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ALKEMADE PUCK, DE KORTE JOHANNUSQ, BONGERS COENCWG, DAANEN HEINAM, HOPMAN MARIATE, JANSSEN THOMASWJ, EIJSVOGELS THIJSMH. Humid Heat Equally Impairs Maximal Exercise Performance in Elite Para-Athletes and Able-Bodied Athletes. Med Sci Sports Exerc 2023; 55:1835-1844. [PMID: 37227231 PMCID: PMC10487364 DOI: 10.1249/mss.0000000000003222] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE This study aimed to compare the impact of hot-humid environmental conditions on performance outcomes, thermoregulatory responses, and thermal perception during exercise between elite para- and able-bodied (AB) athletes. METHODS Twenty elite para-athletes (para-cycling and wheelchair tennis) and 20 elite AB athletes (road cycling, mountain biking, beach volleyball) performed an incremental exercise test in a temperate environment (mean ± SD, 15.2°C ± 1.2°C; relative humidity, 54% ± 7%) and a hot-humid environment (31.9°C ± 1.6°C, 72% ± 5%). Exercise tests started with a 20-min warm-up at 70% of maximal heart rate, after which power output increased by 5% every 3 min until volitional exhaustion. RESULTS Time to exhaustion was shorter in hot-humid versus temperate conditions, with equal performance loss for para- and AB athletes (median (interquartile range), 26% (20%-31%) vs 27% (19%-32%); P = 0.80). AB athletes demonstrated larger exercise-induced increases in gastrointestinal temperature (T gi ) in hot-humid versus temperate conditions (2.2 ± 0.7 vs 1.7 ± 0.5, P < 0.001), whereas T gi responses in para-athletes were similar between conditions (1.3 ± 0.6 vs 1.3 ± 0.4, P = 0.74). Para- and AB athletes showed similar elevations in peak skin temperature ( P = 0.94), heart rate ( P = 0.67), and thermal sensation score ( P = 0.64) in hot-humid versus temperate conditions. CONCLUSIONS Elite para-athletes and AB athletes demonstrated similar performance decrements during exercise in hot-humid versus temperate conditions, whereas T gi elevations were markedly lower in para-athletes. We observed large interindividual variation within both groups, suggesting that in both para- and AB athletes, personalized heat mitigation plans should be developed based on individual thermal testing.
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Affiliation(s)
- PUCK ALKEMADE
- Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, THE NETHERLANDS
| | - JOHANNUS Q. DE KORTE
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, THE NETHERLANDS
| | - COEN C. W. G. BONGERS
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, THE NETHERLANDS
| | - HEIN A. M. DAANEN
- Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, THE NETHERLANDS
- Amsterdam Institute of Sport Science, Amsterdam, THE NETHERLANDS
| | - MARIA T. E. HOPMAN
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, THE NETHERLANDS
| | - THOMAS W. J. JANSSEN
- Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, THE NETHERLANDS
- Amsterdam Institute of Sport Science, Amsterdam, THE NETHERLANDS
| | - THIJS M. H. EIJSVOGELS
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, THE NETHERLANDS
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Goods PS, Maloney P, Miller J, Jennings D, Fahey-Gilmour J, Peeling P, Galna B. Concurrent validity of the CORE wearable sensor with BodyCap temperature pill to assess core body temperature during an elite women's field hockey heat training camp. Eur J Sport Sci 2023:1-9. [PMID: 36939844 DOI: 10.1080/17461391.2023.2193953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
AbstractWearable temperature sensors offer the potential to overcome several limitations associated with current laboratory- and field-based methods for core temperature assessment; however, their ability to provide accurate data at elevated core temperatures (Tc) has been questioned. Therefore, this investigation aimed to determine the concurrent validity of a wearable temperature sensor (CORE) compared to a reference telemetric temperature pill (BodyCAP) during a team-sport heat training camp prior to the 2020 Olympic Games. Female field hockey players (n = 19) in the Australian national squad completed 4 sessions in hot conditions where their temperature was monitored via CORE and BodyCAP. Concurrent validity of the wearable CORE device was determined with reference to the ingested BodyCAP pill. Lin's Concordance Correlation Coefficients determined there was 'poor' agreement between devices during all sessions. Mean bias demonstrated that CORE underestimated Tc in all sessions (-0.06°C to -0.34°C), with wide mean 95% confidence intervals (±0.35°C to ±0.56°C). Locally estimated scatterplot smoothing regression lines illustrated a non-linearity of error, with greater underestimation of Tc by the CORE device, as Tc increased. The two devices disagreed more than ±0.3°C for 41-60% of all data samples in each session. Our findings do not support the use of the CORE device as a valid alternative to telemetric temperature pills for Tc assessment, particularly during exercise in hot conditions where elevated Tc are expected.
