Biomedical subjects

W L Kenney

Publications and source records attributed to W L Kenney.

At least 37 records · Page 2Linked to original sources

PubMed1996

Reflex peripheral vasoconstriction is diminished in older men.

The purpose of this study was to compare reflex control of limb blood flow in healthy young (Y; 26 +/- 2 yr) and older (O;61 +/- 2 yr) men during whole body cooling under resting conditions. To better isolate the effect of chronological age, the two age groups (n = 6 per group) were closely matched for maximal oxygen uptake, body surface area, skinfold thickness, and fat-free weight. Subjects sat in an environmentally controlled chamber clad in standardized (0.6-clo) light cotton clothing at a dry-bulb temperature (Tdb) of 28 degrees C. After 30 min, Tdb was decreased by 2 degrees C every 5 min until Tdb = 10 degrees C, where it was held constant for the remainder of the 120-min session. Esophageal and mean skin temperatures were monitored continuously. Forearm blood flow (FBF) was measured every 5 min by venous occlusion plethysmography by using a mercury-in-Silastic strain gauge while arm temperature between the wrist and elbow was clamped at 37.2 +/- 0.1 degrees C by localized warm air heating. In this way, limb vasoconstriction was driven solely by thermoregulatory reflexes and not by direct effects of localized cooling. Mean skin temperature decreased at a similar rate and to a similar extent (by approximately 6 degrees C over a 2-h period) in both age groups, whereas esophageal temperature was relatively unaffected. In response to the local heating, the Y group maintained a significantly higher FBF than did the O group during the initial 30 min but decreased FBF during the cooling phase at a greater rate and to a greater extent than did the O group, leading to a significantly lower FBF during the final 30 min (at Tdb = 10 degrees C). Because there was no age difference in the mean arterial pressure response, similar effects of age were seen on forearm vascular conductance (FBF/mean arterial pressure). It was concluded that older men have a diminished reflex limb vasoconstrictor response to skin cooling. Furthermore, this difference in control of peripheral blood flow appears to be related to age per se; i.e., it is not a reflection of age-related differences in maximal oxygen uptake or body composition.

Adult↗

PubMed1995

Age predicts cardiovascular, but not thermoregulatory, responses to humid heat stress.

Cross-section comparisons of the effect of age on physiological responses to heat stress have yielded conflicting results, in part because of the inability to separate chronological age from factors which change in concert with the biological aging process. The present study was designed to examine the relative influence of age on cardiovascular and thermoregulatory responses to low intensity cycle exercise (60 W for 1 h) in a warm humid environment (35 degrees C, 80% relative humidity). Specifically, the relative importance of age compared to other individual characteristics [maximal oxygen uptake (VO2max), physical activity level, anthropometry, and adiposity] was determined by multiple regression analysis in a heterogeneous sample of 56 subjects in which age (20-73 years) and VO2max (1.86-4.44 l.min-1) were not interrelated. Dependent variables (with ranges) included final values of thermoregulatory responses [rectal temperature (Tre, 37.8-39.2 degrees C), calculated heat storage (S, 3.4-8.1 J.g-1), sweat loss (238-847 g.m-2)] and cardiovascular responses [heart rate (HR, 94-176 beats.min-1), forearm blood flow (FBF, 5.3-31.3 ml.100 ml-1.min-1), mean arterial blood pressure (MAP, 68-122 mmHg), and forearm vascular conductance (FVC = FBF.MAP-1, 0.06-0.44 ml.100 ml-1.min-1.mmHg-1). Age had no significant influence on Tre, S, or sweat loss, all of which were closely related to VO2max. On the other hand, HR, MAP, FBF, and FVC were related to both age and VO2max. Anthropometric variables and adiposity had secondary, but statistically significant, effects on MAP, FBF, FVC, and sweat loss.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1995

Functional consequences of sarcopenia: effects on thermoregulation.

