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.

Objectives To evaluate how separate and combined climatic parameters affect peak core temperature during exercise in the heat using computer simulations fed with individual data. Methods The impact of eight environmental conditions on rectal temperature (T re) was determined for exercise under heat stress using the Fiala-thermal-Physiology-and-Comfort simulation model. Variations in ambient temperature (T a ±6°C), relative humidity (RH±15%) and solar radiation (SR+921 W/m 2) were assessed in isolation and combination (worst-case/best-case scenarios) and compared with baseline (T a 32°C, RH 75%, SR 0 W/m 2). The simulation model was fed with personal, anthropometric and individual exercise characteristics. Results 54 athletes exercised for 46±10 min at baseline conditions and achieved a peak core temperature of 38.9±0.5°C. Simulations at a higher T a (38°C) and SR (921 W/m 2) resulted in a higher peak T re compared with baseline (+0.6±0.3°C and +0.5±0.2°C, respectively), whereas a higher RH (90%) hardly affected peak T re (+0.1±0.1°C). A lower T a (26°C) and RH (60%) reduced peak T re by-0.4±0.2°C and a minor-0.1±0.1°C, respectively. The worst-case simulation yielded a 1.5±0.4°C higher T re than baseline and 2.0±0.7°C higher than the best-case condition. Conclusion Combined unfavourable climatic conditions produce a greater increase in peak core temperature than the sum of its parts in elite athletes exercising in the heat.