Publications by authors named "Louisa Beale"

11 Publications

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Thermoregulation is not impaired in breast cancer survivors during moderate-intensity exercise performed in warm and hot environments.

Physiol Rep 2021 Jul;9(14):e14968

Environmental Extremes Laboratory, University of Brighton, Eastbourne, UK.

This study aimed to assess how female breast cancer survivors (BCS) respond physiologically, hematologically, and perceptually to exercise under heat stress compared to females with no history of breast cancer (CON). Twenty-one females (9 BCS and 12 CON [age; 54 ± 7 years, stature; 167 ± 6 cm, body mass; 68.1 ± 7.62 kg, and body fat; 30.9 ± 3.8%]) completed a warm (25℃, 50% relative humidity, RH) and hot (35℃, 50%RH) trial in a repeated-measures crossover design. Trials consisted of 30 min of rest, 30 min of walking at 4 metabolic equivalents, and a 6-minute walk test (6MWT). Physiological measurements (core temperature (T ), skin temperature (T ), heart rate (HR), and sweat analysis) and perceptual rating scales (ratings of perceived exertion, thermal sensation [whole body and localized], and thermal comfort) were taken at 5- and 10-min intervals throughout, respectively. Venous blood samples were taken before and after to assess; IL-6, IL-10, CRP, IFN-γ, and TGF-β . All physiological markers were higher during the 35 versus 25℃ trial; T (~0.25℃, p = 0.002), T (~3.8℃, p < 0.001), HR (~12 beats·min , p = 0.023), and whole-body sweat rate (~0.4 L·hr , p < 0.001), with no difference observed between groups in either condition (p > 0.05). Both groups covered a greater 6MWT distance in 25 versus 35℃ (by ~200 m; p = 0.003). Nevertheless, the control group covered more distance than BCS, regardless of environmental temperature (by ~400 m, p = 0.03). Thermoregulation was not disadvantaged in BCS compared to controls during moderate-intensity exercise under heat stress. However, self-paced exercise performance was reduced for BCS regardless of environmental temperature.
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http://dx.doi.org/10.14814/phy2.14968DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8295682PMC
July 2021

Validity of a wearable sweat rate monitor and routine sweat analysis techniques using heat acclimation.

J Therm Biol 2020 May 29;90:102577. Epub 2020 Mar 29.

Environmental Extremes Laboratory, University of Brighton, Eastbourne, BN20 7SR, UK.

Introduction: the aim of this study was to assess the validity of a novel wearable sweat rate monitor against an array of sweat analysis techniques which determine sudomotor function when exercising moderately under heat stress. Construct validity was determined utilising a 5-day short-term heat acclimation (STHA) intervention.

Methods: Nineteen healthy individuals (age: 41 ± 23 years, body mass: 74.0 ± 12.2 kg, height: 174.9 ± 6.9 cm) [male; n = 15, female; n = 4] completed nine trials over a three-week period, in a controlled chamber set to 35 °C, 50% relative humidity for all sessions. The pre and post-trials were separated by five consecutive controlled hyperthermia HA sessions. Sweat analysis was compared from pre and post-trial, whereby whole body sweat rate (WBSR) was assessed via pre and post nude body mass. Local sweat rate (LSR) was determined via technical absorbent patches (TA) (weighed pre and post) and a novel wearable KuduSmart® (SMART) monitor which was placed on the left arm during the 30-min of exercise. Tegaderm patches, used to measure sweat sodium chloride conductivity (SC), and TA patches were placed on the back, chest and forearm for the 30-min cycling.

Results: Sudomotor function significantly adapted via STHA (p < 0.05); demonstrated by a WBSR increase of 24%, LSR increase via the TA method (back: 26%, chest: 45% and arm: 48%) and LSR increase by the SMART monitor (35%). Finally, SC decreased (back: -21%, chest: -25% and arm: -24%, p < 0.05).

Conclusion: All sweat techniques were sensitive to sudomotor function adaptation following STHA, reinforcing their validity. The real time data given by the wearable KuduSmart® monitor provides coaches and athletes instant comparable sudomotor function feedback to traditional routinely used sweat analysis techniques.
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http://dx.doi.org/10.1016/j.jtherbio.2020.102577DOI Listing
May 2020

The importance of contractile reserve in predicting exercise tolerance in asymptomatic patients with severe aortic stenosis.

Echo Res Pract 2019 Sep;6(3):43-52

St. Bartholomew's Hospital, Barts Heart Centre, London, UK.

Background: Mortality dramatically rises with the onset of symptoms in patients with severe aortic stenosis (AS). Surgery is indicated when symptoms become apparent or when there is ventricular decompensation. Cardiopulmonary exercise testing (CPET) in combination with exercise echocardiography can unmask symptoms and provides valuable information regarding contractile reserve. The aim of the present study was to determine the prevalence of reduced exercise tolerance and the parameters predicting adverse cardiovascular events.

