TOSH
Research
The world-class team of scientists and trainers at the Institute for Sport Science and Medicine (ISSM) are on the cutting edge of research in performance enhancement and injury prevention. Collectively, these research programs generate dozens of publications in scientific, medical and sports journals each year.
Through an innovative partnership with the College of Health and Department of Bioengineering at the University of Utah, ISSM supports several doctoral-level graduate students with its graduate research fellowship program. Working in close collaboration with ISSM, scientists, doctors, therapists and students are developing a better understanding of factors that affect human performance and the risk of injury to sports participants of all ages and levels.
ISSM's research staff is currently involved in:
Pelvic Angle Study – Steve Swanson
Running in general and sprinting in particular are frequent topics of biomechanics research. Despite this, research examining the role of pelvic tilt in running is sparse. Several top track and field coaches have proposed that a posterior pelvic tilt will put the runner in a more mechanically efficient sprinting posture and will result in increased stride length and running velocity. Despite the recommendations of these coaches, the pelvic tilt phenomenon and its effects on sprinting mechanics are not well understood. The purpose of our study is to examine the interaction between pelvic tilt and sprinting kinematics. The proposed study has three hypotheses. The first hypothesis is that pelvic tilt can be used as a criterion for sprinter selection. The second hypothesis is that pelvic tilt angle is related to sprint training history. The third hypothesis is that pelvic tilt can be correlated with running speed. The proposed design for testing these hypotheses involves collecting data at different velocities ranging from 80-100% maximal speed before and after a sprint training protocol. Results from this portion of the study should provide data to help answer whether pelvic tilt is a useful criterion for sprinter selection, whether pelvic tilt can be correlated to running velocities, and whether pelvic tilt changes as a result of training. Based on the literature, it is expected that a greater posterior pelvic tilt will be associated with better sprinters, regardless of their training history; performance enhancement due to prolonged training will be associated with greater posterior pelvic tilt; and that greater sprinting speed will be associated with greater posterior pelvic tilt. This study will be done in collaboration with Louisiana State University, Baton Rouge, LA., Li Li, PhD and his PhD student Michael A. Young approached ISSM to do this study as collaboration due to the combined resources of LSU and ISSM. ISSM's real-time Motion Analysis System and our access to the proposed subjects within our training facilities were attractive to Dr. Li and Mr. Young. ISSM was excited to work with Dr. Li and Mr. Young, as they have been studying sprinting mechanics and coordination dynamics for quite some time. Mr. Young also serves as a sport scientist/coach for USA track and field. International Olympic Committee Nutrition Project – Nanna Meyer
Inadequate diets can negatively impact sport training adaptation and performance, and increase the risk of injury and illness. Limited data are available on the diets of winter sport athletes, and no study has examined dietary differences between non-specific (conditioning) and specific (on-ice/on-snow) training periods. The objective of this study is to examine energy and nutrient intakes, supplementation, and iron status in male and female athletes of selected winter sports (n=60, including disabled athletes not part of the IOC grant). Energy, nutrient, and fluid intake during non-specific and specific training periods will be compared. In females, we will examine the prevalence of the female athlete triad (disordered eating/amenorrhea/osteoporosis). In addition, we will compare bone mineral density at the lumbar spine, proximal femur, and whole body in all participants (males and females) among different winter sports athletes (n = 40) grouped into 2 categories based on general loading characteristics and controls (n = 40). Validity and Reliability of Physiological Testing – Markus Amann
Stage races, like the Tour de France, Giro d'Italia, and Vuelta a España, are the premier events in professional road cycling and there is intense interest in identifying techniques to predict potential success in 3-week stage races. According to the results of stage races over the past years, time trial performance, the most common being the 40 km distance, is the main predictor of overall race standings in 3-week stage races. Time trial experts focus on meeting the requirements to be top competitors on all terrain (level and uphill). Some of the best time trial specialists within the last decade have matched and often surpassed the performance of lighter uphill cyclists during mountain climbs. Padilla et al. concluded that time trial specialists have an overall performance advantage over the other groups (flat terrain riders, sprinters, all terrain riders, uphill