The loss of skeletal muscle mass with aging (sarcopenia), and related changes in body size and composition, may impact body temperature and thermoregulation in both hot and cold environmental conditions. Sarcopenia alters the thermal properties of the body as a passive system because of differences in water content, and thus specific heat, of muscle and adipose tissue. With respect to active thermoregulation in warm environments, differences in fat-free weight (FFW) can explain more than 80% of the variance in absolute blood volume (BV) among individuals (Allen et al., 1956) and BV, in turn, profoundly influences the cardiovascular responses to exercise and heat stress. For example, a lower BV for a given body weight may explain more than half of the variability in maximal oxygen uptake (VO2max). Thus, as VO2max declines, any absolute task represents a higher relative VO2max (% VO2max) and proportionately greater cardiovascular strain. Because BV is an important determinant of left-ventricular filling pressure, and because older individuals rely more on the Frank-Starling mechanism to increase cardiac output (Q), a lower BV may also be associated with an inability to increase Q appropriately. These effects are particularly important under conditions of heat stress, where a larger increase in Q is necessary to perfuse both skin and active muscle vascular beds. With exposure to cold, age-related changes in body composition affect the insulation provided by the peripheral tissues, especially in the limbs. This results in an increased reliance on peripheral vasoconstriction to minimize heat loss, yet this vasoconstriction is attenuated in older individuals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗

PubMed1995

Maximal skin vascular conductance in subjects aged 5-85 yr.

This study examined maximal forearm skin vascular conductance (FVCmax) as a function of age in 74 healthy male and female subjects ranging in age from 5 to 85 yr. The skin temperature of the left forearm was uniformly clamped at 42 degrees C by spraying a fine mist of water over the surface. Forearm blood flow (FBF) was measured by venous occlusion plethysmography (Hg-in-Silastic strain gauge). After 60 min of heating, a reactive hyperemia maneuver was performed to verify that forearm skin blood flow was maximal by using laser Doppler flowmetry to isolate the skin component of FBF. The maximal FBF of each subject was then divided by mean arterial pressure to yield FVCmax (in ml.100 ml-1.min-1.100 mmHg-1), i.e., minimal resistance. The model that best fits the data was curvilinear, as described by FVCmax = 13.1 + 86.9 (age-0.75) (r2 = 0.52, P < 0.001). The exclusion of subjects younger than 18 yr of age simplified the model to a linear fit with a slope of -0.16 conductance units/yr for adults. Interindividual variability remained constant across the entire age span. Once the age effect was considered, there were no significant effects of gender, adiposity, resting blood pressure, physical activity level, or body surface area on FVCmax.

Adolescent↗

PubMed1995

Age alters regional distribution of blood flow during moderate-intensity exercise.

During dynamic exercise in warm environments, requisite increases in skin and active muscle blood flows are supported by increasing cardiac output (Qc) and redistributing flow away from splanchnic and renal circulations. To examine the effect of age on these responses, six young (Y; 26 +/- 2 yr) and six older (O; 64 +/- 2 yr) men performed upright cycle exercise at 35 and 60% of peak O2 consumption (VO2peak) in 22 and 36 degrees C environments. To further isolate age, the two age groups were closely matched for VO2peak, weight, surface area, and body composition. Measurements included heart rate, Qc (CO2 rebreathing), skin blood flow (from increases in forearm blood flow (venous occlusion plethysmography), splanchnic blood flow (indocyanine green dilution), renal blood flow (p-amino-hippurate clearance), and plasma norepinephrine concentration. There were no significant age differences in Qc; however, in both environments the O group maintained Qc at a higher stroke volume and lower heart rate. At 60% VO2peak, forearm blood flow was significantly lower in the O subjects in each environment. Splanchnic blood flow fell (by 12-14% in both groups) at the lower intensity, then decreased to a greater extent at 60% VO2peak in Y than in O subjects (e.g., -45 +/- 2 vs. -33 +/- 3% for the hot environment, P < 0.01). Renal blood flow was lower at rest in the O group, remained relatively constant at 35% VO2peak, then decreased by 20-25% in both groups at 60% VO2peak. At 60% VO2peak, 27 and 37% more total blood flow was redistributed away from these two circulations in the Y than in the O group at 22 and 36 degrees, respectively. It was concluded that the greater increase in skin blood flow in Y subjects is partially supported by a greater redistribution of blood flow away from splanchnic and renal vascular beds.

Adult↗

PubMed1994

Effect of age on renal blood flow during exercise.

