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Impact Of Intermittent Hypoxia On The Glycemic Response To An Oral Glucose Tolerance Test, Sahar D. Massoudian, Frank Wojan, Jiahui Zhao, Sophie Lalande

International Journal of Exercise Science: Conference Proceedings

Hypoxia triggers glucose uptake independently from the action of insulin. PURPOSE: To determine the acute effect of intermittent hypoxia, defined as alternating short bouts of breathing hypoxic and room air, on plasma glucose levels during an oral glucose tolerance test in healthy individuals. We hypothesized that exposure to intermittent hypoxia would attenuate the increase in glucose levels in response to an oral glucose tolerance test. METHODS: Nine individuals (5 men, age: 24 ± 4 years, height: 175 ± 9 cm, weight: 71.0 ± 13.5 kg, HbA1c: 5.4 ± 0.1%) participated in the study. Participants visited the laboratory on two occasions. …

A Pilot Study Examining The Effect Of Dynamic Warm-Up Utilization On Rodeo Performance Of College Breakaway Ropers, Tyler Frank

International Journal of Exercise Science: Conference Proceedings

ABSTRACT

Pre-competition dynamic warm up participation has exemplified significant improvements in sport performance and decreased risk of injury for high velocity, high impact sports. Rodeo is recognized as a high velocity/intensity sports with great risk of impact and non-impact related injuries. However, no research has investigated the effect of pre-competition warm up utilization of the performance of rodeo athletes. PURPOSE: Therefore, the purpose of the current research examination was to evaluate the efficacy of per-competition dynamic warm up participation for rodeo athletes. METHODS: Seven collegiate rodeo females, competing as Breakaway Ropers, were selected at participants for the current …

Cortical Activity Measured With Low-Intensity Fatiguing Contractions Of The Quadriceps Muscle Group, Emma D. Bozarth, Lyric D. Richardson, Amy E. Riera, Micheal J. Luera, Amber H. Bozer

International Journal of Exercise Science: Conference Proceedings

Modulation of force production required during exercise is regulated from various mechanisms in the central and peripheral nervous system. Fatigue is influenced by various mechanics that may hinder the ability to continuously sustain force production. The neural activation patterns of these systems can be recorded as electrical impulses using several non-invasive techniques. The ability to examine these during fatiguing exercise has provided further insight into activation patterns in the central nervous system (i.e., motor and pre-motor cortex) during sustained muscle contractions. Electroencephalography (EEG) has been recently utilized to examine changes associated with central fatigue, but limited advancements in technology for …

Effects Of Low-Intensity Fatigue On Motor Unit Firing Properties During Maximal Voluntary Isometric Contractions, Lyric Richardson, Amy Riera, Emma Bozarth, Micheal Luera

International Journal of Exercise Science: Conference Proceedings

Rehabilitation from injuries impairing the neuromuscular system is often difficult to quantify due to task specificity of the affected or immobilized limb or limbs. Often, exercise regimens with clinical practitioners are designed to progress motor performance to a capacity that reflects muscle force production to pre-injury capacity. Modulation of force production from these tasks are regulated from various mechanism in the central and peripheral nervous system. The neural activation of these systems can be recorded as electrical impulses using several non-invasive techniques. Recently, the ability to examine these during fatiguing exercise has provided further insight into activation patterns and firing …

Estimation Of Visceral Fat Via Ultrasound Sonography, Jose M. Moris, Tomas Chapman-Lopez, Yunsuk Koh

International Journal of Exercise Science: Conference Proceedings

Although visceral fat (VF) can be quantified via computed tomography or dual-energy X-ray absorptiometry (DXA), their application for frequent VF assessment is limited because both methods are radiating in nature. Research suggests that ultrasound imaging can be used to predict VF safely without the risk of radiation exposure. However, the complexity and/or lack of replicability limits such application. PURPOSE: To develop an easy-to-replicate ultrasound protocol and a regression model that can accurately estimate VF area (VFA, cm²). METHODS: Thirty healthy adults (9 males and 21 females, age: 23.2 ± 7.4 yr, body mass index: 22.3 ± …

Automated Blood Pressure Device For Incremental Exercise Stress Testing, Natalie Mclaurin, Tianyu Wang, Lin-Sheng Chen, Hirofumi Tanaka

