This study examined whether daily hot water immersion (HWI) after exercise in temperate conditions could induce heat acclimation and improve endurance performance in both temperate and hot conditions. Seventeen males completed a 6-day protocol of treadmill running at 65% VO2max in 18°C followed by either HWI at 40°C or thermoneutral immersion at 34°C for 40 minutes. Measures before and after the intervention showed that HWI lowered resting core temperature and improved thermoregulation and endurance performance during exercise in heat, indicating heat acclimation, but did not improve performance in temperate conditions.
Cold water inmersion reduces anaerobic performanceFernando Farias
Many athletes compete in multiple events on the
same day such as heats and semifinals or round
robin competitions. Under these circumstances,
effective recovery is essential to ensure optimal
performance in a subsequent event or match. A
variety of recovery techniques exist including
cryotherapy (cold water immersion/ice baths,
ice massage, ice packs), whirlpool therapy, mas-
sage and contrast therapy.
Effects of Cold Water Immersion on Muscle OxygenationFernando Farias
Postexercise cold water immersion has been advocated to
athletes as a means of accelerating recovery and improving perform-
ance. Given the effects of cold water immersion on blood flflw,
evaluating in vivo changes in tissue oxygenation during cold water
immersion may help further our understanding of this recovery
modality. This study aimed to investigate the effects of cold water
immersion on muscle oxygenation and performance during repeated
bouts of fatiguing exercise in a group of healthy young adults.
The effect of various cold‑water immersion protocolsFernando Farias
CWI for 10 min at 10 °C appears very likely to be more
effective than passive recovery at restoring force generating
capacity of muscle in a SSC, but no CWI protocol used in
the current study was effective at restoring performance in
a purely concentric movement. CWI does not attenuate the
inflammatory response to an acute bout of normothermic
high-intensity intermittent sprint exercise when compared
with passive recovery. 30-min immersions to the iliac crest
in both cool (20 °C) and cold (10 °C) water appear to exac-
erbate specific aspects of the exercise-induced inflammatory
response. Performance effects CWI used following normo-
thermic sprint exercise are not likely a result of attenuation
of the inflammatory response to this type of exercise.
Effect of cold water immersion on skeletal muscle contractile properties in s...Fernando Farias
This study shows that repeated cold-water immersions (4
4 mins at 4-C) cause considerable alterations to muscle behavior. These alter-
ations signififiantly affect the state of muscles and their response capacity, partic-
ularly in relation to muscle stiffness and muscle contraction velocity.
Effects of seated and standing cold water immersion on recovery from repeated...Fernando Farias
There were
no significant group differences between control and either of the cold water immersion interventions. Seated cold water
immersion was associated with lower DOMS than standing cold water immersion (effect size = 1.86; P = 0.001). These
data suggest that increasing hydrostatic pressure by standing in cold water does not provide an additional recovery benefit
over seated cold water immersion, and that both seated and standing immersions have no benefit in promoting recovery
Post exercise cold water immersion attenuates acute anabolic signallingFernando Farias
these two studies offer new and
important insights into how cold water immersion during
recovery from strength exercise affects chronic training
adaptations and some of the molecular mechanisms that
underpin such adaptations. Cold water immersion delayed
or inhibited satellite cell activity and suppressed the
activation of p70S6K after acute strength exercise. These
effects may have been compounded over time to diminish
the expected increases in muscle mass and strength as a
result of training. The results of these studies challenge the
notion that cold water immersion improves recovery after
exercise. Individuals who use strength training to improve
athletic performance, recover from injury or maintain
their health should therefore reconsider whether to use
cold water immersion as an adjuvant to their training.
Postexercise Cold Water Immersion Benefits Are Not Greater than the Placebo E...Fernando Farias
A CWI placebo is also as effective as
CWI itself in the recovery of muscle strength over 48 h.
This can likely be attributed to improved subjective ratings
of pain and readiness for exercise, suggesting that the hy-
pothesized physiological benefits surrounding CWI may
be at least partly placebo related.
IOSR Journal of Humanities and Social Science is an International Journal edited by International Organization of Scientific Research (IOSR).The Journal provides a common forum where all aspects of humanities and social sciences are presented. IOSR-JHSS publishes original papers, review papers, conceptual framework, analytical and simulation models, case studies, empirical research, technical notes etc.
Cold water inmersion reduces anaerobic performanceFernando Farias
Many athletes compete in multiple events on the
same day such as heats and semifinals or round
robin competitions. Under these circumstances,
effective recovery is essential to ensure optimal
performance in a subsequent event or match. A
variety of recovery techniques exist including
cryotherapy (cold water immersion/ice baths,
ice massage, ice packs), whirlpool therapy, mas-
sage and contrast therapy.
Effects of Cold Water Immersion on Muscle OxygenationFernando Farias
Postexercise cold water immersion has been advocated to
athletes as a means of accelerating recovery and improving perform-
ance. Given the effects of cold water immersion on blood flflw,
evaluating in vivo changes in tissue oxygenation during cold water
immersion may help further our understanding of this recovery
modality. This study aimed to investigate the effects of cold water
immersion on muscle oxygenation and performance during repeated
bouts of fatiguing exercise in a group of healthy young adults.
The effect of various cold‑water immersion protocolsFernando Farias
CWI for 10 min at 10 °C appears very likely to be more
effective than passive recovery at restoring force generating
capacity of muscle in a SSC, but no CWI protocol used in
the current study was effective at restoring performance in
a purely concentric movement. CWI does not attenuate the
inflammatory response to an acute bout of normothermic
high-intensity intermittent sprint exercise when compared
with passive recovery. 30-min immersions to the iliac crest
in both cool (20 °C) and cold (10 °C) water appear to exac-
erbate specific aspects of the exercise-induced inflammatory
response. Performance effects CWI used following normo-
thermic sprint exercise are not likely a result of attenuation
of the inflammatory response to this type of exercise.
Effect of cold water immersion on skeletal muscle contractile properties in s...Fernando Farias
This study shows that repeated cold-water immersions (4
4 mins at 4-C) cause considerable alterations to muscle behavior. These alter-
ations signififiantly affect the state of muscles and their response capacity, partic-
ularly in relation to muscle stiffness and muscle contraction velocity.
Effects of seated and standing cold water immersion on recovery from repeated...Fernando Farias
There were
no significant group differences between control and either of the cold water immersion interventions. Seated cold water
immersion was associated with lower DOMS than standing cold water immersion (effect size = 1.86; P = 0.001). These
data suggest that increasing hydrostatic pressure by standing in cold water does not provide an additional recovery benefit
over seated cold water immersion, and that both seated and standing immersions have no benefit in promoting recovery
Post exercise cold water immersion attenuates acute anabolic signallingFernando Farias
these two studies offer new and
important insights into how cold water immersion during
recovery from strength exercise affects chronic training
adaptations and some of the molecular mechanisms that
underpin such adaptations. Cold water immersion delayed
or inhibited satellite cell activity and suppressed the
activation of p70S6K after acute strength exercise. These
effects may have been compounded over time to diminish
the expected increases in muscle mass and strength as a
result of training. The results of these studies challenge the
notion that cold water immersion improves recovery after
exercise. Individuals who use strength training to improve
athletic performance, recover from injury or maintain
their health should therefore reconsider whether to use
cold water immersion as an adjuvant to their training.
Postexercise Cold Water Immersion Benefits Are Not Greater than the Placebo E...Fernando Farias
A CWI placebo is also as effective as
CWI itself in the recovery of muscle strength over 48 h.
This can likely be attributed to improved subjective ratings
of pain and readiness for exercise, suggesting that the hy-
pothesized physiological benefits surrounding CWI may
be at least partly placebo related.
IOSR Journal of Humanities and Social Science is an International Journal edited by International Organization of Scientific Research (IOSR).The Journal provides a common forum where all aspects of humanities and social sciences are presented. IOSR-JHSS publishes original papers, review papers, conceptual framework, analytical and simulation models, case studies, empirical research, technical notes etc.
High intensity warm ups elicit superior performance Fernando Farias
The benefits of an active warm-up (WU) have been
attributed to increases in muscle temperature, nerve
conductivity, and the speeding of metabolic reactions.1 Non-
temperature-related benefifis include an increased blood-flflw
to working muscles, elevated baseline oxygen consumption,
and the induction of a post-activation potentiation (PAP)
effect.
Post exercise cold water immersion benefits are not greater than the placebo ...Fernando Farias
A recovery placebo administered after an acute high-intensity interval training
session is superior in the recovery of muscle strength over 48 h as compared with TWI and is as effective as CWI. This can be attributed to
improved ratings of readiness for exercise, pain, and vigor, suggesting that the commonly hypothesized physiological benefits surrounding
CWI are at least partly placebo related.