riders) for all cycling terrains. It is now recognized that maximal performance in long-distance events, such as the 40 km time trial, is not only determined by maximal oxygen uptake (VO2max) but especially on the percentage of VO2max that can be sustained over a prolonged time. At or below this specific intensity of exercise, endurance is mainly a function of fuel supply, body temperature, or soft tissue trauma. Outstanding performance at this intensity can be associated with a combination of several factors, including a high percentage of type I muscle fibers, the capacity to store large amounts of muscle and/or liver glycogen, the capacity to spare carbohydrate to reserve by using more fatty acids as energy substrates, and the capacity to efficiently dissipate heat. Above this intensity a significant reduction occurs in endurance time that may be dependent on metabolic disturbances related to acidosis. Theoretically, measurement of the so-called "anaerobic threshold" should provide an indication of this percentage because sustained increase in blood lactate concentration and metabolic acidosis, which occur at exercise intensities above this point, are associated with a decrease in the duration that exercise can be sustained. In recent years, controversy started to surround the term anaerobic threshold. Evidence has accumulated that dissociates lactate production and metabolic acidosis from anaerobiosis. Studies performed over the last 15 years using isotopic tracer technology have suggested that muscles can release lactate when their oxygen supply is more than adequate. Moreover, evidence that muscles become anaerobic when exercise approaches an intensity at which blood lactate level rises precipitously is in dispute. In order to pay tribute to these findings, the term "anaerobic threshold" is replaced by the term "performance threshold" (PT) in our laboratory. However, the assessment of the performance threshold from ventilatory variables or from lactate analyses or from a combined analysis of ventilatory and lactate variables has been refined over the years to better predict performance and guide training strategies. Many researchers have proposed a wide variety of invasive and noninvasive laboratory based strategies to identify this intensity. Nevertheless, a controversy exists not only about whether there is a coincidental relationship between the lactate threshold and the ventilatory threshold (VT) or not, but also about which is a better predictor for prolonged endurance performance. There are numerous methods available in the literature to predict prolonged endurance performance. These methods can be classified into two categories, namely direct and indirect methods. Direct methods (e.g., 40-km time trial on an ergometer in a laboratory) bring together many indices that allow either a complete or a partial representation of the power-duration relationship, whereas indirect methods revolve around the determination of the performance threshold. With regard to direct methods, performance in a series of tests provides a more complete and presumably more valid description of the power-duration relationship than performance in a single test, even if both approaches are well correlated with each other. The problem with direct methods is that they are too stressful to be utilized throughout a competitive season and they might interfere with existing training theories or practices. As for indirect methods, there is a quantitative accumulation of data supporting the utilization of the PT to assess endurance performance and to prescribe training intensities. However, it appears that there is no unique intensity corresponding to the performance threshold, because the wide variety of determination methods available in the literature provide inconsistent results. Thus, the question regarding a valid and reliable predictor for prolonged endurance performance (among the several available performance threshold assessment methods) remains open and needs to be addressed. Limiting Factors of Cycling Performance – Markus Amann
Previous studies have suggested that identifying physiological parameters, such as lactate threshold (Stegmann et al., 1992; Aunola et al., 1991), ventilatory threshold (Hoogeveen et al., 1997), and maximal lactate steady state (Beneke et al., 2000; Baldari et al., 2000; Urhausen et al., 1993) may be useful predictors of prolonged cycling performances. The process of identifying these parameters is based on laboratory test methods. The purpose of this study is to determine which of these methods is the best predictor for a 40-km time trial. The goal is to come up with a valid and reliable lab-based test that enables coaches and athletes to a) correctly direct their training with regard to exercise intensity and duration, b) provide feedback about the optimal race pace for a 40 km time trial, and c) predict an athlete's 40 km time trial performance from a less stressful test. Effects of Hyperoxic/Hypoxic Training – Andy Subudhi
Altitude related research projects are being conducted in collaboration with: 1. Palo Alto Veterans Affairs Health Care System, Palo Alto, CA & US Army Research Institute of Environmental Medicine, Natick, MA.
