Browsing by Author "Noakes, T D"

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    Age-related decrements in cycling and running performance
    (2004) St Clair Gibson, A; Lambert, M I; Noakes, T D
    Objective. This study examined age-related decrements in athletic performance during running and cycling activities. Design. The age group winning times for males aged between 18 and 70 years competing in the 1999 Argus cycle tour (103 km) and 1999 Comrades running marathon (90 km), South Africa's premier endurance cycling and running events respectively, were examined. Main outcome measures. The relationship between speed (cycling and running respectively) and age was calculated using a 4th order polynomial function. The derivative of each of these functions was determined and then the slope of the function corresponding to each age was calculated. Results. The rate of decline in running speed occurred at an earlier age (~ 32 years) during the running race compared with the cycling tour (~ 55 years). Conclusions. These findings establish a trend that there is ‘accelerated' aging during running which can perhaps be attributed to the increased weight-bearing stress on the muscles during running compared with cycling.
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    Factors predicting walking intolerance in patients with peripheral arterial disease and intermittent claudication
    (2008) Parr, B; Noakes, T D; Derman, E W
    Objective. To determine which physiological variables conduce to walking intolerance in patients with peripheral arterial disease (PAD). Design. The physiological response to a graded treadmill exercise test (GTT) in patients with PAD was characterised. Setting. Patients were recruited from the Department of Vascular Surgery, Groote Schuur Hospital, Cape Town. Subjects. Thirty-one patients diagnosed with PAD were included in the study. Outcome measures. During a GTT, peak oxygen consumption (VO2peak), peak minute ventilation (VEpeak), peak heart rate and peak venous lactate concentrations were measured and compared with those from a comparison group. Anklebrachial index (ABI) was measured at rest and after exercise. During the GTT, maximum walking distance (MWD) and pain-free walking distance (PFWD) were measured to determine walking tolerance. Results. Peak venous lactate concentrations did not correlate significantly with either PFWD (r=–0.08; p=0.3) or MWD (r=–0.03; p=0.4). Resting ABI did not correlate with either MWD (r=0.09; p=0.64) or PFWD (r=–0.19; p=0.29). Subjects terminated exercise at significantly (p<0.05) lower levels of cardiorespiratory effort and venous lactate concentrations than did a sedentary but otherwise healthy comparison group: peak heart rate 156±11 v. 114±22 beats per minute (BPM); p=0.001; and peak venous lactate concentration 9.7±2.7 mmol/l v. 3.28±1.39 mmol/l; p=0.001. Conclusion. Perceived discomfort in these patients is not caused by elevated blood lactate concentrations, a low ABI or limiting cardiorespiratory effort but by other factors not measured in this study.
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    Hyponatraemic encephalopathy despite a modest rate of fluid intake during a 109 km cycle race. British Journal of Sports Medicine, 39(10): e38.
    (2005) Dugas, J P; Noakes, T D
    Objective: To report a case of exertional hyponatraemic encephalopathy that occurred despite a modest rate of fluid intake during a 109 km cycling race. Methods: Men and women cyclists were weighed before and after the race. All subjects were interviewed and their water bottles measured to quantify fluid ingestion. A blood sample was drawn after the race for the measurement of serum Na+ concentration. Results: From the full set of data (n  =  196), one athlete was found to have hyponatraemic encephalopathy (serum [Na+] 129 mmol/l). She was studied subsequently in the laboratory for measurement of sweat [Na+] and sweat rate. Conclusions: Despite a modest rate of fluid intake (735 ml/h) and minimal predicted sweat Na+ losses, this female athlete developed hyponatraemic encephalopathy. The rate of fluid intake is well below the rate currently prescribed as optimum. Drinking to thirst and not to a set hourly rate would appear to be the more appropriate behaviour.