Cold water immersion alters muscle recruitment and balanceFernando Farias
The purpose of this study was to evaluate the effects of cold-water immersion on the electromyographic (EMG) response of
the lower limb and balance during unipodal jump landing. The evaluation comprised 40 individuals (20 basketball players
and 20 non-athletes). The EMG response in the lateral gastrocnemius, tibialis anterior, fibular longus, rectus femoris,
hamstring and gluteus medius; amplitude and mean speed of the centre of pressure, flight time and ground reaction force
(GRF) were analysed. All volunteers remained for 20 min with their ankle immersed in cold-water, and were re-evaluated
immediately post and after 10, 20 and 30 min of reheating
Cold water immersion versus whole body cryotherapyFernando Farias
Cold-water immersion was more effective in
accelerating recovery kinetics than whole-body cryotherapy for countermovement jump
performance at 72h post-exercise. Cold-water immersion also demonstrated lower soreness
and higher perceived recovery levels across 24-48h post-exercise.
A Comparative Study of VO2 Max in Young Female Athletes and Non-AthletesIOSR Journals
Abstract:
Aims And Objectives: The purpose of this study was to compare maximum oxygen uptake(VO2
max ) between young female athletes and non-athletes and to show the importance of sports for physical
fitness.
Material & Methods: The present study was carried out in 50 females between the age group of 18-22 yrs.
They were divided into to groups, study group (25 athletes) and control group. (25 non-athletes) The maximum
oxygen uptake (VO2 max) was compared between cases and controls by using Queen’ college step test.(
Harward step test) .
Results: The VO2 max was higher in female athletes than non-athletes.
Conclusion: The present study showed VO2 max levels more in female athletes. Now a days, physical inactivity
is seen among students due to sedentary lifestyle which may lead to many health problems. Hence, we suggest
that students should get involved in sports and it should make a compulsory subject in colleges.
Key words:- VO2 Max; athlete & non athlete ;Young females
fatigue following a
soccer match is multifactorial and related to dehydration,
glycogen depletion, muscle damage and mental fatigue. A
multitude of recovery strategies are currently implemented
in professional soccer clubs to target these causes of fatigue.
Recovery strategies aimed at reducing acute inflammation
from muscle damage and enhancing its rate of removal are
particularly used in professional soccer settings.
Acute cardiopulmonary and metabolic responses to high intensity interval trai...Fernando Farias
Results from the present study quantify the effects of altering either the intensity of the
work or the recovery interval when performing interval sessions consisting of 60s of work and
60s of recovery for multiple repetitions. The information provided may aid those interested in
designing interval training sessions by providing ranges of values that could be expected for
individuals who possess moderate levels of cardiopulmonary fitness. Using a work intensity of
80% or 100% VGO2peak and a recovery intensity of 0% or 50% VGO2peak, subjects were able to
exercise within the ACSM recommended range for exercise intensity. Based upon the data it
would appear that a protocol such as the 80/0 may be appropriate for those individuals who
are just beginning a program or have little experience with interval-type activity. By contrast, a
100/50 protocol could not be completed by all of the subjects and therefore may be too intense
for some individuals.
Short inter-set rest blunts resistance exercise-inducedFernando Farias
Manipulating the rest-recovery interval between sets of resistance exercise may influence
training-induced muscle remodelling. The aim of this study was to determine the acute muscle
anabolic response to resistance exercise performed with short or long inter-set rest intervals.
In a study with a parallel-group design, 16 males completed four sets of bilateral leg-press and
knee-extension exercise at 75% of one-repetition maximum to momentary muscular failure,
followed by ingestion of 25 g of whey protein. Resistance exercise sets were interspersed by
1 min (n = 8) or 5 min of passive rest (n = 8). Muscle biopsies were obtained at rest, 0, 4, 24
and 28 h postexercise during a primed continuous infusion of l-[ring-13C6]phenylalanine to
determine myofibrillar protein synthesis and intracellular signalling.
High chronic training loads and exposure to bouts of maximal velocity running...Fernando Farias
The ability to produce high speeds is considered an important
quality for performance, with athletes shown to achieve 85–94% of
maximal velocity during team sport match-play.3 Well-developed
high-speed running ability and maximal velocity are required of
players during competition in order to beat opposition players
to possession and gain an advantage in attacking and defensive
situations.
Investigation of the changes on muscular endurance in response to aerobic and...Sports Journal
The rationale of the study is to investigate the changes on muscular endurance in response to aerobic and
anaerobic training among type 2 diabetic patients. To achieve the purpose of the study 45 male type 2
diabetic patients from Ongole, in the southern state of Andhra Pradesh, India, were selected as subjects.
The subjects were selected in the age group of 45 to 50 years and they were randomly assigned into three
equal groups of 15 each. Experimental group-I performed aerobic training, experimental group-II
performed anaerobic training and group III acted as control. The muscular endurance was selected as
dependent variable. The data collected from the three groups prior to and post experimentation on
selected dependent variable was statistically analyzed to find out the significant difference if any, by
applying the analysis of covariance (ANCOVA). Whenever the obtained ‘F’ ratio value was found to be
significant for adjusted post-test means, the Scheffe’s test was applied as post hoc test. In all the cases the
level of confidence was fixed at 0.05 level for significance. The result of the study produced 20.48%
percentage of improvement due to aerobic training and 15.32% of improvement due to anaerobic training
in muscular endurance of the diabetic patients
High intensity warm ups elicit superior performance Fernando Farias
The benefits of an active warm-up (WU) have been
attributed to increases in muscle temperature, nerve
conductivity, and the speeding of metabolic reactions.1 Non-
temperature-related benefifis include an increased blood-flflw
to working muscles, elevated baseline oxygen consumption,
and the induction of a post-activation potentiation (PAP)
effect.
Post exercise cold water immersion benefits are not greater than the placebo ...Fernando Farias
A recovery placebo administered after an acute high-intensity interval training
session is superior in the recovery of muscle strength over 48 h as compared with TWI and is as effective as CWI. This can be attributed to
improved ratings of readiness for exercise, pain, and vigor, suggesting that the commonly hypothesized physiological benefits surrounding
CWI are at least partly placebo related.
Cold water immersion alters muscle recruitment and balanceFernando Farias
The purpose of this study was to evaluate the effects of cold-water immersion on the electromyographic (EMG) response of
the lower limb and balance during unipodal jump landing. The evaluation comprised 40 individuals (20 basketball players
and 20 non-athletes). The EMG response in the lateral gastrocnemius, tibialis anterior, fibular longus, rectus femoris,
hamstring and gluteus medius; amplitude and mean speed of the centre of pressure, flight time and ground reaction force
(GRF) were analysed. All volunteers remained for 20 min with their ankle immersed in cold-water, and were re-evaluated
immediately post and after 10, 20 and 30 min of reheating
Cold water immersion versus whole body cryotherapyFernando Farias
Cold-water immersion was more effective in
accelerating recovery kinetics than whole-body cryotherapy for countermovement jump
performance at 72h post-exercise. Cold-water immersion also demonstrated lower soreness
and higher perceived recovery levels across 24-48h post-exercise.
A Comparative Study of VO2 Max in Young Female Athletes and Non-AthletesIOSR Journals
Abstract:
Aims And Objectives: The purpose of this study was to compare maximum oxygen uptake(VO2
max ) between young female athletes and non-athletes and to show the importance of sports for physical
fitness.
Material & Methods: The present study was carried out in 50 females between the age group of 18-22 yrs.
They were divided into to groups, study group (25 athletes) and control group. (25 non-athletes) The maximum
oxygen uptake (VO2 max) was compared between cases and controls by using Queen’ college step test.(
Harward step test) .
Results: The VO2 max was higher in female athletes than non-athletes.
Conclusion: The present study showed VO2 max levels more in female athletes. Now a days, physical inactivity
is seen among students due to sedentary lifestyle which may lead to many health problems. Hence, we suggest
that students should get involved in sports and it should make a compulsory subject in colleges.
Key words:- VO2 Max; athlete & non athlete ;Young females
fatigue following a
soccer match is multifactorial and related to dehydration,
glycogen depletion, muscle damage and mental fatigue. A
multitude of recovery strategies are currently implemented
in professional soccer clubs to target these causes of fatigue.
Recovery strategies aimed at reducing acute inflammation
from muscle damage and enhancing its rate of removal are
particularly used in professional soccer settings.
Acute cardiopulmonary and metabolic responses to high intensity interval trai...Fernando Farias
Results from the present study quantify the effects of altering either the intensity of the
work or the recovery interval when performing interval sessions consisting of 60s of work and
60s of recovery for multiple repetitions. The information provided may aid those interested in
designing interval training sessions by providing ranges of values that could be expected for
individuals who possess moderate levels of cardiopulmonary fitness. Using a work intensity of
80% or 100% VGO2peak and a recovery intensity of 0% or 50% VGO2peak, subjects were able to
exercise within the ACSM recommended range for exercise intensity. Based upon the data it
would appear that a protocol such as the 80/0 may be appropriate for those individuals who
are just beginning a program or have little experience with interval-type activity. By contrast, a
100/50 protocol could not be completed by all of the subjects and therefore may be too intense
for some individuals.
Short inter-set rest blunts resistance exercise-inducedFernando Farias
Manipulating the rest-recovery interval between sets of resistance exercise may influence
training-induced muscle remodelling. The aim of this study was to determine the acute muscle
anabolic response to resistance exercise performed with short or long inter-set rest intervals.
