Tracking & Managing Anxiety in Athletes

The 2016 Rio Olympic games as with the previous games was a great platform for many tech companies to showcase their latest developments. There are radar and camera technologies that capture motion/biomechanics of an athlete on the field and in the pool. There are wearable devices that (also) track motion plus monitor physiological parameters 24/7. They aim to positively alter athlete behaviour and optimise performance. There are also sports apparel and equipment that were designed and developed (after much R&D) to enhance athlete performance. But we will leave that for another time.

Wearables for tracking performance

Going back to wearables and tracking systems; they often look at (somewhat) straightforward parameters – joint positions, speed (or velocity), height, acceleration, impact, angles, rotation rate, heart rate, heart rate variability, sleep and other physiological stuff. Sometimes coaches and athletes only need to look at a single parameter while other times they may need to examine a combination of variables and find correlations or visualise them over time to identify trends. Some companies go further by processing the above data and coming up with (trademarked) indexes such as Player-Load (Catapult), Windows of Trainability (Omegawave) and Recovery Score (Whoop). What they are trying to achieve is break down all the data that is being collected and deliver one metric that simplifies things and make it easy for coaches and athletes to measure performance (and recovery) .

In major games like the Olympics, where athletes trained years to prepare and qualify for that one event and possibly one moment, there can be a lot of anxiety and pressure to perform. Even if all the physical preparation has been done right, the results could still boil down to how well those emotions are managed; the difference could be between a podium finish or not performing as well as expected. So are there wearable technologies that monitor an athlete’s emotions and maybe warn the athlete of dangerous anxiety levels that can lead to choking or panic?

Wearables for tracking anxiety

Turns out there are a number of wearables in the market that do that. Here are three different types:

  1. Head-worn wearables that measure EEG signals (or brain activity) like the Emotive Insight and Muse. Although the Muse is designed as an aid for meditation and relaxation, it is basically monitoring four EEG channels to see how excited or relaxed a person’s brain is. The Emotive Insight has five EEG channels and looks at the user’s cognitive performance in areas such as Engagement, Focus, Interest, Relaxation, Stress, and Excitement. Emotive also has a higher spec neuroheadset that can look at fourteen EEG channels and goes into much more depth of what’s going on in a person’s mind and how he/she is feeling.

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    Emotiv Epoc+: 14 channel wireless EEG system

  2. Wrist-worn devices that measure electrodermal activity (or EDA), blood volume pulse, skin temperature and motion; like the Feel and Empatica E4 wristbands. Based on research, measurements of EDA strongly reflect sympathetic activation which is linked to stress levels and excitement. Measuring heart rate variability through the blood volume pulse sensor also reflects sympathetic and parasympathetic activation. Skin temperature is another reliable measure of stress levels as shown in this research. Finally, motion tracking with inertial measurement units (or IMUs) helps identify the user’s activity and tries to place a connection between anxiety levels and what the user might be doing at that time.

     

     

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    The Empatica E4 and Feel: 4 sensors packed on a wrist device

     

     

  3. Clipped-on devices that measure breathing frequency like the Spire. The Spire is built with force sensors; when it is secured onto the user’s waistband or bra, it detects the expansion/contraction of the user’s torso and diaphragm during breathing, thus deriving the breathing rate. Then algorithms are used to determine from the breathing waveforms whether the user is calm, tensed or focused.

 

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Spire: Breathing frequency tracker

 

Most of these devices also provide an accompanying app to monitor anxiety levels, and they prompt users to meditate or do breathing exercises. On a side note, a breathing exercise for lung patients was adapted for training athletes’ breathing technique and also focuses on dealing with anxiety. Athletes could also listen to brain.fm music that either helps them relax or stay focused. In a way, managing stress levels on a day-to-day basis can be beneficial for athletes because stress levels can increase the likelihood of an athlete falling sick or getting injured, and it also affects recovery.

Emotion Profiling for Performance

On the other hand, when it comes to performing well during competitions/races, some athletes actually perform better with some amount of anxiety. In fact, different athletes in different sports may perform better at varying levels of anxiety. In other words, some athletes perform well at high levels of arousal while others may perform better at lower levels of anxiety. It’s all about finding a sweet spot. As mentioned in this article, one widely used tool by coaches/athletes to identify that sweet spot or optimal performance zone is the individual zones of optimal functioning (IZOF) model. This is a qualitative analysis approach that involves the athlete recounting the emotional experiences related to successful and/or poor performances. All the emotions are then labelled and rated as described here, and this creates an individualised emotion profile showing which emotions are helpful for performance and which ones are unhelpful. Of course, this would only work if athletes have competed for a number of times previously and came out with different outcomes (winning or losing or setting new personal bests).

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Individualised emotion profiling (source: sportlyzer)

Ultimately we could utilise all the different wearables (and tools) mentioned above and somehow piece all that data together to shed some light on the inner workings of each individual athlete. Then the data could be used to “pivot” them in the optimal direction. But at the end of the day, its really down to the athletes themselves pushing hard every day and fighting battles with their body, mind and soul to get to where they would be. So let’s just salute the Olympic athletes for what they do and what they have achieved. And while we await the start of the Paralympics, I leave you with this video below by Under Armour and Michael Phelps. Thanks for reading!

