Exercise Testing, Anthropometry, Lab Tests, Field Tests

The complex framework and the habitat of human beings have led to the development of various branches in the scientific world. Among these, anthropometry and kinanthropometry have drawn the attention of scientists to better understand sports medicine which in the present context is highlighted keeping in view of exercise physiology of athletes. Anthropometry aims at the measurement of living human individuals to understand their physical variation.

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Kinanthropometry aims at studying the human size, shape, proportion, composition in order to understand growth, exercise, performance, and nutrition. Both these fields seem to be interrelated. The data is collected from the individuals mostly patients and it might later help in inducing changes in the lifestyle and to produce various indices and body composition predictions to measure and describe physique. Generally, athletes are prone to strenuous exercise and it is their physiology that undergoes fluctuations to meet the heavy demands of metabolism.

For this purpose, conventional anthropometric measurements were found to be reliable in determining the relationship between various body measurements such as height, weight, percentage of body fat, and medical outcomes. Similarly, Kinanthropometry was found influential to movement and those factors which support the movement, including the components of body build, body measurements, proportions, composition, cardiorespiratory capacities, physical activity including recreational activity as well as highly specialized sports performance.

However, it may be essential to conduct regular tests in various modes to get complete information of parameters that might affect the body’s physiology. Previously, the influence of exercise mode of running and cycling was analyzed on time to exhaustion (TTE) and oxygen uptake (VO2) response during exercise performed at the intensity associated with the achievement of maximal oxygen uptake (IVO2max) (Caputo & Denadai, 2006). It was found that this exercise mode was helpful during exercise at IVO2max in triathletes.

The other mode of testing may include walking for 6 minutes. It was reported that a 6-min walk distance (6MWD) helps in predicting pulmonary hypertension (PH) (Groepenhoff et al., 2008).

They reported that cardiopulmonary exercise test (CPET) parameters offer a reliable strategy for also evaluating peak oxygen consumption (V O2peak) in addition to making a prognostic study using 6MWD. Therefore, this field test may prove beneficial for clinical applications of anthropometry.

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Earlier, there was ambiguity on whether exercise parameters could be used to discriminate between chronic obstructive pulmonary disease (COPD) patients with associated PH (COPD-PH) and COPD patients without associated PH (COPD-nonPH) (Holverda, et al., 2008). But, it was reported that the existence of PH in COPD is associated with a significantly reduced ventilatory efficiency during CPET (Holverda, et al., 2008).

Thus, this report has strengthened the previous description of exercise testing. These tests indicate that athletes may require strong medical supervision to rule out problems like hypertension and cardiovascular diseases. The next problem to consider is palpitation. It was reported that in athletes, the incidence of palpitations varies from 0.3% to as high as 70%, depending on age and type of sport being studied (Lawless & Briner, 2008).In this mode of testing, they have highlighted the importance of Holter monitoring, echocardiography, stress testing, endomyocardial biopsy, genetic testing, electrophysiologic testing, or cardiac magnetic resonance imaging.

They reported that the majority of palpitations in athletes need to be first identified by screening examination, or by a complaint from the athlete and making the pre-participation examination monograph. This test would enquire the athlete whether he/she has palpitations with exercise. Their report also appears to caution athletes with implanted cardioverter-defibrillator devices to restrain from returning to sports, as there is uncertainty about the safety and efficacy of defibrillators in this clinical setting (Lawless & Briner, 2008).

Therefore this article may furnish better insights on the exercise physiology of athletes and the clinical population who are susceptible to palpitation both in the field and hospitals.

Further, the next focus is on submaximal and maximal VO2max testing. Earlier workers highlighted the significance of developing equations to predict VO2max from a submaximal elliptical cross-trainer test (Dalleck, et al., 2006). They recruited participants to complete an elliptical cross-trainer submaximal (3 5-minute submaximal stages) and a VO2max test on the same day. Their findings have indicated that the protocol and equations developed in the study could be used by exercise professionals to provide accurate estimates of VO2max in non-laboratory-based settings.

