The effects of gender and health related fitness components on body mass index, body fat and blood pressure in kinesiology students

BACKGROUND AND PURPOSE: Many Americans do not meet the minimum standards of physical activity required to maintain a healthy lifestyle. The purpose of this study was to determine the prevalence of poor health related fitness outcomes among college age kinesiology majors. METHODS: Health related fitness (HRF) measurements were taken on 93 undergraduate Tarleton kinesiology majors. These measures included body composition, blood pressure, cardiorespiratory endurance (1.5 mile time), flexibility (sit-n-reach), and muscular strength and endurance. One and half mile run, sit ups, bench press, leg press, and the sit and reach were administered and ranked according to ACSM Guidelines (8th ed). Body composition was measured with a three-site skinfold measurement (females: tricep, suprailiac, thigh; males: chest, abdomen, thigh) using a Lange caliper. Height and weight were measured using a medical grade Detecto® scale (Webb City, MO). Blood Pressure was measured using a standard sphygmomanometer and stethoscope. Differences in HRF outcomes were analyzed using independent t-tests with significance set at p\u3c0.05. RESULTS: Resulting HRF scores separated by gender are displayed in the attached table. No significant differences in fitness ranking existed for 1.5 mile run, flexibility, or upper body strength. According to the ACSM’s percentile rankings for percent body fat, males ranked significantly higher than females (M=48.0 ± 36.7%: F=31.4 ± 25.3%; p=0.0001). However, females ranked significantly higher in lower body strength (F= 61.4 ± 28.6%; M= 51.1 ± 33.3%; p=0.04) and sit ups (F=66.3 ± 30.0%; M= 54.7± 37.6%; p=0.007). Health Related Fitness Scores Among Undergraduate Kinesiology Majors Student Characteristics Males Females Gender (N) 42 51 Age (years) 20.6 ± 20.6 19.9 ± 1.5 BMI (kg/m2) 27.3 ± 5.7 23.9 ± 4.3 % Body Fat 13.7 ± 1.2 25.1 ± 1.0 1.5 Mile Run (min:sec) 11:25 ± 1:11 13:23 ± 1:34 Sit & Reach (in) 18.7 ± 2.3 21.0 ± 2.1 Bench Press Ratio (lift/wt) 0.9 ± 0.5 0.5 ± 0.3 Leg Press Ratio (lift/wt) 1.6 ± 0.9 1.5 ± 0.4 Sit ups (1 min) 48.5 ± 8.5 44.6 ± 9.4 DISCUSSION: Overall females ranked higher than males on the health related fitness outcomes. The extent to which these results were based on gender differences in exercise training or central motivation is unknown. Future investigations will focus on health and physical activity habits between genders, as well as differences in internal motivation

Physical Activity Levels and Measures of High-Sensitivity C-reactive Protein in Apparently Healthy Male Firefighters

