Physiological responses to treadmill exercise in size- and fitness-matched male and female firefighter applicants.

Physiological responses during a standardised treadmill test for structural firefighting employment were compared in 41 pairs of size-matched, male and female applicants. Applicants wore personal exercise clothing, running shoes, and fire protective ensemble with self-contained breathing apparatus (added mass 21.2 ± 1.0 kg). Applicants walked at 1.56 m·s-1, completing a 5-min warm-up, 8-min at 10% grade, and then, progressive 1-min stages to exhaustion. The cut-score required completion of 13-min of exercise. Up to the cut-score, no differences in heart rate, oxygen uptake or minute ventilation were detected between sexes. At time 12:30-13:00 min, V̇O2 was 45.7 ± 0.6 vs. 44.2 ± 0.5 mL·kg-1·min-1 (body mass) for males and females, respectively. Despite similar physiological responses at minute 13, females worked at higher fractions of peak than males (p < 0.05). A second analysis compared a subset of 27 fitness-matched (V̇O2peak) male-female pairs. Fitness-matching further reduced or eliminated most observed differences in physiological responses, except small differences in breathing pattern. Practitioner Summary: Physiological responses during a standardised treadmill test for firefighter applicants were investigated in male and female applicants matched on size and fitness. Absolute responses to exercise were the same for both sexes when size-matched, but relative intensity was higher for females. Fitness-matching reduced or eliminated most previously observed differences. Abbreviations: NFPA: National Fire Protection Association; V̇O2: rate of oxygen consumption; V̇O2peak: rate of oxygen consumption at peak exercise; PAR-Q+: Physical Activity Readiness Questionnaire Plus; SCBA: self-contained breathing apparatus; ANOVA: analysis of variance; V̇E: minute ventilation; V̇Epeak: minute ventilation at peak exercise; V̇E/V̇O2: ventilatory equivalent for oxygen.

Ventilatory responses in males and females during graded exercise with and without thoracic load carriage.

PURPOSE AND METHODS: To compare the effects of thoracic load carriage on the ventilatory and perceptual responses to graded exercise, 14 pairs of height-matched, physically active males and females completed randomly ordered modified Balke treadmill exercise tests with and without a correctly sized and fitted 20.4 kg backpack and work clothing. Subjects walked at 1.56 m.s- 1 while grade was increased by 2% every 2 min until exhaustion. Ventilatory responses were measured with open circuit spirometry and perceptual responses were evaluated using the modified Borg scale. Inspiratory capacity maneuvers were performed to calculate operating lung volumes. RESULTS: Despite height matching, males had significantly greater lung volumes and peak oxygen uptake ([Formula: see text]O2peak). Peak [Formula: see text]O2 and ventilation ([Formula: see text]E) were lower (p < 0.05) for all subjects under load. Throughout exercise, the ventilatory equivalents for [Formula: see text]O2 and carbon dioxide production were significantly higher in females, independent of condition. At similar relative submaximal intensities (%[Formula: see text]O2peak), there was no difference in [Formula: see text]E between conditions in either group, however, all subjects adopted a rapid and shallow breathing pattern under load with decreased tidal volume secondary to lower end-inspiratory lung volume. The relative changes in breathing pattern and operating lung volume between unloaded and loaded conditions were similar between males and females. Females reported significantly higher dyspnea ratings for a given [Formula: see text]E compared to males; however, the relationship between dyspnea and [Formula: see text]E was unaffected by load carriage. CONCLUSION: The relative response patterns for ventilatory and perceptual responses to graded exercise with thoracic loading were similar in males and females.

Ventilatory responses to prolonged exercise with heavy load carriage.