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Roels, et al, (2005) have compared maximal heart rate (HRmax), VO2MAX, and the ventilatory threshold (VT; %VO2MAX) during cycle ergometry and free-swimming between swimmers and triathletes. Their study indicated that the exercise testing mode affects the VO2MAX value, and triathletes do not require very specific training adaptations as compared to swimmers.

This could be due to a function of acute physiological responses combined with the specialist training status of the different athletes influencing maximal cardiac output or oxygen extraction (Roels et al., 2005). Therefore, it is reasonable to assume that anthropometric measurements could vary in athletes compared to other sports personnel and clinical population.

Further, monitoring and understanding heart rate is essential in athletes. The reason may be that heart rate is an individual response and heart rate training zones need to be determined by measurement of physiological variables not set by mathematical formulas. In addition, the relationship between exercise intensity and heart rate is different for different exercises.

In other words, heart rates for running would not be different from heart rates for cycling for any given intensity.

For this purpose, lactate testing has drawn the attention of sports medicine professionals. Lactate is an important metabolic product that could be measured with a blood drop at a fingertip. This is analogous to measuring blood sugar levels in diabetic patients. The blood lactate level was believed to increase with the exercise intensity and switches from aerobic to anaerobic activity. Since lactate concentration increases in the blood during exercise due to lack of oxygen at the muscle, it could be easily measured to determine physical performance or to establish proper exercise intensity of exercise for athletes.

Since the lactate test focuses on measuring the complete individual, it gives a precise method for testing and monitoring training intensity and recovery. Therefore, it was widely considered that lactate measurement is more accurate than the obsolete and inaccurate method of using percentages of maximum heart rate to set training zones. The lactate test is usually studied by the curve of lactate versus heart rate plotted on the same graph as the linear “step test”.

This mode of test could also help in assessing the magnitude of physical activity undertaken not only by an athlete but also by normal individuals with a hectic exercise schedule. However, the threshold of lactate may vary with the advancement of age in athletes.

Marcell, et al. (2003) determined whether there was a lack of relationship between lactate threshold (LT) and running performance in older runners and the increase in LT with age. They have reported that LT might be less precise than [OV0312] O (2max) or performance in the prescription of exercise intensities or as an evaluation tool in older individuals. But this report may require further confirmation.

Next, athletes and most clinical population may run the risk of abnormal body fat indicating that there is a need to evaluate this parameter. Ostojic (2006) conducted a study to determine the significance of a comparative approach that involves two different field methods such as skinfolds (SKF) vs bioimpedance analysis (BIA) in top-level athletes for body fat estimation. This report indicated that BIA seems to be the most simple, quick, and inexpensive method for assessing body fat in physically active individuals and athletes.

In another report, it was described that two techniques such as air displacement plethysmography (ADP) and dual energy X-ray absorptiometry (DXA) per cent body fat (%BF) estimations were not that accurate for individual % BF prediction (Silva, et al., 2006). But, it was considered that ADP is a valid and nonbiased tool for the evaluation of body composition in adolescent athletes (Silva, et al., 2006). This may indicate that there are certain discrepancies in body fat testing methodologies which may require further research intervention. Earlier workers described that importance of skinfold (SKF) equations to predict percent body fat (%BF) in athletes (Evans, et al., 2006).

For, this purpose they have developed and cross-validated a %BF prediction equation based on SKF in athletes using a four-component model as the reference measure. They reported that 7 SKF measures such as subscapular, triceps, chest, midaxillary, suprailiac, abdominal, and thigh sites ameliorated equations developed using densitometry (Evans, et al., 2006).

This may indicate that tests that include skin fold measurements could furnish better insights on body fat composition. This strategy could strengthen the medial applications of anthropometric measurements especially medical anthropology and epidemiology as previously described. Hence, athletes may require frequent monitoring of body fat which would otherwise interfere with their performance.

