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Int J Sports Med 2024; 45(10): 733-738
DOI: 10.1055/a-2321-1832
Physiology & Biochemistry

Chasing Gold: Heat Acclimation in Elite Handcyclists with Spinal Cord Injury

Mike Lackner
1   Sports Therapy, Swiss Paraplegic Centre, Nottwil, Switzerland
,
Fabian Grossmann 
2   Institute of Sports Medicine, Swiss Paraplegic Centre, Nottwil, Switzerland
,
Claudio Perret 
3   Neuro-Musculoskeletal Functioning and Mobility, Swiss Paraplegic Research, Nottwil, Switzerland
4   Faculty of Health Sciences and Medicine, University of Lucerne, Luzern, Switzerland
,
Joelle L Flueck 
2   Institute of Sports Medicine, Swiss Paraplegic Centre, Nottwil, Switzerland
,
Anneke Hertig-Godeschalk 
3   Neuro-Musculoskeletal Functioning and Mobility, Swiss Paraplegic Research, Nottwil, Switzerland
› Author Affiliations Funding This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.
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Abstract

Thermoregulation is impaired in individuals with a spinal cord lesion (SCI), affecting sweat capacity, heat loss, and core temperature. This can be particularly problematic for athletes with SCI who exercise in hot and humid conditions, like those during the Tokyo 2020 Paralympic Games. Heat acclimation can support optimal preparation for exercise in such challenging environments, but evidence is limited in endurance athletes with SCI. We evaluated whether seven consecutive days of exercise in the heat would result in heat acclimation. Five elite para-cycling athletes with SCI participated (two females, three males, median (Q1-Q3) 35 (31–51) years, four with paraplegia and one with tetraplegia). All tests and training sessions were performed in a heat chamber (30°C and 75% relative humidity). A time-to-exhaustion test was performed on day 1 (pretest) and day 7 (posttest). On days 2–6, athletes trained daily for one hour at 50–60% of individual peak power (PPeak). Comparing pretest and posttest, all athletes increased their body mass loss (p=0.04), sweat rate (p=0.04), and time to exhaustion (p=0.04). Effects varied between athletes for core temperature and heart rate. All athletes appeared to benefit from our heat acclimation protocol, helping to optimize their preparation for the Tokyo 2020 Paralympic Games.

Keywords

heat chamber - endurance performance - thermoregulation - Paralympics - paraplegia - tetraplegia - para-athletes