PURPOSE: The purpose of this experiment was to study breathing pattern and operating lung volume during 45 min of exercise with a heavy backpack (25 kg) and examine the effect of this exercise on respiratory muscle strength. METHODS: Fifteen males completed randomly ordered graded exercise tests on a treadmill with and without a correctly sized and fitted 25 kg pack. Subsequently, each subject completed, in random order, on separate days, 45 min of treadmill walking with and without the pack. Oxygen demand was matched between conditions (loaded: 3.01 ± 0.11 and unloaded 3.02 ± 0.11 L min(-1)). RESULTS: With load, breathing frequency (f B) and minute ventilation increased by 21.7 and 15.1 % (P < 0.05), respectively, while tidal volume (V T) and end-inspiratory lung volume (EILV) were reduced by 6.3 and 6.4% (P < 0.05), respectively, compared to unloaded. Following loaded exercise, maximal inspiratory pressure decreased by 6.7% (P < 0.05) with no change in maximal expiratory pressure. No changes in maximal inspiratory or expiratory pressures were observed following unloaded exercise. Despite equivalent oxygen demand, perceived exercise stress and breathing discomfort was higher (P < 0.05) in the loaded condition. CONCLUSIONS: The mechanical disadvantage placed on the respiratory system during exercise with a heavy pack led to compensatory changes in breathing pattern and EILV, and a reduction in maximal inspiratory pressure post-exercise. We suggest that in an attempt to minimize the work of breathing, subjects adopted a shallow and frequent breathing pattern. However, this pattern increased deadspace and minute ventilation, which likely contributed to altered perceptions of exercise stress and breathing discomfort.

The impact of thoracic load carriage up to 45 kg on the cardiopulmonary response to exercise.

PURPOSE: The purposes of this experiment were to, first, document the effect of 45-kg thoracic loading on peak exercise responses and, second, the effects of systematic increases in thoracic load on physiological responses to submaximal treadmill walking at a standardized speed and grade. METHODS: On separate days, 19 males (age 27 ± 5 years, height 180.0 ± 7.4 cm, mass 86.9 ± 15.1 kg) completed randomly ordered graded exercise tests to exhaustion in loaded (45 kg) and unloaded conditions. On a third day, each subject completed four randomly ordered, 10-min bouts of treadmill walking at 1.34 m s(-1) and 4 % grade in the following conditions: unloaded, and with backpacks weighted to 15, 30, and 45 kg. RESULTS: With 45-kg thoracic loading, absolute oxygen consumption ([Formula: see text]), minute ventilation, power output, and test duration were significantly decreased at peak exercise. End-inspiratory lung volume and tidal volume were significantly reduced with no changes in end-expiratory lung volume, breathing frequency, and the respiratory exchange ratio. Peak end-tidal carbon dioxide and the ratio of alveolar ventilation to carbon dioxide production were similar between conditions. The reductions in peak physiological responses were greater than expected based on previous research with lighter loads. During submaximal treadmill exercise, [Formula: see text] increased (P < 0.05) by 11.0 (unloaded to 15 kg), 14.5 (15-30 kg), and 18.0 % (30-45 kg) showing that the increase in exercise [Formula: see text] was not proportional to load mass. CONCLUSION: These results provide further insight into the specificity of physiological responses to different types of load carriage.

Dopamine receptor blockade improves pulmonary gas exchange but decreases exercise performance in healthy humans.

Pulmonary gas exchange, as evaluated by the alveolar-arterial oxygen difference (A-aDO2), is impaired during intense exercise, and has been correlated with recruitment of intrapulmonary arteriovenous anastomoses (IPAVA) as measured by agitated saline contrast echocardiography. Previous work has shown that dopamine (DA) recruits IPAVA and increases venous admixture (Q̇s/Q̇t) at rest. As circulating DA increases during exercise, we hypothesized that A-aDO2 and IPAVA recruitment would be decreased with DA receptor blockade. Twelve healthy males (age: 25 ± 6 years, V̇O2 max : 58.6 ± 6.5 ml kg(-1) min(-1) ) performed two incremental staged cycling exercise sessions after ingestion of either placebo or a DA receptor blocker (metoclopramide 20 mg). Arterial blood gas, cardiorespiratory and IPAVA recruitment (evaluated by agitated saline contrast echocardiography) data were obtained at rest and during exercise up to 85% of V̇O2 max . On different days, participants also completed incremental exercise tests and exercise tolerance (time-to-exhaustion (TTE) at 85% of V̇O2 max ) with or without dopamine blockade. Compared to placebo, DA blockade did not change O2 consumption, CO2 production, or respiratory exchange ratio at any intensity. At 85% V̇O2 max , DA blockade decreased A-aDO2, increased arterial O2 saturation and minute ventilation, but did not reduce IPAVA recruitment, suggesting that positive saline contrast is unrelated to A-aDO2. Compared to placebo, DA blockade decreased maximal cardiac output, V̇O2 max and TTE. Despite improving pulmonary gas exchange, blocking dopamine receptors appears to be detrimental to exercise performance. These findings suggest that endogenous dopamine is important to the normal cardiopulmonary response to exercise and is necessary for optimal high-intensity exercise performance.

