Hematological Risk Factors Related to Acute Renal Injury During High Intensity Training
Phase: NA
Conditions: Acute Kidney Injury, Exercise
Sponsor: University of Wyoming

Acute Renal Injury During High Intensity Training (HIFRT-KH)– Study Protocol and Informed Consent 
Forms 
 
Document Date – 05/02/2019 
 
NCT Number - NCT03678285 
 
Notes – There are two protocol numbers and informed consent documents associated with the project 
because data was collected in individual sessions (20180607EJ2013) and also as a part of a mass 
participation event (20190502EJ02396).  Both approval documents and informed consents have been 
included here.  
 
 

 
Vice President for Research & Economic Development 
1000 E. University Avenue, Department 3355 • Room 305/308, Old Main • Laramie, WY 82071 
(307) 766-5353 • (307) 766-5320  • fax (307) 766-2608 •  www.uwyo.edu/research  
 
May 13, 2019 
 
Evan Johnson 
Assistant Professor 
Kinesiology and Health 
University of Wyoming 
 
Protocol #20180607EJ02013 
 
 
Re: “Risk Factors Related to Acute Renal Injury during High Intensity Training” 
 
Dear Evan, Boyi, Gretchen, Derek, Afzal, Evan, and Nicole: 
 
 
Your annual review for the protocol referenced above has been approved.  Your annual review 
and approval will be reported to the IRB at their next convened meeting June 20, 2019.   
 
 
IRB approval for the project/research is for a one-year period.  If this research project extends 
beyond June 6, 2020, a request to extend the approval accompanied by a report on the status of the 
project (Annual Review Form) must be submitted to the IRB at least one month prior to the expiration 
date.  Any significant change(s) in the research/project protocol(s) from what was approved should be 
submitted to the IRB (Protocol Update Form) for review and approval prior to initiating any change.  Per 
recent policy and compliance requirements, any investigator with an active research protocol may be 
contacted by the recently convened Data Safety Monitoring Board (DSMB) for periodic review.  The 
DSMB’s charge (sections 7.3 and 7.4 of the IRB Policy and Procedures Manual) is to review active 
human subject(s) projects to assure that the procedures, data management, and protection of human 
participants follow approved protocols.  Further information and the forms referenced above may be 
accessed at the “Human Subjects” link on the Office of Research and Economic Development website: 
http://www.uwyo.edu/Research/Research/human-subjects/index.html.     
 
 
You may proceed with the project and we wish you luck in the endeavor.  Please feel free to call 
me if you have any questions. 
 
 
 
 
 
 
 
 
Sincerely, 
 
 
 
 
 
 
 
 
Nichole Person 
 
 
 
 
 
 
 
Nichole Person 
Boyi Dai 
Associate Professor 
Kinesiology and Health 
University of Wyoming 
Gretchen Sewczak-Claude 
Assistant Lecturer 
Kinesiology and Health 
University of Wyoming 
Derek Smith 
Associate Professor 
Kinesiology and Health 
University of Wyoming 
Afzal Khan 
Medical Director 
Family Medicine Residency  
University of Wyoming 
Evan Norby 
Interim Program Director 
Family Medicine Residency 
University of Wyoming 
Nicole Sauls 
Graduate Assistant 
Kinesiology and Health 
University of Wyoming 

Staff Assistant, Research Office 
On behalf of the Chairman,  
 
 
 
 
 
 
 
Institutional Review Board 
 
 
 

1 
 
University of Wyoming IRB Proposal Form 
 
 
 
 
 
 
1. Responsible Project Investigator, Co-Investigators, & Faculty Supervisor  
Responsible Project Investigator: 
Name: Evan Johnson 
Title: Assistant Professor 
Department: Kinesiology and Health 
Office Address: Corbett Building 109 
Phone number: 307-766-5282 
Fax number (if applicable): 307-766-4098 
Email address: evan.johnson@uwyo.edu 
Is the project funded? Y___  N__X__ 
If Y, from where?______________________________  
If N, have you applied for funding? Y __X__ N _____    Where? AMSSM-ACSM Clinical 
                                                                                                             Research Grant 
 
Co-Investigators (add more boxes if necessary): 
Name: Boyi Dai 
Title: Associate Professor 
Department: Kinesiology and Health 
Office Address: Corbett Building 110 
Phone number: 307-766-5423 
 
Fax number (if applicable): 
Email address: bdai@uwyo.edu 
Is the project is funded? Y___  N____ 
If Y, from where?______________________________  
If N, have you applied for funding? Y ____ N _____    Where? 
 
Name: Gretchen Sewczak-Claude 
Title: Assistant Lecturer 
Department: Kinesiology and Health 
Office Address: Corbett Building 118 
Phone number: 307-766-5286 
Fax number (if applicable): 
Email address: gsewczak@uwyo.edu 
Is the project is funded? Y___  N____ 
If Y, from where?______________________________  
If N, have you applied for funding? Y ____ N _____    Where? 
 
Institutional Review Board 
Room 308, Old Main 
1000 East University Avenue, Dept. 3355 
Laramie, WY 82071 
 
Phone: 307-766-5322 
Fax: 307-766-2608 
email: irb@uwyo.edu 
(Electronic submission via email is encouraged.) 

2 
 
Name: Derek Smith 
Title: Associate Professor 
Department: Kinesiology and Health 
Office Address: Corbett Building 108 
Phone number: 307-766-5271 
Fax number (if applicable): 
Email address: smithdt@uwyo.edu 
Is the project is funded? Y___  N____ 
If Y, from where?______________________________  
If N, have you applied for funding? Y ____ N _____    Where? 
 
Name: Afzal Khan 
Title: Medical Director 
Department: University of Wyoming Family Medicine Residency Program 
Office Address: 821 East 18th Street 
Phone number: 307-777-7911 
Fax number (if applicable): 
Email address: akhan4@uwyo.edu 
Is the project is funded? Y___  N____ 
If Y, from where?______________________________  
If N, have you applied for funding? Y ____ N _____    Where? 
 
Name: Evan Norby 
Title: Interim Program Director 
Department: University of Wyoming Family Medicine Residency Program 
Office Address: 821 East 18th Street 
Phone number: 307-777-7911 
Fax number (if applicable): 
Email address: enorby@uwyo.edu 
Is the project is funded? Y___  N____ 
If Y, from where?______________________________  
If N, have you applied for funding? Y ____ N _____    Where? 
 
Name: Nicole Sauls 
Title: Graduate Assistant 
Department: Kinesiology and Health 
Office Address: Corbett Building 207 
Phone number: 909-730-3352 
Fax number (if applicable): 
Email address: nsauls@uwyo.edu 
Is the project is funded? Y___  N____ 
If Y, from where?______________________________  
If N, have you applied for funding? Y ____ N _____    Where? 
 
Faculty Supervisor (if PI is a student): n/a 
Name:  
Title:  
Department:  
Office Address:  
 
Phone number:  
Fax number (if applicable): 
Email address:  
If the principal investigator is a graduate or undergraduate student, submit the Research Supervisor Approval form from the faculty 
advisor, thesis or dissertation committee chair indicating review and approval of the proposal for submission to the IRB. The IRB will 
not approve a proposal without the proper Approval form. 

3 
 
2. Title of Study: 
Pharmacological Risk Factors Related to Acute Renal Injury during High Intensity Training  
 
3. Anticipated Project Duration: 
May 1st, 2018 – September 31st, 2019 
 
4. Purpose of Research Project: 
In LAY LANGUAGE, summarize the objectives and significance of the research: 
Physical activity is a well-established intervention used to improve a variety of health domains 
including cardiorespiratory, functional, and metabolic health. Despite the well-known health 
benefits, 31.1% of worldwide adults are considered physically inactive, and only 20.6% of 
adults in the United States meet both the current aerobic and muscle strengthening guidelines 
(ACSM's guidelines for exercise testing and prescription 2016). In response to the physical 
inactivity pandemic, barriers to exercise have been studied, and “lack of time” was a chief 
recurring response (Booth, Bauman, Owen, & Gore, 1997; Daskapan, Emine, & Levent, 2006; 
Sallis & Hovell, 1990).   
As a result, recent investigations have made an attempt to find a more time-efficient exercise 
solution through the comparison of high intensity training (HIT) performed over shorter 
durations in comparison to traditional moderate intensity continuous exercise (MICE). The 
theory behind HIT is that through higher intensity exercise, increased muscle fiber recruitment 
occurs, resulting in maximal skeletal muscle adaptations within a short period of time. HIT has 
demonstrated equivalent and even superior training effects compared to MICE (Burgomaster 
et al., 2008; Gibala, 2007; Nybo et al., 2010); however, other studies have reported potential 
risk including post-exercise physical dysfunction (Drum, Bellovary, Jensen, Moore, & Donath, 
2017; Nybo et al., 2010).  Not all variations of HIT will elicit identical training effects, and 
there may be individuals who are at higher risk for adverse consequences based on their 
specific behavioral patterns.    
High intensity interval training (HIIT) is the most recognized sub-class of HIT and is 
characterized by short bouts of high intensity cardiovascular exercise (i.e., running, cycling, 
rowing, stair-stepping) separated by brief periods of planned rest (Thompson, 2015). 
Traditional resistance and strength training methodologies have also been adapted to the HIT 
framework to create high intensity functional resistance training (HIFRT).  This style of HIT 
incorporates various functional movements (e.g., pull-ups, Olympic lifts) performed at 
relatively high intensities that train the body in all planes of motion.  Recent analyses have 
revealed this mode of training can improve metabolic conditioning, muscular strength, and the 
general physical preparedness of military members (Haddock, Roston, Heinrich, Jahnke, & 

4 
 
Jitnarin, 2016); however, as in any type of exercise, potential acute injury risks have also been 
identified. 
Some forms of HIFRT have been linked with severe post-exercise physical dysfunction and 
incidences of acute exertional rhabdomyolysis (ER) developing from skeletal muscle damage 
(Dilip, Richmond, & Alfonso, 2009; Drum et al., 2017; Xavier, Esteban, & Josep, 2009). Due 
to demand on the kidney’s filtering unit to clear excess  from the blood stream, ER is the most 
common cause of exercise-related acute kidney injury (AKI) in trained populations (Dilip et 
al., 2009). Renal injury risk can be exacerbated by the ingestion of non-steroidal anti-
inflammatory drugs (NSAIDS) which are taken in exercise populations to decrease 
inflammation and musculoskeletal pain. During normal exercise, sympathetic nervous activity 
constricts afferent arterioles to the kidney decreasing blood flow.  However, this signal is 
partially mitigated by prostaglandin production, resulting in very few renal concerns with 
traditional MICE.  The ingestion of NSAIDS prior to exercise can increase renal risk because 
the medication inhibits the cyclooxygenase-2 (COX-2) enzyme which in turn inhibits the 
vasodilation effects of prostaglandins in the renal arteries. The resulting ischemia can induce 
renal injury and decrease the kidney’s ability to filter blood. 
Those who participate in HIFRT may demonstrate increased prevalence of prophylactic 
NSAID use (i.e., medication taken before an exercise session) compared to the normal 
population.  This style of exercise has demonstrated more reporting of severe physical 
dysfunction symptoms such as muscle pain and soreness following HIFRT exercise sessions 
compared to traditional MICE (Drum et al., 2017). Frequent NSAID ingestion may occur in an 
effort to decrease post-exercise discomfort or, when they are taken in anticipation of a 
strenuous workout, the purpose is to circumvent and decrease potential future discomfort from 
occurring in the first place. 
There are many variations of HIFRT workouts, and some are more physically demanding than 
others. One of the most difficult and frequently performed workouts is “Murph” which 
consists of a 1 mile run, 100 pull-ups, 200 push-ups, 300 body-weight squats, and a second 1 
mile run. The workout is performed by many members HIFRT community including 177 
facilities in the United States that hosted “Murph” workouts in 2017 in honor of a Navy SEAL 
(LT. Michael P. Murphy) who died while serving overseas in Afghanistan (The murph 
challenge.2018). Symptoms of severe physical dysfunction have been reported following the 
completion of “Murph”, so there may be a high ingestion rate of NSAIDs prior to the workout 
in anticipation of symptoms such as pain and muscle soreness (Drum et al., 2017). 
Preliminary studies from out laboratory 
A brief questionnaire (QNR) was implemented as a pilot study to evaluate the prevalence of 
NSAID ingestion among HIFRT athletes. One hundred and seven volunteers completed the 
QNR, and the number one reported reason for ingesting NSAIDs was to relieve 
musculoskeletal pain, inflammation, or soreness. 

5 
 
It was also found that 39 (36%) had taken NSAIDs within the last week (Figure 1), 21% had 
ingested NSAIDs prior to a workout, and 20% had consumed higher than the prescribed dose 
(e.g., > 400mg 3x a day of ibuprophen). The results suggest a population with a high 
proportion of NSAID use which supports an essential need to investigate the potential 
negative pharmacological renal effects of NSAIDs especially since 60% of respondents also 
reported that they have completed the strenuous workout “Murph” in the past. 
 
Figure 1. Frequency of NSAID use among HIFRT population.  
 
A second ongoing pilot study within the Human Integrated Physiology Laboratory is seeking 
to quantify the exposure rate of the workout “Murph”.  This investigation is being performed 
via phone call or online QNR. There are about 6,000 HIFRT facilities in the United States, 
but the number of members of each of these gyms and the proportion of members who 
complete the workout “Murph” every year is unknown. Stratified methods of sampling have 
been performed to ensure gyms were randomly selected from all fifty states. Upon 
completion, an accurate estimate of the total exposure rate of “Murph” in the United States 
will be reported. 
 
Purpose / Aims 
 
HIT is a modality of exercise that can produce a high amount of health benefit in a minimal 
amount of time.  However, it is clear that some forms of HIT, particularly within the 
resistance training style (i.e., HIFRT) can introduce risk of renal injury, especially when they 
are combined with NSAID self-administration.  Therefore the aims of our current study are as 
follows: 
 
Aim 1: To investigate the prevalence of AKI following the HIFRT workout, “Murph”, and 
compare the results to previous research evaluating incidence rates in other forms of extreme 
exercise (i.e., marathon running). AKI will be determined through the sample analysis of 
39
34
25
9
0
10
20
30
40
50
Week
Month
Year
Never
# Particpants
Time
Frequency of NSAID Use by HIFRT Athletes

6 
 
blood (serum creatinine, blood urea nitrogen, neutrophil gelatinase-associated lipocalin 
[NGAL], and kidney injury molecule 1 [KIM-1]) and urine (albumin, creatinine, NGAL, and 
KIM-1) biomarkers.  
Aim 2: To evaluate if the ingestion of NSAIDs significantly increase the renal injury 
biomarker concentrations listed above.  
Aim 3: To evaluate biomechanical risk of musculoskeletal injury during the duration of a 
HIFRT workout through the examination of movement patterns using 2D video analysis and 
measurement of potential bilateral asymmetries using force platforms.  
 
The results from the study will be contribute to safe and efficacious prescription of HIFRT 
workouts similar to “Murph”.  
 
References 
ACSM's guidelines for exercise testing and prescription (2016). In Riebe D., Ehrman J., Liguori G. and Magal M. 
(Eds.), (10th ed.). Philadelphia, PA: Wolters Kluwer. 
Booth, M.,L., Bauman, A., Owen, N., & Gore, C.,J. (1997). Physical activity preferences, preferred sources of 
assistance, and perceived barriers to increased activity among physically inactive australians. Prevention 
Medicine, 26(1), 131-137. 
Burgomaster, K.,A., Howarth, K.,R., Phillips, S.,M., Rakobowchuk, M., Macdonald, M.,J., McGee, S.,L., & 
Gibala, M.,J. (2008). Similar metabolic adaptations during exercise after low volume sprint sprint interval 
and traditional endurance training in humans. Journal of Physiology, 586(1), 151-160. 
Daskapan, A., Emine, T., & Levent, E. (2006). Perceived barries to physical activity in university 
students. Journal of Sports Science Medicine, 5(4), 615-620. 
Dilip, P.,R., Richmond, G., & Alfonso, T. (2009). Exertional rhabdomyolysis and acute kidney injury. The 
Physician and Sports Medicine, 37(1), 71-79. 
Drum, S.,N., Bellovary, B.,N., Jensen, R.,L., Moore, M.,T., & Donath, L. (2017). Perceived demands and 
postexercise physical dysfunction in CrossFit compared to an ASCM bsed training session. Journal Sports 
Medicine Physical Fitness, 57(5), 604-609. 
Gibala, M.,J. (2007). High-intensity interval training: A time-efficient strategy for health promotion? Current 
Sports Medicine Report, 6(4), 211-213. 
Haddock, C.,K., Roston, W.,S., Heinrich, K.,M., Jahnke, S.,A., & Jitnarin, N. (2016). The benefits of high-
intensity functional training fitness programs for military personnel. Military  
The murph challenge. (2018). Retrieved from https://themurphchallenge.com/pages/lt-michael-p-murphy 
Nybo, L., Sundstrup, E., Jakobsen, M.,D., Mohr, M., Hornstrup, T., Simonsen, L., & Bulow, J. (2010). High-
intensity training versus traditional exercise interventions for promoting health.Medical Science Sports 
Exercise, 41(10), 1951-1958. 
Reid, S., Speedy, D., & Thomson, J. (2004). Study of hematological and biomechanical parameters in runners 
completing a standard marathon. Clinical Journal of Sports Medicine, 14, 344-353. 
Sallis, F., & Hovell, M. (1990). Determinants of exercise behavior. Exercise and Sport Sciences Reviews, 18(1), 
307-330. 
Thompson, R. (2015). Worldwide survey of fitness trends for 2016: 10th anniversary edition. ACSM's Health & 
Fitness Journal, 19(6), 9-18. 
 

7 
 
5.  Description of Potential Participants: 
A. Age-range and gender: Men and women between the ages of 18-60 
 
B. Describe how the participants will be recruited and/or selected:   
 
Participants will be recruited from a Laramie, Wyoming HIFRT facility, CrossFit 7220. They 
will be asked to volunteer in a double blind, counterbalanced, and crossover investigation. 
Only individuals who: A) self-report having taken NSAIDs prior to workouts in the past, B) 
have at least one year of HIFRT training experience, and C) who have completed the 
prescribed version of the workout “Murph” at least one time will be recruited.  These 
questions were specifically asked on our pilot QNR, along with the question if they would be 
interested in follow-up investigations.  Individuals that answered “yes” to this question along 
with meeting the above criteria will be contacted first. 
 
Additional participants will be recruited by word of mouth and enrolled in the study only after 
meeting the above criteria.  Interested individuals will contact the principal investigator to 
hear full details on the study procedures, exclusionary criteria, risks and benefits prior to any 
involvement.  
 
C. Describe the number of participants expected:  
 
We plan to enroll 10 participants in this project.  The clinical definition of acute kidney injury 
is a rise in serum creatinine (Scr) by ≥0.3 mg/dl.  A 10% difference in Scr rise (i.e., 0.03mg/dl 
difference between trials) induced by NSAID administration would be considered clinically 
significant.  Using the standard deviation of 0.02 mg/dl shown by Reid, Speedy, & Thomson, 
2004, an effect size of 1.5 is estimated for a matched pair, two-tailed analysis.  At a power 
level of 95%, a sample size of 8 is required.  In order to account for any potential subject 
attrition we will enroll 10 participants in the current project. 
 
 
 
Figure 2. Power calculation as completed using G*Power 3.1.9.2 

8 
 
D. Will compensation or incentives be provided for participation ? Y__X__  N____ 
IF Y, please describe:  
 
Participants will receive $100 for full participation in this study.  This will be distributed at 
the participants’ end of enrollment in the study.  If they choose to be removed from the study 
prior to completion they will be compensated based on the below pro-rated basis. 
$10 – Baseline measurements 
$30 – Completion of initial workout 
$30 – Completion of second workout 
$30 – Completion bonus for finishing all study measurement periods 
 
E. Description of special classes: n/a 
 
     F. Criteria for exclusion from participant pool:  
 
1. 
Score of “0” on the Functional Movement Screening (FMS) test indicating pain during 
any of the seven functional movements 
2. 
Kidney or other medical conditions contraindicating participation in HIFRT 
3. 
Pregnancy, suspected pregnancy, or breastfeeding 
4. 
Blood donations within the last eight weeks leading up to testing day 
5. 
Any musculoskeletal injuries which have resulted in > 1 week of absence from HIFRT 
within the last six months 
6. 
Not passing the physical activity readiness questionnaire (PAR-Q) 
7. 
Evidence of clinically relevant metabolic, cardiovascular, hematologic, hepatic, 
gastrointestinal, renal, pulmonary, endocrine or psychiatric history of disease, based on 
the medical history questionnaire 
8. 
Surgical operation on digestive tract or kidneys, except appendectomy 
9. 
Inability to participate in the entire study  
10. Recurrent urinary tract infections or kidney stones 
11. History of protein or blood in urine 
12. Moving from a location of low altitude to Laramie within the past 3 months 
13. Inability to understand and write English* 
*English is a required language because the questionnaires which will be used in this 
investigation are written in English language. 
 