In a study with a parallel-group design, 16 males completed four sets of bilateral leg-press and
knee-extension exercise at 75% of one-repetition maximum to momentary muscular failure,
followed by ingestion of 25 g of whey protein. Resistance exercise sets were interspersed by
1 min (n = 8) or 5 min of passive rest (n = 8). Muscle biopsies were obtained at rest, 0, 4, 24
and 28 h postexercise during a primed continuous infusion of l-[ring-13C6]phenylalanine to
determine myofibrillar protein synthesis and intracellular signalling.
High chronic training loads and exposure to bouts of maximal velocity running...Fernando Farias
The ability to produce high speeds is considered an important
quality for performance, with athletes shown to achieve 85–94% of
maximal velocity during team sport match-play.3 Well-developed
high-speed running ability and maximal velocity are required of
players during competition in order to beat opposition players
to possession and gain an advantage in attacking and defensive
situations.
Investigation of the changes on muscular endurance in response to aerobic and...Sports Journal
The rationale of the study is to investigate the changes on muscular endurance in response to aerobic and
anaerobic training among type 2 diabetic patients. To achieve the purpose of the study 45 male type 2
diabetic patients from Ongole, in the southern state of Andhra Pradesh, India, were selected as subjects.
The subjects were selected in the age group of 45 to 50 years and they were randomly assigned into three
equal groups of 15 each. Experimental group-I performed aerobic training, experimental group-II
performed anaerobic training and group III acted as control. The muscular endurance was selected as
dependent variable. The data collected from the three groups prior to and post experimentation on
selected dependent variable was statistically analyzed to find out the significant difference if any, by
applying the analysis of covariance (ANCOVA). Whenever the obtained ‘F’ ratio value was found to be
significant for adjusted post-test means, the Scheffe’s test was applied as post hoc test. In all the cases the
level of confidence was fixed at 0.05 level for significance. The result of the study produced 20.48%
percentage of improvement due to aerobic training and 15.32% of improvement due to anaerobic training
in muscular endurance of the diabetic patients
Jour Resp Cardiov Phy Ther. 2016; 5(1): 12-20.
�
ORIGINAL ARTICLE
EFFECTS OF CPAP ON THE PHYSICAL EXERCISE TOLERANCE OF MODERATE TO
SEVERE CHRONIC OBSTRUCTIVE PULMONARY DISEASE
!
MICHEL SILVA REIS1,2, HUGO VALVERDE REIS1,2, DANIEL TEIXEIRA SOBRAL1,2, APARECIDA MARIA
CATAI3, AUDREY BORGHI-SILVA4
!
1Research Group in Cardiorespiratory Physical Therapy (GECARE), Department of Physical Therapy, Faculty of
Medicine, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
2Physical Education Undergraduation Program, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
3Laboratory of Cardiovascular Physical Therapy, Department of Physical Therapy, UFSCar, São Carlos, SP, Brazil
4Laboratory of Cardiopulmonary Physical Therapy, Department of Physical Therapy, Universidade Federal de São
Carlos (UFSCar), São Carlos, SP, Brazil
!
!
Received September 21, 2016; accepted April 18, 2017
Objective: The aim of this study was to evaluate the effect of continuous positive airway pressure
(CPAP) on the exercise tolerance of patients with moderate to severe chronic obstructive pulmonary
disease (COPD). Methods: ten men with COPD (69 ± 9 years), FEV1/FVC (58.90 ± 11.86%) and FEV1
(40.98 ± 10.97% of predict) were submitted to a symptom-limited incremental exercise test (IT) on
the cyclo ergometer. Later, on another visit, they were randomized to perform a constant load
exercise protocol until maximal tolerance with and without CPAP (5cmH2O) in the following
conditions: i) 50% of the peak workload; and ii) 75% of the peak workload. Heart rate (HR), arterial
pressure (AP) and peripheral oxygen saturation were obtained at rest and during the exercise
protocols. For statistical procedures, Shapiro-Wilk normality test and two-way ANOVA with Tukey
post hoc (p<0.05) were performed. Results: There was a signi`icant improvement in exercise time
tolerance during the 75% of the peak workload protocol with CPAP when compared with
spontaneous breath (SB) (438±75 vs. 344±73ms, respectively). Conclusion: CPAP with 5 cmH2O
seems to be useful to improve exercise tolerance in patients with COPD.
!
!
!
!
!
!
Corresponding Author
Michel Silva Reis ([email protected])
!
Journal of Respiratory and CardioVascular Physical Therapy
KEYWORDS:
Noninvasive
ventilation;
COPD;
exercise
tolerance;
CPAP
mailto:[email protected]
Jour Resp Cardiov Phy Ther. 2016; 5(1): 12-20.
INTRODUCTON
Patients with chronic obstructive pulmonary disease
(COPD) present a reduced physical exercise tolerance that
can be determined by ventilatory and/or peripheral
mechanism1,2. Progressive increase in the expiratory
air`low resistance, which limits the tidal volume gain
beyond the expiratory and inspiratory reserve volumes,
may be accentuated because these patients ventilate ...
Title: A Study to Evaluate the Hemodynamic Effects of Swiss Ball Exercise in Post-Operative Coronary Artery Bypass Graft Patients
Introduction:
Coronary artery bypass graft (CABG) surgery is a common procedure to restore blood flow to the heart in patients with coronary artery disease.
Post-operative cardiac rehabilitation is crucial for optimizing recovery and improving overall cardiovascular health.
Swiss ball exercises have gained popularity as a rehabilitation tool due to their potential to improve balance, core stability, and functional capacity.
Objective:
To assess the hemodynamic effects of Swiss ball exercise in patients undergoing post-operative coronary artery bypass graft surgery.
Methods:
Study Design: A prospective, randomized controlled trial.
Participants: Patients who underwent coronary artery bypass graft surgery and met inclusion criteria.
Randomization: Patients will be randomly assigned to either the intervention group (Swiss ball exercise) or the control group (standard cardiac rehabilitation).
Intervention: The intervention group will perform supervised Swiss ball exercises as part of their cardiac rehabilitation program.
Control Group: The control group will receive standard cardiac rehabilitation without Swiss ball exercises.
Outcome Measures: Hemodynamic parameters, including heart rate, blood pressure, cardiac output, stroke volume, and systemic vascular resistance, will be measured at baseline and at specified time intervals during the study period.
Data Analysis: Statistical analysis will be performed to compare the hemodynamic parameters between the intervention and control groups.
Expected Results:
Improved Hemodynamic Parameters: It is hypothesized that the Swiss ball exercise group will exhibit improved hemodynamic parameters compared to the control group.
Increased Cardiac Output and Stroke Volume: Swiss ball exercises may enhance cardiac performance, leading to increased cardiac output and stroke volume.
Decreased Systemic Vascular Resistance: Swiss ball exercises may result in improved vascular function, leading to reduced systemic vascular resistance.
Enhanced Functional Capacity: Patients in the intervention group may experience improved functional capacity, as reflected by increased exercise tolerance and reduced exertional symptoms.
Significance:
Clinical Application: The findings of this study may provide evidence supporting the inclusion of Swiss ball exercises in post-operative cardiac rehabilitation programs for CABG patients.
Rehabilitation Guidelines: The study results may contribute to the development of guidelines for incorporating Swiss ball exercises into standard cardiac rehabilitation protocols.
Improved Patient Outcomes: If Swiss ball exercises are found to have positive hemodynamic effects, their implementation in post-operative rehabilitation
Effect of time-of-day specific obese training on body composition and physica...IOSR Journals
The best strategy for management of obese, outside pharmacological interventions, is physical exercise associated to diet. Recent research has discovered that the problem of obesity is largely due to a biological clock and that lipid oxidation is higher in the evening compared to the morning and at night compared to day. The purpose of this study is to investigate the effect of time-of-day specific obese training on body composition and physical capacity in obese following a low calorie diet. 20 sedentary pre-obese and obese with a mean BMI of 34.3 kg/m2 aged 20 to 47 years subjects participated in a concurrent strength and specific endurance training for obese. Subjects were divided into two training groups: a Morning training Group (MG: n = 10) and an Evening training Group (EG: n=10). The specific training associated to lower caloric diet has increased physical capacity (17,7% for EG and 15,6% for MG), decreased body weight (7,3% for EG and 6% for MG) fat percentage (19,5% for EG and 11,3% for MG) and waist circumference (10,2% for EG and 8,2% for MG) in both groups. Afternoon training was more effective than morning training on fat loss (24.9% for EG versus 15.9% for MG) and on lean mass variation (+2.9% for EG versus -0.5% for MG).
