the remaining studies in moderate conditions (10°C to 26.6°C). According to cooling strategies, ice vests and water spray are effective in reducing Tsk and decreasing the risk of heat stroke. CONCLUSIONS: The 90% of the studies applied contact thermometry and due to their effect in the data assessed, it is necessary more research into the SCI population using infrared thermography due to its differences in characteristics, methodology, and applications. The methodological differences among studies make difficult to perform a meta-analysis.

Effect of 10 km run on lower limb skin temperature and thermal response after a cold-stress test over the following 24 h.

Skin temperature assessment has received much attention as a possible measurement of physiological response against stress produced by exercise and research studies usually measure skin temperature 24 or 48 h after exercise. Scientific evidence about skin temperature evolution during the 24-h period immediately after exercising is, however, scarce. The aim was to assess the effect of a 10 km run at moderate intensity on baseline skin temperature and thermal response after a cold stress test during that 24 h period. Fourteen participants were measured before, immediately after, and at 2, 5, 9 and 24 h after a 10 km run at a perceived exertion rate of 11 points (max 20 points). Fourteen control participants who undertook no exercise were also measured during that day. The measurements included muscle pain and fatigue perception, reactive oxygen species, heart rate variability, skin temperature of the lower limbs, and skin temperature after cold stress test. Exercise resulted in a skin temperature increase (e.g., 0.5-1.3 °C of posterior leg 9 h after exercise) and this effect continued in some regions (0.4-0.9 °C of posterior leg) over that 24 h period. However, the thermal response to the cold stress test remained the same (p > 0.05). In conclusion, 10 km aerobic running exercise results in a skin temperature increase, peaking at between 5 and 9 h after exercise, but does not alter the thermal response to a cold stress test. This study provides a sound basis for post-exercise skin temperature response that can be used as a setting-off point for comparisons with future studies that analyze greater muscle damage.

Validity and Reliability of Two Near-infrared Spectroscopy Devices to Measure Resting Hemoglobin in Elite Cyclists.

A new method to monitor internal training load from muscle oxygen saturation using near-infrared spectroscopy could be of practical application for research and training purposes. This technology has been validated in different scientific fields, including sports science, and Humon Hex and Moxy are two leading brands. However, its relationship with hemoglobin has not been studied. Forty-eight professional cyclists, 19 men and 29 women, underwent a blood test to measure hemoglobin in the early morning. Immediately afterwards, hemoglobin and muscle oxygenation were monitored at rest by Moxy and Humon Hex on their right quadriceps (where the skinfold was measured). Venous blood hemoglobin was higher than the measurement for both devices (p<0.001). Both hemoglobin (p<0.001) and muscle oxygen saturation measurements (p<0.05) were higher in Humon Hex than for Moxy, and there was a reasonable reproducibility (ICC=0.35 for hemoglobin and 0.26 for muscle oxygen saturation). Skinfold had an inverse relationship with hemoglobin measurement (r=-0.85 p<0.001 for Humon Hex and r=-0.75 p<0.001 for Moxy). These findings suggest that resting hemoglobin data provided by these devices are not coincident with those of blood sample, and skinfold has an inverse relationship with blood hemoglobin measurement.

Physiological parameters and the use of compression stockings in individuals with spinal cord injuries: a scoping review.

STUDY DESIGN: Scoping review. OBJECTIVE: To summarize information on the physiological effects of compression stockings (CS) in individuals with spinal cord injuries (SCI) and suggest areas for future research. METHODS: We asked, "What are the physiological effects of CS use in individuals with SCI?" Original studies of patients with SCI regardless of sex and age that focused on SCI and CS were included. Five biomedical databases were searched. Studies were selected by three researchers in two stages, starting with an abstract and title screening and continuing with a full text review for application of the inclusion and exclusion criteria. A narrative synthesis was then performed. RESULTS: An initial search yielded 283 titles, of which five met the inclusion criteria and were subjected to the full text review. Among them, there were 78 individuals with SCI. The studies found that the use of CS at rest reduced deep vein thrombosis (DVT) and vascular capacitance but increased systolic blood pressure and norepinephrine level., three studies tested the use of CS During exercise; one found that time of the last lap in a standard court test was negatively affected; however, the greatest benefits were observed after exercises, such as reduced blood lactate level, improved autonomic function, and increased blood flow to the upper limbs. CONCLUSION: We conclude that future research should examine the physiological effects and relationship of CS with: (a) pharmacological interventions, (b) body position changes, (c) physical fitness level, (d) wheelchair use duration, (e) exercise-induced thermal stress, (f) thermal stress mitigation, and (g) edema reduction.

Skin Temperature Assessment During Lumbar Sympathetic Blocks by Infrared Thermography.

Complex Regional Pain Syndrome (CRPS) is a pain disorder that can be triggered by injuries or surgery affecting most often limbs. Its multifaceted pathophysiology makes its diagnosis and treatment a challenging work. To reduce pain, patients diagnosed with CRPS commonly undergo sympathetic blocks which involves the injection of a local anesthetic drug around the nerves. Currently, this procedure is guided by fluoroscopy which occasionally is considered as little accurate. For this reason, the use of infrared thermography as a technique of support has been considered.In this work, thermal images of feet soles in patients with lower limbs CRPS undergoing lumbar sympathetic blocks were recorded and evaluated. The images were analyzed by means of a computer-aided intuitive software tool developed using MATLAB. This tool provides the possibility of editing regions of interest, extracting the most important information of these regions and exporting the results data to an Excel file.Clinical Relevance- The final purpose of this work is to value the potential of infrared thermography and the analysis of its images as an intraoperatory technique of support in lumbar sympathetic blocks in patients with lower limbs CRPS.