Enter your details:
Name:
E-mail:
 
Thank you for subscribing.
Subscribe to our newsletter!


Yang Zhang1, Stevo Popovic1, Dusko Bjelica1, , ,

1University of Montenegro, Faculty for Sport and Physical Education, Niksic, Montenegro
2

Exercise Core Body Temperature is Adequately Regulated Following Spinal Cord Injury: A Meta-Analysis

J. Anthr. Sport Phys. Educ. 2019, 3(4), 53-60 | DOI: 10.26773/jaspe.191010

Abstract

Damage to the spinal cord results in malfunction of sympathetic pathways, which consequently influences thermoregulation during exercise. A consensus view is that athletes with spinal cord injury (SCI) are at a heightened thermal strain than the able-bodied athletes. However, a number of studies have reported similar increases in core body temperature in both populations. This study presented an up-to-date review of core body temperature response to exercise, from a meta-analytic point of view. Inclusion criteria were persons with SCI and control population (either healthy persons or wheelchair athletes without SCI) completed an exercise trial and their core body temperature responses were recorded under the same environmental conditions. Effect of SCI on thermoregulatory capabilities was quantified as raw mean core body temperature difference. Twelve studies examining 100 persons with SCI (Cervical (C2) to Lumbar (L5)) and 97 persons without SCI were meta-analyzed. The exercise interventions were submaximal exercise and the unweighted means ± standard deviations heat index and exercise duration were 31.5±11.9°C and 57±20 min, respectively. Regardless of injury, core body temperature was not different: raw mean difference, 0.048°C; 95% confidence interval, -0.12°C to 0.22°C. In conclusion, under SCI sport-specific exercise and environmental conditions, SCI does not produce outsized thermoregulatory impact, though the influence could be variable as a result of different lesion levels.

Keywords

Paraplegia, Tetraplegia, Rectal Temperature, Heat Stress



View full article
(PDF – 455KB)

References

American College of Sports Medicine, Armstrong, L.E., Casa, D.J., Millard-Stafford, M., Moran, DS., Pyne, S. W., & Roberts, W.O. (2007). American College of Sports Medicine position stand. Exertional heat illness during training and competition. Medicine and Science in Sports and Exercise, 39(3), 556-572.

Boot, C.R., Binkhorst, R.A., & Hopman, M.T. (2006). Body temperature responses in spinal cord injured individuals during exercise in the cold and heat. International Journal of Sports Medicine, 27(8), 599-604.

Boulant, J.A. (2006). Neuronal basis of Hammel’s model for set-point thermoregulation. Journal of Applied Physiology, 100(4), 1347-1354.

Casa, D.J., DeMartini, J.K., Bergeron, M.F., Csillan, D., Eichner, E.R., Lopez, R.M., Ferrara, M.S., Miller, K.C., O’Connor, F., Sawka, M.N., & Yeargin, S.W. (2015). National Athletic Trainers’ Association Position Statement: Exertional Heat Illnesses. Journal of Athletic Training, 50(9), 986-1000.

Castellani, J.W., Armstrong, L.E., Kenefick, R.W., Pasqualicchio, A.A., Riebe, D., Gabaree, C.L., & Maresh, C.M. (2001). Cortisol and testosterone concentrations in wheelchair athletes during submaximal wheelchair ergometry. European Journal of Applied Physiology, 84(1-2), 42-47.

Conti, B., Sanchez-Alavez, M., Winsky-Sommerer, R., Morale, M., Lucero, J., Brownell, S., Fabre, V., Huitron-Resendiz, S., Henriksen, S., Zorrilla, E.P., de Lecea, L., & Bartfai, T. (2006). Transgenic mice with a reduced core body temperature have an increased life span. Science, 314(5800), 825-828.

Dawson, B., Bridle, J., & Lockwood, R. J. (1994). Thermoregulation of paraplegic and able bodied men during prolonged exercise in hot and cool climates. Paraplegia, 32(12), 860-870.

Edwards, T., Barfield, J.P., Niemiro, G.M., Beals, J.W., Broad, E.M., Motl, R.W., De Lisio, M., Burd, N.A., & Pilutti, L.A. (2018). Physiological responses during a 25-km time trial in elite wheelchair racing athletes. Spinal Cord Series and Cases, 4, 77.

Egger, M., Davey Smith, G., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. British Medical Journal, 315(7109), 629-634.

Fitzgerald, P.I., Sedlock, D.A., & Knowlton, R.G. (1990). Circulatory and thermal adjustments to prolonged exercise in paraplegic women. Medicine and Science in Sports and Exercise, 22(5), 629-635.

Folkow, B., Strom, G., & Uvnas, B. (1949). Cutaneous vasodilatation elicited by local heating of the anterior hypothalamus in cats and dogs. Acta physiologica Scandinavica, 17(4), 317-326.

Fu, R., Vandermeer, B.W., Shamliyan, T.A., O’Neil, M.E., Yazdi, F., Fox, S.H., & Morton, S.C. (2013). Handling continuous outcomes in quantitative synthesis. Rockville, MD: Agency for Healthcare Research and Quality.

Fuller, A., Carter, R.N., & Mitchell, D. (1998). Brain and abdominal temperatures at fatigue in rats exercising in the heat. Journal of Applied Physiology, 84(3), 877-883.