The Validity and Reliability of a Treadmill Test for Structural Firefighter Applicants.

OBJECTIVE: This 2-part study evaluated validity and reliability of a treadmill test for structural firefighters. METHODS: Wearing fire protective ensemble, 260 participants walked at 1.56 m·s-1, completing a 5-min warm-up, an 8-min stage at a 5.71° incline, then graded stages to exhaustion. In Part 2, 21 participants completed the test on 3 separate days under standardized conditions. RESULTS: Average (±SD) oxygen uptake () during minutes 1-13 was similar to reported values for simulated fire-rescue work. During the 13th min, was consistent with recommendations for firefighters. in Part 2, exercise duration increased between trials 1 and 2 before stabilizing but was consistent. CONCLUSIONS: Congruence with reported during simulated firefighting and recommendations for confirmed validity. Acceptable test-retest reliability was demonstrated. We conclude that the test is valid and reliable for evaluating cardiorespiratory endurance for firefighting.

Reductions in cerebral blood flow during passive heat stress in humans: partitioning the mechanisms.

Cerebral blood flow (CBF) is reduced during passive heat stress, with 50% of this reduction associated with hyperventilatory-induced hypocapnia and subsequent cerebral vasoconstriction. It remains unknown, however, what other factors may contribute to the remaining 50%. We tested the hypothesis that the distribution of cardiac output plays an important role in maintaining cerebral perfusion during mild and severe heat stress. Middle cerebral artery and posterior cerebral artery blood flow velocity (MCAv and PCAv; transcranial Doppler) and left ventricular end-diastolic and end-systolic volumes (2-D echocardiography) were measured under conditions of normothermia and mild and severe passive heat stress (core temperature +0.8 ± 0.1°C (Protocol I; n = 10) and 1.8 ± 0.1°C (Protocol II; n = 8) above baseline). Venous return was manipulated by passive tilt table positioning (30 deg head-down tilt (HDT) and 30 deg head-up tilt (HUT)). Measurements were made under poikilocapnic and isocapnic conditions. Protocol I consisted of mild heat stress which resulted in small reductions in end-tidal CO2 (−5.6 ± 3.5%), MCAv/PCAv (−7.3 ± 2.3% and −10.3 ± 2.9%, respectively) and stroke volume (−8.5 ± 4.2%); while end-diastolic volume was significantly reduced (−16.9 ± 4.0%) and cardiac output augmented (17.2 ± 7.4%). During mild heat stress, CBF was related to left ventricular end-diastolic volume (MCAv, r2 = 0.81; PCAv, r2 = 0.83; P < 0.05) and stroke volume (MCAv, r2 = 0.38; PCAv, r2 = 0.43), but not with cardiac output. Protocol II consisted of severe heat stress which resulted in much greater reductions in end-tidal CO2 (−87.5 ± 31.5%) and CBF (MCAv, −36.4 ± 6.1%; PCAv, −30.1 ± 4.8%; P < 0.01 for all variables), while end-diastolic volume and stroke volume decreased to a similar extent as for mild heat stress. Importantly, isocapnia restored MCAv and PCAv back to normothermic baseline. This investigation therefore produced two novel findings: first, that venous return and stroke volume are related to CBF during mild heat stress; and second, that hyperventilatory hypocapnia has a major influence on CBF during severe passive heat stress.

