Research Spotlight: Cory Smith, PhD

Before entering the field of academia, Cory Smith, PhD, Assistant Professor in the Department of Health, Human Performance, and Recreation, worked as an emergency medical technician. “I was always interested in what was going on with all of the patients and wanted to dive deeper,” he says. When he decided to pursue his PhD, he “naturally fell into the interest of human physiology and, specifically, applied physiology, looking at that translation between what research is finding and how we can apply that to actually improve the quality of life of patients.”

The populations Dr. Smith is most interested in are military members and occupational workers in extreme environments. “There’s a big gap in research and the support of those individuals,” he notes.

Dr. Smith describes his research team’s move to Baylor from the University of Texas in Fall 2022 as “a great transition.” His reasoning for making the transition was two-fold: first, the prestige of Baylor, “the ability to work with high-quality individuals, which has already resulted in impactful projects from the clinical side of research to our occupational and environmental research,” and secondly, Baylor’s rich history with the military. Dating back to 1888, Baylor has been involved in military education and ROTC programs, with Robbins College itself offering Military-Baylor graduate programs in Nutrition, Occupational Therapy, Physical Therapy, and Physician Assistant Studies. The value that the University places on military members’ health, survivability, and performance made the transition to Baylor “an easy decision.”

His current occupational research deals with “the physical, cognitive, and task performance of humans in austere environments,” which range from cold and high-altitude environments to low-gravity simulations of lunar conditions for astronauts. The research team targets neurophysiological biofeedback, exploring how the brain functions when exposed to these environments but not accustomed to them.

“That’s what separates our work from what’s been done in the past,” Dr. Smith comments. Previously, research on environments has focused on individual stressors, such as cold or altitude alone, assuming that negative affects simply add to each other. However, from anecdotal and patient experience, “that doesn’t seem to be the case.”

Upon investigation, Dr. Smith has found that in multi-stressor environments—the most common environments encountered in military service—the result of combining stressors is not always additive and sometimes can result in opposing responses.

Also, the majority of research is conducted on people who are acclimatized, meaning they have been living in cold, high-altitude environments for extended time periods and developed physical adaptations. However, as Dr. Smith explains, “With today’s rapid travel, we’re able to take an individual from Texas and have them in Alaska by tomorrow morning, and we are not acclimatized. It takes weeks and months of constant exposure to get those adaptations.”

The team’s most recent study examined the impacts of cold and high altitude on marksmen. The marksmen performed simulated tasks, and the study measured their accuracy and decision-making. “Are they engaging the target correctly? Are they doing their job correctly? That ultimately means their survivability, health, and mission success.”

Through these experiments, Dr. Smith found that, when adding hypoxia (lack of sufficient oxygen) to cold, the reactions were completely different than with cold alone. When exposed to only acute cold, the marksmen’s dexterity and cognition dropped, resulting in poor performance, but when completing operational tasks, their perception of their temperature changed and improved performance dramatically.

However, the cold and high altitude group showed none of the deficits of the group exposed to cold alone. This was because their perception of the cold was affected by the hypoxic conditions. “They stopped caring as much [about the cold],” Dr. Smith says, a telltale sign of low blood oxygen. After physical exertion, which increased their oxygen, performance worsened significantly, showing that complex environments alter performance and responses much differently than individual stressors.

Other active studies by Dr. Smith and his team include a project to develop an algorithm for determining when pilots will start to make poor decisions under hypoxic conditions. The need for this type of research was highlighted recently through the news story involving a pilot who experienced a hypoxic event while flying over Washington, D.C. “If they had something that would have alerted them, they would have known that they needed to decrease altitude or get supplemental oxygen,” he says.

Future studies currently in submission will—both medically and performance-wise—support the United States’ military goal of reestablishing Arctic dominance. Because of this goal, more unacclimatized individuals are traveling to austere areas in the Arctic. Dr. Smith’s potential study involves walking donors, people who can immediately give blood donations to people near them. It will involve extracting 500 milliliters of blood and then exposing these individuals to cold and hypoxic environments as if they were deployed to the Arctic. Researchers will then analyze blood flow and task performance.

“In other words,” Dr. Smith says, “we’re looking at how blood loss in these complex environments impacts the physiology of our soldiers.” By understanding these impacts, the military can improve standard operating procedures, which are currently unclear and assume that everyone, including men and women, can give the same amount of blood. Especially in complex environments, this can place women at a higher risk of detrimental side effects.

Dr. Smith is also fostering a relationship with Dr. Jason Carter, Dean of the Robbins College, and Dr. Michael Scullin, Associate Professor of Psychology and Neuroscience. Both Dr. Carter and Dr. Scullin conduct research on sleep, and the research relationship would be “designed to examine how we can optimize performance, sleep, and safety of our soldiers in these Arctic environments.”

By combining his medical and environmental physiology backgrounds and his passion for military support, Dr. Smith is helping to close the gaps in research on this population and improve their overall health and quality of life.