Collaborative research effort with The University of Colorado Health Science Center The goal of this proposal is to determine the role of brain swelling in the pathophysiology of acute altitude illness, also known as acute mountain sickness (AMS). It has been shown that exercise caused a >3 fold rise in AMS symptom severity, a drop in arterial oxygen saturation (SaO2) during exercise, and slight fluid retention. In addition, it was shown that subjects ill with AMS had a small drop in plasma volume and a large rise in extracellular water compared to those that remained free of AMS. In further studies, magnetic resonance imaging revealed that most brains swell when humans ascend to high altitude. The overall hypothesis is that brain swelling, which can include elevated brain water and blood volume, causes the symptoms of AMS. The approach is to use several new and innovative technologies to dissect the role of cellular, molecular, and physiological responses in the pathophysiology of AMS. The new and innovative approaches include measurement in humans acutely deprived of oxygen of 1) nitric oxide (NO) production; 2) vascular endothelial growth factor (VEGF); and 3) heat shock factor/heat shock protein72 (HSF/HSP72);. In addition the study will make the first noninvasive measurements of cerebral perfusion pressure (eCPP), intracranial pressure (eICP), cerebral blood volume (CBV), blood-brain barrier (BBB) permeability, brain water and craniospinal volumes in humans exposed to acute hypoxia for 9 hrs. Although many hundreds of studies of AMS over the past two centuries have examined the role of ventilation, pulmonary gas exchange and fluid balance, the pathophysiology of AMS remains largely unsolved (see Hackett and Roach, NEJM, 345:2, 2001 for a recent review). This proposal focuses on the role of brain swelling in the pathophysiology of AMS, and uses exercise as a tool to develop more severe symptoms of AMS sooner than would be the case in resting subjects. The approach proposed here departs from the traditional paradigm, followed by many in this field, of searching for pathophysiological clues in the peripheral responses (pulmonary, renal, vascular) observed in AMS. The justification for focusing on brain swelling is that a) the symptoms of AMS are largely neurological; b) high altitude cerebral edema (HACE), considered the end-stage of severe AMS, has recently been identified as a vasogenic edema, opening the door for a role for BBB permeability in AMS; c) new, noninvasive techniques make measurement of brain water and CBV possible; and d) available experimental evidence and theoretical arguments support a significant role for brain swelling in the pathophysiology of AMS. Cerebral Oxygenation During Maximal Exercise – Andy Subudhi
Collaborative research effort with The University of Colorado Health Science Center Factors that limit human exercise performance are a subject of debate in the scientific community. Many investigations have focused on peripheral factors, such as muscle oxygenation, thought to be associated with fatigue during intense exercise, yet these studies have fallen short of providing an adequate explanation of the phenomenon. Thus, theories identifying the central nervous system as the ultimate governor of maximal exercise performance have attracted recent attention. This study will explore the role of cerebral oxygenation as a limiting factor to maximal exercise. Near infrared spectroscopy (NIRS) allows non-invasive monitoring of central and peripheral changes in oxygenation during exercise (reviewed in Ide and Secher 2000) that may provide valuable insight into factors affecting fatigue. During exercise of moderate to high intensity, muscle oxygenation decreases in proportion to increased metabolic demand (Hansen et al. 1996). However, near maximal exercise intensity, muscle oxygenation plateaus at a theoretical minimum (Belardinelli et al. 1995). Such results are consistent with the theory that maximal exercise is limited by muscle oxygenation. In contrast, cerebral oxygenation remains stable or increases during moderate intensity exercise (Ide et al. 1999) and decreases only near maximal intensity (Nielsen et al. 1999), suggesting a relationship between cerebral oxygenation and maximal exercise capacity. Additionally, Nielsen et al. (1999) demonstrated that administration of supplemental oxygen during incremental exercise to maximal exertion prolonged endurance by maintaining cerebral oxygenation rather than enhancing muscle oxygenation. These exciting findings provide empirical evidence linking cerebral oxygenation to fatigue and implore further study. Field observations recorded by NIRS during incremental exercise tests to maximal exertion at high altitude (5,260 meters, 17,250 feet) appear to magnify the drop in cerebral oxygenation preceding the voluntary termination of exercise (Colier et al. 2000). These preliminary results demonstrate the utility of using hypoxia as a novel model to study the association between cerebral oxygenation and fatigue. The purpose of this pilot study is to develop a controlled laboratory model to quantify the effects of maximal exercise on cerebral oxygenation in a hypoxic environment.
