Effective cooling strategies to attenuate the increase in body temperature in humans with spinal cord injury

Abstract

Individuals with spinal cord injury have a reduced afferent input to the thermoregulation center and lack both sweating capacity and vasomotor control below the level of the spinal cord lesion. A loss of heat loss capacity results in an excessive rise in core temperature, which in turn decreases exercise performance and increases the risk of heat-related illness. To prevent hyperthermia and improve exercise performance during exercise in hot environments, a popular strategy, body cooling, has been proposed. However, despite the interest and vast array of research into cooling strategies for able-bodied humans, less is known about the application of these cooling strategies for individuals with thermoregulatory impairment due to spinal cord injury. The purpose of this review was to investigate effective cooling strategies for attenuating the increase in body temperature in humans with spinal cord injury exercising in a hot environment. Cooling strategies for individuals with spinal cord injury involve external cooling such as water immersion and use of sprays, and cooling garments and internal cooling by ingestion of cold fluid. We addressed the practical issues associated with each of these methods. We concluded from our review that external cooling has been criticized for its impracticality during sporting competitions, although water immersion and the application of cooling garments do reduce the core temperature in individuals with spinal cord injury. However, ice ingestion has recently received considerable interest in studies of able-bodied humans. Therefore, we propose that ice ingestion could be an effective strategy for individuals with spinal cord injury.