Physical characteristics cannot be used to predict cooling time using cold-water immersion as a treatment for exertional hyperthermia

2018 ◽  
Vol 43 (8) ◽  
pp. 857-860
Author(s):  
Martin P. Poirier ◽  
Sean R. Notley ◽  
Andreas D. Flouris ◽  
Glen P. Kenny
Keyword(s):  
Lean Body Mass ◽  
Body Mass ◽  
Rectal Temperature ◽  
Cold Water ◽  
Water Immersion ◽  
Cold Water Immersion ◽  
Physical Characteristics ◽  
Cooling Time ◽  
Safe Alternative ◽  
Men And Women

We examined if physical characteristics could be used to predict cooling time during cold water immersion (CWI, 2 °C) following exertional hyperthermia (rectal temperature ≥39.5 °C) in a physically heterogeneous group of men and women (n = 62). Lean body mass was the only significant predictor of cooling time following CWI (R2 = 0.137; P < 0.001); however, that prediction did not provide the precision (mean residual square error: 3.18 ± 2.28 min) required to act as a safe alternative to rectal temperature measurements.

scholarly journals Cold-Water Immersion Cooling Rates in Football Linemen and Cross-Country Runners With Exercise-Induced Hyperthermia

2017 ◽  
Vol 52 (10) ◽  
pp. 902-909 ◽  
Author(s):  
Sandra Fowkes Godek ◽  
Katherine E. Morrison ◽  
Gregory Scullin
Keyword(s):  
Cooling Rate ◽  
Body Mass ◽  
Body Fat ◽  
Cold Water ◽  
Water Immersion ◽  
Cold Water Immersion ◽  
Physical Characteristics ◽  
Cooling Rates ◽  
Cross Country ◽  
Cross Country Runners

Context:  Ideal and acceptable cooling rates in hyperthermic athletes have been established in average-sized participants. Football linemen (FBs) have a small body surface area (BSA)-to-mass ratio compared with smaller athletes, which hinders heat dissipation. Objective:  To determine cooling rates using cold-water immersion in hyperthermic FBs and cross-country runners (CCs). Design:  Cohort study. Setting:  Controlled university laboratory. Patients or Other Participants:  Nine FBs (age = 21.7 ± 1.7 years, height = 188.7 ± 4 cm, mass = 128.1 ± 18 kg, body fat = 28.9% ± 7.1%, lean body mass [LBM] = 86.9 ± 19 kg, BSA = 2.54 ± 0.13 m2, BSA/mass = 201 ± 21.3 cm2/kg, and BSA/LBM = 276.4 ± 19.7 cm2/kg) and 7 CCs (age = 20 ± 1.8 years, height = 176 ± 4.1 cm, mass = 68.7 ± 6.5 kg, body fat = 10.2% ± 1.6%, LBM = 61.7 ± 5.3 kg, BSA = 1.84 ± 0.1 m2, BSA/mass = 268.3 ± 11.7 cm2/kg, and BSA/LBM = 298.4 ± 11.7 cm2/kg). Intervention(s):  Participants ingested an intestinal sensor, exercised in a climatic chamber (39°C, 40% relative humidity) until either target core temperature (Tgi) was 39.5°C or volitional exhaustion was reached, and were immediately immersed in a 10°C circulated bath until Tgi declined to 37.5°C. A general linear model repeated-measures analysis of variance and independent t tests were calculated, with P &lt; .05. Main Outcome Measure(s):  Physical characteristics, maximal Tgi, time to reach 37.5°C, and cooling rate. Results:  Physical characteristics were different between groups. No differences existed in environmental measures or maximal Tgi (FBs = 39.12°C ± 0.39°C, CCs = 39.38°C ± 0.19°C; P = .12). Cooling times required to reach 37.5°C (FBs = 11.4 ± 4 minutes, CCs = 7.7 ± 0.06 minutes; P &lt; .002) and therefore cooling rates (FBs = 0.156°C·min−1 ± 0.06°C·min−1, CCs = .255°C·min−1 ± 0.05°C·min−1; P &lt; .002) were different. Strong correlations were found between cooling rate and body mass (r = −0.76, P &lt; .001), total BSA (r = −0.74, P &lt; .001), BSA/mass (r = 0.73, P &lt; .001), LBM/mass (r = 0.72, P &lt; .002), and LBM (r = −0.72, P &lt; .002). Conclusions:  With cold-water immersion, the cooling rate in CCs (0.255°C·min−1) was greater than in FBs (0.156°C·min−1); however, both were considered ideal (≥0.155°C·min−1). Athletic trainers should realize that it likely takes considerably longer to cool large hyperthermic American-football players (&gt;11 minutes) than smaller, leaner athletes (7.7 minutes). Cooling rates varied widely from 0.332°C·min−1 in a small runner to only 0.101°C·min−1 in a lineman, supporting the use of rectal temperature for monitoring during cooling.

