OpenUCT :: Browsing by Author "Noakes, Timothy D"

Browsing by Author "Noakes, Timothy D"

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Open Access
A commentary on the intellectual health of the nation
(2007) Vaughan, Christopher L; Reddy, B Dayanand; Noakes, Timothy D; Moran, V C
The record of high-quality research at South African universities is not as impressive as we may have thought, according to some international rankings. Whatever we might think of these assessments, we have to take them seriously. We suggest ways in which our universities and other institutions of higher learning might raise the level of their game.
Open Access
Blood lactate levels during exercise : the effects of exercise duration, bicarbonate infusion and beta-receptor antagonism
(1985) Bertram, Sheila Rae; Noakes, Timothy D
This study examines factors that determine blood lactate accumulation during exercise in order to examine the opposing theories that such accumulation occurs either as a result of muscle anaerobiosis or an "overflow" of oxygen-independent glycolysis.
Open Access
Carbohydrate metabolism during active and passive post-exercise recovery
(1984) Peters, Edith M; Noakes, Timothy D
It is known that light muscular activity performed during the immediate post-exercise recovery period, increases the rate at which lactate and protons are removed from the circulation. This study examined the effect which this light activity had on muscle glycogen and lactate levels, as well as the restoration of blood fuel and hormonal homeostasis. A further dimension of the study was to monitor the metabolic adaptations which took place in the inactive leg during light one-legged post-exercise activity. Eight subjects participated in this study. The testing procedure involved three phases: the assessment of each subject's maximal exercise capacity on the cycle ergometer; the imposition of an intense intermittent exercise protocol which was followed by a passive recovery of 90 minutes; and lastly, the repetition of the exhaustive intermittent protocol followed by a partially-active recovery phase during which the subject cycled with one leg at approximately 30 percent of two-legged VO2. max. for the first 45 minutes of the 90-minute recovery period. During the latter two phases, blood samples and muscle biopsies were taken at rest and during the post-exercise recovery. The light one-legged activity expedited the return of blood lactate and pH levels to basal values (p < 0,01), during the initial 30 minutes of recovery but slowed down the removal of lactate and protons during the latter 15 minutes of the active recovery. There were no significant differences in the blood glucose, pyruvate, alanine, and insulin levels during the different recovery protocols, but plasma glucagon levels were significantly lower 0,05) delayed as a result of activity during the immediate post-exercise period, but that muscle lactate levels were significantly lower in the passive leg than in the active leg after the first 45 minutes of the recovery period. As resynthesis of glycogen took place during the active recovery, this study appeared to indicate (i) that lactate oxidation was an important source of substrate during the initial 30 minutes of the active recovery (ii) that oxidation was possibly the primary fate of lactate during the active post-exercise recovery period and (iii) that intramuscular glyconeogenesis in the fast-twitch muscle fibres of the previously active legs was a distinct possibility. Apparent suprabasal production of lactate in the active fibres of the active leg during the latter stages of the active recovery, however, appeared to indicate partial reliance on exogenous glucose as substrate in these fibres during this stage of the recovery.
