Sex differences in adaptation to intermittent post-exercise sauna bathing in trained middle-distance runners

Heat Adaptation for Females: A Systematic Review and Meta-Analysis of Physiological Adaptations and Exercise Performance in the Heat

BACKGROUND

Heat adaptation regimes are used to prepare athletes for exercise in hot conditions to limit a decrement in exercise performance. However, the heat adaptation literature mostly focuses on males, and consequently, current heat adaptation guidelines may not be optimal for females when accounting for the biological and phenotypical differences between sexes.

OBJECTIVES

We aimed to examine: (1) the effects of heat adaptation on physiological adaptations in females; (2) the impact of heat adaptation on performance test outcomes in the heat; and (3) the impact of various moderators, including duration (minutes and/or days), total heat dose (°C.min), exercise intensity (kcal.min-1), total energy expended (kcal), frequency of heat exposures and training status on the physiological adaptations in the heat.

METHODS

SPORTDiscus, MEDLINE Complete and Embase databases were searched to December 2022. Random-effects meta-analyses for resting and exercise core temperature, skin temperature, heart rate, sweat rate, plasma volume and performance tests in the heat were completed using Stata Statistical Software: Release 17. Sub-group meta-analyses were performed to explore the effect of duration, total heat dose, exercise intensity, total energy expended, frequency of heat exposure and training status on resting and exercise core temperature, skin temperature, heart rate and sweat rate. An explorative meta-regression was conducted to determine the effects of physiological adaptations on performance test outcomes in the heat following heat adaptation.

RESULTS

Thirty studies were included in the systematic review; 22 studies were meta-analysed. After heat adaptation, a reduction in resting core temperature (effect size [ES] =  - 0.45; 95% confidence interval [CI] - 0.69, - 0.22; p < 0.001), exercise core temperature (ES =  - 0.81; 95% CI - 1.01, - 0.60; p < 0.001), skin temperature (ES =  - 0.64; 95% CI - 0.79, - 0.48; p < 0.001), heart rate (ES =  - 0.60; 95% CI - 0.74, - 0.45; p < 0.001) and an increase in sweat rate (ES = 0.53; 95% CI 0.21, 0.85; p = 0.001) were identified in females. There was no change in plasma volume (ES = - 0.03; 95% CI - 0.31, 0.25; p = 0.835), whilst performance test outcomes were improved following heat adaptation (ES = 1.00; 95% CI 0.56, 1.45; p < 0.001). Across all moderators, physiological adaptations were more consistently observed following durations of 451-900 min and/or 8-14 days, exercise intensity ≥ 3.5 kcal.min-1, total energy expended ≥ 3038 kcal, consecutive (daily) frequency and total heat dose ≥ 23,000 °C.min. The magnitude of change in performance test outcomes in the heat was associated with a reduction in heart rate following heat adaptation (standardised mean difference =  - 10 beats.min-1; 95% CI - 19, - 1; p = 0.031).

CONCLUSIONS

Heat adaptation regimes induce physiological adaptations beneficial to thermoregulation and performance test outcomes in the heat in females. Sport coaches and applied sport practitioners can utilise the framework developed in this review to design and implement heat adaptation strategies for females.

Responses to a 5-Day Sport-Specific Heat Acclimatization Camp in Elite Female Rugby Sevens Athletes

PURPOSE

To describe the physiological (resting core temperature, exercising heart rate, and sweat rate) and psychophysical (rating of perceived exertion, thermal sensation, and thermal comfort) responses to a short-term heat acclimatization (HA) training camp in elite female rugby sevens athletes.

METHODS

Nineteen professional female rugby sevens athletes participated in a 5-day HA camp in Darwin, Australia (training average: 32.2°C and 58% relative humidity). Training involved normal team practice prescribed by appropriate staff. Markers of physiological and psychophysical adaptations to HA were collected at various stages during the camp. Partial eta-squared effect sizes (from linear mixed-effects models), rank-biserial correlations (from Freidman tests), and P values were used to assess changes across the protocol.

RESULTS

Resting core temperature did not significantly change. Exercising heart rate showed a large and significant reduction from day 1 to day 5 (175 [13] vs 171 [12] beats·min-1), as did sweat rate (1.1 [0.3] vs 1.0 [0.2] L·h-1). Thermal sensation showed a large and significant reduction between day 1 and day 5 (median [interquartile range] = 5 [5-5.5] vs 4.5 [4-5]). Changes in rating of perceived exertion and thermal comfort were unclear.

CONCLUSIONS

Beneficial cardiovascular adaptations were observed simultaneously across a full squad of elite female rugby sevens players (without expensive facilities/equipment or modifying training content). However, beneficial changes in resting core temperature, sweat rate, and thermal/effort perceptions likely require a greater thermal impulse. These data contribute to the development of evidence-informed practice for minimal effective HA doses in female team-sport athletes, who are underrepresented in the current research.