International Journal of Exercise Science: Conference Proceedings

Blood pressure (BP) measurement plays a critical role in cardiac stress testing and is most commonly assessed manually. The emphasis of social distancing during the COVID-19 pandemic has renewed the interest in and the need for an automated BP device that is specifically designed for incremental exercise stress testing. PURPOSE: To assess the accuracy of a new automated blood pressure device specifically manufactured for cardiac stress testing in comparison to traditional manual BP readings serving as the reference standard. METHODS: Thirty-five apparently healthy adults aged 35±16 years were studied during an incremental stress test on the cycle ergometer. …

Differences In Functional Movement Screening Score Between College Rodeo Events, Meghan E. Younger, Andrew A. Wolfe, Andrea Green, Gillian Braden, Justin Stanely, Jessie Ramirez

International Journal of Exercise Science: Conference Proceedings

The sport of rodeo is recognized as a high velocity/intensity activity, with a wide range of varying dynamic movements occurring across difference rodeo events. High velocities and extreme dynamic range of motion movements, compound with uncooperative livestock, contribute to elevated risk of injury. While these factors generally attribute to rodeo injuries, little is known in regards to movement limitations of rodeo athletes. PURPOSE: Therefore, the purpose of the current investigation was to identify movement pattern differences among rodeo events using the Functional Movement Screening (FMS) test. METHODS: College rodeo athletes (n = 85) from a mid-size university in the southwest …

A Comparison Of Resistance Exercise To Aerobic Exercise On Cognitive Processing Speed In Young Adults, Jamie A. Ambriz, Amber M. Shipherd, Robert Kowalsky

International Journal of Exercise Science: Conference Proceedings

Processing speed is the progression by which an individual receives information, begins to understand it, and then responds to it. Processing speed affects academic performance and research has established a positive relationship between exercise and processing speed. While the majority of research on cognition has focused on aerobic exercise, several studies have still demonstrated resistance exercise can improve cognitive abilities, including processing speed. However, these studies have relied primarily on a more tradition approach with free weights and machines. Additionally, there are a lack of studies directly comparing these modes of exercise (aerobic vs. resistance) and the appropriate duration …

Facilitation Of Mental Health In Undergraduate, Adventure-Sport Curricula Students: The Effect Of Mental Toughness, Wheels Pelton, Hiroki Matsuo, Grant Morgan, Steven Maynard, Andreas Stamatis

International Journal of Exercise Science: Conference Proceedings

Mental toughness (MT) has been positively associated with academic/physical performance and mental health (MH). Adventure sports studies involve exposure to exploratory and risk-taking activities aiming to facilitate positive psychological outcomes. Although such programs are frequently promoted for this purpose, there is a lack of empirical evidence concerning the effects of such a curriculum on the levels of MT/MH in undergraduate students. PURPOSE: To examine the effect of an adventure-sport curriculum on the levels of MT/MH of first-year (FY), and non-FY (NFY) undergraduate students of an expeditionary (EXP) studies program and compare it to FY students of another program (FWL). …

Nutrient Adequacy In Endurance Athletes, Kamiah Moss, Andreas Kreutzer, Austin J. Graybeal, Robyn Braun-Trocchio, Yan Zhang, Ryan R. Porter, Meena Shah

International Journal of Exercise Science: Conference Proceedings

Adequate nutrition is critical to optimal performance in endurance athletes. However, it remains unclear if endurance athletes are consuming enough energy, macronutrients, and micronutrients. PURPOSE: The purpose of this study was to determine if endurance athletes are meeting their nutritional requirements and whether it varies by gender. METHODS: Endurance athletes (n=44), 39.0±14.2 y, participated in the study. Dietary intake was assessed using the five-step multiple-pass 24-hour recall method, a validated measure, that involved asking the participants to recall in detail the type and amount of foods and beverages they consumed the previous day. Energy, macronutrient, and micronutrient intakes …

Associations Of Changes In Body Composition And Athletic Performance In Collegiate American Football Players, Jake Boykin, Dale Kieth, Christine Harrison, Javier A. Zaragoza, Jessica Prather, Matthias Tinnin, Lemuel W. Taylor Iv, Grant M. Tinsley