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is an open access international journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Similar to Post-exercise hot water immersion induces heat acclimation and improves endurance exercise performance in the heat (20)
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Post-exercise hot water immersion induces heat acclimation and improves endurance exercise performance in the heat
1. Post-exercise hot water immersion induces heat acclimation and
improves endurance exercise performance in the heat
M. J. Zurawlew, N. P. Walsh, M. B. Fortes, C. Potter
College of Health and Behavioural Sciences, Bangor University, Bangor, Gwynedd, UK
Corresponding author: Prof. Neil P. Walsh, FACSM, College of Health and Behavioural Sciences, Bangor University, Bangor
LL57 2PZ, UK. Tel.: +44 1248 383480, E-mail: n.walsh@bangor.ac.uk
Accepted for publication 15 November 2015
We examined whether daily hot water immersion (HWI)
after exercise in temperate conditions induces heat
acclimation and improves endurance performance in
temperate and hot conditions. Seventeen non-heat-
acclimatized males performed a 6-day intervention
involving a daily treadmill run for 40 min at 65% V̇ O2max
in temperate conditions (18 °C) followed immediately by
either HWI (N = 10; 40 °C) or thermoneutral (CON,
N = 7; 34 °C) immersion for 40 min. Before and after the
6-day intervention, participants performed a treadmill run
for 40 min at 65% V̇ O2max followed by a 5-km treadmill
time trial (TT) in temperate (18 °C, 40% humidity) and
hot (33 °C, 40% humidity) conditions. HWI induced heat
acclimation demonstrated by lower resting rectal
temperature (Tre, mean, À0.27 °C, P < 0.01), and final
Tre during submaximal exercise in 18 °C (À0.28 °C,
P < 0.01) and 33 °C (À0.36 °C, P < 0.01). Skin
temperature, Tre at sweating onset and RPE were lower
during submaximal exercise in 18 °C and 33 °C after
6 days in HWI (P < 0.05). Physiological strain and
thermal sensation were also lower during submaximal
exercise in 33 °C after 6 days in HWI (P < 0.05). HWI
improved TT performance in 33 °C (4.9%, P < 0.01) but
not in 18 °C. Thermoregulatory measures and
performance did not change in CON. Hot water immersion
after exercise on 6 days presents a simple, practical, and
effective heat acclimation strategy to improve endurance
performance in the heat.
Athletes, military personnel, and firefighters are
often required to perform in the heat which increases
physiological demands and places substantial strain
on heat loss mechanisms (Cheung et al., 2000). To
reduce the risk of exertional-heat-illness (EHI) and
improve exercise capability in the heat these individ-
uals often prepare by completing an exercise heat
acclimation protocol. The adaptive responses to
exercise heat acclimation have been widely docu-
mented (Taylor, 2014) and include, but are not lim-
ited to, earlier onset of cutaneous vasodilatation and
sweating, increases in sweating rate, reduced cardio-
vascular strain, and, in-turn, reduced core tempera-
ture and physiological strain, and improved
endurance capacity during exercise in the heat. Some
evidence supports the notion that the ergogenic ben-
efit of exercise heat acclimation extends to endurance
performance in cool conditions (Lorenzo et al.,
2010) but recent evidence presents a mixed picture
(Neal et al., 2015).
Conventional exercise heat acclimation protocols
typically consist of a daily bout of exercise heat stress
over a 5- to 16-day period where core temperature is
increased for 1–2 h in an artificial hot environment
(Nadel et al., 1974; Garrett et al., 2009). Exercise
intensity during heat acclimation programs has
either been fixed, self-regulated or manipulated to
control a precise level of hyperthermia (Fox et al.,
1963; Taylor, 2014). Owing to the ensuing adapta-
tions, the training stimulus typically decreases during
conventional exercise heat acclimation programs
(Taylor, 2014). The controlled hyperthermia tech-
nique has the advantage that the adaptive stimulus is
kept constant (core temperature clamped at 38.5 °C)
(Fox et al., 1963), thus optimizing adaptation and,
via thermal clamping, affording greater insight into
underlying mechanisms (Taylor, 2014). However,
there are practical disadvantages using these exercise
heat acclimation protocols. These protocols can be
costly and impractical for non-acclimated individu-
als residing in cooler climates as their completion
requires access to an environmental chamber or tem-
porary relocation to a hotter climate to complete the
protocol. The controlled hyperthermia technique
also requires measurement of core temperature and
control of exercise intensity to maintain core temper-
ature at 38.5 °C.
One novel, as yet unexplored, approach to these
practical limitations may be to have non-heat-
acclimated individuals undertake hot water
745
Scand J Med Sci Sports 2016: 26: 745–754
doi: 10.1111/sms.12638
ª 2015 John Wiley & Sons A/S.
Published by John Wiley & Sons Ltd
2. immersion (HWI) immediately after daily exercise
performed in temperate conditions. Related support
comes from studies showing thermoregulatory adap-
tations (Fox et al., 1963; Beaudin et al., 2009) and
performance benefits (Scoon et al., 2007) of passive
heat acclimation using controlled hyperthermia in a
vapor barrier suit or sauna, but these methods are
somewhat limited in terms of their practicality and
no measures of thermoregulation were reported dur-
ing exercise heat stress (Scoon et al., 2007; Beaudin
et al., 2009). Support also comes from studies in
non-heat-acclimated individuals showing that
repeated HWI over a 10- to 14-day period decreased
core temperature at rest before and during HWI
(Brebner et al., 1961; Brazaitis & Skurvydas, 2010)
and during light exercise in the heat (Brebner et al.,
1961; Bonner et al., 1976). More practical alterna-
tives for heat acclimation would be welcome as these
studies used a thermal clamp (Bonner et al., 1976)
and an unpleasant 44 °C HWI protocol (Brazaitis &
Skurvydas, 2010). Extending beyond the obvious
practical advantages, as combined elevations in core
temperature and skin temperature are important to
achieve full heat acclimation (Fox et al., 1964; Regan
et al., 1996), there is a reasoned physiological argu-
ment for why HWI (elevated core and skin tempera-
ture) immediately after daily exercise in temperate
conditions (elevated core temperature) might elicit
favorable heat acclimation responses.
To date, no study has investigated whether a daily
HWI following exercise in temperate conditions
induces heat acclimation and improvements in
endurance exercise performance in hot and temper-
ate conditions. To this end, we hypothesized that a
short-term (6-day) protocol involving a 40-min HWI
each day after submaximal treadmill running in a
temperate laboratory would induce heat acclimation
and performance improvements during a 5-km tread-
mill time trial in both temperate (18 °C) and hot
(33 °C) conditions.
Methods
Participants
Seventeen physically active, non-heat acclimatized
males who had not been exposed to hot environmen-
tal conditions in the past 3 months and completed 2
or more hours of endurance exercise per week were
recruited to participate in the study. Participants
were randomly assigned to either a 6-day hot water
immersion (HWI: N = 10; mean Æ SD, age:
23 Æ 3 years; body mass: 69.5 Æ 6.9 kg; V̇ O2max
60.5 Æ 6.8 mL/kg/min) or control (CON: N = 7;
age: 23 Æ 3 years; body mass: 72.1 Æ 5.8 kg;
V̇ O2max 60.1 Æ 8.9 mL/kg/min) intervention. A 6-
day intervention was completed to align with other
short-term heat acclimation protocols (Aoyagi et al.,
1995; Cotter et al., 1997). There were no differences
in the characteristics of participants in HWI and
CON. The study received local ethics approval and
was conducted in accordance with the Declaration of
Helsinki (2013). All participants provided full writ-
ten informed consent, were healthy, non-smokers,
free from any known cardiovascular or metabolic
diseases and were not taking any medication.
Study design
Prior to (days À3 to À1), and following (days +1 to
+4) the 6-day HWI or CON intervention, experimen-
tal trials were completed in temperate
(18.0 Æ 0.1 °C, 42.5 Æ 3.6% RH) and hot condi-
tions (33.0 Æ 0.3 °C, 40.2 Æ 0.7% RH; Fig. 1).
Experimental trials included a 40-min submaximal
run followed by 60-min rest, then a 5-km treadmill
time trial (TT). On the day of, and in the 24 h prior
to experimental trials (Fig. 1), no alcohol, any form
of diuretics, caffeine or tobacco were consumed and
no exercise, other than that prescribed, was under-
taken. During the intervention (days 1–6), partici-
pants were required to consume their normal diet
and fluid intake, including caffeine and alcohol
(≤3 units per day) and to reduce their regular train-
ing by the volume of endurance exercise completed
during the intervention in the laboratory.
Preliminary measurements and familiarization
A continuous incremental exercise test on a motor-
ized treadmill (HP Cosmos Mercury 4.0; Nussdorf-
Traunstein, Germany) was used to assess V̇ O2max
in temperate conditions (19 °C, 42% RH), as
described (Fortes et al., 2013). Using the interpola-
tion of the running speed – V̇ O2 relationship, the
running speed that elicited 65% V̇ O2max was then
determined and verified 30 min later. This individu-
alized running speed was used for both the sub-
maximal exercise during experimental trials and in
the daily exercise throughout the 6-day interven-
tion. Following the speed verification, participants
rested in the laboratory for 60 min. During this
time they were familiarized with the speed controls
of the treadmill within the environmental chamber
(Delta Environmental Systems, Chester, UK) and
with all instrumentation and procedures used in the
experimental trials. Participants then entered the
environmental chamber (18 °C, 40% RH) and
completed a maximal effort 5-km treadmill TT at
self-selected intensities. One familiarization was
deemed sufficient to mitigate against learning
effects (Laursen et al., 2007). The chamber was
silent and the only information the participant
received was the distance covered displayed on a
screen in front of them.
746
Zurawlew et al.
3. Experimental trials
Participants completed a diet diary in the 24 h
prior to their first experimental trial (Fig. 1) and
were asked to replicate this prior to further experi-
mental trials. On the day of each experimental
trial, participants arrived at the laboratory at
07:30 hours fasted. They were provided with a
standardized breakfast (0.03 MJ/kg) and a bolus
of water equivalent to 7 mL/kg of body mass. At
0800 h on days -1 and +2 a venous blood sample
was taken without stasis following a seated rest.
