Background: It is well accepted that persons with spinal cord injury (SCI) have impaired ability to regulate core temperature due to impaired vasomotor and sudomotor activity below their level of injury. Impaired heat dissipation puts SCI athletes at great risk of exercise-induced hyperthermia (EIH) (≯37.8°C). There is minimal evidence for efficacy of any specific cooling method in SCI athletes in a thermoneutral sport-specific setting. Objective: To evaluate the extent of EIH in persons with and without SCI and subsequently examine the effect of a cooling vest to attenuate rise in core body temperature (Tc). Methods: SCI (n = 17) and able-bodied (AB; n = 19) athletes participated in a 60-minute intermittent sprinting exercise in a thermoneutral (21.1°C-23.9°C) environment. Participants were separated according to their level of injury: tetraplegia defined as above T1 (TP; n = 6), high paraplegia defined as T5 through T1 (HP; n = 5), low paraplegia defined as T6 and below (LP; n = 6), and AB (n = 19). Tc was recorded at 15-minute intervals using an ingestible thermometer pill. This protocol was completed with a cooling vest (V) and without a cooling vest (NV). Results: All SCI and most AB athletes experienced EIH. After 60 minutes, Tc of TP athletes was significantly increased compared to HP (P = .03) and AB athletes (P = .007). There was no significant effect of the vest on Tc over time for any group. Conclusions: TP athletes have the highest risk of exercise-induced hyperthermia. The cooling vest does not significantly attenuate rise in Tc in SCI or AB athletes.

Guttmann L, Silver J, Wyndham CH. Thermoregulation in spinal man. J Physiol. 1958;142(3):406–419.
,
Thermoregulation in spinal man
,
J Physiol.
, vol.
142
(pg.
406
-
419
)
Price MJ. Thermoregulation during exercise in individuals with spinal cord injuries. Sports Med. 2006;36(10):863–879.
,
Thermoregulation during exercise in individuals with spinal cord injuries
,
Sports Med.
, vol.
36
(pg.
863
-
879
)
Petrofsky JS. Thermoregulatory stress during rest and exercise in heat in patients with a spinal cord injury. Eur J Appl Physiol Occup Physiol. 1992;64(6):503–507.
,
Thermoregulatory stress during rest and exercise in heat in patients with a spinal cord injury
,
Eur J Appl Physiol Occup Physiol.
, vol.
64
(pg.
503
-
507
)
Price MJ, Campbell IG. Effects of spinal cord lesion level upon thermoregulation during exercise in the heat. Med Sci Sports Exerc. 2003;35(7):1100–1107.
,
Effects of spinal cord lesion level upon thermoregulation during exercise in the heat
,
Med Sci Sports Exerc.
, vol.
35
(pg.
1100
-
1107
)
Price MJ, Campbell IG. Thermoregulatory responses of paraplegic and able-bodied athletes at rest and during prolonged upper body exercise and passive recovery. Eur J Appl Physiol Occup Physiol. 1997;76(6):552–560.
,
Thermoregulatory responses of paraplegic and able-bodied athletes at rest and during prolonged upper body exercise and passive recovery
,
Eur J Appl Physiol Occup Physiol.
, vol.
76
(pg.
552
-
560
)
Chila AG, American Osteopathic Association. Foundations of Osteopathic Medicine (3rd ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011.
,
American Osteopathic Association
,
Foundations of Osteopathic Medicine.
Binkley HM, Beckett J, Casa DJ, Kleiner DM, Plummer PE. National Athletic Trainers’ Association Position Statement: Exertional heat illnesses. J Athl Train. 2002;37(3):329–343.
,
National Athletic Trainers’ Association Position Statement: Exertional heat illnesses
,
J Athl Train.
, vol.
37
(pg.
329
-
343
)
Gonzalez-Alonso J, Teller C, Andersen SL, Jensen FB, Hyldig T, Nielsen B. Influence of body temperature on the development of fatigue during prolonged exercise in the heat. J Appl Physiol. 1999;86(3):1032–1039.
