Wheelchair racing is one of the most popular sporting activities of individuals with spinal cord injury. Athletes with this impairment have unique changes in metabolic, cardiorespiratory, neuromuscular and thermoregulatory systems, which reduce their overall physiological capacity compared with able-bodied individuals or individuals with other types of impairments. This review on spinal cord injury: (i) presents the International Stoke Mandeville Games Federation classification of wheelchair athletes; (ii) describes methods commonly used to characterise anaerobic and aerobic fitness; (iii) presents the findings of physiological studies that have evaluated wheelchair racing performance; (iv) identifies the risks associated with temperature regulation when competing in wheelchair races; and (v) discusses special conditions that can influence wheelchair racing performance. Currently there is limited research that has examined the relationship between sprint or distance wheelchair racing performance and the anaerobic and aerobic components of physical fitness. Although the descriptive evidence indicates that the profiles of these athletes reflect their training and participation in these specific events, the association between their physiological profiles and real or simulated racing performance is unclear. The generally accepted concept that high values of aerobic and anaerobic power are strongly correlated with endurance and sprint racing performance, respectively, are not necessarily true in this population. Athletes with spinal cord injury have an impaired thermoregulatory capacity, because the compromised autonomic and somatic nervous system functions disrupt control of skin blood flow and sweating below the level of the lesion. As a result, they may be more susceptible to hyperthermia during distance wheelchair racing performance. Wheelchair athletes should follow recommendations advocated for able-bodied individuals to minimise their risks of heat stress during competition. Many athletes with quadriplegia voluntarily induce autonomic dysreflexia (commonly known as boosting) during distance racing events to improve performance. Experimental evidence indicates that boosting can improve performance time by 10% in elite wheelchair marathon racers during simulated racing, as a result of increased oxygen utilisation in the boosted state. However, since boosting can be dangerous to health, the International Paralympic Committee has banned athletes from voluntarily inducing it during competition. The use of antigravity suits to increase lower-body positive pressure can increase the peak oxygen uptake, cardiac output and stroke volume. However, the use of abdominal binders does not influence these physiological responses. An effect of either of these techniques on wheelchair racing performance has not been demonstrated.

Physiology of wheelchair racing in athletes with spinal cord injury.

The human body constantly exchanges heat with the environment. Temperature regulation is a homeostatic feedback control system that ensures deep body temperature is maintained within narrow limits despite wide variations in environmental conditions and activity-related elevations in metabolic heat production. Extensive research has been performed to study the physiological regulation of deep body temperature. This review focuses on healthy and disordered human temperature regulation during heat stress. Central to this discussion is the notion that various morphological features, intrinsic factors, diseases, and injuries independently and interactively influence deep body temperature during exercise and/or exposure to hot ambient temperatures. The first sections review fundamental aspects of the human heat stress response, including the biophysical principles governing heat balance and the autonomic control of heat loss thermoeffectors. Next, we discuss the effects of different intrinsic factors (morphology, heat adaptation, biological sex, and age), diseases (neurological, cardiovascular, metabolic, genetic), and injuries (spinal cord injury, deep burns, heat stroke), with emphasis on the mechanisms by which these factors enhance or disturb the regulation of deep body temperature during heat stress. We conclude with key unanswered questions in this field of research.

Human temperature regulation under heat stress in health, disease, and injury.

People with disability experience multidimensional inequalities, which heighten their vulnerability to climate change. An understanding of the vulnerability and adaptive capacity of people with disability can be gained through considering how they have fared during the types of events associated with climate change, such as droughts, floods, heat waves, hurricanes, and wildfires. A systematic review was conducted to identify factors associated with climate change vulnerability and adaptive capacity of people with disability. Papers were sourced from 12 electronic databases, the Google search engine, the websites of 21 organizations, and the reference lists of included papers; 34 papers (relating to 28 studies) met the selection criteria. Most studies were located in the United States, and almost half were focused on hurricane events. Factors contributing to vulnerability included personal factors (e.g., female gender, uncoupled or living alone, nonwhite ethnicity, and low income), environmental fa...

Factors associated with the climate change vulnerability and the adaptive capacity of people with disability: A systematic review