 
6.  Procedure: 
A. Description of participants' activities:  

9 
 
 
Figure 3. Overall outline of a single testing week for individual data collections. Each 
participant will complete two testing weeks one month apart. 
 
 
Familiarization: Subjects will report to the Human Integrated Physiology (HIP) laboratory to 
provide informed consents (graded exercise testing, dual x-ray absorptiometry [DXA] scan, and 
form for overall study), complete initial screening procedures (physical activity readiness 
questionnaire (PAR-Q), medical history questionnaire, anthropometrics DXA scan, functional 
movement screening (FMS; Figure 4), and graded exercise test), spot urine sample, and blood 
draw. Female participants will review their menstrual cycle history with a female investigator 
(Attachment VIII), in order to schedule their first baseline visit to correspond with their early 
follicular phase (i.e. 4-5 days after the end of their period). 
 Informed consent obtained for overall research study 
 Informed consent for exercise stress testing (VO2max test) 
 Informed consent for DXA scan 
 University of Wyoming medical history questionnaire  
 PAR-Q 
 Anthropometrics (age, height, weight) 
 Spot urine sample (albumin, creatinine, NGAL, and KIM-1]) 
Familiarization
Screening 
Questionnaires
Anthropometrics
Spot Urine 
Sample
Blood draw
DXA Scan
Functional 
Movement 
Screen
Graded Exercise 
Test
Baseline
Blood Draw
Begin 24hr urine 
collection #1
McGill Pain Scale
Workout 
Completion of 
Murph
Rating of 
Perceived 
Exertion
Heart Rate
Immediately post 
blood draw
McGill Pain Scale
Return 24hr urine 
collection #1
Begin 24hr urine 
collection #2
24 hrs post
Avoid use of 
NSAIDS
Blood Draw
Return 24hr urine 
collection #2
Begin 24hr urine 
collection #3
McGill Pain Scale
48 hrs post
Avoid use of 
NSAIDS
Blood Draw
Return 24hr urine 
collection #3
McGill Pain Scale

10 
 
 Blood draw (serum creatinine, blood urea nitrogen, NGAL, and KIM-1) 
 DXA scan 
 FMS  
 Graded exercise test to determine maximal heart rate and oxygen uptake 
 
DXA scans will be administered by the principal investigator or a graduate student that has 
undergone the appropriate x-ray safety training at the University of Wyoming, Environmental 
Health and Safety Office. These graduate students include Nicole Sauls and Breton Van Syoc. 
 
Figure 4. The seven movement patterns and scoring system for FMS. 
 
Baseline (24 hours prior to workout session): Subjects will report the HIP Laboratory to provide 
baseline measures including a blood draw, McGill pain scale (Attachment 4), and begin the first 24 
hour urine jug collection.  
 The first 24 hour urine jug collection will be submitted to investigators the following day 
immediately prior to the workout session.  
 
Workout Session: Participants will report to the CrossFit 7220 gymnasium. Once arrived they will 
turn in their first 24 hour urine sample jug, receive a new 24 hour urine sample jug, perform a full 
body dynamic warm-up, review movement standards for the exercises to be completed as part of the 
workout, and complete the workout “Murph” while performance measures are recorded (rating of 
perceived exertion (RPE), heart rate, 2D movement analysis, and force evaluations). Immediately 
following the workout, a blood draw will be taken by the primary investigator and the participant 
will be asked to mark their level of muscle soreness on the McGill pain scale. 
 Turn in 24 hour urine sample jug 
 Receive empty 24 hour urine sample jug 
 
Dynamic warm-up (500m row and two rounds of 10 wall push-ups, 10 ring rows, 5 body 
weight-squats, 10 each side forward leg swings, 10 arm circles in each direction, and a 30 
second plank hold) 
 
Review of movement standards and practice opportunity  
 
Complete “Murph” (1 mile run, 100 pull-ups, 200 push-ups, 300 body weight squats, and 
a final 1 mile run) 
Scoring (0-3)
0: pain anywhere in body during 
movement
1: unable to complete movement 
2: completes movement with 
compensation
3: performs movement correctly 
without any compensation
 

11 
 
 
RPE and heart rate recorded after completion of every segment (e.g. 1 segment = 1 mile 
run, 100 pull-ups, 200 push-ups, 300 squats, or final 1 mile run) 
 2D movement analysis and bilateral force evaluations capturing repetitions at the 
beginning and end of each segment  
 Post blood draw 
 Post McGill pain scale to measure muscle soreness 
 
24 hours post: Subjects will report to the HIP lab to turn in their second 24 hour urine collection 
jug and be provided with the third and final 24 hour collecting jug. They will also take part in a 
blood draw and fill out the McGill pain scale to continue monitoring muscle soreness.  
Participants will be asked to abstain from the ingestion of NSAIDS during this time.  
Participants will be asked to refrain from exercise during this time. 
 
48 hours post: Subjects will turn in their third and final 24 hour collecting jug, provide one last 
blood draw, and complete the McGill pain scale. Once the 48 hour post tests have been finished, the 
subjects have officially completed one testing week of the study. 
 
Pharmacological Intervention: All participants will complete the above cycle (baseline through 
48 hours post measurements) on two occasions separated by one month.  On one of their baseline 
visits they will be given a single dose of NSAIDs in the form of 400mg of ibuprofen (provided to 
investigators by Ivinson hospital) to consume 45 minutes prior to their arrival on the “workout 
session” day.  On the other baseline visit participants will be given a single dose of a placebo pill (2 
x 4g oral glucose pills, Walgreens) to consume 45 minutes prior to their arrival on the “workout 
session” day.  The medications will be divided into individual doses by an investigator that does not 
have direct interaction with the participants during the data collection phases of this study into “A” 
medication and “B” medication.  Which of the medications is ibuprofen will be unknown to the 
participants and the investigators who interact with the participants (e.g., guide them through the 
exercise sessions, assist with their completion of the pain scale).  The order of dosing (i.e., which 
medication the participants are given during their first and second workout sessions) will be 
randomized and counterbalanced.  The medication blinding investigator will reveal the content of 
each medication to the rest of the investigation team only following completion of all data collection. 
 
A. What will non-participants do while participants participate? Note: this only applies 
when research is conducted in the classroom and some students may participate and some 
may not.  
 
N/A 
 
B. What will participants be told about the research project? 
 
Participants will receive full disclosure of methods, risk and benefits.  No deception will be used 
during the implementation of the above intervention.  They will not be told if they are consuming 
the placebo or ibuprofen prior to their workout sessions.  However, upon completion of the entire 
data collection, participants will be contacted with their results, including information about which 
medication was associated with each trial. 
 
C. Estimated time required for participants:  
 

12 
 
Two testing weeks with a month in between will be completed by each participant. During the first 
testing week, they will visit the Human Integrated Physiology Laboratory (Corbett Building 
Rooms 208 and 206) on 4 occasions (Familiarization, baseline, 24 hours post, 48 hours post) and 
the CrossFit 7220 facility for the workout session. The second week will be identical to the first 
with the exemption of no familiarization day. This totals visiting the university laboratory on 7 
occasions and CrossFit 7220 on 2 occasions. The following calculates the estimated total number 
of hours spent by each participant:  
 
1st Testing Week 
 
 Familiarization: 2 hours 
 Baseline: 30 minutes 
 Workout session: 2 hours 
 24 hours post: 30 minutes 
 48 hours post: 30 minutes 
 
2nd Testing Week 
 
 Baseline: 30 minutes 
 Workout session: 2 hours 
 24 hours post: 30 minutes 
 48 hours post: 30 minutes 
 
Total= 9 hours spent per participant performing study related activities 
 
 
D. Where will research take place?   
 
All familiarization, baseline, 24 hour post, and 48 hour post data collection days will take place in 
the Human Integrative Physiology (HIP) laboratory (Corbett Building Rooms 208 and 206). Both 
workout sessions will take place at the CrossFit 7220 facility.  
 
E. Method of data collection:  Qualitative ___  Quantitative__X_ (check one or both). In 
a paragraph or two, please describe how you will collect your data: 
 
Data collection will occur via blood draws, urine sample collections, 2D video analyses, force 
evaluation, muscle soreness, heart rate monitoring, and RPE scale evaluations.  
 
A qualified investigator will obtain a single blood sample via venipuncture to an antecubital vein 
using sterile technique and universal precaution standards. Samples will be drawn into vacutainers 
for later examination in the University of Wyoming’s HIP lab. Samples will assess kidney injury 
biomarkers including serum creatinine and blood urea nitrogen. In concordance with the Acute 
Kidney Injury Network, occurrence of AKI will be defined as an increase in serum creatinine of 0.3 
mg/dL or an increase of 1.5 times greater than baseline measures. Our lab group has successfully 
drawn and stored blood samples as part of a current project. Additionally, investigator Johnson has 
successfully performed similar sample collections within laboratory environments and on athletes 
in field based locations. 
 

13 
 
A total of three 24 hour urine collection jugs will be collected over a 72 hour period. Samples will 
assess albumin, creatinine, neutrophil gelatinase-associated lipocalin (NGAL), and kidney injury 
molecule 1 (KIM-1) kidney injury biomarkers. Total volume, urine color, and urine specific gravity 
will also be analyzed from every sample. Dipsticks will be used on fresh samples while three 2mL 
aliquots of each 24hr sample will be separated and stored at room temperature until they are returned 
to the University of Wyoming where they will be frozen at -80C for future analysis. Investigator 
Johnson has consistently used 24 hour urine collections as a part of his ongoing research regarding 
human hydration. 
 
 Two camcorders will be set up in front of and to the right of the participant to analyze body-weight 
squat, and push-up movement patterns. Reflective markers will be placed on anatomical landmarks 
(shoulder centers, greater trochanters, knee centers, ankle centers, elbow centers, and wrists) which 
will be manually digitized to measure elbow, shoulder, hip, and knee joint angles in the frontal and 
sagittal planes.  
 
Two force platforms will be used to analyze bilateral force production at a sampling frequency of 
1000 Hz (Figures 5, 6). The peak force for each limb during the concentric phases of the squat and 
push-up segments of the workout will be used to assess bilateral asymmetry which is calculated as: 
(right side-left side)/(larger value of the two sides). 
 
 
Figure 5. Frontal plane view                        Figure 6. Sagittal plane view 
 
Muscle soreness will be measured using a McGill short-form pain questionnaire to assess muscle 
pain and soreness (attachment IV).  
 
A heart rate monitor will be worn by participants around their chest in order to record accurate heart 
rate continuously throughout the workout. The values will be compared with the maximal heart rate 
values from the maximal graded exercise test performed during the familiarization visit in order to 
quantify relative exercise intensity.  
 
The Borg’s RPE scale will be utilized to monitor how hard a subject is working after each segment 
of the workout as well (Figure 7). 
 
 

14 
 
 
 
Figure 7. Borg’s RPE Scale 
 
F. Please describe how and when participants may terminate participation:  
 
Participants are free to terminate their participation in the investigation at any time with no 
penalty. 
 
G. Description of biological samples (examples may include blood or urine):  
 
Blood samples will be collected on all days of data collection (familiarization, baseline, workout, 
24 hours post, and 48 hours post) to analyze serum creatinine, blood urea nitrogen, NGAL, and 
KIM-1. A qualified investigator will obtain a single blood sample via venipuncture to an 
antecubital vein using sterile technique and universal precaution standards. Samples will be 
drawn into vacutainers for later examination at the University of Wyoming’s HIP lab (serum 
creatinine and blood urea nitrogen). They will be analyzed via colormetric enzyme-linked 
immunosorbent assays (ELISA). ELISA antibodies will be supplied by Abcam (Cambridge, MA, 
USA) and microplates will be read according to the manufacturer’s instructions on 
spectrophotometer (Epoch 2, Bitotek, Winooski, VT, USA).  
 
A total of three, 24 hour urine collection samples will be collected over a 72 hour period. Samples 
will assess albumin, creatinine, neutrophil gelatinase-associated lipocalin [NGAL], and kidney 
injury molecule 1 [KIM-1] kidney injury biomarkers. A portion from each sample will be shipped 
to Yale University for analysis (NGAL and KIM-1). Total volume, urine color, and urine specific 
gravity will also be analyzed for every sample. Dipsticks will be used on fresh samples while 
three, 2mL aliquots of each 24hr sample will be separated and stored at room temperature until 
they are returned to the University of Wyoming where they will be frozen at -80C for future 
analysis. Fresh samples will be evaluated for urine color and specific gravity using a handheld 
refractometer to establish hydration state.  
 
H. Description of equipment to be used on or by participants:  
 

15 
 
Participants will utilize spot and 24 hour urine collection containers (Figure 8, 9) which 
contain screw tops to avoid breakage or spilling. A “Go Girl” urinary funnel device will be 
provided to female participants to assist with urine collection (Figure 10).  
 
 
 
 
 
 
 
 
 
 
      Figure 8. 24 hour urine collection jug                 Figure 9. Spot urine collection container 
 
 
 
 
 
 
 
 
 
 
 
 Figure 10. “Go Girl” urinary device 
 
      
Blood draws will be collected using a winged infusion set with a tube holder. Samples will be drawn 
into vacutainers for later examination in the University of Wyoming’s HIP lab (Figure 11). 
 
 
  
 
 
 
 
Figure 11. Winged infusion set with a tube holder 
 
 
 
 
Scans to assess fat mass, lean mass, and bone mineral density will be taken using a dual x-ray 
absorptiometry with a GE Lunar Prodigy (Figure 12).  
 
 
 
 

16 
 
 
 
 
 
Figure 12. General Electric Dual X-Ray Absorptiometry 
 
 
A scale will be used to assess bodyweight on familiarization day (Figure 13). 
 
 
 
 
 
 
 
 
Figure 13. Bodyweight scale 
 
 
Participants will utilize the FMS testing kit (measuring device, hurdle, and measuring stick) during 
familiarization to assess movement patterns (Figure 14).  
 
 
 
 
 
 
 
 
 
 
 
 
 
Figure 14. FMS testing kit  
 
 
 
 
 
 
 
 
VO2max testing equipment includes a treadmill (Figure 14), electrocardiogram (ECG) monitor 
(Figure 15), metabolic cart disposables (Figures 16-22), metabolic stress testing system (Figure 
23) and heart rate monitors to record exercise intensity (Figure 24).  

17 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Figure 15.  Trackmaster treadmill                              Figure 16. Mortara Instrument X12+ ECG 
                                                                                       Monitor      
 
 
 
 
 
 
 
 
 
 
Figure 17. Prepster electrode skin prep pads          Figure 18. ECG Vermed Performance    
                                                                                PlusDiagnositc Electrodes 
 
 
  
Figure 19. Dynarex sterile alcohol prep                 Figure 20. MGC Diagnostics Prevent 
pads                                                                         mask 
 
 
 
 

18 
 
 
 
 
 
 
 
 
 
             
Figure 21. MGC Diagnostics Prevent                  Figure 22. MGC Diagnostics Adult mouthpiece 
Flow Sensors 
 
  
Figure 23. MGC Diagnostics pulmonary           Figure 24. MGC Diagnostics metabolic stress 
function filter                                                       testing system 
 
 
 
 
 
 
 
 
 
 
 
 
Figure 25. Polar A300 activity heart rate 
Monitor 
 
 
 
 
 
 
 
 
 
 

19 
 
Biomechanics measures will collected using two JVC GC-PX100 camcorders with a resolution 
of 1920 to 1080 pixels and a sampling frequency of 60 Hz (Figure 26). Two portable force plates 
will be used to collect bilateral limb forces during the bodyweight squats and push-ups (Figure 
27). Reflective markers will be placed on anatomical land marks to later analyze joint angles 
(Figure 28). 
 
 
 
 
 
 
 
 
 
 
 
 
 
Figure 26. JVC GC-PX100 camcorder               Figure 27. Portable bilateral force plates 
 
 
 
 
 
 
 
Figure 28. Qualisys reflective markers 
 
 
 
 
7. Confidentiality Procedures: 
     A. Explain whether or not participants will be identified by name, appearance, or 
nature of data:  
 
Participants will not be identified by name, appearance, or nature of data. 
 
B. Are you collecting personal health information? (See the IRB manual at: 
http://www.uwyo.edu/research/compliance/human-subjects/index.html ). 
 
Yes ____X_____ No _____________ 
C. Will the data you collect be anonymous or confidential (check the one that applies)? 
Note: research is only anonymous if the researcher does not know the identity of the 
participants and there are no identifiers linking the participant to the research. 
 
            Anonymous______                        Confidential __X____ 

20 
 
D. Explain the procedure that will be used to protect privacy and confidentiality:  
 
Each participant will receive an exclusive identification number to be used on all data collection 
sheets and samples. There will only be one master sheet where the subject’s names will 
correspond to their identification number. This sheet will be held on a secure password 
protected computer by the graduate student investigator, Nicole Sauls. Participant names will 
not be used in presentations, reports, data bases, or publication based on the research 
investigation.  
 
E. How and where will data be stored (may be indefinitely)?  
 
Data sheets will be kept in a locked file cabinet. The data will be entered into an electronic 
spreadsheet on a password protected computer and will not include subject names. The original 
data sheets will be kept for at least six years following the completion of research. The 
electronic files will be held indefinitely in case questions about publications come up in the 
future. 
 
F. How long will the data, research summary, and signed consent forms be stored 
(may be indefinitely)? Note: The regulations require that The PI or project director 
maintain the signed informed consent forms, assent script/forms (if applicable), and the 
written research summary, relating to research for at least three years after completion 
of the research. 
 
All data, research summaries, and signed consent forms will be stored in a locked file cabinet in 
the principal investigator’s office. These data files will be kept for at least six years following 
the completion of data collection.  
 
G. Who will have access to the data?  
 
The data will only be accessible to the primary investigator, co-investigators, and 
Responsible graduate and undergraduate students.  
 
 
8. Benefits to Participants: 
     A. Describe the indirect research benefits for the participants:  
 
Indirect research benefits include DXA scan measures, VO2max performance, and functional 
movement screen results.  
 
     B. Describe the direct research benefits or state there are no direct benefits to the 
participants (do not include incentives in this section): 
 
Participants will receive up to $100 for their participation. 
 
9. Risks to Participants: 

21 
 
This section should include a detailed description of any reasonably foreseeable risks or discomforts to 
the participants as a result of each procedure, including discomfort or embarrassment with survey or 
interview questions, exposure to minor pain, discomfort, injury from invasive medical procedures, or 
harm from possible side effects of drugs. All projects are deemed to involve some level of risk to 
participants, however obvious or obscure. Consequently, proposals must state that minimal risk is 
involved when the proposed research is viewed as involving little or no risk to participants. Risk is 
minimal where the probability and magnitude of harm or discomfort anticipated in the proposed research 
are not greater, in and of themselves, than those ordinarily encountered in daily life or during the 
performance of routine physical or psychological examinations or tests. Even when risk is minimal, 
investigators must still state what the minimal is and why it is minimal (example would be potential for 
embarrassment or boredom). 
 
Describe the risks to participants:   
 
Urine collection inconvenience – The 24 hour urine collection jugs may present inconvenience 
and slight embarrassment for participants. To minimize these inconveniences, a reusable shopping 
tote will be provided to make carrying the samples more discrete. Also, a female urination device 
will be provided to appropriate participants to make urine collection easier.  
 
Blood Draw and Venipuncture Risk- Blood draws performed on familiarization, baseline, 24 hours 
post, and 48 hours post will be performed by a trained investigator, Dr. Johnson, using sterile 
techniques and universal precautions. However, risk does include pain, bruising, fainting, 
hematoma, nausea, phlebitis, bleeding, blood clots, and sensitive responses to plastic or adhesive 
tape used during or as a reaction to the venipuncture. To minimize bleeding and the incidence of 
a hematoma, firm pressure with gauze will be placed on the site of needle removal.  
 