Open Access
Chronic disease risk factors, healthy days and medical claims in South African employees presenting for health risk screening
(BioMed Central Ltd, 2008) Kolbe-Alexander, Tracy L; Buckmaster, Chris; Nossel, Craig; Dreyer, Liezel; Bull, Fiona; Noakes, Timothy D; Lambert, Estelle
BACKGROUND: Non-communicable diseases (NCD) accounts for more than a third (37%) of all deaths in South Africa. However, this burden of disease can be reduced by addressing risk factors. The aim of this study was to determine the health and risk profile of South African employees presenting for health risk assessments and to measure their readiness to change and improve lifestyle behaviour. METHODS: Employees (n = 1954) from 18 companies were invited to take part in a wellness day, which included a health-risk assessment. Self-reported health behaviour and health status was recorded. Clinical measures included cholesterol finger-prick test, blood pressure and Body Mass Index (BMI). Health-related age was calculated using an algorithm incorporating the relative risk for all case mortality associated with smoking, physical activity, fruit and vegetable intake, BMI and cholesterol. Medical claims data were obtained from the health insurer. RESULTS: The mean percentage of participation was 26% (n = 1954) and ranged from 4% in transport to 81% in the consulting sector. Health-related age (38.5 +/- 12.9 years) was significantly higher than chronological age (34.9 +/- 10.3 yrs) (p < 0.001). Both chronological and risk-related age were significantly different between the sectors (P < 0.001), with the manufacturing sector being the oldest and finance having the youngest employees. Health-related age was significantly associated with number of days adversely affected by mental and physical health, days away from work and total annual medical costs (p < 0.001). Employees had higher rates of overweight, smoking among men, and physical inactivity (total sample) when compared the general SA population. Increased health-related expenditure was associated with increased number of risk factors, absenteeism and reduced physical activity. CONCLUSION: SA employees' health and lifestyle habits are placing them at increased risk for NCD's, suggesting that they may develop NCD's earlier than expected. Inter-sectoral differences for health-related age might provide insight into those companies which have the greatest need for interventions, and may also assist in predicting future medical expenditure. This study underscores the importance of determining the health and risk status of employees which could assist in identifying the appropriate interventions to reduce the risk of NCD's among employees.
Open Access
A comparative study of the effects of meclofenamate, diclofenac and placebo, in combination with physiotherapy, on the healing of acute quadriceps and hamstring muscle tears
(1991) Reynolds, Jonathan F; Bowerbank, Patricia; Noakes, Timothy D
A double-blind, placebo controlled research technique was used to determine the effects of two non-steroidal anti-inflammatory drugs, meclofenamate and diclofenac, in combination with physiotherapy treatment, on the rate and extent of healing of acute hamstring muscle tears. Sixty patients were recruited and treated at No's 1 and 2 Military Hospitals in Voortrekkerhoogte and Wynberg, Cape Town, respectively. Patients were randomly allocated to one of three treatment groups: meclofenamate, diclofenac and placebo. Patient assessments were performed on days 1, 3 and 7 of the 7-day study period. These assessments included pain assessment (visual analogue scale), swelling measurement (thigh circumference measurement at the site of the muscle tear) and muscle performance test (Cybex isokinetic dynamometer and data reduction computer). All patients received physiotherapy treatment on all 7 days of the study. This comprised early rest, ice, compression and elevation (RICE), and later, ultrasound and deep transverse friction massage. An intensive regime of strengthening and stretching exercises was used throughout the study, beginning with stretching and isometric exercises gradually moving onto isotonic exercises and aerobic exercise including swimming, running and cycling. No competitive sport was allowed during the study period. Statistical significance was determined using the analysis-of-variance (ANOVA) test with an acceptance level of p<0.05. No differences in pain, swelling or muscle performance were demonstrated between the three treatment groups. In terms of the pain and swelling assessments, the injuries did not appear to be very severe. Accordingly, the groups were divided into severe and non-severe sub-groups and statistical significance was determined using the ANOVA test with an acceptance level of p<0.05. A significant difference was found in the severe hamstring injury sub-group. In this group, pain reduction was greater in the placebo group than in the meclofenamate group on day 7. There were no other significant differences found in this sub-group analysis. Relatively few side effects were encountered, and those encountered were mild. No patients were withdrawn from the study as a result of these adverse events. Drowsiness and gastro-intestinal disturbance were the most common side effects reported. In conclusion, the study found that no benefit was gained from the use of meclofenamate or diclofenac in combination with physiotherapeutic modalities as compared to the use of physiotherapeutic modalities on their own. Thus, the widespread use of NSAIDs in the treatment of acute muscle injuries may not be justified.