Thermal responses of men and women during cold-water immersion: influence of exercise intensity

1992 ◽  
Vol 65 (3) ◽  
pp. 265-270 ◽  
Author(s):  
William D. McArdle ◽  
Michael M. Toner ◽  
John R. Magel ◽  
Robert J. Spinal ◽  
Kent B. Pandolf
Keyword(s):  
Exercise Intensity ◽  
Cold Water ◽  
Water Immersion ◽  
Cold Water Immersion ◽  
Men And Women

scholarly journals Physiologic and Perceptual Responses to Cold-Shower Cooling After Exercise-Induced Hyperthermia

2016 ◽  
Vol 51 (3) ◽  
pp. 252-257 ◽  
Author(s):  
Cory L. Butts ◽  
Brendon P. McDermott ◽  
Brian J. Buening ◽  
Jeffrey A. Bonacci ◽  
Matthew S. Ganio ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cooling Rate ◽  
Rectal Temperature ◽  
Muscle Pain ◽  
Cold Water ◽  
Thermal Sensation ◽  
Water Immersion ◽  
Heat Stroke ◽  
Cold Water Immersion ◽  
Exercise Induced

Exercise conducted in hot, humid environments increases the risk for exertional heat stroke (EHS). The current recommended treatment of EHS is cold-water immersion; however, limitations may require the use of alternative resources such as a cold shower (CS) or dousing with a hose to cool EHS patients.Context: To investigate the cooling effectiveness of a CS after exercise-induced hyperthermia.Objective: Randomized, crossover controlled study.Design: Environmental chamber (temperature = 33.4°C ± 2.1°C; relative humidity = 27.1% ± 1.4%).Setting: Seventeen participants (10 male, 7 female; height = 1.75 ± 0.07 m, body mass = 70.4 ± 8.7 kg, body surface area = 1.85 ± 0.13 m2, age range = 19–35 years) volunteered.Patients or Other Participants: On 2 occasions, participants completed matched-intensity volitional exercise on an ergometer or treadmill to elevate rectal temperature to ≥39°C or until participant fatigue prevented continuation (reaching at least 38.5°C). They were then either treated with a CS (20.8°C ± 0.80°C) or seated in the chamber (control [CON] condition) for 15 minutes.Intervention(s): Rectal temperature, calculated cooling rate, heart rate, and perceptual measures (thermal sensation and perceived muscle pain).Main Outcome Measure(s): The rectal temperature (P = .98), heart rate (P = .85), thermal sensation (P = .69), and muscle pain (P = .31) were not different during exercise for the CS and CON trials (P &gt; .05). Overall, the cooling rate was faster during CS (0.07°C/min ± 0.03°C/min) than during CON (0.04°C/min ± 0.03°C/min; t16 = 2.77, P = .01). Heart-rate changes were greater during CS (45 ± 20 beats per minute) compared with CON (27 ± 10 beats per minute; t16 = 3.32, P = .004). Thermal sensation was reduced to a greater extent with CS than with CON (F3,45 = 41.12, P &lt; .001).Results: Although the CS facilitated cooling rates faster than no treatment, clinicians should continue to advocate for accepted cooling modalities and use CS only if no other validated means of cooling are available.Conclusions:

scholarly journals Chemically Activated Cooling Vest’s Effect on Cooling Rate Following Exercise-Induced Hyperthermia: A Randomized Counter-Balanced Crossover Study

Medicina ◽  
2020 ◽  
Vol 56 (10) ◽  
pp. 539
Author(s):  
Yuri Hosokawa ◽  
Luke N. Belval ◽  
William M. Adams ◽  
Lesley W. Vandermark ◽  
Douglas J. Casa
Keyword(s):  
Cooling Rate ◽  
Body Mass ◽  
Cold Water ◽  
Water Immersion ◽  
Heat Stroke ◽  
Cooling Capacity ◽  
Cold Water Immersion ◽  
Whole Body ◽  
Climatic Chamber ◽  
Exercise Induced