X-Ray Radiation Risk (DXA Scan)- All tests will be performed by trained investigators with 
qualified supervision, and all precautions will be made to minimize the minimal risks associated 
with DXA Scans. The following are the four types of minimal risk:  
1. Exposure to a small amount of radiation will occur during the scan (approximately 1/20th 
of the amount of radiation that occurs with bone fracture x-rays). It is important to note 
this scan is performed routinely in hospitals and medical offices.  
2. Females will be required to take a urine sample pregnancy test and it must be confirmed 
as negative prior to testing. There are no exceptions and the only risk that may occur is if 
the urine test is positive, the participant may be pregnant.  
3. Radiation exposure can cause tissue damage or change in genes that could lead to other 
complications. The exact risks are unknown, but the chances of complications (cancer 
and/or tumors) increase the more an individual is exposure to radiation.  
4. The DXA could identify an individual has low bone mineral density (BMD) meaning an 
individual either is at-risk for osteoporosis or currently has osteoporosis. If BMD is 
classified as low from the scan according to age, sex, and ethnicity, a copy of the DXA 
scan will be given to the participant and they will be referred to see their primary health 
care provider for a follow-up appointment to discuss the results. The University of 
Wyoming does not provide licensed health care provider interpretation of results; it is the 
responsibility of the individual’s health care provider. The participant will be asked to sign 
a health care provider referral document acknowledging that they have been referred for a 
follow-up appointment with their personal health care provider.  
 

22 
 
Exercise Stress Test Risks- All tests will be performed by trained investigators with qualified 
supervision, and all precautions will be made to minimize the minimal risks associated with 
exercise stress testing. The risks associated with exercise stress testing include but are not limited 
to:  
1. Minor jaw/mouth discomfort from wearing a mouthpiece 
2. Feelings of claustrophobia from the mouthpiece and head gear 
3. Redness or mild irritation from the skin electrodes, alcohol, or gel used to prepare the skin 
for electrodes 
4. Dizziness, fatigue, shortness of breath, muscle or connective tissue strain, heart attack, 
irregular heartbeat, and death.  
a. The overall risk of exercise testing in a mixed population is approximately 6 cardiac 
(heart) events per 10,000 exercise tests and the risk of death during or immediately 
after an exercise test is less than or equal to 0.01%. 
5. Muscle, ligament, tendon or joint discomfort, soreness, swelling, pain, strain, tear, or injury 
 
Exercise intervention – As with any exercise participation there is some risk of musculoskeletal 
injury with the completion of “Murph” in this investigation.  This risk will be minimized by the 
following: 
1. Anyone with a pre-existing injury will be excluded 
2. All exercise sessions will be overseen by an investigator with a certification as a CrossFit 
instructor.  They will alert the participants if exercise form puts the individual at risk for 
injury 
3. All participants will have at least 1 year of HIFRT experience and will have completed 
“Murph” on at least one occasion prior to their inclusion in the study. 
 
Non-steroidal anti-inflammatory drug administration – As mentioned in the background to this 
investigation, NSAIDs have the potential to enhance risk of kidney injury when combined with 
exercise.  Previous investigations have found significantly elevated Scr in individuals that use 
NSAIDs before or during endurance exercise.  However, regardless of administration Scr levels 
returned to normal given proper rest.  Additionally this risk will be minimized by the following: 
1. Only individuals that have self-reported to taking NSAIDs prior to working out will be 
recruited 
2. Individuals will be asked to refrain from any NSAID consumption in the day before or in 
the two days following the exercise session 
3. Individuals will be asked to refrain from exercise in the day before and for the two days 
following the experimental exercise session 
 
 
 
 
 
 
 

23 
 
10. Description of procedure to obtain informed consent or other information to be provided to 
participant: 
 
A. How and when will the participants be approached to obtain consent?  
 
Participants will be recruited from the Laramie, Wyoming HIFRT facility, CrossFit 7220 to 
participate in a single blind, counterbalanced, and crossover investigation. Only individuals 
who: self-report having taken NSAIDs prior to workouts in the past, have at least one year of 
HIFRT training experience, and who have completed the prescribed version of the workout 
“Murph” at least one time will be recruited.  These questions were specifically asked on our 
pilot QNR, along with the question if they would be interested in follow-up investigations.  
Individuals that answered “yes” to this question along with meeting the above criteria will be 
contacted first via e-mail or in person while at the gym. 
 
Additional participants will be recruited by word of mouth and enrolled in the study only after 
meeting the above criteria.  Interested individuals will contact principal investigator to hear 
full details on the study procedures, exclusionary criteria, and risk prior to any involvement.  
 
B. Who will be responsible for obtaining consent (check the box that applies)? 
 
Project Director ___X___ Evan Johnson, PhD 
Member of Project team ___X____ Nicole Sauls (Co-investigator), or 
 Breton Van Syoc (Master’s Student), or 
 Brandon Strannigan (Undergraduate Student), or 
 Hunter Anderson (Undergraduate Student), or 
 Brittany Wells (Undergraduate Student) 
            Other ______ (Please explain, and include name, affiliation, and title) 
 
C. How will information be relayed to participant (read to, allowed to read, audio-
recorded, video-recorded)? 
 
Participants will have the consent form read to them by a responsible investigator. They will 
also have time to ask questions if any clarification is needed. A copy of the consent forms will 
also be given to take with them to the remaining sessions. The copies will include contact 
information for the primary investigator and the IRB office in case any questions or concerns 
arise during or after their time spent in the HIP Laboratory or CrossFit 7220 facilities.  
 
D. Provide a description of feedback, debriefing, or counseling referral that will be 
provided if this is relevant to the research: 
 
All participants will be sent individual reports following the completion of all data collection 
containing graded exercise testing, FMS, and heart rate results. Urine and blood analysis 
results will also be provided within a year from the completion date as these analyses take 
much more time to complete.  
 

24 
 
E. Explain the procedure that will be used to obtain assent of children, if relevant to 
the research (See: http://www.uwyo.edu/research/compliance/human-
subjects/index.html ): N/A 
 
F. If children are involved, who will be responsible for obtaining assent (check the 
box that applies)?  
 
N/A 
 
Project Director ______ 
Member of Project team _______ (list name or position) 
            Other ______ (Please explain, and include name, affiliation, and title) 
 
 
11A. Attach copies of survey instruments, interview questions, tests, and other pertinent 
documentation that will be used to conduct the research.  Note: Please see the informed consent 
outline for suggested language for consent forms. 
Attachment Name 
Description 
Attachment 1: 
Informed consent for research participation 
Attachment 2: 
Medical History Questionnaire 
Attachment 3: 
Physical Activity Readiness Questionnaire (PAR-Q) 
Attachment 4: 
McGill Pain Questionnaire 
Attachment 5: 
Exercise stress testing informed consent 
Attachment 6: 
Exercise stress test data collection sheet 
Attachment 7: 
DXA scan informed consent 
Attachment 8: 
Letter of support from CrossFit 7220 
Attachment 9: 
Menstrual History (Female participants only) 
Attachment 10: 
List of additional student research assistants not listed as co-investigators 
 
11B. If participants will be recruited through an institution such as a school or hospital, or if the 
research will be conducted at such an institution, provide a letter of agreement/approval to do so 
from an authorized representative of that institution. The IRB will not approve a proposal without 
the proper letter(s) of support. – See Attachment 8 
 
11C. If collaborators and/or students will be helping with the research and those individuals are not 
listed as co-investigators on the proposal, please provide the names of those individuals in an 
attachment to the proposal so that human subjects training can be verified. – See Attachment 10 
 
 
 
 
 
 
 
 

ATTACHMENT 1 – Informed consent for research participation 
 
 
University of Wyoming Consent Form 
 
I. 
General purpose of the study: 
 
 
Ingestion of over-the-counter non-steroidal anti-inflammatory drugs (NSAIDS) prior to endurance 
exercise events has been associated with increased risk for acute kidney injury (AKI). High 
intensity functional resistance training (HIFRT) may also present risk for AKI due to high exercise 
intensities and NSAID ingestion. However, the direct effects of NSAID use prior to performing a 
long duration HIFRT workout on AKI is unknown.  
 
The first aim of the study is to investigate the incidence of AKI following the commonly performed 
workout, “Murph” (1 mile run, 100 pull-ups, 200 push-ups, 300 body-weight squats, and a final 1 
mile run) and compare these results seen in other forms of extreme exercise. Blood and urine 
samples are used in the diagnosis of kidney injury, so they will be used to determine AKI 
incidences.  
 
The second aim is to evaluate if the ingestion of NSAIDS prior to performing “Murph” increases 
the rate of AKI incidence.  
 
The third aim is to determine risk of musculoskeletal injury during “Murph” by analyzing 
movement patterns and force production during the push-up and body-weight squats portion of the 
workout.  
 
By doing this we hope to assist in the continued programming of safe and efficacious HIFRT 
workouts. The goal is not to take away from the many benefits of HIFRT. Instead, we hope to 
educate the exercising population on the potential risks associated with HIFRT, so they can adjust 
behavioral or movement patterns that will minimize risk for injury.  
 
 
II. 
Procedure: 
 
All sessions will take place at CrossFit 7220 or University of Wyoming’s Human Integrated 
Physiology Laboratory. Data will be collected by Evan Johnson PhD, graduate, and undergraduate 
students that have been appropriately trained to carry out the research protocol.  
 
Participation will include two data collection weeks, one-month apart. Each week will consist of 4 
consecutive data collection days. The only additional commitment is a familiarization day prior to 
the first week of testing where baseline measures will be assessed. We estimate the total time 
commitment for both weeks to be 9 hours. The schedule is outlined below:  
 
 
 
 
 
 
 
 
 

Attachment I – Participant Consent Form 
2 
 
1st Testing Week 
 
 Familiarization: 2 hours 
 Baseline: 30 minutes 
 Workout session: 2 hours 
 24 hours post: 30 minutes 
 48 hours post: 30 minutes 
 
On the familiarization day, consent and initial screening forms will be filled out if you choose to 
participate. Female participants will review their menstrual cycle history with a female 
investigator, in order to schedule your first baseline visit to correspond with your early follicular 
phase (i.e. 4-5 days after the end of your period). Next, you will have your blood drawn by a 
trained investigator and you will provide a spot urine sample. You will then receive a DXA scan to 
measure body fat percentage and bone mineral density followed by a functional movement 
screening (FMS) to analyze your ability to perform several movement patterns. Lastly, you will 
perform a graded exercise stress test to identify your maximal heart rate and maximal oxygen 
consumption (VO2max). This session will take an estimated 2 hours.  
 
Baseline collection days will take place and 24 hours prior to the workout session.  
A second blood draw will be taken and the first 24 hour urine collection jug will be provided. This 
jug is to be returned 24 hours later at the beginning of your workout session. You will complete the 
McGill pain scale to evaluate your baseline measures of muscle pain or soreness. This session is 
estimated to take 30 minutes. 
 
During the workout session, you will perform the standard version of “Murph” (1 mile run, 100 pull-
ups, 200 push-ups, 300 body-weight squats, and a final 1 mile run).  This day is also where you will 
be randomly assigned a placebo or 400mg of the over-the-counter NSAID, ibuprofen. This selection 
will be double-blind, so neither you nor the researcher will know which is given. However, if you 
receive ibuprofen the first data collection week, you will be administered the placebo the second data 
collection week. The same is applied if you are given the placebo first in which case you would 
receive ibuprofen the second week of data collection. You will not wear a weighted vest during this 
exercise session. Prior to exercising, you will return your first urine collection jug and receive a 
second to again return 24 hours later at the next session. Next, a certified trainer will lead you through 
a full body dynamic warm-up and review all movement and workout standards. If there are no other 
questions or concerns, you will perform all repetitions of “Murph” as prescribed. During the workout, 
your rating of perceived exertion and heart rate will be recorded. Your movements during the push-
up and body-weight squat portions will be analyzed using 2D camcorders and your force production 
will be measured using portable force plates. Immediately after the completion of all repetitions, a 
post-exercise blood draw will be taken and you will be asked to fill out a McGill pain scale to quantity 
muscle soreness. This session is estimated to take 2 hours.  
 
The day following the workout (approximately 24 hours post) will consist of turning in your second 
24 hour urine collection jug and being provided with the third and final 24 hour jug. You will also 
provide another blood draw and fill out the McGill pain questionnaire to identify any muscle pain or 
soreness. This session is estimated to take 30 minutes.  
 
The final day of the week will be approximately 48 hours post workout. You will turn in your third 
and final 24 hour urine collection jug and provide one last blood draw. After completing a final 
2nd Testing Week 
 
 Baseline: 30 minutes 
 Workout session: 2 hours 
 24 hours post: 30 minutes 
 48 hours post: 30 minutes 

Attachment I – Participant Consent Form 
3 
 
McGill pain questionnaire, the single testing week is completed. This sessions is also expected to 
take about 30 minutes.  
 
It is also important to note, you will be asked to abstain from ingesting NSAIDS and alcohol for 24 
and 48 hours post workout.  You will also be asked to avoid strenuous exercise for the 24 hours 
before and 48 hours post workout.  
 
This exact procedure will be reproduced on two occasions, one-month apart.   Thus, in the second 
occurrence the times to complete each segment will be replicated.  For example if the initial run took 
you 10 minutes to complete during the first trial, you will not be allowed to move onto the pull-up 
segment during your second trial until at least 10 minutes has passed.  It is OK if the second trial 
takes longer to complete. 
 
 
III. 
Disclosure of risks 
 
Urine collection inconvenience – The 24 hour urine collection jugs may present inconvenience and 
slight embarrassment. To minimize these inconveniences, a reusable shopping tote will be provided 
to you to make carrying the jugs more discrete. Also, a female urination device will be provided to 
if necessary to make urine collection easier.  
 
Blood Draw and Venipuncture Risk- Blood draws performed during the familiarization, baseline, 
24 hours post, and 48 hours post sessions will be performed by a trained investigator, Dr. Johnson, 
using sterile techniques and universal precautions. However, risks do include pain, bruising, 
fainting, hematoma, nausea, phlebitis, bleeding, blood clots, and sensitive responses to plastic or 
adhesive tape used during or as a reaction to the venipuncture. To minimize bleeding and the 
incidence of a hematoma, firm pressure with gauze will be placed on the site of needle removal.  
 
X-Ray Radiation Risk (DXA Scan)- All tests will be performed by trained investigators with 
qualified supervision, and all precautions will be made to minimize the minimal risks associated 
with DXA Scans. The following are the four types of minimal risk:  
1. Exposure to a small amount of radiation will occur during the scan (approximately 1/20th of 
the amount of radiation that occurs with bone fracture x-rays). It is important to note this 
scan is performed routinely in hospitals and medical offices.  
2. Females will be required to take a urine sample pregnancy test and it must be confirmed as 
negative prior to testing. There are no exceptions and the only risk that may occur is if the 
urine test is positive, the participant may be pregnant.  
3. Radiation exposure can cause tissue damage or change in genes that could lead to other 
complications. The exact risks are unknown, but the chances of complications (cancer and/or 
tumors) increase the more an individual is exposure to radiation.  
4. The DXA could identify an individual has low bone mineral density (BMD) meaning an 
individual either is at-risk for osteoporosis or currently has osteoporosis. If BMD is classified 
as low from the scan according to age, sex, and ethnicity, a copy of the DXA scan will be 
given to the participant and they will be referred to see their primary health care provider for 
a follow-up appointment to discuss the results. The University of Wyoming does not provide 
licensed health care provider interpretation of results; it is the responsible of the individual’s 
health care provider. The participant will be asked to sign a health care provider referral 
document acknowledging that they have been referred for a follow-up appointment with 
their personal health care provider.  

Attachment I – Participant Consent Form 
4 
 
 
Graded Exercise Test Risks- All tests will be performed by trained investigators with qualified 
supervision, and all precautions will be made to minimize the minimal risks associated with exercise 
stress testing. The risks associated with exercise stress testing include but are not limited to:  
1. Minor jaw/mouth discomfort from wearing a mouthpiece 
2. Feelings of claustrophobia from the mouthpiece and head gear 
3. Redness or mild irritation from the skin electrodes, alcohol, or gel used to prepare the skin 
for electrodes 
4. Dizziness, fatigue, shortness of breath, muscle or connective tissue strain, heart attack, 
irregular heartbeat, and death.  
a. The overall risk of exercise testing in a mixed population is approximately 6 cardiac 
(heart) events per 10,000 exercise tests and the risk of death during or immediately after 
an exercise test is less than or equal to 0.01%. 
5. Muscle, ligament, tendon or joint discomfort, soreness, swelling, pain, strain, tear, or injury 
 
Exercise intervention – As with any exercise participation there is some risk of musculoskeletal 
injury with the completion of “Murph” in this investigation.  This risk will be minimized by the 
following: 
4. Anyone with a pre-existing injury will be excluded 
5. All exercise sessions will be overseen by an investigator with a certification as a CrossFit 
instructor. They will alert the participants if exercise form puts the individual at risk for 
injury. 
6. All participants will have at least 1 year of HIFRT experience and will have completed 
“Murph” on at least one occasion prior to their inclusion in the study. 
 
Non-steroidal anti-inflammatory drug administration – NSAIDs have the potential to enhance risk 
of kidney injury when combined with exercise.  Previous investigations have found significantly 
elevated Scr in individuals that use NSAIDs before or during endurance exercise.  However, 
regardless of administration Scr levels returned to normal given proper rest. Additionally this risk 
will be minimized by the following: 
4. Only individuals that have self-reported to taking NSAIDs prior to working out will be 
recruited 
5. Individuals will be asked to refrain from any NSAID consumption in the day before or in 
the two days following the exercise session 
6. Individuals will be asked to refrain from exercise in the day before and for the two days 
following the experimental exercise session 
 
 
IV. 
Description of benefits: 
 
You will receive up to $100 for your participation in this investigation. This will be distributed at 
the end of your enrollment in the study.  If you choose stop participation in the study prior to 
completion you will be paid for your involvement based on the below pro-rated basis. 
1. $10 – Baseline measurements 
2. $30 – Completion of initial workout 
3. $30 – Completion of second workout 
4. $30 – Completion bonus for finishing all study measurement periods,  
 

Attachment I – Participant Consent Form 
5 
 
You will also receive indirect benefits including DXA scan measures, graded exercise test 
performance scores, and functional movement screen results.  We will provide you with blood 
analysis results within a year of your participation as these measurements take longer to evaluate.  
 
 
V. 
Confidentiality: 
 
Each member of the research team has undergone certification for proper data management during 
human subject research. All information will be kept confidential and each participant will receive 
an exclusive identification number to use on all data collection sheets and samples. There will only 
be one master sheet where your name will correspond to an identification number. This sheet will be 
held on a secure and password protected computer by the graduate student investigator, Nicole Sauls. 
Your name will not be used in presentations, reports, data bases, or publication based on the research 
investigation.  
 
Data sheets will be kept in a locked and secure file cabinet. The data will be entered into an electronic 
spreadsheet on a password protected computer and will not include identification information. The 
original data sheets will be kept for at least six years following the completion of research. The 
electronic files will be held indefinitely in case questions about publications come up in the future.  
 
 
VI. 
Freedom of consent: 
 
Participation is voluntary, refusal to participate will involve no penalty or loss of benefits to which 
you are otherwise entitled, and you may discontinue participation at any time. If you choose to 
discontinue your participation please contact Principal Investigatory Evan Johnson 202-431-4065, 
and return any equipment you may have been issued (i.e., 24 hour urine collection jugs and totes) 
 
 
VII.  Questions about the research:  
 
 
Should you have any questions about this research following today please contact: 
 
Evan Johnson 
Corbett Building – Room 109 - 307-766-5282 
 
If you have questions about your rights as a research subject, please contact the University of 
Wyoming IRB Administrator at 307-766-5320

Attachment II – Medical History Questionnaire 
1 
 
 
 
 
 
 
 
Office for Research and Economic Development 
1000 East University Avenue • Department 3355 • Laramie, WY 82071 
Campus: Office of Research • Room 305/308 • Old Main  
(307) 766-5353 • (307) 766-5320 • fax (307) 766-2608 •  www.uwyo.edu/research  
 
 
UNIVERSITY OF WYOMING  
HEALTH HISTORY SCREENING QUESTIONNAIRE (UWHHSQ) 
Please complete thoroughly and accurately. 
 