Heart attack or stroke is the number one cause of on-duty death in firefighters. High-sensitivity C-reactive protein (hs-CRP) is a nontraditional risk factor that has been linked to increased risk of future cardiac events. Purpose: The purpose of this study was to determine if physically active firefighters are less likely to have elevated levels of high-sensitivity C-reactive protein (hs-CRP) than sedentary firefighters. Methods: Self-Reported Physical Activity was determined using the International Physical Activity Questionnaire (IPAQ) in 62 male firefighters from Central Texas. Descriptive measures and blood lipid and metabolic measures were taken to determine cardiovascular risk. After participants were screened for exclusion criteria, a total number of 60 (N=60) firefighters completed the experiment process. The firefighters completed the IPAQ and where placed into two groups based on their score, physically active or sedentary. Participants’ anthropometric measurements (body mass index, body composition), blood pressure, hs-CRP and cholesterol levels were measured. Venous blood samples were collected, centrifuged, and sent to an off-site facility for lipid, glucose, and hs-CRP testing. In addition, each firefighter was asked the total number of years involved in the occupation, and approximate number of fires they have worked. A two-way ANOVA with age as a covariate, was used to detect differences in active and inactive firefighters. Pearson product-moment correlations coefficient were used to determine relationships between activity level, cardiac risk and hs-CRP. Significant markers from the ANOVA and correlation coefficients were used to develop a regression equation to predict hs-CRP. Results: There was a significant difference in the number of MET*minutes/wk between volunteer (VT) and career (CT) firefighters (VT: 1927 ± 1369, CT: 2727 ± 1284). This study also determined that hs-CRP risk scores were not correlated to traditional cardiovascular risk factors including total cholesterol (r= 0.014, p= 0.916), LDL-Cholesterol (r= 0.095, p= 0.480), HDL-Cholesterol (r= 0.140, p= 0.295), glucose (r= 0.082, p= 0.540), age (r= 0.021, p= 0.876), and Framingham risk score (FRS)-TC (r= 0.061, p= 0.295). For fire departments that do not have the financial means to pay for hs-CRP testing for all their firefighters, we have devised a regression formula, using significant correlations, to estimate hs-CRP levels. The formula below uses SBP, activity level, weight, body fat percent and waist circumference to estimate hs-CRP (hs-CRP = -2.907 + 0.015(SBP) – 0.487(Act) + 0.032(Wt kg) + 0.048(BF%) – 0.010 (Waist cm). Conclusion: Both FRS and hs-CRP risk levels should be used when evaluating risk of CVD in firefighters, and an exercise prescription should be recommended to those firefighters with increased CVD risk

Gender & Sport Related Differences in Electrocardiogram & Pre-participation Exams (PPE) in College Age Athletes

TACSM Abstract Gender & sport related differences in electrocardiogram & pre-participation exams (PPE) in college age athletes Harp J, Garcia B, Fulfer S, Cvikel J ,. Blevins-McNaughton J. Clinical Exercise Research Facility; Kinesiology; Tarleton State University; Stephenville, TX Category: Masters Advisor/ Mentor: Blevins-McNaughton, JS ([email protected]) ABSTRACT Background and Purpose: The NCAA requires all college level athletes receive a pre-participation physical exam. However, the pre-participation exams occasionally do not require electrocardiogram screening to help detect cardiac abnormalities. Though electrocardiograms may not be available at all testing’s, using specific markers and finding differences between gender and sport abnormalities could help detect cardiac abnormalities. The purpose of this study was to determine if there were significant differences in resting 12-Lead ECG markers in a group NCAA Div. II collegiate level athletes. Methods: Three hundred and eight college level athlete’s ages 18 to 25 participated in this study. Age, gender, height, weight, BMI, blood pressure and heart rate were measured during a pre-participation exam. Electrocardiogram measurements were gathered by using Mortara X-Scribe™ , Vacumed Turbo Fit 5™, Welch Allyn CardioPerfect™. Twelve-Lead ECGs were categorized by sport and analyzed by the lab director and the attending physician. One-way ANOVA was used to analyze differences in ECG findings in genders and sports. Independent t-test and linear regression were used to analyze differences between male and female outcomes. Significance was set at the 0.05 level. Results: No significant differences in wave conformation or arrhythmias were found between sports. Cross country athletes had significantly lower resting heart rate (61 ± 12.5 bpm) than football (70.6 ± 14 bpm), baseball (72.6 ± 12.8 bpm), track and field (73.2 ± 13.4 bpm), and cheerleading (75 ± 11.8 bpm) (P=0.003) . Resting systolic blood pressure was significantly higher in football (124.8 ± 10.4 mmHg) and baseball (124 ± 10.4 mmHg) than softball (115.8 ± 5.4 mmHg), track and field (119.2 ± 10.9 mmHg), cross country (112.7 ± 11.2 mmHg), and cheerleading (114.9 ± 7.9 mmHg) (P=0.001). Similarly, heart work expressed as rate pressure product (RPP) was significantly lower in cross country compared to all other sports. Relative to ECG parameters cross country athletes showed ECG changes typical for cardiovascular endurance training compared to all other sports including sinus bradycardia, increased RR interval, and leftward axis shift. Discussion: Although marked differences in 12-lead ECG parameters were not found between sports in this sample, two athletes were sent for further echo evaluation due to abnormal ECGs, but were subsequently cleared to participate in their sport