Background and objectives: Exertional heat stroke (EHS) is a potentially lethal, hyperthermic condition that warrants immediate cooling to optimize the patient outcome. The study aimed to examine if a portable cooling vest meets the established cooling criteria (0.15 °C·min−1 or greater) for EHS treatment. It was hypothesized that a cooling vest will not meet the established cooling criteria for EHS treatment. Materials and Methods: Fourteen recreationally active participants (mean ± SD; male, n = 8; age, 25 ± 4 years; body mass, 86.7 ± 10.5 kg; body fat, 16.5 ± 5.2%; body surface area, 2.06 ± 0.15 m2. female, n = 6; 22 ± 2 years; 61.3 ± 6.7 kg; 22.8 ± 4.4%; 1.66 ± 0.11 m2) exercised on a motorized treadmill in a hot climatic chamber (ambient temperature 39.8 ± 1.9 °C, relative humidity 37.4 ± 6.9%) until they reached rectal temperature (TRE) >39 °C (mean TRE, 39.59 ± 0.38 °C). Following exercise, participants were cooled using either a cooling vest (VEST) or passive rest (PASS) in the climatic chamber until TRE reached 38.25 °C. Trials were assigned using randomized, counter-balanced crossover design. Results: There was a main effect of cooling modality type on cooling rates (F[1, 24] = 10.46, p < 0.01, η2p = 0.30), with a greater cooling rate observed in VEST (0.06 ± 0.02 °C·min−1) than PASS (0.04 ± 0.01 °C·min−1) (MD = 0.02, 95% CI = [0.01, 0.03]). There were also main effects of sex (F[1, 24] = 5.97, p = 0.02, η2p = 0.20) and cooling modality type (F[1, 24] = 4.38, p = 0.047, η2p = 0.15) on cooling duration, with a faster cooling time in female (26.9 min) than male participants (42.2 min) (MD = 15.3 min, 95% CI = [2.4, 28.2]) and faster cooling duration in VEST than PASS (MD = 13.1 min, 95% CI = [0.2, 26.0]). An increased body mass was associated with a decreased cooling rate in PASS (r = −0.580, p = 0.03); however, this association was not significant in vest (r = −0.252, p = 0.39). Conclusions: Although VEST exhibited a greater cooling capacity than PASS, VEST was far below an acceptable cooling rate for EHS treatment. VEST should not replace immediate whole-body cold-water immersion when EHS is suspected.

The Influence of Physical Characteristics in the Treatment of Exertional Hyperthermia by Cold Water Immersion

2015 ◽  
Vol 47 ◽  
pp. 461-462
Author(s):  
Brian J. Friesen ◽  
Martin P. Poirier ◽  
Daniel Gagnon ◽  
Ryan McGinn ◽  
Glen P. Kenny
Keyword(s):  
Cold Water ◽  
Water Immersion ◽  
Cold Water Immersion ◽  
Physical Characteristics

scholarly journals Effect of cold water immersion on muscle damage indexes after simulated soccer training in young soccer players

2020 ◽  
Vol 12 (1) ◽  
pp. 236-241
Author(s):  
Saman Khakpoor Roonkiani ◽  
Mohsen Ebrahimi ◽  
Ali Shamsi Majelan
Keyword(s):  
Body Mass Index ◽  
Muscle Damage ◽  
Body Mass ◽  
Cold Water ◽  
Water Immersion ◽  
Cold Water Immersion ◽  
Soccer Players ◽  
Control Group ◽  
Significant Difference ◽  
Soccer Training

Summary Study aim: To investigate the effect of cold water immersion (CWI) on muscle damage indexes after simulated soccer activity in young soccer players. Material and methods: Eighteen professional male soccer players were randomly divided into two groups: CWI (n = 10, age 19.3 ± 0.5, body mass index 22.2 ± 1.3) and control (n = 8, age 19.4 ± 0.8, body mass index 21.7 ± 1.5). Both groups performed a simulated 90-minute soccer-specific aerobic field test (SAFT90). Then, the CWI group subjects immersed themselves for 10 minutes in 8°C water, while the control group subjects sat passively for the same time period. Blood samples were taken before, immediately after, 10 minutes, 24 hours and 48 hours after the training session in a fasted state. Blood lactate, creatine kinase (CK) and lactate dehydrogenase (LDH) enzyme levels were measured. Results: Lactate, CK and LDH levels increased significantly after training (p < 0.001). There were significant interactions between groups and subsequent measurements for CK (p = 0.0012) and LDH (p = 0.0471). There was no significant difference in lactate level between the two groups at any aforementioned time. Conclusion: It seems that CWI after simulated 90-minute soccer training can reduce the values of muscle damage indexes in soccer players.