Left ventricular systolic and diastolic function during tilt-table positioning and passive heat stress in humans.

The ventricular response to passive heat stress has predominantly been studied in the supine position. It is presently unclear how acute changes in venous return influence ventricular function during heat stress. To address this question, left ventricular (LV) systolic and diastolic function were studied in 17 healthy men (24.3 ± 4.0 yr; mean ± SD), using two-dimensional transthoracic echocardiography with Doppler ultrasound, during tilt-table positioning (supine, 30° head-up tilt, and 30° head-down tilt), under normothermic and passive heat stress (core temperature 0.8 ± 0.1°C above baseline) conditions. The supine heat stress LV volumetric and functional response was consistent with previous reports. Combining head-up tilt with heat stress reduced end-diastolic (25.2 ± 4.1%) and end-systolic (65.4 ± 10.5%) volume from baseline, whereas heart rate (37.7 ± 2.0%), ejection fraction (9.4 ± 2.4%), and LV elastance (37.7 ± 3.6%) increased, and stroke volume (-28.6 ± 9.4%) and early diastolic inflow (-17.5 ± 6.5%) and annular tissue (-35.6 ± 7.0%) velocities were reduced. Combining head-down tilt with heat stress restored end-diastolic volume, whereas LV elastance (16.8 ± 3.2%), ejection fraction (7.2 ± 2.1%), and systolic annular tissue velocities (22.4 ± 5.0%) remained elevated above baseline, and end-systolic volume was reduced (-15.3 ± 3.9%). Stroke volume and the early and late diastolic inflow and annular tissue velocities were unchanged from baseline. This investigation extends previous work by demonstrating increased LV systolic function with heat stress, under varied levels of venous return, and highlights the preload dependency of early diastolic function during passive heat stress.

Evidence for Validity and Reliability, and Development of Performance Standards and Cut-Scores for Job-Related Tests of Physical Aptitude for Structural Firefighters.

OBJECTIVE: This multi-part study aimed to revise an existing battery of physical aptitude tests for firefighter applicants. Test validity and reliability were evaluated and performance thresholds were determined. METHODS: In Part I, 49 structural firefighters rated the similarity between the physical demands of the tests and corresponding work activities. In Part II, 23 participants completed the tests on 3 separate days. In Part III, cut-scores were determined using the Bookmark method by an expert panel of 25 firefighter supervisors. RESULTS: Analysis revealed high levels of validity and reliability. The expert panel provided invaluable direction through a combination of independent and group work, leading to consensus on acceptable completion times. CONCLUSION: Rigorous processes established scientific credibility for the revised battery of tests. Expert knowledge from firefighter supervisors contributed to determining cut-scores following established scientific methods.

Increased left ventricular twist, untwisting rates, and suction maintain global diastolic function during passive heat stress in humans.

Left ventricular (LV) systolic function increases with passive heat stress (HS); however, less is known about diastolic function. Eight healthy subjects (24.0 +/- 2.0 yr of age) underwent whole body passive heating approximately 1 degrees C above baseline (BL). Cardiac magnetic resonance imaging was used to measure biventricular volumes, function, filling velocities, volumetric flow rates, and LV twist and strain at BL and after 45 min of HS. Passive heating reduced left atrial volume (-17.6 +/- 11.7 ml, P < 0.05), right and LV end-diastolic volumes (-22.7 +/- 11.0 and -25.7 +/- 24.9 ml, respectively; P < 0.05), and LV stroke volume (-6.7 +/- 6.8 ml, P < 0.05) from BL. LV ejection fraction (EF), end-systolic elastance, septal and lateral mitral annular systolic velocities, circumferential strain, and peak LV twist increased with HS (P < 0.05). Right ventricular stroke volume, EF, and systolic tissue velocities were unchanged with HS (P > 0.05). Early LV diastolic tissue and blood velocities and strain rates were maintained with HS, whereas untwisting rate increased significantly from 166.4 +/- 46.9 to 268.7 +/- 76.8 degrees /s (P < 0.05). The major novel finding of this study was that, secondary to an increase in peak LV twist and untwisting rate, early diastolic blood and tissue velocities and strain rates are maintained despite a reduction in filling pressure.