Red Flags in Family History and Auscultations that may require 12-Lead ECG when Screening Athletes

The main components of pre-participation physical exams (PPE) at the NCAA Division II level include a thorough medical history and physical evaluation (AHA). “Red flags” for risk on the PPE and medical history include, but are not limited to, heart murmur, diagnosed enlarged heart in a family member, unexplained chest pain, and complaints of skipped heartbeats. The purpose of this investigation was to determine if the use of 12-lead ECG for the PPE would reveal further red flags specific to cardiac abnormalities. Twelve-lead electrocardiogram (ECG) was performed on all new athletes at Tarleton State University during the Summer and Fall 2012 (N=200). Twelve-lead ECGs were reviewed and analyzed by the lab director and attending physician. Upon completion of the PPE, medical history, and ECG, five athletes needed follow-up based on PPE and 12-lead ECG. Reasons for initial concern were the previously stated “red flags” as well as abnormal ECG readings. The abnormal ECG readings included left ventricular hypertrophy (LVH), incomplete right bundle branch block (IRBBB), sinus arrhythmia, and right atrial enlargement (RAE). LVH, IRBB, and sinus arrhythmia were all found to be normal training induced adaptations, however RAE is a non-training induced cardiac abnormality. Of those five, all of them had some type of cardiac adaptation, but one of them presented with RAE. The athlete was an 18-year old male, 64.5” tall, 116 pounds, and in his first year of collegiate cross-country athletics. His HR was 81bpm and blood pressure was 122/72 mmHg. His grandmother was diagnosed with an enlarged heart. The clearing physician, an orthopedic doctor, found only training induced abnormalities in all five athletes. All five athletes were cleared for competition. Endurance athletes often have abnormal ECG readings as a result of training induced abnormalities. In the present investigation, an athlete with RAE competed for an entire cross-country season without any issues or complaints. Physicians trained in reading ECGs should be responsible for clearing athletes for participation. In this case, right atrial enlargement appeared in the ECG, yet the orthopedic doctor did not request follow up tests. Physicians who are versed in exercise training induced changes that might be classified as normal or abnormal should be the final step in clearing athletes for competition

Gender & Sport Related Differences in Electrocardiogram & Pre-Participation Exams (PPE) in College Age Athletes

Background and Purpose: The NCAA requires all college level athletes receive a pre-participation physical exam. However, the pre-participation exams occasionally do not require electrocardiogram screening to help detect cardiac abnormalities. Though electrocardiograms may not be available at all testing’s, using specific markers and finding differences between gender and sport abnormalities could help detect cardiac abnormalities. The purpose of this study was to determine if there were significant differences in resting 12-Lead ECG markers in a group NCAA Div. II collegiate level athletes. Methods: Four hundred fifty-one college level athlete’s ages 18 to 25 participated in this study. Age, gender, height, weight, BMI, blood pressure and heart rate were measured during a pre-participation exam. Electrocardiogram measurements were gathered by using Mortara X-Scribe™ , Vacumed Turbo Fit 5™, Welch Allyn CardioPerfect™. Twelve-Lead ECGs were categorized by sport and analyzed by the lab director and the attending physician. One-way ANOVA was used to analyze differences in ECG findings in sports. Independent t-test and linear regression were used to analyze differences between male and female outcomes. Significance was set at the 0.05 level. Results: No significant differences in wave durations were found between male and female athletes. However, P wave amplitude was higher in males (1.50 ± 0.61 mm) than females (1.44 ± .55 mm) (P=0.01). Males had higher resting blood pressures (SBP=123.1 ± 10.9 mmHg) (DBP=73.6 ± 8.1 mmHg) than females (SBP=112.6 ± 9.6 mmHg) (DBP=69.9 ± 7.9 mmHg) (P\u3c0.001). Males also had a higher frequency of arrhythmias, T wave inversions, and 1st degree atrioventricular blocks when compared to females. Similarly, SBP was significantly higher in football compared to all other sports. Relative to ECG parameters cross country athletes showed ECG changes typical for cardiovascular endurance training compared to all other sports including sinus bradycardia, increased RR interval, and leftward axis shift. Discussion: Although marked differences in 12-lead ECG parameters were not found between sports in this sample, two athletes were sent for further echocardiogram evaluation due to abnormal ECGs, but were subsequently cleared to participate in their sport