Methods: Thirty-two patients with asymptomatic severe AS were included in this study. Patients were followed up as part of an enhanced surveillance clinic.

Results: Age was 69 ± 15.7 years, 75% of patients were male. Patients had a raised NT-ProBNP of 301 pg/mL. VO2peak was 19.5 ± 6.2 mL/kg/min. Forty-one percent of patients had a reduced %VO2peak and this predicted unplanned cardiac hospitalisation (P = 0.005). Exercise systolic longitudinal velocity (S') and age were the strongest independent predictors for VO2peak (R 2 = 0.76; P < 0.0001). Exercise S' was the strongest independent predictor for NT-ProBNP (R 2 = 0.48; P = 0.001).

Conclusion: A large proportion of patients had a lower than predicted VO2peak. The major determinant of exercise and NT-ProBNP is the ability of the left ventricle (LV) to augment S' on exercise rather than the severity of aortic valve obstruction or resting structural remodelling of the LV. Reduced exercise tolerance and more adverse remodelling, rather than valve obstruction predicted unplanned hospitalisation. This study demonstrates that for those patients, in whom a watchful waiting is an agreed strategy, a detailed assessment should be undertaken including CPET, exercise echocardiography and biomarkers to ensure those with exercise limitation and risk of decompensation are detected early and treated appropriately.
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http://dx.doi.org/10.1530/ERP-19-0005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6589858PMC
September 2019

Reliability of a wearable sweat rate monitor and routine sweat analysis techniques under heat stress in females.

J Therm Biol 2019 Jan 18;79:209-217. Epub 2018 Dec 18.

Environmental Extremes Laboratory, University of Brighton, Eastbourne BN20 7SR, UK.

Introduction: The aim of the study was to evaluate the reliability of five different sweat analysis techniques which measure; whole body sweat rate [WBSR], local sweat rate [LSR] (via technical absorbent [TA] method and KuduSmart monitor), sweat conductivity [SC] and sweat gland activation [SGA] in a female population when exercising moderately under heat stress.

Methods: Fourteen females (age; 26 ± 7 years, body mass; 66.5 ± 7.6 kg, height; 167.1 ± 6.4 cm) completed a preliminary threshold walking test (to determine exercise intensity) and two main trials, separated by 2 days. Main trials consisted of 30-min seated rest in the environmental chamber (35 °C, 50% relative humidity) in an upper body sauna-suit, before its removal, and walking at a moderate intensity (4 metabolic equivalents) for 30-min (speeds ranged from 4.8 to 6.5 km h). WBSR was measured via nude mass pre and post exercise. The TA and Tegaderm patches (for sweat sodium chloride) were placed on the back, forearm and chest for the entire 60-min, replicated for all participants for both trials. SGA was assessed following the 60-min trial and the KuduSmart® monitor was placed on the left arm for the 30-min of exercise.

Results: WBSR, LSR methods and SC demonstrated no difference between trials (p > 0.05), good agreement (within limits), strong correlations (r ≥ 0.88) and low typical error of measurements [TEM] (< 0.04 L min, 0.13 mg min cm and 8 mmol L, respectively). SGA method showed moderate intra-class correlation (r = 0.80), with high TEM (5 glands) and large limits of agreement.

Conclusion: Sudomotor function is reliable, as demonstrated by good reliability, small TEM and strong correlations. The use of these sweat techniques is appropriate and practical in females who are exercising at moderate intensity under heat stress, and so, may aid future interventions. SGA shows larger variation and should be used with caution.
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http://dx.doi.org/10.1016/j.jtherbio.2018.12.019DOI Listing
January 2019

Short-Term Psychological and Physiological Effects of Varying the Volume of High-Intensity Interval Training in Healthy Men.

Percept Mot Skills 2019 Feb 21;126(1):119-142. Epub 2018 Nov 21.

3 Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Australia.