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Affiliation(s)
- Paul Sr Goods
- Murdoch Applied Sports Science Laboratory, School of Allied Health, Murdoch University, Perth, Western Australia, Australia.,Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Perth, Western Australia, Australia.,Western Australian Institute of Sport, Mt Claremont, WA, Australia
| | - Peta Maloney
- REST Hub, Australian Institute of Sport, Canberra, ACT, Australia
| | - Joanna Miller
- REST Hub, Australian Institute of Sport, Canberra, ACT, Australia
| | - Denise Jennings
- Hockey Australia High Performance Program, Perth, WA, Australia
| | | | - Peter Peeling
- Western Australian Institute of Sport, Mt Claremont, WA, Australia.,School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Brook Galna
- Murdoch Applied Sports Science Laboratory, School of Allied Health, Murdoch University, Perth, Western Australia, Australia.,Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Perth, Western Australia, Australia
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Alkemade P, Daanen HAM, Janssen TWJ, Broad E, Goosey-Tolfrey VL, Ibusuki T, Kneepkens H, Périard JD, Eijsvogels TMH. Heat preparedness and exertional heat illness in Paralympic athletes: A Tokyo 2020 survey. Temperature (Austin) 2022; 10:264-275. [PMID: 37332304 PMCID: PMC10274519 DOI: 10.1080/23328940.2022.2147364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022] Open
Abstract
Paralympic athletes may be at increased risk for exertional heat illness (EHI) due to reduced thermoregulatory ability as a consequence of their impairment. This study investigated the occurrence of heat-stress related symptoms and EHI, and the use of heat mitigation strategies in Paralympic athletes, both in relation to the Tokyo 2020 Paralympic Games and previous events. Paralympic athletes competing in Tokyo 2020 were invited to complete an online survey five weeks prior to the Paralympics and up to eight weeks after the Games. 107 athletes (30 [24-38] years, 52% female, 20 nationalities, 21 sports) completed the survey. 57% of respondents had previously experienced heat-stress related symptoms, while 9% had been medically diagnosed with EHI. In Tokyo, 21% experienced at least one heat-stress related symptom, while none reported an EHI. The most common symptom and EHI were, respectively, dizziness and dehydration. In preparation for Tokyo, 58% of respondents used a heat acclimation strategy, most commonly heat acclimatization, which was more than in preparation for previous events (45%; P = 0.007). Cooling strategies were used by 77% of athletes in Tokyo, compared to 66% during past events (P = 0.18). Cold towels and packs were used most commonly. Respondents reported no medically-diagnosed EHIs during the Tokyo 2020 Paralympic Games, despite the hot and humid conditions in the first seven days of competition. Heat acclimation and cooling strategies were used by the majority of athletes, with heat acclimation being adopted more often than for previous competitions.
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Affiliation(s)
- Puck Alkemade
- Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Hein A. M. Daanen
- Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Thomas W. J. Janssen
- Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | | | - Victoria L. Goosey-Tolfrey
- Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LeicestershireLE11 3TU, UK
| | - Tatsuru Ibusuki
- Department of Rehabilitation Medicine, Akeno Central Hospital, Oita, Japan
| | - Hiske Kneepkens
- Sport Medisch Centrum Papendal, NOC*NSF, Arnhem, The Netherlands
| | - Julien D. Périard
- University of Canberra Research Institute for Sport and Exercise, Bruce, New south wales, Australia
| | - Thijs M. H. Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
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Teunissen LPJ, Jansen KMB, Janssen E, Kingma BRM, de Korte JQ, Eijsvogels TMH. Impact of different climatic conditions on peak core temperature of elite athletes during exercise in the heat: a Thermo Tokyo simulation study. BMJ Open Sport Exerc Med 2022; 8:e001313. [PMID: 35813127 PMCID: PMC9234798 DOI: 10.1136/bmjsem-2022-001313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2022] [Indexed: 11/04/2022] Open
Abstract
Objectives To evaluate how separate and combined climatic parameters affect peak core temperature during exercise in the heat using computer simulations fed with individual data. Methods The impact of eight environmental conditions on rectal temperature (Tre) was determined for exercise under heat stress using the Fiala-thermal-Physiology-and-Comfort simulation model. Variations in ambient temperature (Ta±6°C), relative humidity (RH±15%) and solar radiation (SR+921 W/m2) were assessed in isolation and combination (worst-case/best-case scenarios) and compared with baseline (Ta32°C, RH 75%, SR 0 W/m2). The simulation model was fed with personal, anthropometric and individual exercise characteristics. Results 54 athletes exercised for 46±10 min at baseline conditions and achieved a peak core temperature of 38.9±0.5°C. Simulations at a higher Ta (38°C) and SR (921 W/m2) resulted in a higher peak Tre compared with baseline (+0.6±0.3°C and +0.5±0.2°C, respectively), whereas a higher RH (90%) hardly affected peak Tre (+0.1±0.1°C). A lower Ta (26°C) and RH (60%) reduced peak Tre by −0.4±0.2°C and a minor −0.1±0.1°C, respectively. The worst-case simulation yielded a 1.5±0.4°C higher Tre than baseline and 2.0±0.7°C higher than the best-case condition. Conclusion Combined unfavourable climatic conditions produce a greater increase in peak core temperature than the sum of its parts in elite athletes exercising in the heat.
