Intermittent Cooling Reduces Perceived Exertion but Has No Effect on Baseball Hitting or Defense Performance in a Hot Environment

Core Body Temperatures in Intermittent Sports: A Systematic Review

BACKGROUND

Hyperthermia (and associated health and performance implications) can be a significant problem for athletes and teams involved in intermittent sports. Quantifying the highest thermal strain (i.e. peak core body temperature [peak Tc]) from a range of intermittent sports would enhance our understanding of the thermal requirements of sport and assist in making informed decisions about training or match-day interventions to reduce thermally induced harm and/or performance decline.

OBJECTIVE

The objective of this systematic review was to synthesise and characterise the available thermal strain data collected in competition from intermittent sport athletes.

METHODS

A systematic literature search was performed on Web of Science, MEDLINE, and SPORTDiscus to identify studies up to 17 April 2023. Electronic databases were searched using a text mining method to provide a partially automated and systematic search strategy retrieving terms related to core body temperature measurement and intermittent sport. Records were eligible if they included core body temperature measurement during competition, without experimental intervention that may influence thermal strain (e.g. cooling), in healthy, adult, intermittent sport athletes at any level. Due to the lack of an available tool that specifically includes potential sources of bias for physiological responses in descriptive studies, a methodological evaluation checklist was developed and used to document important methodological considerations. Data were not meta-analysed given the methodological heterogeneity between studies and therefore were presented descriptively in tabular and graphical format.

RESULTS

A total of 34 studies were selected for review; 27 were observational, 5 were experimental (2 parallel group and 3 repeated measures randomised controlled trials), and 2 were quasi-experimental (1 parallel group and 1 repeated measures non-randomised controlled trial). Across all included studies, 386 participants (plus participant numbers not reported in two studies) were recruited after accounting for shared data between studies. A total of 4 studies (~ 12%) found no evidence of hyperthermia, 24 (~ 71%) found evidence of 'modest' hyperthermia (peak Tc between 38.5 and 39.5 °C), and 6 (~ 18%) found evidence of 'marked' hyperthermia (peak Tc of 39.5 °C or greater) during intermittent sports competition.

CONCLUSIONS

Practitioners and coaches supporting intermittent sport athletes are justified to seek interventions aimed at mitigating the high heat strain observed in competition. More research is required to determine the most effective interventions for this population that are practically viable in intermittent sports settings (often constrained by many competing demands). Greater statistical power and homogeneity among studies are required to quantify the independent effects of wet bulb globe temperature, competition duration, sport and level of competition on peak Tc, all of which are likely to be key modulators of the thermal strain experienced by competing athletes.

REGISTRATION

This systematic review was registered on the Open Science Framework ( https://osf.io/vfb4s ; https://doi.org/10.17605/OSF.IO/EZYFA , 4 January 2021).

Effects of ice slurry ingestion on body temperature and softball pitching performance in a hot environment: a randomized crossover trial

BACKGROUND

Although softball players are often required to play in hot environments, scarce evidence is available regarding the effects of ice slurry ingestion on body temperature and pitching performance in softball pitchers in a hot environment. Thus, this study investigated the effects of ice slurry ingestion before and between innings on body temperature and softball pitching performance in a hot environment.

METHODS

In a randomized crossover design, seven heat-acclimatized amateur softball pitchers (four males and three females) completed simulated softball games consisting of 15 best-effort pitches per inning for seven innings with between-pitch rest intervals of 20 s. Participants were assigned to either a control trial (CON: ingestion of 5.0 g·kg^-1 of cool fluid [9.8 ± 2.2 °C] before simulated softball games and 1.25 g·kg^-1 of cool fluid between inning intervals) or an ice trial (ICE: ingestion of ice slurry [- 1.2 ± 0.1 °C] based on the same timings and doses as the CON). Participants performed both trials in an outdoor ground during the summer season (30.8 ± 2.7 °C, 57.0 ± 7.9% relative humidity).

RESULTS

Ice slurry ingestion before the simulated softball game (pre-cooling) resulted in a greater reduction in rectal temperature compared with cool fluid ingestion (p = 0.021, d = 0.68). No significant differences were observed between the trials in rectal temperature changes during the simulated softball game (p > 0.05). Compared to the CON, heart rate during the game was significantly decreased (p < 0.001, d = 0.43), and handgrip strength during the game was significantly increased (p = 0.001, d = 1.16) in the ICE. Ratings of perceived exertion, thermal comfort, and thermal sensation were improved in the ICE compared to those in the CON (p < 0.05). Ball velocity and pitching accuracy were not affected by ICE.

