Perceptual Strain Research Articles

Heat Strain in Different Hot Environments Hiking in Wildland Firefighting Garments.

Wildland firefighters can work at high intensity in hot environments for extended periods of time. The resulting heat strain may be modified by the environmental conditions (i.e., ambient temperature and humidity [RH]) even at equal wet-bulb globe temperatures. This investigation assessed if a hot and dry condition would create greater strain than moderate and high humidity at equivalent wet-bulb globe temperature (28°C). Twelve participants (age 24±2 y) walked at 40-50% maximum aerobic capacity for 90 and 40 min separated by a 20 min rest in dry (40°C, 20% RH), moderate-humidity (34°C, 50% RH), and high-humidity (29°C, 90% RH) conditions wearing fire resistant jacket, pants, gloves, and helmet with the neck and face exposed. Peak core temperature was higher in moderate-humidity (38.9±0.2°C, p=0.01) and high-humidity (38.9±0.6°C, p<0.01) than dry condition (38.5±0.3°C). Average net heat gain was less in dry (33±22 W) compared to moderate-humidity (38±23 W, p<0.01) and high-humidity (39±28 W, p<0.01). Peak heart rate (174±14 bpm, p=0.94), Physiological Strain Index (7.7±1.4 score, p=0.99), perceived exertion (8±2 rating, p=0.97), and Perceptual Strain Index (7.3±1.6 score, p=0.99) were not different in high-humidity compared to the dry condition (167±19 bpm, 6.9±1.3 score, 6±2 rating, 7.3±1.7 score, respectively). Whole-body sweat rate (15±6 mL/min, p=0.58) and thermal sensation (7±1 rating, p=0.37) were not different. Hiking in a humid condition while wearing protective garments creates greater exertional heat strain compared to a dry condition of equivalent wet-bulb globe temperature. Wildland firefighters should consider extra strategies to mitigate hyperthermia when humidity is high.

Effect Of Beverage Temperature On The Relation Between Perceptual And Physiological Strain During Exercise-heat Stress

Effect Of Beverage Temperature On The Relation Between Perceptual And Physiological Strain During Exercise-heat Stress

Exercise and Heat Stress in Well-Healed Burn Survivors: Effects of Cooling Modalities on Thermal and Perceptual Responses.

Burn injuries that require grafting impair thermoregulation, which may dissuade individuals with such injuries from being physically active. We tested the hypothesis that cooling modalities attenuate core temperature elevations and perceptions of heat stress during physical activity in the heat among adults with well-healed burn injuries. Adults with no burn injuries (non-burned), 20-40% body surface area burn injuries (moderate burn), and > 40% body surface area burn injuries (large burn) performed 1 hour of moderate intensity exercise (2.5 ± 0.2 mph and 2% grade) on four different occasions in two environmental conditions (30 °C & 39 °C, 40% relative humidity). Within each environmental condition, we applied one of the following cooling modalities, random assigned, for each visit: no cooling (control), fan at 4 m/s (fan), water spray every 5 min (water spray; scaled to burn area size), or a combination of water spray + fan. In 30 °C, perceptual strain index (PeSI) was reduced in the non-burned and moderate burn groups with water spray + fan, whereas PeSI was reduced with all cooling modalities in the large burn group. The cooling modalities did not affect core temperature responses. In the 39 °C environment, water spray and water spray + fan attenuated the elevation in core temperature (p ≤ 0.007) only in the large burn group. In the moderate burn group, PeSI was decreased with water spray + fan (p = 0.017). In the large burn group, both water spray alone and water spray + fan (p ≤ 0.041) lowered PeSI. For both environments across burn groups, the applied cooling modalities were generally more effective at reducing indices of perceptual strain relative to indices of thermal strain (e.g., core temperature).

Efficacy of the FIFA cooling break heat policy during an intermittent treadmill football simulation in hot conditions in trained males

ObjectiveTo evaluate the efficacy of the Fédération Internationale de Football Association (FIFA) cooling break policy against alternative cooling configurations in attenuating thermal strain during simulated football in the heat.Methods12 males...