 
Date  
  
/ 
/ 
 
 
 
Name:  
 
 
 
 
 
 
 
 
 
  Ethnicity: 
 
 
Address: 
 
 
 
 
 
City: 
 
 
State:  
Zip: 
 
 
Date of Birth:   
/ 
/ 
  Age:  
  Phone #: 
 
 
 
Email:  
 
 
 
@ 
 
 
 
Emergency contact information:  Name:________________________________ Phone #:  
_________ 
Personal healthcare provider to contact in case of an emergency: 
Name________________________________ Phone #:  
_________  
City:_________________________________ 
 
CARDIOVASCULAR HEALTH HISTORY 
Have you ever been diagnosed with or had any of the following? 
 
Heart Attack?  
 
 
 
 
 
Yes 
 
No 
 
Heart Surgery ? 
 
 
 
 
 
Yes  
 
No 
 
Cerebrovascular accident (e.g. Stroke)?  
 
 
Yes 
 
No 
 
Transient Ischemic Attack (TIA)? 
 
 
 
Yes 
 
No 
 
Carotid Artery Disease?  
 
 
 
 
Yes 
 
No 
 
Cardiac Catheterization? 
 
 
 
 
Yes 
 
No 
 
Coronary Angioplasty?  
 
 
 
 
Yes 
 
No 
 
Pacemaker/Implantable Cardiac Device? 
 
 
Yes 
 
No 
 
Irregular Heart Rate/Heart Rhythm Disturbance? 
 
Yes 
 
No 
 
Atrial Fibrillation? 
 
 
 
 
 
Yes 
 
No 
 
Heart Valve Disease? 
 
 
 
 
 
Yes 
 
No 
 
Heart Failure?  
 
 
 
 
 
Yes 
 
No 
 
Heart Murmur?  
 
 
 
 
 
Yes 
 
No 
 
Heart Transplantation?  
 
 
 
 
Yes 
 
No 
 
Congenital Heart Disease? 
 
 
 
 
Yes 
 
No 
 
Have you ever experienced any of the following symptoms: 
 
Chest discomfort with exertion?  
 
 
 
Yes 
 
No 
 
Unreasonable breathlessness?  
 
 
 
Yes 
 
No 
 
 

Attachment II – Medical History Questionnaire 
2 
 
 
 
Dizziness, fainting, or blackouts? 
 
 
 
Yes 
 
No 
 
 
Syncope (loss of consciousness)? 
 
 
 
Yes 
 
No 
Hypoxia (low oxygen levels)? 
 
 
 
 
Yes 
 
No 
Do you currently take heart medications? 
 
 
Yes 
 
No 
 
 
If yes, what? 
 
 
 
 
 
 
 
 
 
 
Have you been diagnosed with diabetes (Type 1 or Type 2) or  
problems with blood sugar levels? 
 
 
 
 
Yes 
 
No 
 
If yes, please note Type 1 or Type 2 
 
 
 
 
 
 
 
 
If you circled yes to any of the above statements in this section, consult your physician or other appropriate health care 
provider before engaging in exercise.  You may need to use a facility with a medically qualified staff. 
 
 
CARDIOVASCULAR RISK FACTORS 
 
Are you a male over 45 years old? 
 
 
 
 
Yes 
 
No 
 
Are you a female over 55 years old? 
 
 
 
 
Yes 
 
No 
  Have you had a hysterectomy?  
 
 
 
 
Yes 
 
No 
  Have you had both of your ovaries surgically removed?  
 
Yes 
 
No 
  Are you postmenopausal? 
 
 
 
 
 
Yes 
 
No 
 
 
Do you currently smoke or have you quit within the last 
six months? 
 
 
 
 
 
 
 
Yes 
 
No 
 
Is your blood pressure greater than 140/90 mm Hg? 
 
 
Yes 
 
No 
    I Don’t Know 
 
If known, what is your blood pressure?   _____/ ____ mm Hg 
Do you currently take blood pressure medications? 
 
 
Yes 
 
No 
Do you currently take any medications for your heart? 
 
 
Yes 
 
No 
Is your total blood cholesterol level greater than 200 mg/dl? 
 
Yes 
 
No 
    I Don’t Know 
Do you know your cholesterol level? 
 
 
 
 
Yes 
 
No 
 
 
If yes, Total Cholesterol 
 
 
 
 
 
LDL 
 
 
 
 
 
 
 
HDL 
 
 
 
 
 
 
 
Triglycerides 
 
 
 
 
Do you have a close blood relative who has suffered a heart attack  
or had any kind of heart surgery before the age of 55 (for father  
or brother) or age 65 (for mother or sister)? 
 
 
 
Yes 
 
No 
 
Are you more than 20 pounds overweight? 
 
 
 
Yes 
 
No 
    I Don’t Know 
 
Are you physically inactive (i.e., do you get less than 30 minutes  
of physical activity less than three times a week)? 
 
 
Yes 
 
No 
 
Have you had a recent surgery (in the past 2 years)? 
 
 
Yes 
 
No 
 
Have you had an exercise stress test, heart catheterization, 

Attachment II – Medical History Questionnaire 
3 
 
or echocardiogram? 
 
 
 
 
 
 
Yes 
 
No 
 
If yes, please explain 
 
 
 
 
 
 
 
 
_ 
To the best of your knowledge, is there any reason that might 
 
Yes 
 
No 
make it unsafe for you to participate in exercise? 
 
If you circled yes to two or more of the statements in the above section you should consult your physician or other appropriate 
health care provider before engaging in exercise.  You might benefit from using a facility with a professionally/medically 
qualified exercise program and staff. 
 
 
THYROID HEALTH HISTORY 
Have you ever been diagnosed with or had any of the following? 
 
Goiter (enlarged thyroid gland)? 
 
 
 
Yes 
 
No 
 
Hyperthyroidism (overactive thyroid)?  
 
 
Yes  
 
No 
 
Hypothyroidism (underactive thyroid))?  
 
 
Yes 
 
No 
 
Thyroid nodule? 
 
 
 
 
 
Yes 
 
No 
 
Thyroid Cancer? 
 
 
 
 
 
Yes 
 
No 
 
Do you take any type of thyroid medication, i.e, synthroid? 
Yes 
 
No 
 
If yes, please list _____________________________________ 
 
CARDIOVASCULAR HEALTH HISTORY 
Have you ever been diagnosed with or had any of the following? 
 
Heart Attack?  
 
 
 
 
 
Yes 
 
No 
 
Heart Surgery ? 
 
 
 
 
 
Yes  
 
No 
 
Cerebrovascular accident (e.g. Stroke)?  
 
 
Yes 
 
No 
 
Transient Ischemic Attack (TIA)? 
 
 
 
Yes 
 
No 
 
Carotid Artery Disease?  
 
 
 
 
Yes 
 
No 
 
Cardiac Catheterization? 
 
 
 
 
Yes 
 
No 
 
 
 
To the best of my knowledge, the information I have provided above is an accurate assessment of my health 
and medical history. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Name of Participant 
 
 
 
Participant’s Signature  
 
 
Date 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Name of Administering Staff 
 
 
Signature of Staff Member 
 
 
Date 
 
Please stop here.  The remainder of this Health History Screening Questionnaire will be administered to you by 
one of our staff. 
 
 
 

Attachment II – Medical History Questionnaire 
4 
 
GENERAL MEDICAL AND DIETARY HISTORY 
 
Height:  
 Weight: 
 
 BMI (calculated): 
 
 
 
       
 
 
 
 
 
 
 
 
 
     Circle One 
 
Do you currently participate in > 7 hours of moderate to intense cardiovascular exercise per week? 
 
 
 
 
 
 
 
 
 
Yes 
 
No 
 
Have you drastically changed your diet in the last month? 
 
Yes 
 
No 
 
Has your weight fluctuated > 5lbs in the past month? 
 
 
Yes 
 
No 
 
Do you have any history of acute or chronic Glomerulonephritis   
Yes 
 
No 
(such as post-streptococcal lupus rheumatoid arthritis, or other  
immune system diseases such as Amyloidosis or Sarcoidosis) 
 
Do you have recurrent urinary tract infections (especially pyelonephritis) Yes 
 
No 
 
 
Do you have a history of kidney stones?   
 
 
 
Yes 
 
No 
(especially those requiring surgical intervention or lithotripsy) 
 
Do you have any history of diabetic-induced renal injury? 
 
Yes 
 
No 
 
Do you have any history of hypertension-induced renal injury? 
 
Yes 
 
No 
 
Have you had kidney surgery such as nephrectomy? 
 
 
Yes 
 
No 
 
Have you ever had kidney dialysis? 
 
 
 
 
Yes 
 
No 
 
Do you have any history of protein or blood in urine? 
 
 
Yes 
 
No 
 
Do you drink alcohol? 
 
  
 
 
 
 
Yes 
 
No 
 
If yes, how many drinks per week? 
 
 
 
 
 
 
 
 
 
 
Are you taking any prescription or over-the-counter medication?  
Yes 
 
No 
 
If yes, what medication and what dosage? 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Do you take any of the following vitamins, supplements, or herbal/homeopathic medications 
Calcium, Cat’s claw, Chaparral, Chromium, Cranberry, Creatine, Ephedra, Germanium, Hydrazine, Licorice,  l-
Lysine, Pennyroyal, Thunder god vine, Vitamin C, Willow bark, Wormwood oil, Yellow oleander,Yohimbe? 
 
 
 
 
 
 
 
 
 
 
Yes 
 
No 
 
If other, what type and what dosage? 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
STAFF:  Administer the remaining portion of the UWHHSQ. 

Attachment II – Medical History Questionnaire 
5 
 
Do you use table salt?  
 
 
 
 
 
Yes 
 
No                  Sometimes 
 
If yes, is it iodized? 
 
 
 
 
 
Yes 
 
No                  Not Sure  
 
If yes, please list the brand______________________________ 
 
Has your body weight been stable over the past 6 months? 
 
Yes 
 
No 
 
If no, please explain 
 
 
 
 
 
 
 
 
 
 
 
 
Have you been on a recent diet or a prescribed diet? 
 
 
Yes 
 
No 
If yes, please explain 
 
 
 
 
 
 
 
 
 
 
 
 
Are you currently restricting calories, i.e., “dieting” to lose weight?  
Yes 
 
No 
Do you follow a vegetarian Diet?  
 
 
 
 
Yes 
 
No                   
Do you shop at the Farmers Market or Food Coop (Big Hallow)?  
Yes 
 
No                  Sometimes 
Do you belong to a CSA (Community Supported Agriculture)? 
 
Yes 
 
No                   
Do you have a garden and grow your own food?  
 
 
Yes 
 
No                  Sometimes 
Comments __________________________________________________________________________ 
__________________________________________________________________________ 
 
Have you been diagnosed with asthma, exercise-induced asthma, reactive airway disease, chronic obstructive 
pulmonary disease (COPD), or any other respiratory disease? 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes 
 
No 
 
If yes, please describe:  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Have you ever been diagnosed with cancer? 
 
 
 
Yes 
 
No 
 
If yes, please describe when and what type: 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Have you ever undergone a lymphectomy? 
 
 
 
Yes 
 
No 
 
If yes, please describe when and why?  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Do you have musculoskeletal problems that limit your physical  
activity such as walking? 
 
 
 
 
 
Yes 
 
No 
 
Have you recently (in last 3 months) had an X-ray or CT scan in which 
Contrasting dyes were used?  
 
 
 
 
 
Yes 
 
No 
If yes, when ______________________________________ 
 
 
Have you recently (in last week) used an iodine-containing (brown- 
colored) antiseptic skin cleaner   
 
 
 
 
Yes 
 
No 
If yes, when ______________________________________ 
 
Do you have concerns about your safety when you exercise 
 
Yes 
 
No 
 
Do you have a history of chronic kidney stones?  
 
 
Yes 
 
No 
If yes, When was your last kidney stone?________________ 
 
Do you have a history of frequent urinary tract infections? 
 
Yes 
 
No 

Attachment II – Medical History Questionnaire 
6 
 
If yes, When was your last urinary tract infection?__________ 
 
Have you ever experienced burning or cramping sensations in  
your l legs when walking short distances? 
 
 
 
Yes 
 
No 
 
Do you have any other health problems, illnesses, diseases, 
infections, surgeries, allergies, or hospitalizations? 
 
 
Yes 
 
No 
 
If yes, please explain 
 
 
 
 
 
 
 
 
 
 
 
FAMILY HISTORY 
Please check all that apply 
Family Member 
High Blood 
Pressure 
Diabetes 
Type I or II 
Heart Diseases 
Comments 
Mother 
 
 
 
If yes, was it before the age of 65? 
 Yes           No 
Father 
 
 
 
If yes, was it before the age of 65? 
 Yes           No 
Sibling 
 
 
 
 
Gender:                    Age: 
Sibling 
 
 
 
 
Gender:                    Age: 
Paternal 
Grandmother 
 
 
 
Age: 
Paternal  
Grandfather 
 
 
 
Age: 
Maternal 
Grandmother 
 
 
 
Age: 
Maternal 
Grandfather 
 
 
 
Age: 
FOR FEMALES ONLY: 
Are you pre-        , peri-         or post-         menopausal? 
If premenopausal, are you using any form of contraception  
(birth control) or hormone therapy for any reason?  
 
Yes 
 
No 
 
If yes, why and what type? 
 
 
 
 
________________________________  
Do you regularly use vaginal douches?   
 
 
Yes 
 
No 
If yes, please record the type used and date of your last douche  
 
 
 
 
 
 
 
If you are premenopausal: 
 
Do you have regular menstral cycles? 
 
 
Yes 
 
No 
 
I Don’t Know 
 
How frequent are your menstrual cycles? 
 
 
 
 
 
 
 
 
Are you pregnant? 
 
 
 
 
Yes 
 
No 
 
I Don’t Know 
 
Could you be pregnant?  
 
 
 
Yes 
 
No 
 
I Don’t Know 
 
Are you trying to become pregnant? 
 
 
Yes 
 
No 
 
If you are peri- or postmenopausal: 
 
For how long?  
 
 
 
 
 
 
 
 
 
 
When was your last menstrual period? ____________________________________________________  
 
Have you had a hysterectomy w/ or w/out ovary removal? 
Yes 
 
No 
 
Have you had an oophorectomy without removal of your 
Yes 
 
No 
  uterus? 

Attachment II – Medical History Questionnaire 
7 
 
 
Are you currently taking any type of hormone replacement  
therapy or using any form of contraception (birth control)? 
Yes 
 
No 
 
 
 
 
If yes, what type? 
 
 
 
How long? 
 
 
Dosage  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Name of Administering Staff 
 
 
Signature of Staff Member 
 
 
Date

Attachment III – Physical Activity Readiness Questionnaire 
1 
 
 
Physical Activity Readiness Questionnaire 
 
General Health Questions 
Read the questions below and honestly check: YES or NO 
YES NO 
1) Has your doctor ever said you have a heart condition □ or high blood pressure □? 
 
 
2) Do you feel pain in your chest at rest, during your daily activities, or when you 
perform physical activity? 
 
 
3) Do you lose balance because of dizziness OR have you lost consciousness in the last 
12 months? Please answer NO if your dizziness was associated with over-breathing 
during vigorous exercise. 
 
 
4) Have you ever been diagnosed with another chronic medical condition other than 
heart disease or high blood pressure? Please list: ____________________________ 
 
 
5) Are you currently taking prescribed medications for a chronic medical condition? 
Please list condition(s) and medication(s): _________________________________ 
 
 
6) Do you currently have (or have had within the past 12 months) a bone, joint, or soft 
tissue (muscle, ligament, or tendon) problem that could be made worse by becoming 
more physically active? Please answer NO if you had a problem in the past, but it 
does not limit your current ability to be physically active. 
 
 
7) Has your doctor ever said that you should only do medically supervised physical 
activity?  
 
 
 
If you answered NO to all of the questions above, you are cleared for physical activity.  
 
 
 
 
 
Name: __________________________________   Date: ___________________________________ 
Signature: _______________________________   Witness: ______________________________

Attachment IV – Short-Form McGill Pain Questionnaire 
1 
 
 
SHORT-FORM MCGILL PAIN QUESTIONNAIRE 
 
Patient’s Name: _______________________  
 
Date: _____________________________ 
 
 
 
 
None  
 
Mild  
 
Moderate 
 
Severe 
Throbbing 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Shooting 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Stabbing 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Sharp  
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Cramping 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Gnawing 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Hot-buring 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Aching 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Heavy  
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Tender 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Splitting 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Tiring-Exhausting 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Sickening 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Fearful 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Punishing-Cruel 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
 
Visual Analog Scale (VAS) 
 
No Pain 
 
 
 
 
 
 
 
      Worst Possible Pain 
 

Attachment IV – Short-Form McGill Pain Questionnaire 
1 
 
 
Present Pain Intensity 
0) No Pain   
  
_____ 
1) Mild          
 
_____ 
2) Discomforting 
_____ 
3) Distressing 
 
_____ 
4) Horrible 
 
_____ 
5) Excruciating  
_____ 
 

Attachment V – Exercise stress test informed consent 
1 
 
 

Attachment V – Exercise stress test informed consent 
1 
 
 
 

Attachment VI – Exercise stress test data collection sheet 
1 
 
 

Attachment VI – Exercise stress test data collection sheet 
2 
 
 

Attachment VI – Exercise stress test data collection sheet 
3 
 
 

Attachment VII – DXA scan informed consent 
1 
 
 
 
 
 
 
 
 

Attachment VIII- Distant Data Collection Site Letter of Support 
 
 
 
 
 
 
 

Attachment IX- Menstrual cycle history 
 
 
 
 
 
 
 
 
 
 
 
 
 
Participant # ______ 
Year: _______________ 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Last menstrual cycle dates: _____________ (start) _____________ (end)
Day 
Jan. 
Feb. 
Mar. 
Apr. 
May  
Jun. 
Jul. 
Aug. 
Sep. 
Oct. 
Nov. 
Dec. 
1 
  
  
  
  
  
  
  
  
  
  
  
  
2 
  
  
  
  
  
  
  
  
  
  
  
  
3 
  
  
  
  
  
  
  
  
  
  
  
  
4 
  
  
  
  
  
  
  
  
  
  
  
  
5 
  
  
  
  
  
  
  
  
  
  
  
  
6 
  
  
  
  
  
  
  
  
  
  
  
  
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11 
  
  
  
  
  
  
  
  
  
  
  
  
12 
  
  
  
  
  
  
  
  
  
  
  
  
13 
  
  
  
  
  
  
  
  
  
  
  
  
14 
  
  
  
  
  
  
  
  
  
  
  
  
15 
  
  
  
  
  
  
  
  
  
  
  
  
16 
  
  
  
  
  
  
  
  
  
  
  
  
17 
  
  
  
  
  
  
  
  
  
  
  
  
18 
  
  
  
  
  
  
  
  
  
  
  
  
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27 
  
  
  
  
  
  
  
  
  
  
  
  
28 
  
  
  
  
  
  
  
  
  
  
  
  
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30 
  
  
  
  
  
  
  
  
  
  
  
  
31 
  
  
  
  
  
  
  
  
  
  
  
  

Attachment X- Additional Student Researchers Not Included as Co-Investigators 
 
 
 
 
Additional Student Researchers 
1. Hillary Yoder 
2. Miranda Zamora 
3. Hunter Anderson 
4. Brittany Wells 
5. Brandon Stranigan 
6. Breton Van Syoc 
7. Emelda Malm

 
 
 
 

1 
 
 

2 
 
University of Wyoming IRB Proposal Form 
 
 
 
 
 
 
1. Responsible Project Investigator, Co-Investigators, & Faculty Supervisor  
Responsible Project Investigator: 
Name: Evan Johnson 
Title: Assistant Professor 
Department: Kinesiology and Health 
Office Address: Corbett Building 109 
Phone number: 307-766-5282 
Fax number (if applicable): 307-766-4098 
Email address: evan.johnson@uwyo.edu 
Is the project funded? Y_X__ N__ __ 
If Y, from where? UW INBRE  
 
 
Co-Investigators (add more boxes if necessary): 
 
 
 
 
 
Name: Nicole Sauls 
Title: Graduate Assistant 
Department: Kinesiology and Health 
Office Address: Corbett Building 207 
Phone number: 909-730-3352 
Fax number (if applicable): 
Email address: nsauls@uwyo.edu 
 
 
 
 
Name: Derek Smith 
Title: Associate Professor 
Department: Kinesiology and Health 
Office Address: Corbett Building 108 
Phone number: 307-766-5271 
Fax number (if applicable): 
Email address: smithdt@uwyo.edu 
 
Institutional Review Board 
Room 308, Old Main 
1000 East University Avenue, Dept. 3355 
Laramie, WY 82071 
 
Phone: 307-766-5322 
Fax: 307-766-2608 
email: irb@uwyo.edu 
(Electronic submission via email is encouraged.) 