International Journal of Exercise Science: Conference Proceedings

Football practitioners ubiquitously employ offseason resistance training to improve on-field performance. Early offseason training is frequently designed to emphasize accretion of lean and total body mass. While this is a main objective of sport-specific conditioning, there are few investigations comparing correlated changes in body composition, maximal strength, and football-specific performance tests after an early-offseason training program. PURPOSE: The purpose of this analysis was to quantify the relationship between changes in athletic performance and body composition in collegiate American football players. METHODS: Before and after a 7-week offseason training program, body composition and athletic performance were assessed in NCAA Division III …

Living Situation And Physical Activity In The Covid-19 Pandemic Among Private University Students, Eduardo Gonzalez Villarreal, Laura S. Kabiri, Augusto X. Rodriguez, Cassandra S. Diep, Heidi Y. Perkins, Amanda M. Perkins-Ball

International Journal of Exercise Science: Conference Proceedings

Physical activity levels among college students in private institutions were significantly altered by the COVID-19 pandemic. With COVID-19’s impact on universities, many students experienced transition, including a change in living situation. Behaviors in college help establish life-long habits that can determine health outcomes, so it’s important to investigate any declines in physical activity observed during the pandemic. PURPOSE: The purpose of this study was to assess differences in physical activity based on living situation among 18- to 25-year-old private university students during the COVID-19 pandemic. METHODS: Adults (n=109) between 18- and 25-years-old in the greater Houston area completed …

A Comparison Of Running Economy Across Seven Carbon-Plated Racing Shoes, Garrett P. Jones, Dustin P. Joubert

International Journal of Exercise Science: Conference Proceedings

Running economy is defined as the oxygen consumption (VO₂) or energy cost required to run at a given speed. It is a key determinant of performance, as improved economy allows a runner to run faster at the same physiological intensity. Advancements in running shoe technology, particularly in the Nike Vaporfly, have been shown to improve running economy. Other brands have now also developed new, advanced shoes with a carbon-fiber plate and thicker, new midsole foams. However, none of these new shoes have been compared to the Vaporfly. PURPOSE: Compare the effects of 7 different carbon-plated shoes and 1 …

Relationship Between Changes In Upper Body Fat-Free Mass And Bench Press Performance In American Football Players, Dale S. Keith, Jake R. Boykin, Christine M. Harrison, Javier A. Zaragoza, Jessica Prather, Matthias Tinnin, Lem W. Taylor, Grant M. Tinsley

International Journal of Exercise Science: Conference Proceedings

Horizontal pushing strength and strength endurance are relevant attributes for blocking and block shedding in American football. Since most positions in American football require the ability to either block or shed a block, and since bench press repetitions to failure (RTF) with 225 pounds is a component of the NFL draft combine, improving horizontal pushing strength and strength endurance have been key areas of emphasis for strength and conditioning coaches working with these athletes. PURPOSE: The purpose of this analysis was to quantify the relationship between changes in upper body fat-free mass (FFM) and metrics of bench press performance …

Predictors Of Cardiometabolic Disease Risk Factors In Professional Firefighters, Drew E. Gonzalez, Megan Leonard, M. Hunter Martaindale, Richard J. Bloomer, Jacquelyn Pence, Steven E. Martin, Matthew J. Mcallister

International Journal of Exercise Science: Conference Proceedings

The leading cause of mortality (~50% of deaths) among on-duty firefighters is sudden cardiac death. Firefighters with adequate cardiorespiratory fitness levels (among other muscular fitness metrics) and lower body fat percentage (BF%) are likely to better combat on-duty cardiac events and cardiovascular disease (CVD) risk. Individuals with higher VO₂max values may be at lower risk noted by lower oxidative stress and inflammatory biomarkers, which may be more ideal predictors of CVD risk compared to traditional biomarkers (i.e., blood glucose and lipids) among the fire community; however, more research is needed to elucidate. PURPOSE: This study examined the relationship …

Sexual Function, Behavior, And Satisfaction In Master Athletes, Tianyu Wang, Melanie Heath, Sebastian K. Tanaka, Hirofumi Tanaka

International Journal of Exercise Science: Conference Proceedings

Sexual function and satisfaction are good indicators of overall life satisfaction and important elements of successful aging. Currently, it is not clear if maintaining habitual exercise into later life would yield the benefits of maintaining sexual activity and satisfaction. PURPOSE: To evaluate the relationship between sustained participation in competitive exercise and its effects on sexual function, behavior, and satisfaction. METHODS: A total of 166 masters athletes (97 men; 57±13 years) who had been training 45.6±15.9 years in various sports disciplines including swimming, cycling, and running completed a comprehensive questionnaire. On average, the participants were involved in aerobic and resistance trainings …