Pilot Study for Using ECG in Pre-participation Physical Exams in Collegiate Athletes

Title[j1] : Pilot Study for Using ECG in Pre-participation Physical Exams in Collegiate Athletes Authors: Bryan Ruiz, Mathew Massingill, Mike Cedeno, Steve Simpson, Joe Priest, Jennifer Blevins-McNaughton (Clinical Exercise Research Facility, Tarleton State University, masters) Background and Purpose: Disagreement exists in the sports medicine field concerning the best way to recognize and prevent unexpected deaths in sports. The purpose of this pilot study was to determine the extent to which using 12-lead ECG in pre-participation physical exams (PPE) meet diagnostic criteria for sudden cardiac death. Methods: Twenty-seven (N = 27) Division II athletes ages 18 to 24 were screened for ECG abnormalities during routine PPE. All subjects were required to go through a detailed medical and health history as a requirement of participation in NCAA athletic activity. This included a 29 item sign, symptom, and injury history list; vision screening; dental exam; and a general medical and musculoskeletal exam. Height, weight, supine 12-lead ECG (HP, QRS Card Suite® and Welch Allyn, CardioPerfect®) and supine blood pressures were measured using a standard sphygmomanometer and stethoscope. Each subject rested in a supine position for two minutes after which a blood pressure and average resting 12-lead ECG was recorded. Results are reported as means ± SD. Results: Descriptive results for males and females are presented in the attached table. Two male football athletes had diastolic blood pressures equal to 90 mmHg. One male football athlete (168 kg) had a borderline ECG marked by RSR’ pattern in V1, Lead III, and avF. This athlete also had a family history of hypertrophic cardiomyopathy. None of the other athletes screened met ECG criteria for needing further cardiac workup as described by Lawless and Best (2008). Variable Males (N = 20) Females (N = 7) Age 20.7 ± 1.8 19.4 ± 1.4 Weight (kg) 92.9 ± 26.0 77.1 ± 23.3 BMI (kg/m2) 28.7 ± 6.6 27.6 ± 6.7 Resting HR (bpm) 70.8 ± 11.2 72.4 ± 8.2 Resting SBP (mmHg) 122.3 ± 7.5 117.0 ± 11.3 Resting DBP (mmHg) 66.8 ± 15.6 65.0 ± 12.3 Resting RPP (mmHg·bpm-2) 86.5 ± 15.8 84.7 ± 13.1 PR interval (msec) 162.5 ± 20.3 143.6 ± 13.6 QRS interval (msec) 98.6 ± 11.2 93.1 ± 15.1 QT interval (msec) 382.9 ± 27.9 352.4 ± 123.5 Axis (°) 70.6 ± 26.9 61.3 ± 36.9 Conclusion: The goal for the future is to continue to use ECG in PPE as well as to follow this pilot group in the future to identify and match cardiac events to appropriate screening tools. [j1

Gender & sport related differences in electrocardiogram & pre-participation exams (PPE) in college age athletes