Open Access
The effect of anabolic-androgenic hormones on postprandial triglyceridaemia and lipoprotein profiles in man
(1997) Hislop, Michael Stuart; Marais, David; Noakes, Timothy D
It has been hypothesised that endogenous testosterone and AAS may predispose humans to premature CHD. However, there is no direct evidence to link these hormones with a greater prevalence of premature CHD. The aim of this thesis was to better describe atherosclerotic risk associated with these hormones by clarifying their effect on additional risk factors for premature atherosclerosis. Little is known about the effect of testosterone and AAS on 'atherogenic dyslipidaemia', a phenotype characterised by elevated postprandial triglyceridaemia, small dense LDL and a low HDLC concentration, which confers a high risk of CHD. Accordingly, the magnitude of postprandial triglyceridaemia, LDL and HDL particle size, and LDLC, HDLC and Lp(a) concentration were compared in male (n=9) and female (n=3) bodybuilders after self administration of AAS for 5-6 weeks (ON cycle) and again after a 4-6 week 'washout' period (OFF cycle), and in normal males (T) (n=10) before and during a reversible suppression of endogenous testosterone, induced using a GnRH agonist (triptorelin), and in a control group (C) (n=8). Lipoprotein size was assessed by gradient gel electrophoresis (GGE), lipoprotein concentrations by immuno and enzymatic assay, and postprandial triglyceridaemia by a standardised oral fat tolerance test (65g/m² ). HDLC decreased in male bodybuilders (0.94±0.30 vs 0.70±0.27 mmol/L, p=0.004; x ± SD) and female bodybuilders (1.3±0.5 vs 0.8±0.2 mmol/L) ON cycle. GGE studies suggested that mostly HDL₂ was reduced. There were no significant reductions in LDL particle size ON cycle. Two males had larger LDL species ON cycle. Lp(a) decreased in male bodybuilders (124.7±128.0 to 69.3±73.3 U/L, p=0.008). ON cycle postprandial triglyceride excursion was unchanged in female bodybuilders and reduced (11.6±10.0 vs 7.5±5.4 mmol/L.hr; p=0.027) in male bodybuilders. In the triptorelin study, HDLC was increased in T (1.07±0.18 vs 1.41±0.28 mmol/L, p=0.002) and not in C. GGE studies indicated an increase of HDL₂ in five T subjects and no increase in C. Total cholesterol increased in T (4.77±0.80 vs 5.24±1.04 mmol/L, p=0.039) but not in C. LDL size increased in four T subjects, and not in C. Lp(a) increased in T (277.9±149.l vs 376.5±222.2 U/L, p=0.004), but not in C. Postprandial triglyceridaemia was unchanged in both T and C. The results of these studies did not show any additional atherogenic effects of endogenous testosterone or AAS in humans. Rather, a suppression of Lp(a) may be an antiatherogenic effect of these hormones. A reduced postprandial triglyceridaemia and increased LDL size in individuals who are predisposed to 'atherogenic dyslipidaemia', may be further antiatherogenic effects of AAS use.
Open Access
The effect of carbohydrate-loading and carbohydrate ingestion on fuel substrate kinetics during prolonged cycling
(1995) Bosch, Andrew Norman; Noakes, Timothy D; Dennis, Steve
It has been well established that both carbohydrate-loading before and carbohydrate ingestion during exercise can enhance endurance performance by supplying carbohydrate for oxidation. However, the precise mechanism(s) underlying the proposed ergogenic effects of these procedures remain to be established. The studies in this thesis were therefore designed to examine the effects of carbohydrate-loading and carbohydrate ingestion on fuel substrate kinetics.
Open Access
The effect of muscle glycogen status on control of substrate metabolism during exercise
(1998) Weltan, Sandra Mary; Noakes, Timothy D; Dennis, Steve
Glycogen depletion has frequently been shown to result in a decrease in respiratory exchange ratio (RER). However, the metabolic response to glycogen depletion has generally been studied in overnight fasted subjects or in subjects who were already fatigued, or hypoglycaemic, or both, raising the question of whether the differences seen were due to general "carbohydrate deficiency" or due specifically to muscle or liver glycogen depletion. If euglycaemia and especially hyperglycaemia is maintained, the " carbohydrate deficiency" is overcome. In addition, because insulin stimulates muscle glucose uptake and not liver glucose uptake during euglycaemia (except at very high concentrations), insulin infusion would differentiate between liver and muscle glycogen depletion, since if the decrease in RER previously observed is abolished with insulin infusion while euglycaemia is maintained, this would indicate that the decrease is specifically due to muscle glycogen depletion. Thus, the aim of this study was to investigate the metabolic effect of glycogen content while an adequate amount or an excess of carbohydrate was provided in the form of an intravenous glucose infusion and when plasma insulin concentrations are raised.