The present study examined the effect of age on the control of renal blood flow (RBF; PAH clearance) and renal vascular conductance (RVC = RBF/mean arterial pressure) during and after a bout of dynamic exercise in a warm environment. Six healthy fit older men (O; 67 +/- 1 years) and 6 young men (Y; 24 +/- 2 years) were matched for body size, adiposity, and maximal oxygen uptake (VO2max). Subjects exercised at approximately 50% of VO2max for 90 minutes in an environment of 30 degrees C, 60% humidity on each of 4 consecutive days, with data collected on days 1 and 4. There was no effect of repeated days of exercise on RBF or RVC, despite a 4% expansion of blood volume in Y (< 1% in O). On each day, resting RBF was significantly lower in O (e.g., Y = 1127 +/- 67, O = 852 +/- 114 mL/min on day 1; p < 0.05). During exercise, Y decreased RBF to a significantly (p < 0.05) greater extent [-508 (-45%) and -365 (-36%) mL/min on days 1 and 4, respectively] than the O [-98 (-12%) and -83 (-12%) mL/min]. RVC followed a similar pattern, decreasing by 52% and 37% during exercise for Y vs only 15% and 13% for O. The relationships between delta RBF and HR and delta RBF and plasma norepinephrine concentration were independent of age, implying similar sympathetic control during exercise. During recovery, RBF and RVC increased as expected in Y, but continued to decrease in O, falling significantly below exercise values (p < 0.05). Compared to young men, fit healthy older men redistribute less blood flow away from the kidneys during dynamic exercise in the heat, an effect which appears to result from the existence of a smaller resting RBF rather than differential sympathetic control. On the other hand, chronological age seems to be associated with altered control of RBF and RVC during recovery from exercise.

Adult↗

PubMed1994

Rationale for a personal monitor for heat strain.

Worker heat-stress exposures can be controlled for short periods above the threshold limit value (TLV) by self-assessment, if the worker can avoid overexposure based on excessive heart rate and/or excessive core temperature. A socially acceptable surrogate for core temperature and a measure of heart rate are objective measures that can increase the reliability of the self-assessment decision. This article describes a surface-mounted temperature sensor developed to indicate when rectal temperature reaches a safe limit. Protective criteria were established for temperature sensor alert limits. A fixed threshold for heart rate may cause premature alerts during bursts of activity and miss lower, but sustained, heart rates that represent significant physiological strain. For these reasons, heart rate criteria based on seven moving-time averages also were developed. The criteria are based on a relationship between heart rate and endurance time. The temperature sensor and heart rate criteria form the basis of a real-time personal monitor for heat strain.

Body Temperature↗

PubMed1994

Effect of systemic yohimbine on the control of skin blood flow during local heating and dynamic exercise.

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Adult↗

PubMed1993

Physiological evaluation of liquid-barrier, vapor-permeable protective clothing ensembles for work in hot environments.

Work clothes using fabrics with vapor-transmitting characteristics are in limited use in various industrial applications, and there is a growing interest in their purported ability to help reduce heat stress. This study was performed to compare two vapor-transmitting ensembles with other clothing ensembles previously tested. The evaluation was based on an established experimental protocol that determines the critical values of air temperature and water-vapor pressure so that an individual maintains thermal balance, while controlling other factors that contribute to worker heat stress (e.g., air motion and metabolism). There were no differences between the two vapor-transmitting garments in their effects on worker heat stress. When compared to the results of other studies, the two vapor-transmitting garments had critical environmental characteristics similar to two layers of cotton coveralls and they performed better from a heat stress standpoint than a disposable vapor-barrier suit worn over cloth coveralls.

Adult↗

PubMed1993

Mechanisms of control of skin blood flow during prolonged exercise in humans.