Heat strain differences walking in hot-dry and warm-wet environments of equivalent wet bulb globe temperature

ABSTRACT Wet bulb globe temperature (WBGT) is a commonly used measure to predict heat strain in workers. Different combinations of environmental conditions can create equivalent WBGT, yet it remains unknown whether biophysical, physiological, and perceptual responses vary when working in different but equivalent hot conditions. The purpose of the study was to compare body heat storage and physiological and perceptual strain during walking in hot-dry and warm-wet conditions of the same WBGT. Twelve subjects (age: 22 ± 2 y) walked for 90 min at 60% maximum heart rate in a 27.8°C WBGT environment of hot-dry (HD: 40°C, 19% relative humidity) or warm-wet (WW: 30°C, 77% relative humidity) conditions. Partitional calorimetry was used to estimate heat storage. Core temperature at 90 min (HD: 38.5 ± 0.5°C; WW: 38.4 ± 0.3°C, p = 0.244) and cumulative heat storage (HD: 115 ± 531 Kj; WW: 333 ± 269 Kj, p = 0.242) were not different. At 90 min, heart rate was not different (HD: 160 ± 19 bpm; WW: 154 ± 15 bpm, p = 0.149) but skin temperature (HD: 36.6 ± 0.9°C; WW: 34.7 ± 0.6°C, p < 0.001), thirst (HD: 6.8 a.u.; WW: 5.3 a.u. p = 0.043), and sweat rate (HD: 15.1 ± 4.4 g·min−1; WW: 10.0 ± 4.1 g·min−1, p < 0.001) were greater in HD compared to WW. Hot environments of equivalent 27.8°C WBGT created equivalent core temperature despite differences in physiological strain during exercise, including earlier onset of cardiovascular strain, greater sweat rate, and higher skin temperature compared to a WW environment. ClinicalTrials.gov ID NCT04624919.

The fan cooling vest use reduces thermal and perceptual strain during outdoor exercise in the heat on a sunny summer day.

The fan cooling vest is coming into very common use by Japanese outdoor manual workers. We examined that to what extent using this vest reduces thermal strain and perception during outdoor exercise in the heat on a sunny summer day. Ten male baseball players in high school conducted two baseball training sessions for 2-h with (VEST) or without (CON) a commercially available fan cooling vest on a baseball uniform. These sessions commenced at 10 a.m. on separate days in early August. The fan airflow rate attached the vest was 62 L·s-1. Neither ambient temperature (Mean ± SD: VEST 31.9 ± 0.2°C; CON 31.8 ± 0.7°C), wet-bulb globe temperature (VEST 31.2 ± 0.4°C; CON 31.4 ± 0.5°C) nor solar radiation (VEST 1008 ± 136 W·m-2; CON 1042 ± 66 W·m-2) was different between trials. Mean skin temperature (VEST 34.5 ± 1.1°C; CON 35.1 ± 1.4°C), infrared tympanic temperature (VEST 38.9 ± 0.9°C; CON 39.2 ± 1.2°C), heart rate (VEST 127 ± 31 bpm; CON 139 ± 33 bpm), body heat storage (VEST 140 ± 34 W·m-2; CON 160 ± 22 W·m-2), thermal sensation (- 4-4: VEST 0 ± 2; CON 3 ± 1) and rating of perceived exertion (6-20: VEST 11 ± 2; CON 14 ± 2) were lower in VEST than CON (all P < 0.05). Total distance measured with a global positioning system (VEST 3704 ± 293 m; CON 3936 ± 501 m) and body fluid variables were not different between trials. This study indicates that the fan cooling vest use can reduce thermal strain and perception during outdoor exercise in the heat on a sunny summer day. Cooling with this vest would be effective to mitigate thermal risks and perceptual stress in athletes and sports participants under such settings.

Agreement between measured and self-reported physiological strain in males and females during simulated occupational heat stress.