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Affiliation(s)
- Lennart P J Teunissen
- Department of Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Kaspar M B Jansen
- Department of Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Emiel Janssen
- Department of Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Boris R M Kingma
- Department of Training & Performance Innovations, TNO, Unit Defence, Safety & Security, Soesterberg, The Netherlands
| | - Johannus Q de Korte
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
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de Korte JQ, Veenstra BJ, van Rijswick M, Derksen EJK, Hopman MTE, Bongers CCWG, Eijsvogels TMH. A Heart Rate Based Algorithm to Estimate Core Temperature Responses in Elite Athletes Exercising in the Heat. Front Sports Act Living 2022; 4:882254. [PMID: 35813051 PMCID: PMC9256956 DOI: 10.3389/fspor.2022.882254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Non-invasive non-obtrusive continuous and real-time monitoring of core temperature (Tc) may enhance pacing strategies, the efficacy of heat mitigation measures, and early identification of athletes at risk for heat-related disorders. The Estimated Core Temperature (ECTemp™) algorithm uses sequential heart rate (HR) values to predict Tc. We examined the validity of ECTemp™ among elite athletes exercising in the heat. Methods 101 elite athletes performed an exercise test in simulated hot and humid environmental conditions (ambient temperature: 31.6 ± 1.0°C, relative humidity: 74 ± 5%). Tc was continuously measured using a validated ingestible telemetric temperature capsule system. In addition, HR was continuously measured and used to compute the estimated core temperature (Tc-est) using the ECTemp™ algorithm. Results Athletes exercised for 44 ± 10 min and n = 5,025 readouts of Tc (range: 35.8-40.4°C), HR (range: 45-207 bpm), and Tc-est (range: 36.7-39.9°C) were collected. Tc-est demonstrated a small yet significant bias of 0.15 ± 0.29°C (p < 0.001) compared to Tc, with a limit of agreement of ±0.45°C and a root mean square error of 0.35 ± 0.18°C. Utilizing the ECTemp™ algorithm as a diagnostic test resulted in a fair to excellent sensitivity (73-96%) and specificity (72-93%) for Tc-est thresholds between 37.75 and 38.75°C, but a low to very-low sensitivity (50-0%) for Tc-est thresholds >39.0°C, due to a high prevalence of false-negative observations. Conclusion ECTemp™ provides a valuable and representative indication of thermal strain in the low- to mid-range of Tc values observed during exercise in the heat. It may, therefore, be a useful non-invasive and non-obtrusive tool to inform athletes and coaches about the estimated core temperature during controlled hyperthermia heat acclimation protocols. However, the ECTemp™ algorithm, in its current form, should not solely be used to identify athletes at risk for heat-related disorders due to low sensitivity and high false-negative rate in the upper end of the Tc spectrum.
