1
|
Brown HA, Topham TH, Clark B, Ioannou LG, Flouris AD, Smallcombe JW, Telford RD, Jay O, Périard JD. Quantifying Exercise Heat Acclimatisation in Athletes and Military Personnel: A Systematic Review and Meta-analysis. Sports Med 2024; 54:727-741. [PMID: 38051495 DOI: 10.1007/s40279-023-01972-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Athletes and military personnel are often expected to compete and work in hot and/or humid environments, where decrements in performance and an increased risk of exertional heat illness are prevalent. A physiological strategy for reducing the adverse effects of heat stress is to acclimatise to the heat. OBJECTIVE The aim of this systematic review was to quantify the effects of relocating to a hotter climate to undergo heat acclimatisation in athletes and military personnel. ELIGIBILITY CRITERIA Studies investigating the effects of heat acclimatisation in non-acclimatised athletes and military personnel via relocation to a hot climate for < 6 weeks were included. DATA SOURCES MEDLINE, SPORTDiscus, CINAHL Plus with Full Text and Scopus were searched from inception to June 2022. RISK OF BIAS A modified version of the McMaster critical review form was utilised independently by two authors to assess the risk of bias. DATA SYNTHESIS A Bayesian multi-level meta-analysis was conducted on five outcome measures, including resting core temperature and heart rate, the change in core temperature and heart rate during a heat response test and sweat rate. Wet-bulb globe temperature (WBGT), daily training duration and protocol length were used as predictor variables. Along with posterior means and 90% credible intervals (CrI), the probability of direction (Pd) was calculated. RESULTS Eighteen articles from twelve independent studies were included. Fourteen articles (nine studies) provided data for the meta-analyses. Whilst accounting for WBGT, daily training duration and protocol length, population estimates indicated a reduction in resting core temperature and heart rate of - 0.19 °C [90% CrI: - 0.41 to 0.05, Pd = 91%] and - 6 beats·min-1 [90% CrI: - 16 to 5, Pd = 83%], respectively. Furthermore, the rise in core temperature and heart rate during a heat response test were attenuated by - 0.24 °C [90% CrI: - 0.67 to 0.20, Pd = 85%] and - 7 beats·min-1 [90% CrI: - 18 to 4, Pd = 87%]. Changes in sweat rate were conflicting (0.01 L·h-1 [90% CrI: - 0.38 to 0.40, Pd = 53%]), primarily due to two studies demonstrating a reduction in sweat rate following heat acclimatisation. CONCLUSIONS Data from athletes and military personnel relocating to a hotter climate were consistent with a reduction in resting core temperature and heart rate, in addition to an attenuated rise in core temperature and heart rate during an exercise-based heat response test. An increase in sweat rate is also attainable, with the extent of these adaptations dependent on WBGT, daily training duration and protocol length. PROSPERO REGISTRATION CRD42022337761.
Collapse
Affiliation(s)
- Harry A Brown
- Research Institute for Sport and Exercise (UCRISE), University of Canberra, Bruce, ACT, Australia
| | - Thomas H Topham
- Research Institute for Sport and Exercise (UCRISE), University of Canberra, Bruce, ACT, Australia
| | - Brad Clark
- Research Institute for Sport and Exercise (UCRISE), University of Canberra, Bruce, ACT, Australia
| | - Leonidas G Ioannou
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Andreas D Flouris
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - James W Smallcombe
- Faculty of Medicine and Health, Heat and Health Research Incubator, The University of Sydney, Sydney, NSW, Australia
| | - Richard D Telford
- Research Institute for Sport and Exercise (UCRISE), University of Canberra, Bruce, ACT, Australia
| | - Ollie Jay
- Faculty of Medicine and Health, Heat and Health Research Incubator, The University of Sydney, Sydney, NSW, Australia
| | - Julien D Périard
- Research Institute for Sport and Exercise (UCRISE), University of Canberra, Bruce, ACT, Australia.