Human thermoregulatory responses during cold water immersion after artificially induced sunburn

1992 ◽  
Vol 262 (4) ◽  
pp. R617-R623 ◽  
Author(s):  
K. B. Pandolf ◽  
R. W. Gange ◽  
W. A. Latzka ◽  
I. H. Blank ◽  
A. J. Young ◽  
...  
Keyword(s):  
Skin Temperature ◽  
Rectal Temperature ◽  
Cold Water ◽  
Water Immersion ◽  
Cold Water Immersion ◽  
The Body ◽  
Esophageal Temperature ◽  
Mean Skin Temperature ◽  
Thermoregulatory Responses ◽  
The Mean

Thermoregulatory responses during cold-water immersion (water temperature 22 degrees C) were compared in 10 young men before as well as 24 h and 1 wk after twice the minimal erythemal dose of ultraviolet-B radiation that covered approximately 85% of the body surface area. After 10 min of seated rest in cold water, the mean exercised for 50 min on a cycle ergometer (approximately 51% of maximal aerobic power). Rectal temperature, regional and mean heat flow (hc), mean skin temperature from five sites, and hearrt rate were measured continuously for all volunteers while esophageal temperature was measured for six subjects. Venous blood samples were collected before and after cold water immersion. The mean skin temperature was higher (P less than 0.05) throughout the 60-min cold water exposure both 24 h and 1 wk after sunburn compared with before sunburn. Mean hc was higher (P less than 0.05) after 10 min resting immersion and during the first 10 min of exercise when 24 h postsunburn was compared with presunburn, with the difference attributed primarily to higher hc from the back and chest. While rectal temperature and heart rate did not differ between conditions, esophageal temperature before immersion and throughout the 60 min of cold water immersion was higher (P less than 0.05) when 24 h postsunburn was compared with presunburn. Plasma volume increased (P less than 0.05) after 1 wk postsunburn compared with presunburn, whereas plasma protein concentration was reduced (P less than 0.05). After exercise cortisol was greater (P less than 0.05) 24 h postsunburn compared with either presunburn or 1 wk postsunburn.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Temperate-Water Immersion as a Treatment for Hyperthermic Humans Wearing American Football Uniforms

2017 ◽  
Vol 52 (8) ◽  
pp. 747-752 ◽  
Author(s):  
Kevin C. Miller ◽  
Tyler Truxton ◽  
Blaine Long
Keyword(s):  
Rectal Temperature ◽  
Cold Water ◽  
Thermal Sensation ◽  
Water Immersion ◽  
Cold Water Immersion ◽  
American Football ◽  
Body Core Temperature ◽  
Temperate Water ◽  
Cooling Rates ◽  
Before And After

Context:  Cold-water immersion (CWI; 10°C) can effectively reduce body core temperature even if a hyperthermic human is wearing a full American football uniform (PADS) during treatment. Temperate-water immersion (TWI; 21°C) may be an effective alternative to CWI if resources for the latter (eg, ice) are unavailable. Objective:  To measure rectal temperature (Trec) cooling rates, thermal sensation, and Environmental Symptoms Questionnaire (ESQ) scores of participants wearing PADS or shorts, undergarments, and socks (NOpads) before, during, and after TWI. Design:  Crossover study. Setting:  Laboratory. Patients or Other Participants:  Thirteen physically active, unacclimatized men (age = 22 ± 2 years, height = 182.3 ± 5.2 cm, mass = 82.5 ± 13.4 kg, body fat = 10% ± 4%, body surface area = 2.04 ± 0.16 m2). Intervention(s):  Participants exercised in the heat (40°C, 50% relative humidity) on 2 days while wearing PADS until Trec reached 39.5°C. Participants then underwent TWI while wearing either NOpads or PADS until Trec reached 38°C. Thermal sensation and ESQ responses were collected at various times before and after exercise. Main Outcome Measure(s):  Temperate-water immersion duration (minutes), Trec cooling rates (°C/min), thermal sensation, and ESQ scores. Results:  Participants had similar exercise times (NOpads = 38.1 ± 8.1 minutes, PADS = 38.1 ± 8.5 minutes), hypohydration levels (NOpads = 1.1% ± 0.2%, PADS = 1.2% ± 0.2%), and thermal sensation ratings (NOpads = 7.1 ± 0.4, PADS = 7.3 ± 0.4) before TWI. Rectal temperature cooling rates were similar between conditions (NOpads = 0.12°C/min ± 0.05°C/min, PADS = 0.13°C/min ± 0.05°C/min; t12 = 0.82, P = .79). Thermal sensation and ESQ scores were unremarkable between conditions over time. Conclusions:  Temperate-water immersion produced acceptable (ie, &gt;0.08°C/min), though not ideal, cooling rates regardless of whether PADS or NOpads were worn. If a football uniform is difficult to remove or the patient is noncompliant, clinicians should begin water-immersion treatment with the athlete fully equipped. Clinicians should strive to use CWI to treat severe hyperthermia, but when CWI is not feasible, TWI should be the next treatment option because its cooling rate was higher than the rates of other common modalities (eg, ice packs, fanning).