Heart rate variability and muscle sympathetic nerve activity response to acute stress: the effect of breathing.

Previous research has suggested a relationship between low-frequency power of heart rate variability (HRV; LF in normalized units, LFnu) and muscle sympathetic nerve activity (MSNA). However, investigations have not systematically controlled for breathing, which can modulate both HRV and MSNA. Accordingly, the aims of this experiment were to investigate the possibility of parallel responses in MSNA and HRV (LFnu) to selected acute stressors and the effect of controlled breathing. After data were obtained at rest, 12 healthy males (28 +/- 5 yr) performed isometric handgrip exercise (30% maximal voluntary contraction) and the cold pressor test in random order, and were then exposed to hypoxia (inspired fraction of O(2) = 0.105) for 7 min, during randomly assigned spontaneous and controlled breathing conditions (20 breaths/min, constant tidal volume, isocapnic). MSNA was recorded from the peroneal nerve, whereas HRV was calculated from ECG. At rest, controlled breathing did not alter MSNA but decreased LFnu (P < 0.05 for all) relative to spontaneous breathing. MSNA increased in response to all stressors regardless of breathing. LFnu increased with exercise during both breathing conditions. During cold pressor, LFnu decreased when breathing was spontaneous, whereas in the controlled breathing condition, LFnu was unchanged from baseline. Hypoxia elicited increases in LFnu when breathing was controlled, but not during spontaneous breathing. The parallel changes observed during exercise and controlled breathing during hypoxia suggest that LFnu may be an indication of sympathetic outflow in select conditions. However, since MSNA and LFnu did not change in parallel with all stressors, a cautious approach to the use of LFnu as a marker of sympathetic activity is warranted.

Effects of self-contained breathing apparatus on ventricular function during strenuous exercise.

The purpose of this study was to investigate left-ventricular function during strenuous exercise with the self-contained breathing apparatus (SCBA). With the use of two-dimensional echocardiography, images of the left ventricle (LV) were acquired during sustained exercise (3 x 10 min) under two conditions: 1) SCBA, or 2) low resistance breathing valve. Twenty healthy men volunteered for the study, and in each condition subjects wore fire protective equipment. Heart rate, systolic blood pressure, cavity areas during systole and diastole (ESCA and EDCA, respectively), esophageal pressure, ventilation rate, oxygen consumption, perceived physical, thermal and respiratory distress, and core temperature were measured at regular intervals. Urine specific gravity (<1.020 g/ml) and hematological variables were used to infer hydration status. All subjects began both trials in a euhydrated state. No differences were found between conditions for heart rate, systolic blood pressure, ventilation rate, oxygen consumption, perceived distress, or any hematological variables. Peak expiratory esophageal pressure was always higher (P < 0.05), while EDCA and stroke area (SA) were significantly lower (P < 0.05) with the SCBA. ESCA, end-systolic transmural pressure (ESTMP), and LV contractility (ESTMP/ESCA) were similar between conditions. Sustained exercise with fire protective equipment resulted in significant reductions in EDCA, ESCA, and SA from the start of exercise, which was associated with a 6.3 +/- 0.8% reduction in plasma volume, an increase in core temperature (37.0 +/- 0.4 to 38.8 +/- 0.3 degrees C), and a significant increase in heart rate (146.9 +/- 2.1 to 181.7 +/- 2.4 beats/min) throughout exercise. The results from this study support research by others showing that increased intrathoracic pressure reduces LV preload (EDCA); however, the novelty of the present study is that when venous return is compromised by sustained exercise and heat stress, SA cannot be maintained.

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.

Influence of work clothing on physiological responses and performance during treadmill exercise and the Wildland Firefighter Pack Test.