Urine samples were collected on all experimental
trials and analyzed for urine specific gravity
(USG) using a handheld refractometer (Atago Uri-
con-Ne refractometer; NSG Precision cells, New
York City, New York, USA). A pre-exercise nude
body mass (NBM) was taken using a digital plat-
form scale (Model 705; Seca, Hamburg, Germany)
and then the participant was instrumented for the
exercise protocol. At 08:45 hours, dressed in T-
shirt, running shorts, socks, and shoes participants
rested for 15 min in the laboratory (18 °C) to
establish baseline measures.
Submaximal exercise
At 09:00 hours dressed in running shorts, socks,
and shoes, the participant entered the environmen-
tal chamber that was maintained at either 18 °C,
40% RH or 33 °C, 40% RH and completed a 40-
min 65% V̇ O2max treadmill run (1% gradient;
(Jones & Doust, 1996). During this time no fluids
were consumed. Rectal temperature (Tre), skin
temperatures (Tsk), and heart rate (HR) were mon-
itored continuously and rating of perceived exer-
tion (RPE) (Borg, 1970) and thermal sensation
(TS) (Hollies & Goldman, 1977) were recorded
every 5 min. V̇ O2, and respiratory exchange ratio
(RER) were assessed from 60 s expired gas sam-
ples collected by Douglas bag method at 9–10, 19–
20, 29–30, and 39–40 min of exercise. Local fore-
arm sweat rate was measured every 20 s for the
first 15 min of exercise to assess the onset of
sweating. A NBM was then taken to estimate
whole body sweat losses, and the participant sat
quietly in the laboratory in temperate conditions
(18 °C) dressed in T-shirt, running shorts, socks,
and shoes for 60 min. A single bolus of water
(5 mL/kg body mass) was consumed within the
first 20 min of this rest period.
Five-km treadmill time trial
The TT was completed immediately following a
NBM after the 60-min rest period. The participant
re-entered the environmental chamber dressed in
running shorts, socks, and shoes and completed the
TT run on a motorized treadmill (1% gradient) at
self-selected speeds. Participants were instructed to
run the 5-km TT as quickly as possible. No feedback
other than the distance covered was provided. No
fluids were consumed during the TT. Tre and HR
were measured continuously, and on completion a
NBM was recorded to estimate whole body sweat
losses. The participant was then provided with water
equivalent to sweat losses and was free to leave the
laboratory.
Fig. 1. Schematic of study design.
747
Heat acclimation by post-exercise hot bath
4. Intervention
The 6-day HWI and CON interventions were com-
pleted over consecutive days (days 1–6; Fig. 1). Par-
ticipants in HWI and CON completed the same
submaximal exercise protocol on each of these days
in temperate conditions (18 °C) and a 40-min water
immersion (HWI; 40 °C and CON; 34 °C) following
its cessation. The CON intervention controlled for
any training and/or hydrostatic effects on subse-
quent thermoregulatory measures and endurance
performance.
Submaximal exercise
On each day participants reported to the labora-
tory between 06:00 hours and 10:00 hours. A pre-
exercise NBM (after voiding) was taken and after
fitting a rectal thermistor and HR monitor partici-
pants rested in the laboratory for 15 min to estab-
lish baseline measures. Participants then ran for
40 min on a motorized treadmill at 65% V̇ O2max
in a temperate environment (18 °C) dressed in
running shorts, socks, and shoes. A bolus of water
(5 mL/kg of body mass) was consumed in the first
20 min of exercise, to replicate normal training
procedures, and Tre and HR were monitored con-
tinuously. At the cessation of exercise participants
undertook the water immersion (2–3 min transi-
tion).
Water immersion
Following transition, participants were immersed to
the neck in a water bath dressed in shorts. Those
completing HWI were immersed in 39.9 Æ 0.3 °C
water while a thermoneutral water temperature of
34.1 Æ 0.4 °C was used for CON. The water tem-
perature was maintained during immersions by add-
ing hot or cold water and allowing water to drain to
maintain immersion to neck level, where necessary.
The 34 °C water temperature on CON was chosen
as pilot testing showed that Tre returned to baseline
after exercise at a similar rate to sitting in temperate
laboratory conditions (18 °C), and thus would not
provide any additional cooling effect. During
immersion, no fluids were consumed and Tre and
HR were monitored continuously. Immersion ended
after 40 min unless the participant removed them-
selves due to discomfort in HWI. Following immer-
sion participants sat in the laboratory for 15 min
without fluids and a NBM was taken and adjusted
for fluid intake during the submaximal exercise in
order to estimate whole body sweat loss. Partici-
pants were free to leave the laboratory when
Tre ≤ 38.5 °C.
Measurement and instrumentation
Body temperatures
Tre was measured using a flexible, sterile, disposable
rectal thermistor (Henleys Medical Supplies Ltd.,
Herts, UK) inserted 10 cm beyond the rectal sphinc-
ter and recorded using a data logger (YSI model
4000A; YSI, Dayton, Ohio, USA). Skin tempera-
tures from four sites on the right side of the body (on
the chest at a midpoint between the acromion pro-
cess and the nipple, the lateral mid-bicep, the ante-
rior mid-thigh, and lateral calf) were measured using
insulated thermistors (Grant EUS-U, Cambridge,
UK) and recorded using a portable data logger
(Grant SQ2020, Cambridge, UK). Mean Tsk was
calculated using a four-site weighted equa-
tion (Ramanathan, 1964).
Sweating responses
Changes in dry NBM were used to estimate whole
body sweating rate during all intervention days and
experimental trials. Local forearm sweating rate was
measured by dew point hygrometry during the sub-
maximal run of experimental trials as described (For-
tes et al., 2013).
Physiological strain
Physiological strain index (PhSI) was calculated
using Tre and HR data collected every 5 min
throughout submaximal exercise during experimen-
tal trials, as described (Tikuisis et al., 2002). This
index describes physiological strain on a 0 (no strain)
to 10 (very high strain) scale.
Blood sample collection and analysis
Venous blood samples were collected from an ante-
cubital vein into an EDTA vacutainer (BD, Oxford,
UK) and aliquots of whole blood were used for the
immediate determination of hemoglobin in duplicate
(Hemocue, Sheffield, UK) and hematocrit in tripli-
cate (capillary tube method). Plasma volume (day
À1) was estimated from body mass, as described
(Sawka et al., 1992). The change in plasma volume
(day +2) was estimated by correcting the initial
plasma volume for the percentage change in plasma
volume as described (Dill & Costill, 1974).
Statistical analysis
Data in the results are presented as mean Æ stan-
dard deviation (SD), or mean and 90% confidence
interval of the change for one-tailed tests where
stated, and statistical significance was accepted at
748
Zurawlew et al.
5. P < 0.05. The meaningfulness of the within-subject
differences was also calculated using Cohen’s d
effect size with effect sizes greater than 0.2, 0.5,
and 0.8 representing small, medium, and large
effects. Two sample size calculations (G*Power
3.1.2) were performed using mean data taken from
a 5-day heat acclimation study (Garrett et al.,
2009) and a 5-km treadmill TT reliability study
(Laursen et al., 2007). For a one-tailed t-test with
alpha level set at 0.05 and power set at 0.8 a sam-
ple size of nine participants was calculated to
detect a meaningful heat acclimation induced dif-
ference in final exercising Tre (0.3 °C). To detect a
meaningful improvement in 5-km treadmill TT per-
formance (set at 3%) it was estimated that a sam-
ple size of seven participants was needed. To
ensure adequate power for both key variables, and
allowing for dropout, a sample size of 10 partici-
pants was used for HWI. All data were checked
for normality and sphericity, and analyzed using t-
tests. RER and V̇ O2 were analyzed using one-way
repeated measures ANOVA’s with Greenhouse–
Geisser correction to the degrees of freedom where
necessary. Tukey’s HSD or Bonferroni-adjusted
paired t-test post hoc tests were used where appro-
priate. Sweating threshold was calculated by plot-
ting individual relationships between local forearm
sweating rate and Tre, as described (Cheuvront
et al., 2009). To assess cumulative hyperthermia,
area under the curve (AUC) analysis was per-
formed on the daily Tre (time Tre was >38.5 °C) in
HWI (Cheuvront et al., 2008). Pearson’s correla-
tions were performed to determine the strength of
the relationship between the AUC and the change
in hallmark heat acclimation variables, e.g., change
in resting Tre. All data were analyzed using SPSS
version 20 (IBM Corporation, New York City,
New York, USA), or GraphPad Prism Version
5.02 (GraphPad Software Inc, La Jolla, California,
USA).
Results
Intervention
All participants in HWI and CON completed the 6-
day intervention. Tre increased on average
1.13 Æ 0.24 °C during 40 min of daily submaximal
exercise. Tre increased a further 1.01 Æ 0.31 °C dur-
ing HWI and returned to the pre-exercise resting
level during CON immersion (À1.10 Æ 0.26 °C).