,
Influence of body temperature on the development of fatigue during prolonged exercise in the heat
,
J Appl Physiol.
, vol.
86
(pg.
1032
-
1039
)
Armstrong LE, Casa DJ, Millard-Stafford M, Moran DS, Pyne SW, Roberts WO. American College of Sports Medicine position stand. Exertional heat illness during training and competition. Med Sci Sports Exerc. 2007;39(3):556–572.
,
American College of Sports Medicine position stand. Exertional heat illness during training and competition
,
Med Sci Sports Exerc.
, vol.
39
(pg.
556
-
572
)
Armstrong LE, Crago AE, Adams R, Roberts WO, Maresh CM. Whole-body cooling of hyperthermic runners: Comparison of two field therapies. Am J Emerg Med. 1996;14(4):355–358.
,
Whole-body cooling of hyperthermic runners: Comparison of two field therapies
,
Am J Emerg Med.
, vol.
14
(pg.
355
-
358
)
Clements JM, Casa DJ, Knight J, et al. Ice-water immersion and cold-water immersion provide similar cooling rates in runners with exercise-induced hyperthermia. J Athl Train. 2002;37(2):146–150.
,
Ice-water immersion and cold-water immersion provide similar cooling rates in runners with exercise-induced hyperthermia
,
J Athl Train.
, vol.
37
(pg.
146
-
150
)
Smith JE. Cooling methods used in the treatment of exertional heat illness. Br J Sports Med. 2005;39(8):503-507; discussion 507.
,
Cooling methods used in the treatment of exertional heat illness
,
Br J Sports Med.
, vol.
39
Giesbrecht GG, Jamieson C, Cahill F. Cooling hyperthermic firefighters by immersing forearms and hands in 10°C and 20°C water. Aviat Space Environ Med. 2007;78(6):561–567.
,
Cooling hyperthermic firefighters by immersing forearms and hands in 10°C and 20°C water
,
Aviat Space Environ Med.
, vol.
78
(pg.
561
-
567
)
Duffield R, Dawson B, Bishop D, Fitzsimons M, Lawrence S. Effect of wearing an ice cooling jacket on repeat sprint performance in warm/humid conditions. Br J Sports Med. 2003;37(2):164–169.
,
Effect of wearing an ice cooling jacket on repeat sprint performance in warm/humid conditions
,
Br J Sports Med.
, vol.
37
(pg.
164
-
169
)
Khomenok GA, Hadid A, Preiss-Bloom O, et al. Hand immersion in cold water alleviating physiological strain and increasing tolerance to uncompensable heat stress. Eur J Appl Physiol. 2008;104(2):303–309.
,
Preiss-Bloom O, et al. Hand immersion in cold water alleviating physiological strain and increasing tolerance to uncompensable heat stress
,
Eur J Appl Physiol.
, vol.
104
(pg.
303
-
309
)
Bennett BL, Hagan RD, Huey KA, Minson C, Cain D. Comparison of two cool vests on heat-strain reduction while wearing a firefighting ensemble. Eur J Appl Physiol Occup Physiol. 1995;70(4):322–328.
,
Comparison of two cool vests on heat-strain reduction while wearing a firefighting ensemble
,
Eur J Appl Physiol Occup Physiol.
, vol.
70
(pg.
322
-
328
)
Castle PC, Macdonald AL, Philp A, Webborn A, Watt PW, Maxwell NS. Precooling leg muscle improves intermittent sprint exercise performance in hot, humid conditions. J Appl Physiol. 2006;100(4):1377–1384.
,
Precooling leg muscle improves intermittent sprint exercise performance in hot, humid conditions
,
J Appl Physiol.
, vol.
100
(pg.
1377
-
1384
)
Armstrong LE, Maresh CM, Riebe D, et al. Local cooling in wheelchair athletes during exercise-heat stress. Med Sci Sports Exerc. 1995;27(2):211–216.
,
Local cooling in wheelchair athletes during exercise-heat stress
,
Med Sci Sports Exerc.
, vol.
27
(pg.