The thermoregulatory responses of ten paraplegic (PA; T3/4-L4) and nine able-bodied (AB) upper body trained athletes were examined at rest and during prolonged arm-cranking exercise and passive recovery. Exercise was performed for 90 min at 80% peak heart rate, and at 21.5 (1.7) degrees C and 47.0 (7.8)% relative humidity on a Monark cycle ergometer (Ergomedic 814E) adapted for arm exercise. Mean peak oxygen uptake values for the PA and AB athlete groups were 2.12 (0.41) min(-1) and 3.19 (0.38) l x min(-1), respectively (P<0.05). At rest, there was no difference in aural temperature between groups [36.2 (0.4) degrees C for both groups]. However, upper body skin temperatures for the PA athletes were approximately 1.0 degrees C warmer than for the AB athletes, whereas lower body skin temperatures were cooler than those for the AB athletes (1.3 degrees C and 2.7 degrees C for the thigh and calf, respectively). Upper and lower body skin temperatures for the AB athletes were similar. During exercise, blood lactate peaked after 15 min of exercise for both groups [3.33 (1.26) mmol x l(-1) and 4.30 (1.03) mmol x l(-1) for the PA and AB athletes, respectively, P<0.05] and decreased throughout the remainder of the exercise period. Aural temperature increased by 0.7 (0.5) degrees C and 0.6 (0.4) degrees C for the AB and PA athletes, respectively. Calf skin temperature for the PA athletes increased during exercise by 1.4 (2.8) degrees C (P<0.05), whereas a decrease of 0.8 (2.0) degrees C (P<0.05) was observed for the AB athletes. During the first 20 min of recovery from exercise, the calf skin temperature of the AB athletes decreased further [-2.6 (1.3) degrees C; P<0.05]. Weight losses and changes in plasma volume were similar for both groups [0.7 (0.5) kg and 0.7 (0.4) kg; 5.4 (4.9)% and 9.7 (6.2)% for the PA and AB athletes, respectively]. In conclusion, the results of this study suggest that the PA athletes exhibit different thermoregulatory responses at rest and during exercise and passive recovery to those of upper body trained AB athletes. Despite this, during 90 min of arm-crank exercise in a cool environment, the PA athletes appeared to be at no greater thermal risk than the AB athletes.

Thermoregulatory responses of paraplegic and able-bodied athletes at rest and during prolonged upper body exercise and passive recovery

STUDY DESIGN Single trial, two factor repeated measures design. SETTING England, Cheshire. OBJECTIVES To examine the thermoregulatory responses of able-bodied (AB) athletes, paraplegic (PA) athletes and a tetraplegic (TP) athlete at rest, during prolonged upper body exercise and recovery. METHODS Exercise was performed on a Monark cycle ergometer (Ergomedic 814E) adapted for arm exercise at 60% VO2 peak for 60 min in cool conditions ('normal' laboratory temperature; 21.5+/-1.7 degrees C and 47+/-7.8% relative humidity). Aural and skin temperatures were continually monitored. RESULTS Mean (+/-S.D.) peak oxygen uptake values were greater (P<0. 05) for the AB when compared to the PA (3.45+/-0.45 l min-1 and 2. 00+/-0.46 l min-1, respectively). Peak oxygen uptake for the TP was 0.91 l min-1. At rest, aural temperature was similar between groups (36.2+/-0.3 degrees C, 36.3+/-0.3 degrees C and 36.3 degrees C for AB, PA and TP athletes, respectively). During exercise, aural temperature demonstrated relatively steady state values increasing by 0.6+/-0.4 degrees C and 0.6+/-0.3 degrees C for the AB and PA athletes, respectively. The TP athlete demonstrated a gradual rise in aural temperature throughout the exercise period of 0.9 degrees C. Thigh skin temperature increased by 1.3+/-2.5 degrees C for the AB athletes (P<0.05) whereas the PA athletes demonstrated little change in temperature (0.1+/-3.4 degrees C and -0.7 degrees C respectively). Calf temperature increased for the PA athletes by 1.0+/-3.6 degrees C (P<0.05), whereas a decrease was observed for the AB athletes of -1.0+/-2.0 degrees C (P<0.05) during the exercise period. During 30 min of passive recovery, the AB athletes demonstrated greater decreases in aural temperatures than those for the PA athletes (P<0. 05). Aural temperature for the TP increased peaking at 5 min of recovery remaining elevated until the end of the recovery period. Fluid consumption and weight losses were similar for the AB and PA athletes (598+/-433 ml and 403+/-368 ml; 0.38+/-0.39 kg and 0.38+/-0. 31 kg, respectively), whereas changes in plasma volume were greater for the AB athletes (-9.8+/-5.8% and 4.36+/-4.9%, respectively; P<0. 05). CONCLUSION The results of this study suggest that under the experimental conditions PA athletes are at no greater thermal risk than AB athletes. A relationship between the available muscle mass for heat production and sweating capacity appears evident for the maintenance of thermal balance. During recovery from exercise, decreases in aural temperature, skin temperature and heat storage were greatest for the AB athletes with the greatest capacity for heat loss and lowest for the TP athlete with the smallest capacity for heat loss. Initial observations on one TP athlete suggest substantial thermoregulatory differences when compared to AB and PA athletes.

/pdf/thermoregulatory-responses-of-spinal-cord-injured-and-able-3t5n9o6al8.pdf

Thermoregulatory responses of spinal cord injured and able-bodied athletes to prolonged upper body exercise and recovery.

Thermoregulation of paraplegic and able bodied men during prolonged exercise in hot and cool climates

/pdf/thermoregulation-of-paraplegic-and-able-bodied-men-during-4tw1lciscr.pdf

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Thermoregulation of paraplegic and able bodied men during prolonged exercise in hot and cool climates