Restricted
Effects of elevated plasma adrenaline levels on substrate metabolism, effort perception and muscle activation during low-to-moderate intensity exercise
(2005) West, Sacha J; Goedecke, Julia H; Van Niekerk, Lizl; Collins, Malcolm; St Clair Gibson, Alan; MacDonald, Ian A; Noakes, Timothy D; Lambert, Estelle V
The aim of this study was to differentiate the role of raised plasma adrenaline (Adr) concentrations from sympathoadrenal activation associated with moderate-intensity exercise, on muscle activation, cardiopulmonary responses, fuel metabolism, and ratings of perceived exertion (RPE) during low-intensity exercise. Two groups of subjects (MOD, n=6; LOW, n=7) cycled on two occasions for 90 min. MOD cycled at 68% VO2max with saline infusion, and at 34% VO2max with Adr infusion. LOW cycled twice at 34% VO2max, with either Adr or saline infusion. Infusions (0.015 g Adr/kg/min) started at 15 min and increased plasma [Adr] somewhat higher than during exercise at 68% VO2max (~1.9 vs. 1.4 nM, at 75 min). Mean plasma glucose and lactate concentrations during LOW were significantly higher with Adr than saline infusion (5.1±0.6 vs. 4.4±0.3 mmol/l, P<0.01 and 2.1±0.8 vs. 1.3±0.5 mmol/l, P<0.01, respectively). Elevated [Adr], without increased exercise intensity, did not alter glycogenolysis. There were also no effects of Adr infusion at 34% VO2max on heart rate, oxygen consumption, [FFA], respiratory exchange ratio, intramuscular triglyceride utilization, muscle activation or RPE. In conclusion, elevated [Adr] similar to those found during moderate-intensity exercise increased plasma glucose and lactate availability, but did not alter intramuscular fuel utilization, effort perception or muscle activation.
Open Access
The effects of endurance training on lactate production and removal during progressive exercise in man
(1991) Macrae, Holden Steve-Henry; Noakes, Timothy D
It is a well-documented finding that blood lactate concentrations at any given absolute or relative (% of maximum oxygen uptake; % VO₂ₘₐₓ) workload, are lower following endurance training. The search for the mechanisms responsible for lower blood lactate concentrations after training, however, has led to conflicting results, particularly when the possible causes of this finding have been investigated in humans. In this study, three questions related to the effects of endurance training on lactate metabolism were investigated.
Open Access
Effects of exercise training on left ventricular function and exercise capacity in patients with coronary artery disease and varying degrees of left ventricular dysfunction
(1999) Digenio, Andres G; Noakes, Timothy D
The medical profession has increased its acceptance of the benefits of exercise training for patients with uncomplicated coronary artery disease. Access to more modem technology and better management of this condition has led to an increase in the number of patients surviving acute coronary episodes . Some of these patients may have developed chronic asymptomatic left ventricular dysfunction and/or residual myocardial ischaemia, and could become potential candidates for cardiac rehabilitation if exercise training could induce physiological benefits without further deteriorating their condition. Over the last 10 years, several patients at moderate to high risk of future cardiovascular events because of the presence of left ventricular dysfunction and/or myocardial ischaemia have been accepted for cardiac rehabilitation at the Johannesburg Cardiac Rehabilitation Center. The purpose of the study was to evaluate the effects of exercise training on left ventricular function and exercise capacity in patients with coronary artery disease and varying degrees of left ventricular dysfunction and/or myocardial ischaemia attending the Johannesburg Cardiac Rehabilitation Center.
