Acute Fatigue Research Articles

Occupational Fatigue: Relationship With Personality Traits and Decent Work.

Psychology of working theory (PWT) and psychology of working framework (PWF) offered a psychological view of decent work. The present study examined the associations among personality traits, decent work and Occupational Fatigue Exhaustion Recovery Scale (OFER). Two hundred and thirty four participants filled out the Big Five Questionnaire, the Italian version of the Decent Work Scale, and the Italian version of the OFER Scale. Hierarchical regressions showed that decent work explained incremental variance beyond personality traits with respect to OFER both considering total score and its three dimensions (chronic fatigue, acute fatigue, persistent fatigue). The present study underlined the value of decent work in relation to occupational fatigue beyond the contributions of personality, in particular in relation to the dimensions of Adequate compensation and Free time and rest for less occupational fatigue (both as total and as dimensions).

The biomechanical characteristics of the strongman atlas stone lift.

BackgroundThe atlas stone lift is a popular strongman exercise where athletes are required to pick up a large, spherical, concrete stone and pass it over a bar or place it on to a ledge. The aim of this study was to use ecologically realistic training loads and set formats to (1) establish the preliminary biomechanical characteristics of athletes performing the atlas stone lift; (2) identify any biomechanical differences between male and female athletes performing the atlas stone lift; and (3) determine temporal and kinematic differences between repetitions of a set of atlas stones of incremental mass.MethodsKinematic measures of hip, knee and ankle joint angle, and temporal measures of phase and repetition duration were collected whilst 20 experienced strongman athletes (female: n = 8, male: n = 12) performed three sets of four stone lifts of incremental mass (up to 85% one repetition maximum) over a fixed-height bar.ResultsThe atlas stone lift was categorised in to five phases: the recovery, initial grip, first pull, lap and second pull phase. The atlas stone lift could be biomechanically characterised by maximal hip and moderate knee flexion and ankle dorsiflexion at the beginning of the first pull; moderate hip and knee flexion and moderate ankle plantarflexion at the beginning of the lap phase; moderate hip and maximal knee flexion and ankle dorsiflexion at the beginning of the second pull phase; and maximal hip, knee extension and ankle plantarflexion at lift completion. When compared with male athletes, female athletes most notably exhibited: greater hip flexion at the beginning of the first pull, lap and second pull phase and at lift completion; and a shorter second pull phase duration. Independent of sex, first pull and lap phase hip and ankle range of motion (ROM) were generally smaller in repetition one than the final three repetitions, while phase and total repetition duration increased throughout the set. Two-way interactions between sex and repetition were identified. Male athletes displayed smaller hip ROM during the second pull phase of the first three repetitions when compared with the final repetition and smaller hip extension at lift completion during the first two repetitions when compared with the final two repetitions. Female athletes did not display these between-repetition differences.ConclusionsSome of the between-sex biomechanical differences observed were suggested to be the result of between-sex anthropometric differences. Between-repetition differences observed may be attributed to the increase in stone mass and acute fatigue. The biomechanical characteristics of the atlas stone lift shared similarities with the previously researched Romanian deadlift and front squat. Strongman athletes, coaches and strength and conditioning coaches are recommended to take advantage of these similarities to achieve greater training adaptations and thus performance in the atlas stone lift and its similar movements.

Exploring the Relationship between Patient Acuity, Patient Assignments and Fatigue among Nurses

This study surveyed 114 registered nurses throughout Ohio to determine if there was a relationship between patient acuity and perceived fatigue. Also examined for a potential relationship to perceived fatigue were nurse-patient ratios (NPRs) and the method by which nurse-patient assignments (NPAs) were created. Two validated fatigue scales, the Fatigue Assessment Scale (FAS) and the Occupational Fatigue Exhaustion Recovery (OFER) scale were used to capture participants perception of fatigue at their workplace. Resultsindicated that the interaction between patient acuity and NPR was significantly related to FAS ratings while NPR had a significant relationship to acute fatigue on the OFER scale. Most nurses experience substantial fatigue, with high acuity patients having an overall greater impact. We recommend that NPAs shall contain fewer high acuity patients than lower acuity patients. Additionally, The OFER acute fatigue scale (OPER-AF) suggests that assignments should contain no more than five patients to mitigate fatigue.