- Pelvic Angle Study – Steve Swanson
- International Olympic Committee Nutrition Project – Nanna Meyer
- Validity and Reliability of Physiological Testing – Markus Amann
- Limiting Factors of Cycling Performance – Markus Amann
- Effects of Hyperoxic/Hypoxic Training – Andy Subudhi
- Exercise-Induced Rise in the Severity of Acute Altitude Illness - Andy Subudhi
- Cerebral Oxygenation During Maximal Exercise - Andy Subudhi
Pelvic Angle Study – Steve Swanson
Running in general and sprinting in particular are frequent topics of biomechanics research. Despite this, research examining the role of pelvic tilt in running is sparse. Several top track and field coaches have proposed that a posterior pelvic tilt will put the runner in a more mechanically efficient sprinting posture and will result in increased stride length and running velocity. Despite the recommendations of these coaches, the pelvic tilt phenomenon and its effects on sprinting mechanics are not well understood. The purpose of our study is to examine the interaction between pelvic tilt and sprinting kinematics. The proposed study has three hypotheses. The first hypothesis is that pelvic tilt can be used as a criterion for sprinter selection. The second hypothesis is that pelvic tilt angle is related to sprint training history. The third hypothesis is that pelvic tilt can be correlated with running speed. The proposed design for testing these hypotheses involves collecting data at different velocities ranging from 80-100% maximal speed before and after a sprint training protocol. Results from this portion of the study should provide data to help answer whether pelvic tilt is a useful criterion for sprinter selection, whether pelvic tilt can be correlated to running velocities, and whether pelvic tilt changes as a result of training. Based on the literature, it is expected that a greater posterior pelvic tilt will be associated with better sprinters, regardless of their training history; performance enhancement due to prolonged training will be associated with greater posterior pelvic tilt; and that greater sprinting speed will be associated with greater posterior pelvic tilt. This study will be done in collaboration with Louisiana State University, Baton Rouge, LA., Li Li, PhD and his PhD student Michael A. Young approached ISSM to do this study as collaboration due to the combined resources of LSU and ISSM. ISSM's real-time Motion Analysis System and our access to the proposed subjects within our training facilities were attractive to Dr. Li and Mr. Young. ISSM was excited to work with Dr. Li and Mr. Young, as they have been studying sprinting mechanics and coordination dynamics for quite some time. Mr. Young also serves as a sport scientist/coach for USA track and field. International Olympic Committee Nutrition Project – Nanna Meyer
Inadequate diets can negatively impact sport training adaptation and performance, and increase the risk of injury and illness. Limited data are available on the diets of winter sport athletes, and no study has examined dietary differences between non-specific (conditioning) and specific (on-ice/on-snow) training periods. The objective of this study is to examine energy and nutrient intakes, supplementation, and iron status in male and female athletes of selected winter sports (n=60, including disabled athletes not part of the IOC grant). Energy, nutrient, and fluid intake during non-specific and specific training periods will be compared. In females, we will examine the prevalence of the female athlete triad (disordered eating/amenorrhea/osteoporosis). In addition, we will compare bone mineral density at the lumbar spine, proximal femur, and whole body in all participants (males and females) among different winter sports athletes (n = 40) grouped into 2 categories based on general loading characteristics and controls (n = 40). Validity and Reliability of Physiological Testing – Markus Amann
Stage races, like the Tour de France, Giro d'Italia, and Vuelta a España, are the premier events in professional road cycling and there is intense interest in identifying techniques to predict potential success in 3-week stage races. According to the results of stage races over the past years, time trial performance, the most common being the 40 km distance, is the main predictor of overall race standings in 3-week stage races. Time trial experts focus on meeting the requirements to be top competitors on all terrain (level and uphill). Some of the best time trial specialists within the last decade have matched and often surpassed the performance of lighter uphill cyclists during mountain climbs. Padilla et al. concluded that time trial specialists have an overall performance advantage over the other groups (flat terrain riders, sprinters, all terrain riders, uphill riders) for all cycling terrains. It is now recognized that maximal performance in long-distance events, such as the 40 km time trial, is not only determined by maximal oxygen uptake (VO2max) but especially