Open Access
The effects of sodium chloride ingestion on fluid balance and body fluid distribution during exercise
(1993) Sanders, Barry; Noakes, Timothy D
The aim of the first experiment of this thesis was to determine whether the ingestion of a concentrated sodium chloride solution (100mEq/1) during exercise would expand the plasma volume when fluid was ingested at approximately half the rate at which it was being lost as sweat. Six male cyclists exercised for 90 minutes in the heat (32 ± 1 °C, 55 ± 5% RH) at 66 ± 1 % of VO₂ₘₐₓ while ingesting either no fluid CNF), water (W), or a saline CS) solution (100mEq/1). In the Wand S trials, subjects drank 400ml of the fluid immediately prior to commencing exercise, and 100ml of fluid every 10 minutes during exercise until 80 minutes. In the S trial sodium chloride was ingested in capsules. One capsule containing 0.585g of sodium chloride was ingested with every 100ml of water. At the end of the 90 minute exercise bout they rested in a sitting position for one hour in cool conditions (22 ± 1 °C and 70 ± 5% RH). After the initial drop in plasma volume due to the onset of exercise. plasma volume decreased progressively during the NF trial and was significantly less than the 10 minute value at 80 and 90 minutes (p<0.0033). At 40, 60, 80 and 90 minutes of exercise, the plasma volume in the NF trial was significantly less than in the W and the S trials (p<0.05). There was no significant difference between the W and the S trials at any time. Further, after the initial drop in plasma volume due to the onset of exercise. plasma volume did not decrease any further in either the W or the S trial. Plasma sodium concentrations in the NF and the S trial were significantly elevated at 40, 60, 80 and 90 minutes (p<0.0033). Plasma sodium concentration in the NF and the S trials were also significantly higher than in the W trial at 80 and 90 minutes of exercise (p<0.05). Since the ingestion of a sodium chloride solution containing 100mEq/1 did not have a beneficial effect on plasma volume and plasma sodium concentration, when fluid ingestion rates were approximately half of the rate of sweat loss, it is concluded the under these conditions, the ingestion of a concentrated sodium chloride beverage has no advantage over the ingestion of water. The aim of the second experiment of this thesis was to determine the effect of varying concentrations of sodium chloride ingestion on fluid balance, when the rate of fluid ingestion matched the sweat rate. Six male cyclists cycled for 4 hours at 55% of VO₂ₘₐₓ in mild conditions (20 ± 1°c and 70 ± 5% RH), while ingesting either a low salt (LS) (4.6 mEq/1), a medium salt (MS) (50 mEq/1) or a high salt (HS) (100 mEq/1) beverage. Each beverage also contained a glucose polymer in an 8% concentration (8g/100ml). The subjects ingested 400ml of beverage immediately prior to commencement of exercise, and 150ml of fluid every 10 minutes during exercise until 220 minutes. Sodium chloride in the MS and HS trials was given to the subjects as supplemental gel capsules so that the drink was palatable. At the end of exercise, subjects recovered in a sitting position for 30 minutes. At the end of the 4 hours of exercise, fluid loss via the urine was significantly greater in the LS and the MS trials than in the HS trial (p<0.05). As a result, the fluid deficits in the LS and the MS trials were significantly greater than the fluid deficit in the HS trial. There was no significant difference between the MS and the LS trials for urinary fluid loss. During the 4 hour exercise bout, plasma sodium concentrations in the LS, the MS and the HS trials were not significantly different from one another, nor were they significantly different from resting values. There was no significant difference in the rectal temperature response to exercise in the three trials. It can therefore be concluded that in conditions where fluid ingestion matches sweat rate, attenuation of urinary fluid loss to optimise fluid replacement, relies on the ingestion of sodium chloride in quantities greater than that lost in the sweat. Therefore, for the ingestion of sodium chloride in excess of that which is currently available in sports drinks to beneficial, fluid must be ingested in volumes matching sweat loss.
