Thermal behavior alleviates thermal discomfort during steady-state exercise without affecting whole body heat loss

Small Performance Effects of a Practical Mixed-Methods Cooling Strategy in Elite Team Sport Athletes

Purpose: The ingestion of ice slurry and application of ice towels can elicit favorable physiological, perceptual, and performance benefits when used individually; however, the combined use and effectiveness of these practical cooling strategies have not been assessed using a sport-specific performance test, based on actual match demands, in an elite team sport context. Methods: Ten non-heat acclimated elite male rugby sevens athletes undertook two cycling heat response tests (HRT) designed to be specific to the demands of rugby sevens in hot conditions (35°C, 80% rH). In a crossover design, the HRTs were conducted with (COOLING) and without (HOT) the combined use of internal (ice slushy ingestion) and external (application of ice towels to the head, neck, and face) pre- and per-cooling strategies. Physiological, perceptual, and performance variables were monitored throughout each HRT. Results: COOLING resulted in reductions in mean tympanic temperature (-0.4 ± 0.2°C; d = 1.18); mean heart rate (-5 ± 8 bpm; d = 0.53); thermal discomfort (-0.5 ± 0.9 AU; d = 0.48); and thirst sensation (-1.0 ± 1.1 AU; d = 0.61) during the HRT. COOLING also resulted in a small increase in 4-min time trial power output (by 7 ± 33 W, ~3%; d = 0.35) compared to HOT. Discussion: A combination of internal and external pre- and per-cooling strategies can result in a range of small physiological, perceptual, and performance benefits during a rugby sevens specific HRT, compared to undertaking no cooling. Practitioners should include such strategies when performing in hot conditions.

Heating Up to Keep Cool: Benefits and Persistence of a Practical Heat Acclimation Protocol in Elite Female Olympic Team-Sport Athletes

PURPOSE

Although recommendations for effective heat acclimation (HA) strategies for many circumstances exist, best-practice HA protocols specific to elite female team-sport athletes are yet to be established. Therefore, the authors aimed to investigate the effectiveness and retention of a passive HA protocol integrated in a female Olympic rugby sevens team training program.

METHODS

Twelve elite female rugby sevens athletes undertook 10 days of passive HA across 2 training weeks. Tympanic temperature (TTymp), sweat loss, heart rate, and repeated 6-second cycling sprint performance were assessed using a sport-specific heat stress test Pre-HA, after 3 days (Mid-HA), after 10 days (Post-HA), and 15 days post-HA (Decay).

RESULTS

Compared with Pre-HA, submaximal TTymp was lower Mid-HA and Post-HA (both by -0.2 [0.7] °C; d ≥ 0.71), while resting TTymp was lower Post-HA (by -0.3 [0.2] °C; d = 0.81). There were no differences in TTymp at Decay compared with Pre-HA, nor were there any differences in heart rate or sweat loss at any time points. Mean peak 6-second power output improved Mid-HA and Post-HA (76 [36] W; 75 [34] W, respectively; d ≥ 0.45) compared with Pre-HA. The observed performance improvement persisted at Decay by 65 (45) W (d = 0.41).

CONCLUSIONS

Ten days of passive HA can elicit some thermoregulatory and performance benefits when integrated into a training program in elite female team-sport athletes. However, such a protocol does not provide a sufficient thermal impulse for thermoregulatory adaptations to be retained after 15 days with no further heat stimulus.

Voluntary Cooling during Exercise Is Augmented in People with Multiple Sclerosis Who Experience Heat Sensitivity

INTRODUCTION

We tested the hypothesis that people with multiple sclerosis (MS) who experience heat sensitivity voluntarily engage in cool-seeking behavior during exercise to a greater extent than healthy controls.

METHODS

In a 27.0°C ± 0.2°C, 41% ± 2% RH environment, seven participants with relapsing-remitting MS who exhibited heat sensitivity and seven healthy controls completed two randomized trials cycling for 40 min (EX) at 3.5 W·kg-1 metabolic heat production, followed by 30 min recovery (REC). In one trial, participants were restricted from engaging in cooling (CON). In the other trial, participants voluntarily pressed a button to receive 2 min of ~2°C water perfusing a top (COOL). Mean skin and core temperatures and mean skin wettedness were recorded continuously. Total time in cooling provided an index of cool-seeking behavior. RPE, total symptom scores (MS only), and subjective fatigue (MS only) were recorded every 10 min.