Monitoring physiological strain is recommended to safeguard workers during heat exposure, but is logistically challenging. The perceptual strain index (PeSI) is a subjective estimate thought to reflect the physiological strain index (PSI) that requires no physiological monitoring. However, sex is known to influence perceptions of heat stress, potentially limiting the utility of the PeSI. The objective of this study was to assess whether sex modifies the relationship between PeSI and PSI. Thirty-four adults (15 females) walked on a treadmill (moderate intensity; ~200 W/m2) for 180 min or until termination (volitional fatigue, rectal temperature ≥39.5°C) in 16°C, 24°C, 28°C, and 32°C wet-bulb globe temperatures. Rectal temperature and heart rate were recorded to calculate PSI (0-10 scale). Rating of perceived exertion and thermal sensation were recorded to calculate PeSI (0-10 scale). Relationships between PSI and PeSI were evaluated via linear mixed models. Mean bias (95% limits of agreement [LoA]) between PSI and PeSI was assessed via Bland-Altman analysis. Mean absolute error between measures was calculated by summing absolute errors between the PeSI and the PSI and dividing by the sample size. PSI increased with PeSI (p < 0.01) but the slope of this relation was not different between males and females (p = 0.83). Mean bias between PSI and PeSI was small (-0.4 points), but the 95% LoA (-3.5 to 2.7 points) and mean absolute error were wide (1.3 points). Our findings indicate that sex does not appreciably impact the agreement between the PeSI and PSI during simulated occupational heat stress. The PeSI is not a suitable surrogate for the PSI in either male or female workers.

Thermoregulatory and perceptual implications of varying torso soft armour coverage during treadmill walking in dry heat

Modular armour allows soldiers to adjust the level of coverage according to the threat level. We hypothesized that armour configurations with lower levels of torso soft armour coverage attenuate physiological and perceptual responses during exercise in the heat. Fifteen adults (5 females/10 males, 26 ± 5 years) walked (5 km/h, 1% incline, 1h) in dry heat (38 °C, 20% humidity) while wearing body armour that provided; i) high coverage (HC: 0.57 ± 0.09 m2, 18.5 ± 0.3 kg), ii) moderate coverage (MC: 0.44 ± 0.07 m2, 18.1 ± 0.3 kg), iii) low coverage (LC1: 0.21 ± 0.03 m2, 17.4 ± 0.1 kg), or iv) low coverage with weight equalization (LC2: 0.21 ± 0.03 m2, 18.6 ± 0.2 kg). Core temperature (Tcore), heart rate (HR), metabolic heat production (M-W), whole-body sweat rate (WBSR), and perceptual responses were measured. M-W during exercise (629 ± 126 W) did not differ between configurations (p = 0.30). The change in Tcore (HC: 0.88 ± 0.37 °C, MC: 0.85 ± 0.32 °C, LC1: 0.91 ± 0.38 °C, LC2: 0.89 ± 0.42 °C, p = 0.93), HR (HC: 97 ± 14 bpm, MC: 103 ± 16 bpm, LC1: 96 ± 15 bpm, LC2: 97 ± 20 bpm, p = 0.08), and WBSR (HC: 10.2 ± 3.4 g/min, MC: 10.3 ± 4.3 g/min, LC1: 9.9 ± 4.7 g/min, LC2: 10.4 ± 4.5 g/min, p = 0.84) did not differ between configurations. Perceptual responses did not differ between configurations (all p ≥ 0.15). Reducing torso soft armour coverage, with minimal reductions in armour load, does not reduce physiological or perceptual strain during walking in dry heat.

Effects of ice slurry ingestion on body temperature and softball pitching performance in a hot environment: a randomized crossover trial

