Upper-Body versus Lower-Body Cooling in Individuals with Paraplegia during Arm-Crank Exercise in the Heat

Author:

ALKEMADE PUCK1,EIJSVOGELS THIJS M. H.2,JANSSEN THOMAS W. J.,JANSEN KASPAR M. B.3,KINGMA BORIS R. M.4,DAANEN HEIN A. M.

Affiliation:

1. Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, THE NETHERLANDS

2. Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, THE NETHERLANDS

3. Department of Design Engineering, Delft University of Technology, Delft, THE NETHERLANDS

4. Department Human Performance, Unit Defence, Safety and Security, TNO, The Netherlands Organization for Applied Sciences, Soesterberg, THE NETHERLANDS

Abstract

ABSTRACT Purpose For wheelchair users with a spinal cord injury, the lower body may be a more convenient cooling site than the upper body. However, it remains unknown if leg cooling reduces thermal strain in these individuals. We compared the impact of upper-body versus lower-body cooling on physiological and perceptual outcomes during submaximal arm-crank exercise under heat stress in individuals with paraplegia. Methods Twelve male participants with paraplegia (T4–L2, 50% complete lesion) performed a maximal exercise test in temperate conditions, and three heat stress tests (32°C, 40% relative humidity) in which they received upper-body cooling (COOL-UB), lower-body cooling (COOL-LB), or no cooling (CON) in a randomized counterbalanced order. Each heat stress test consisted of four exercise blocks of 15 min at 50% of peak power output, with 3 min of rest in between. Cooling was applied using water-perfused pads, with 14.8-m tubing in both COOL-UB and COOL-LB. Results Gastrointestinal temperature was 0.2°C (95% confidence interval (CI), 0.1°C to 0.3°C) lower during exercise in COOL-UB versus CON (37.5°C ± 0.4°C vs 37.7°C ± 0.3°C, P = 0.009), with no difference between COOL-LB and CON (P = 1.0). Heart rate was lower in both COOL-UB (−7 bpm; 95% CI, −11 to −3 bpm; P = 0.01) and COOL-LB (−5 bpm; 95% CI, −9 to −1 bpm; P = 0.049) compared with CON. The skin temperature reduction at the cooled skin sites was larger in COOL-LB (−10.8°C ± 1.1°C) than in COOL-UB (−6.7°C ± 1.4°C, P < 0.001), which limited the cooling capacity in COOL-LB. Thermal sensation of the cooled skin sites was improved and overall thermal discomfort was lower in COOL-UB (P = 0.01 and P = 0.04) but not in COOL-LB (P = 0.17 and P = 0.59) compared with CON. Conclusions Upper-body cooling more effectively reduced thermal strain than lower-body cooling in individuals with paraplegia, as it induced greater thermophysiological and perceptual benefits.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physical Therapy, Sports Therapy and Rehabilitation,Orthopedics and Sports Medicine

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