Purpose: The NCAA requires all college level athletes to receive a pre-participation physical exam (PPE). However, most colleges do not require electrocardiogram (ECG) screening to help detect cardiac abnormalities. Using specific ECG markers could help detect cardiac abnormalities based on gender and or sport. The purpose of this this study was to provide preliminary information about the usefulness of 12-lead ECGs in detecting potential cardiac risk during sport. Methods: Division II level college level athlete’s ages 18 to 25 (N=111) participated in this study. Age, gender, height, weight, BMI, blood pressure and heart rate were measured during PPE exams. Twelve-lead ECG (ECG) was obtained, categorized by sport, and analyzed by the lab director and attending physician. One-way ANOVA was used to analyze differences in ECG findings between sports (football (n=40), basketball (BB, n=10), track and field (T&F, n=18), and cheerleading (n=20). Independent t-test were used to analyze ECG differences between genders. Significance was set at alpha 0.05 level. Results: The group was analyzed for ECG differences between sports. Track & field (T&F)(114 ± 8.2 mmHg) and cheerleading (114 ± 7.4 mmHg) had significantly lower resting systolic BP than football (FB)(126 ± 11.8) and basketball (BB) (124 ± 8.7)(p=0.0001). P wave duration was significantly higher FB (0.081 ± 0.021) compared to BB (0.072 ± 0.017), T&F (0.075 ± 0.012), and cheerleading (0.066 ± 0.023) (p=0.05). Furthermore, QTC measures were significantly lower in FB (0.35 ± 0.07) compared to BB (0.45 ± 0.16), T&F (0.41 ± 0.05), and cheerleading (0.38 ± 0.03). No significant differences were noted for any ECG parameters between genders. Systolic BP (male= 123.5 ± 11.3 mmHg; female= 110.6 ± 9.0 mmHg ) (0.0001), diastolic BP (male=71.9 ± 8.0 mmHg; female=68.0 ± 7.0 mmHg) (0.006), and resting rate pressure product (male= 89.0 ± 19.9 mmHg·bpm/100; female= 79.1 ± 17.3 mmHg·bpm/100) (0.021) were significantly higher in males than females. Of all 111 athletes 5, 12-lead ECGs required follow-up with the attending physician to rule out cardiac risk during activity. All 5 athletes were cleared, and none were required to obtain further diagnostic procedures. Discussion: Electrocardiogram markers that may be identified as potential risk depending on sport, gender, and race should be a focus of all PPE. The screening procedures is very low, risk and takes only a few minutes to complete. Further investigations are needed to focus on sport and race specific ECG abnormalities, as well as follow-up with the athlete upon graduation to match the PPE, ECG with any activity related injuries or sudden death

Pilot Study for Pre-existing Conditions in Pre-participation Physical Exams in Collegiate Athletes

Title[j1] : Pilot Study for Pre-existing Conditions in Pre-participation Physical Exams in Collegiate Athletes Authors: Mathew Massingill, Bryan Ruiz, Mike Cedeno, Jamie Cvikel Steve Simpson, Joe Priest, Jennifer Blevins-McNaughton (Clinical Exercise Research Facility, Tarleton State University, masters) Background and Purpose: Disagreement exists in the sports medicine field concerning the best way to recognize and prevent unexpected deaths in sports. The purpose of this pilot study was to determine the extent to which suspect cardiac conditions were present during pre-participation physical exams (PPE) in collegiate athletes. Methods: Twenty-seven (N = 27) Division II athletes ages 18 to 24 were screened for ECG abnormalities during routine PPE. All subjects were required to go through a detailed medical and health history as a requirement of participation in NCAA athletic activity. This included a 29 item sign, symptom, and injury history list; vision screening; dental exam; and a general medical and musculoskeletal exam. Height, weight, supine 12-lead ECG (HP, QRS Card Suite® and Welch Allyn, CardioPerfect®) and supine blood pressures were measured using a standard sphygmomanometer and stethoscope. Each subject rested in a supine position for two minutes after which a blood pressure and average resting 12-lead ECG was recorded. Results are reported as means ± SD. Results: Of the 27 athletes tested, 16 participated in football, 4 basketball, 3 cheerleading, 2 track and field, 1 golf, and 1 softball. Two male football athletes had diastolic blood pressures equal to 90 mmHg. One male football athlete (168 kg) had a borderline ECG marked by RSR’ pattern in V1, Lead III, and avF. His resting BP was 128/84 mmHg. This athlete also had a family history of hypertrophic cardiomyopathy. Three other athletes (golf, football) reported family history of cardiac problems or hypertension. All of the athletes had normal resting blood pressures and heart rates. One athlete (cheer) reported a history of heart palpitations (flutter). No other abnormalities were found in the physical or medical screenings for this group of athletes. Conclusion: The goal for the future is to continue to use perform thorough medical and health history screening tools in the PPE. Similarly, we will be following this pilot group in the future to identify and match medical and health histories with future events. [j1