RESULTS

Core temperature (+0.5°C ± 0.1°C) and skin wettedness (+0.53 ± 0.02 a.u.) increased but were not different between groups or trials at end exercise (P = 0.196) or end recovery (P = 0.342). Mean skin temperature was reduced in COOL compared with CON at end exercise (P ≤ 0.002), with no differences between groups (P ≥ 0.532). MS spent more total time in cooling during EX (MS, 13 ± 3 min; healthy, 7 ± 4 min; P < 0.001) but not REC (MS, 2 ± 1 min; healthy, 0 ± 1 min; P = 0.496). RPE was greater at end exercise in MS (P = 0.001). Total symptom scores increased during exercise (P = 0.005) but was not different between trials (P = 0.321), whereas subjective fatigue was not attenuated in the cooling trial (P = 0.065).

CONCLUSION

Voluntary cooling is augmented in MS but does not consistently mitigate perceptions of heat-related symptoms or subjective fatigue.

Heat Safety in the Workplace: Modified Delphi Consensus to Establish Strategies and Resources to Protect the US Workers

The purpose of this consensus document was to develop feasible, evidence-based occupational heat safety recommendations to protect the US workers that experience heat stress. Heat safety recommendations were created to protect worker health and to avoid productivity losses associated with occupational heat stress. Recommendations were tailored to be utilized by safety managers, industrial hygienists, and the employers who bear responsibility for implementing heat safety plans. An interdisciplinary roundtable comprised of 51 experts was assembled to create a narrative review summarizing current data and gaps in knowledge within eight heat safety topics: (a) heat hygiene, (b) hydration, (c) heat acclimatization, (d) environmental monitoring, (e) physiological monitoring, (f) body cooling, (g) textiles and personal protective gear, and (h) emergency action plan implementation. The consensus-based recommendations for each topic were created using the Delphi method and evaluated based on scientific evidence, feasibility, and clarity. The current document presents 40 occupational heat safety recommendations across all eight topics. Establishing these recommendations will help organizations and employers create effective heat safety plans for their workplaces, address factors that limit the implementation of heat safety best-practices and protect worker health and productivity.

The requirement for physical effort reduces voluntary cooling behavior during heat exposure in humans

We tested the hypothesis that cool-seeking behavior during heat exposure is attenuated when physical effort is required. Twelve healthy adults (mean(SD), 24(4) years, four women) underwent three experimental trials during two hours of exposure to 41(1) °C, 20(0)% relative humidity in which subjects undertook intermittent exercise alternating between seated rest and cycling exercise at ~4 metabolic equivalents every 15 min. In all trials, subjects wore a water perfused suit top. In the control trial (Control), no water perfused the suit. In the other trials, subjects were freely able to perfuse 2.1(0.2) °C water through the suit. In one cooling trial, subjects received two minutes of cooling by pressing a button (Button). The other cooling trial permitted cooling by engaging in isometric handgrip exercise at 15% of maximal grip strength (Handgrip), with cooling maintained throughout the duration the required force was produced or until two minutes elapsed. In both Button and Handgrip, a one-minute washout proceeded cooling. Core temperature increased over time in all trials (P<0.01) and there were no differences between trials (P = 0.32). Mean skin temperature at the end of heat exposure was lowest in Button [34.2(1.5) °C] compared to Handgrip [35.6(0.8) °C, P = 0.03] and Control [36.9(0.7) °C, P<0.01]. The total number of behaviors [8(3) vs. 10(5), P = 0.04] and cumulative cooling time [850(323) vs. 1230(616) seconds, P = 0.02] were lower in Handgrip compared to Button. These data indicate that when physical effort is required, the incidence and duration of cooling behavior during heat exposure is attenuated compared to when behaving requires minimal physical effort.

Human thermoregulation during prolonged exposure to warm and extremely humid environments expected to occur in disabled submarine scenarios