Cardiorespiratory Coordination Among Intermediate And Novice Female Collegiate Rowers, Zoey Jackson, Michelle Etchebaster, Paula Gutiérrez, Gemma Hernández, Sergi G. Retortillo, Zacharias Papadakis

International Journal of Exercise Science: Conference Proceedings

Elite rowers present high levels of cardiorespiratory performance. Rowers’ on-water performance can be predicted by a cardiopulmonary exercise test (CPET) and related measured parameters such as maximum oxygen uptake test (VO2max), ventilation (VE), heart rate (HR), expired fraction of oxygen (FeO2) and carbon dioxide (FeCO2). However, such testing provides little information about the non-linear dynamic interactions during rowing and the qualitative synergetic reconfigurations between cardiovascular and respiratory systems to adjust to the individual rowing performance. Cardiorespiratory coordination (CRC) has been proposed as a method to measure the co-variation among cardiorespiratory variables during a CPET. PURPOSE: To measure and compare …

Exploring Physical Fitness Profile Of College Students Through Principal Component Analysis: A Case Study, Alejandra Rincon Cortes, Melissa Dorvily, Zoey Jackson, Michelle Etchebaster, Zacharias Papadakis

International Journal of Exercise Science: Conference Proceedings

Universities offer lifetime physical fitness (PF) courses and organize health fairs to keep their students physically fit. Despite these efforts, only 49.9% of US students meeting the National Guidelines for physical activity, reporting low fitness levels, as evaluated by the respective scores of the five fitness components. Fitness evaluation though is a time-consuming process and students’ time constrains have been postulated as reasons for lack of participation, motivation, and involvement. PURPOSE: Since time availability may influence students’ participation in a battery of fitness testing for evaluating their PF levels, this study aimed through principal component analysis (PCA) to reduce the …

Assessment Of Youth Athlete Body Composition Using Bioimpedance Techniques As Compared To A Three-Compartment Model, Jacob J. Green, Abby Ambrosius, Christopher Dodge, Brandon Merfeld, Chinguun Khurelbaatar, Makenna Carpenter, Patrick Harty, Christian Rodriguez, Madelin Siedler, Matthew Stratton, Dale Keith, Jake Boykin, Andrew R. Jagim, Grant M. Tinsley

International Journal of Exercise Science: Conference Proceedings

Body composition is believed to contribute to success in many sports. For this reason, assessment of body composition with various devices is commonly performed. The agreement between devices warrants exploration, particularly in groups with limited data, such as youth athletes. PURPOSE: To determine the agreement between a 3-compartment model (3C) and bioelectrical impedance analysis (BIA) devices for assessing body composition in youth athletes. METHODS: The body composition of 90 youth athletes was evaluated (51 F, 39 M; age: 18.2±2.4 y; body mass: 69.0±12.5 kg; height: 172.0±9.9 cm; BMI: 23.2±3.2 kg/m², BF%: 19.7±6.9%). 3C values were produced …

Is Our Student Body Fit? A Comparison Of Current Fitness Levels To Normative Data, Melissa Dorvily, Michelle Etchebaster, Zoey Jackson, Zacharias Papadakis

International Journal of Exercise Science: Conference Proceedings

Physical Activity (PA) among university students yields 40-50% participation and this statistic continues to make a steady decline. This has caused a widespread call to action for universities to provide resources and education to encourage students to increase physical activity. Prior to and during COVID-19 pandemic our student body reported decreased levels of PA. Amid the return to an in-person student life, many students have reported increased challenges in returning to fitness related activities. In tandem with our Exercise is Medicine-On Campus (EIM-OC) initiative, an interactive health fair open to the entire body of 4,495 students was held to address …

Examining The Relationship Between Trait Energy And Fatigue And Feelings Of Depression In Young Healthy Adults, Marc-Antoine D. Harris, Lauren Nesshoever, Ashley Carpenter, Selina Sampieri, Jennifer Keefer, Chelsea C. Yager, Andrew C. Pickett, Matthew L. Smith, Ali Boolani, Andreas Stamatis, Zacharias Papadakis