on the percentage of VO2max that can be sustained over a prolonged time. At or below this specific intensity of exercise, endurance is mainly a function of fuel supply, body temperature, or soft tissue trauma. Outstanding performance at this intensity can be associated with a combination of several factors, including a high percentage of type I muscle fibers, the capacity to store large amounts of muscle and/or liver glycogen, the capacity to spare carbohydrate to reserve by using more fatty acids as energy substrates, and the capacity to efficiently dissipate heat. Above this intensity a significant reduction occurs in endurance time that may be dependent on metabolic disturbances related to acidosis. Theoretically, measurement of the so-called "anaerobic threshold" should provide an indication of this percentage because sustained increase in blood lactate concentration and metabolic acidosis, which occur at exercise intensities above this point, are associated with a decrease in the duration that exercise can be sustained. In recent years, controversy started to surround the term anaerobic threshold. Evidence has accumulated that dissociates lactate production and metabolic acidosis from anaerobiosis. Studies performed over the last 15 years using isotopic tracer technology have suggested that muscles can release lactate when their oxygen supply is more than adequate. Moreover, evidence that muscles become anaerobic when exercise approaches an intensity at which blood lactate level rises precipitously is in dispute. In order to pay tribute to these findings, the term "anaerobic threshold" is replaced by the term "performance threshold" (PT) in our laboratory. However, the assessment of the performance threshold from ventilatory variables or from lactate analyses or from a combined analysis of ventilatory and lactate variables has been refined over the years to better predict performance and guide training strategies. Many researchers have proposed a wide variety of invasive and noninvasive laboratory based strategies to identify this intensity. Nevertheless, a controversy exists not only about whether there is a coincidental relationship between the lactate threshold and the ventilatory threshold (VT) or not, but also about which is a better predictor for prolonged endurance performance. There are numerous methods available in the literature to predict prolonged endurance performance. These methods can be classified into two categories, namely direct and indirect methods. Direct methods (e.g., 40-km time trial on an ergometer in a laboratory) bring together many indices that allow either a complete or a partial representation of the power-duration relationship, whereas indirect methods revolve around the determination of the performance threshold. With regard to direct methods, performance in a series of tests provides a more complete and presumably more valid description of the power-duration relationship than performance in a single test, even if both approaches are well correlated with each other. The problem with direct methods is that they are too stressful to be utilized throughout a competitive season and they might interfere with existing training theories or practices. As for indirect methods, there is a quantitative accumulation of data supporting the utilization of the PT to assess endurance performance and to prescribe training intensities. However, it appears that there is no unique intensity corresponding to the performance threshold, because the wide variety of determination methods available in the literature provide inconsistent results. Thus, the question regarding a valid and reliable predictor for prolonged endurance performance (among the several available performance threshold assessment methods) remains open and needs to be addressed. Limiting Factors of Cycling Performance – Markus Amann
Previous studies have suggested that identifying physiological parameters, such as lactate threshold (Stegmann et al., 1992; Aunola et al., 1991), ventilatory threshold (Hoogeveen et al., 1997), and maximal lactate steady state (Beneke et al., 2000; Baldari et al., 2000; Urhausen et al., 1993) may be useful predictors of prolonged cycling performances. The process of identifying these parameters is based on laboratory test methods. The purpose of this study is to determine which of these methods is the best predictor for a 40-km time trial. The goal is to come up with a valid and reliable lab-based test that enables coaches and athletes to a) correctly direct their training with regard to exercise intensity and duration, b) provide feedback about the optimal race pace for a 40 km time trial, and c) predict an athlete's 40 km time trial performance from a less stressful test. Effects of Hyperoxic/Hypoxic Training – Andy Subudhi
Altitude related research projects are being conducted in collaboration with: 1. Palo Alto Veterans Affairs Health Care System, Palo Alto, CA & US Army Research Institute of Environmental Medicine, Natick, MA.