Military and civilian emergency situations often involve prolonged exposures to warm and very humid environments. We tested the hypothesis that increases in core temperature and body fluid losses during prolonged exposure to warm and very humid environments are dependent on dry bulb temperature. On three occasions, 15 healthy males (23 ± 3 yr) sat in 32.1 ± 0.1°C, 33.1 ± 0.2°C, or 35.0 ± 0.1°C and 95 ± 2% relative humidity normobaric environments for 8 h. Core temperature (telemetry pill) and percent change in body weight, an index of changes in total body water occurring secondary to sweat loss, were measured every hour. Linear regression models were fit to core temperature (over the final 4 h) and percent changes in body weight (over the entire 8 h) for each subject. These equations were used to predict core temperature and percent changes in body weight for up to 24 h. At the end of the 8-h exposure, core temperature was higher in 35°C (38.2 ± 0.4°C, P < 0.01) compared with 32°C (37.2 ± 0.2°C) and 33°C (37.5 ± 0.2°C). At this time, percent changes in body weight were greater in 35°C (-1.9 ± 0.5%) compared with 32°C (-1.4 ± 0.3%, P < 0.01) but not 33°C (-1.6 ± 0.6%, P = 0.17). At 24 h, predicted core temperature was higher in 35°C (39.2 ± 1.4°C, P < 0.01) compared with 32°C (37.6 ± 0.9°C) and 33°C (37.5 ± 0.9°C), and predicted percent changes in body weight were greater in 35°C (-6.1 ± 2.4%) compared with 32°C (-4.6 ± 1.5%, P = 0.04) but not 33°C (-5.3 ± 2.0%, P = 0.43). Prolonged exposure to 35°C, but not 32°C or 33°C, dry bulb temperatures and high humidity is uncompensable heat stress, which exacerbates body fluid losses.

Effects of Acute Exercise on Cutaneous Thermal Sensation

The aim of this study was to assess the effect of exercise intensity on the thermal sensory function of active and inactive limbs. In a randomised and counterbalanced manner, 13 healthy young male participants (25 ± 6 years, 1.8 ± 0.1 m, 77 ± 6 kg) conducted: (1) 30-min low-intensity (50% heart rate maximum, HRmax; LOW) and (2) 30-min high-intensity (80% HRmax; HIGH) cycling exercises, and (3) 30 min of seated rest (CONTROL). Before, immediately after, and 1 h after, each intervention, thermal sensory functions of the non-dominant dorsal forearm and posterior calf were examined by increasing local skin temperature (1 °C/s) to assess perceptual heat sensitivity and pain thresholds. Relative to pre-exercise, forearm heat sensitivity thresholds were increased immediately and 1 hr after HIGH, but there were no changes after LOW exercise or during CONTROL (main effect of trial; p = 0.017). Relative to pre-exercise, calf heat sensitivity thresholds were not changed after LOW or HIGH exercise or during CONTROL (main effect of trial; p = 0.629). There were no changes in calf (main effect of trial; p = 0.528) or forearm (main effect of trial; p = 0.088) heat pain thresholds after exercise in either LOW or HIGH or CONTROL. These results suggest that cutaneous thermal sensitivity function of an inactive limb is only reduced after higher intensity exercise but is not changed in a previously active limb after exercise. Exercise does not affect heat pain sensitivity in either active or inactive limbs.

Thermal Behavior Augments Heat Loss Following Low Intensity Exercise

We tested the hypothesis that thermal behavior alleviates thermal discomfort and accelerates core temperature recovery following low intensity exercise. Methods: In a 27 0 C, 48 6% relative humidity environment, 12 healthy subjects (six females) completed 60 min of exercise followed by 90 min of seated recovery on two occasions. Subjects wore a suit top perfusing 34 ± 0 °C water during exercise. In the control trial, this water continually perfused throughout recovery. In the behavior trial, the upper body was maintained thermally comfortable by pressing a button to receive cool water (3 2 °C) perfusing through the top for 2 min per button press. Results: Physiological variables (core temperature, p ≥ 0.18; mean skin temperature, p = 0.99; skin wettedness, p ≥ 0.09; forearm skin blood flow, p = 0.29 and local axilla sweat rate, p = 0.99) did not differ between trials during exercise. Following exercise, mean skin temperature decreased in the behavior trial in the first 10 min (by -0.5 0.7 °C, p < 0.01) and upper body skin temperature was reduced until 70 min into recovery (by 1.8 1.4 °C, p < 0.05). Core temperature recovered to pre-exercise levels 17 31 min faster (p = 0.02) in the behavior trial. There were no differences in skin blood flow or local sweat rate between conditions during recovery (p ≥ 0.05). Whole-body thermal discomfort was reduced (by -0.4 0.5 a.u.) in the behavior trial compared to the control trial within the first 20 min of recovery (p ≤ 0.02). Thermal behavior via upper body cooling resulted in augmented cumulative heat loss within the first 30 min of recovery (Behavior: 288 92 kJ; Control: 160 44 kJ, p = 0.02). Conclusions: Engaging in thermal behavior that results in large reductions in mean skin temperature following exercise accelerates the recovery of core temperature and alleviates thermal discomfort by promoting heat loss.