Open Access
Epidemiology and prevention of rugby injuries amongst schoolboy, senior club and provincial rugby players in the Western Cape
(2000) Upton, Patrick Anthony Howard; Noakes, Timothy D
This thesis comprises a series of independent investigations examining rugby injuries occurring to players from under 14 to senior provincial level in the Cape Province (now the Western Cape). The first two studies report data aimed at gaining a more detailed understanding of rugby injuries in specific populations or under specific conditions, whilst the remainder of the thesis reports injury data from both a retrospective and a prospective epidemiological survey involving the same 3990 boys from 25 high schools. Following publication of data showing a progressive rise in the number of spinal cord injuries in the Western Cape, coupled with a sustained media attack on the attitudes of the (then) South African Rugby Board, certain experimental law changes were introduced to South African schoolboy rugby in 1990 and 1991. The purpose of the law changes was either to make the game safer or to make it more open and flowing, or both. Accordingly, the studies described in chapters 4 -8 set out to analyse the effects of these law changes on the incidence and nature of rugby injuries. This was accomplished by comparing data with a similar study conducted in 1983 and 1984 in the same 25 schools (Roux, 1992). The study reported in chapter 2 determined whether the use of neoprene (thermal) pants might reduce the risk of hamstring injury amongst 60 senior club rugby players, all of whom had previously sustained a hamstring muscle tear. The rationale was that the few seasons prior to this 1992 study had been characterised by an increasing use by rugby players of thermal or neoprene pants; a practice which seemed to have evolved spontaneously and without any scientific assessment of its value. We concluded that the wearing of thermal pants can reduce the risk of hamstring injury during rugby. However, other risk factors for injury are probably more important. These include levels of preseason physical fitness, correct warm up and stretching procedures before activity and adequate rehabilitation before returning to activity following injury. The objective of the study reported in chapter 3 was to determine the influence of preseason strength and endurance training on risk of injury in rugby players from two South African provincial teams during the 1992 rugby season. Players from one province followed a supervised scientifically-designed physical training programme, while those from the other did not follow a structured programme. The findings of the study, the first study to prove the relationship between pre-season preparation and early season injury, showed that inadequate pre-season endurance training is a major contributor to the high injury rate at the beginning of the season amongst provincial rugby players. Further, strength and endurance training are interrelated as risk factors. Thus, compared to players with adequate strength and endurance training, those with adequate strength training and insufficient endurance training are at greatest risk of injury, followed by players with insufficient strength and endurance training. It was also shown that contact practices 2 days after inter-provincial match contributed more to an increased number of injuries than to success; that "niggling" injuries may develop into more serious injury if players attempt to "play through" them; and that the lack of structured treatment and rehabilitation of an injury places players at risk of being re-injured.
Open Access
Exercise and the heart : effects of exercise training on coronary artery disease and on myocardial function, metabolism and vulnerability to ventricular fibrillation
(1981) Noakes, Timothy D; Opie, Lionel H
There is epidemiological and experimental evidence suggesting that exercise training may reduce the mortality rate from coronary heart disease, in particular the sudden death rate, and that it may improve the peak functional capacity of the heart. This thesis includes experimental work that is relevant to both these questions.
Open Access
Exercise tolerance and skeletal muscle structure and function in patients with severe chronic heart failure
(1995) Derman, Kirsten Louise; Noakes, Timothy D
Fatigue and exercise intolerance are common symptoms experienced by patients with chronic heart failure (CHF). Historically it has been argued that central cardiopulmonary factors including pulmonary congestion and reduced lung compliance cause dyspnoea that limits the exercise tolerance of such patients. But recent studies have indicated that exercise capacity in patients with CHF may not be limited solely by central cardiorespiratory factors. Rather the focus has shifted to aspects of the peripheral circulation and skeletal muscle function as possible factors limiting the exercise tolerance of patients with CHF. However there are few studies describing both the structural and functional abnormalities in the skeletal muscle of patients with CHF. In the first study of this dissertation, 11 patients with end-stage heart failure (NYHA class Ill-IV) and 10 healthy control subjects (C) underwent i) graded