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Affiliation(s)
- Johannus Q. de Korte
- Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Bertil J. Veenstra
- Institute of Training Medicine & Training Physiology, TGTF, Royal Netherlands Army, Utrecht, Netherlands
| | - Mark van Rijswick
- Institute of Training Medicine & Training Physiology, TGTF, Royal Netherlands Army, Utrecht, Netherlands
| | - Eline J. K. Derksen
- Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Maria T. E. Hopman
- Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Coen C. W. G. Bongers
- Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Thijs M. H. Eijsvogels
- Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
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Impact of thermal sensation on exercise performance in the heat: a Thermo Tokyo sub-study. Eur J Appl Physiol 2021; 122:437-446. [PMID: 34797439 DOI: 10.1007/s00421-021-04845-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Thermal perception, including thermal sensation (TS), influences exercise performance in the heat. TS is a widely used measure and we examined the impact of initial TS (iTS) on performance loss during exercise in simulated Tokyo environmental conditions among elite athletes. METHODS 105 Elite outdoor athletes (endurance, skill, power and mixed trained) participated in this crossover study. Participants performed a standardized exercise test in control (15.8 ± 1.2 °C, 55 ± 6% relative humidity (RH)) and simulated Tokyo (31.6 ± 1.0 °C, 74 ± 5% RH) conditions to determine performance loss. TS was assessed ± 5 min prior to exercise (iTS) and every 5 min during the incremental exercise test (TS). Based on iTS in the Tokyo condition, participants were allocated to a neutral (iTS = 0, n = 11), slightly warm (iTS = 1, n = 50), or warm-to-hot (iTS = 2/3, n = 44) subgroup. RESULTS For the whole cohort iTS was 1 [1-2] and TS increased to 3 [3-3] at the end of exercise in the Tokyo condition. Average performance loss was 26.0 ± 10.7% in the Tokyo versus control condition. The slightly warm subgroup had less performance loss (22.3 ± 11.3%) compared to the warm-to-hot subgroup (29.4 ± 8.5%, p = 0.003), whereas the neutral subgroup did not respond different (28.8 ± 11.0%, p = 0.18) from the slightly warm subgroup. CONCLUSION iTS impacted the magnitude of performance loss among elite athletes exercising in hot and humid conditions. Athletes with a warm-to-hot iTS had more performance loss compared to counterparts with a slightly warm iTS, indicating that pre-cooling strategies and/or heat acclimation may be of additional importance for athletes in the warm-to-hot iTS group to mitigate the impact of heat stress.
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de Korte JQ, Bongers CCWG, Hopman MTE, Eijsvogels TMH. Exercise Performance and Thermoregulatory Responses of Elite Athletes Exercising in the Heat: Outcomes of the Thermo Tokyo Study. Sports Med 2021; 51:2423-2436. [PMID: 34396493 PMCID: PMC8514392 DOI: 10.1007/s40279-021-01530-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 11/30/2022]
Abstract
Objective We examined the impact of simulated Tokyo 2020 environmental condition on exercise performance, thermoregulatory responses and thermal perception among Dutch elite athletes. Methods 105 elite athletes from different sport disciplines performed two exercise tests in simulated control (15.9 ± 1.2 °C, relative humidity (RH) 55 ± 6%) and Tokyo (31.6 ± 1.0 °C, RH 74 ± 5%) environmental conditions. Exercise tests consisted of a 20-min warm-up (70% HRmax), followed by an incremental phase until volitional exhaustion (5% workload increase every 3 min). Gastrointestinal temperature (Tgi), heart rate, exercise performance and thermal perception were measured. Results Time to exhaustion was 16 ± 8 min shorter in the Tokyo versus the control condition (− 26 ± 11%, whereas peak power output decreased with 0.5 ± 0.3 W/kg (16 ± 7%). Greater exercise-induced increases in Tgi (1.8 ± 0.6 °C vs. 1.5 ± 0.5 °C, p < 0.001) and higher peak Tgi (38.9 ± 0.6 °C vs. 38.7 ± 0.4 °C, p < 0.001) were found in the Tokyo versus control condition. Large interindividual variations in exercise-induced increase in Tgi (range 0.7–3.5 °C) and peak Tgi (range 37.6–40.4 °C) were found in the Tokyo condition, with greater Tgi responses in endurance versus mixed- and skill-trained athletes. Peak thermal sensation and thermal comfort scores deteriorated in the Tokyo condition, with aggravated responses for power versus endurance- and mixed-trained athletes. Conclusion Large performance losses and Tgi increases were found among elite athletes exercising in simulated Tokyo conditions, with a substantial interindividual variation and significantly different responses across sport disciplines. These findings highlight the importance of an individual approach to optimally prepare athletes for safe and maximal exercise performance during the Tokyo Olympics. Supplementary Information The online version contains supplementary material available at 10.1007/s40279-021-01530-w.
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Affiliation(s)
- Johannus Q de Korte
- Department of Physiology (392), Radboud University Medical Centre, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Coen C W G Bongers
- Department of Physiology (392), Radboud University Medical Centre, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Maria T E Hopman
- Department of Physiology (392), Radboud University Medical Centre, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Thijs M H Eijsvogels
- Department of Physiology (392), Radboud University Medical Centre, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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