Assessment of Occupational Fatigue in Healthcare Professionals During the COVID-19 Pandemia

Aim: This study aimed to determine the level of occupational fatigue in healthcare professionals during the COVID-19 pandemic process and assess some variables considered to have a relationship with it. Material and Method: This study used a descriptive cross-sectional design and was carried out on physicians and nurses between June and July 2020. The study data were collected using a questionnaire with items questioning some socio-demographic data of the healthcare professionals, characteristics of their workplace and working conditions, and contact with patients with COVID-19, and the items of the Occupational Fatigue-Exhaustion Recovery Scale. The study group consisted of 308 females and 98males. In non-normal distributions, the Mann-Whitney U test was used for variables with two groups and Kruskal–Wallis-H test for variables with more than two groups.Results: The mean scores of the healthcare professionals from the chronic fatigue and acute fatigue sub-domains of the Occupational Fatigue Exhaustion Recovery Scale were 60.65±29.10, 65.52±21.64 and 45.09±19.1, respectively. In the study group, fatigue levels were higher in women who were aged 49 years or younger, had weekly working hours of more than 40 hours, and came into contact with COVID 19 patients every day.. Conclusion: The fatigue and burnout levels of healthcare professionals who are directly involved in the care of patients with COVID-19 during the pandemic process were above moderate levels, and the level of their recovery was at a moderate level. It is recommended that necessary administrative initiatives should be taken to improve healthcare workers’ rights, whose working conditions are getting more difficult in the pandemic environment, their needs for rest should be planned, and that working environments that will ensure that not only the risk of contamination but also the risk factors that will arise due to fatigue are under control should be created.

You only get one brain. Adult reflections on acute and ongoing symptom experiences after traumatic brain injury in adolescence

ABSTRACT Background This research adds to the scarce literature regarding adolescent experiences of traumatic brain injury (TBI). It uses a qualitative methodology to explore the symptoms experienced after sustaining a TBI at this unique stage of development including their persistence into adulthood. Methods Thirteen adults (aged 20–25 years; mean 23 years) who sustained a mild-moderate TBI during adolescence (aged 13–17 years at injury), approximately 7.7 years (range = 6.7–8.0 years) prior, participated in the research. Semi-structured individual interviews, analyzed using thematic analysis, explored participants’ experiences surrounding and following their TBIs. Results TBI during adolescence can result in significant acute symptoms, particularly headaches, fatigue, and difficulties in thinking. Participants’ descriptions of the extent and impact of these symptoms reflected feelings of frustration and often anxiety and/or depression. Difficulties could persist for years post-TBI and sometimes had not resolved at all. Conclusions Even mild TBI during adolescence can result in significant acute and ongoing symptoms, which can contribute to emotional distress in the long term.

Psychometric properties of the Portuguese version of the occupational fatigue exhaustion/recovery (OFER) scale among industrial shift workers

Reliable and valid instruments are essential for understanding fatigue in occupational settings. This study analyzed the psychometric properties of the Portuguese version of the Occupational Fatigue Exhaustion/Recovery (OFER). A cross-sectional study was conducted with 260 workers (M = 46.52 ± 13.16 years) from a textile industry, exposed to shift work. Convergent and discriminant validity, internal consistency reliability and exploratory and confirmatory factor analysis were performed. Results showed an adequate fit to data (χ2 (84) = 209,102, CFI = 0.936, GFI = 0.902, RMSEA = 0.076 CI90% (0.063–0.089)), yielding a 13-item, three factor structure. Two items were removed due to low factor loading. The OFER presented an adequate internal consistency, with the subscales presenting good reliability values (Chronic Fatigue (α = 0.81), Acute Fatigue (α = 0.84) and Recovery between Shifts (α = 0.77)). Findings suggest that the Portuguese version of OFER can be a useful tool to assess occupational fatigue of shift workers and prevent work related injuries.