BackgroundAlthough softball players are often required to play in hot environments, scarce evidence is available regarding the effects of ice slurry ingestion on body temperature and pitching performance in softball pitchers in a hot environment. Thus, this study investigated the effects of ice slurry ingestion before and between innings on body temperature and softball pitching performance in a hot environment.MethodsIn a randomized crossover design, seven heat-acclimatized amateur softball pitchers (four males and three females) completed simulated softball games consisting of 15 best-effort pitches per inning for seven innings with between-pitch rest intervals of 20 s. Participants were assigned to either a control trial (CON: ingestion of 5.0 g·kg−1 of cool fluid [9.8 ± 2.2 °C] before simulated softball games and 1.25 g·kg−1 of cool fluid between inning intervals) or an ice trial (ICE: ingestion of ice slurry [− 1.2 ± 0.1 °C] based on the same timings and doses as the CON). Participants performed both trials in an outdoor ground during the summer season (30.8 ± 2.7 °C, 57.0 ± 7.9% relative humidity).ResultsIce slurry ingestion before the simulated softball game (pre-cooling) resulted in a greater reduction in rectal temperature compared with cool fluid ingestion (p = 0.021, d = 0.68). No significant differences were observed between the trials in rectal temperature changes during the simulated softball game (p > 0.05). Compared to the CON, heart rate during the game was significantly decreased (p < 0.001, d = 0.43), and handgrip strength during the game was significantly increased (p = 0.001, d = 1.16) in the ICE. Ratings of perceived exertion, thermal comfort, and thermal sensation were improved in the ICE compared to those in the CON (p < 0.05). Ball velocity and pitching accuracy were not affected by ICE.ConclusionsIce slurry ingestion before and between innings reduced thermal, cardiovascular, and perceptual strain. However, it did not affect softball pitching performance compared to cool fluid ingestion.

Effect of air blowing inside isolated hospital clothing on perceptual and physiological heat strain in laboratory conditions.

Heat stress is one of the most common complaints of health care employees who wear isolation gowns to protect themselves from biological agents, particularly during the warmer seasons. This study was conducted in a climatic chamber to determine the influence of airflow within isolated hospital gowns on physiological-perceptual heat strain indices. The experiment was conducted in three trials: regular clothes (CON), an impenetrable gown without air blowing (GO), and a gown with air blowing (GO + FAN) at temperature conditions of 27°C and 25% relative humidity (RH). During the trial, physiological-perceptual response data were recorded for a half-hour on a treadmill at a speed of km/hr and a slope of 0% activity at 5-min intervals. The ASHRAE Likert scale was used to assess thermal comfort (TC), thermal sensation (TS), and skin wetness sensation (WS). As the results show, there was a significant difference in mean scores for TC and WS in both sexes when working in the CON, GO, and GO + FAN groups (P < 0.001). In women, the mean scores for TS, TC, and WS reduced considerably (P < 0.001) in the GO and GO + FAN in the amount of 10 and 12 CFM (20 [Formula: see text]/h), but in males, there was a statistically significant difference between mean scores (P < 0.001) in the GO + FAN at 12 CFM (20 [Formula: see text]/h) and 14 CFM (24 [Formula: see text]/h). Also, the greatest difference between the average heart rate, chest temperature, and temperature inside the clothes in women and men in the trials GO and GO + FAN was observed in the air flow 12 CFM and 14 CFM, respectively (P < 0.001). The usage of an air blower in isolated hospital clothes has been shown to influence physiological-perceptual parameters in men and women substantially. The existence of airflow in these gowns can improve safety, performance, and thermal comfort while also decreasing the risk of heat-related disorders.

Association between physiological and perceptual heat strain while wearing stab-resistant body armor

In this study, we explored the association between physiological and perceptual heat strain while wearing stab-resistant body armor (SRBA). Human trials were performed on ten participants in warm and hot environments. Physiological responses (core temperature, skin temperature, and heart rate), and perceptual responses (thermal sensation vote, thermal comfort vote, restriction of perceived exertion (RPE), wetness of skin, and wetness of clothing) were recorded throughout the trials, and subsequently, the physiological strain index (PSI), and perceptual strain index (PeSI) were calculated. The results indicated that the PeSI showed a significant moderate association with the PSI, and was capable of predicting PSI for low (PSI = 3) and high (PSI = 7) levels of physiological strain with the areas under the curves of 0.80 and 0.64, respectively. Moreover, Bland-Altman analysis indicated that the majority of the PSI ranged within the 95% confidence interval, and the mean difference between PSI and PeSI was 0.14 ± 2.02 with the lower 95% limit and upper 95% limit being −3.82 to 4.10, respectively. Therefore, the subjective responses could be used as an indicator for predicting physiological strain while wearing SRBA. This study could provide fundamental knowledge for the usage of SRBA, and the development of physiological heat strain assessment.