3 
 
Name: Christopher Bell 
          (See Attachment 9 for letter of support) 
Title: Associate Professor and Director, 
Integrative Biology Lab 
Health and Exercise Science 
Department: Health and Exercise Science – Colorado State University 
 
Office Address: 205E Moby B Complex,  
                            Colorado State University,  
                            Fort Collins, Colorado 
                            80523-1582 
 
Phone number: 970-491-7522 
Fax number (if applicable): 
Email address: christopher.bell@colostate.edu 
 
Faculty Supervisor (if PI is a student): n/a 
Name:  
Title:  
Department:  
Office Address:  
 
Phone number:  
Fax number (if applicable): 
Email address:  
If the principal investigator is a graduate or undergraduate student, submit the Research Supervisor Approval form from the faculty 
advisor, thesis or dissertation committee chair indicating review and approval of the proposal for submission to the IRB. The IRB will 
not approve a proposal without the proper Approval form. 
 
2. Title of Study: 
Risk Factors Related to Acute Renal Injury during a Mass Participation High Intensity 
Functional Resistance Training Event  
 
3. Anticipated Project Duration: 
May 1st, 2019 – April 30st, 2020 
 
 
 
 
 
 
 
 

4 
 
4. Purpose of Research Project: 
In LAY LANGUAGE, summarize the objectives and significance of the research: 
Physical activity is a well-established intervention used to improve a variety of health domains 
including cardiorespiratory, functional, and metabolic health. Despite the well-known health 
benefits, 31.1% of worldwide adults are considered physically inactive, and only 20.6% of 
adults in the United States meet both the current aerobic and muscle strengthening guidelines 
(ACSM's guidelines for exercise testing and prescription 2016). In response to the physical 
inactivity pandemic, barriers to exercise have been studied, and “lack of time” was a chief 
recurring response (Booth, Bauman, Owen, & Gore, 1997; Daskapan, Emine, & Levent, 2006; 
Sallis & Hovell, 1990).   
As a result, recent investigations have made an attempt to find a more time-efficient exercise 
solution through the comparison of high intensity training (HIT) performed over shorter 
durations in comparison to traditional moderate intensity continuous exercise (MICE). The 
theory behind HIT is that through higher intensity exercise, increased muscle fiber recruitment 
occurs, resulting in maximal skeletal muscle adaptations within a short period of time. HIT has 
demonstrated equivalent and even superior training effects compared to MICE (Burgomaster 
et al., 2008; Gibala, 2007; Nybo et al., 2010); however, other studies have reported potential 
risk including post-exercise physical dysfunction (Drum, Bellovary, Jensen, Moore, & Donath, 
2017; Nybo et al., 2010).  Not all variations of HIT will elicit identical training effects, and 
there may be individuals who are at higher risk for adverse consequences based on their 
specific behavioral patterns.    
High intensity interval training (HIIT) is the most recognized sub-class of HIT and is 
characterized by short bouts of high intensity cardiovascular exercise (i.e., running, cycling, 
rowing, stair-stepping) separated by brief periods of planned rest (Thompson, 2015). 
Traditional resistance and strength training methodologies have also been adapted to the HIT 
framework to create high intensity functional resistance training (HIFRT).  This style of HIT 
incorporates various functional movements (e.g., pull-ups, Olympic lifts) performed at 
relatively high intensities that train the body in all planes of motion.  Recent analyses have 
revealed this mode of training can improve metabolic conditioning, muscular strength, and the 
general physical preparedness of military members (Haddock, Roston, Heinrich, Jahnke, & 
Jitnarin, 2016); however, as in any type of exercise, potential acute injury risks have also been 
identified. 
Some forms of HIFRT have been linked with severe post-exercise physical dysfunction and 
incidences of acute exertional rhabdomyolysis (ER) developing from skeletal muscle damage 
(Dilip, Richmond, & Alfonso, 2009; Drum et al., 2017; Xavier, Esteban, & Josep, 2009). Due 
to demand on the kidney’s filtering unit to clear excess myoglobin from the blood stream, 
exercise-related acute kidney injury (AKI) can be a severe complication of ER in trained 
populations (Dilip et al., 2009).  

5 
 
There are many variations of HIFRT workouts, and some are more physically demanding than 
others. One of the most difficult and frequently performed workouts is “Murph” which 
consists of a 1-mile run, 100 pull-ups, 200 push-ups, 300 body-weight squats, and a second 1-
mile run. The workout is performed by many members HIFRT community including 177 
facilities in the United States that hosted “Murph” workouts in 2017 in honor of a Navy SEAL 
(LT. Michael P. Murphy) who died while serving overseas in Afghanistan (The murph 
challenge.2018). Symptoms of severe physical dysfunction have been reported following the 
completion of “Murph” (Drum et al., 2017). 
Preliminary studies from our laboratory 
An ongoing study within the Human Integrated Physiology Laboratory (Protocol 
#20180607EJ02013 “Pharmacological Risk Factors Related to Acute Renal Injury during 
High Intensity Training”) is performing a similar data collection with participants reporting 
the laboratory on an individual basis.  This allowed our research team to collect initial data for 
our overall kidney injury risk evaluation following the above workout and test an additional 
biomechanical question embedded within the protocol.  Early findings from this study 
indicate that a majority of individuals exhibit proteinuria most prevalent in the 24h after the 
workout and a small proportion of individuals have presented with blood in the urine within 
the 24h after the workout.  In almost all cases both protein and blood have resolved by the 
48h point.  One participant displayed trace blood in their 48h post, spot urine sample.  This 
participant was followed up with at 72h and the urine reagent strip used at this time point was 
unremarkable.  Six participants have displayed proteinuria in the 48h post, time point.  All six 
of these were “trace” findings (i.e., 15 mg/dL) upon completion they were alerted to be aware 
of the signs and symptoms of more severe kidney injury including;  decreased urine output, 
fluid retention, causing swelling in your legs, ankles or feet, shortness of breath, fatigue,  
confusion, nausea, weakness, irregular heartbeat, chest pain or pressure, or irregularly dark 
urine.  If any participant noticed any of these symptoms following their completion of the 
study they were told to contact us or a doctor immediately.  These findings suggest our 
hypothesis about the risk of AKI during this is founded and worth exploring in a greater 
number of individuals.  The data from the individual trials will be combined with data 
collected from the proposed mass participation event so that we will be able to reach our 
required participant number specific to the evaluation of certain biomarkers and their ability 
to predict risk for AKI following HIFRT.  
 
Purpose / Aims 
 
HIT is a modality of exercise that can produce a high amount of health benefit in a minimal 
amount of time.  However, it is clear that some forms of HIT, particularly within the 
resistance training style (i.e., HIFRT) can introduce risk of renal injury.  Therefore the aims of 
our current study are as follows: 
 

6 
 
Aim 1: To investigate the prevalence of AKI following the HIFRT workout, “Murph”, and 
compare the results to previous research evaluating incidence rates in other forms of extreme 
exercise (i.e., marathon running). AKI will be determined through the sample analysis of 
blood (serum creatinine, blood urea nitrogen, neutrophil gelatinase-associated lipocalin 
[NGAL], and kidney injury molecule 1 [KIM-1]) and urine (albumin, creatinine, NGAL, and 
KIM-1) biomarkers.  
Aim 2: To evaluate if the baseline concentration of proenkephalin A is related to the risk or 
severity of renal injury biomarker concentrations listed above post-workout.  
 
The proposed updates to the previous investigation (single subject research) will allow us to 
apply the data collection techniques we have practiced collecting data on a larger number of 
individuals in a shorter period. The results from the compiled studies will contribute to safe 
and efficacious prescription of HIFRT workouts like “Murph”.  
 
References 
ACSM's guidelines for exercise testing and prescription (2016). In Riebe D., Ehrman J., Liguori G. and Magal M. 
(Eds.), (10th ed.). Philadelphia, PA: Wolters Kluwer. 
Booth, M.,L., Bauman, A., Owen, N., & Gore, C.,J. (1997). Physical activity preferences, preferred sources of 
assistance, and perceived barriers to increased activity among physically inactive australians. Prevention 
Medicine, 26(1), 131-137. 
Burgomaster, K.,A., Howarth, K.,R., Phillips, S.,M., Rakobowchuk, M., Macdonald, M.,J., McGee, S.,L., & 
Gibala, M.,J. (2008). Similar metabolic adaptations during exercise after low volume sprint sprint interval 
and traditional endurance training in humans. Journal of Physiology, 586(1), 151-160. 
Daskapan, A., Emine, T., & Levent, E. (2006). Perceived barries to physical activity in university 
students. Journal of Sports Science Medicine, 5(4), 615-620. 
Dilip, P.,R., Richmond, G., & Alfonso, T. (2009). Exertional rhabdomyolysis and acute kidney injury. The 
Physician and Sports Medicine, 37(1), 71-79. 
Drum, S.,N., Bellovary, B.,N., Jensen, R.,L., Moore, M.,T., & Donath, L. (2017). Perceived demands and 
postexercise physical dysfunction in CrossFit compared to an ASCM bsed training session. Journal Sports 
Medicine Physical Fitness, 57(5), 604-609. 
Gibala, M.,J. (2007). High-intensity interval training: A time-efficient strategy for health promotion? Current 
Sports Medicine Report, 6(4), 211-213. 
Haddock, C.,K., Roston, W.,S., Heinrich, K.,M., Jahnke, S.,A., & Jitnarin, N. (2016). The benefits of high-
intensity functional training fitness programs for military personnel. Military  
The murph challenge. (2018). Retrieved from https://themurphchallenge.com/pages/lt-michael-p-murphy 
Nybo, L., Sundstrup, E., Jakobsen, M.,D., Mohr, M., Hornstrup, T., Simonsen, L., & Bulow, J. (2010). High-
intensity training versus traditional exercise interventions for promoting health.Medical Science Sports 
Exercise, 41(10), 1951-1958. 
Reid, S., Speedy, D., & Thomson, J. (2004). Study of hematological and biomechanical parameters in runners 
completing a standard marathon. Clinical Journal of Sports Medicine, 14, 344-353. 
Sallis, F., & Hovell, M. (1990). Determinants of exercise behavior. Exercise and Sport Sciences Reviews, 18(1), 
307-330. 

7 
 
Thompson, R. (2015). Worldwide survey of fitness trends for 2016: 10th anniversary edition. ACSM's Health & 
Fitness Journal, 19(6), 9-18. 
Bonaza, N.A., Smuin, D., Onks, C.A., Silvis, M.L., Dhawan, A. (2016). Reliability, Validity, and Injury 
Predictive Value of the Functional Movement Screen. The American Journal of Sports Medicine. 45(3), 
725-732. 
 
 
 
 
5.  Description of Potential Participants: 
A. Age-range and gender: Men and women between the ages of 18-70 
 
B. Describe how the participants will be recruited and/or selected:   
 
Following registration for a charity event (The Murph Challenge, See Attachment 8) held at 
the University of Wyoming on Memorial Day (May 27, 2019) individuals will receive an e-
mail asking if they would like to volunteer to take part in the observational study*.  We plan 
to recruit charity registrants into the study from Laramie, Wyoming and the surrounding 
communities including the University of Wyoming Reserve Officers Training Corps (ROTC), 
Cheyenne, and Fort Collins. Only individuals who: A) have at least one year of HIFRT 
training experience, and B) have completed the workout “Murph” at least one time in any of 
the below repetition schemes described below (Table 1.) will be recruited.  
 
Participants will be recruited by e-mail communication following their digital registration for 
The Murph Challenge at UW. Interested individuals will contact the principal investigator to 
hear full details on the study procedures, exclusionary criteria, risks and benefits prior to any 
involvement.  
 
*Because the data collection will take place within a charity event that raises funds for the Lt. 
Michael Murphy Foundation, we have asked for explicit permission from Lt. Murphy’s father 
(who is the executor of the Foundation).  He has reviewed a summary of the research question 
and basic methodology and given us approval (See Attachment 11) to use the workout taking 
place at an Official Murph Challenge Site (See Attachment 8). 
 
C. Describe the number of participants expected:  
 
We plan to enroll 80 participants in this project, up to 20 of whom from the Fort Collins area. 
The number is based on our primary variable of interest, proenkaphalin A.  The prospective 
nature of this investigation is based upon A) observation of acute kidney injury following 
extreme exercise (Monsour 2017) and, B) Proenkaphalin being identified as a predictor of 
AKI following cardiac surgery (Shah 2015).  The statistical test driving this analysis will be 
similar to that used by Shah et. al.  For our investigation the statistical test we have used to 
justify our sample size is an independent t-test of baseline proenkaphalin concentrations 
comparing those participants that develop AKI following the workout compared against those 

8 
 
that do not develop AKI.  AKI is defined as an increase in serum creatinine of >1.5 fold over 
the observation period (Makris 2016).   
 
Shah et. al. found that the baseline concentrations of proenkaphalin were 78.0±35.9 and 
55.4±17.4 pmol/L within participants that developed AKI versus those that did not, 
respectively.  Given a sample population of 84, α = 0.05, power of .90, and a conservative 
estimate that 60% of participants will develop markers consistent with AKI an effect size of 
.80 can be calculated.  Therefore, our goal is to enroll 100 participants between this 
investigation combined with the previous individual investigation with the knowledge that 
there will be some attrition and not all data will be usable.  Up to 40 individuals will complete 
the individual version described in our previous iteration of this investigation.  Thus, once the 
data from the two studies are combined, we will be able to meet our goal of 100 participants.  
 
Plasma creatinine will be used to diagnose AKI.  All other primary and secondary markers 
will be compared between groups similar to proenkaphalin.  Because the aim of this 
investigation is to determine the feasibility of proenkaphalin as a predictor of AKI as a result 
of high intensity exercise, this variable and not the other primary and secondary variables has 
been used in the calculation of our eventual sample size. 
 
 
Makris K, Spanou L. Acute Kidney Injury: Definition, Pathophysiology and Clinical 
Phenotypes. The Clinical Biochemist Reviews. 2016;37(2):85-98. 
 
Mansour SG, Verma G, Pata RW, Martin TG, Perazella MA, Parikh CR. Kidney Injury and 
Repair Biomarkers in Marathon Runners. American journal of kidney diseases : the official 
journal of the National Kidney Foundation. 2017;70(2):252-261. 
doi:10.1053/j.ajkd.2017.01.045. 
 
Shah KS, Taub P, Patel M, Rehfeldt M, Struck J, Clopton P, Mehta RL, Maisel AS. 
Proenkephalin predicts acute kidney injury in cardiac surgery patients. Clin.Nephrol., 2015,  
83, 1, 29-35,. 
 
 
D. Will compensation or incentives be provided for participation? Y__X__  N____ 
IF Y, please describe:  
 
Participants will receive $100 for full participation in this study.  This will be distributed at 
the participants’ end of enrollment in the study.  If they choose to be removed from the study 
prior to completion they will be compensated based on the below pro-rated basis. 
$20 – Baseline measurements 
$30 – Completion of workout 
$10 – Completion of 24h post visit 
$40 - Completion of 48h post visit plus bonus for finishing all study measurement periods 
E. Description of special classes: n/a 
     F. Criteria for exclusion from participant pool:  
 
1. 
Score of “0” on the Functional Movement Screening (FMS) test as evaluated by two 
investigators * indicating pain during any of the seven functional movements 

9 
 
2. 
Self- reported Kidney Disease (e.g., chronic kidney disease, polycystic kidney disease, 
glomerulonephritis, diabetic nephropathy, interstitial nephritis, Goodpasture syndrome) 
or other medical condition contraindicating participation in HIFRT (Hypertension, 
dyslipidemia, type II diabetes mellitus, BMI >30) 
3. 
Pregnancy, suspected pregnancy, or breastfeeding 
4. 
Blood donations within the last eight weeks leading up to testing day 
5. 
Any musculoskeletal injuries which have resulted in > 1 week of absence from HIFRT 
within the last six months 
6. 
Not passing the physical activity readiness questionnaire (PAR-Q) 
7. 
Surgical operation on digestive tract or kidneys, except appendectomy 
8. 
Inability to participate in the entire study  
9. 
Recurrent urinary tract infections or kidney stones (> 3 within the past year) 
10. History of protein or blood in urine 
11. Moving from a location of low altitude (< 3,000’) to Laramie within the past 3 months 
12. Inability to understand and write English** 
 
* If a participant scores a 0 on the FMS during the familiarization period, she/he will 
continue with the remainder of the familiarization protocol on that day. Participants who 
score a 0 will be re-screened by a second screener prior to the first workout. Although the 
FMS has demonstrated good interrater reliability, it has also been reported as varied 
(Bonazza 2016). If the participant scores a 0 a second time, she/he will be excluded from 
the study to avoid further risk of injury/exacerbation of current pain. It is possible for a 
participant to score a 0 on the familiarization day and a non-0 on the intervention day as 
participant pain rating may change based on prior day/week of activity. Regardless of this, 
there is value in performing the FMS on the familiarization day. 
 
**English is a required language because the questionnaires which will be used in this 
investigation are written in English language. 
 
The medical history questionnaire will be initially reviewed by the responsible graduate 
student (Nicole Sauls), if there are any questionable responses the principle investigator 
(Evan Johnson) will be contacted prior to any measurements being taken. Both may 
disqualify an individual if any responses meet the specified exclusionary criteria above.  
 
 
 
 
 
 
 
 
 

10 
 
 
6.  Procedure: 
• Description of participants' activities:  
 
Figure 3. Overall outline of a single testing week for individual data collections. Each 
participant will complete two testing weeks one month apart. 
 
 
Familiarization / Baseline: Subjects will report to the Human Integrated Physiology (HIP; University 
of Wyoming) or the Integrative Biology Laboratory (IBL; Colorado State University) within 3 days of 
the workout to provide informed consent complete initial screening procedures.  The Colorado State 
location has been added because the investigators feel it may enhance the participant pool if 
individuals from Fort Collins can also be recruited.  By allowing individuals from Fort Collins to 
complete baseline and post-workout measurements at Colorado State University this will limit the 
number of times they are required to drive to Laramie which could be a deterrent to participation (See 
Attachment 4 for CSU IRB statement showing their awareness of the protocol and willingness to cede 
to UW IRB upon approval).   
 
Familiarization 
/ Baseline
Screening 
Questionnaires
Anthropometrics
Spot Urine 
Sample
Blood draw
Functional 
Movement 
Screen
Begin 24hr urine 
collection #1
McGill Pain Scale
Workout 
Completion of 
w orkout
Rating of 
Perceived 
Exertion
Heart Rate
Immediately pre 
& post blood 
draw s
McGill Pain Scale
Return 24hr urine 
collection #1
Begin 24hr urine 
collection #2
24 hrs post
Avoid use of 
NSAIDS
Blood Draw
Return 24hr urine 
collection #2
Begin 24hr urine 
collection #3
McGill Pain Scale
48 hrs post
Avoid use of 
NSAIDS
Blood Draw
Return 24hr urine 
collection #3
McGill Pain Scale

11 
 
Baseline measurements include, physical activity readiness questionnaire (PAR-Q; Attachment 3), 
medical history questionnaire, anthropometrics, functional movement screening (FMS; Figure 4),), 
spot urine sample, and blood draw. Informed consent will be obtained for overall research study.  
Participants will also complete the McGill pain scale (Attachment 5) and begin the first 24 hour urine 
jug collection. Participants will be asked to abstain from the ingestion of NSAIDS, caffeine, and 
alcohol, and refrain from exercise for 24h prior to this visit and between this visit and the end of their 
study participation.  
 
• University of Wyoming medical history questionnaire  
• PAR-Q  
• Anthropometrics (age, height, weight) 
• Spot urine sample (albumin, creatinine, NGAL, and KIM-1]) 
• Blood draw (serum creatinine, blood urea nitrogen, NGAL, and KIM-1) 
• FMS  
• The first 24-hour urine jug collection will be submitted to investigators immediately prior to 
the workout session.  
• McGill pain scale 
• Blood pressure measurement 
 
All blood draws will be performed by a person trained in phlebotomy and supervised by Dr. Johnson, 
Dr. Smith or Dr. Bell.  The named investigators have successfully completed >2,000 blood draws 
during exercise related research investigations.  They have all completed required blood borne 
pathogen training.  
 