Publication History

Received: 22 November 2023

Accepted: 17 April 2024

Article published online:
17 June 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Ely MR, Cheuvront SN, Roberts WO. et al. Impact of weather on marathon-running performance. Med Sci Sports Exerc 2007; 39: 487-493
    CrossrefPubMedSearch in Google Scholar
  • 2 Guy JH, Deakin GB, Edwards AM. et al. Adaptation to hot environmental conditions: An exploration of the performance basis, procedures and future directions to optimise opportunities for elite athletes. Sports Med 2015; 45: 303-311
    CrossrefPubMedSearch in Google Scholar
  • 3 Lei TH, Wang F. Looking ahead of 2021 Tokyo Summer Olympic Games: How does humid heat affect endurance performance? Insight into physiological mechanism and heat-related illness prevention strategies. J Therm Biol 2021; 99: 102975
    CrossrefPubMedSearch in Google Scholar
  • 4 Racinais S, Alonso JM, Coutts AJ. et al. Consensus recommendations on training and competing in the heat. Br J Sports Med 2015; 49: 1164-1173
    CrossrefPubMedSearch in Google Scholar
  • 5 Sawka MN, Leon LR, Montain SJ. et al. Integrated physiological mechanisms of exercise performance, adaptation, and maladaptation to heat stress. Compr Physiol 2011; 1: 1883-1928
    CrossrefPubMedSearch in Google Scholar
  • 6 Buono MJ, Numan TR, Claros RM. et al. Is active sweating during heat acclimation required for improvements in peripheral sweat gland function?. Am J Physiol Regul Integr Comp Physiol 2009; 297: R1082-R1085
    CrossrefPubMedSearch in Google Scholar
  • 7 Shapiro Y, Hubbard RW, Kimbrough CM. et al. Physiological and hematologic responses to summer and winter dry-heat acclimation. J Appl Physiol Respir Environ Exerc Physiol 1981; 50: 792-798
    PubMedSearch in Google Scholar
  • 8 Périard JD, Racinais S, Sawka MN. Adaptations and mechanisms of human heat acclimation: Applications for competitive athletes and sports. Scand J Med Sci Sports 2015; 25: 20-38
    CrossrefPubMedSearch in Google Scholar
  • 9 Hou S, Rabchevsky AG. Autonomic consequences of spinal cord injury. Compr Physiol 2014; 4: 1419-1453
    CrossrefPubMedSearch in Google Scholar
  • 10 Griggs KE, Leicht CA, Price MJ. et al. Thermoregulation during intermittent exercise in athletes with a spinal-cord injury. Int J Sports Physiol Perform 2015; 10: 469-475
    CrossrefPubMedSearch in Google Scholar
  • 11 Hopman MT, Oeseburg B, Binkhorst RA. Cardiovascular responses in persons with paraplegia to prolonged arm exercise and thermal stress. Med Sci Sports Exerc 1993; 25: 577-583
    CrossrefPubMedSearch in Google Scholar
  • 12 Price MJ. Thermoregulation during exercise in individuals with spinal cord injuries. Sports Med 2006; 36: 863-879
    CrossrefPubMedSearch in Google Scholar
  • 13 Grossmann F, Flueck JL, Perret C. et al. The Thermoregulatory and Thermal Responses of Individuals With a Spinal Cord Injury During Exercise, Acclimation and by Using Cooling Strategies-A Systematic Review. Front Physiol 2021; 12: 636997
    CrossrefPubMedSearch in Google Scholar
  • 14 Pritchett RC, Al-Nawaiseh AM, Pritchett KK. et al. Sweat gland density and response during high-intensity exercise in athletes with spinal cord injuries. Biol Sport 2015; 32: 249-254
    CrossrefPubMedSearch in Google Scholar
  • 15 Pritchett K, Broad E, Scaramella J. et al. Hydration and Cooling Strategies for Paralympic Athletes. Current Nutrition Reports 2020; 9: 137-146
    CrossrefPubMedSearch in Google Scholar
  • 16 Chalmers S, Esterman A, Eston R. et al. Short-term heat acclimation training improves physical performance: a systematic review, and exploration of physiological adaptations and application for team sports. Sports Med 2014; 44: 971-988
    CrossrefPubMedSearch in Google Scholar
  • 17 Tyler CJ, Reeve T, Hodges GJ. et al. The Effects of Heat Adaptation on Physiology, Perception and Exercise Performance in the Heat: A Meta-Analysis. Sports Med 2016; 46: 1699-1724
    CrossrefPubMedSearch in Google Scholar
