Risks of Heat Illness in Athletes With Spinal Cord Injury: Current Evidence and Needs

Zhang, Yang; Bishop, Phillip A.

doi:10.3389/fspor.2019.00068

Cited by 5 publications

(5 citation statements)

References 27 publications

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“…A total of 40 studies ( Fu et al, 2011 ; Luo et al, 2011 ; Han et al, 2014 ; Li et al, 2015 ; Wang, 2015 ; Zhou et al, 2015 ; Bu, 2016 ; Cao et al, 2016 ; Huang, 2016 ; Li and Chang, 2016 ; Li et al, 2016 ; Zhang, 2016 ; Zhu et al, 2016 ; Gao, 2017 ; Guo, 2017 ; Hu et al, 2017 ; Li, 2017 ; Liu, 2017 ; Wang and Ning, 2018 ; Xue, 2018 ; Zhang, 2018 ; Fan et al, 2019 ; Liu et al, 2019 ; Xiao et al, 2019 ; Zhang, 2019 ; Li and Liu, 2020 ; Wang et al, 2020 ; Wu, 2020 ; Xiao et al, 2020 ; Zhang et al, 2020 ; Wang et al, 2021 ; Xu, 2021 ; Yang, 2021 ; Huang et al, 2022 ; Ouyang and Zhang, 2022 ; Song et al, 2022 ; Wang, 2022 ; Zhang et al, 2022 ; Zhao, 2022 ; Yan et al, 2023 ) comprising 4,473 participants reported the total efficiency rate, and the pooled data showed that XST improved the total efficiency rate (RR = 1.19; 95% CI [1.15 to 1.23]; p < 0.00001) ( Supplementary Figure S9 ). Considering that high heterogeneity (I 2 = 52%, p < 0.0001) could not be changed significantly through the sensitivity analysis ( Supplementary Figure S10 ), we performed subgroup analyses, respectively, by the duration of treatment (7 days, RR = 1.17; 95% CI [1.02 to 1.34]; p = 0.03; 14 days, RR = 1.16; 95% CI [1.12 to 1.21]; p < 0.00001; 28 days, RR = 1.27; 95% CI [1.20 to 1.34]; p < 0.00001) ( Supplementary Figure S11 ), by the dosage form (XST injection, RR = 1.18; 95% CI [1.14 to 1.22]; p < 0.00001; XST oral preparation, RR = 1.55; 95% CI [1.24 to 1.94]; p < 0.00001) ( Supplementary Figure S12 ), by the combination treatment (conventional treatment, RR = 1.18; 95% CI [1.13 to 1.24]; p < 0.00001; neuroprotective agent...…”

Section: Resultsmentioning

confidence: 99%

“…Of all studies, 15 studies ( Luo et al, 2011 ; Zhu et al, 2016 ; Shen and Zhang, 2017 ; Xue, 2018 ; Liu et al, 2019 ; Zhang, 2019 ; Wang et al, 2020 ; Wu, 2020 ; Wang et al, 2021 ; Huang et al, 2022 ; Ping et al, 2022 ; Song et al, 2022 ; Zhao, 2022 ; Wu et al, 2023 ; Yan et al, 2023 ) comprising 4,288 cases reported adverse events. No heterogeneity was found (I 2 = 0%, p = 0.97); thus, a fixed-effects model was adopted.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy and safety of Panax notoginseng saponins (Xuesaitong) for patients with acute ischemic stroke: a systematic review and meta-analysis of randomized controlled trials

Shi,

Feng,

et al. 2023

Front. Pharmacol.

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Background: Stroke is the major cause of mortality and permanent disability and is associated with an astonishing economic burden worldwide. In the past few decades, accumulated evidence has indicated that Xuesaitong (XST) has therapeutic benefits in cases of acute ischemic stroke (AIS). Our study aimed to provide the best current body of evidence of the efficacy and safety of XST for patients with AIS.Methods: This is a systematic review and meta-analysis of randomized controlled trials (RCTs). We searched eight electronic databases from inception to 17 July 2023 for relevant RCTs. The investigators independently screened trials, extracted data, and assessed the risk of bias. A meta-analysis was conducted using RevMan 5.3 and STATA 16.0 software.Results: In total, 46 RCTs involving 7,957 patients were included. The results showed that XST improved the long-term functional outcomes with lower modified Rankin Scale (mRS) scores (MD = −0.67; 95% CI [−0.92 to −0.42]; p < 0.00001) and a higher proportion of functional independence (mRS ≤2) (RR = 1.08; 95% CI [1.05 to 1.12]; p < 0.00001). Low-quality evidence indicated that XST improved the activities of daily living (MD = 10.17; 95% CI [7.28 to 13.06]; p < 0.00001), improved the neurological impairment (MD = −3.39; 95% CI [−3.94 to −2.84]; p < 0.00001), and enhanced the total efficiency rate (RR = 1.19; 95% CI [1.15 to 1.23]; p < 0.00001). No significant difference was found in the all-cause mortality or incidence of adverse events between the XST and control groups. The certainty of evidence was estimated as moderate to very low.Conclusion: Presently, the administration of XST within 14 days of AIS is associated with favorable long-term functional outcomes. In addition, XST can improve activities of daily living, alleviate neurological deficits, and has shown good tolerability. However, the current evidence is too weak, and the confidence of evidence synthesis was restricted by the high risk of bias. Given the insufficient evidence, appropriately sized and powered RCTs investigating the efficacy and safety of XST for patients with AIS are warranted.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=446208, CRD42023446208.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of Panax notoginseng saponins (Xuesaitong) for patients with acute ischemic stroke: a systematic review and meta-analysis of randomized controlled trials

Shi,

Feng,

et al. 2023

Front. Pharmacol.