211
-
216
)
Webborn N, Price MJ, Castle PC, Goosey-Tolfrey VL. Effects of two cooling strategies on thermoregulatory responses of tetraplegic athletes during repeated intermittent exercise in the heat. J Appl Physiol. 2005;98(6):2101–2107.
,
Effects of two cooling strategies on thermoregulatory responses of tetraplegic athletes during repeated intermittent exercise in the heat
,
J Appl Physiol.
, vol.
98
(pg.
2101
-
2107
)
Hagobian TA, Jacobs KA, Kiratli BJ, Friedlander AL. Foot cooling reduces exercise-induced hyperthermia in men with spinal cord injury. Med Sci Sports Exerc. 2004;36(3):411–417.
,
Foot cooling reduces exercise-induced hyperthermia in men with spinal cord injury
,
Med Sci Sports Exerc.
, vol.
36
(pg.
411
-
417
)
Goosey-Tolfrey V, Swainson M, Boyd C, Atkinson G, Tolfrey K. The effectiveness of hand cooling at reducing exercise-induced hyperthermia and improving distance-race performance in wheelchair and able-bodied athletes. J Appl Physiol. 2008;105(1):37–43.
,
The effectiveness of hand cooling at reducing exercise-induced hyperthermia and improving distance-race performance in wheelchair and able-bodied athletes
,
J Appl Physiol.
, vol.
105
(pg.
37
-
43
)
Pritchett RC, Bishop PA, Yang Z, et al. Evaluation of artificial sweat in athletes with spinal cord injuries. Eur J Appl Physiol. 2010;109(1):125–131.
,
Evaluation of artificial sweat in athletes with spinal cord injuries
,
Eur J Appl Physiol.
, vol.
109
(pg.
125
-
131
)
Hasegawa H, Takatori T, Komura T, Yamasaki M. Wearing a cooling jacket during exercise reduces thermal strain and improves endurance exercise performance in a warm environment. J Strength Cond Res. 2005;19(1):122–128.
,
Wearing a cooling jacket during exercise reduces thermal strain and improves endurance exercise performance in a warm environment
,
J Strength Cond Res.
, vol.
19
(pg.
122
-
128
)
Doerr DF. Divers unlimited suit heat stress assessment and a countermeasure [abstract]. Kennedy Space Center, FL: Biomedical Laboratory; November 1997.
,
Divers unlimited suit heat stress assessment and a countermeasure [abstract].
Webborn N, Price MJ, Castle P, Goosey-Tolfrey VL. Cooling strategies improve intermittent sprint performance in the heat of athletes with tetraplegia. Br J Sports Med. 2010;44(6):455–460.
,
Cooling strategies improve intermittent sprint performance in the heat of athletes with tetraplegia
,
Br J Sports Med.
, vol.
44
(pg.
455
-
460
)
Goosey-Tolfrey VL, Leicht CA. Field-based physiological testing of wheelchair athletes. Sports Med. 2013;43(2):77–91.
,
Field-based physiological testing of wheelchair athletes
,
Sports Med.
, vol.
43
(pg.
77
-
91
)
House JR, Lunt HC, Taylor R, Milligan G, Lyons JA, House CM. The impact of a phase-change cooling vest on heat strain and the effect of different cooling pack melting temperatures [published online ahead of print November 15, 2012]. Eur J Appl Physiol.
,
The impact of a phase-change cooling vest on heat strain and the effect of different cooling pack melting temperatures [published online ahead of print November 15, 2012]
,
Eur J Appl Physiol.
Chou C, Tochihara Y, Kim T. Physiological and subjective responses to cooling devices on firefighting protective clothing. Eur J Appl Physiol. 2008;104(2):369–374.
,
Physiological and subjective responses to cooling devices on firefighting protective clothing
,
Eur J Appl Physiol.
, vol.
104
(pg.
369
-
374
)
Sparling PB, Snow TK, Millard-Stafford ML. Monitoring core temperature during exercise: Ingestible sensor vs. rectal thermistor. Aviat Space Environ Med. 1993;64(8):760–763.