scholarly journals Validity of Core Temperature Measurements at 3 Rectal Depths During Rest, Exercise, Cold-Water Immersion, and Recovery

2017 ◽  
Vol 52 (4) ◽  
pp. 332-338 ◽  
Author(s):  
Kevin C. Miller ◽  
Lexie E. Hughes ◽  
Blaine C. Long ◽  
William M. Adams ◽  
Douglas J. Casa
Keyword(s):  
Anal Sphincter ◽  
Core Temperature ◽  
Rectal Temperature ◽  
Cold Water ◽  
Water Immersion ◽  
Recovery Period ◽  
Heat Stroke ◽  
Cold Water Immersion ◽  
Cross Sectional ◽  
Valid Estimate

Context:  No evidence-based recommendation exists regarding how far clinicians should insert a rectal thermistor to obtain the most valid estimate of core temperature. Knowing the validity of temperatures at different rectal depths has implications for exertional heat-stroke (EHS) management. Objective:  To determine whether rectal temperature (Trec) taken at 4 cm, 10 cm, or 15 cm from the anal sphincter provides the most valid estimate of core temperature (as determined by esophageal temperature [Teso]) during similar stressors an athlete with EHS may experience. Design:  Cross-sectional study. Setting:  Laboratory. Patients or Other Participants:  Seventeen individuals (14 men, 3 women: age = 23 ± 2 years, mass = 79.7 ± 12.4 kg, height = 177.8 ± 9.8 cm, body fat = 9.4% ± 4.1%, body surface area = 1.97 ± 0.19 m2). Intervention(s):  Rectal temperatures taken at 4 cm, 10 cm, and 15 cm from the anal sphincter were compared with Teso during a 10-minute rest period; exercise until the participant's Teso reached 39.5°C; cold-water immersion (∼10°C) until all temperatures were ≤38°C; and a 30-minute postimmersion recovery period. The Teso and Trec were compared every minute during rest and recovery. Because exercise and cooling times varied, we compared temperatures at 10% intervals of total exercise and cooling durations for these periods. Main Outcome Measure(s):  The Teso and Trec were used to calculate bias (ie, the difference in temperatures between sites). Results:  Rectal depth affected bias (F2,24 = 6.8, P = .008). Bias at 4 cm (0.85°C ± 0.78°C) was higher than at 15 cm (0.65°C ± 0.68°C, P &lt; .05) but not higher than at 10 cm (0.75°C ± 0.76°C, P &gt; .05). Bias varied over time (F2,34 = 79.5, P &lt; .001). Bias during rest (0.42°C ± 0.27°C), exercise (0.23°C ± 0.53°C), and recovery (0.65°C ± 0.35°C) was less than during cooling (1.72°C ± 0.65°C, P &lt; .05). Bias during exercise was less than during postimmersion recovery (0.65°C ± 0.35°C, P &lt; .05). Conclusions:  When EHS is suspected, clinicians should insert the flexible rectal thermistor to 15 cm (6 in) because it is the most valid depth. The low level of bias during exercise suggests Trec is valid for diagnosing hyperthermia. Rectal temperature is a better indicator of pelvic organ temperature during cold-water immersion than is Teso.

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