Exercise in a warm environment raises internal temperature and leads to a rapid increase in skin blood flow (SkBF). As exercise continues, and internal temperature approaches 38 degrees C, the rate of rise of SkBF is markedly attenuated despite further significant increases in internal temperature. To find whether this attenuation is mediated by increased cutaneous active vasoconstrictor activity or by a reduced rate of rise of active vasodilator activity, each of 12 male subjects had 0.64 cm2 forearm skin sites iontophoretically treated with bretylium tosylate for selective local blockade of noradrenergic vasoconstrictor nerves. SkBF was monitored there and at adjacent untreated control sites by laser-Doppler blood flowmetry (LDF). Whole body skin temperature (Tsk) was controlled by water-perfused suits, and esophageal temperature (Tes) was monitored as an index of internal temperature. Mean arterial pressure (MAP) was monitored and cutaneous vascular conductance was calculated as LDF/MAP. Sweat rate was also monitored by dew point hygrometry in 11 subjects. Tsk was raised to 38 degrees C, after which subjects began 20-30 min of exercise on a bicycle ergometer. The rate of the initial rapid increase in SkBF with increasing Tes was not altered by bretylium treatment (P > 0.05 between sites). The attenuation of the rate of rise during the latter phase of exercise was not abolished by bretylium treatment (P > 0.05 between sites); instead, there was a trend for the attenuation to be enhanced at those sites. We conclude that the attenuated rate of rise of SkBF is due to limitation of active vasodilator activity and not due to increased vasoconstrictor tone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1993

Effects of age and acclimation on responses to passive heat exposure.

To examine the effect of chronological age on thermoregulation during passive heat exposure, six older (O, 61 +/- 1 yr) and six young (Y, 26 +/- 2 yr) men sat at rest during a 30-min baseline period (dry-bulb temperature = 28 degrees C), a 60-min thermal transient (28-46 degrees C by 2 degrees C steps every 5 min), and 30 min at 46 degrees C dry-bulb temperature. Subjects were matched for maximal O2 consumption, anthropometry, and body composition. Testing was repeated after a 9-day active heat acclimation protocol. There were no age differences in rectal (Tre), mean skin (Tsk), or mean body temperature (Tb = 0.8Tre + 0.2Tsk) before or after acclimation, but heart rate was lower (P < 0.01) in the O group in both acclimation states. Heat acclimation resulted in a significantly lower baseline Tre and Tb in both groups, which remained lower throughout the passive heat stress (P < 0.05). To examine the effects of age and acclimation on thermoregulatory effector function, forearm blood flow (by venous occlusion plethysmography) and chest sweating rate (SRch, by dew-point hygrometry) were plotted against Tb. The slope of the forearm blood flow-Tb relationship was significantly (P < 0.05) lower in the O group before and after acclimation. A lower maximal SRch (P < 0.05) was achieved by the O group, but neither the slope of SRch-Tb relationship nor the Tb threshold for sweating was affected by age. Predictably, acclimation resulted in a lower Tb threshold for the onset of sweating and skin vasodilation.(ABSTRACT TRUNCATED AT 250 WORDS)

Acclimatization↗

PubMed1993

Exercise training alters feed efficiency and body composition in iron deficient rats.

Studies of body composition and feed efficiency were conducted on 80 male Sprague-Dawley rats to determine how exercise training alters growth and development in iron deficient animals. Animals were assigned to iron deficient (ID) or control (CN) diets (AIN-76, w/o cellulose), and sedentary (SD) or exercised groups [EX, treadmill running, 4 d.wk-1, 90 min.d-1, 65% maximal oxygen consumption (VO2max), maintained for 6 or 12 wk. The ID diet caused a sustained moderate iron deficiency (Hb 7.2 +/- 0.2 g.dl-1). Iron deficient animals failed to increase maximal oxygen consumption despite the rigorous training program, through training resulted in 25% or 35% higher VO2max in 6- or 12-wk CN rats. At 6 wk, IDEX animals had significantly (33%) lower growth rates than did IDSD animals, which in turn were 22% less than CNs. Overall, exercise did not alter relative amounts of protein in the carcass (% total mass); however, a significant interaction between diet and treatment duration was evident in IDEX animals at 12 wk, who had lower % protein than CNEX-12 or IDSD-6 rats. Training decreased fat 11% in CN at 6 wk but not 12 wk, and 20% in IDs at 12 wk but not 6 wk. Feed efficiency and energy intake were 28% and 12% lower in IDEX animals than CNEX at 6 wk. Training increased caloric intake in CNEX animals but not IDEX animals at 6 and 12 wk. Thus, exercise training exacerbates the poor growth associated with ID through alterations in both food intake and feed efficiency in early phases of training, but adaptation is apparent.

Animals↗

PubMed1993

Fluid restriction prior to cycle exercise: effects on plasma volume and plasma proteins.