CONCLUSIONS

Ice slurry ingestion before and between innings reduced thermal, cardiovascular, and perceptual strain. However, it did not affect softball pitching performance compared to cool fluid ingestion.

Effects of mixed-cooling strategies on executive functions in simulated tennis in hot and humid conditions

This study aimed to investigate the effects of mixed-cooling strategies, which combines external (cooling vest + neck cooled collar) and internal cooling (cold sports drink ingestion) on measures of executive function during simulated tennis in hot/humid conditions. In a counterbalanced design (randomised order), eight males undertook two trials [one with the mixed-cooling strategy, (MCOOL condition) and another without (CON condition)] in a climate chamber (36.5°C, 50% relative humidity). All subjects completed an intermittent treadmill protocol simulating a three-set tennis match with a 90-second break during odd-numbered games and 120-second breaks between sets, in accordance with the activity profile and International Tennis Federation rules. The mixed-cooling strategies were adopted before test and break time during the simulated tennis match. Stroop task, 2-back task, More-odd shifting task, gastrointestinal temperature (Tgi), skin temperature, blood lactic acid (BLA), heart rate, urine specific gravity (USG), sweat rate (SR), thermal sensation (TS) and perceived exertion (RPE) were measured. Results showed that the mean exercise time was longer in the MCOOL condition than in the CON condition. The SR was greater in CON trial compared with that in MCOOL trial. Results of two-way analysis of variance with repeated measures revealed that time×condition interactions were significant in BLA, Stroop response time, and switch cost of the more-odd shifting task. There were main effects of condition for Tgi, HR, TS, RPE, BLA, Stroop response time, and switch cost of the more-odd shifting task. In a hot/wet environment, pre- and intermittent mixed-cooling strategies can significantly improve exercise time and measures of executive function of tennis players in a simulated tennis match.

Performance effects of internal pre- and per-cooling across different exercise and environmental conditions: A systematic review

Exercise in a hot and humid environment may endanger athlete's health and affect physical performance. This systematic review aimed to examine whether internal administration of ice, cold beverages or menthol solutions may be beneficial for physical performance when exercising in different environmental conditions and sports backgrounds. A systematic search was performed in PubMed, Web of Science, Scopus and SPORTDiscus databases, from inception to April 2022, to identify studies meeting the following inclusion criteria: healthy male and female physically active individuals or athletes (aged ≥18 years); an intervention consisting in the internal administration (i.e., ingestion or mouth rinse) of ice slush, ice slurry or crushed ice and/or cold beverages and/or menthol solutions before and/or during exercise; a randomized crossover design with a control or placebo condition; the report of at least one physical performance outcome; and to be written in English. Our search retrieved 2,714 articles in total; after selection, 43 studies were considered, including 472 participants, 408 men and 64 women, aged 18-42 years, with a VO2max ranging from 46.2 to 67.2 mL⋅kg-1⋅min-1. Average ambient temperature and relative humidity during the exercise tasks were 32.4 ± 3.5°C (ranging from 22°C to 38°C) and 50.8 ± 13.4% (varying from 20.0% to 80.0%), respectively. Across the 43 studies, 7 exclusively included a menthol solution mouth rinse, 30 exclusively involved ice slurry/ice slush/crushed ice/cold beverages intake, and 6 examined both the effect of thermal and non-thermal internal techniques in the same protocol. Rinsing a menthol solution (0.01%) improved physical performance during continuous endurance exercise in the heat. Conversely, the ingestion of ice or cold beverages did not seem to consistently increase performance, being more likely to improve performance in continuous endurance trials, especially when consumed during exercises. Co-administration of menthol with or within ice beverages seems to exert a synergistic effect by improving physical performance. Even in environmental conditions that are not extreme, internal cooling strategies may have an ergogenic effect. Further studies exploring both intermittent and outdoor exercise protocols, involving elite male and female athletes and performed under not extreme environmental conditions are warranted. Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021268197], identifier [CRD42021268197].