Figure 4. The seven movement patterns and scoring system for FMS. 
 
 
Workout Session: Participants will report to the University of Wyoming, “Tailgate Field” in Laramie, 
WY for the workout. Once arrived they will be directed to the HIP lab within the Corbett building to 
turn in their first 24-hour urine sample jug and receive a new 24-hour urine sample jug. At this point 
they will have their pre-workout blood pressure measured and a blood draw performed.  
 
Scoring (0-3)
0: pain anywhere in body during 
movement
1: unable to complete movement 
2: completes movement with 
compensation
3: performs movement correctly 
without any compensation
 

12 
 
All participants will have previously registered to complete the workout as part of a charity event 
being held at the University of Wyoming.  Not all individuals completing the charity event will be 
participants in the research study.  Participants and non-participants will work out side by side in a 
mass participation event similar to a 5k.  Waves of charity participants will be instructed to start the 
event every 30 min so that it can be ensured there is adequate space for all people at the pull up 
stations.  For this work out a modular pull up bar will be constructed on the UW Tailgate Field with 
the help of the UW engineering department.  The charity event will have individuals stationed to allow 
flow of participants between stations (run, pull-ups, push-ups, squats, second run).  An investigator 
will be paired with each research volunteer to individually guide the participant and ensure safety 
throughout the entire workout. 
 
All research participants will be led through a full body dynamic warm-up, review movement 
standards for the exercises to be completed as part of the workout and complete the workout “Murph” 
while heart rate is recorded. Immediately following the workout, a blood draw will be taken by the 
primary investigator and the participant will be asked to mark their level of muscle soreness on the 
McGill pain scale. 
 
Participants can complete the workout in any of the below iterations.  They can only complete a 
version of the workout at or below a difficulty level that they have previously completed.  For 
example if the hardest level of difficulty a participant had previously completed was “Prescription, 
Cindy” they would not be eligible to complete the workout as “Prescription” as a part of the research 
study. Participants are not expected to complete the most difficult version they have previously 
completed, and the difficulty decision will be left up to only the participant. This will be confirmed 
and recorded by their completion of the training history questionnaire (Attachment 7). 
 
Table 1. Workout iteration descriptions 
 
Difficulty 
Iteration Title 
Weight Vest 
(yes/no) 
Repetition Scheme 
(consecutive or non-consecutive*) 
Hardest 
Prescription Plus 
Yes 
Consecutive 
 
Prescription Plus, Cindy 
Yes 
Non-Consecutive 
Prescription 
No 
Consecutive 
Prescription, Cindy 
No 
Non-Consecutive 
Scaled** 
No 
Consecutive 
Easiest 
Scaled, Cindy 
No 
Non-Consecutive 
 
*non-consecutive – As opposed to completing all 100 pull-ups before moving on to the 200 push-ups individuals 
complete 20 rounds of 5 pull-ups, 10 push-ups, 15 squats.  The same total number of repetitions for each 
exercise are completed. 
**Scaled – Instead of pull-ups the individual can substitute “ring-rows” or other pulling motion of their choosing.  
Instead of traditional push-ups, the individual will complete the push-ups in a modified fashion with knees on the 
ground or by placing the hands on an elevated surface. 
 
List of workout day measurements 
• 
Turn in 24-hour urine sample jug 
• 
Receive empty 24-hour urine sample jug 
• 
Dynamic warm-up (500m jog and two rounds of 10 wall push-ups, 5 body weight-squats, 10 each side forward leg swings, 10 arm 
circles in each direction, and a 30 second plank hold) 
• 
Review of movement standards and practice opportunity  
• 
Complete “Murph” (1-mile run, 100 pull-ups, 200 push-ups, 300 body weight squats, and a final 1-mile run) 
• 
heart rate recorded continuously via telemetric strap (i.e., heart rate monitor watch) 
• 
Pre and Post workout spot urine samples 
• 
Pre and Post workout blood draw 
• 
Pre and Post workout McGill pain scale to measure muscle soreness 

13 
 
• 
Pre and Post workout blood pressure measurement 
 
24 hours post: Subjects will report to the HIP or IPL to turn in their second 24-hour urine collection 
jug and be provided with the third and final 24 hour collecting jug. They will also take part in a blood 
draw and fill out the McGill pain scale to continue monitoring muscle soreness and have their blood 
pressure measured. Participants will be asked to abstain from the ingestion of NSAIDS, caffeine, and 
alcohol, and refrain from exercise during this time.  
• Turn in 24-hour urine sample jug 
• Receive empty 24-hour urine sample jug 
• 24h Post workout spot urine samples 
• 24h Post workout blood draw 
• 24h Post workout McGill pain scale to measure muscle soreness 
• 24h Post workout blood pressure measurement 
 
48 hours post: Subjects will report to the HIP or IPL and turn in their third and final 24-hour 
collecting jug, provide one last blood draw, and complete the McGill pain scale. Once the 48-hour 
post tests have been finished, the subjects have officially completed the study and will be paid. 
• Turn in 24-hour urine sample jug 
• 48h Post workout spot urine samples 
• 48h Post workout blood draw 
• 48h Post workout McGill pain scale to measure muscle soreness 
• 48h Post workout blood pressure measurement 
 
A. What will non-participants do while participants participate?  
 
Non-participants will be completing the workout of their choosing alongside the research participants.  
Research investigators will have minimal interaction with non-participants and only provide 
information about logistics of their own completion of the workout. 
 
B. What will participants be told about the research project? 
 
Participants will receive full disclosure of methods, risk and benefits.  No deception will be used 
during the implementation of the above intervention.  Upon completion of the entire data collection, 
participants will be contacted with their results. 
 
C. Estimated time required for participants:  
 
During the testing week, they will visit the Human Integrated Physiology Laboratory (Corbett 
Building Rooms 208 and 206) or a combination of HIP and IPL at CSU for a total of 4 occasions 
(Baseline, workout, 24 hours post, 48 hours post). The following calculates the estimated total number 
of hours spent by each participant:  
 
• Familiarization/Baseline: 2 hours 
• Workout session: 2 hours 
• 24 hours post: 30 minutes 
• 48 hours post: 30 minutes 
 
 

14 
 
Total= 5 hours spent per participant performing study related activities 
 
D. Where will research take place?   
 
All familiarization/baseline, 24-hour post, and 48-hour post data collection days will take place in the 
Human Integrative Physiology (HIP) laboratory (Corbett Building Rooms 208 and 206) or at the 
Integrative Biology Laboratory (IBL) located at Colorado State University.  The workout session will 
take place outdoors on the Tailgate Field located at the University of Wyoming.  All blood draws on the 
day of the workout will take place for all subjects within the HIP laboratory.   
 
E. Method of data collection:  Qualitative ___   Quantitative _X (check one or both). In a 
paragraph or two, please describe how you will collect your data: 
 
Data collection will occur via blood draws, urine sample collections, muscle soreness, heart rate 
monitoring, and RPE scale evaluations.  
 
A qualified investigator will obtain a single blood sample via venipuncture to an antecubital vein using 
sterile technique. At all times when blood samples are being handled, either for processing or analysis, 
the investigators will follow universal precaution standards. Samples will be drawn into vacutainers for 
later examination in the University of Wyoming’s HIP lab. Samples will assess kidney injury 
biomarkers including serum creatinine and blood urea nitrogen. In concordance with the Acute Kidney 
Injury Network, occurrence of AKI will be defined as an increase in serum creatinine of 0.3 mg/dL or 
an increase of 1.5 times greater than baseline measures. Our lab group has successfully drawn and stored 
blood samples as part of a current project. Additionally, investigator Johnson has successfully 
performed similar sample collections within laboratory environments and on athletes in field-based 
locations as well as in collaboration with multi-site data collection. 
 
A total of three x 24-hour urine collection jugs will be collected over a 72 hour period. Samples will 
assess albumin, creatinine, neutrophil gelatinase-associated lipocalin (NGAL), and kidney injury 
molecule 1 (KIM-1) kidney injury biomarkers. At all times when urine samples are being handled, either 
for processing or analysis, the investigators will follow universal precaution standards and assume that 
small amounts of blood may be contained in the urine samples. Total volume, urine color, and urine 
specific gravity will also be analyzed from every sample. Dipsticks will be used on fresh samples while 
five 2mL aliquots of each 24hr sample will be separated and stored at room temperature until they are 
returned to the University of Wyoming where they will be frozen at -80C for future analysis. Investigator 
Johnson has consistently used 24-hour urine collections as a part of his ongoing research regarding 
human hydration. 
 
Muscle soreness will be measured using a McGill short-form pain questionnaire to assess muscle pain 
and soreness (Attachment 5).  
 
A heart rate monitor will be worn by participants around their chest in order to record accurate heart 
rate continuously throughout the workout. The values will be compared with age predicted maximal 
heart rate values in order to quantify relative exercise intensity.  
 
The Borg’s RPE scale will be utilized to monitor how hard a subject is working after each segment of 
the workout as well (Figure 5). 
 

15 
 
 
Figure 5. Borg’s RPE Scale 
 
F. Please describe how and when participants may terminate participation:  
 
Participants are free to terminate their participation in the investigation at any time with no penalty. 
 
G. Description of biological samples (examples may include blood or urine):  
 
Blood samples will be collected on all days of data collection (familiarization/baseline, workout, 24 
hours post, and 48 hours post) to analyze serum creatinine, blood urea nitrogen, NGAL, and KIM-1. 
A qualified investigator will obtain a single blood sample via venipuncture to an antecubital vein 
using sterile technique.  At all times when blood samples are being handled, either for processing or 
analysis, the investigators will follow universal precaution standards. Samples will be drawn into 
vacutainers for later examination at the University of Wyoming’s HIP lab or at John’s Hopkins 
University (serum creatinine and blood urea nitrogen). They will be analyzed via colorimetric 
enzyme-linked immunosorbent assays (ELISA). ELISA antibodies will be supplied by Abcam 
(Cambridge, MA, USA) and microplates will be read according to the manufacturer’s instructions on 
spectrophotometer (Epoch 2, Bitotek, Winooski, VT, USA).  Samples for proenkaphalin 
quantification will be sent to Lund University for quantification of Proenkaphalin-A. 
 
A total of three, 24-hour urine collection samples will be collected over a 72-hour period. Samples 
will assess albumin, creatinine, neutrophil gelatinase-associated lipocalin [NGAL], and kidney injury 
molecule 1 [KIM-1] kidney injury biomarkers. At all times when urine samples are being handled, 
either for processing or analysis, the investigators will follow universal precaution standards and 
assume that small amounts of blood may be contained in the urine samples. A portion from each 
sample will be shipped to John’s Hopkins University for analysis (NGAL and KIM-1). Total volume, 
urine color, and urine specific gravity will also be analyzed for every sample. Dipsticks will be used 
on fresh samples while five, 2mL aliquots of each 24hr sample will be separated and stored at room 
temperature until they are returned to the University of Wyoming where they will be frozen at -80C 
for future analysis. Fresh samples will be evaluated for urine color and specific gravity using a 
handheld refractometer to establish hydration state.  
 

16 
 
H. Description of equipment to be used on or by participants:  
 
Participants will utilize spot and 24-hour urine collection containers (Figure 6, 7) which 
contain screw tops to avoid breakage or spilling. A “Go Girl” urinary funnel device will be 
provided to female participants to assist with urine collection (Figure 8).  
 
 
 
 
 
 
 
 
 
 
      Figure 6. 24 hour urine collection jug                 Figure 7. Spot urine collection container 
 
 
 
 
 
 
 
 
 Figure 8. “Go Girl” urinary device 
 
      
Blood draws will be collected using a winged infusion set with a tube holder. Samples will be drawn 
into vacutainers for later examination in the University of Wyoming’s HIP lab or John’s Hopkins 
University (Figure 9). 
 
 
  
 
 
 
 
Figure 9. Winged infusion set with a tube holder 
 
 
 
 
 
 
 
 
 
 
 

17 
 
 
A scale will be used to assess bodyweight on familiarization day (Figure 10). 
 
 
 
 
 
 
 
 
Figure 10. Bodyweight scale 
 
 
Participants will utilize the FMS testing kit (measuring device, hurdle, and measuring stick) during 
familiarization to assess movement patterns (Figure 11).  
 
 
 
 
 
 
 
 
 
 
 
 
 
Figure 11. FMS testing kit  
 
 
Heart rate will be recorded telemetrically during the workout by heart rate monitor watch and chest 
strap (Figure 12). 
 
 
 
 
 
 
 
 
 
 
 
Figure 12. Polar A300 activity heart rate 
Monitor 
 
 
 

18 
 
7. Confidentiality Procedures: 
     A. Explain whether or not participants will be identified by name, appearance, or 
nature of data:  
 
Participants will not be identified by name, appearance, or nature of data. 
 
B. Are you collecting personal health information? (See the IRB manual at: 
http://www.uwyo.edu/research/compliance/human-subjects/index.html ). 
 
Yes ____X_____ No _____________ 
C. Will the data you collect be anonymous or confidential (check the one that applies)? 
Note: research is only anonymous if the researcher does not know the identity of the 
participants and there are no identifiers linking the participant to the research. 
 
            Anonymous______                        Confidential __X____ 
D. Explain the procedure that will be used to protect privacy and confidentiality:  
 
Each participant will receive an exclusive identification number to be used on all data collection 
sheets and samples. There will only be one master sheet where the subject’s names will 
correspond to their identification number. This sheet will be held on a secure password 
protected computer by the graduate student investigator, Nicole Sauls. Participant names will 
not be used in presentations, reports, data bases, or publication based on the research 
investigation.  
 
Because the data collection for this protocol will take place in a group setting it is very possible 
that participants will be visually identifiable by other participants and by those non-participants 
who are simultaneously completing the charity workout.  However, any data or written 
information respective to the participant’s engagement in the study will be kept confidential. 
 
Participants can grant the researchers associated with this project the permission to use pictures 
taken of them during data collection as part of scientific presentations and publications 
(Attachment 6).  The participant names will never be used in any presentations or publications.  
This permission is not required to be part of the study.  If a participant chooses not to grant this 
permission they can still participate in all aspects of the research, but no pictures of their 
participation will be taken at any time. 
 
E. How and where will data be stored (may be indefinitely)?  
 
Data sheets will be kept in a locked file cabinet. The data will be entered into an electronic 
spreadsheet on a password protected computer and will not include subject names. The original 
data sheets will be kept for at least six years following the completion of research. The 
electronic files will be held indefinitely in case questions about publications come up in the 
future. 
 
F. How long will the data, research summary, and signed consent forms be stored 
(may be indefinitely)? Note: The regulations require that The PI or project director 
maintain the signed informed consent forms, assent script/forms (if applicable), and the 

19 
 
written research summary, relating to research for at least three years after completion 
of the research. 
 
All data, research summaries, and signed consent forms will be stored in a locked file cabinet in 
the principal investigator’s office for at least six years following the completion of data 
collection.  
G. Who will have access to the data?  
 
The data will only be accessible to the primary investigator, co-investigators, and 
Responsible graduate and undergraduate students. These are students listed in attachment 10. 
 
 
8. Benefits to Participants: 
     A. Describe the indirect research benefits for the participants:  
 
Indirect research benefits include, and functional movement screen results.  
 
     B. Describe the direct research benefits or state there are no direct benefits to the 
participants (do not include incentives in this section): 
 
Participants will receive up to $100 for their participation. 
 
9. Risks to Participants: 
This section should include a detailed description of any reasonably foreseeable risks or discomforts to 
the participants as a result of each procedure, including discomfort or embarrassment with survey or 
interview questions, exposure to minor pain, discomfort, injury from invasive medical procedures, or 
harm from possible side effects of drugs. All projects are deemed to involve some level of risk to 
participants, however obvious or obscure. Consequently, proposals must state that minimal risk is 
involved when the proposed research is viewed as involving little or no risk to participants. Risk is 
minimal where the probability and magnitude of harm or discomfort anticipated in the proposed research 
are not greater, in and of themselves, than those ordinarily encountered in daily life or during the 
performance of routine physical or psychological examinations or tests. Even when risk is minimal, 
investigators must still state what the minimal is and why it is minimal (example would be potential for 
embarrassment or boredom). 
 
Describe the risks to participants:   
 
Urine collection inconvenience – The 24-hour urine collection jugs may present inconvenience 
and slight embarrassment for participants. To minimize these inconveniences, a reusable shopping 
tote will be provided to make carrying the samples more discrete. Also, a female urination device 
will be provided to appropriate participants to make urine collection easier.  
 
Blood Draw and Venipuncture Risk- Blood draws performed on familiarization, baseline, 24 hours 
post, and 48 hours post will be performed by a trained investigator, Dr. Johnson, using sterile 
techniques and universal precautions. However, risk does include pain, bruising, fainting, 

20 
 
hematoma, nausea, phlebitis, infection, bleeding, blood clots, and sensitive responses to plastic or 
adhesive tape used during or as a reaction to the venipuncture. To minimize bleeding and the 
incidence of a hematoma, firm pressure with gauze will be placed on the site of needle removal.  
 
 
Exercise intervention – Participation in any physical activity or exercise has risk.  These risks 
include but are not limit to, pain, fainting, dizziness, fatigue, nausea, shortness of breath, chest 
pain or angina, swelling, bruising, muscle/bone/joint soreness, joint damage, bone fracture, 
ligament/tendon/connective tissue damage, head and cervical spine injuries, hospitalization, and 
death. As with any exercise participation there is some cardiovascular risk (arrhythmia, sudden 
cardiac death, acute myocardial infarction). The incidence of sudden cardiac death in young adults 
has been estimated at 0.9 and 2.3 per 100,000 for non-athletes and athletes, respectively. These 
risks will be minimized by the following: 
1. Anyone with a pre-existing injury will be excluded 
2. All exercise sessions will be overseen by an investigator and an individual with a high 
intensity exercise training instructor certificate.  Both supervisors will alert the participants 
if exercise form puts the individual at risk for injury 
3. All participants will have at least 1 year of HIFRT experience and will have completed 
“Murph” on at least one occasion prior to their inclusion in the study  
 
Injury Liability 
 
The University of Wyoming, the project investigator, and the research team are not liable for any 
injury participants might sustain while participating in this study and are not able to offer financial 
compensation or absorb the costs of medical treatment should the participant sustain such an 
injury. 
 
Emergency Action Plan 
 
In the event of an emergency, the responsible investigators will immediately report the situation 
to 911 and provide pertinent information describing severity of event, including any health and 
safety risks, to emergency responders. In the event of a cardiac emergency (cardiac arrest), a CPR-
certified investigator will initiate the chain of survival until the arrival of emergency responders. 
An ambulance with an Emergency Medical Technician will be present at The Murph Challenge  
 
10. Description of procedure to obtain informed consent or other information to be provided to 
participant: 
 
A. How and when will the participants be approached to obtain consent?  
 
Participants will be recruited from individuals who register online for The Murph Challenge 
charity event in Laramie, Wyoming. Following contact with the principal investigator, a 
responsible graduate student (listed below in Section B) will schedule the individual’s initial 
appointment (Familiarization Day) or in the case of individuals from the Fort Collins area 
speak by phone. At this meeting, prior to any measurements being recorded, the responsible 
graduate student will review the consent document with the potential volunteer to clarify any 
questions they may have. The individual will complete the medical history questionnaire 
(Attachment 2) which will be reviewed by the responsible graduate student prior to the 
participant taking part in any exercise, hematological, or urinary testing. If an individual 

21 
 
chooses to volunteer, the signed consent form will be returned to the responsible graduate 
student.  All consent documents, medical history questionnaires, and the research summary 
will be returned to the principle investigator who will store the document in a locked and 
secure file cabinet for 6 years.  
 
B. Who will be responsible for obtaining consent (check the box that applies)? 
 
Project Director ___X___ Evan Johnson, PhD 
Member of Project team ___X____ Nicole Sauls (Co-investigator), or 
 Brittany Wells (Undergraduate Student) 
 Lauren Elliot (Undergraduate Student) 
            Other ______ (Please explain, and include name, affiliation, and title) 
 
C. How will information be relayed to participant (read to, allowed to read, audio-
recorded, video-recorded)? 
 
Participants will have the consent form read to them by a responsible investigator. They will 
also have time to ask questions if any clarification is needed. A copy of the consent forms will 
also be given to take with them to the remaining sessions. The copies will include contact 
information for the primary investigator and the IRB office in case any questions or concerns 
arise during or after their time spent in the HIP Laboratory the IPL or outside during the 
workout.  
 
