Comparison of Rectal and Aural Core Body Temperature Thermometry in Hyperthermic, Exercising Individuals: A Meta-Analysis

Abstract

Objective: To compare mean differences in core body temperature (Tcore) as assessed via rectal thermometry (Tre) and aural thermometry (Tau) in hyperthermic exercising individuals. Data Sources: PubMed, Ovid MEDLINE, SPORTDiscus, CINAHL, and Cochrane Library in English from the earliest entry points to August 2009 using the search terms aural, core body temperature, core temperature, exercise, rectal, temperature, thermistor, thermometer, thermometry, and tympanic. Study Selection: Original research articles that met these criteria were included: (1) concurrent measurement of Tre and Tau in participants during exercise, (2) minimum mean temperature that reached 38°C by at least 1 technique during or after exercise, and (3) report of means, standard deviations, and sample sizes. Data Extraction: Nine articles were included, and 3 independent reviewers scored these articles using the Physiotherapy Evidence Database (PEDro) scale (mean  =  5.1 ± 0.4). Data were divided into time periods pre-exercise, during exercise (30 to 180 minutes), and postexercise, as well as Tre ranges <37.99°C, 38.00°C to 38.99°C, and >39.00°C. Means and standard deviations for both measurement techniques were provided at all time intervals reported. Meta-analysis was performed to determine pooled and weighted mean differences between Tre and Tau. Data Synthesis: The Tre was conclusively higher than the Tau pre-exercise (mean difference [MD]  =  0.27°C, 95% confidence interval [CI]  =  0.15°C, 0.39°C), during exercise (MD  =  0.96°C, 95% CI  =  0.84°C, 1.08°C), and postexercise (MD  =  0.71°C, 95% CI  =  0.65°C, 0.78°C). As Tre measures increased, the magnitude of difference between the techniques also increased with an MD of 0.59°C (95% CI  =  0.53°C, 0.65°C) when Tre was <38°C; 0.79°C (95% CI  =  0.72°C, 0.86°C) when Tre was between 38.0°C and 38.99°C; and 1.72°C (95% CI  =  1.54°, 1.91°C) when Tre was >39.0°C. Conclusions: The Tre was consistently greater than Tau when Tcore was measured in hyperthermic individuals before, during, and postexercise. As Tcore increased, Tau appeared to underestimate Tcore as determined by Tre. Clinicians should be aware of this critical difference in temperature magnitude between these measurement techniques when assessing Tcore in hyperthermic individuals during or postexercise.