This paper aims to improve the prediction of rectal temperature (T_re) from insulated skin temperature (T_is) and micro-climate temperature (T_mc) previously reported (Richmond et al., Insulated skin temperature as a measure of core body temperature for individuals wearing CBRN protective clothing. Physiol Meas 2013; 34:1531–43.) using additional physiological and/or environmental variables, under several clothing and climatic conditions. Twelve male (25.8±5.1 years; 73.6±11.5kg; 178±6cm) and nine female (24.2±5.1 years; 62.4±11.5kg; 169±3cm) volunteers completed six trials, each consisting of two 40-min periods of treadmill walking separated by a 20-min rest, wearing permeable or impermeable clothing, under neutral (25°C, 50%), moderate (35°C, 35%), and hot (40°C, 25%) conditions, with and without solar radiation (600W m⁻²). Participants were measured for heart rate (HR) (Polar, Finland), skin temperature (T_s) at 11 sites, T_is (Grant, Cambridge, UK), and breathing rate (f) (Hidalgo, Cambridge, UK). T_mc and relative humidity were measured within the clothing. T_re was monitored as the ‘gold standard’ measure of T_c for industrial or military applications using a 10cm flexible probe (Grant, Cambridge, UK). A stepwise multiple regression analysis was run to determine which of 30 variables (T_is, T_s at 11 sites, HR, f, T_mc, temperature, and humidity inside the clothing front and back, body mass, age, body fat, sex, clothing, Thermal comfort, sensation and perception, and sweat rate) were the strongest on which to base the model. Using a bootstrap methodology to develop the equation, the best model in terms of practicality and validity included T_is, T_mc, HR, and ‘work’ (0 = rest; 1 = exercise), predicting T_re with a standard error of the estimate of 0.27°C and adjusted r² of 0.86. The sensitivity and specificity for predicting individuals who reached 39°C was 97 and 85%, respectively. Insulated skin temperature was the most important individual parameter for the prediction of T_re. This paper provides novel information about the viability of predicting T_c under a wide range of conditions, using predictors which can practically be measured in a field environment.

Purpose: Individuals with a spinal-cord injury have impaired thermoregulatory control due to a loss of sudomotor and vasomotor effectors below the lesion level. Thus, individuals with high-level lesions (tetraplegia) possess greater thermoregulatory impairment than individuals with lower-level lesions (paraplegia). Previous research has not reflected the intermittent nature and modality of wheelchair court sports or replicated typical environmental temperatures. Hence, the purpose of this study was to investigate the thermoregulatory responses of athletes with tetraplegia and paraplegia during an intermittent-sprint protocol (ISP) and recovery in cool conditions.Methods: Sixteen wheelchair athletes, 8 with tetraplegia (TP, body mass 65.2 ± 4.4 kg) and 8 with paraplegia (body mass 68.1 ± 12.3 kg), completed a 60-min ISP in 20.6°C ± 0.1°C, 39.6% ± 0.8% relative humidity on a wheelchair ergometer, followed by 15 min of passive recovery. Core temperature (T_core) and mean (T_sk) and individual skin temperatures were measured throughout.Results: Similar external work (P = .70, ES = 0.20) yet a greater T_core (P < .05, ES = 2.27) and T_sk (P < .05, ES = 1.50) response was demonstrated by TP during the ISP.Conclusions: Despite similar external work, a marked increase in T_core in TP during exercise and recovery signifies that thermoregulatory differences between the groups were predominantly due to differences in heat loss. Further increases in thermal strain were not prevented by the active and passive recovery between maximal-effort bouts of the ISP, as T_core continually increased throughout the protocol in TP.

International sporting competitions, including the Paralympic Games, are increasingly being held in hot and/or humid environmental conditions. Thus, a greater emphasis is being placed on preparing athletes for the potentially challenging environmental conditions of the host cities, such as the upcoming Games in Tokyo in 2020. However, evidence-based practices are limited for the impairment groups that are eligible to compete in Paralympic sport. This review aims to provide an overview of heat-related issues for Paralympic athletes alongside current recommendations to reduce thermal strain and technological advancements in the lead up to the Tokyo 2020 Paralympic Games. When competing in challenging environmental conditions, a number of factors may contribute to an athlete’s predisposition to heightened thermal strain. These include the characteristics of the sport itself (type, intensity, duration, modality, and environmental conditions), the complexity and severity of the impairment and classification of the athlete. For heat vulnerable Paralympic athletes, strategies such as the implementation of cooling methods and heat acclimation can be used to combat the increase in heat strain. At an organizational level, regulations and specific heat policies should be considered for several Paralympic sports. Both the utilization of individual strategies and specific heat health policies should be employed to ensure that Paralympics athletes’ health and sporting performance are not negatively affected during the competition in the heat at the Tokyo 2020 Paralympic Games.