Toxicity and Efficacy After Adjuvant Vaginal Brachytherapy Using 30 Gy in 6 Fractions for Stages I and II Endometrial Cancer

PurposeThis study aimed to evaluate outcomes and toxicity in patients with endometrial cancer per our institutional adjuvant vaginal cuff brachytherapy (VBT) fractionation scheme. Methods and MaterialsWe identified women with International Federation of Gynecology and Oncology stages I and II endometrial cancer who underwent surgical staging and adjuvant high-dose-rate VBT without external beam radiation. All patients received 30 Gy in 6 fractions to the upper one-third of the vagina, prescribed to a depth of 5 mm and delivered twice weekly. Toxicities were prospectively elicited at each follow up, and rates of recurrence and survival were retrospectively assessed. ResultsWe identified 247 eligible patients treated between 1992 and 2018 with a median follow up of 5.8 years (range, 0.1-24.7 years). Most patients had stage I disease (52% stage IA; 37% stage IB), and 11% of patients were stage II. Deep myometrial invasion was predictive of local recurrence (P = .002). The 5-year rates of local recurrence, regional recurrence, and distant metastases were 5%, 5%, and 7%, respectively. Five-year overall and disease-free survival were 91% and 83%, respectively. The most common grade 1 toxicities were acute fatigue (11% crude rate), urinary frequency (11%), chronic (>6 months) urinary frequency (13%), urinary incontinence (13%), and vaginal stenosis (21%). There were few grade 2 toxicities (all <5%) and no grade 3 to 5 toxicities. ConclusionsThe adjuvant VBT fractionation scheme of 30 Gy in 6 fractions results in low rates of toxicity, with no grade ≥3 adverse events, and local control rates comparable with those from other published series using different fractionation schemes.

Physical fatigue and its effect on road crossing decisions: an examination of the embodied perception perspective.

Road crossing is an everyday task that requires integration of information (e.g., speed and distance of an oncoming vehicle) to effectively guide behaviour. The embodied perception perspective suggests that individuals' perception of environmental stimuli is influenced by their psychophysiological state. Upon this premise, the current study examined whether acute physical fatigue influences visual perception and associated decision-making in road crossing. Using a between-subject design, 54 participants (healthy adults, aged 18-35) were divided into a fatigue and no-fatigue group. To manipulate fatigue, participants completed a vigorous cycling protocol (fatigue group) or a light cycling protocol (no-fatigue group) prior to completing a video-based examination of road crossing decisions (cross vs. not cross; action-based) and verbal judgments of speed and distance of an oncoming vehicle. Measures of heart rate, self-perceived recovery, and preferred walking speed indicated that fatigue was successfully induced (all p's < 0.03). Participants effectively distinguished between different speeds (30-50-70km/h; p < 0.001), and distances (10-100m in 10m increments; p < 0.001). Moreover, both vehicle speed and distance (p's < 0.001) significantly influenced road crossing decisions. However, no significant effects of fatigue were observed for visual perception or road crossing decisions (all p's > 0.26). This study demonstrated that individuals are sensitive to changes in vehicle speed and distance and respond to these changes in making road crossing decisions. In contrast to the embodied perception perspective, however, physical fatigue did not alter perceptual judgments of vehicle speed and distance nor did it influence road crossing decisions in a video-simulated road crossing environment.

A Systematic Review on Markers of Functional Overreaching in Endurance Athletes

The aim of this brief review was to present an overview of noninvasive markers in trained to professional endurance athletes that can reflect a state of functional overreaching. A systematic literature search was conducted in the PubMed, Scopus, and PsycINFO databases. After screening 380 articles, 12 research papers were included for the systematic review. Good consensus was found between the different papers in which noninvasive parameters were able to reflect a state of functional overreaching. Changes in power output (PO), heart rate (HR; [sub]maximal and HR recovery), rating of perceived exertion, and scores in the Daily Analysis of Life Demands for Athletes (DALDA) and/or Profile of Mood States (POMS) were shown to be able to reflect functional overreaching, whereas changes in maximal oxygen uptake and HR-variability parameters were not. Functional overreaching within a maximal performance test was characterized by a decrease in peak PO and a lower maximum HR, whereas a lower mean PO and a lower HR were observed during time trials. Changes in parameters during a standardized submaximal test when functionally overreached were characterized by a higher PO at a fixed HR or a lower HR at a fixed intensity, higher rating of perceived exertion, and a faster HR recovery. Although both the DALDA and POMS were able to reflect functional overreaching, the POMS was not able to differentiate this response from acute fatigue, which makes it unsuitable for accurately monitoring functional overreaching.

Acute and chronic fatigue in nurses providing direct patient care and in non-direct care roles: A cross-sectional analysis.