The purpose of this study was to test the hypothesis that changes in exercise intensity dominate the PV response to cycle exercise in the heat independent of the initial plasma volume (PV) and total circulating protein (TCP) content. The two experimental treatments (counterbalanced design) were performed by nine trained male cyclists (age = 23 +/- 1 yr, VO2peak = 63 +/- 4 ml.kg-1.min-1) in both a euhydrated (EU) and hypohydrated (HP, 24-h fluid restriction) state. Blood volume was measured (carbon monoxide dilution) 30 min prior to each test and subsequent changes in PV were calculated from serial venous blood samples using hematocrit and hemoglobin concentration. Following 20 min of seated rest in a warm environment (Tdb = 30 degrees C, 50-60% RH), each subject cycled in a semi-reclining posture for 60 min at three successive intensities (60, 120, and 180 W for 20 min each, representing approximately 22, 37, and 53% VO2peak). Fluid restriction reduced (P < 0.05) body weight by 1.4 +/- 0.3 kg (1.8 +/- 0.4%), PV by 353 +/- 73 ml (8 +/- 2%), TCP by 20 +/- 7 g (7 +/- 2%), and elevated serum osmolality by 6 +/- 2 mOsm.kg-1 (2 +/- 1%). After 20 min of passive heat exposure (prior to exercise), TCP content remained lower (P < 0.05) in HP (17 +/- 5 g) compared with EU as PV increased (P < 0.05) in EU (222 +/- 27 ml) but not (P > 0.05) in HP (122 +/- 35 ml).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1993

Simultaneous derivation of clothing-specific heat exchange coefficients.

Clothing adds resistance to heat exchange between the wearer and the environment. If clothing-specific heat exchange coefficients are known, a combined rational/empirical approach can be used to describe thermal exchange between clothed humans and the environment. However, during exercise these coefficients--typically calculated using thermal manikins--change, primarily due to wetting of the fabric during intense sweating and body movement. A procedure is described that allows for the simultaneous determination of both total insulation (IT) and resistance to water vapor permeation (Re) on exercising clothed subjects without the need to directly measure skin water vapor pressure or continuously weigh the subjects. Two tests are performed by each subject in each clothing ensemble. In one test, ambient water vapor pressure (Pa) is systematically increased in stepwise fashion while dry-bulb temperature (Tdb) is held constant; in the second test protocol Pa is held constant while Tdb is increased. Heat exchange data are collected at the time at which core temperature is forced out of equilibrium by the environment (according to the assumption that heat production is balanced by heat loss immediately prior to this critical environmental limit). Previous studies using similar approaches have typically estimated IT a priori and used this value in the subsequent derivation of Re for each clothing ensemble or condition tested. In the proposed method, IT and Re are derived from the solution of two simultaneous equations based on heat balance data from both tests. This paper describes and critiques this methodology via an error analysis, and compares the coefficients obtained with those from similar trials using other physiological and nonphysiological approaches.

Clothing↗

PubMed1992

Hypohydration affects forearm vascular conductance independent of heart rate during exercise.

Elevated body core temperature stimulates cutaneous vasodilation, which can be modified by nonthermal factors. To test whether hypohydration affects forearm vascular conductance discretely from relative alterations in heart rate (HR), eight trained cyclists exercised progressively for 20 min each at 60, 120, and 180 W [approximately 22, 37, and 55% of maximal cycling O2 consumption (VO2peak), respectively] in a warm humid environment (dry bulb temperature 30 degrees C; wet bulb temperature 24 degrees C). Esophageal temperature and forearm blood flow were measured every 30 s, and mean arterial pressure and HR were measured at rest and during each exercise intensity (minutes 15, 35, and 55). In the hypovolemic (HP) compared with the euvolemic (EU) state, blood volume was contracted by 24-h fluid restriction an average of 510 ml, and this difference was sustained throughout exercise. The esophageal temperature and HR responses were similar between EU and HP states at 60 and 120 W but were significantly (P < 0.05) higher in HP by the end of 180 W. In contrast, the forearm blood flow response was significantly (P < 0.05) depressed during exercise at 120 and 180 W in HP, whereas mean arterial pressure remained similar between conditions. When body core temperature is elevated in a hypohydrated state, forearm vascular conductance is reduced at exercise intensities of approximately 37% VO2peak, which is independent of relative changes in HR. These findings are consistent with the notion that during exercise an attenuated cutaneous vasodilation is elicited by alterations in regionalized sympathetic outflow, which is unaccompanied by activation of cardiac pacemaker cells.