International Journal of Exercise Science: Conference Proceedings

Depression is usually co-morbid with fatigue. However, we are unaware of studies exploring the relationship between trait energy and fatigue and feelings of depression. Recent evidence suggests that energy and fatigue are two distinct moods. PURPOSE: To examine the association between trait mental and physical energy and fatigue and feelings of depression, within an otherwise healthy young adult cohort. METHODS: Using a cross-sectional design, healthy respondents (n=495) completed a series of self-reported surveys measuring depression, lifestyle factors (sleep, diet, physical activity), and trait mental and physical energy and fatigue. Using a step-wise regression, we controlled for demographics and …

Effects Of A Carbon-Plated Racing Shoe On Running Economy At Slower Running Speeds, Trace A. Dominy, Dustin P. Joubert

International Journal of Exercise Science: Conference Proceedings

Advancements in running shoe technology, such as the inclusion of a carbon-fiber plate along with new, thicker midsole foams, have been shown to improve running economy. Running economy can be defined as the oxygen consumption (VO₂) or caloric expenditure at a fixed running speed. Specifically in the Nike Vaporfly line of racing shoes, running economy improvements have been shown in the 2.7-4.2% range at running speeds of 14-18 km·hr^-1. These previously tested speeds are relevant for runners completing the marathon distance in 3 hours and faster. However, it is unclear if the same running economy benefits …

Association Between Self-Reported Prior Nights’ Sleep And Single-Task Gait In Healthy Young Adults: An Exploratory Study Using Machine Learning, Billal Siddiq, Ali Boolani, Haikun Huang, Lap-Fai Yu, Maggie Stark, Zachary Grin, Chelsea C. Yager, Seema Teymouri, Dylan Bradley, Rebecca Martin, Joel Martin, Andreas Stamatis

International Journal of Exercise Science: Conference Proceedings

Failure to obtain 7-9 hours of sleep has been associated with decreased gait speed in young adults. While Machine Learning (ML) has been used to identify sleep quality in young adults, there are no current studies that have used ML to identify prior night’s sleep in a sample of young adults. PURPOSE: To use ML to identify prior night’s sleep in healthy young adults using single-task walking gait. METHODS: Participants (n=126, age 24.3±4.0yrs; 65% female) completed a survey on their prior night’s sleep and performed a 2-minute walk around a 6m track. Gait data were collected using inertial …

Exergame Versus Traditional Cycling: A Comparison Of Psychological Factors, Mckay Bloxham, Casi Helbig

International Journal of Exercise Science: Conference Proceedings

Previous research has noted that increased enjoyment levels endorsed the involvement in long-term exercise persistence. PURPOSE: The purpose of the study was to compare enjoyment levels and perceived time of the Spinner NXT, a stationary bike commonly found in cycling classes, and the TACX trainer, a stationary bike which allows users to immerse themselves in any location in the world and participate in competitions if desired. METHODS: Sample size consisted of 30 Texas Lutheran University students. Each participant was assigned a number to protect their identity and was randomly assigned which bicycle they would start with. Participant was …

Acute Partial Sleep Deprivation And High-Intensity Exercise Effects On Cardiovascular Autonomic Regulation And Lipemia Network, Zacharias Papadakis, Sergi G. Retortillo

International Journal of Exercise Science: Conference Proceedings

Autonomic nervous system imbalance demonstrated by decreased heart rate variability (HRV) is linked to acute partial sleep deprivation (ASPD) and cardiovascular disease (CVD). Cardiometabolic lipemia has been linked to changes in HRV. Habitually active individuals exercising in the morning hours under APSD and consuming afterwards a high-fat breakfast, may disrupt the network coordination of both the cardiovascular autonomic regulation and cardiometabolic lipemic systems jeopardizing their health. The human organism is comprised by an integrated network of interconnected organ systems and functions, therefore, a disruption/failure of one system can trigger a cascade of failures manifested as disease state. PURPOSE: To …

Comparison Of Laboratory-Grade And Consumer-Grade Hand-To-Foot Bioelectrical Impedance Analyzers For Body Composition Estimation, Gabrielle C. Dehaven, Madelin R. Siedler, Christian Rodriguez, Sarah White, Abegale D. Williams, Patrick S. Harty, Matthew T. Stratton, Dale Keith, Jacob Green, Jake Boykin, Grant M. Tinsley