Thermoregulatory, Cardiovascular and Perceptual Responses of Spectators of a Simulated Football Match in Hot and Humid Environmental Conditions.

Major sporting events are often scheduled in thermally challenging environments. The heat stress may impact athletes but also spectators. We examined the thermal, cardiovascular, and perceptual responses of spectators watching a football match in a simulated hot and humid environment. A total of 48 participants (43 ± 9 years; n = 27 participants <50 years and n = 21 participants ≥50 years, n = 21) watched a 90 min football match in addition to a 15 min baseline and 15 min halftime break, seated in an environmental chamber (Tair = 31.9 ± 0.4 °C; RH = 76 ± 4%). Gastrointestinal temperature (Tgi), skin temperature (Tskin), and heart rate (HR) were measured continuously throughout the match. Mean arterial pressure (MAP) and perceptual parameters (i.e., thermal sensation and thermal comfort) were scored every 15 min. Tri (37.3 ± 0.4 °C to 37.4 ± 0.3 °C, p = 0.11), HR (76 ± 15 bpm to 77 ± 14 bpm, p = 0.96) and MAP (97 ± 10 mm Hg to 97 ± 10 mm Hg, p = 0.67) did not change throughout the match. In contrast, an increase in Tskin (32.9 ± 0.8 °C to 35.4 ± 0.3 °C, p < 0.001) was found. Further, 81% of participants reported thermal discomfort and 87% a (slightly) warm thermal sensation at the end of the match. Moreover, the thermal or cardiovascular responses were not affected by age (all p-values > 0.05). Heat stress induced by watching a football match in simulated hot and humid conditions does not result in substantial thermal or cardiovascular strain, whereas a significant perceptual strain was observed.

Effects of liquid cooling garment on physiological and psychological strain of firefighter in hot and warm environments

This study aimed to explore the effects of a liquid cooling garment on the physiological and psychological strains of firefighters. Twelve participants wearing firefighting protective equipment with the liquid cooling garment (LCG group) and without the liquid cooling garment (CON group) were recruited to conduct human trials in a climate chamber. During the trials, physiological parameters (mean skin temperature (Tsk), core temperature (Tc), and heart rate (HR)) and psychological parameters (thermal sensation vote (TSV), thermal comfort vote (TCV), and rating of perceived exertion (RPE)) were measured continuously. The heat storage, sweating loss, physiological strain index (PSI), and perceptual strain index (PeSI) were calculated. The results indicated that the liquid cooling garment decreased the mean skin temperature (maximum value of 0.62 °C), scapula skin temperature (maximum value of 1.90 °C), sweating loss (26%), and PSI (0.95 scales) with a significant difference (p < 0.05) at some time points when compared with the CON group. Moreover, the liquid cooling garment had little influence (p > 0.05) on core temperature, heart rate, TSV, TCV, RPE, and PeSI. The association analysis indicated that psychological strain had the potential to predict physiological heat strain with an R2 value of 0.86 between the PeSI and PSI. This study offers insights into the evaluation of cooling system performance, the design of next-generation cooling systems, and the improvement of firefighters’ benefits.

The effect of evaporative cooling vests on the physiological and perceptual strain indices of construction workers