Total AUC (Tre >38.5 °C during submaximal exer-
cise and immersion) for the 6-day HWI intervention
was 156 Æ 83 °C/min and for CON was 2 Æ 4 °C/
min. Total AUC in HWI was greater on day 3 com-
pared with day 1 (P = 0.05) but was not different on
days 4–6 compared with day 1; indicating no signifi-
cant reduction in the total AUC. No daily differ-
ences in total AUC were observed in CON. Heat
acclimation was demonstrated in HWI by an
increase in whole body sweat rate by day 4
(P = 0.02) and an increase in immersion time by day
3 (P = 0.04; Table 1). By day 5, 9 of 10 participants
completed the full 40-min immersion in HWI: one
participant was removed due to reaching the Tre
safety limit (Tre 39.5 °C). On all other occasions
when the 40-min immersion was not completed par-
ticipants removed themselves due to discomfort
(Table 1). In CON, all participants completed all 40-
min immersions and whole body sweat rate was
unchanged from day 1 (0.39 Æ 0.08 L/h).
Experimental trials
Resting responses
Resting Tre was lower following 6 days in HWI in 9
of 10 participants with a mean change in resting Tre
of À0.27 °C (CI: À0.16 to À0.39 °C, P = 0.001,
d = 0.75; Fig. 2a). There was no change in resting
Tre in CON (Fig. 2a). A moderate negative correla-
tion (r = À0.39) was observed between the total
AUC for the 6-day HWI intervention and the
Table 1. The influence of submaximal running at 65% V̇ O2max for 40 min in 18 °C and post-exercise hot water immersion in 40 °C water immersed
to the neck (HWI; n = 10) on daily thermoregulatory variables, heart rate, and immersion time. Data displayed as mean Æ SD
HWI intervention day
1 2 3 4 5 6
Submaximal exercise
Change in Tre (°C) 1.11 Æ 0.25 1.15 Æ 0.23 1.15 Æ 0.26 1.22 Æ 0.17 1.12 Æ 0.19 1.17 Æ 0.23
Heart rate (beats/min) 142 Æ 13 142 Æ 15 142 Æ 14 140 Æ 12 139* Æ 12 140 Æ 11
Hot water immersion
Change in Tre (° C) 0.95 Æ 0.27 0.94 Æ 0.33 1.04 Æ 0.40 0.99 Æ 0.31 1.08 Æ 0.28 1.09 Æ 0.30
Immersion time (min:s) 32:50 Æ 07:14 35:18 Æ 06:43 38:00* Æ 03:30 39:21* Æ 01:25 39:36* Æ 01:16 39:45* Æ 00:47
Participants completing
40 min immersion (n)
4 6 7 8 9 9
Submaximal exercise and hot water immersion
Sweat rate (L/h) 0.89 Æ 0.30 0.98 Æ 0.33 1.03 Æ 0.36 1.08* Æ 0.30 1.08** Æ 0.26 1.14** Æ 0.31
*P < 0.05, **P < 0.01 vs day 1.
749
Heat acclimation by post-exercise hot bath
6. decrease in resting Tre. USG was not different
between experimental trials and there was a modest
increase in plasma volume from day À1 to day +2 in
HWI (3 Æ 5%, P = 0.05), with no change in CON
(1 Æ 3%, P = 0.31).
Submaximal exercise responses
After the 6-day HWI intervention, end Tre during
submaximal exercise was lower in 9 of 10 participants
in 18 °C and 10 of 10 participants in 33 °C (Fig. 2b)
where change in end Tre was À0.28 °C (CI: À0.16 to
À0.40 °C, P = 0.001, d = 0.78) in 18 °C and
À0.36 °C (CI: À0.24 to À0.49 °C, P = 0.0001,
d = 0.70) in 33 °C. A modest negative correlation
(r = À0.45) was observed between total AUC for the
6-day HWI intervention and the decrease in end sub-
maximal exercise Tre in 33 °C. CON demonstrated
no change in end exercise Tre in either 18 °C or 33 °C
(Fig. 2b). HWI decreased end exercise Tsk (18 °C:
P = 0.001, d = 0.86; 33 °C: P = 0.001, d = 0.60;
Fig. 3c) and decreased Tre at the onset of sweating in
both 18 °C (P = 0.001, d = 0.86; Fig. 3a) and 33 °C
(P = 0.02, d = 0.57). End exercise RPE (18 °C:
P = 0.01, d = 0.74; 33 °C: P = 0.04, d = 0.72;
Fig. 3e) and HR were lowered in 18 °C and 33 °C
after 6 days in HWI (18 °C: À7, CI: À2 to À11 bpm;
P = 0.02, d = 0.52; 33 °C: À6, CI: À2 to À10 bpm;
P = 0.01, d = 0.40) and PhSI (P = 0.01, d = 0.87;
Fig. 3d) and TS were lower in 33 °C (P = 0.01,
d = 0.70; Fig. 3f). HWI had no effect on V̇ O2 and
RER in 18 °C or 33 °C. There was no effect of CON
on any of the above variables (Fig. 3a–f).
Five-km treadmill time trial performance
Endurance exercise performance, assessed via a 5-km
treadmill TT, was not altered in CON in either 18 °C
(PRE: 1208 Æ 191 s and POST: 1216 Æ 167 s) or
33 °C (PRE: 1321 Æ 219 s and POST:
1299 Æ 207 s) indicating no training effect. One
HWI participant did not complete the PRE 33 °C
TT and another HWI participant’s TT data were
excluded from analysis due to obvious lack of effort
on the POST 18 °C TT (mean % HR max was 82%
compared with 91% for the group and 96% for his
PRE 18 °C TT). Endurance exercise performance
was impaired in 33 °C compared with 18 °C before
the intervention (P = 0.03, d = 0.40; Fig. 4a). The 6-
day HWI intervention did not alter TT performance
in 18 °C but improved TT performance in 33 °C
(P = 0.01, d = 0.42; Fig. 4a,b). The 4.9% improve-
ment in TT performance in 33 °C in HWI restored
performance to the level observed in 18 °C condi-
tions (Fig. 4a). After the 6-day HWI intervention
end TT Tre was lower in 33 °C (À0.17 °C; CI:À0.04
to À0.30; P = 0.02, d = 0.49). There were no other
PRE to POST differences in Tre in HWI or CON
during the TT.
Discussion
These novel findings suggest that heat acclimation
can be achieved by HWI after exercise in temperate
conditions on 6 days and, as such, presents a practi-
cal strategy to improve heat dissipation and endur-
ance performance in the heat. There are two
principal findings in the present study that support
this recommendation. Firstly, we observed clear evi-
dence of heat acclimation after the HWI intervention
demonstrated by lower resting Tre (À0.27 °C) and
lower end submaximal exercise Tre in both 18 °C
(À0.28 °C) and 33 °C (À0.36 °C). Hallmark heat
acclimation responses also included a lower set point
for sweating onset and reductions in Tsk, PhSI, RPE,
and TS during submaximal exercise in the heat after
6 days in HWI. Adaptations were evident sooner
than day 6 of HWI; for example, whole body sweat
37.0
38.0
39.0
40.0
HWI CON
18 °C 33 °C 18 °C 33 °C
EndTre(°C)
35.5
36.0
36.5
37.0
37.5
38.0
HWI CON
ResƟngTre(°C)
PRE
POST
**
** **
(a)
(b)
Fig. 2. Influence of a 6-day post-exercise hot water immer-
sion (HWI) or control (CON) intervention on resting rectal
core temperature (Tre, a) and end exercise Tre (b) assessed
following 40-min running at 65% V̇ O2max in 18 °C (40%
RH) and 33 °C (40% RH). Bars show mean at PRE and
POST. Lines represent individual participants. ** P < 0.01,
PRE greater than POST.
750
Zurawlew et al.
7. rate was increased by day 4 of the intervention. Sec-
ondly, the HWI intervention improved 5-km tread-
mill TT performance 4.9% in 33 °C restoring
performance to the level achieved in 18 °C. Strengths
of this study include control of the time of day for
the intervention and experimental trials and the
inclusion of a control group. Including CON pro-
vides confidence that the adaptations shown in HWI
were attributed to bathing in hot water after exercise,
since the daily exercise and thermoneutral water
immersions completed by CON did not affect ther-
moregulatory or performance outcomes. We recog-
nize that the addition of a traditional exercise heat
acclimation group would have enabled for compar-
isons with the HWI intervention. Additionally,
though we observed a modest expansion of plasma
volume in HWI we recognize the weakness of esti-
mating this using hemoglobin and hematocrit and
recommend tracer techniques be used to verify this
finding.