Adult↗

PubMed1992

Estrogen replacement in middle-aged women: thermoregulatory responses to exercise in the heat.

Thermoregulatory, cardiovascular, and body fluid responses during exercise in the heat were tested in five middle-aged (48 +/- 2 yr) women before and after 14-23 days of estrogen replacement therapy (ERT). The heat and exercise challenge consisted of a 40-min rest period followed by semirecumbent cycle exercise (approximately 40% maximal O2 uptake) for 60 min. At rest, the ambient temperature was elevated from a thermoneutral (dry bulb temperature 25 degrees C; wet bulb temperature 17.5 degrees C) to a warm humid (dry bulb temperature 36 degrees C; wet bulb temperature 27.5 degrees C) environment. Esophageal (Tes) and rectal (Tre) temperatures were measured to estimate body core temperature while arm blood flow and sweating rate were measured to assess the heat loss response. Mean arterial pressure and heart rate were measured to evaluate the cardiovascular response. Blood samples were analyzed for hematocrit (Hct), hemoglobin ([Hb]), plasma 17 beta-estradiol (E2), progesterone (P4), protein, and electrolyte concentrations. Plasma [E2] was significantly (P < 0.05) elevated by ERT without affecting the plasma [P4] levels. After ERT, Tes and Tre were significantly (P < 0.05) depressed by approximately 0.5 degrees C, and the Tes threshold for the onset of arm blood flow and sweating rate was significantly (P < 0.05) lower during exercise. After ERT, heart rate during exercise was significantly lower (P < 0.05) without notable variation in mean arterial pressure. Isotonic hemodilution occurred with ERT evident by significant (P < 0.05) reductions in Hct and [Hb], whereas plasma tonicity remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Aldosterone↗

PubMed1992

Body composition and the expiratory reserve volume of pre-pubertal lean and obese boys and girls.

Previously, we examined the expiratory reserve volume (ERV) of the lungs as a function of percentage body fat in an adult population (age range 18-58 years). A negative correlation resulted when ERV (expressed as a percentage of vital capacity, (ERV/VC) x 100) was regressed on percentage fat for both sexes. In the present study, similar comparisons were made for 33 pre-pubertal boys and girls (aged 7-12.5 years). The regression equation for the boys ((ERV/VC) x 100 = 44.2 - 0.56%fat, r = -0.77, P = 0.002) was similar to that of the adult men ((ERV/VC) x 100 = 48.7 - 0.80 %fat, r = -78) and women ((ERV/VC) x 100 = 49.5 - 0.63 %fat, r = -0.70). However, the girls studied did not follow the same pattern. In this group of pre-pubertal girls, a significant increase in (ERV/VC) x 100 with increasing body fatness was seen ((ERV/VC) x 100 = 29.3 + 0.19 %fat, r = 0.48, P = 0.03). In all four groups, no correlation was seen with age or height. Whereas there was a significant correlation between weight and (ERV/VC) x 100 in the adults, no such relationship was evident in the younger subjects. In pre-pubertal obese girls limited upper body muscle development, perhaps as a result of limited physical activity, may explain the different relationship between ERV and body fatness.

Body Composition↗

PubMed1992

Control of skin blood flow during exercise.

When body temperature rises, skin blood flow (SkBF) increases to effect transfer of metabolic heat from the core to the skin. This convective heat transfer is never more important than during dynamic exercise. Control of SkBF involves a complex interaction of regulatory systems (body temperature, blood pressure, metabolism, etc.) and efferent mechanisms (passive withdrawal of constrictor tone, reflex vasoconstriction, active vasodilation). The purpose of this paper is to provide an updated review of this complex control system--control that allows for maintenance of blood pressure and perfusion of active muscle without adverse impact on thermoregulation. Also discussed are vasomotor mechanisms, various components of exercise that are important in the control of SkBF (e.g., intensity, posture, and duration of exercise), and the influences of such factors as blood volume and tonicity, aerobic fitness and heat acclimation, and age.

Age Factors↗