Aim: One of the most harmful agents in construction sites is heat exposure. The aim of this study was to evaluate the performance of new evaporative cooling vests in construction workers. Materials and Methods: This case–control study was implemented on 60 construction workers in hot conditions (air temperature 49.0°, relative humidity 5.5%) in the summer of 2019. In this study, 30 people with cooling vests (case group) and 30 people without cooling vests (control group) were working for 120 min in a hot environment. In both groups, heart rate oral temperature and wet bulb globe temperature (WBGT) index were measured. Moreover, the Perceptual Strain Index (PeSI) and Heat Strain Score Index (HSSI) questionnaires were completed by the workers. Data were analyzed after inter to SPSS16 software. Results: All of the WBGT values were higher than occupational exposure limit. The mean and standard deviation (SD) of the work heart rate in the case and control groups, was equal to 111.1 ± 7.6 beats per minute (bpm) and 114.3 ± 7.9 bpm respectively (P < 0.05). Also the average and SD of the oral temperature in the case and control groups, respectively, was equal to 36.36 ± 0.41 and 36.37 ± 0.55. There was no statistically significant difference. Mean and SD of Physiological Strain Index (PSI), in case and control groups, were 2.53 ± 0.66 and 3.64 ± 0.81, respectively. The mean and SD of the PeSI and the HSSI in the case group were 4.64 ± 0.79 and 10.12 ± 1.71, respectively, and in the control group, 6.41 ± 0.85 and 15.88 ± 0.1.43. Statistically, the difference between PSI, PeSI, and HSSI means was significant. Conclusions: This study results showed that hot environmental conditions were stressful for construction workers and also Iranian evaporative cooling vests (Hifitcool brand) were able to reduce perceptual and physiological heat strain in construction workers in the hot conditions.

Delineating the impacts of air temperature and humidity for endurance exercise.

What is the central question of this study? What are the independent effects of air temperature and humidity on performance, physiological and perceptual responses during endurance exercise? What is the main finding and its importance? When examined independently, elevated air temperature increased heat strain and impaired aerobic exercise performance, but to a lesser extent than has been reported previously. These findings highlight the importance of absolute humidity relative to temperature when exercising or working under severe heat stress. Many studies have reported that ambient heat stress increases physiological and perceptual strain and impairs endurance exercise, but effects of air temperature per se remain almost unexamined. Most studies have used matched relative humidity, thereby exponentially increasing absolute humidity (water content in air) concurrently with temperature. Absolute (not relative) humidity governs evaporative rate and is more important at higher work rates and air temperatures. Therefore, we examined the independent effects of air temperature and humidity on performance, thermal, cardiovascular and perceptual measures during endurance exercise. Utilizing a crossover design, 14 trained participants (7 females) completed 45min fixed-intensity cycling (70% ) followed by a 20-km time trial in each of four environments: three air temperatures at matched absolute humidity (Cool, 18°C; Moderate, 27°C; and Hot, 36°C; at 1.96kPa, air velocity ∼4.5m/s), and one at elevated humidity (Hot Humid, 36°C at 3.92kPa). Warmer air caused warmer skin (0.5°C/°C; P<0.001), higher heart rate (1bpm/°C; P<0.001), sweat rate (0.04l/h/°C; P<0.001) and thermal perceptions during fixed-intensity exercise, but minimally affected core temperature (<0.01°C/°C; P=0.053). Time-trial performance was comparable between Cool and Moderate (95% CI: -1.4, 5.9%; P=0.263), but 3.6-6% slower in Hot (95% CI: ±2.4%; P≤0.006). Elevated humidity increased core temperature (P<0.001), perceived temperature and discomfort but not skin temperature or heart rate, and reduced mean blood pressure (P=0.046) during fixed-intensity exercise. Elevated humidity impaired time-trial performance by 3.4% (95% CI: ±2.2%; P=0.006). In conclusion, these findings quantify the importance of absolute humidity alongside air temperature when exercising under severe heat stress.

Shorter Versus Longer Durations of Rowing-Based Interval Exercise Attenuate the Physiological and Perceptual Response

