Thermoregulatory Considerations for the Performance of Exercise in SCI

Brunt, Vienna E.

doi:10.1007/978-1-4939-6664-6_7

Cited by 3 publications

(3 citation statements)

References 127 publications

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“…To regulate body core temperature (Tc), it is essential that the produced heat can be dissipated rapidly [ 7 ]. The primary thermoregulatory reflexes to dissipate heat are: an increase in sweating for evaporative heat loss and an increase in skin blood flow for heat loss by convection and radiation [ 7 , 8 ]. Thus, the higher the lesion level, the larger the risk for overheating and consequently for reduced performance or heat-related illnesses (e.g., dizziness, heatstroke) in athletes with SCI [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Fluid Balance and Thermoregulatory Responses during Wheelchair Basketball Games in Hot vs. Temperate Conditions

et al. 2022

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The impaired vaso- and sudomotor functions limit sweat capacity in individuals with a spinal cord injury (SCI) and might increase the risk for heat-related illness and decreased performance, especially in hot conditions (HOT). This study investigated the differences in fluid balance and thermal responses between wheelchair basketball (WCB) games in HOT and temperate conditions (TMP). Eleven male WCB athletes (39.8 y, 82.8 kg) with SCI (lesion level C5-L4) participated, five in HOT (31 °C) and eight in TMP games (21 °C). Fluid balance, sweat rate, body core temperature, distance, velocity and thermal sensation were assessed. The relative change in body mass was higher in the HOT group (median: −0.35%, interquartile-range: 0.15%, p = 0.02) compared to TMP (+0.11%, 0.35%) group. The sweat rate was significantly higher in the HOT group (0.93 L/h, 0.58 L/h, p = 0.02) compared to the TMP groups (0.48 L/h, 0.19 L/h). Body core temperature increased significantly higher in the TMP group (1.05 °C, 0.15 °C, p = 0.01) compared to the HOT group (0.8 °C, 0.4 °C). The mean velocity (HOT: 1.12 m/s, 0.11 m/s, TMP: 1.07 m/s, 0.08 m/s, p = 0.54) did not differ between the games. The WCB game in HOT leads to significantly higher sweat rate and loss in body mass compared to TMP. Even relative body mass loss was less than 2%. Athletes thus have to be supported with enough fluid, especially during games in HOT.

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Section: Introductionmentioning

confidence: 99%

Fluid Balance and Thermoregulatory Responses during Wheelchair Basketball Games in Hot vs. Temperate Conditions

et al. 2022

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“…Circulating blood from the active limbs likely contributes to the robust temperature sensitivity, as warmed venous return from the working limbs directly impacts temperature conduction through the pulmonary artery to the level of the esophageal probe. Upper-limb exercise also results in greater heat production due to poor work efficiency (compared to the lower limbs), as well as less afferent input to the central nervous system resulting in greater heat storage [18]. It has been previously suggested that T int might be impacted by the location of the pill in the intestinal tract, and as such, there have been recommendations to standardize pill ingestion 6 hours prior to measurement time for optimal intestinal transit time [9].…”

Section: Discussionmentioning

confidence: 99%

“…However, given the known differences in both gut motility [10] and abdominal skin temperature with higher level SCI [11,12], it is unknown whether the telemetric pill provides equally sensitive assessment of T core in all individuals with SCI. Furthermore, much of the SCI thermoregulation research has been conducted in athletes with SCI [7,11,[13][14][15][16], with relatively little knowledge on the generalizability of methods to untrained adults with SCI who may have altered thermoregulatory sensitivity to exercise [17] and lower levels of heat production related to reduced aerobic capacity [18]. The ability to rely on non-invasive methods to estimate exerciseor environment-induced T core elevations is particularly important to untrained adults with SCI who are not habitually exposed to temperature stressors, and therefore may be at elevated risk for heat stress exposure.…”

Section: Introductionmentioning

confidence: 99%

Comparison between esophageal and intestinal temperature responses to upper-limb exercise in individuals with spinal cord injury

Kamijo

Goosey‐Tolfrey

et al. 2019

Spinal Cord

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Study Design: Experimental study. Objective: Individuals with spinal cord injuries (SCI) may present with impaired sympathetic control over thermoregulatory responses to environmental and exercise stressors, which can impact regional core temperature (T core) measurement. The purpose of this study was to investigate whether regional differences in T core responses exist during exercise in individuals with SCI. Setting: Rehabilitation centre in Wakayama, Japan. Methods: We recruited 12 men with motor-complete SCI (7 tetraplegia, 5 paraplegia) and 5 able-bodied controls to complete a 30-minute bout of arm-cycling exercise at 50% V O 2 peak. T core was estimated using telemetric pills (intestinal temperature; T int) and esophageal probes (T eso). Heat storage was calculated from baseline to 15 and 30 minutes of exercise. Results: At 15 minutes of exercise, elevations in T eso (Δ0.39±0.22˚C; P<0.05), but not T int (Δ0.04±0.18˚C; P=0.09), were observed in able-bodied men. At 30 minutes of exercise, men with paraplegia and able-bodied men both exhibited increases in T eso (paraplegia: Δ0.56±0.30˚C, P<0.05; able-bodied men: Δ0.60±0.31˚C, P<0.05) and T int (paraplegia: Δ0.38±0.33˚C, P<0.05; able-bodied men: Δ0.30±0.30˚C, P<0.05). T eso began rising 7.2 min earlier than T int (pooled, P<0.01). Heat storage estimated by T eso was greater than heat storage estimated by T int at 15 minutes (P=0.02) and 30 minutes (P=0.03) in men with paraplegia. No elevations in T eso , T int , or heat storage were observed in men with tetraplegia. Conclusions: While not interchangeable, both T eso and T int are sensitive to elevations in T core during arm-cycling exercise in men with paraplegia, although T eso may have superior sensitivity to capture temperature information earlier during exercise.

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Human temperature regulation under heat stress in health, disease, and injury

Cramer

Gagnon

Laitano

et al. 2022

Physiological Reviews

115

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The human body constantly exchanges heat with the environment. Temperature regulation is a homeostatic feedback control system that ensures deep body temperature is maintained within narrow limits despite wide variations in environmental conditions and activity-related elevations in metabolic heat production. Extensive research has been performed to study the physiological regulation of deep body temperature. This review focuses on healthy and disordered human temperature regulation during heat stress. Central to this discussion is the notion that various morphological features, intrinsic factors, diseases, and injuries independently and interactively influence deep body temperature during exercise and/or exposure to hot ambient temperatures. The first sections review fundamental aspects of the human heat stress response, including the biophysical principles governing heat balance and the autonomic control of heat loss thermoeffectors. Next, we discuss the effects of different intrinsic factors (morphology, heat adaptation, biological sex, and age), diseases (neurological, cardiovascular, metabolic, and genetic), and injuries (spinal cord injury, deep burns, and heat stroke), with emphasis on the mechanisms by which these factors enhance or disturb the regulation of deep body temperature during heat stress. We conclude with key unanswered questions in this field of research.

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Thermoregulatory Considerations for the Performance of Exercise in SCI

Cited by 3 publications

References 127 publications

Fluid Balance and Thermoregulatory Responses during Wheelchair Basketball Games in Hot vs. Temperate Conditions

Fluid Balance and Thermoregulatory Responses during Wheelchair Basketball Games in Hot vs. Temperate Conditions

Comparison between esophageal and intestinal temperature responses to upper-limb exercise in individuals with spinal cord injury

Human temperature regulation under heat stress in health, disease, and injury

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