| |
Collapse
|
2
|
Périard JD, Girard O, Townsend N, Bourdon P, Cocking S, Ihsan M, Lacome M, Nichols D, Travers G, Wilson MG, Piscione J, Racinais S. Hematological Adaptations Following a Training Camp in Hot and/or Hypoxic Conditions in Elite Rugby Union Players. Int J Sports Physiol Perform 2023; 18:1053-1061. [PMID: 37553108 DOI: 10.1123/ijspp.2023-0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/30/2023] [Accepted: 07/08/2023] [Indexed: 08/10/2023]
Abstract
PURPOSE To investigate the effects of a training camp with heat and/or hypoxia sessions on hematological and thermoregulatory adaptations. METHODS Fifty-six elite male rugby players completed a 2-week training camp with 5 endurance and 5 repeated-sprint sessions, rugby practice, and resistance training. Players were separated into 4 groups: CAMP trained in temperate conditions at sea level, HEAT performed the endurance sessions in the heat, ALTI slept and performed the repeated sprints at altitude, and H + A was a combination of the heat and altitude groups. RESULTS Blood volume across all groups increased by 140 mL (95%CI, 42-237; P = .006) and plasma volume by 97 mL (95%CI 28-167; P = .007) following the training camp. Plasma volume was 6.3% (0.3% to 12.4%) higher in HEAT than ALTI (P = .034) and slightly higher in HEAT than H + A (5.6% [-0.3% to 11.7%]; P = .076). Changes in hemoglobin mass were not significant (P = .176), despite a ∼1.2% increase in ALTI and H + A and a ∼0.7% decrease in CAMP and HEAT. Peak rectal temperature was lower during a postcamp heat-response test in HEAT (0.3 °C [0.1-0.5]; P = .010) and H + A (0.3 °C [0.1-0.6]; P = .005). Oxygen saturation upon waking was lower in ALTI (3% [2% to 5%]; P < .001) and H + A (4% [3% to 6%]; P < .001) than CAMP and HEAT. CONCLUSION Although blood and plasma volume increased following the camp, sleeping at altitude impeded the increase when training in the heat and only marginally increased hemoglobin mass. Heat training induced adaptations commensurate with partial heat acclimation; however, combining heat training and altitude training and confinement during a training camp did not confer concomitant hematological adaptations.
Collapse
Affiliation(s)
- Julien D Périard
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT,Australia
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
| | - Olivier Girard
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Crawley, WA,Australia
| | - Nathan Townsend
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha,Qatar
| | - Pitre Bourdon
- Department of Sport Science, ASPIRE, Academy for Sports Excellence, Doha,Qatar
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA,Australia
| | - Scott Cocking
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
- Department of Sport Science, ASPIRE, Academy for Sports Excellence, Doha,Qatar
| | - Mohammed Ihsan
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
| | - Mathieu Lacome
- Department of Research, Sport Laboratory, Expertise and Performance, French Institute of Sports (INSEP), Paris,France
- Department of Performance and Analytics, Parma Calcio, Parma,Italy
| | - David Nichols
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
| | - Gavin Travers
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
- Space Medicine Team, European Astronaut Center, Köln,Germany
| | - Mathew G Wilson
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
- Institute of Sport, Exercise and Health, University College London, London,United Kingdom
| | - Julien Piscione
- Department of Research, Sport Laboratory, Expertise and Performance, French Institute of Sports (INSEP), Paris,France
| | - Sebastien Racinais
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
- Department of Research, Sport Laboratory, Expertise and Performance, French Institute of Sports (INSEP), Paris,France
| |
Collapse
|
3
|
Kelly MK, Bowe SJ, Jardine WT, Condo D, Guy JH, Snow RJ, Carr AJ. Heat Adaptation for Females: A Systematic Review and Meta-Analysis of Physiological Adaptations and Exercise Performance in the Heat. Sports Med 2023; 53:1395-1421. [PMID: 37222863 PMCID: PMC10289939 DOI: 10.1007/s40279-023-01831-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2023] [Indexed: 05/25/2023]
Abstract
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.
Collapse
Affiliation(s)
- Monica K Kelly
- Centre for Sport Research, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Steven J Bowe
- Deakin Biostatistics Unit, Faculty of Health, Deakin University, Burwood, VIC, Australia
- Faculty and School of Health, Victoria University of Wellington, Kelburn, Wellington, New Zealand
| | - William T Jardine
- Centre for Sport Research, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Dominique Condo
- Centre for Sport Research, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Joshua H Guy
- School of Health, Medical and Applied Sciences, Central Queensland University, Cairns, QLD, Australia
| | - Rodney J Snow
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC, Australia
| | - Amelia J Carr
- Centre for Sport Research, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| |
Collapse
|
4
|
Donnan KJ, Williams EL, Bargh MJ. The effectiveness of heat preparation and alleviation strategies for cognitive performance: A systematic review. Temperature (Austin) 2023; 10:404-433. [PMID: 38130656 PMCID: PMC10732620 DOI: 10.1080/23328940.2022.2157645] [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: 08/24/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
A range of occupational and performance contexts (e.g. military personnel operations, emergency services, sport) require the critical maintenance of cognitive performance in environmentally challenging environments. Several reviews exist which evaluate the effectiveness of heat preparation strategies to facilitate physical performance. To date, no review has explored the usefulness of heat preparation strategies for cognitive performance. Therefore, this systematic review aimed to evaluate a range of interventions for the maintenance of cognitive performance, during or following active or passive heat exposure. Studies to be included were assessed by two authors reviewing title, abstract, and full-text. Forty articles were identified which met the inclusion criteria. Interventions were categorised into chronic (i.e. acclimation/acclimatisation) and acute strategies (i.e. hydration, cooling, supplementation, psychological). The results indicate that medium-term consecutive heat acclimation may mitigate some cognitive deficits under heat stress, although heat acclimation effectiveness could be influenced by age. Further, pre-cooling appears the most effective cooling method for maintaining cognitive performance under heat stress, although results were somewhat ambiguous. The hydration literature showed that the most effective hydration strategies were those which individualised electrolyte fortified fluid volumes to match for sweat loss. Limited research exploring psychological interventions indicates that motivational self-talk could be facilitative for maintaining cognitive skills following exercise in hot conditions. These findings can be used to help inform strategies for maintaining critical cognitive and decision-making skills in hot environments.