Cooling strategies that help prevent a reduction in exercise capacity whilst exercising in the heat have received considerable research interest over the past 3 decades, especially in the lead up to a relatively hot Olympic and Paralympic Games. Progressing into the next Olympic/Paralympic cycle, the host, Rio de Janeiro, could again present an environmental challenge for competing athletes. Despite the interest and vast array of research into cooling strategies for the able-bodied athlete, less is known regarding the application of these cooling strategies in the thermoregulatory impaired spinal cord injured (SCI) athletic population. Individuals with a spinal cord injury (SCI) have a reduced afferent input to the thermoregulatory centre and a loss of both sweating capacity and vasomotor control below the level of the spinal cord lesion. The magnitude of this thermoregulatory impairment is proportional to the level of the lesion. For instance, individuals with high-level lesions (tetraplegia) are at a greater risk of heat illness than individuals with lower-level lesions (paraplegia) at a given exercise intensity. Therefore, cooling strategies may be highly beneficial in this population group, even in moderate ambient conditions (~21 °C). This review was undertaken to examine the scientific literature that addresses the application of cooling strategies in individuals with an SCI. Each method is discussed in regards to the practical issues associated with the method and the potential underlying mechanism. For instance, site-specific cooling would be more suitable for an athlete with an SCI than whole body water immersion, due to the practical difficulties of administering this method in this population group. From the studies reviewed, wearing an ice vest during intermittent sprint exercise has been shown to decrease thermal strain and improve performance. These garments have also been shown to be effective during exercise in the able-bodied. Drawing on additional findings from the able-bodied literature, the combination of methods used prior to and during exercise and/or during rest periods/half-time may increase the effectiveness of a strategy. However, due to the paucity of research involving athletes with an SCI, it is difficult to establish an optimal cooling strategy. Future studies are needed to ensure that research outcomes can be translated into meaningful performance enhancements by investigating cooling strategies under the constraints of actual competition. Cooling strategies that meet the demands of intermittent wheelchair sports need to be identified, with particular attention to the logistics of the sport.

The purpose of this study was to determine whether a player’s physical impairment or activity profile was related to the amount of thermal strain experienced during wheelchair rugby match play. 17 elite wheelchair rugby players played a competitive match, whilst activity profiles, measures of core and skin temperature, heart rate and perceptual responses were taken. Players were divided into 2 groups depending on their physical impairment: players with a cervical spinal cord injury, (n=10) or non-spinal related physical impairment (n=7). Total distance was lower (4 842±324 vs. 5 541±316 m, p<0.01, ES=2.2) and mean speed slower (1.13±0.11 vs. 1.27±0.11 m∙s⁻¹, p<0.03, ES=1.3) in players with a spinal cord injury. Yet, the change in core temperature (1.6±0.4 vs. 0.7±0.3°C, p<0.01, ES=2.5) was significantly greater in players with a spinal cord injury. In conclusion, players with a spinal cord injury were under greater thermal strain during wheelchair rugby match play, as a result of their reduced heat loss capacity, due to their physical impairment and not because of their activity profile.

By combining galvanic skin conductance (GSC), stratum corneum hydration (HYD) and regional surface sweat rate (RSR) measurements at the arm, thigh, back and chest, we closely monitored the passage of sweat from gland to skin surface. Through a varied exercise-rest protocol, sweating was increased slowly and decreased in 16 male and female human participants (25.3 ± 4.7 yr, 174.6 ± 10.1 cm, 71.3 ± 12.0 kg, 53.0 ± 6.8 ml·kg⁻¹·min⁻¹). ∆GSC and HYD increased before RSR, indicating pre-secretory sweat gland activity and skin hydration. ∆GSC and HYD typically increased concomitantly during rest in a warm environment (30.1 ± 1.0°C, 30.0 ± 4.7% relative humidity) and only at the arm did ∆GSC increase before an increase in HYD. HYD increased before RSR, before sweat was visible on the skin, but not to full saturation, contradicting earlier hypotheses. Maximal skin hydration did occur, as demonstrated by a plateau in all regions. Post exercise rest resulted in a rapid decrease in HYD and RSR but a delayed decline in ∆GSC. Evidence for reabsorption of surface sweat into the skin following a decline in sweating, as hypothesized in the literature, was not found. This suggests that skin surface sweat, after sweating is decreased, may not diffuse back into the dermis, but is only evaporated. These data, showing distinctly different responses for the three measured variables, provide useful information about the fate of sweat from gland to surface that is relevant across numerous research fields (e.g., thermoregulation, dermatology, ergonomics and material design). NEW & NOTEWORTHY After sweat gland stimulation, sweat travels through the duct, penetrating the epidermis before appearing on the skin surface. We found that only submaximal stratum corneum hydration was required before surface sweating occurred. However, full hydration occurred only once sweat was on the surface. Once sweating reduces, surface sweat evaporation continues, but there is a delayed drying of the skin. This information is relevant across various research fields, including environmental ergonomics, dermatology, thermoregulation, and skin-interface interactions.