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“…For example, assuming a solar load of 350 W/m 2 and an airspeed of 5.5 m/s (20 km/h cycling with no wind), a WBGT of 24 °C could translate to 24.5 °C and 85%, or 35.4 °C and 20%. Heat stress would be decreased in dry-warm conditions, due to the benefits of velocity-based (convective) cooling efficiencies during the handcycle and push segments [29,30]. Unfortunately, while World Triathlon uses a heat policy that relies on WBGT, these data were not reported in program notes.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Water and Air Temperature on Wheelchair Triathlon Performance: A Retrospective Analysis of Elite Competition Data

Borg,

Gibson,

Bach

et al. 2024

Preprint

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Aims: Impaired thermoregulatory function is a clinical feature of many health conditions that affect triathletes using wheelchairs and consequently, individual athlete performances may fluctuate according to environmental temperature. We aimed to determine the effect of 1) water temperature on wheelchair triathlon swim time, and 2) air temperature on handcycle and wheelchair run (push) time. Methods: Published race records from 2017 to 2023 (n = 49 events) were extracted from the World Triathlon website. Bayesian negative binomial regression was used to separately model the nonlinear relationships between water temperature and swim time, and air temperature and handcycle and push time. Age, sex, sport class, whether wetsuits were worn (swim model) and swim time (handcycle and push model) were included as fixed effects. The models accounted for differences in race tactics and water conditions or course geography. Results: Over the observed water temperature range of 15.7–30.5 °C, male swim time (mm:ss) improved from 14:13 min (95% credible interval [CrI] = 12:27, 16:09) to 12:35 min (95% CrI = 11:00, 14:19). Female swim time improved from 15:33 min (95% CrI = 13:24, 17:55) to 12:46 min (95% CrI = 11:03, 14:38). It was unclear whether handcycle and push time slowed over the observed air temperature range of 14–33 °C. Conclusion: Given the known negative influence of high environmental temperatures on endurance exercise in able bodied athletes, the effect of heat on wheelchair triathlon performance requires ongoing consideration, including investigating whether subgroups of Para athletes are at increased risk of performance declines and significant heat illness.

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“…The expert working group recognise that these recommendations may not be suitable for Paralympic athletes where there may be specific physiological considerations and the use of particular moving and handling techniques in the management process. While the reported incidence rate of exertional heat illness is low among Paralympic athletes, 24 their thermoregulatory risk and management of heat strain require special attention. 25 Sporting events with Paralympic athletes should explore classification specific EHS management strategies to safely and effectively cool these athletes.…”

Section: Limitationmentioning

confidence: 99%

Prehospital management of exertional heat stroke at sports competitions: International Olympic Committee Adverse Weather Impact Expert Working Group for the Olympic Games Tokyo 2020

et al. 2021

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ObjectivesThis document aimed to summarise the key components of exertional heat stroke (EHS) prehospital management.MethodsMembers of the International Olympic Committee Adverse Weather Impact Expert Working Group for the Olympic Games Tokyo 2020 summarised the current best practice regarding the EHS prehospital management.ResultsSports competitions that are scheduled under high environmental heat stress or those that include events with high metabolic demands should implement and adopt policy and procedures for EHS prehospital management. The basic principles of EHS prehospital care are: early recognition, early diagnosis, rapid, on-site cooling and advanced clinical care. In order to achieve these principles, medical organisers must establish an area called the heat deck within or adjacent to the main medical tent that is optimised for EHS diagnosis, treatment and monitoring. Once admitted to the heat deck, the rectal temperature of the athlete with suspected EHS is assessed to confirm an elevated core body temperature. After EHS is diagnosed, the athlete must be cooled on-site until the rectal temperature is below 39°C. While cooling the athlete, medical providers are recommended to conduct a blood analysis to rule out exercise-associated hyponatraemia or hypoglycaemia, provided that this can be safely performed without interrupting cooling. The athlete is transported to advanced care for a full medical evaluation only after the treatment has been provided on-site.ConclusionsA coordination of care among all medical stakeholders at the sports venue, during transport, and at the hospital is warranted to ensure effective management is provided to the EHS athlete.

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Risks of Heat Illness in Athletes With Spinal Cord Injury: Current Evidence and Needs

Cited by 5 publications

References 27 publications

Efficacy and safety of Panax notoginseng saponins (Xuesaitong) for patients with acute ischemic stroke: a systematic review and meta-analysis of randomized controlled trials

Efficacy and safety of Panax notoginseng saponins (Xuesaitong) for patients with acute ischemic stroke: a systematic review and meta-analysis of randomized controlled trials

The Influence of Water and Air Temperature on Wheelchair Triathlon Performance: A Retrospective Analysis of Elite Competition Data

Prehospital management of exertional heat stroke at sports competitions: International Olympic Committee Adverse Weather Impact Expert Working Group for the Olympic Games Tokyo 2020

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