Fusco, M.M., Hardy, J.D., & Hammel, H.T. (1961). Interaction of central and peripheral factors in physiological temperature regulation. The American Journal of Physiology, 200(3), 572-580.

Goosey-Tolfrey, V., Swainson, M., Boyd, C., Atkinson, G., & Tolfrey, K. (2008). The effectiveness of hand cooling at reducing exercise-induced hyperthermia and improving distance-race performance in wheelchair and able-bodied athletes. Journal of Applied Physiology, 105(1), 37-43.

Griggs, K.E., Havenith, G., Price, M.J., Mason, B.S., & Goosey-Tolfrey, V.L. (2017). Thermoregulatory responses during competitive wheelchair rugby match play. International Journal of Sports Medicine, 38(3), 177-183.

Grobler, L., Derman, W., Racinais, S., Ngai, A.S.H., & van de Vliet, P. (2019). Illness at a Para Athletics Track and Field World Championships under hot and humid ambient conditions. PM & R. https://doi.org/10.1002/pmrj.12086

Higgins, J.P., & Green, S. (2008). Cochrane Handbook for Systematic Reviews of Interventions. In J.P. Higgins & S. Green (Eds.), Cochrane Handbook for Systematic Reviews of Interventions (pp. 177). Chichester: Wiley-Blackwell.

Jessen, C., & Ludwig, O. (1971). Spinal cord and hypothalamus as core sensors of temperature in the conscious dog. II. Addition of signals. Pflügers Archiv, 324(3), 205-216.

Lepretre, P.M., Goosey-Tolfrey, V.L., Janssen, T.W., & Perret, C. (2016). Editorial: Rio, Tokyo Paralympic Games and Beyond: How to Prepare Athletes with Motor Disabilities for Peaking. Frontiers in Physiology, 7, 497.

Moseley, A.M., Herbert, R.D., Sherrington, C., & Maher, C.G. (2002). Evidence for physiotherapy practice: a survey of the Physiotherapy Evidence Database (PEDro). The Australian Journal of Physiotherapy, 48(1), 43-49.

Nybo, L., Secher, N.H., & Nielsen, B. (2002). Inadequate heat release from the human brain during prolonged exercise with hyperthermia. The Journal of Physiology, 545(2), 697-704.

Price, M.J. (2016). Preparation of Paralympic Athletes; Environmental Concerns and Heat Acclimation. Frontiers in Physiology, 6, 415.

Price, M.J., & Campbell, I.G. (1997). Thermoregulatory responses of paraplegic and able-bodied athletes at rest and during prolonged upper body exercise and passive recovery. European Journal of Applied Physiology and Occupational Physiology, 76(6), 552-560.

Price, M.J., & Campbell, I.G. (1999). Thermoregulatory responses of spinal cord injured and able-bodied athletes to prolonged upper body exercise and recovery. Spinal Cord, 37(11), 772-779.

Price, M.J., & Trbovich, M. (2018). Thermoregulation following spinal cord injury. Handbook of Clinical Neurology, 157, 799-820.

Shafton, A.D., Kitchener, P., McKinley, M.J., & McAllen, R.M. (2014). Reflex control of rat tail sympathetic nerve activity by abdominal temperature. Temperature°, 1(1), 37-41.

Song, K., Wang, H., Kamm, G.B., Pohle, J., de Castro Reis, F., Heppenstall, P., Wende, H., & Siemens, J. (2016). The TRPM2 channel is a hypothalamic heat sensor that limits fever and can drive hypothermia. Science, 353(6306), 1393-1398.

Theisen, D., Vanlandewijck, Y., Sturbois, X., & Francaux, M. (2001). Cutaneous vascular response and thermoregulation in individuals with paraplegia during sustained arm-cranking exercise. International Journal of Sports Medicine, 22(2), 97-102.

Trbovich, M., Ortega, C., Schroeder, J., & Fredrickson, M. (2014). Effect of a cooling vest on core temperature in athletes with and without spinal cord injury. Topics in Spinal Cord Injury Rehabilitation, 20(1), 70-80.

Van Duijnhoven, N.T., Janssen, T.W., Green, D.J., Minson, C.T., Hopman, M.T., & Thijssen, D.H. (2009). Effect of functional electrostimulation on impaired skin vasodilator responses to local heating in spinal cord injury. Journal of Applied Physiology, 106(4), 1065-1071.

Veltmeijer, M.T., Pluim, B., Thijssen, D.H., Hopman, M.T., & Eijsvogels, T.M. (2014). Thermoregulatory responses in wheelchair tennis players: a pilot study. Spinal Cord, 52(5), 373-377.

Walter, M., & Krassioukov, A.V. (2018). Autonomic Nervous System in Paralympic Athletes with Spinal Cord Injury. Physical Medicine and Rehabilitation Clinics of North America, 29(2), 245-266.

Walters, T., Ryan, K., Tate, L., & Mason, P. (2000). Exercise in the heat is limited by a critical internal temperature. Journal of Applied Physiology, 89(2), 799-806.

Zacharakis, E.D., Kounalakis, S.N., Nassis, G.P., & Geladas, N.D. (2013). Cardiovascular drift in trained paraplegic and able-bodied individuals during prolonged wheelchair exercise: effect of fluid replacement. Applied Physiology, Nutrition, and Metabolism, 38(4), 375-381.