ABSTRACTPurpose: This study compared physiological and perceptual variables between short and long durations of rowing-based highintensity interval exercise (HIIE). Methods: Fourteen active adults (age = 26.4 ± 7.2 yr) performed incremental rowing exercise to fatigue to measure maximal oxygen uptake (VO2max) and peak power output (PPO). The subsequent 20 min sessions required HIIE (eight 60 s efforts at 85%PPO with 90 s of active recovery at 20%PPO or 24 20 s efforts at 85%PPO with 30 s of active recovery at 20%PPO) or moderate intensity continuous exercise (MICE) at 40%PPO. During exercise, VO2, heart rate (HR), blood lactate concentration (BLa), rating of perceived exertion (RPE), and affective valence were measured. Results: Data show significantly (p < 0.001) higher peak VO2 (84 ± 7 vs. 76 ± 5%VO2peak, d = 0.99), peak HR (94 ± 4%HRpeak vs. 90 ± 4%HRpeak, d = 1.12), BLa (7.0 ± 2.5 mM vs. 4.1 ± 1.0 mM, d = 1.22), end-exercise RPE (12.8 ± 2.0 vs. 11.0 ± 1.7, d = 1.29), and lower affective valence (2.1 ± 1.6 vs. 2.9 ± 1.2, d = 0.61) with long versus short HIIE. Time spent above 85%HRpeak was significantly higher (p < 0.001) in short versus long HIIE (606 ± 259 vs. 448 ± 26 s, d = 0.91). Conclusion: Longer rowing-based intervals elicit greater cardiometabolic and perceptual strain versus shorter efforts, making the latter preferable to optimize perceptual responses to HIIE.

Effects of mixed-method cooling between exercise bouts on thermoregulation and cycling time-trial performance in the heat

This study investigated the effects of mixed-method cooling during a short break between exercise bouts on thermoregulation and cycling time-trial (TT) performance in the heat. In a randomized crossover design, nine physically active men performed two 30-min cycling bouts that consisted of 25-min constant-paced cycling at 55% of maximal oxygen uptake followed by a 5-min TT in the heat (35 °C, 50% relative humidity). The two bouts were separated by a 15-min break. During the break, participants were assigned to a control trial (CON; 5 g kg−1 fluid ingestion at room temperature) or a mixed-method cooling trial (COOL; 5 g kg−1 ice slurry ingestion and cooling vest to cool the neck and torso). Physiological (rectal [Tre], forehead deep-tissue [Tdeep-head], mean skin [T‾sk], forehead skin [Thead], and neck skin [Tneck] temperatures, heart rate [HR], and skin blood flow [SkBF]) and perceptual data (ratings of perceived exertion [RPE], thermal comfort [TC], and thermal sensation [TS]) were measured. At the end of the 15-min break, Tdeep-head (−0.5 ± 0.2 °C, p < 0.001), T‾sk (−5.6 ± 3.1 °C, p = 0.001), Thead (−0.8 ± 0.4 °C, p = 0.001), Tneck (−9.8 ± 6.0 °C, p = 0.002), HR (−17 ± 6 bpm, p < 0.001), SkBF (−27.7 ± 13.9%, p = 0.002), TC (+2.6 ± 2.5, p = 0.024), and TS (−4.7 ± 2.5, p = 0.011) improved in COOL compared to CON. Reductions in T‾sk and Tneck were quickly lost (5 min) during the second exercise bout but Tdeep-head, Thead, and TS remained lower in COOL until the commencement of the second TT. Compared to CON, Tre (−0.2 ± 0.2 °C, p = 0.002) and RPE (−1.3 ± 0.9, p = 0.010) were lower in COOL during the second exercise bout. The reduction in mean power output at the second TT was attenuated in COOL (−13.9 ± 26.9 W) compared to CON (−29.3 ± 29.4 W; p = 0.015). In conclusion, the mixed-method cooling during a short break reduced physiological and perceptual strain and improved cycling TT performance.

Acute physiological and psychophysical responses to different modes of heat stress.