  • 18 Trbovich MB, Kiratli JB, Price MJ. The effects of a heat acclimation protocol in persons with spinal cord injury. J Therm Biol 2016; 62: 56-62
    CrossrefPubMedSearch in Google Scholar
  • 19 Castle PC, Kularatne BP, Brewer J. et al. Partial heat acclimation of athletes with spinal cord lesion. Eur J Appl Physiol 2013; 113: 109-115
    CrossrefPubMedSearch in Google Scholar
  • 20 Gee CM, Lacroix MA, Pethick WA. et al. Cardiovascular responses to heat acclimatisation in athletes with spinal cord injury. J Sci Med Sport 2021; 24: 756-762
    CrossrefPubMedSearch in Google Scholar
  • 21 Kirshblum SC, Burns SP, Biering-Sorensen F. et al. International standards for neurological classification of spinal cord injury (revised 2011). The journal of spinal cord medicine 2011; 34: 535-546
    CrossrefPubMedSearch in Google Scholar
  • 22 Baker LB. Sweating Rate and Sweat Sodium Concentration in Athletes: A Review of Methodology and Intra/Interindividual Variability. Sports Med 2017; 47: 111-128
    CrossrefPubMedSearch in Google Scholar
  • 23 American College of Sports Medicine position stand. American College of Sports M Sawka MN, Burke LM, Eichner ER. et al. Exercise and fluid replacement. Med Sci Sports Exerc 2007; 39: 377-390
    CrossrefPubMedSearch in Google Scholar
  • 24 Fritz CO, Morris PE, Richler JJ. Effect size estimates: current use, calculations, and interpretation. J Exp Psychol Gen 2012; 141: 2-18
    CrossrefPubMedSearch in Google Scholar
  • 25 Grossmann F, Flueck JL, Perret C. et al. The thermoregulatory and thermal responses of individuals with a spinal cord injury during exercise, acclimation and by using cooling strategies: A systematic review. Front Physiol 2021; 12: 636997
    CrossrefPubMedSearch in Google Scholar
  • 26 Price MJ, Trbovich M. Thermoregulation following spinal cord injury. Handb Clin Neurol 2018; 157: 799-820
    CrossrefPubMedSearch in Google Scholar
  • 27 Krassioukov A. Autonomic function following cervical spinal cord injury. Respir Physiol Neurobiol 2009; 169: 157-164
    CrossrefPubMedSearch in Google Scholar
  • 28 Gondim FA, Lopes AC, Oliveira GR. et al. Cardiovascular control after spinal cord injury. Curr Vasc Pharmacol 2004; 2: 71-79
    CrossrefPubMedSearch in Google Scholar
  • 29 Gonzalez-Alonso J, Mora-Rodriguez R, Below PR. et al. Dehydration reduces cardiac output and increases systemic and cutaneous vascular resistance during exercise. J Appl Physiol (1985) 1995; 79: 1487-1496
    CrossrefPubMedSearch in Google Scholar
  • 30 González-Alonso J, Calbet JA, Nielsen B. Muscle blood flow is reduced with dehydration during prolonged exercise in humans. J Physiol 1998; 513: 895-905
    CrossrefPubMedSearch in Google Scholar
  • 31 Stöhr EJ, González-Alonso J, Pearson J. et al. Dehydration reduces left ventricular filling at rest and during exercise independent of twist mechanics. J Appl Physiol (1985) 2011; 111: 891-897
    CrossrefPubMedSearch in Google Scholar
  • 32 Sawka MN, Toner MM, Francesconi RP. et al. Hypohydration and exercise: effects of heat acclimation, gender, and environment. J Appl Physiol Respir Environ Exerc Physiol 1983; 55: 1147-1153
    PubMedSearch in Google Scholar
  • 33 Sawka MN. Physiological consequences of hypohydration: Exercise performance and thermoregulation. Med Sci Sports Exerc 1992; 24: 657-670
    CrossrefPubMedSearch in Google Scholar
  • 34 Janse Van Rensburg DC, Schwellnus M, Derman W. et al. Illness Among Paralympic Athletes: Epidemiology, Risk Markers, and Preventative Strategies. Physical medicine and rehabilitation clinics of North America 2018; 29: 185-203
    CrossrefPubMedSearch in Google Scholar
  • 35 Horvath SM, Shelley WB. Acclimatization to extreme heat and its effect on the ability to work in less severe environments. Am J Physiol 1946; 146: 336-343
    CrossrefPubMedSearch in Google Scholar
  • 36 Houmard JA, Costill DL, Davis JA. et al. The influence of exercise intensity on heat acclimation in trained subjects. Med Sci Sports Exerc 1990; 22: 615-620
    CrossrefPubMedSearch in Google Scholar