D. Provide a description of feedback, debriefing, or counseling referral that will be 
provided if this is relevant to the research: 
 
All participants will be sent individual reports following the completion of all data collection 
containing FMS, and heart rate results. Urine and blood analysis results will also be provided 
within a year from the completion date as these analyses take much more time to complete.  
E. Explain the procedure that will be used to obtain assent of children, if relevant to 
the research (See: http://www.uwyo.edu/research/compliance/human-
subjects/index.html ): N/A 
 
F. If children are involved, who will be responsible for obtaining assent (check the 
box that applies)?  
 
N/A 
Project Director ______ 
Member of Project team _______ (list name or position) 
            Other ______ (Please explain, and include name, affiliation, and title) 
 
 
 
 

22 
 
 
11A. Attach copies of survey instruments, interview questions, tests, and other pertinent 
documentation that will be used to conduct the research.  Note: Please see the informed consent 
outline for suggested language for consent forms. 
Attachment Name 
Description 
Attachment 1: 
Informed consent for research participation 
Attachment 2: 
Medical History Questionnaire 
Attachment 3: 
Physical Activity Readiness Questionnaire (PAR-Q) 
Attachment 4: 
Colorado State University – IRB – e-mail chain  
Attachment 5: 
McGill Pain Questionnaire 
Attachment 6: 
Photo release waiver 
Attachment 7: 
Training History Questionnaire 
Attachment 8: 
The Murph Challenge – Website Description 
Attachment 9: 
Christopher Bell – Colorado State Collaborator – Letter of Support 
Attachment 10: 
Additional Student Researchers List 
Attachment 11: 
Daniel Murphy – Research within charity event approval e-mails 
 
11B. If participants will be recruited through an institution such as a school or hospital, or if the 
research will be conducted at such an institution, provide a letter of agreement/approval to do so 
from an authorized representative of that institution. The IRB will not approve a proposal without 
the proper letter(s) of support.  
 
11C. If collaborators and/or students will be helping with the research and those individuals are not 
listed as co-investigators on the proposal, please provide the names of those individuals in an 
attachment to the proposal so that human subjects training can be verified. – See Attachment 10 
 
 
 
 
 
 
 
 

ATTACHMENT 1 – Informed consent for research participation 
 
23 
 
 
University of Wyoming Consent Form 
 
I. 
General purpose of the study: 
 
 
High intensity functional resistance training (HIFRT) may present risk for acute kidney injury 
(AKI) due to high exercise intensities and skeletal muscle damage. However, the direct effects of a 
specific long duration HIFRT workout on AKI risk is unknown.  
 
The first aim of the study is to investigate the incidence of AKI following the commonly performed 
workout, “Murph” (1-mile run, 100 pull-ups, 200 push-ups, 300 body-weight squats, and a final 1-
mile run) and compare these results seen in other forms of extreme exercise. Blood and urine 
samples are used in the diagnosis of kidney injury, so they will be used to determine AKI 
incidences.  
 
The second aim is to evaluate if the baseline concentration of the blood biomarker “proenkephalin 
A” is related to the occurrence or severity of AKI following HIFRT.  
 
By doing this we hope to assist in the continued programming of safe and efficacious HIFRT 
workouts. The goal is not to take away from the many benefits of HIFRT. Instead, we hope to 
educate the exercising population on the potential risks associated with HIFRT, so they can adjust 
behavioral or movement patterns that will minimize risk for injury.  
 
II. 
Procedure: 
 
All sessions will take place at University of Wyoming’s Human Integrated Physiology Laboratory 
or Colorado State University’s Integrated Physiology Laboratory. Data will be collected by Evan 
Johnson PhD, Christopher Bell PhD, graduate, and undergraduate students that have been 
appropriately trained to carry out the research protocol.  
 
You are / will be ineligible for the study if any of the following are true 
1. 
Score of “0” on the Functional Movement Screening (FMS) test as evaluated by two 
investigators, indicating pain during any of the seven functional movements 
2. 
Self- reported Kidney Disease (e.g., chronic kidney disease, polycystic kidney disease, 
glomerulonephritis, diabetic nephropathy, interstitial nephritis, Goodpasture syndrome) or 
other medical condition contraindicating participation in HIFRT (Hypertension, dyslipidemia, 
type II diabetes mellitus, BMI >30) 
3. 
Pregnancy, suspected pregnancy, or breastfeeding 
4. 
Blood donations within the last eight weeks leading up to testing day 
5. 
Any musculoskeletal injuries which have resulted in > 1 week of absence from HIFRT within 
the last six months 
6. 
Not passing the physical activity readiness questionnaire (PAR-Q) 

Attachment 1 – Participant Consent Form 
24 
 
7. 
Surgical operation on digestive tract or kidneys, except appendectomy 
8. 
Inability to participate in the entire study  
9. 
Recurrent urinary tract infections or kidney stones (> 3 within the past year) 
10. History of protein or blood in urine 
11. Moving from a location of low altitude (< 3,000’) to Laramie within the past 3 months 
12. Inability to understand and write English** 
 
Participation will include one data collection week. The week will consist of 4 data collection days. 
The only additional commitment may be a familiarization phone call, e-mail, or visit prior to the 
first week of testing where exclusionary criteria will be assessed. We estimate the total time 
commitment to be 5 hours. The schedule is outlined below:  
 
 Testing Week 
 
• Familiarization / Baseline: 2 hours minutes 
• Workout session: 2 hours 
• 24 hours post: 30 minutes 
• 48 hours post: 30 minutes 
 
On the familiarization day, consent and initial screening forms will be filled out if you choose to 
participate, if you are located in the Fort Collins area this will take place over the phone. For 
individuals in the Laramie area the familiarization and baseline visits will take place 
simultaneously.  On the baseline day at either the University of Wyoming’s Human Integrated 
Physiology Laboratory or Colorado State University’s Integrated Physiology Laboratory we will 
measure your height, weight, and waist girth.  You will then take part in a functional movement 
screen (FMS) to analyze your ability to perform several movement patterns. If you score a 0 on the 
FMS during the familiarization period, you will continue with the remainder of the familiarization 
protocol, however you will be re-screened by a second screener prior to the first workout. 
Although the FMS has demonstrated good interrater reliability, it has also been reported as varied.  
Therefore, we want to make sure we are certain that this measure disqualifies you from 
participation. You will have your blood drawn by a trained investigator, provide a spot urine 
sample, and have your blood pressure measured. The first 24-hour urine collection jug will be 
provided. This jug is to be returned 24 hours later at the beginning of your workout session. You 
will complete the McGill pain scale to evaluate your baseline measures of muscle pain or soreness. 
This session is estimated to take 2 hours total which could be divided over multiple days. 
 
During the workout session, you will the workout “Murph” (1-mile run, 100 pull-ups, 200 push-
ups, 300 body-weight squats, and a final 1-mile run) at a difficulty level similar to what you have 
done previously.  You can choose to do a less difficult version (e.g., with scaled push-ups) but 
cannot choose to do a more difficult version (e.g., with a weight vest) than you have previously 
completed.  Prior to exercising, you will tell the investigator what you have eaten prior to exercise 
and then return your first urine collection jug and receive a second to again return 24 hours later at 

Attachment 1 – Participant Consent Form 
25 
 
the next session. Next, a trainer with a coaching certificate will lead you through a full body 
dynamic warm-up and review all movement and workout standards. If there are no other questions 
or concerns, you will perform all repetitions of “Murph” as chosen. You must complete this 
workout at a level equal or of lesser difficulty than your previous attempts.  For example, if you 
have only completed the workout with scaled push-ups and ring-rows substituted for pull ups 
previously, you are not eligible to perform the workout in this study with un-modified push-ups or 
traditional pull ups.  If you have completed the workout “un-scaled” previously and attempt that 
version, you can change your mind during the workout if the effort level progresses out of your 
comfort zone.  During the workout, your heart rate will be recorded through a heart rate monitor 
watch and chest strap. Immediately after the completion of all repetitions, a post-exercise blood 
pressure will be measured, a draw will be taken, you will submit a second spot urine sample and 
you will be asked to fill out a McGill pain scale to quantity muscle soreness. This session is 
estimated to take 2 hours.  All workouts will be completed in Laramie Wyoming on the University 
of Wyoming campus.  
 
The day following the workout (approximately 24 hours post) at either the University of 
Wyoming’s Human Integrated Physiology Laboratory or Colorado State University’s Integrated 
Physiology Laboratory you will turn in your second 24-hour urine collection jug and being 
provided with the third and final 24-hour jug. You will also provide another spot urine sample, 
have your blood pressure measured, have your blood drawn and fill out the McGill pain 
questionnaire to identify any muscle pain or soreness. This session is estimated to take 30 minutes.  
 
The final day of the participation approximately 48 hours post workout you will report to either 
the University of Wyoming’s Human Integrated Physiology Laboratory or Colorado State 
University’s Integrated Physiology Laboratory. You will turn in your third and final 24-hour urine 
collection jug provide a final spot urine sample, have your blood pressure measured, and provide 
one last blood draw. After completing a final McGill pain questionnaire, the testing is completed. 
This session is also expected to take about 30 minutes. If blood is apparent in your 48hour post 
exercise urine sample, we will ask you to report at 72 hours to ensure that urine measurements 
have returned to normal.  After participation you should be alert for signs and symptoms of kidney 
injury such as; decreased urine output, fluid retention, causing swelling in your legs, ankles or 
feet, shortness of breath, fatigue, confusion, nausea, weakness, irregular heartbeat, chest pain or 
pressure, or irregularly dark urine.  If any of these symptoms are apparent following your 
completion of the study, you should contact us or a doctor immediately. 
 
It is also important to note; you will be asked to abstain from ingesting NSAIDS and alcohol for 
48 hours before and 48 hours post workout.  You will also be asked to avoid strenuous exercise for 
the 48 hours before and 48 hours post workout.  
 
III. 
Disclosure of risks 
 

Attachment 1 – Participant Consent Form 
26 
 
Urine collection inconvenience – The 24-hour urine collection jugs may present inconvenience 
and slight embarrassment. To minimize these inconveniences, a reusable shopping tote will be 
provided to you to make carrying the jugs more discrete. Also, a female urination device will be 
provided to if necessary, to make urine collection easier.   A female investigator will give 
instructions on how best to utilize the female urination device should it be requested. 
 
Blood Draw and Venipuncture Risk- Blood draws performed during the familiarization, baseline, 
24 hours post, and 48 hours post sessions will be performed by a trained investigator, Dr. Johnson, 
Dr. Smith, Dr. Bell, or an individual with phlebotomy training using sterile techniques and 
universal precautions.  The named investigators have performed >2,000 of blood draws during 
scientific research studies.  However, risks do include pain, bruising, fainting, hematoma, nausea, 
phlebitis, infection, bleeding, blood clots, and sensitive responses to plastic or adhesive tape used 
during or as a reaction to the venipuncture. To minimize bleeding and the incidence of a 
hematoma, firm pressure with gauze will be placed on the site of needle removal.  
 
Exercise intervention – Participation in any physical activity or exercise has risk.  These risks 
include but are not limit to, pain, fainting, dizziness, fatigue, nausea, shortness of breath, chest 
pain or angina, swelling, bruising, muscle/bone/joint soreness, joint damage, bone fracture, 
ligament/tendon/connective tissue damage, head and cervical spine injuries, hospitalization, and 
death. As with any exercise participation there is some cardiovascular risks (arrhythmia, sudden 
cardiac death, acute myocardial infarction). The incidence of sudden cardiac death in young adults 
has been estimated at 0.9 and 2.3 per 100,000 for non-athletes and athletes, respectively. These 
risks will be minimized by the following: 
Anyone with a pre-existing injury will be excluded 
1. All exercise sessions will be overseen by an investigator with a high intensity exercise 
training instructor certificate. They will alert the participants if exercise form puts the 
individual at risk for injury.  A member of the research team will serve as a second 
observer to ensure that all  
exercise is completed safely.  Either of the individuals named above can stop an exercise 
session at any time if they feel there is apparent risk for musculoskeletal or other injury. 
2. All participants will have at least 1 year of HIFRT experience and will have completed 
“Murph” on at least one occasion prior to their inclusion in the study.   
 
Injury Liability 
 
The University of Wyoming, the project investigator, and the research team are not liable for any 
injury participants might sustain while participating in this study and are not able to offer financial 
compensation or absorb the costs of medical treatment should the participant sustain such an 
injury.  
 
 
 

Attachment 1 – Participant Consent Form 
27 
 
IV. 
Description of benefits: 
 
You will receive up to $100 for your participation in this investigation. This will be distributed at 
the end of your enrollment in the study.  If you choose stop participation in the study prior to 
completion you will be paid for your involvement based on the below pro-rated basis. 
$20 – Baseline measurements 
$30 – Completion of workout 
$10 – Completion of 24h post visit 
$40 - Completion of 48h post visit plus bonus for finishing all study measurement periods 
 
You will also receive indirect benefits including functional movement screen results.  We will 
provide you with blood analysis results within a year of your participation as these measurements 
take longer to evaluate.  
 
V. 
Confidentiality: 
 
Each member of the research team has undergone certification for proper data management during 
human subject research. All information will be kept confidential, to the extent allowed by law, and 
each participant will receive an exclusive identification number to use on all data collection sheets 
and samples. There will only be one master sheet where your name will correspond to an 
identification number. This sheet will be held on a secure and password protected computer by the 
graduate student investigator, Nicole Sauls. Your name will not be used in presentations, reports, 
data bases, or publication based on the research investigation.  
 
Because the data collection for this protocol will take place in a group setting it is very possible 
that you will be visually identifiable by other participants and by non-participants who are 
simultaneously completing the charity workout.  However, any data or written information 
respective to the participant’s engagement in the study will be kept confidential. 
 
Data sheets will be kept in a locked and secure file cabinet. The data will be entered into an 
electronic spreadsheet on a password protected computer and will not include identification 
information. The original data sheets will be kept for at least six years following the completion of 
research. The electronic files will be held indefinitely in case questions about publications come up 
in the future. All documents related to your participation in this research will only be accessible by 
the principle investigator and graduate students involved in data collection. Each member of the 
research team has undergone certification for proper data management during human subjects’ 
research.  Other students using the data will only have access to de-identified data.  
 
If you choose, you can grant the researchers associated with this project the permission to use 
pictures taken of you during data collection as part of scientific presentations and publications.  
Your name will never be used in any of these presentations or publications.  This permission is not 

Attachment 1 – Participant Consent Form 
28 
 
required to be part of the study.  If you choose not to grant this permission you can still participate 
in all aspects of the research, but no pictures of your participation will be taken at any time.  
 
VI. 
Freedom of consent: 
 
Participation is voluntary, refusal to participate will involve no penalty or loss of benefits to which 
you are otherwise entitled, and you may discontinue participation at any time. If you choose to 
discontinue your participation please contact Principal Investigatory Evan Johnson 202-431-4065, 
and return any equipment you may have been issued (i.e., 24-hour urine collection jugs and totes) 
 
VII.  Questions about the research:  
 
 
Should you have any questions about this research following today please contact: 
Evan Johnson 
Corbett Building – Room 109 - 307-766-5282 
 
If you have questions about your rights as a research subject, please contact the University of 
Wyoming IRB Administrator at 307-766-5320 
 
I ______________________ have read the information on this study and understand the commitments, 
risks, and benefits associated with the protocol. 
Any questions I had, have been answered, and I agree to participate. I understand that I can change my mind 
and stop at any time. I understand the purpose of the study as well as the potential benefits and risks that 
are involved. I understand that participation is voluntary. I understand that significant new findings 
developed during this research will be shared with the participant. I understand that no rights have been 
waived by signing the consent form. I have been given a copy of the consent form. 
 
 
 
Participant 
 
 
 
 
Investigator 
 
Printed name ____________________ 
Printed name ____________________ 
 
Signature 
____________________ 
Signature 
____________________ 
 
Date 
 
_____________________     Date 
 
____________________    

Attachment 2 – Medical History Questionnaire 
1 
 
 
 
 
 
 
 
Office for Research and Economic Development 
1000 East University Avenue • Department 3355 • Laramie, WY 82071 
Campus: Office of Research • Room 305/308 • Old Main  
(307) 766-5353 • (307) 766-5320 • fax (307) 766-2608 •  www.uwyo.edu/research  
 
 
UNIVERSITY OF WYOMING  
HEALTH HISTORY SCREENING QUESTIONNAIRE (UWHHSQ) 
Please complete thoroughly and accurately. 
 
 
Date  
  
/ 
/ 
 
 
 
Name:  
 
 
 
 
 
 
 
 
 
 Ethnicity: 
 
 
Address: 
 
 
 
 
 
City: 
 
 
State:  
Zip: 
 
 
Date of Birth:   
/ 
/ 
 Age: 
 
 Phone #: 
 
 
 
Email:  
 
 
 
@ 
 
 
 
Emergency contact information:  Name: ________________________________ Phone #: 
 
_________ 
Personal healthcare provider to contact in case of an emergency: 
Name________________________________ Phone #:  
_________  
City:_________________________________ 
 
CARDIOVASCULAR HEALTH HISTORY 
Have you ever been diagnosed with or had any of the following? 
 
Heart Attack?  
 
 
 
 
 
Yes 
 
No 
 
Heart Surgery ? 
 
 
 
 
 
Yes  
 
No 
 
Cerebrovascular accident (e.g. Stroke)?  
 
 
Yes 
 
No 
 
Transient Ischemic Attack (TIA)? 
 
 
 
Yes 
 
No 
 
Carotid Artery Disease?  
 
 
 
 
Yes 
 
No 
 
Cardiac Catheterization? 
 
 
 
 
Yes 
 
No 
 
Coronary Angioplasty?  
 
 
 
 
Yes 
 
No 
 
Pacemaker/Implantable Cardiac Device? 
 
 
Yes 
 
No 
 
Irregular Heart Rate/Heart Rhythm Disturbance? 
 
Yes 
 
No 
 
Atrial Fibrillation? 
 
 
 
 
 
Yes 
 
No 
 
Heart Valve Disease? 
 
 
 
 
 
Yes 
 
No 
 
Heart Failure?  
 
 
 
 
 
Yes 
 
No 
 
Heart Murmur? 
 
 
 
 
 
Yes 
 
No 
 
Heart Transplantation?  
 
 
 
 
Yes 
 
No 
 
Congenital Heart Disease? 
 
 
 
 
Yes 
 
No 
 
Have you ever experienced any of the following symptoms? 
 
Chest discomfort with exertion?  
 
 
 
Yes 
 
No 
 
Unreasonable breathlessness?  
 
 
 
Yes 
 
No 
 

Attachment 2 – Medical History Questionnaire 
2 
 
 
 
 
Dizziness, fainting, or blackouts? 
 
 
 
Yes 
 
No 
 
 
Syncope (loss of consciousness)? 
 
 
 
Yes 
 
No 
Hypoxia (low oxygen levels)? 
 
 
 
 
Yes 
 
No 
Do you currently take heart medications? 
 
 
Yes 
 
No 
 
 
If yes, what? 
 
 
 
 
 
 
 
 
 
 
Have you been diagnosed with diabetes (Type 1 or Type 2) or  
problems with blood sugar levels? 
 
 
 
 
Yes 
 
No 
 
If yes, please note Type 1 or Type 2 
 
 
 
 
 
 
 
 
If you circled yes to any of the above statements in this section, consult your physician or other appropriate health care 
provider before engaging in exercise.  You may need to use a facility with a medically qualified staff. 
 
 
CARDIOVASCULAR RISK FACTORS 
 
Are you a male over 45 years old? 
 
 
 
 
Yes 
 
No 
 
Are you a female over 55 years old? 
 
 
 
 
Yes 
 
No 
  Have you had a hysterectomy? 
 
 
 
 
Yes 
 
No 
  Have you had both of your ovaries surgically removed?  
 
Yes 
 
No 
  Are you postmenopausal? 
 
 
 
 
 
Yes 
 
No 
 
 
Do you currently smoke or have you quit within the last 
six months? 
 
 
 
 
 
 
 
Yes 
 
No 
 
Is your blood pressure greater than 140/90 mm Hg? 
 
 
Yes 
 
No 
    I Don’t Know 
 
If known, what is your blood pressure?   _____/ ____ mm Hg 
Do you currently take blood pressure medications? 
 
 
Yes 
 
No 
Do you currently take any medications for your heart?  
 
Yes 
 
No 
Is your total blood cholesterol level greater than 200 mg/dl? 
 