,
Monitoring core temperature during exercise: Ingestible sensor vs. rectal thermistor
,
Aviat Space Environ Med.
, vol.
64
(pg.
760
-
763
)
O’Brien C, Hoyt RW, Buller MJ, Castellani JW, Young AJ. Telemetry pill measurement of core temperature in humans during active heating and cooling. Med Sci Sports Exerc. 1998;30(3):468–472.
,
Telemetry pill measurement of core temperature in humans during active heating and cooling
,
Med Sci Sports Exerc.
, vol.
30
(pg.
468
-
472
)
Mittal BB, Sathiaseelan V, Rademaker AW, Pierce MC, Johnson PM, Brand WN. Evaluation of an ingestible telemetric temperature sensor for deep hyperthermia applications. Int J Radiat Oncol Biol Phys. 1991;21(5):1353–1361.
,
Evaluation of an ingestible telemetric temperature sensor for deep hyperthermia applications
,
Int J Radiat Oncol Biol Phys.
, vol.
21
(pg.
1353
-
1361
)
Byrne C, Lim CL. The ingestible telemetric body core temperature sensor: A review of validity and exercise applications. Br J Sports Med. 2007;41(3):126–133.
,
The ingestible telemetric body core temperature sensor: A review of validity and exercise applications
,
Br J Sports Med.
, vol.
41
(pg.
126
-
133
)
Gonzalez EG, Myers SJ, Edelstein JE, Lieberman JS, Downey JA. Downey and Darling’s Physiological Basis of Rehabilitation Medicine (3rd ed.). Waltham, MA: Butterworth Heinemann; 2001.
,
Downey and Darling’s Physiological Basis of Rehabilitation Medicine.
Mills PB, Krassioukov A. Autonomic function as a missing piece of the classification of paralympic athletes with spinal cord injury. Spinal Cord. 2011;49(7):768–776.
,
Autonomic function as a missing piece of the classification of paralympic athletes with spinal cord injury
,
Spinal Cord.
, vol.
49
(pg.
768
-
776
)
Curt A, Weinhardt C, Dietz V. Significance of sympathetic skin response in the assessment of autonomic failure in patients with spinal cord injury. J Auton Nerv Syst. 1996;61(2):175–180.
,
Significance of sympathetic skin response in the assessment of autonomic failure in patients with spinal cord injury
,
J Auton Nerv Syst.
, vol.
61
(pg.
175
-
180
)
Olive JL, McCully KK, Dudley GA. Blood flow response in individuals with incomplete spinal cord injuries. Spinal Cord. 2002;40(12):639–645.
,
Blood flow response in individuals with incomplete spinal cord injuries
,
Spinal Cord.
, vol.
40
(pg.
639
-
645
)
Saboisky J, Marino FE, Kay D, Cannon J. Exercise heat stress does not reduce central activation to non-exercised human skeletal muscle. Exp Physiol. 2003;88(6):783–790.
,
Exercise heat stress does not reduce central activation to non-exercised human skeletal muscle
,
Exp Physiol.
, vol.
88
(pg.
783
-
790
)
Sawka MN, Young AJ, Latzka WA, Neufer PD, Quigley MD, Pandolf KB. Human tolerance to heat strain during exercise: Influence of hydration. J Appl Physiol. 1992;73(1):368–375.
,
Human tolerance to heat strain during exercise: Influence of hydration
,
J Appl Physiol.
, vol.
73
(pg.
368
-
375
)
Downey JA, Huckaba CE, Kelley PS, Tam HS, Darling RC, Cheh HY. Sweating responses to central and peripheral heating in spinal man. J Appl Physiol. 1976;40(5):701–706.
,
Sweating responses to central and peripheral heating in spinal man
,
J Appl Physiol.
, vol.
40
(pg.
701
-
706
)
Guttmann L. Reflection on the 1976 Toronto Olympiad for the physically disabled. Paraplegia. 1976;14(3):225–240.
,
Reflection on the 1976 Toronto Olympiad for the physically disabled
,
Paraplegia.