exercise to exhaustion for determination of peak oxygen consumption (VO₂ peak) and peak work load (Wlpeak); ii) isometric and isokinetic tests of skeletal muscle function and iii) radionuclide angiography for determination of ejection fraction (EF%). VO₂ peak (12.5 ± 1.0 vs 34.3 ± 3.5 mlO₂fkg/min; p<0.001), Wlpeak (73 ± 10 vs 224 ± 14 W; p<0.001), total work performed by the quadriceps muscles (TWQ) in a 30 sec isokinetic test (TWQ; 1565 ± 166 vs 2892 ± 345 J; p<0.05), and hamstring muscles (TWH) (TWH; 604 ± 163 vs 2003 ± 326 J; p<0.05), maximum voluntary isometric contraction (MVC) of the quadriceps muscles (MVC; 134 ± 12 vs 194 ± 11 Nm; p<0.001) and isokinetic peak torque of the ~uadriceps (PKTQ) (PKTQ; 133 ± 15 vs 203 ± 23 Nm; p<0.05) and hamstring muscles (PKTH) (PKTH; 60 ± 8 vs 108 ± 16 Nm; p<0.05) and time to fatigue during a test of isometric endurance (68 ± 12 vs 100 ± 10 sec; p<0.05) were all significantly lower in patients with CHF. However when corrected for the reduced lean thigh volume (muscle mass) in patients with CHF, PKTQ, PKTH and MVC were no longer different from control values. But the total work performed by the quadriceps and hamstring muscles in a 30 second isokinetic test was reduced even when corrected for the reduced lean thigh volume in patients with CHF. Furthermore, patients with CHF terminated progressive cycle exercise to exhaustion at heart rates, rates of ventilation, respiratory exchange ratios and blood lactate concentrations that were significantly lower than values achieved by control subjects during maximal dynamic exercise. These data suggest that skeletal muscle functional abnormalities including a decreased resistance to the development of fatigue exist in patients with severe CHF. In the second study of this dissertation, 10 patients with CHF who participated in the first study and eight control subjects underwent a skeletal muscle biopsy of the vastus lateralis muscle for light and electron microscopic analysis. Significant histological and ultrastructural changes were found in all SM biopsies from patients with CHF. These included atrophy and hypertrophy of fibres, fibre splitting, internalized nuclei, nuclear knots, moth-eaten fibres, increased lipid droplets. Electron microscopy showed a large variety of nonspecific abnormalities, including mitochondrial changes, Z-band degeneration and accumulation of intracellular glycogen. Ultrastructural morphometry revealed capillary basement membrane width significantly increased in the SM of patients with CHF, (409 ± 13 vs 121 ± 3 nm; p<0.01). A novel, blinded, impartially scored method for grading SM pathology showed that SM biopsies of patients with CHF had higher scores for myopathic changes compared to C (12.0 ± 1.5 vs 1.6 ± 1.0 arbitrary units; p<0.05). SM pathology score correlated significantly with VO₂ peak, Wlpeak, and TWQ (p<0.05 to p<0.02) but not with EF%. EF% did not correlate with either VO₂ peak, Wlpeak or TWQ. These data support the hypothesis that: i) severe SM structural and functional abnormalities may limit exercise capacity in patients with CHF; ii) the severity of SM pathology but not resting systolic cardiac function, predicts exercise performance in patients with CHF.
Open Access
Factors affecting energy expenditure and the efficiency of fuel utilization : feeding and exercise models
(1993) Lambert, Estelle Victoria; Koeslag, Johan; Noakes, Timothy D
The first aim of this dissertation was to monitor both rat and human responses to short-term perturbations in energy balance brought about through food energy restriction and refeeding, exercise training and the cessation of exercise training or surgical lipectomy. The second aim of this dissertation was to identify factors which might explain differences in food energy intake in weight-matched, weight-stable "large and small eaters". The final aim of this dissertation was to identify factors which might explain differences in resting energy expenditure in a large sample of weight-stable men and women, including exercising and non-exercising persons, and including persons who may be regarded as "restrained eaters".
Open Access
Factors limiting the exercise tolerance of patients with end-stage renal failure undergoing maintenance haemodialysis
(1994) Diesel, Wayne Jonathan; Noakes, Timothy D
Exercise tolerance, measured as peak oxygen consumption (VO₂ peak), is very low in patients with end-stage renal failure undergoing maintenance haemodialysis. Due to their associated anaemia and low peak heart rates during maximal exercise it has been argued that the reduced blood oxygen carrying capacity and central cardiovascular limitations are primarily responsible for the poor exercise tolerance of these patients. However, others suggest that peripheral (skeletal muscle) limitations including impaired substrate utilization, muscle weakness caused by peripheral neuropathy and myopathy, malnutrition and general physical deconditioning are responsible for the poor exercise tolerance. The present thesis was therefore designed to study whether central cardiovascular function or anaemia or muscle weakness causes patients with end-stage renal failure to terminate exercise at workrates well below those achieved by healthy controls.
