The importance of using infrared thermography (IRT) to assess skin temperature (t) is increasing in clinical settings. Recently, its use has been increasing in sports and exercise medicine; however, no consensus guideline exists to address the methods for collecting data in such situations. The aim of this study was to develop a checklist for the collection of t using IRT in sports and exercise medicine. We carried out a Delphi study to set a checklist based on consensus agreement from leading experts in the field. Panelists (n = 24) representing the areas of sport science (n = 8; 33%), physiology (n = 7; 29%), physiotherapy (n = 3; 13%) and medicine (n = 6; 25%), from 13 different countries completed the Delphi process. An initial list of 16 points was proposed which was rated and commented on by panelists in three rounds of anonymous surveys following a standard Delphi procedure. The panel reached consensus on 15 items which encompassed the participants' demographic information, camera/room or environment setup and recording/analysis of t using IRT. The results of the Delphi produced the checklist entitled "Thermographic Imaging in Sports and Exercise Medicine (TISEM)" which is a proposal to standardize the collection and analysis of t data using IRT. It is intended that the TISEM can also be applied to evaluate bias in thermographic studies and to guide practitioners in the use of this technique.
Thirteen male instructors were monitored during a total of 44 live fire training exercises (ambient temperature 74+/-42 degrees C). Exposure time during the 'Hot Fire' (HF), 'Fire Behaviour' and 'Fire Attack' exercises was 33.0+/-7.9 min (n=30); 26.3+/-5.5 min (n=6); and 7.3+/-2.6 min (n=8) respectively. At the end of the exercises, mean core temperature (t(core)) was 38.5+/-0.9 degrees C (n=32), however eight instructors had a t(core) above 39 degrees C. The mean maximum temperature under the fire hood was 41.2+/-4.6 degrees C (n=40). Mean maximum heart rate (HR) was 138+/-26 bpm (n=34) however, in five exercises, HR exceeded 90% of the instructors' HR reserve. Mean fluid deficit was 0.62+/-0.6 l (n=30) at the end of the HF exercises, the maximum being 2.54 l. Four instructors doubted their ability to perform a rescue at the end of the exercise. The energy cost of performing simulated rescues of a 50 kg dummy in the cool was investigated in a pilot study. Mean HR during the rescues was 79+/-7% of the instructors' HR reserve and it was estimated that this could increase t(core) by 0.4 to 0.6 degrees C. The physiological responses to the fire-fighting exercises varied considerably and reflected the differences in work performed and external heat load. The results obtained from some individuals give cause for concern, and signs of heat strain were seen in at least two individuals.
AFD experienced a more intense protracted finger vasoconstriction than CAU during hand immersion, whilst ASN experienced an intermediate response. This greater sensitivity to cold may explain why AFD are more susceptible to cold injuries.
BackgroundOne of the chronic symptoms of non-freezing cold injury (NFCI) is cold sensitivity. This study examined the effects of prior exercise on the response to a cold sensitivity test (CST) in NFCI patients with the aim of improving diagnostic accuracy.MethodsTwenty three participants, previously diagnosed with NFCI by a Cold Injuries Clinic, undertook two CSTs. Participants either rested (air temperature 31°C) for approximately 80 min (prior rest condition (REST)) or rested for 30 min before exercising gently for 12 min (prior exercise condition (EX)). Following REST and EX, the participants placed their injured foot, covered in a plastic bag, into 15°C water for 2 min; this was followed by spontaneous rewarming in 31°C air for 10 min.ResultsThe great toe skin temperature (Tsk) before immersion averaged 32.5 (3.4)°C in both conditions. Following immersion, the rate of rewarming of the great toe Tsk was faster in EX compared to REST and was higher 5 min (31.7 (3.4)°C vs. 29.8 (3.4)°C) and 10 min (33.8 (4.0)°C vs. 32.0 (4.0)°C) post-immersion. Over the first 5 min of rewarming, changes in the great toe Tsk correlated with the changes in skin blood flow (SkBF) in EX but not the REST condition. No relationship was observed between Tsk in either CST and the severity of NFCI as independently clinically assessed.ConclusionsExercise prior to the CST increased the rate of the toe Tsk rewarming, and this correlated with the changes in SkBF. However, the CST cannot be used in isolation in the diagnosis of NFCI, although the EX CST may prove useful in assessing the severity of post-injury cold sensitivity for prognostic and medico-legal purposes.
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