, vol.
14
(pg.
225
-
240
)
Downey JA, Darling RC, Chiodi HP. The response of tetraplegia patients to cold. Arch Phys Med Rehabil. 1967;48(12):645–649.
,
The response of tetraplegia patients to cold
,
Arch Phys Med Rehabil.
, vol.
48
(pg.
645
-
649
)
Downey JA, Chiodi HP, Darling RC. Central temperature regulation in the spinal man. J Appl Physiol. 1967;22(1):91–94.
,
Central temperature regulation in the spinal man
,
J Appl Physiol.
, vol.
22
(pg.
91
-
94
)
Downey JA, Huckaba CE, Myers SJ, Darling RC. Thermoregulation in the spinal man. J Appl Physiol. 1973;34(6):790–794.
,
J Appl Physiol.
, vol.
34
(pg.
790
-
794
)
Price M, Goosey-Tolfrey V. Heat flow of the paraplegic and able-bodied lower limb during resting heat exposure. J Therm Biol. 2008;33(4):255–260.
,
Heat flow of the paraplegic and able-bodied lower limb during resting heat exposure
,
J Therm Biol.
, vol.
33
(pg.
255
-
260
)
Havenith G, van Middendorp H. The relative influence of physical fitness, acclimatization state, anthropometric measures and gender on individual reactions to heat stress. Eur J Appl Physiol Occup Physiol. 1990;61(5-6):419–427.
,
The relative influence of physical fitness, acclimatization state, anthropometric measures and gender on individual reactions to heat stress
,
Eur J Appl Physiol Occup Physiol.
, vol.
61
(pg.
419
-
427
)
Kenny GP, Schissler AR, Stapleton J, et al. Ice cooling vest on tolerance for exercise under uncompensable heat stress. J Occup Environ Hyg. 2011;8(8):484–491.
,
Ice cooling vest on tolerance for exercise under uncompensable heat stress
,
J Occup Environ Hyg.
, vol.
8
(pg.
484
-
491
)
Gao C, Kuklane K, Holmer I. Cooling vests with phase change materials: The effects of melting temperature on heat strain alleviation in an extremely hot environment. Eur J Appl Physiol. 2011;111(6):1207–1216.
,
Cooling vests with phase change materials: The effects of melting temperature on heat strain alleviation in an extremely hot environment
,
Eur J Appl Physiol.
, vol.
111
(pg.
1207
-
1216
)
Muir IH, Bishop PA, Ray P. Effects of a novel ice-cooling technique on work in protective clothing at 28°C, 23°C, and 18°C WBGTs. Am Ind Hyg Assoc J. 1999;60(1):96–104.
,
Effects of a novel ice-cooling technique on work in protective clothing at 28°C, 23°C, and 18°C WBGTs
,
Am Ind Hyg Assoc J.
, vol.
60
(pg.
96
-
104
)
Lopez RM, Cleary MA, Jones LC, Zuri RE. Thermoregulatory influence of a cooling vest on hyperthermic athletes. J Athl Train. 2008;43(1):55–61.
,
Thermoregulatory influence of a cooling vest on hyperthermic athletes
,
J Athl Train.
, vol.
43
(pg.
55
-
61
)
Barwood MJ, Newton PS, Tipton MJ. Ventilated vest and tolerance for intermittent exercise in hot, dry conditions with military clothing. Aviat Space Environ Med. 2009;80(4):353–359.
,
Ventilated vest and tolerance for intermittent exercise in hot, dry conditions with military clothing.
,
Aviat Space Environ Med.
, vol.
80
(pg.
353
-
359
)
Goosey-Tolfrey VL, Diaper NJ, Crosland J, Tolfrey K. Fluid intake during wheelchair exercise in the heat: Effects of localized cooling garments. Int J Sports Physiol Perform. 2008;3(2):145–156.
,
Fluid intake during wheelchair exercise in the heat: Effects of localized cooling garments
,
Int J Sports Physiol Perform.
, vol.
3
(pg.
145
-
156
)
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