- Acute Mountain Sickness and Work Performance at 4,300 m Altitude: Effect of Energy Deficit, Antioxidants, and Carbohydrate Supplementation
- Effect of FIO2 on Physiological Responses and Performance in Trained Cyclists at Moderate Altitude
- The Effects of Dietary Macronutrients on Exercise Performance and Oxidative Stress with Acute Hypoxic Exposure
- The Effects of Oxygenated Water on Physical Performance at Simulated Altitude
Collaborative research effort with The University of Colorado Health Science Center The goal of this proposal is to determine the role of brain swelling in the pathophysiology of acute altitude illness, also known as acute mountain sickness (AMS). It has been shown that exercise caused a >3 fold rise in AMS symptom severity, a drop in arterial oxygen saturation (SaO2) during exercise, and slight fluid retention. In addition, it was shown that subjects ill with AMS had a small drop in plasma volume and a large rise in extracellular water compared to those that remained free of AMS. In further studies, magnetic resonance imaging revealed that most brains swell when humans ascend to high altitude. The overall hypothesis is that brain swelling, which can include elevated brain water and blood volume, causes the symptoms of AMS. The approach is to use several new and innovative technologies to dissect the role of cellular, molecular, and physiological responses in the pathophysiology of AMS. The new and innovative approaches include measurement in humans acutely deprived of oxygen of 1) nitric oxide (NO) production; 2) vascular endothelial growth factor (VEGF); and 3) heat shock factor/heat shock protein72 (HSF/HSP72);. In addition the study will make the first noninvasive measurements of cerebral perfusion pressure (eCPP), intracranial pressure (eICP), cerebral blood volume (CBV), blood-brain barrier (BBB) permeability, brain water and craniospinal volumes in humans exposed to acute hypoxia for 9 hrs. Although many hundreds of studies of AMS over the past two centuries have examined the role of ventilation, pulmonary gas exchange and fluid balance, the pathophysiology of AMS remains largely unsolved (see Hackett and Roach, NEJM, 345:2, 2001 for a recent review). This proposal focuses on the role of brain swelling in the pathophysiology of AMS, and uses exercise as a tool to develop more severe symptoms of AMS sooner than would be the case in resting subjects. The approach proposed here departs from the traditional paradigm, followed by many in this field, of searching for pathophysiological clues in the peripheral responses (pulmonary, renal, vascular) observed in AMS. The justification for focusing on brain swelling is that a) the symptoms of AMS are largely neurological; b) high altitude cerebral edema (HACE), considered the end-stage of severe AMS, has recently been identified as a vasogenic edema, opening the door for a role for BBB permeability in AMS; c) new, noninvasive techniques make measurement of brain water and CBV possible; and d) available experimental evidence and theoretical arguments support a significant role for brain swelling in the pathophysiology of AMS. Cerebral Oxygenation During Maximal Exercise – Andy Subudhi
Collaborative research effort with The University of Colorado Health Science Center Factors that limit human exercise performance are a subject of debate in the scientific community. Many investigations have focused on peripheral factors, such as muscle oxygenation, thought to be associated with fatigue during intense exercise, yet these studies have fallen short of providing an adequate explanation of the phenomenon. Thus, theories identifying the central nervous system as the ultimate governor of maximal exercise performance have attracted recent attention. This study will explore the role of cerebral oxygenation as a limiting factor to maximal exercise. Near infrared spectroscopy (NIRS) allows non-invasive monitoring of central and peripheral changes in oxygenation during exercise (reviewed in Ide and Secher 2000) that may provide valuable insight into factors affecting fatigue. During exercise of moderate to high intensity, muscle oxygenation decreases in proportion to increased metabolic demand (Hansen et al. 1996). However, near maximal exercise intensity, muscle oxygenation plateaus at a theoretical minimum (Belardinelli et al. 1995). Such results are consistent with the theory that maximal exercise is limited by muscle oxygenation. In contrast, cerebral oxygenation remains stable or increases during moderate intensity exercise (Ide et al. 1999) and decreases only near maximal intensity (Nielsen et al. 1999), suggesting a relationship between cerebral oxygenation and maximal exercise capacity. Additionally, Nielsen et al. (1999) demonstrated that administration of supplemental oxygen during incremental exercise to maximal exertion prolonged endurance by maintaining cerebral oxygenation rather than enhancing muscle oxygenation. These exciting findings provide empirical evidence linking cerebral oxygenation to fatigue and implore further study. Field observations recorded by NIRS during incremental exercise tests to maximal exertion at high altitude (5,260 meters, 17,250 feet) appear to magnify the drop in cerebral oxygenation preceding the voluntary termination of exercise (Colier et al. 2000). These preliminary results demonstrate the utility of using hypoxia as a novel model to study the association between cerebral oxygenation and fatigue. The purpose of this pilot study is to develop a controlled laboratory model to quantify the effects of maximal exercise on cerebral oxygenation in a hypoxic environment.
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