This method of body fat determination may also be of great help to clinical populations having obesity complaints. Further, individuals with abnormal fat deposition and obesity may also run the risk of poor body mass index (BMI).So, there is need to connect this part of description with BMI testing.

Previously, studies were conducted to determine whether the stature-adjusted body mass index (BMI) is a valid proxy for adiposity across both athletic and nonathletic populations, and whether skinfold measurements increase in proportion to body size (Nevill, et al., 2006). But there are certain discrepancies with respect to skinfold thickness in male and female athletes compared to controls. This has indicated that there is a need of more valid assessment of fatness using surface anthropometry such as skinfolds taken by experienced practitioners following established procedures.

Nooyens et al. (2007) reported that skinfold thickness during adolescence is a better predictor of high body fatness during adulthood than BMI during adolescence. Therefore, this may strengthen the connection between skinfold thickness during adolescence and body fatness during adulthood rather than BMI and skinfold thickness. Similarly, in another report it was described that the BMI is widely used as a measure of excess weight, rather than excess body fat (Freedman, et al., 2007).

Their findings have indicated that although skinfold thickness when used in addition to BMI-for-age could improve the estimation of body fatness, the improvement among overweight children is small. This report may appear beneficial to young athletes especially children near the age of 18 which is nothing but the adolescent stage. Hence, this report could help in understanding the problems concerned with BMI and body fat in school or collegiate athletes.

However, there seems to be controversy regarding the utility of BMI as an index of body fat rather than index of overweight in athletes and non athletes. In clinical population such as diabetics, BMI is the sole important parameter to detect abnormalities in height and weight. But, the gaining importance of skinfold thickness over BMI in athletic population may need further clarification.

Strength is another important factor that determines the athlete’s performance and ability to withstand injuries. To this end, various tests have come into effect. It was reported that a repetitions-to-maximum test is a predictor of a 1 repetition maximum (1RM) performance for evaluating upper and lower body strength in women high school athletes (Horvat, et al., 2007).

In another study, it was described that the side bridge endurance test and the trunk flexor endurance test were highly reliabile for athletes (Evans, et al., 2007). They have found a significant difference in endurance performance between male and female athletes in some muscle groups but not others. Therefore, the implication of this testing and training of trunk muscle endurance test is that it should be ‘multidirectional’ for all athletes who wish to optimise performance and lessen injury risk (Evans, et al., 2007).

In another study, researchers have employed a new vertical jump force test (VJFT) for the assessment of bilateral strength asymmetry in a total of 451 athletes (Impellizzeri, et al., 2007).They have found significant correlation between VJFT and both the isokinetic leg extension test and the isometric leg press test, thus indicating the validity and reliability of VJFT in sports medicine.

Fagnani, et al., (2006) described that whole-body vibration is a suitable training method to improve knee extension maximal strength, counter-movement jump, and flexibility in a young female athletes. These tests may differ from the conventional lab tests that might concentrate on clinical parameters such as assessing heart rate, physical hypertension, etc. Since these tests determine the strength of athletes, it is reasonable to connect this part of description with ergonomics that involves designing according to the human needs or work demands.

Its principles were found to be very much applicable for understanding the exercise physiology of athletes. It was reported that ‘live high, train low’ altitude training model for athletes would enable significant improvements in red cell mass, maximal oxygen uptake, oxygen uptake at ventilatory threshold, and 3000m and 5000m race time (Chapman and Levine, 2007).

Similarly, training athletes to adapt hot /humid weather would help them to improve performance. This may be because well prepared athletes have a fitness level so high that they can produce more metabolic heat than could be dissipated, making it compatible with manageable heat production (Martin, 2007).

Next, respiratory problems in athletes may be common in addition to that of cardiac origin. Recent workers characterized the etiology of upper respiratory symptoms in elite athletes when they were presented to a sports physician for treatment (Cox, et al., 2008). They reported that only 57% of presentations were associated with an identified pathogen or other laboratory parameters indicative of infection. Their report suggested that there is a need for consideration of alternate diagnostic options when evaluating upper respiratory symptoms in athletes. This is because certain episodes of respiratory symptoms in athletes were not associated with the identification of a respiratory pathogen (Cox, et al., 2008).