Current recommendations state that heat acclima-
tion should comprise repeated bouts of exercise in
the heat over 1–2 weeks (Racinais et al., 2015). Here
the findings suggest that HWI after exercise in tem-
perate conditions on 6 days presents an alternative
heat acclimation strategy that overcomes some of the
practical limitations of current heat acclimation
strategies. Hallmarks of successful heat acclimation
include a decrease in resting and exercising core tem-
perature and an improved exercise capacity in the
heat (Nadel et al., 1974). The utility of short-term
exercise heat acclimation protocols lasting 4–6 days
0.0
0.5
1.0
1.5
HWI CON
18 °C 33 °C 18 °C 33 °C
WBSR(L/h)
36.5
36.7
36.9
37.1
37.3
37.5
HWI CON
18 °C 33 °C 18 °C 33 °C
Tre
(°C)atsweaƟngonset
27.0
29.0
31.0
33.0
35.0
37.0
HWI CON
18 °C 33 °C 18 °C 33 °C
EndTsk(°C)
0
1
2
3
4
5
HWI CON
18 °C 33 °C 18 °C 33 °C
EndPhSI
10
15
20
HWI CON
18 °C 33 °C 18 °C 33 °C
EndRPE
7
8
9
10
11
12
13
HWI CON
18 °C 33 °C 18 °C 33 °C
EndthermalsensaƟon
(a)
(b)
(d)
(e)
PRE
POST
PRE
POST
(c) (f)** **
*** *
***
*
Fig. 3. Influence of a 6-day post-exercise hot water immersion (HWI) or control (CON) intervention on rectal core tempera-
ture at sweating onset (Tre, a), whole body sweat rate (WBSR, b) and end exercise responses for mean skin temperature (Tsk,
c), physiological strain index (PhSI, d), RPE (e), and thermal sensation (f) following 40-min running at 65% V̇ O2max in 18 °C
(40% RH) and 33 °C (40% RH). Bars show mean at PRE and POST and SD. * P < 0.05 and ** P < 0.01, PRE greater than
POST.
751
Heat acclimation by post-exercise hot bath
8. has been investigated (Sunderland et al., 2008; Gar-
rett et al., 2012), as most adaptations occur within
the first 6 days of heat acclimation (Armstrong &
Maresh, 1991) and because a shorter heat acclima-
tion protocol is considered to integrate better into
an athlete’s training/tapering program. In line
with other short-term (Cotter et al., 1997), and
traditional, longer term exercise heat acclimation
protocols (Armstrong & Kenney, 1993), our 6-day
post-exercise HWI intervention, decreased exercise
Tre (Fig. 2b), the Tre at the onset of sweating
(Fig. 3a), Tsk (Fig. 3c), PhSI (Fig. 3d) and improved
exercise performance in the heat (Fig. 4a). Further-
more, the thermoregulatory benefits of HWI we
observed during submaximal exercise in the heat
were also apparent in temperate (18 °C) conditions
(Fig. 2b). There appear to be additional acclimation
advantages of the post-exercise HWI intervention
because, unlike some short-term exercise heat accli-
mation studies (Sunderland et al., 2008; Garrett
et al., 2009, 2012), we also demonstrate a reduction
in resting Tre (À0.27 °C). The responsible mecha-
nism requires elucidation but likely includes
increased resting skin blood flow and sweating sensi-
tivity (Taylor, 2014), and/or a potential decrease in
thermoregulatory set point (Aoyagi et al., 1997);
although this concept is controversial (Romanovsky,
2007). The magnitude of adaptation demonstrated in
HWI in the current study, where the total AUC for
Tre >38.5 °C was not different on day 6 vs. day 1,
compares very favorably with short-term
exercise heat acclimation studies (Sunderland et al.,
2008; Garrett et al., 2009, 2012), including those
using controlled hyperthermia (Tre 38.5 °C) that
maintain a constant adaptation impulse during daily
exercise heat stress (Garrett et al., 2012; Taylor,
2014). Work by Fox et al. and later by Regan et al.
demonstrated that while heat acclimation is depen-
dent upon the degree of core temperature elevation,
the elevation of skin temperature is important for
full heat acclimation (Fox et al., 1964; Regan et al.,
1996); therefore, indicating the importance of the
external thermal stress and a likely role for raised Tsk
in the observed adaptations in HWI. Peripheral
adaptations to local HWI, with and without a rise in
core temperature increased local sweating responses
(Fox et al., 1964), later coined “sweat gland train-
ing” (Avellini et al., 1982), but the increase in local
sweating was more dramatic when both core temper-
ature and skin temperature were elevated (Fox et al.,
1964). Thus the combined elevation of Tre (~39.3 °C
after each HWI) and Tsk during daily HWI in 40 °C
(where Tsk equilibrates with water temperature) after
exercise likely accounts for the additional observed
benefits shown compared with short-term exercise
heat acclimation.
The majority of studies investigating the effect of
heat acclimation on endurance performance have
used time-to-exhaustion protocols, e.g., V̇ O2max
ramp protocols (Sawka et al., 1985; Garrett et al.,
2009) or fixed intensity tests (Nielsen et al., 1997;
Scoon et al., 2007). While such tests have shown heat
acclimation improvements of ~14–32% (Nielsen
et al., 1997; Scoon et al., 2007; Garrett et al., 2009),
this magnitude of improvement needs to be consid-
ered in the context of the variability in time-to-
exhaustion protocols, reported to be as high as 27%
(Jeukendrup et al., 1996). Only a handful of studies
have assessed the effect of heat acclimation on self-
paced TT performance and these used daily exercise
in the heat to induce heat acclimation (Lorenzo
et al., 2010; Garrett et al., 2012). To our knowledge,
this is the first study to investigate the effects of a
daily post-exercise HWI intervention on TT perfor-
mance and here we demonstrate an improvement in
5-km TT performance of 4.9% in the heat, where
performance was restored to the level achieved in
18 °C conditions (Fig. 4a). The magnitude of
performance improvement exceeds the CV (~2%) for
the 5-km TT (Laursen et al., 2007), and thus, we
1000
1100
1200
1300
1400
Timetocomplete5km(s)
–2
0
2
4
6
8
18 C 33 °° C
18 °C 33 °C
ΔTTperformance(%)
**
PRE
POST
*(a)
(b)
Fig. 4. Influence of a 6-day post-exercise hot water immer-
sion (HWI) intervention on 5-km treadmill TT perfor-
mance (a) and % change in 5-km treadmill TT
performance (b) in 18 °C (40% RH) and 33 °C (40%
RH). Shown are mean and SD (a) and mean and 90% CI
of the difference (b). * P < 0.05 and ** P < 0.01.
752
Zurawlew et al.
9. contend, represents a meaningful performance
improvement (Fig. 4b) attributable to the heat accli-
mation adaptations observed. The reduced heat
strain after 6 days in HWI is also likely to benefit
more prolonged endurance exercise performance in
the heat, by blunting the rise in core temperature;
though this requires investigation. The potential ben-
efits of heat acclimation on endurance performance
in cooler conditions received little attention until one
study showed that 10 daily bouts of exercise heat
stress improved cycling TT performance by 6% in
13 °C conditions (Lorenzo et al., 2010). Considering
the decrease in thermal strain during submaximal
exercise in 18 °C after 6 days in HWI (Fig. 2b), we
might have anticipated, but did not observe, an
improvement in 5-km TT performance in 18 °C. It is
conceivable, but requires investigation, that the HWI
intervention might improve endurance performance
in temperate conditions that presents a greater ther-
mal burden such as a 10-km TT (final Tre during
18 °C 5 km TT was only 38.6 °C).
In conclusion, HWI immediately after exercise in
temperate conditions on six consecutive days reduced
heat strain during submaximal exercise in both tem-
perate and hot conditions, and improved 5-km tread-
mill TT performance in the heat. For those residing
and training in temperate conditions, incorporating a
hot bath into the post-exercise washing routine on
six consecutive days represents a simple, practical,
economical, and effective heat acclimation strategy
to improve endurance performance in the heat.
Perspectives
This heat acclimation intervention overcomes a num-
ber of practical limitations with current exercise heat
acclimation protocols. For example, access to a hot
environment is not required, neither is precise con-
trol of exercising Tre, but also because a post-exercise
hot bath does not interfere with daily training and
might be incorporated into post-exercise washing
routines. Analogous to “live-high train-low” (Stray-
Gundersen et al., 2001) we contend these findings
support the concept, ‘train-cool bathe-hot’.
Although this alternative heat acclimation strategy
conflicts with current athlete practice which includes
post-exercise cryotherapy, the benefits of cryother-
apy to improve recovery have been questioned (Lee-
der et al., 2012). The benefits of HWI are likely
greater when core temperature is elevated following
exercise, but future research that is mindful of the
prior exercise heat strain, safety, and real-world limi-
tations is required to verify this and establish
whether the intervention can be optimized for mili-
tary/occupational or athlete scenarios. For example,
the intervention might be manipulated (e.g., reducing
the water temperature, duration and/or frequency of
exposures) for the military/occupational scenario
where the aim is to improve tolerance and safety (re-
duce EHI risk) to a standard heat challenge in large
groups (one-size-fits-all). For athletes wishing to
optimize performance in the heat, the intervention
could be manipulated to ensure constant physiologi-
cal strain during exposures. Future studies are also
required to investigate the decay of heat acclimation
following this intervention, in males and females,
and to assess the purported benefits for cellular train-
ing adaptations (Tamura et al., 2014) and immunity
(Walsh et al., 2011).
Key words: thermoregulation, hyperthermia, perfor-
mance, running, heat illness, hot bath.
Acknowledgements
We thank the following people for their valuable assistance
with data collection: Tom Ibbitson, David Harding, Liam
Renton, Jonathan Donoghue, Lauren Casling, Benjamin
Price, Thomas Storer, Jason Edwards and Kevin Williams.