Dealing with the Heat

A while back, I wrote a post about overheating in the iPad – how too much heat renders the iPad useless because it just shuts down. When that happens, you could either remove the iPad from an external heat source (e.g. direct sunlight), allowing it to cool passively; or apply some form of active cooling to it (chemically, mechanically, or electronically). Then once the internal temperature has dropped below the “shut-down threshold”, the iPad usually performs normally again.

Athletes can also suffer from an ‘overheating’ type of situation and in some cases can lead to hyperthermia. Due to an extended period of high intensity physical exertion, and/or being in hot and humid conditions, an athlete’s core body temperature could go up to say 40 degrees C. Lots of studies have shown that this (excessive heat) can have a negative impact on the athletes’ exercise performance (or muscular endurance) and possibly some adverse effects on certain cognitive abilities.

So how do we deal with this heating issue that affects athletic performance? On top of ensuring proper hydration and sticking to safety guidelines (mostly common sense), there are a number of cooling strategies and technologies that could keep athletes cool, which then prevents heat illnesses, and ultimately helps maintain performance.

Heat Acclimatisation

Although not exactly a cooling strategy, heat acclimatisation is a common practice for athletes living in cooler climates and preparing to compete in warmer and humid climates. The acclimatisation process might involve moving to another location with similar weather to live and train, or it could be training in an indoor controlled environment where heating and humidifiers are applied. Basically, the aim is to get the athletes accustomed to the higher air temperatures and so reduce the impact of heat on their performance. In some cases, heat chambers are also designed to be hypoxic chambers so athletes can also be conditioned for high altitudes (which would be handy for events like the 2010 football World Cup).

An example of PAFC players training in a heat chamber in UniSA (source: perthnow.com.au)

Cooling Strategies 

Pre-cooling is the process of cooling athletes before performing any exercise. There is evidence to show that pre-cooling procedures benefits athletes in endurance sports, and to some extent athletes in team-sports that require high-intensity repeated sprints (study link). It was gathered from this article that whole body pre-cooling is the more effective cooling procedure compared to only upper body cooling using cooling vests such as the adidas adipower or game ready vests. Although logistically, preparing the equipment for whole body cooling may take a bit more effort, compared to just distributing a bunch of cooling vests to the athletes.

An Example of a Portable Ice Bath from icoolsport

This article looked at a half-time cooling strategy that involves getting the soccer players to immerse their forearms and hands in 12 degrees water and putting a cold wet towel (that was previously soaked in 5 degrees water) around their neck. Their results showed that this primitive active cooling method significantly reduced the athletes’ body core temperature in 15 minutes.

A Novel Cooling Tech

A company called Avacore Technologies developed a novel technology that allows an athlete to cool down by simply wearing a specialised glove. How it works relies on the fact that the palm of our hands are radiator surfaces; which means when our body temperature goes up, blood flow naturally increases through those (radiator) skin regions to dissipate heat. This is achieved through special blood vessels called arteriovenous anastomoses or AVAs.

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Retia Venosa

The glove system known as Rapid Thermal Exchange (RTX)  was invented by two Stanford biologists who were doing research on thermal-regulation. The system not only regulates a continuous flow of cool water through a pad (or grip/cone) which the user’s palm maintains contact with, it also creates a slight vacuum within the glove and that limits the blood vessels from constricting, which allows better blood flow and ultimately better cooling. There is a lot more explanation on their FAQ page, and links to scientific studies/evidence at the bottom of the page here. Or if you prefer to watch a video, check out this one from CNET where the presenter actually did a test herself and showed that it actually works – cooling her significantly and improving her endurance.

[A side note on the video: using an ingestible temperature sensor would have saved the presenter from that gagging experience (around 1:40 of the video)]

So not only is this glove technology keeping athletes cool and preventing diminished performance, coaches are seeing their athletes push harder and longer when the RTX is used in between training sets. The rates in gain is so dramatic that the gloves have been labelled as more effective than steroids. But even with such good reports, not everyone is rushing to purchase these gloves yet. As mentioned in their paper, the inventors recognised that there are a few barriers and one of it is people’s resistance to new views. Another challenge is to develop something more compact or even wearable, so that it increases the potential of effective application in other areas such as mining, firefighting, or emergency services.

Recently, Avacore launched an Indiegogo campaign to crowdfund their new consumer version which is just one standalone portable device instead of a few components. Looking at the number of backers, I would say it was very well received.

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Different versions of the Avacore Cooling “Glove” (avacore.com)

Something for the makers and tinkers

Interestingly, someone who really liked the product but thought that the CoreControl Pro version was too expensive, decided to make a DIY version for a fraction of the price. He even made a CoreControl DIY Instructable. Based on the comments, there’s at least 2 other people who followed the instructions and built one for themselves. One other guy even made some improvements and published his own guide on how to build it.

Closer to home, a mate of mine also attempted to develop a product similar to Avacore’s hand cooling concept. One main difference is that his design does not require the use of ice and water, something that most of the methods mentioned earlier use. Instead, his entire system is electromechanical, very portable and can be easily switched between cooling or heating. If anyone in Melbourne would like to be one of the first few to trial his prototype, drop me a message/comment and I could help organise something.

Finally, with all the cooling technologies and methods out there for athletes, I think something that will really complement them, is a wearable temperature sensor (such as the cosinuss) that can constantly monitor body core temperature. That way, coaches can know exactly when to stop the athletes from their activity and stick their hand into a body cooling glove.