Thermoregulation during intermittent exercise in athletes with a spinal-cord injury

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 (Tcore) and mean (Tsk) and individual skin temperatures were measured throughout. Results: Similar external work (P = .70, ES = 0.20) yet a greater Tcore (P < .05, ES = 2.27) and Tsk (P < .05, ES = 1.50) response was demonstrated by TP during the ISP. Conclusions: Despite similar external work, a marked increase in Tcore 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 Tcore continually increased throughout the protocol in TP

Thermoregulatory responses during competitive wheelchair rugby match play

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

Effects of cooling before and during simulated match play on thermoregulatory responses of athletes with tetraplegia

Objectives: Athletes with high level spinal cord injuries (tetraplegia) are under greater thermal strain during exercise than the able-bodied. The purpose of this study was to investigate the effectiveness of pre-cooling using an ice vest and the combination of pre-cooling and cooling during play using water sprays in athletes with tetraplegia. Design: Counter-balanced, cross-over design. Methods: Eight wheelchair rugby players with tetraplegia completed a 60 min intermittent sprint protocol (ISP) on a wheelchair ergometer in 20.2 °C ± 0.2 °C and 33.0% ± 3.1% relative humidity. The ISP was conducted on three occasions; no cooling (NC), pre-cooling with an ice vest (P) and pre-cooling with an ice vest and water sprays between quarters (PW). Gastrointestinal (Tgi) temperature, mean skin temperature (Tsk) and perceptual responses were measured throughout. Results: At the end of pre-cooling, the change in Tgi was not significantly different between conditions (P > 0.05) but the change in Tsk was significantly greater in P and PW compared to NC (P 0.05). Conclusions: Water spraying between quarters combined with pre-cooling using an ice vest lowers thermal strain to a greater degree than pre-cooling only in athletes with tetraplegia, but has no effect on simulated wheelchair rugby performance or perceptual responses

Evaporative heat loss insufficient to attain heat balance at rest in individuals with a spinal cord injury at high ambient temperature

The aim of the study was to determine whether climatic limits for achieving heat balance at rest are affected by spinal cord injury (SCI). Twenty-three males (8 able-bodied (AB), 8 with paraplegia (PP) and 7 with tetraplegia (TP)) rested in 37°C and 20% relative humidity (RH) for 20 mins. With the ambient temperature held constant, RH was increased by 5% every 7 mins, until gastrointestinal temperature (Tgi) showed a clear inflection or increased by >1°C. Tgi, skin temperatures, perceptual responses and metabolic energy expenditure were measured throughout. Metabolic heat production (AB: 123 (21) W, PP: 111 (15) W, TP: 103 (29) W) and required rate of evaporative cooling for heat balance (Ereq, AB: 113 (20) W, PP: 107 (17) W, TP: 106 (29) W) were similar between groups (p = 0.22 and p = 0.79). Compared to AB, greater increases in Tgi were observed in TP (p = 0.01), with notable increases in mean skin temperature (Tsk) for TP and PP (p = 0.01). A Tgi inflection point was demonstrated by 7 AB, only 3 out of 8 PP and none of TP. Despite metabolic heat production (and Ereq) being similar between groups evaporative heat loss was not large enough to obtain heat balance in TP, linked to a shortfall in evaporative cooling potential. Although PP possess a greater sweating capacity, the continual increase in Tgi and Tsk, in most PP, while lower than for TP, implies that latent heat loss for PP is also insufficient to attain heat balance

Infographic. Thermoregulatory impairment in athletes with a spinal cord injury

Presented in this infographic is a summary of studies investigating the thermoregulatory impairment of athletes with a spinal cord injury during real-world sporting scenarios. The infographic depicts the heightened thermal strain experienced by athletes with tetraplegia (high level lesions), both compared to athletes with paraplegia (low level lesions) and within the sport of wheelchair rugby. In addition to the cooling interventions presented, the infographic highlights the significant need for appropriate interventions to reduce the risk of overheating and potential performance decrements. This infographic was field tested with those who work within a wheelchair sports environment, ranging from practitioners, researchers, athletes with an SCI and sports clinicians. The experimental studies were also designed in consultation with the wheelchair rugby coaches and players

Activity profiles of elite wheelchair rugby players during competition

To quantify the activity profiles of elite wheelchair rugby and establish classification-specific arbitrary speed zones. Additionally, indicators of fatigue during full matches were explored. Methods: Seventy-five elite wheelchair rugby players from eleven national teams were monitored using a radio-frequency based, indoor tracking system across two international tournaments. Players who participated in complete quarters (n = 75) and full matches (n = 25) were included and grouped by their International Wheelchair Rugby Federation functional classification: group I (0-0.5), II (1.0-1.5), III (2.0-2.5) and IV (3.0-3.5). Results: During a typical quarter, significant increases in total distance (m), relative distance (m·minˉ¹), and mean speed (m·sˉ¹) were associated with an increase in classification group (P < 0.001), with the exception of group III and IV. However, group IV players achieved significantly higher peak speeds (3.82 ± 0.31 m·sˉ¹) than groups I (2.99 ± 0.28 m·sˉ¹), II (3.44 ± 0.26 m·sˉ¹) and III (3.67 ± 0.32 m·sˉ¹). Groups I and II differed significantly in match intensity during very low/low speed zones and the number of high-intensity activities in comparison with groups III and IV (P < 0.001). Full match analysis revealed that activity profiles did not differ significantly between quarters. Conclusions: Notable differences in the volume of activity were displayed across the functional classification groups. However, the specific on-court requirements of defensive (I and II) and offensive (III and IV) match roles appeared to influence the intensity of match activities and consequently training prescription should be structured accordingly

A pragmatic approach to resolving technological unfairness: The case of Nike’s Vaporfly & Alphafly running footwear

Background Technology is often introduced into sport to facilitate it or to improve human performance within it. On occasion, some forms of novel technology require regulation or prevention entirely to ensure that a sport remains fair and accessible. Recently, the Nike Vaporfly and Alphafly shoes have received some concerns over their appropriateness for use in competitive distance running. Methods This paper evaluates the use of these shoes against an existing framework for sports technology discourse and adopts a pragmatic approach to attempt to resolve them. Results It is proposed that the three concerns regarding cost, access and coercion cannot be ruled out but likely remain short term issues. As a result, it is proposed that these running shoes are acceptable forms of technology but that ongoing vigilance will be required as such technologies develop further in the future. Conclusions The Nike Vaporfly/Alphafly shoes do push the perceived acceptability of running shoes to the limits of the current sports regulations. However, the alleged gains have not manifested themselves to a level that could be considered excessive when reviewing historical performances or when evaluated against a set of well-cited criteria. The sport will need to adopt a stance of ongoing vigilance as such technologies continue to develop or be optimised in the future