International Journal of Exercise Science: Conference Proceedings

Bioelectrical impedance analysis (BIA) is a simple and effective technique to estimate body composition, including body fat percentage (BFP). While these analyzers are a popular method of describing a person’s body composition, laboratory-grade devices are expensive and inaccessible to most people. As a result, they may be an unrealistic method for consumers to use. However, consumer-grade devices are increasingly available. PURPOSE: The purpose of this study was to compare laboratory-grade and consumer-grade bioelectrical impedance analyzers. METHODS: Seventy-five adults (40 F, 35 M) were evaluated using a laboratory-grade, hand-to-foot, multifrequency bioelectrical impedance analyzer (BIA_LAB; Seca mBCA 515) …

The Limited Role Of Grit In The Associations Between Lifestyle Behavior And Feelings Of Energy And Fatigue During The Early Stages Of The Covid-19 Pandemic, Meesha Carter, Jessica Adams, Joel Martin, Matthew L. Smith, Italia Milani, Shane V. Caswell, Nelson Cortes, Ali Boolani, Andreas Stamatis, Zacharias Papadakis

International Journal of Exercise Science: Conference Proceedings

Grit has been positively associated with feelings of energy (when measured as the opposite end of fatigue). During the COVID-19 pandemic, grit has been inter-related with positive health-related behaviors, which are known to influence feelings of energy and fatigue. PURPOSE: To identify the association between grit, health-related behaviors and feelings of mental and physical energy (ME, PE) and fatigue (MF, PF) during the COVID-19 health crisis. METHODS: Using snowball sampling method during the early stages of the pandemic, participants (n=859) completed validated online surveys regarding physical activity (PA), diet, time sitting, grit, and feelings of ME, MF, PE …

Factors Influencing Motivation To Perform Mental And Physical Tasks During The Initial Lockdown Period Of The Covid-19 Pandemic, Alex J. Barber, Niklas J. Mckone, Joel R. Martin, Sumona Mondal, Shantanu Sur, Italia Milani, Nelson Cortes, Shane V. Caswell, Ali Boolani, Andreas Stamatis

International Journal of Exercise Science: Conference Proceedings

Drastic changes to lifestyles have occurred during the COVID-19 pandemic. A consequence of non-pharmaceutical interventions (NPIs) used against this health crisis, such as stay-at-home orders, has been increased isolation and less social interaction for a majority of people. For overall wellbeing, it is important to stay both physically and mentally active. However, for many individuals motivation may be a barrier. There are non-modifiable (e.g., sex, age) and modifiable factors (e.g., physical activity, diet) that may be associated with motivation to perform physical/mental tasks. PURPOSE: To explore if there is an association between non-modifiable and modifiable variables on motivation to …

Effects Of Acupuncture, Electroacupuncture, And Electrostimulation Treatments On Plantaris By Casting Model, Joo Hyun Kim, Jinho Park, Eun Hye Kwon, Thorburn Brocks Symons, Jesse Delacruz, Junghoon Lee, Yoonjung Park, Eunhee Chung, Sukho Lee

International Journal of Exercise Science: Conference Proceedings

It is essential to seek the therapeutic strategy for attenuating muscle atrophy because muscle atrophy diminishes the quality of life. Acupuncture and electrostimulation have been used as a therapeutic intervention to control pain under pathological conditions. However, little is known about the effects of acupuncture and electrostimulation on skeletal muscle mass and function. PURPOSE: To test whether acupuncture, electroacupuncture, and electrostimulation affect muscle mass and contractile properties METHODS: Forty female Sprague Dawley rats were randomly divided into 5 groups: 1) Control (CON), 2) Cast (CT), 3) CT+ Acupuncture (AC), 4) CT+ Electroacupuncture (EA), and 5) CT+ Electrostimulation (ES) (n=8 …

Myocardial Infarction In A 23-Year-Old Post-Collegiate Athlete, Michael Mungia, Melissa D. Long

International Journal of Exercise Science: Conference Proceedings

CASE HISTORY: The patient is a 23-year-old post-collegiate football player who was playing a recreational basketball game when his chest started hurting. The patient reported he was in a great amount of pain, and he felt it was not with his breathing but rather with his heartbeat. The patient had EMS contacted and awaited their arrival where they originally evaluated him. The patient’s health at the time of arrival was good according to the emergency personnel, so the patient opted to return home. The patient went home and was still in discomfort making him unable to sleep. He then …