Yes 
 
No 
    I Don’t Know 
Do you know your cholesterol level? 
 
 
 
 
Yes 
 
No 
 
 
If yes, Total Cholesterol 
 
 
 
 
 
LDL 
 
 
 
 
 
 
 
HDL 
 
 
 
 
 
 
 
Triglycerides 
 
 
 
 
Do you have a close blood relative who has suffered a heart attack  
or had any kind of heart surgery before the age of 55 (for father  
or brother) or age 65 (for mother or sister)? 
 
 
 
Yes 
 
No 
 
Are you more than 20 pounds overweight? 
 
 
 
Yes 
 
No 
    I Don’t Know 
 
Are you physically inactive (i.e., do you get less than 30 minutes  
of physical activity less than three times a week)? 
 
 
Yes 
 
No 
 
Have you had a recent surgery (in the past 2 years)? 
 
 
Yes 
 
No 
 

Attachment 2 – Medical History Questionnaire 
3 
 
 
Have you had an exercise stress test, heart catheterization, 
or echocardiogram? 
 
 
 
 
 
 
Yes 
 
No 
 
If yes, please explain 
 
 
 
 
 
 
 
 
_ 
To the best of your knowledge, is there any reason that might 
 
Yes 
 
No 
make it unsafe for you to participate in exercise? 
 
If you circled yes to two or more of the statements in the above section, you should consult your physician or other 
appropriate health care provider before engaging in exercise.  You might benefit from using a facility with a 
professionally/medically qualified exercise program and staff. 
 
 
THYROID HEALTH HISTORY 
Have you ever been diagnosed with or had any of the following? 
 
Goiter (enlarged thyroid gland)? 
 
 
 
Yes 
 
No 
 
Hyperthyroidism (overactive thyroid)?  
 
 
Yes  
 
No 
 
Hypothyroidism (underactive thyroid))? 
 
 
Yes 
 
No 
 
Thyroid nodule? 
 
 
 
 
 
Yes 
 
No 
 
Thyroid Cancer? 
 
 
 
 
 
Yes 
 
No 
 
Do you take any type of thyroid medication, i.e., Synthroid? 
Yes 
 
No 
 
If yes, please list _____________________________________ 
 
CARDIOVASCULAR HEALTH HISTORY 
Have you ever been diagnosed with or had any of the following? 
 
Heart Attack?  
 
 
 
 
 
Yes 
 
No 
 
Heart Surgery ? 
 
 
 
 
 
Yes  
 
No 
 
Cerebrovascular accident (e.g. Stroke)?  
 
 
Yes 
 
No 
 
Transient Ischemic Attack (TIA)? 
 
 
 
Yes 
 
No 
 
Carotid Artery Disease? 
 
 
 
 
Yes 
 
No 
 
Cardiac Catheterization? 
 
 
 
 
Yes 
 
No 
 
 
 
To the best of my knowledge, the information I have provided above is an accurate assessment of my health 
and medical history. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Name of Participant 
 
 
 
Participant’s Signature  
 
 
Date 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Name of Administering Staff 
 
 
Signature of Staff Member 
 
 
Date 
 
Please stop here.  The remainder of this Health History Screening Questionnaire will be administered to you by 
one of our staff. 
 
 
 

Attachment 2 – Medical History Questionnaire 
4 
 
GENERAL MEDICAL AND DIETARY HISTORY 
 
Height:  
 Weight: 
 
 BMI (calculated): 
 
 
 
       
 
 
 
 
 
 
 
 
 
     Circle One 
 
Do you currently participate in > 7 hours of moderate to intense cardiovascular exercise per week? 
 
 
 
 
 
 
 
 
 
Yes 
 
No 
 
Have you drastically changed your diet in the last month? 
 
Yes 
 
No 
 
Has your weight fluctuated > 5lbs in the past month? 
 
 
Yes 
 
No 
 
Do you have any history of acute or chronic Glomerulonephritis   
Yes 
 
No 
(such as post-streptococcal lupus rheumatoid arthritis, or other  
immune system diseases such as Amyloidosis or Sarcoidosis) 
 
Do you have recurrent urinary tract infections (especially pyelonephritis) Yes 
 
No 
 
 
Do you have a history of kidney stones?   
 
 
 
Yes 
 
No 
(especially those requiring surgical intervention or lithotripsy) 
 
Do you have any history of diabetic-induced renal injury? 
 
Yes 
 
No 
 
Do you have any history of hypertension-induced renal injury?  
Yes 
 
No 
 
Have you had kidney surgery such as nephrectomy? 
 
 
Yes 
 
No 
 
Have you ever had kidney dialysis? 
 
 
 
 
Yes 
 
No 
 
Do you have any history of protein or blood in urine? 
 
 
Yes 
 
No 
 
Do you drink alcohol?  
  
 
 
 
 
Yes 
 
No 
 
If yes, how many drinks per week? 
 
 
 
 
 
 
 
 
 
 
Are you taking any prescription or over-the-counter medication? 
Yes 
 
No 
 
If yes, what medication and what dosage? 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Do you take any of the following vitamins, supplements, or herbal/homeopathic medications? 
Calcium, Cat’s claw, Chaparral, Chromium, Cranberry, Creatine, Ephedra, Germanium, Hydrazine, Licorice, l-
Lysine, Pennyroyal, Thunder god vine, Vitamin C, Willow bark, Wormwood oil, Yellow oleander,Yohimbe? 
 
 
 
 
 
 
 
 
 
 
Yes 
 
No 
 
If other, what type and what dosage?  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
STAFF:  Administer the remaining portion of the UWHHSQ. 

Attachment 2 – Medical History Questionnaire 
5 
 
Do you use table salt?  
 
 
 
 
 
Yes 
 
No                  Sometimes 
 
If yes, is it iodized? 
 
 
 
 
 
Yes 
 
No                  Not Sure  
 
If yes, please list the brand______________________________ 
 
Has your body weight been stable over the past 6 months? 
 
Yes 
 
No 
 
If no, please explain 
 
 
 
 
 
 
 
 
 
 
 
 
Have you been on a recent diet or a prescribed diet? 
 
 
Yes 
 
No 
If yes, please explain 
 
 
 
 
 
 
 
 
 
 
 
 
Are you currently restricting calories, i.e., “dieting” to lose weight?  
Yes 
 
No 
Do you follow a vegetarian Diet?  
 
 
 
 
Yes 
 
No                   
Do you shop at the Farmers Market or Food Coop (Big Hallow)?  
Yes 
 
No                  Sometimes 
Do you belong to a CSA (Community Supported Agriculture)? 
 
Yes 
 
No                   
Do you have a garden and grow your own food? 
 
 
Yes 
 
No                  Sometimes 
Comments __________________________________________________________________________ 
__________________________________________________________________________ 
 
Have you been diagnosed with asthma, exercise-induced asthma, reactive airway disease, chronic obstructive 
pulmonary disease (COPD), or any other respiratory disease? 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes 
 
No 
 
If yes, please describe:  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Have you ever been diagnosed with cancer? 
 
 
 
Yes 
 
No 
 
If yes, please describe when and what type: 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Have you ever undergone a lymphectomy? 
 
 
 
Yes 
 
No 
 
If yes, please describe when and why?  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Do you have musculoskeletal problems that limit your physical  
activity such as walking? 
 
 
 
 
 
Yes 
 
No 
 
Have you recently (in last 3 months) had an X-ray or CT scan in which 
Contrasting dyes were used?  
 
 
 
 
 
Yes 
 
No 
If yes, when ______________________________________ 
 
 
Have you recently (in last week) used an iodine-containing (brown- 
colored) antiseptic skin cleaner   
 
 
 
 
Yes 
 
No 
If yes, when ______________________________________ 
 
Do you have concerns about your safety when you exercise 
 
Yes 
 
No 
 
Do you have a history of chronic kidney stones?  
 
 
Yes 
 
No 
If yes, when was your last kidney stone? ________________ 
 
Do you have a history of frequent urinary tract infections? 
 
Yes 
 
No 

Attachment 2 – Medical History Questionnaire 
6 
 
If yes, When was your last urinary tract infection? __________ 
 
Have you ever experienced burning or cramping sensations in  
your l legs when walking short distances? 
 
 
 
Yes 
 
No 
 
Do you have any other health problems, illnesses, diseases, 
infections, surgeries, allergies, or hospitalizations? 
 
 
Yes 
 
No 
 
If yes, please explain 
 
 
 
 
 
 
 
 
 
 
 
 
Do you have any allergies to ibuprofen or other NSAIDs (naproxen, meloxicam, indomethacin) 
Yes 
 
No 
 
FAMILY HISTORY 
Please check all that apply 
Family Member 
High Blood 
Pressure 
Diabetes 
Type I or II 
Heart Diseases 
Comments 
Mother 
 
 
 
If yes, was it before the age of 65? 
 Yes           No 
Father 
 
 
 
If yes, was it before the age of 65? 
 Yes           No 
Sibling 
 
 
 
 
Gender:                    Age: 
Sibling 
 
 
 
 
Gender:                    Age: 
Paternal 
Grandmother 
 
 
 
Age: 
Paternal  
Grandfather 
 
 
 
Age: 
Maternal 
Grandmother 
 
 
 
Age: 
Maternal 
Grandfather 
 
 
 
Age: 
FOR FEMALES ONLY: 
Are you pre-        , peri-         or post-         menopausal? 
If premenopausal, are you using any form of contraception  
(birth control) or hormone therapy for any reason?  
 
Yes 
 
No 
 
If yes, why and what type? 
 
 
 
 
________________________________  
Do you regularly use vaginal douches?   
 
 
Yes 
 
No 
If yes, please record the type used and date of your last douche  
 
 
 
 
 
 
 
If you are premenopausal: 
 
Do you have regular menstrual cycles?  
 
Yes 
 
No 
 
I Don’t Know 
 
How frequent are your menstrual cycles? 
 
 
 
 
 
 
 
 
Are you pregnant? 
 
 
 
 
Yes 
 
No 
 
I Don’t Know 
 
Could you be pregnant? 
 
 
 
Yes 
 
No 
 
I Don’t Know 
 
Are you trying to become pregnant? 
 
 
Yes 
 
No 
 
If you are peri- or postmenopausal: 
 
For how long?  
 
 
 
 
 
 
 
 
 
 
When was your last menstrual period? ____________________________________________________ 
 
 

Attachment 2 – Medical History Questionnaire 
7 
 
Have you had a hysterectomy w/ or w/out ovary removal? 
Yes 
 
No 
 
Have you had an oophorectomy without removal of your 
Yes 
 
No 
  uterus? 
 
Are you currently taking any type of hormone replacement  
therapy or using any form of contraception (birth control)? 
Yes 
 
No 
 
 
 
 
If yes, what type? 
 
 
 
How long? 
 
 
Dosage  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Name of Administering Staff 
 
 
Signature of Staff Member 
 
 
Date

Attachment 3 – Physical Activity Readiness Questionnaire 
1 
 
 
Physical Activity Readiness Questionnaire 
 
General Health Questions 
Read the questions below and honestly check: YES or NO 
YES 
NO 
1) Has your doctor ever said you have a heart condition □ or high blood pressure □? 
 
 
2) Do you feel pain in your chest at rest, during your daily activities, or when you 
perform physical activity? 
 
 
3) Do you lose balance because of dizziness OR have you lost consciousness in the last 
12 months? Please answer NO if your dizziness was associated with over-breathing 
during vigorous exercise. 
 
 
4) Have you ever been diagnosed with another chronic medical condition other than 
heart disease or high blood pressure? Please list: ____________________________ 
 
 
5) Are you currently taking prescribed medications for a chronic medical condition? 
Please list condition(s) and medication(s): _________________________________ 
 
 
6) Do you currently have (or have had within the past 12 months) a bone, joint, or soft 
tissue (muscle, ligament, or tendon) problem that could be made worse by becoming 
more physically active? Please answer NO if you had a problem in the past, but it 
does not limit your current ability to be physically active. 
 
 
7) Has your doctor ever said that you should only do medically supervised physical 
activity?  
 
 
 
If you answered NO to all of the questions above, you are cleared for physical activity.  
 
 
 
 
 
Name: __________________________________   Date: ___________________________________ 
Signature: _______________________________   Witness: ______________________________

Attachment 4 – Colorado State University Acknowledgement of Research Collaboration with UW 
1 
 
 
From: Bell,Christopher <Christopher.Bell@ColoState.EDU>  
Sent: Thursday, February 21, 2019 2:39 PM 
To: Felton-Noyle,Tammy <Tammy.Felton-Noyle@colostate.edu> 
Cc: Evan C. Johnson <evan.johnson@uwyo.edu> 
Subject: Question about request for CSU IRB to cede to UW IRB 
  
Hi Tammy 
  
I’ve been invited to collaborate with a researcher from University of Wyoming, Dr. Evan Johnson 
(cc’d).  University of Wyoming will be the primary data collection site, and Dr. Johnson will be the 
project PI, but we hope that some data can be collected here at CSU (e.g. some screening, blood 
and urine samples).  Can you remind me of what materials we will need to submit to you as part of 
a request for CSU to cede to the University of Wyoming IRB? 
  
Thanks,  
Chris 
--- 
Christopher Bell, Ph.D. 
Department of Health and Exercise Science 
1582 Campus Delivery 
205E Moby B Complex 
Colorado State University 
Fort Collins 
Colorado 
80523-1582 
USA 
 
Telephone: 970-491-7522 
Fax: 970-491-0445 
 
 
From: "Felton-Noyle,Tammy" <Tammy.Felton-Noyle@colostate.edu> 
Date: Thursday, February 21, 2019 at 2:57 PM 
To: Christopher Bell <Christopher.Bell@ColoState.EDU> 
Cc: "Evan C. Johnson" <evan.johnson@uwyo.edu>, Carolyn Broccardo <Carolyn.Broccardo@uwyo.edu> 
Subject: RE: Question about request for CSU IRB to cede to UW IRB 
  
That is great!! I am cc’ing a fantastic friend and colleague up that way. 
 If you can share with us the following: 
·         Protocol # 
·         Protocol Title 
·         Copy of currently approved protocol. 
·         Is this federally funded? 
·         Provide whether there is a pending amendment to include CSU as a research site. 
·         Will you be doing the same work just a CSU or will you be delegated to different work? 
Carolyn, I just want to pull in you in the loop and we can discuss when more information is gathered! 
At your service, 
  
Tammy L. Felton-Noyle, CIP, CCRP 
Research Integrity and Compliance Review Office 
Colorado State University 
Phone: (970) 491-1655 
Fax: (970) 491-2293 

Attachment 4 – Colorado State University Acknowledgement of Research Collaboration with UW 
2 
 
 
On Thu, Feb 21, 2019 at 3:01 PM Bell,Christopher <Christopher.Bell@colostate.edu> wrote: 
  
Thanks Tammy. 
Hello Carolyn! 
We’ll be back in touch with you both again soon. 
Thanks, 
Chris 
 
From: Evan C. Johnson <evan.johnson@uwyo.edu>  
Sent: Thursday, February 21, 2019 3:09 PM 
To: Bell,Christopher <Christopher.Bell@ColoState.EDU> 
Cc: Felton-Noyle,Tammy <Tammy.Felton-Noyle@colostate.edu>; Carolyn Broccardo <Carolyn.Broccardo@uwyo.edu> 
Subject: Re: Question about request for CSU IRB to cede to UW IRB 
  
Thank you Tammy and Carolyn - 
  
This is Evan Johnson from UW here.  We are in the process of our initial submission and I just wanted to make 
sure we were getting out ahead of the curve for our application.  We don't have much of the information you 
requested above, but we do have a title, 
  
"Risk Factors Related to Acute Renal Injury during a Mass Participation High Intensity Functional 
Resistance Training Event"  
I know it's not the most poetic, but it gets the point across.   
  
I will keep everyone updated as we progress through our initial approval.  Thank you! 
  
-Evan 
 
Felton-Noyle,Tammy via uwy.onmicrosoft.com  
3:37 PM (4 
hours ago)
to Carolyn, Evan, Christopher 
This is great, then! We are getting in on the development side!! Far easier! As you write your submission, please 
be sure to include CSU as a research site and include what activities will be done here. As you are the primary, we 
would be willing to cede IRB review to UW’s IRB and can work with Carolyn to do this in parallel to the IRB review 
process. 
  
Looking forward to working with all of you. 
 
  
Tammy 
At your service, 
  
Tammy L. Felton-Noyle, CIP, CCRP 
Research Integrity and Compliance Review Office 
Colorado State University 
Phone: (970) 491-1655 
Fax: (970) 491-2293 
Website: https://vprnet.research.colostate.edu/RICRO/ 
 
 
 

Attachment 5 – McGill Pain Scale 
1 
 
 
 
SHORT-FORM MCGILL PAIN QUESTIONNAIRE 
 
Patient’s Name: _______________________  
 
Date: _____________________________ 
 
 
 
 
None  
 
Mild  
 
Moderate 
 
Severe 
Throbbing 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Shooting 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Stabbing 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Sharp  
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Cramping 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Gnawing 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Hot-buring 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Aching 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Heavy  
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Tender 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Splitting 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Tiring-Exhausting 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Sickening 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Fearful 
 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
Punishing-Cruel 
0) _______  
 
1) ______  
 
2)_______  
 
3)_______ 
 
Visual Analog Scale (VAS) 
 
No Pain 
 
 
 
 
 
 
 
      Worst Possible Pain 
 

Attachment 5 – McGill Pain Scale 
1 
 
 
Present Pain Intensity 
0) No Pain  
  
_____ 
1) Mild          
 
_____ 
2) Discomforting 
_____ 
3) Distressing 
 
_____ 
4) Horrible 
 
_____ 
5) Excruciating  
_____ 

Attachment 6 – Photo Release Form 
1 
 
 
 
 
 
 
 
 

Attachment 7- Training History Questionnaire 
 
 
 
As a part of this study, you will be completing the workout “Murph” (1-mile run, 100 pull-ups, 200 push-
ups, 300 body-weight squats, and a final 1-mile run) within an estimated 1 – 2 hours.  
This is a high intensity, large volume exercise session that should not be completed by an individual that 
is not properly trained.  The following questionnaire ensures that you have completed Murph previously 
and confirms the difficulty level of that previous experience so that this workout will not introduce 
excessive risk of musculoskeletal and/or kidney injury.  
 
1. On how many occasions have you completed “Murph” in the past? 
• Once 
• Twice 
• Three times 
• Other (how many times?) _________ 
 
2. Please check the last version of “Murph”, you completed below.  
       Prescribed Repetitions: 1-mile run, 100 Pull-Ups, 200 Push-Ups, 300 Air-Squats, 1-mile run 
Cindy Repetitions: 1-mile run, 20 rounds of: 5 Pull-Ups, 10 Push-Ups, 15 Air Squats, 1-mile run 
 
• I have never performed Murph 
• Prescribed repetitions with a 20lb weighted vest 
• Cindy style repetitions with a weighted vest 
• Prescribed repetitions without a weighted vest 
• Cindy Style repetitions without a weighted vest 
• Other (e.g., modified push-ups, pull-ups, air-squats, run, or other scales) 
o Describe modified version here_______________________________________________ 
 
3. On average how many times per week over the past 1 year have you participated in high intensity 
resistance training exercise (e.g., CrossFit classes, Gym based high intensity interval training)?  
□ <1X per week 
    
□ 1X per week  
   □ 2X per week 
   □ 3 or more X per week 
4. How many times years have you participated in high intensity resistance training exercise (e.g., 
CrossFit classes, Gym based high intensity interval training)?  
□ 1 year 
    
□ 2 years 
   □ 3 years 
   □ Other (describe)______________________ 
5. What other training do you take part in on at least a weekly basis? 
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________ 

Attachment 8- Confirmation for the University of Wyoming’s registration    as official host of “The 
Murph Challenge” 
 
 
 
 

Attachment 9 – Colorado State University – Collaboration Acknowledgement 
 
 
 
 
 

Attachement 10 – Additional Student Researchers 
 
 
 
 
Carson Keeter 
Miranda Zamora 
Carly Hibbs 
Joshua Loseke 
Brittney Wells 
Lauren Elliot 
Summer Taube 
Emelda Malm-Anann 
Riley Veis 
 
 

Attachement 11 – Daniel Murphy – Research within charity event approval e-mails 
 
 
 
 
 
 
 
 
 

Attachement 11 – Daniel Murphy – Research within charity event approval e-mails 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Attachement 11 – Daniel Murphy – Research within charity event approval e-mails