We assessed the short-term effects of varying the volume of high-intensity interval training (HIIT) on psychological and physiological responses of 23 healthy adult males ( M = 21 years; M peak oxygen uptake [VO] = 47.2 ml·kg·min). Participants were randomly assigned to low- and very-low-volume HIIT groups and engaged in nine supervised exercise sessions over three weeks. The low-volume HIIT group performed 8-12 60-second work bouts on a cycle ergometer at the peak power output achieved during the incremental test, interspersed by 75 seconds of low-intensity active recovery. The very-low-volume HIIT performed 4-6 work bouts with the same intensity, duration, and rest intervals. During training, participants' ratings of perceived exertion (Borg Category Ratio-10 scale) and their affective responses (Feeling Scale -5/+5) during the last 15 seconds of each work bout were recorded. Physiological data were VO, endurance, and anaerobic performance before and after the intervention. Throughout training, participants in the very-low-volume group (relative to the low-volume group) reported lower ratings of perceived exertion in Week 1 ( M = 4.1 vs. M = 6.3; p < .01) and Week 3 ( M = 4.0 vs. M = 6.2; p < .01), and higher affective response in these same two weeks (Week 1: M = 1.9 vs. M = 0.3; p = .04; Week 3: M = 2.1 vs. M = 0.9; p = .06). Regarding physical fitness, Wingate peak power increased significantly after training in the very-low-volume HIIT group ( M = 1,049 W vs. M = 1,222 W; p < .05), but not in the low-volume HIIT group ( M = 1,050 W vs. M = 1,076 W). No significant change was found after training in physiological variables of peak power output, VO, and endurance performance. In summary, in this short-term training period, the very-low-volume HIIT enhanced anaerobic capacity and was perceived as less strenuous and more pleasurable than low-volume HIIT.
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http://dx.doi.org/10.1177/0031512518809734DOI Listing
February 2019

Prognostic importance of tissue velocity imaging during exercise echocardiography in patients with systolic heart failure.

Echo Res Pract 2015 Mar 3;2(1):19-27. Epub 2015 Mar 3.

Cardiology Department, District General Hospital , Kings Drive, Eastbourne, BN21 2UD , UK.

Resting echocardiography measurements are poor predictors of exercise capacity and symptoms in patients with heart failure (HF). Stress echocardiography may provide additional information and can be expressed using left ventricular ejection fraction (LVEF), or diastolic parameters (E/E'), but LVEF has some major limitations. Systolic annular velocity (S') provides a measure of longitudinal systolic function, which is relatively easy to obtain and shows a good relationship with exercise capacity. The objective of this study was to investigate the relationship among S', E/E' and LVEF obtained during stress echocardiography and both mortality and hospitalisation. A secondary objective was to compare S' measured using a simplified two-wall model. A total of 80 patients with stable HF underwent exercise stress echocardiography and simultaneous cardiopulmonary exercise testing. Volumetric and tissue velocity imaging (TVI) measurements were obtained, as was peak oxygen uptake (VO2 peak). Of the total number of patients, 11 died and 22 required cardiac hospitalisation. S' at peak exertion was a powerful predictor for death and hospitalisation. Cut-off points of 5.3 cm/s for death and 5.7 cm/s for hospitalisation provided optimum sensitivity and specificity. This study suggests that, in patients with systolic HF, S' at peak exertion calculated from the averaged spectral TVI systolic velocity of six myocardial segments, or using a simplified measure of two myocardial segments, is a powerful predictor of future events and stronger than LVEF, diastolic velocities at rest or exercise and VO2 peak. Results indicate that measuring S' during exercise echocardiography might play an important role in understanding the likelihood of adverse clinical outcomes in patients with HF.
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http://dx.doi.org/10.1530/ERP-14-0074DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676458PMC
March 2015

Why sprint interval training is inappropriate for a largely sedentary population.

Front Psychol 2014 23;5:1505. Epub 2014 Dec 23.

Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University Perth, WA, Australia.

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http://dx.doi.org/10.3389/fpsyg.2014.01505DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274872PMC
January 2015

Oxygen Cost of Recreational Horse-Riding in Females.

J Phys Act Health 2015 Jun 15;12(6):808-13. Epub 2014 Aug 15.

School of Sport and Service Management, University of Brighton, Eastbourne, United Kingdom.

Background: The purpose of this study was to characterize the physiological demands of a riding session comprising different types of recreational horse riding in females.

Methods: Sixteen female recreational riders (aged 17 to 54 years) completed an incremental cycle ergometer exercise test to determine peak oxygen consumption (VO₂peak) and a 45-minute riding session based upon a British Horse Society Stage 2 riding lesson (including walking, trotting, cantering and work without stirrups). Oxygen consumption (VO₂), from which metabolic equivalent (MET) and energy expenditure values were derived, was measured throughout.

Results: The mean VO₂ requirement for trotting/cantering (18.4 ± 5.1 ml·kg⁻¹·min⁻¹; 52 ± 12% VO₂peak; 5.3 ± 1.1 METs) was similar to walking/trotting (17.4 ± 5.1 ml·kg⁻¹·min⁻¹; 48 ± 13% VO₂peak; 5.0 ± 1.5 METs) and significantly higher than for work without stirrups (14.2 ± 2.9 ml·kg⁻¹·min⁻¹; 41 ± 12% VO₂peak; 4.2 ± 0.8 METs) (P = .001).