Open Access
Limits to exogenous glucose oxidation by skeletal muscle during prolonged, moderate-intensity exercise in man
(1993) Hawley, John Alan; Noakes, Timothy D; Dennis, Steve
Several factors may determine the rate. at which exogenous carbohydrate (CHO) is utilised by the human working muscles during prolonged (> 90 min moderate-intensity (63% of peak sustained power output [PPO]) exercise. These include i) the rate of gastric emptying of an ingested fluid, ii) the rate of digestion, absorption and subsequent transport of glucose into the systemic circulation, and iii) the rate of glucose uptake and oxidation by the working muscles. To test the hypothesis that the rate of gastric emptying is the primary factor limiting the rate of CHO delivery to the working muscles during exercise, uniformly labelled ¹⁴carbon (U-¹⁴C) tracer techniques were used in association with conventional gas exchange measurements and post-exercise gastric aspiration to compare the rates of gastric emptying, intestinal CHO delivery and ingested CHO oxidation from 15 g/100 ml solutions of glucose, maltose, a 22 chain-length glucose polymer, and an isocaloric 'soluble' starch preparation. Two groups of six highly-trained male cyclists or triathletes each ingested two of the test drinks which were given as a 400 ml loading bolus immediately before and then as eight 100 ml feedings at 10 min intervals during 90 min of continuous cycling at a work rate of 63% of PPO (~70% of maximal oxygen consumption [VO₂ₘₐₓ]).
Open Access
Modelling perception-action coupling in the phenomenological experience of “hitting the wall” during long-distance running with exercise induced muscle damage in highly trained runners
(Springer International Publishing, 2018-07-10) Venhorst, Andreas; Micklewright, Dominic P; Noakes, Timothy D
Background “Hitting the wall” (HTW) can be understood as a psychophysiological stress process characterised by (A) discrete and poignant onset, (B) dynamic interplay between physiological, affective, motivational, cognitive, and behavioural systems, and (C) unintended alteration of pace and performance. A preceding companion article investigated the psychophysiological responses to 20-km self-paced treadmill time trials after producing exercise-induced muscle damage (EIMD) via a standardised muscle-lengthening contraction protocol. Methods A 5-step procedure was applied determining the extent to which the observed data fit the hypothesised cause-effect relationships. Running with EIMD negatively impacts performance fatigability via (A) amplified physiological responses and a non-adaptive distress response and (B) deterioration in perceived fatigability: increase in perceived physical strain precedes decrease in valence, which in turn precedes increase in action crisis, eventually dissolving the initially aspired performance goal. Results First, haematological indicators of EIMD predicted increased blood cortisol concentration, which in turn predicted increased performance fatigability. Second, perceived physical strain explained 44% of the relationship between haematological indicators of EIMD and valence, which in turn predicted increased action crisis, which in turn predicted increased performance fatigability. The observed data fitted the hypothesised dual-pathway model well with good model-fit indices throughout. Conclusions The hypothesised interrelationships between physiological strain, perception, and heuristic and deliberative decision-making processes in self-regulated and goal-directed exercise behaviour were applied, tested, and confirmed: amplified physiological strain and non-adaptive distress response as well as strain-perception-thinking-action coupling impact performance fatigability. The findings provide novel insights into the psychophysiological processes that underpin the phenomenological experience of HTW and alteration in pacing behaviour and performance.
Open Access
Pulmonary function and acid-base balance high intensity constant-load exercise
(1993) Odendal, Elsabe; Noakes, Timothy D
The possibility that an inadequate response of the pulmonary system might limit high intensity exercise in man has received increasing attention over the past few years. However, very few scientific investigations have focused systematically on pulmonary function during high intensity constant-load exercise. Furthermore, many studies have examined only one part of the pulmonary system during exercise and some have not included blood gas measurements as a measure of the adequacy of pulmonary function. The studies reported in this thesis were designed to investigate the possible failure of the gas exchanging and pump functions of the pulmonary system during high intensity constant-load exercise. In particular, the aim was to determine the extent to which the pulmonary system might be a factor causing fatigue during this form of exercise.