This study investigated physiological responses and performance during three separate exercise challenges (Parts I, II, and III) with wildland firefighting work clothing ensemble (boots and coveralls) and a 20.4 kg backpack in four conditions: U-EX (no pack, exercise clothing); L-EX (pack, exercise clothing); U-W (no pack, work clothing); and, L-W (pack and work clothing). Part I consisted of randomly-ordered graded exercise tests, on separate days, in U-EX, L-EX and L-W conditions. Part II consisted of randomly-ordered bouts of sub-maximal treadmill exercise in the four conditions. In Part III, subjects completed, in random-order on separate days, 4.83 km Pack Tests in L-EX or L-W conditions. In Part I, peak oxygen uptake was reduced (p < .05) in L-W. In Part II, mass-specific oxygen uptake was significantly higher in both work clothing conditions. In Part III, Pack Test time was slower (p < .05) in L-W. These results demonstrate the negative impact of work clothing and load carriage on physiological responses to exercise and performance.

The Influence of Body Mass on Physical Fitness Test Performance in Male Firefighter Applicants.

OBJECTIVE: The influence of body mass on test performance was investigated in 414 male firefighter applicants who completed a maximal treadmill test and five task-simulation tests while dressed in fire protective ensemble. METHODS: Subjects were assigned to six mass categories from less than 70 kg to more than 110 kg, in 10 kg increments (n = 69 in each). RESULTS: Treadmill performance was lower (P < 0.05) in the two heaviest groups. Charged hose advance time was slower in the two lightest groups. The lightest group had slower times for weighted sled pull, forcible entry, and victim rescue tests. The heaviest group was slower on the ladder climb test. CONCLUSION: Lighter subjects had a small advantage in endurance-oriented tests while higher mass appeared to improve performance slightly in strength-oriented tests. However, mass explained only 4% to 19% of the variance in performance.

Does fitness level modulate the cardiovascular hemodynamic response to exercise?

Subjects with greater aerobic fitness demonstrate better diastolic compliance at rest, but whether fitness modulates exercise cardiac compliance and cardiac filling pressures remains to be determined. On the basis of maximal oxygen consumption (VO2max), healthy male subjects were categorized into either low (LO: VO2max=43+/-6 ml.kg-1.min-1; n=3) or high (HI: VO2max=60+/-3 ml.kg-1.min-1; n=5) aerobic power. Subjects performed incremental cycle exercise to 90% Vo(2max). Right atrial (RAP) and pulmonary artery wedge (PAWP) pressures were measured, and left ventricular (LV) transmural filling pressure (TMFP=PAWP-RAP) was calculated. Cardiac output (CO) and stroke volume (SV) were determined by direct Fick, and LV end-diastolic volume (EDV) was estimated from echocardiographic fractional area change and Fick SV. There were no between-group differences for any measure at rest. At a submaximal workload of 150 W, PAWP and TMFP were higher (P<0.05) in LO compared with HI (12 vs. 8 mmHg, and 9 vs. 4 mmHg, respectively). At peak exercise, CO, SV, and EDV were lower in LO (P<0.05). RAP was not different at peak exercise, but PAWP (23 vs. 15 mmHg) and TMFP (12 vs. 6 mmHg) were higher in LO (P<0.05). Compared with less fit subjects, subjects with greater aerobic fitness demonstrated lower LV filling pressures during exercise, whereas SV and EDV were either similar (submaximal exercise) or higher (peak exercise), suggesting superior diastolic function and compliance.

Effect of acute increases in pulmonary vascular pressures on exercise pulmonary gas exchange.