Nurses are at risk for work-related fatigue, which can impact their health, well-being, and job readiness. The purpose of this study was to examine the levels, types, and factors associated with fatigue in registered nurses (RNs) in direct patient care (DCRNs) and in non-direct patient care (non-DCRNs) roles. A cross-sectional survey was administered to 313 RNs. Measures included: Multidimensional Fatigue Symptom Inventory, Occupational Fatigue Exhaustion Recovery, Brief COPE, PROMIS® Global Sleep Disturbance, and Job Content Questionnaire. Acute fatigue levels in RNs were similar to those in diseased populations, and nearly 50% reported moderate/high levels of chronic fatigue. DCRNs reported higher levels of acute and chronic fatigue than non-DCRNs, but the differences were small and disappeared when accounting for other factors associated with fatigue including sleep disturbance, job strain, workplace support, maladaptive coping, and especially intershift recovery, which accounted for 20%-41% of fatigue variability. This study suggests that it may not be only nurses providing direct patient care who are at risk for acute and chronic fatigue. Intershift recovery may be particularly important in alleviating acute and chronic fatigue in nurses.

Relationship among faculty fatigue, academic rank, andscholarship and service productivity.

To examine the relationship among the level of fatigue, academic rank, workload (credit hours) and faculty productivity (as measured by scholarship and service activities). Descriptive cross-sectional correlational design. All full-time faculty in national year-round nursing college. An Internet survey was distributed May/June 2017 to all full-time faculty (n=318). Responses reported are from 81 faculty members in the prelicensure baccalaureate programme. Survey items included workload, scholarship and service activities and demographic data. Fatigue was measured by the trait version of Occupational Fatigue, Exhaustion Recovery scale which has three subscales: Acute, Persistent, and Chronic. Mean fatigue for all traits ranged from 45.9 to 52.48. More service activities were reported than scholarship activities. There was a significant positive correlation between chronic fatigue and credit hours. No significant differences existed in fatigue scores based on frequency of scholarship and service activities. This first study of fatigue in nursing faculty establishes the existence of fatigue in this group. This can be serious related to the existence of chronic fatigue. Strategies to reduce fatigue are important to support the long-term employment of nursing faculty. What problem did the study address? Fatigue in faculty members and its relationship to academic rank and scholarship and service productivity. What were the main findings? Fatigue in faculty members exists. Higher rank was associated with more scholarship and service activities. Chronic fatigue is less than acute or persistent fatigue. Chronic fatigue is related to workload. Where and on whom will the research have impact?Findings may impact retention of nursing faculty members and academic leaders responsible for supporting work-life balance among nursing faculty.

Fatigue prevalence in men treated for prostate cancer: A systematic review and meta-analysis.

BACKGROUNDThe side effects of prostate cancer (PCa) treatment are very prominent, with cancer-related fatigue (CRF) being the most common. Fatigue is a distressing symptom that interferes with daily functioning and seriously affects patient quality of life during, and for many years after, treatment. However, compared with other types of cancer, such as breast cancer, little is known about the prevalence of PCa-related fatigue.AIMTo determine the prevalence of CRF in patients with PCa.METHODSA systematic search of EMBASE, PubMed, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure, WANFANG DATA, Technology Journal Database and the Chinese Biological Medical Database was conducted up to July 28, 2020. Included studies measured the incidence of PCa-related fatigue and differentiated fatigue outcomes (incidence) between treatment modalities and fatigue assessment times. In our meta-analysis, both fixed and random-effects models were used to estimate the pooled prevalence of PCa-related fatigue. Subgroup analyses were performed using treatment modalities and fatigue assessment times. Publication and sensitivity bias analyses were performed to test the robustness of the associations.RESULTSFourteen studies, involving 4736 patients, were eligible for the review. The pooled CRF prevalence was 40% in a total sample of 4736 PCa patients [95% confidence interval (CI): 29-52; P < 0.01; I2 = 98%]. The results of the subgroup analyses showed the prevalence of CRF after androgen deprivation therapy treatment, radical prostatectomy and radiotherapy to be 42% (95%CI: 20-67, P < 0.01, I2 = 91%), 21% (95%CI: 16-26, P = 0.87, I2 = 0%) and 40% (95%CI: 22-58, P < 0.01, I2 = 90%), respectively. The prevalence of acute and persistent fatigue was 44% (95%CI: 25-64; P < 0.01; I2 = 93%) and 29% (95%CI: 25-32; P = 0.30; I2 = 17%), respectively.CONCLUSIONOur meta-analysis showed that fatigue is a common symptom in men with PCa, especially those using hormone therapy.