Conclusions: The oxygen cost of different activities typically performed in a recreational horse riding session meets the criteria for moderate intensity exercise (3-6 METs) in females, and trotting combined with cantering imposes the highest metabolic demand. Regular riding could contribute to the achievement of the public health recommendations for physical activity in this population.
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http://dx.doi.org/10.1123/jpah.2012-0428DOI Listing
June 2015

Tissue doppler-derived contractile reserve is a simple and strong predictor of cardiopulmonary exercise performance across a range of cardiac diseases.

Echocardiography 2013 May 15;30(5):527-33. Epub 2013 Jan 15.

Cardiology Department, Eastbourne Hospital, East Sussex Hospitals NHS Trust, Eastbourne, United Kingdom.

Background: Resting echocardiographic measures of cardiac function such as left ventricular ejection fraction correlate poorly with exercise capacity. Assessment during exercise using measures less dependent on hemodynamic loading conditions, such as tissue Doppler imaging (TDI), may more accurately characterize the relationship between cardiac function and exercise capacity.

Methods And Results: One hundred one subjects with various cardiac diagnoses underwent exercise stress echocardiography with simultaneous cardiopulmonary gas exchange analysis. Standard two-dimensional, Doppler and spectral TDI parameters were assessed at both rest and peak exercise. Across all subjects the strongest relationship with peak oxygen uptake (pVO2 ) was with peak left ventricular systolic tissue velocity (S') during exercise (r = 0.84, P < 0.001). The strength of the relationship was greater than that observed with any other common echocardiographic measure of systolic or diastolic cardiac function.

Conclusion: There is a very strong relationship between measurements of S' during exercise and exercise capacity. The previously observed poor correlation with standard measures of systolic and diastolic cardiac function may be explained both by the load dependence of parameters such as ejection fraction and by reliance on resting as opposed to exercise assessment.
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http://dx.doi.org/10.1111/echo.12084DOI Listing
May 2013

Limitations to high intensity exercise prescription in chronic heart failure patients.

Eur J Cardiovasc Nurs 2011 Sep 18;10(3):167-73. Epub 2010 Jul 18.

University of Brighton, United Kingdom.

Background: Interval training is recommended for chronic heart failure patients (CHF), but specific guidelines on setting appropriate workloads have not been fully established. The aim of this study was to compare a traditional method of interval training prescription with a protocol specifically designed for CHF.

Methods: Ten CHF and 7 healthy controls performed 2 maximal incremental cycle tests to determine interval training workload; a standard test (10Wmin(-)(1)) and a steep test (25W.10(-)(s)). Peak work rate and oxygen uptake (VO(2 peak)) were determined. Training workloads were defined as 100% standard test and 50% steep test peak work rate.

Results: Training workload determined from the standard test was higher than from the steep test in healthy controls (151 ± 17W vs 118 ± 13W; P<0.01), whereas in CHF there was no significant difference between methods (88 ± 10W vs 96 ± 9W; P>0.05). Steep test VO(2peak) reached 91 ± 5% of standard test VO(2 peak) in controls, and 99 ± 4% in CHF, with no significant differences between tests in either group.

Conclusion: Prescribing interval training from a standard test results in higher workloads than from a steep test in healthy individuals, but in CHF both methods prescribe similar workloads. However it should not be assumed that the two tests can be used interchangeably for CHF. This small-sized study raises issues about interval training prescription that may be hypothesis-generating for future larger-scale studies.
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http://dx.doi.org/10.1016/j.ejcnurse.2010.06.002DOI Listing
September 2011

Defining exercise synchrony in fit young adults: a tissue Doppler study.

J Am Soc Echocardiogr 2008 Jul 19;21(7):808-12. Epub 2008 May 19.

Department of Cardiology, Eastbourne District General Hospital, Eastbourne, United Kingdom.

Objective: Exercise-induced changes in the synchrony of left ventricular contraction may be an important therapeutic target in heart failure. There are limited data to support the feasibility of exercise assessments. In addition, the effect of exercise on synchrony in healthy individuals is undetermined.

Methods: Eleven healthy young men underwent tissue Doppler assessments before and immediately after maximal cardiopulmonary exercise. Left ventricular synchrony was assessed using pulsed wave tissue Doppler of the lateral, septal, inferior, and anterior walls. The maximal dispersion times between the walls for onset and peak systolic velocities were used as synchrony indices.

Results: The proportion of the cardiac cycle taken between Q wave and time to onset or peak systolic motion was constant at rest and peak exercise. There was no significant exercise-induced change seen in either interventricular or intraventricular synchrony.

Conclusion: Exercise synchrony assessment is technically feasible. Synchronization of cardiac contraction is maintained after maximal exercise in healthy individuals.
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http://dx.doi.org/10.1016/j.echo.2007.12.012DOI Listing
July 2008
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