New Findings What is the central question of this study? What are the profiles of acute physiological and psychophysical strain during and in recovery from different modes of heating, and to what extent do these diminish after repeated exposure? What is the main finding and its importance? Mode of heating affects the strain profiles during heat stress and recovery. Exercise in the heat incurred the greatest cardiovascular strain during heating and recovery. Humid heat was poorly tolerated despite heat strain being no greater than in other heating modes, and tolerance did not improve with multiple exposures. Heat stress is common and arises endogenously and exogenously. It can be acutely hazardous while also increasingly advocated to drive health and performance‐related adaptations. Yet, the nature of strain (deviation in regulated variables) imposed by different heating modes is not well established, despite the potential for important differences. We, therefore, compared three modes of heat stress for thermal, cardiovascular and perceptual strain profiles during exposure and recovery when experienced as a novel stimulus and an accustomed stimulus. In a crossover design, 13 physically active participants (five females) underwent 5 days of 60‐min exposures to hot water immersion (40°C), sauna (55°C, 54% relative humidity) and exercise in the heat (40°C, 52% relative humidity), and a thermoneutral water immersion control (36.5°C), each separated by ≥4 weeks. Physiological (thermal, cardiovascular, haemodynamic) and psychophysical strain responses were assessed on days 1 and 5. Sauna evoked the warmest skin (40°C; P < 0.001) but exercise in the heat caused the largest increase in core temperature, sweat rate, heart rate (post hoc comparisons all P < 0.001) and systolic blood pressure (P ≤ 0.002), and possibly decrease in diastolic blood pressures (P ≤ 0.130), regardless of day. Thermal sensation and feeling state were more favourable on day 5 than on day 1 (P ≤ 0.021), with all modes of heat being equivalently uncomfortable (P ≥ 0.215). Plasma volume expanded the largest extent during immersions (P < 0.001). The current data highlight that exercising in the heat generates a more complex strain profile, while passive heat stress in humid heat has lower tolerance and more cardiovascular strain than hot water immersion.

Telepractice Considerations for Evaluation and Treatment of Voice Disorders: Tailoring to Specific Populations

The aim of this clinical focus article is to provide recommendations for implementation of telepractice services for the evaluation and treatment of voice disorders and to use case examples to highlight the advantages of this modality of service delivery. In this clinical focus article, key factors for successful telepractice evaluation and treatment of voice and related disorders are discussed relative to clinical outcome measures. Case examples of telepractice voice therapy are described for a pediatric, transgender, and chronic cough client including associated acoustic, auditory-perceptual, and quality-of-life treatment outcomes. Acoustic, perceptual, and quality-of-life outcome measures demonstrated functional voice improvements after treatment using the telepractice modality. The pediatric client showed decreased perceptual voice strain and increased speech intelligibility. The transgender client showed increased habitual speaking fundamental frequency (pitch) and quality of life. The chronic cough client showed improved vocal hygiene and reduced cough severity. A review of the literature shows comparable outcomes for in-person and telepractice voice therapy, but special considerations must be made to ensure therapeutic success. We present three representative types of voice cases that illustrate implementation of voice evaluation and treatment using the telepractice modality. In all three cases, the clients' personal therapeutic goals were achieved without needing to travel to the clinic. Furthermore, asynchronous practice opportunities were found to be positive byproducts of using the telepractice modality.

Exposure to acute noxious heat evokes a cardiorespiratory shock response in humans

Background: Noxious acute cold stimuli cause cold shock via the sympathetic nervous system. However, no studies have investigated respiratory “heat shock” in response to noxious acute heat stimuli (≥ 42 °C). Methods: In the present study, we examined whether short-duration whole-body immersion (for 5 min) in noxious hot water (45 °C) is a sufficient stimulus to induce a respiratory acute shock response. Results and conclusion: Our results indicate that short-duration whole-body immersion in noxious 45 °C water produces a significantly greater body temperature, heart rate, and perceptual and respiratory strain than immersion in innocuous warm 37 °C water (p < .05). The initial first minute of hot water immersion (HWI) at 45 °C (vs. immersion at 37 °C) caused a cardiorespiratory shock response, which manifested as acute hyperventilation, and increased ventilatory tidal volume, respiratory exchange ratio, and heart rate (p < .05). Adjustment to this initial respiratory heat shock response within the first minute of immersion was observed as compared with remaining HWI time (1–5 min). Intriguingly, the time-course kinetics of breathing frequency, oxygen uptake, and carbon dioxide washout did not differ between whole-body immersion at 37 °C and immersion at 45 °C, but were higher than in control thermoneutral conditions of an empty bath (p < .05). This may be because of events initiated not only by the water temperature but also by the change in the hydrostatic pressure acting upon the body when immersed in the water bath.