Did rest breaks help with acute fatigue among nursing staff on 12-h shifts during the COVID-19 pandemic? A cross-sectional study.

AimThis study aimed to explore whether 30‐min rest breaks were as effective at lowering acute fatigue among 12‐h shift hospital nursing staff who cared for patients with COVID‐19 as among those who did not.DesignThe study was cross‐sectional in design.MethodsData from the SAFE‐CARE study collected online between May and June 2020 were used. A subsample (N = 338) comprised of nursing staff who reported working 12‐h shifts, and providing direct patient care in hospitals was used in this study. Data on socio‐demographics, work and rest breaks, and subjective measures of fatigue, psychological distress, sleep and health were used. Hierarchical multiple linear regression followed by stratified analyses was conducted to explore the relationships between rest breaks and acute fatigue among nursing staff groups with and without COVID‐19 patient care.ResultsThe sample, on average, had high acute fatigue. Around 72% reported providing care to patients with COVID‐19, and 71% reported taking rest breaks ‘sometimes’, ‘often’ or ‘always’. In the group that cared for patients with COVID‐19, there was no significant relationship between rest breaks and acute fatigue (p = .507). In the group that cared for patients hospitalized for other reasons, rest breaks were associated with lower acute fatigue (p = .010).ConclusionOur findings showed both the importance and inadequacy of rest breaks in reducing acute fatigue. The process of within‐work recovery is complex, and routine rest breaks should be facilitated by nursing management on hospital units during and after the COVID‐19 pandemic.ImpactRest breaks may present an effective strategy in lowering fatigue. Although rest breaks were not associated with less fatigue among staff caring for patients with COVID‐19, other co‐workers experienced some fatigue recovery. For frontline nursing staff, routine rest breaks are encouraged, and a systematic evaluation pertaining the sufficiency of rest breaks during high work demands in future research is needed.

Tapering and Repeated High-Intensity Effort Ability in Young Elite Rugby Union Players: Influence of Pretaper Fatigue Level.

To assess the effects of a short-term taper on the ability to perform repeated high-intensity efforts, depending on players' fatigue level following an intensive training block. After a 3-day off-season camp, 13 players followed the same 3-week preseason training block followed by a 7-day exponential taper. Performance was assessed by a repeated high-intensity effort test before and after the taper. Total sprint time, percentage of decrement, and the number of sprints equal to or higher than 90% of the best sprint were retained for analysis. Players were a posteriori classified in normal training or acute fatigue groups based on their readiness to perform prior to the taper, assessed through the magnitude of difference in psychological (Profile of Mood State Questionnaire), cardiovascular (submaximal constant-duration cycling), and neuromuscular (countermovement jump) tests between the preintensive and postintensive training blocks. Training load declined by 55% (9%) during the taper (P = .001, g = -2.54). The overall group showed a small improvement in total sprint time (-3.40% [3.90%], P = .04, g = -0.39) following the taper. Relative changes tended to be higher in the acute fatigue compared with the normal training group (-5.07% [4.52%] vs -1.45% [1.88%], respectively; P = .08; d = 1.01). No taper-induced improvement was observed in percentage of decrement or number of sprints equal to or higher than 90% of the best sprint. A 7-day taper consisting of 55% training load reduction improved repeated high-intensity effort performance in young elite rugby union players. Pretaper level of fatigue seems to be a key determinant in the taper supercompensation process, as acutely fatigued players at the end of the intensive training block tended to benefit more from the taper.