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    Intra-operative pneumatic tourniquet – perceptions of use and complications in the orthopaedic community of South Africa
    (1996) Gibson, A St Clair; Lambert, M I; Milligan, J; Merwe, W van der; Walters, J; Noakes, T D
    OBJECTIVES: To assess views on use, maintenance and side-effects of the pneumatic tourniquet in the South African orthopaedic community. METHODS: A census-type questionnaire study was conducted of all 475 orthopaedic surgeons registered with the Orthopaedic Association of South Africa during 1993/94. The chi-square test was used to determine statistical significance between different groups of respondents. RESULTS: Seventy-seven per cent of the questionnaires were returned. Ninety-nine per cent of respondents used a pneumatic tourniquet. Eighty-four per cent believed that the tourniquet may damage underlying tissue both as a result of applied pressure effects and ischaemic consequences. Fifty-four per cent of respondents personally checked the calibration of the pneumatic tourniquet, although 76% of respondents believe that the apparatus needs to be checked at least once per month. More respondents who did not check the tourniquet apparatus than respondents who did check it believe that applied pressure does not cause tissue damage (P < 0.001), that the operating room technician or hospital engineer should be responsible for checking equipment (P < 0.001), and that equipment did not need to be checked more than once every 6 months (P < 0.001). CONCLUSIONS: Although most orthopaedic surgeons are aware of the pneumatic tourniquet's side-effects, a minority appear to be unaware of the hazards of excessive applied pressure alone or excessive applied pressure caused by use of faulty equipment. It needs to be emphasised to these surgeons that regular checking of the pneumatic tourniquet apparatus is necessary in order to prevent postoperative complications ascribed to use of the tourniquet.
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    New use of current technology to measure rectal temperature and heart rate during endurance exercise
    (Academy of Science of South Africa, 2005) Dugas, J; Burger, B; Noakes, T D
    The technology necessary to log data remotely and independently has been available for some years. This technology has been applied mostly to environmental and natural sciences, however, and not in life sciences. This was due primarily to the cost of the technology and the small demand for it in the life sciences, especially in studies of exercise physiology. Our recent collaboration with a local technology company (SyGade Solutions (Pty) Ltd., Johannesburg) has resulted in the use of miniature data loggers to record rectal temperature, heart rate (HR), and altitude during road and cycle racing. This technology has the potential to measure these variables simultaneously and in a free-living situation and will therefore contribute to more innovative research.
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    Predictors of the successful outcome of one-year survivors of coronary artery bypass surgery
    (2005) Eales, C J; Noakes, T D; Stewart, A; Becker, P
    This study was conducted on a South African cohort to establish the actors that may predict the successful outcome of coronary artery bypass surgery when assessed in terms of improved quality of life one year after the surgery. Information was sought on the socio-economic status of patients, their risk-factor profiles and clinical history. From the patient files, information was recorded on left ventricular ejection fraction, number of vessels bypassed, bypass time, and aortic cross-clamp time. The characteristics that were predictive of a successful outcome one year after surgery were identified. Patients in this study represented a high-risk population with multiple risk factors (obese, heavy smokers, hypertensive, hypercholesterolaemic, inactive, family history of heart disease, diabetes, and regular intake of alcohol). Measured medical parameters could not distinguish between the group with an improved quality of life and the group who did not have improved quality of life. One year after CABG all patients with an improved quality of life were men. The additional identified predictor variables for a successful outcome were: being married, patients' height, the knowledge that smoking affects the cardiovascular system, number of years that sporting activities were stopped prior to CABG surgery, a better quality sex life after the operation, acceptance of self-responsibility for rehabilitation, and the spouse knowing the diet the patient should follow. The predictors of a successful outcome at the time of the operation were: being married (OR = 22.6; p = 0.02); taller than 170 cm (OR = 15.5; p = 0.01); stopped all sporting activities for a period less than 20 years prior to their surgery (OR 11.4; p = 0.01). We concluded that the outcome of coronary artery bypass surgery could not be predicted on the basis of a medical model that considers exclusively the extent of the patient's disease and associated co-morbidities. Patients should be carefully selected and an intensive post-operative educational intervention should be provided to patients and their spouses/caregivers.