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• W2981267846 abstract "Dear Editor-in-Chief, In previous studies on thermoregulation after spinal cord injury (SCI), participants were tested at a sport-specific exercise intensity (1). A recent study from Forsyth et al. (2) used a fixed metabolic heat production method in an attempt to quantify the “true independent” influence of SCI level. Contrary to the authors’ belief that other biophysical factors had been isolated, in my opinion, their results are likely biased by the aerobic fitness level of their participants and are also likely flawed by an inappropriate study design. First, with regard to aerobic fitness, the able-bodied participants in the study of Forsyth et al. (2) had V˙O2max values that were twice as great as those with tetraplegia. Just as low aerobic fitness can compromise heat dissipation (3) and sweating (4), higher aerobic fitness can also lead to improved thermoregulation. For example, an 18% increase in V˙O2max has been reported to reduce heat storage by 35% under the same test condition (5). In addition, the authors made no mention as to the average oxygen consumption during the trials and sports classification of their SCI athletes. All participants, both able-bodied and SCI, exercised at same metabolic heat production; thus, the more fit, able-bodied participants were exercising at a lower percentage of V˙O2max. Presumably, participants with tetraplegia likely exercised close to maximal capacity, which could catalyze a sharp surge in esophageal temperature (6); furthermore, it is debatable if such exercise intensity mimics sport-specific physical demands. Importantly, the artificial environment (i.e., 35°C, 50% relative humidity, 0.5 m⋅s−1 air velocity) was designed such that even able-bodied participants were not able to achieve heat balance. Surprisingly, the sample populations were drawn from “wheelchair basketball, wheelchair rugby, wheelchair track and road, para-cycling, and para-alpine skiing.” For wheelchair basketball and rugby, the venue temperature per regulation is typically held between 19°C and 22°C, under which both dry and evaporative heat exchange could be enhanced. Neither these competitors nor para-alpine skiers compete in such an extreme environment, nor do they need to acclimatize to such conditions; hence, the findings are not applicable to these sports. Although wheelchair road (e.g., T54) and para-cycling (e.g., H1–5) athletes could likely compete in the heat, readers should be cautious when interpreting the results where ecologically valid airflow during wheelchair movement was unnaturally absent. To be clear, this notion that application of wind to simulate outdoor exercise is not new. That is, for instance, an air velocity of 9.9 km⋅h−1 could reduce heat storage, sweat loss, and ΔTsk by 47%, 11%, and 65% (50 min), respectively, compared with a wind still condition (7). That said, the hyperthermia outcome (2) is far from a foregone conclusion without proceeding from realistic indoor and outdoor environments that allow reasonable convection and evaporation for specific SCI athletes. It is possible that the inadequate thermoregulatory control after SCI could be partially compensated by relatively low exercise intensity and short duration among adaptive sports (i.e., heat production) and adequate environmental conditions for convection and evaporation (i.e., heat absorption capacity). In view of the explicitly low incident rates of heat illness among para-athletes (8), readers are left to question the consensus that SCI athletes are under heightened thermal risks. Yang Zhang Faculty for Sport and Physical Education University of Montenegro Podgorica, MONTENEGRO" @default.
• W2981267846 created "2019-10-25" @default.
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• W2981267846 date "2019-11-01" @default.
• W2981267846 modified "2023-09-27" @default.
• W2981267846 title "Thermoregulation following Spinal Cord Injury: Theory and Fact" @default.
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• W2981267846 doi "https://doi.org/10.1249/mss.0000000000002086" @default.
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