PHYSIOLOGICAL MECHANISM OF FATIGUE. Review

Relevance. Fatigue, both intellectual and physical, reduces the efficiency of daily activities and quality of life, in addition, fatigue is one of the factors contributing to the development of various pathological conditions, such as cardiovascular disease and others. Therefore, it is important to understand the mechanisms underlying the development of fatigue, which will improve prevention and development.&#x0D; Objective: to analyze the physiological and biochemical mechanisms underlying the development of fatigue.&#x0D; Methods. Analysis of scientific publications of the international scientific database PubMed by keywords. The following research methods were used in writing the paper: systematization of material, analysis and generalization.&#x0D; Results. In this article we discussed the physiological and biochemical mechanisms of fatigue. The correlation between fatigue and the general mental condition, physiological, biochemical processes, activity of neurotransmitters, intellectual and physical activity, food has been defined. The central and peripheral mechanisms of fatigue were considered. Central fatigue is divided into spinal and supraspinal and involves the neuromuscular junction. Peripheral fatigue occurs at the level of the muscles and mainly involves muscle bioenergetics or an excitation-contraction coupling.&#x0D; Currently fatigue is considered as a general reaction to stress that lasts for a period of time, taken in an account the cumulative effects of days, weeks or months, and the effects of sleep disorders are also very important, because the effects of fatigue are closely linked to sleep deprivation. Therefore, the time required for recovery depends on the severity of fatigue. There are currently many research methods, such as electromyography, transcranial magnetic stimulation, magnetic resonance imaging, and spectroscopy, which are useful in undestending the physiological correlates of fatigue.&#x0D; In turn, psychological, behavioral or physical triggers can have a beneficial effect against the development of acute fatigue and improve performance, as well as provide a better understanding of the function of neurotransmitters, physiological and biochemical processes important in the development of body fatigue in general.

Revisiting the acute effects of resistance exercise on motor imagery ability

Motor imagery (MI) shares psychological and physiological similarities with the physical practice of the same action. Yet, it remains unclear whether fatigue elicited by exercise impairs MI ability. Fourteen participants performed MI of a self-paced walking sequence of 22 m before and after a resistance exercise eliciting muscle fatigue from upper and lower limbs, selectively. We indexed MI ability using psychometric and behavioral methods. Electromyography of the quadriceps was also recorded during physical practice trials of the walking sequence. For both experimental conditions, we recorded improved temporal congruence between MI and physical practice of the walking sequence (9.89 %, 95 % CI [7.03, 12.75], p < 0.01). Vividness decreased immediately after the fatiguing exercise (6.35 %, 95 % CI [5.18, 7.51], p < 0.05), before rapidly returning to pre-fatigue values during recovery trials. The results challenge the hypothesis of an effect of acute fatigue elicited by a resistance exercise on MI ability, i.e. restricted to MI tasks focusing fatigued effectors. The beneficial effects of fatigue conditions on the psychometric and behavioral indexes of MI ability are discussed in the broader context of psychobiological fatigue models linking perceived exertion with the reallocation of attentional resources. The general perception of fatigue, rather than local muscle fatigue, appeared linked to the acute effects of resistance exercise on MI ability.

Expiratory Pause Maneuver to Assess Inspiratory Muscle Pressure During Assisted Mechanical Ventilation: A Bench Study.

The generation of excessive inspiratory muscle pressure (Pmus) during assisted mechanical ventilation in patients with respiratory failure may result in acute respiratory muscle injury and/or fatigue, and exacerbate ventilator-induced lung injury. A readily available noninvasive surrogate measure of Pmus may help in titrating both mechanical ventilation and sedation to minimize these risks. This bench study explored the feasibility and accuracy of using a ventilator's expiratory pause hold function to measure Pmus across multiple operators. A standardized technique for executing a brief (<1 s) expiratory pause maneuver was used to measure the airway occlusion pressure change (Δ Paw) by using 3 simulated Pmus (Δ Pmus: 5, 10, 15 cm H2O) under (1) pressure support ventilation (0, 10, 15 cm H2O), (2) volume and pressure-regulated volume ventilation, (3) flow and pressure-triggering, and (4) varying levels of PEEP and pressure-rise time. Individual and grouped measurements were made by 4-7 clinicians on 3 different ventilators. The concordance between occlusion Δ Paw and Δ Pmus was arbitrarily set at ≤ 2 cm H2O. Data were evaluated by using analysis of variance and the Tukey-Kramer posttest. Correlation was assessed by using the Pearson R test; bias and precision were assessed by using the Bland-Altman method. Alpha was set at 0.05. Grouped expiratory pause maneuver measurements of occlusion Δ Paw across simulated Δ Pmus, mode and level of ventilatory support showed reasonable concordance, regardless of the ventilator used. Occlusion Δ Paw accuracy frequently decreased by ∼3 cm H2O when both pressure support ventilation and Δ Pmus reached 15 cm H2O. Expiratory pause maneuver accuracy was not affected by trigger mechanism and/or sensitivity, PEEP, or the post-trigger pressurization rate. In general, only small differences in Δ Paw occurred among the individual operators. The expiratory pause maneuver generally provided reproducible, stable approximations of Δ Pmus across ventilators and ventilator settings, and a range of simulated effort. Technique standardization produced relatively consistent results across multiple operators. The expiratory pause maneuver seemed feasible for general use in monitoring inspiratory effort during assisted mechanical ventilation.