Collapse
Affiliation(s)
- Kate J. Donnan
- Department of Sport, Exercise, and Rehabilitation Sciences, University of Hull, Hull, HU6 7RX, UK
| | - Emily L. Williams
- Centre for Human Performance, Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QS, UK
| | - Melissa J. Bargh
- School of Sport and Exercise Science, College of Social Science of University of Lincoln, Lincoln, LN6 7TS, UK
| |
Collapse
|
5
|
Shushan T, McLaren SJ, Buchheit M, Scott TJ, Barrett S, Lovell R. Submaximal Fitness Tests in Team Sports: A Theoretical Framework for Evaluating Physiological State. Sports Med 2022; 52:2605-2626. [PMID: 35817993 PMCID: PMC9584880 DOI: 10.1007/s40279-022-01712-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2022] [Indexed: 02/01/2023]
Abstract
Team-sports staff often administer non-exhaustive exercise assessments with a view to evaluating physiological state, to inform decision making on athlete management (e.g., future training or recovery). Submaximal fitness tests have become prominent in team-sports settings for observing responses to a standardized physical stimulus, likely because of their time-efficient nature, relative ease of administration, and physiological rationale. It is evident, however, that many variations of submaximal fitness test characteristics, response measures, and monitoring purposes exist. The aim of this scoping review is to provide a theoretical framework of submaximal fitness tests and a detailed summary of their use as proxy indicators of training effects in team sports. Using a review of the literature stemming from a systematic search strategy, we identified five distinct submaximal fitness test protocols characterized in their combinations of exercise regimen (continuous or intermittent) and the progression of exercise intensity (fixed, incremental, or variable). Heart rate-derived indices were the most studied outcome measures in submaximal fitness tests and included exercise (exercise heart rate) and recovery (heart rate recovery and vagal-related heart rate variability) responses. Despite the disparity between studies, these measures appear more relevant to detect positive chronic endurance-oriented training effects, whereas their role in detecting negative transient effects associated with variations in autonomic nervous system function is not yet clear. Subjective outcome measures such as ratings of perceived exertion were less common in team sports, but their potential utility when collected alongside objective measures (e.g., exercise heart rate) has been advocated. Mechanical outcome measures either included global positioning system-derived locomotor outputs such as distance covered, primarily during standardized training drills (e.g., small-sided games) to monitor exercise performance, or responses derived from inertial measurement units to make inferences about lower limb neuromuscular function. Whilst there is an emerging interest regarding the utility of these mechanical measures, their measurement properties and underpinning mechanisms are yet to be fully established. Here, we provide a deeper synthesis of the available literature, culminating with evidence-based practical recommendations and directions for future research.
Collapse
Affiliation(s)
- Tzlil Shushan
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Sydney, NSW Australia
| | - Shaun J. McLaren
- Newcastle Falcons Rugby Club, Newcastle upon Tyne, UK ,grid.8250.f0000 0000 8700 0572Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Martin Buchheit
- HIIT Science, Revelstoke, BC Canada ,grid.418501.90000 0001 2163 2398French National Institute of Sport (INSEP), Laboratory of Sport, Expertise and Performance (EA 7370), Paris, France ,Kitman Labs, Performance Research Intelligence Initiative, Dublin, Ireland ,grid.1019.90000 0001 0396 9544Institute for Health and Sport, Victoria University, Melbourne, VIC Australia
| | - Tannath J. Scott
- Netball Australia, Melbourne, VIC Australia ,grid.10346.300000 0001 0745 8880Carnegie Applied Rugby Research (CARR) Centre, Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Steve Barrett
- Department of Sport Science Innovation, Playermaker, London, UK
| | - Ric Lovell
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Sydney, NSW Australia
| |
Collapse
|