The purpose of this study was to determine the effect of acute increases in pulmonary vascular pressures, caused by the application of lower-body positive pressure (LBPP), on exercise alveolar-to-arterial PO2 difference (A-aDO2), anatomical intrapulmonary (IP) shunt recruitment, and ventilation. Eight healthy men performed graded upright cycling to 90% maximal oxygen uptake under normal conditions and with 52 Torr (1 psi) of LBPP. Pulmonary arterial (PAP) and pulmonary artery wedge pressures (PAWP) were measured with a Swan-Ganz catheter. Arterial blood samples were obtained from a radial artery catheter, cardiac output was calculated by the direct Fick method, and anatomical IP shunt was determined by administering agitated saline during continuous two-dimensional echocardiography. LBPP increased both PAP and PAWP while upright at rest, and at all points during exercise (mean increase in PAP and PAWP 3.7 and 4.0 mmHg, respectively, P<0.05). There were no differences in exercise oxygen uptake or cardiac output between control and LBPP. Despite the increased PAP and PAWP with LBPP, A-aDO2 was not affected. In the upright resting position, there was no evidence of shunt in the control condition, whereas LBPP caused shunt in one subject. At the lowest exercise workload (75 W), shunt occurred in three subjects during control and in four subjects with LBPP. LBPP did not affect IP shunt recruitment during subsequent higher workloads. Minute ventilation and arterial PcO2 were not consistently affected by LBPP. Therefore, small acute increases in pulmonary vascular pressures do not widen exercise A-aDO2 or consistently affect IP shunt recruitment or ventilation.

Physiological and performance consequences of heavy thoracic load carriage in females.

The purposes of this experiment were to study physiological responses to graded exercise to exhaustion (Part I) and ventilatory responses during 45 min of exercise (Part II) with and without a 25-kg backpack. In Part I, on separate days, 24 females completed randomly ordered modified Balke treadmill tests. Analysis revealed significant decreases in absolute peak oxygen uptake (3.5%), peak power output (20%), and test duration (40%) under load. There was a significant but modest negative relationship between body mass and the change in test duration between conditions (r = -0.44). While physiological responses to peak exercise were similar, exercise performance was negatively impacted under load. On separate days in Part II, 14 females completed randomly ordered, loaded and unloaded exercise challenges of submaximal treadmill walking at matched oxygen demands. Under load, breathing frequency, dead space, and minute ventilation were increased by 19.9%, 29.8%, and 11.6% (P < 0.05), respectively, while tidal volume and end-inspiratory lung volume decreased by 13.6% and 6.0% (P < 0.05), respectively. After loaded exercise, maximal inspiratory pressure was decreased by 11.5% (P < 0.05) with no changes in maximal expiratory pressure in either condition. Despite matched oxygen uptake between loaded and unloaded exercise challenges, perceived exertion and breathing discomfort were higher (P < 0.05) under load. With heavy load carriage, the altered breathing pattern led to increased dead space and minute ventilation, which likely contributed to higher perceptions of exercise stress and breathing discomfort. These results are similar to previous research in males and underscore the impact of heavy load carriage during exercise.

Load carriage, human performance, and employment standards.

The focus of this review is on the physiological considerations necessary for developing employment standards within occupations that have a heavy reliance on load carriage. Employees within military, fire fighting, law enforcement, and search and rescue occupations regularly work with heavy loads. For example, soldiers often carry loads >50 kg, whilst structural firefighters wear 20-25 kg of protective clothing and equipment, in addition to carrying external loads. It has long been known that heavy loads modify gait, mobility, metabolic rate, and efficiency, while concurrently elevating the risk of muscle fatigue and injury. In addition, load carriage often occurs within environmentally stressful conditions, with protective ensembles adding to the thermal burden of the workplace. Indeed, physiological strain relates not just to the mass and dimensions of carried objects, but to how those loads are positioned on and around the body. Yet heavy loads must be borne by men and women of varying body size, and with the expectation that operational capability will not be impinged. This presents a recruitment conundrum. How do employers identify capable and injury-resistant individuals while simultaneously avoiding discriminatory selection practices? In this communication, the relevant metabolic, cardiopulmonary, and thermoregulatory consequences of loaded work are reviewed, along with concomitant impediments to physical endurance and mobility. Also emphasised is the importance of including occupation-specific clothing, protective equipment, and loads during work-performance testing. Finally, recommendations are presented for how to address these issues when evaluating readiness for duty.