Latent variable dose–response modelling of external training load measures and musculoskeletal responses in elite rugby league players

ABSTRACT Establishing dose–response relationships between training load and fatigue can help the planning of training. The aim was to establish the relative importance of external training load measurements to relate to the musculoskeletal response on a group and individual player level. Sixteen elite male rugby league players were monitored across three seasons. Two- to seven-day exponential weighted averages (EWMA) were calculated for total distance, and individualised speed thresholds (via 30–15 Intermittent Fitness Test) derived from global positioning systems. The sit and reach, dorsiflexion lunge, and adductor squeeze tests represented the musculoskeletal response. Partial least squares and repeated measures correlation analyses established the relative importance of training load measures and then investigated their relationship to the collective musculoskeletal response for individual players through the construction of latent variables. On a group level, 2- and 3-day EWMA total distance had the highest relative importance to the collective musculoskeletal response (p < 0.0001). However, the magnitude of relationships on a group (r value = 0.20) and individual (r value = 0.06) level were trivial to small. The lack of variability in the musculoskeletal response over time suggest practitioners adopting such measures to understand acute musculoskeletal fatigue responses should do so with caution.

The effect of experience on the psychophysiological response and shooting performance under acute physical stress of soldiers

Present research studied the psychophysiological response and shooting performance taking into consideration the experience of the soldier after a physical stress protocol, which leaded to acute fatigue conditions. Sixty soldiers were divided into experienced and non-experienced groups to conduct a high-intensity interval training (HIIT) based on endurance type exercises (10 intervals of 40 m run at maximum intensity with 2 changes of direction and 45 s of recovery. Psychophysiological and shooting performance variables were measured before, during and after the HIIT protocol. Significant increases in heart rate, blood lactate, lower limbs strength, as well as a significant decrease in blood oxygen saturation and body temperature were found in both groups. Shooting performance was affected by experience and fatigue, being more accentuated in non-experienced. Present HIIT protocol elicited a similar psychophysiological response than in previously reported combat manoeuvres, thus proving to be an optimal stimuli approach/intervention for soldier's specific physical preparation

Attenuated cardiovascular reactivity is related to higher anxiety and fatigue symptoms in truck drivers.

Depression and anxiety have been linked with reduced stress-induced cardiovascular reactivity (CVR), which could be indicative of autonomic dysregulation. Less is known about the association between work-related fatigue and CVR. Truck drivers experience high levels of depression, anxiety, and fatigue, with repeated psychophysiological stressors on the road, yet little is known about the effects of these conditions on their CVR. Three hundred eighty six truck drivers completed the Hospital Anxiety and Depression Scale (HADS) and the Occupational Fatigue Exhaustion/Recovery Scale (OFER-15). Systolic (SBP) and diastolic (DBP) blood pressure and heart rate (HR) were measured at rest and during a stressor protocol to measure CVR. Multivariate regression analyses were used to determine relationships between variables and adjusted for nine key covariates. Higher symptoms of persistent fatigue were related to a reduced SBP reactivity (β=-.236, p=.009) and reduced DBP reactivity (β=-.257, p=.005), whereas there was a positive trend between acute fatigue and DBP reactivity (β=.169, p=.052). Higher symptoms of anxiety were related to a reduced SBP reactivity (β=-.164, p=.016). This study demonstrated in a population of truck drivers that both anxiety and persistent fatigue were related to an attenuated SBP reactivity in a combined model, whereas there was a positive trend between acute fatigue solely and DBP reactivity. These novel findings may have serious implications for cardiovascular disease risk in truck drivers, and future research should attempt to establish the causal effect of these associations and the underlying physiological mechanisms.