We are also indebted to the participants for their time and
co-operation.
Conflicts of interest
The authors of the study declare that they have no conflicts of
interest.
References
Aoyagi Y, McLellan TM, Shephard
RJ. Effects of 6 versus 12 days of
heat acclimation on heat tolerance
in lightly exercising men wearing
protective clothing. Eur J Appl
Physiol Occup Physiol 1995: 71:
187–196.
Aoyagi Y, McLellan TM, Shephard
RJ. Interactions of physical training
and heat acclimation. The
thermophysiology of exercising in
a hot climate. Sports Med 1997:
23: 173–210.
Armstrong CG, Kenney WL. Effects
of age and acclimation on
responses to passive heat
exposure. J Appl Physiol 1993: 75:
2162–2167.
Armstrong LE, Maresh CM. The
induction and decay of heat
acclimatisation in trained athletes.
Sports Med 1991: 12: 302–312.
Avellini BA, Shapiro Y, Fortney SM,
Wenger CB, Pandolf KB. Effects on
heat tolerance of physical training in
water and on land. J Appl Physiol
Respir Environ Exerc Physiol 1982:
53: 1291–1298.
Beaudin AE, Clegg ME, Walsh ML,
White MD. Adaptation of
exercise ventilation during an
actively-induced hyperthermia
following passive heat acclimation.
Am J Physiol Regul Integr
Comp Physiol 2009: 297: R605–
R614.
Bonner RM, Harrison MH, Hall CJ,
Edwards RJ. Effect of heat
acclimatization on intravascular
753
Heat acclimation by post-exercise hot bath
10. responses to acute heat stress in man.
J Appl Physiol 1976: 41: 708–713.
Borg G. Perceived exertion as an
indicator of somatic stress. Scand J
Rehabil Med 1970: 2: 92–98.
Brazaitis M, Skurvydas A. Heat
acclimation does not reduce the
impact of hyperthermia on central
fatigue. Eur J Appl Physiol 2010:
109: 771–778.
Brebner DF, Clifford JM, Kerslake
DM, Nelms JD, Waddell JL. Rapid
acclimitization to heat in man. UK
Ministry of Defence: I A M Scientific
Memorandum 1961: 38: 1–14.
Cheung SS, McLellan TM, Tenaglia S.
The thermophysiology of
uncompensable heat stress.
Physiological manipulations and
individual characteristics. Sports
Med 2000: 29: 329–359.
Cheuvront SN, Bearden SE, Kenefick
RW, Ely BR, Degroot DW, Sawka
MN, Montain SJ. A simple and valid
method to determine thermoregula-
tory sweating threshold and sensitivity.
J Appl Physiol 2009: 107: 69–75.
Cheuvront SN, Chinevere TD, Ely BR,
Kenefick RW, Goodman DA,
McClung JP, Sawka MN. Serum
S-100beta response to exercise-heat
strain before and after acclimation.
Med Sci Sports Exerc 2008: 40:
1477–1482.
Cotter JD, Patterson MJ, Taylor NA.
Sweat distribution before and after
repeated heat exposure. Eur J Appl
Physiol Occup Physiol 1997: 76:
181–186.
Dill DB, Costill DL. Calculation of
percentage changes in volumes of
blood, plasma, and red cells in
dehydration. J Appl Physiol 1974:
37: 247–248.
Fortes MB, Di Felice U, Dolci A,
Junglee NA, Crockford MJ, West L,
Hillier-Smith R, Macdonald JH,
Walsh NP. Muscle-damaging
exercise increases heat strain during
subsequent exercise heat stress.
Med Sci Sports Exerc 2013: 45:
1915–1924.
Fox RH, Goldsmith R, Hampton IFG,
Lewis HE. The nature of the increase
in sweating capacity produced by
heat acclimatization. J Physiol 1964:
171: 368–376.
Fox RH, Goldsmith R, Kidd DJ,
Lewis HE. Acclimatization to heat in
man by controlled elevation of
body temperature. J Physiol 1963:
166: 530–547.
Garrett AT, Creasy R, Rehrer NJ,
Patterson MJ, Cotter JD.
Effectiveness of short-term heat
acclimation for highly trained
athletes. Eur J Appl Physiol 2012:
112: 1827–1837.
Garrett AT, Goosens NG, Rehrer NJ,
Patterson MJ, Cotter JD. Induction
and decay of short-term heat
acclimation. Eur J Appl Physiol
2009: 107: 659–670.
Hollies NRS, Goldman RFG.
Psychological scaling in comfort
assessment. In: Hollies NRS,
Goldman RFG, eds. Clothing
Comfort: Interaction of Thermal,
Ventilation, Construction, and
Assessment Factors. Ann Arbor:
Ann Arbor Science Publishers,
1977: 107–120.
Jeukendrup A, Saris WH, Brouns F,
Kester AD. A new validated
endurance performance test. Med Sci
Sports Exerc 1996: 28: 266–270.
Jones AM, Doust JH. A 1% treadmill
grade most accurately reflects the
energetic cost of outdoor running.
J Sports Sci 1996: 14: 321–327.
Laursen PB, Francis GT, Abbiss CR,
Newton MJ, Nosaka K. Reliability
of time-to-exhaustion versus time-
trial running tests in runners.
Med Sci Sports Exerc 2007: 39:
1374–1379.
Leeder J, Gissane C, van SK, Gregson
W, Howatson G. Cold water
immersion and recovery from
strenuous exercise: a meta-analysis.
Br J Sports Med 2012: 46: 233–240.
Lorenzo S, Halliwill JR, Sawka MN,
Minson CT. Heat acclimation
improves exercise performance.
J Appl Physiol 2010: 109: 1140–1147.
Nadel ER, Pandolf KB, Roberts MF,
Stolwijk JA. Mechanisms of thermal
acclimation to exercise and heat. J
Appl Physiol 1974: 37: 515–520.
Neal RA, Corbett J, Massey HC,
Tipton MJ. Effect of short-term heat
acclimation with permissive
dehydration on thermoregulation
and temperate exercise performance.
Scand J Med Sci Sports 2015: Jul 29.
doi: 10.1111/sms.12526. [Epub ahead
of print].
Nielsen B, Strange S, Christensen NJ,
Warberg J, Saltin B. Acute and
adaptive responses in humans to
exercise in a warm, humid
environment. Pflugers Arch 1997:
434: 49–56.
Racinais S, Alonso JM, Coutts AJ,
Flouris AD, Girard O, Gonzalez-
Alonso J, Hausswirth C, Jay O, Lee
JK, Mitchell N, Nassis GP, Nybo L,
Pluim BM, Roelands B, Sawka MN,
Wingo JE, Periard JD. Consensus
recommendations on training and
competing in the heat. Scand J Med
Sci Sports 2015: 25(Suppl. 1): 6–19.
Ramanathan NL. A new weighting
system for mean surface temperature
of the human body. J Appl Physiol
1964: 19: 531–533.
Regan JM, Macfarlane DJ, Taylor NA.
An evaluation of the role of skin
temperature during heat adaptation.
Acta Physiol Scand 1996: 158: 365–
375.
Romanovsky AA. Thermoregulation:
some concepts have changed.
Functional architecture of the
thermoregulatory system. Am J
Physiol Regul Integr Comp Physiol
2007: 292: R37–R46.
Sawka MN, Young AJ, Cadarette BS,
Levine L, Pandolf KB. Influence of
heat stress and acclimation on maximal
aerobic power. Eur J Appl Physiol
Occup Physiol 1985: 53: 294–298.
Sawka MN, Young AJ, Pandolf KB,
Dennis RC, Valeri CR. Erythrocyte,
plasma, and blood volume of healthy
young men. Med Sci Sports Exerc
1992: 24: 447–453.
Scoon GS, Hopkins WG, Mayhew S,
Cotter JD. Effect of post-exercise
sauna bathing on the endurance
performance of competitive male
runners. J Sci Med Sport 2007: 10:
259–262.
Stray-Gundersen J, Chapman RF,
Levine BD. “Living high-training
low” altitude training improves sea
level performance in male and
female elite runners. J Appl Physiol
2001: 91: 1113–1120.
Sunderland C, Morris JG, Nevill ME.
A heat acclimation protocol for team
sports. Br J Sports Med 2008: 42:
327–333.
Tamura Y, Matsunaga Y, Masuda H,
Takahashi Y, Takahashi Y, Terada
S, Hoshino D, Hatta H. Postexercise
whole body heat stress additively
enhances endurance training-induced
mitochondrial adaptations in mouse
skeletal muscle. Am J Physiol
Regul Integr Comp Physiol 2014:
307: R931–R943.
Taylor NA. Human heat adaptation.
Compr Physiol 2014: 4: 325–365.
Tikuisis P, McLellan TM, Selkirk G.
Perceptual versus physiological
heat strain during exercise-heat
stress. Med Sci Sports Exerc 2002:
34: 1454–1461.
Walsh NP, Gleeson M, Pyne DB,
Nieman DC, Dhabhar FS, Shephard
RJ, Oliver SJ, Bermon S, Kajeniene
A. Position statement. Part two:
maintaining immune health. Exerc
Immunol Rev 2011: 17: 64–103.
754
Zurawlew et al.