Trojjan and Beedie (2008) reported placebo effect in athletes. They described that physiological changes similar to those resulting from active medication have been observed as the result of the administration of placebos. As it is widely known that placebos are used in clinical trials, this report may warrant the efficient implementation of placebo effect to test athletes in variety of clinical settings. Here, it may also prompt researchers to determine clinical parameters in addition to placebo effect. But this should be carefully considered.

In a recent investigation, nearly 100 elite athletes were assessed for biochemical parameters in association with clinical assessment. These included serum iron, ferritin, transferrin, percent transferrin saturation, sodium, potassium, magnesium, urea and creatinine, total protein, albumin, creatine kinase (CK), lactate dehydrogenase, total bilirubin, cholesterol and triglycerides (non-fasting), and random glucose. It was revealed that most abnormalities found on routine biochemical screening were of no clinical significance and such tests need to be abandoned (Fallon, 2008).

This may be in contrary to the cases of clinical population like diabetics and cardiovascular patients where screening of biochemical parameters is mandatory. Further, the beginning of cardiac problems in young athletes has become serious concern. As such, appropriate research intervention may be compulsory. It was reported that the influence of sudden cardiac death (SCD) in young athletes may necessitate the assurance of additional resources to identify those at risk (Drezner, 2008).These are systematic preparticipation screening program, standardized comprehensive personal and family history questionnaire and a screening electrocardiogram (ECG) during their school and college education (Drezner, 2008).

Therefore, this report may indicate the importance of ECG in addition to other approaches. This was further strengthened by another report that described that ECG screening of young athletes should be used with caution only after further studies are conducted to determine what would constitute a normal ECG in athletes, and whether ECG-based screening protocols are superior in finding disease and saving lives (Lawless and Best, 2008).

Next, there is also a need to consider ethical values of athletes keeping in view of drug abuse. It was reported that the world anti-doping code (WADC) with harmonized international sport federation (IF) policies are meant to prevent doping by athletes, but not appropriate medical treatment (Kaufman, 2007). Ethical issues were reported to emerge when anticonvulsants have other psychotropic properties. Hence, athletes are strongly instructed to list all medications taken with diagnoses, obtain therapeutic use exemptions (TUEs) as indicated, and contact the appropriate IF or Olympic organization to determine the status of the proposed medication (banned, restricted, nonbanned)(Kaufman,2007). Previously, certain areas of medial ethics that present unique challenges in sports medicine were reported (Dunn, et al., 2007).

These are informed consent, third parties, advertising, confidentiality, drug use, and innovative technology. But further confirmations may require refining or modifying the codes of sports medicine ethics to enable their widespread acceptance.

Finally, the recommended strategies or tests for athletes need to reliable and should have the potential of reproducibility. Athletes are more prone to groin pain and there is a necessity of good therapeutic test. It was reported that the examination techniques such as adductor muscle related pain and strength, and flexibility, abdominal muscle related pain, and strength and pain at the symphysis joint were found to be reproducible when a intraobserver and interobserver reliability study was made (Holmich, et al., 2004).

The other reliable tests include the side bridge endurance test and the trunk flexor endurance test, as previously described in the earlier section of this report (Evans, et al., 2007). Although there are good number other tests that appear to be reliable and reproducible, they may need further clarification due to discrepancies. These may include the combination of BMI and skin folding test, screening of biochemical parameters and ECG.

Similarly, training athletes to adapt hot /humid weather would help them to improve performance. This may be because well prepared athletes have a fitness level so high that they can produce more metabolic heat than can be dissipated, making it compatible with manageable heat production (Martin, 2007).Therefore, in view of the above information it can be inferred that exercise physiology is influenced by many field and lab tests in compliance with the clinical populations. However, additional verifications were also suggestive for concrete information on the anthropometric measurements and their clinical applications with reference to the exercise physiology of athletes.

References

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