Background: In individuals with a spinal cord injury thermoregulatory mechanisms are fully or partially interrupted. This could lead to exercise-induced hyperthermia in temperate conditions which can be even more distinct in hot conditions. Hyperthermia has been suggested to impair physiological mechanisms in athletes, which could negatively influence physical performance and subjective well-being or cause mild to severe health issues.Objective: The aim was to evaluate the literature on the thermoregulatory and thermal responses of individuals with a spinal cord injury during exercise in temperate and hot conditions taking the effects of cooling techniques and heat acclimation into account.Data sources: Two electronic databases, PubMed and Web of Science were searched. Studies were eligible if they observed the influence of exercise on various thermoregulatory parameters (e.g., core and skin temperature, sweat rate, thermal sensation) in individuals with a spinal cord injury.Results: In total 32 articles were included of which 26 were of strong, 3 of moderate and 3 of weak quality. Individuals with a high lesion level, especially those with a tetraplegia, reached a higher core and skin temperature with a lower sweat rate. The use of cooling techniques before and during exercise can positively affect the burden of the impaired thermoregulatory system in all individuals with a spinal cord injury.Conclusion: Due to the absence of normal thermoregulatory abilities, individuals with a high-level spinal cord injury need special attention when they are exercising in temperate and hot conditions to prevent them from potential heat related issues. The use of cooling techniques can reduce this risk.

The impaired vaso- and sudomotor functions limit sweat capacity in individuals with a spinal cord injury (SCI) and might increase the risk for heat-related illness and decreased performance, especially in hot conditions (HOT). This study investigated the differences in fluid balance and thermal responses between wheelchair basketball (WCB) games in HOT and temperate conditions (TMP). Eleven male WCB athletes (39.8 y, 82.8 kg) with SCI (lesion level C5-L4) participated, five in HOT (31 °C) and eight in TMP games (21 °C). Fluid balance, sweat rate, body core temperature, distance, velocity and thermal sensation were assessed. The relative change in body mass was higher in the HOT group (median: −0.35%, interquartile-range: 0.15%, p = 0.02) compared to TMP (+0.11%, 0.35%) group. The sweat rate was significantly higher in the HOT group (0.93 L/h, 0.58 L/h, p = 0.02) compared to the TMP groups (0.48 L/h, 0.19 L/h). Body core temperature increased significantly higher in the TMP group (1.05 °C, 0.15 °C, p = 0.01) compared to the HOT group (0.8 °C, 0.4 °C). The mean velocity (HOT: 1.12 m/s, 0.11 m/s, TMP: 1.07 m/s, 0.08 m/s, p = 0.54) did not differ between the games. The WCB game in HOT leads to significantly higher sweat rate and loss in body mass compared to TMP. Even relative body mass loss was less than 2%. Athletes thus have to be supported with enough fluid, especially during games in HOT.

The aim was to investigate the test-retest reliability of performance and physiological variables of a submaximal wheelchair rugby field-test. Eight trained wheelchair rugby athletes with a spinal cord injury (age: median 40, interquartile range 6.9y; body mass: median 77.7, interquartile range 23.9kg) performed two times a submaximal field-test, with a duration of 41min, split up into four sets of eight min. Each set included eight laps with one eight-meter sprint (SP8) and one four-meter sprint (SP4). The absolute and relative reliability and the performance decrease (fatigue) across the sets were investigated. The examined variables were: sprinting time, heart rate and RPE. The measured parameters showed moderate (peak heart rate ICC3,1=0.663, peak rate of perceived exertion ICC3,1=0.718), good (SP4 ICC3,1=0.874) and excellent (mean heart rate ICC3,1=0.905, SP8 ICC3,1=0.985) test-retest reliability. Fatigue was observed for SP8 in test 2 between set 2/3 and set 2/4. For test 1 a significant decrease of performance for SP4 was found between set 2/3, set 2/4 and between set 3/4. In conclusion the submaximal field-test showed moderate to excellent reliability for all measured parameters. The observed fatigue seems not to be clinically relevant. The test can be recommended to assess the effects of training or interventions.