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Whole body cryotherapy (WBC) is the therapeutic application of extreme cold air for a short duration. Minimal evidence is available for determining optimal exposure time. To explore whether the length of WBC exposure induces differential changes in inflammatory markers, tissue oxygenation, skin and core temperature, thermal sensation and comfort. This study was a randomised cross over design with participants acting as their own control. Fourteen male professional first team super league rugby players were exposed to 1, 2, and 3 minutes of WBC at -135°C. Testing took place the day after a competitive league fixture, each exposure separated by seven days. No significant changes were found in the inflammatory cytokine interleukin six. Significant reductions (p<0.05) in deoxyhaemoglobin for gastrocnemius and vastus lateralis were found. In vastus lateralis significant reductions (p<0.05) in oxyhaemoglobin and tissue oxygenation index (p<0.05) were demonstrated. Significant reductions (p<0.05) in skin temperature were recorded. No significant changes were recorded in core temperature. Significant reductions (p<0.05) in thermal sensation and comfort were recorded. Three brief exposures to WBC separated by 1 week are not sufficient to induce physiological changes in IL-6 or core temperature. There are however significant changes in tissue oxyhaemoglobin, deoxyhaemoglobin, tissue oxygenation index, skin temperature and thermal sensation. We conclude that a 2 minute WBC exposure was the optimum exposure length at temperatures of -135°C and could be applied as the basis for future studies.

PurposeThermal perception, including thermal sensation (TS), influences exercise performance in the heat. TS is a widely used measure and we examined the impact of initial TS (iTS) on performance loss during exercise in simulated Tokyo environmental conditions among elite athletes.Methods105 Elite outdoor athletes (endurance, skill, power and mixed trained) participated in this crossover study. Participants performed a standardized exercise test in control (15.8 ± 1.2 °C, 55 ± 6% relative humidity (RH)) and simulated Tokyo (31.6 ± 1.0 °C, 74 ± 5% RH) conditions to determine performance loss. TS was assessed ± 5 min prior to exercise (iTS) and every 5 min during the incremental exercise test (TS). Based on iTS in the Tokyo condition, participants were allocated to a neutral (iTS = 0, n = 11), slightly warm (iTS = 1, n = 50), or warm-to-hot (iTS = 2/3, n = 44) subgroup.ResultsFor the whole cohort iTS was 1 [1–2] and TS increased to 3 [3–3] at the end of exercise in the Tokyo condition. Average performance loss was 26.0 ± 10.7% in the Tokyo versus control condition. The slightly warm subgroup had less performance loss (22.3 ± 11.3%) compared to the warm-to-hot subgroup (29.4 ± 8.5%, p = 0.003), whereas the neutral subgroup did not respond different (28.8 ± 11.0%, p = 0.18) from the slightly warm subgroup.ConclusioniTS impacted the magnitude of performance loss among elite athletes exercising in hot and humid conditions. Athletes with a warm-to-hot iTS had more performance loss compared to counterparts with a slightly warm iTS, indicating that pre-cooling strategies and/or heat acclimation may be of additional importance for athletes in the warm-to-hot iTS group to mitigate the impact of heat stress.

Declines in sensory functioning with aging are evident for many of the senses. In the present study, thresholds were determined for somatosensory (warming and cooling temperature, pain, touch, and two-point discrimination) and taste stimuli in 178 healthy individuals aged 20-89 yrs. Somatosensory stimuli were applied to the upper lip (glabrous skin) and the chin (hairy skin). The sample was divided into two groups, based on a bimodal split “< 45 yrs” and “≥ 65 yrs”. In all instances, there were elevations in thresholds for the older individuals. Further, males were less sensitive than females for cool at the chin site, for touch, and for sour taste. We conclude that there are elevations in sensory thresholds with age for multimodal somatosensory and gustatory senses.

Exercise conducted in hot, humid environments increases the risk for exertional heat stroke (EHS). The current recommended treatment of EHS is cold-water immersion; however, limitations may require the use of alternative resources such as a cold shower (CS) or dousing with a hose to cool EHS patients.Context: To investigate the cooling effectiveness of a CS after exercise-induced hyperthermia.Objective: Randomized, crossover controlled study.Design: Environmental chamber (temperature = 33.4°C ± 2.1°C; relative humidity = 27.1% ± 1.4%).Setting: Seventeen participants (10 male, 7 female; height = 1.75 ± 0.07 m, body mass = 70.4 ± 8.7 kg, body surface area = 1.85 ± 0.13 m 2 , age range = 19–35 years) volunteered.Patients or Other Participants: On 2 occasions, participants completed matched-intensity volitional exercise on an ergometer or treadmill to elevate rectal temperature to ≥39°C or until participant fatigue prevented continuation (reaching at least 38.5°C). They were then either treated with a CS (20.8°C ± 0.80°C) or seated in the chamber (control [CON] condition) for 15 minutes.Intervention(s): Rectal temperature, calculated cooling rate, heart rate, and perceptual measures (thermal sensation and perceived muscle pain).Main Outcome Measure(s): The rectal temperature ( P = .98), heart rate ( P = .85), thermal sensation ( P = .69), and muscle pain ( P = .31) were not different during exercise for the CS and CON trials ( P > .05). Overall, the cooling rate was faster during CS (0.07°C/min ± 0.03°C/min) than during CON (0.04°C/min ± 0.03°C/min; t 16 = 2.77, P = .01). Heart-rate changes were greater during CS (45 ± 20 beats per minute) compared with CON (27 ± 10 beats per minute; t 16 = 3.32, P = .004). Thermal sensation was reduced to a greater extent with CS than with CON ( F 3,45 = 41.12, P < .001).Results: Although the CS facilitated cooling rates faster than no treatment, clinicians should continue to advocate for accepted cooling modalities and use CS only if no other validated means of cooling are available.Conclusions:

Odontoblasts function as mechanosensory receptors because of the expression of mechanosensitive channels in these cells. However, it is unclear if odontoblasts direct the signal transmission evoked by heat/cold or osmotic changes. This study investigated the effects of heat/cold or osmotic changes on calcium signaling and the functional expression of the thermo/mechanosensitive transient receptor potential (TRP) channels in primary cultured mouse odontoblastic cells, with the use of RT-PCR, fluorometric calcium imaging, and electrophysiology. TRPV1, TRPV2, TRPV3, TRPV4, and TRPM3 mRNA was expressed, but TRPM8 and TRPA1 mRNA was not. The receptor-specific stimulation of TRPV1-3 (heat-sensing receptors) and TRPV4/ TRPM3 (mechanic receptors) caused increases in the intracellular calcium concentration. Moreover, the channel activities of TRPV1-4 and TRPM3 were confirmed by a whole-cell patch-clamp technique. These results suggest that primary cultured mouse odontoblasts express heat/mechanosensitive TRP channels and play a role in the underlying mechanisms of thermo/mechanosensitive sensory transmission.

Increased brain dopamine availability improves prolonged exercise tolerance in the heat. It is unclear whether supplementing the amino-acid precursor of dopamine increases exercise capacity in the heat. Eight healthy male volunteers [mean age 32 ± 11 (SD) years; body mass 75.3 ± 8.1 kg; peak oxygen uptake ( ) 3.5 ± 0.3 L min −1 ] performed two exercise trials separated by at least 7 days in a randomised, crossover design. Subjects consumed 500 mL of a flavoured sugar-free drink (PLA), or the same drink with 150 mg kg body mass −1 tyrosine (TYR) in a double-blind manner 1 h before cycling to exhaustion at a constant exercise intensity equivalent to 68 ± 5% in 30°C and 60% relative humidity. Pre-exercise plasma tyrosine:large neutral amino acids increased 2.9-fold in TYR ( P  < 0.01), while there was no change in PLA ( P  > 0.05). Subjects cycled longer in TYR compared to PLA (80.3 ± 19.7 min vs. 69.2 ± 14.0 min; P  < 0.01). Core temperature, mean weighted skin temperature, heart rate, ratings of perceived exertion and thermal sensation were similar in TYR and PLA during exercise and at exhaustion ( P  > 0.05) despite longer exercise time in TYR. The results show that acute tyrosine supplementation is associated with increased endurance capacity in the heat in moderately trained subjects. The results also suggest for the first time that the availability of tyrosine, a nutritional dopamine precursor, can influence the ability to subjectively tolerate prolonged submaximal constant-load exercise in the heat.

We compared the effects of an ice-slush beverage (ISB) and a cool liquid beverage (CLB) on cycling performance, changes in rectal temperature ( T re ) and stress responses in hot, humid conditions. Ten trained male cyclists/triathletes completed two exercise trials (75 min cycling at ~60% peak power output + 50 min seated recovery + 75% peak power output × 30 min performance trial) on separate occasions in 34°C, 60% relative humidity. During the recovery phase before the performance trial, the athletes consumed either the ISB (mean ± SD −0.8 ± 0.1°C) or the CLB (18.4 ± 0.5°C). Performance time was not significantly different after consuming the ISB compared with the CLB (29.42 ± 2.07 min for ISB vs. 29.98 ± 3.07 min for CLB, P  = 0.263). T re (37.0 ± 0.3°C for ISB vs. 37.4 ± 0.2°C for CLB, P  = 0.001) and physiological strain index (0.2 ± 0.6 for ISB vs. 1.1 ± 0.9 for CLB, P  = 0.009) were lower at the end of recovery and before the performance trial after ingestion of the ISB compared with the CLB. Mean thermal sensation was lower ( P  < 0.001) during recovery with the ISB compared with the CLB. Changes in plasma volume and the concentrations of blood variables (i.e., glucose, lactate, electrolytes, cortisol and catecholamines) were similar between the two trials. In conclusion, ingestion of ISB did not significantly alter exercise performance even though it significantly reduced pre-exercise T re compared with CLB. Irrespective of exercise performance outcomes, ingestion of ISB during recovery from exercise in hot humid environments is a practical and effective method for cooling athletes following exercise in hot environments.

Objective: Drug resistant neurogenic pain can be relieved by repetitive transcranial magnetic stimulation (rTMS) of the motor cortex. This study was designed to assess the influence of pain origin, pain site, and sensory loss on rTMS efficacy. Patients and methods: Sixty right handed patients were included, suffering from intractable pain secondary to one of the following types of lesion: thalamic stroke, brainstem stroke, spinal cord lesion, brachial plexus lesion, or trigeminal nerve lesion. The pain predominated unilaterally in the face, the upper limb, or the lower limb. The thermal sensory thresholds were measured within the painful zone and were found to be highly or moderately elevated. Finally, the pain level was scored on a visual analogue scale before and after a 20 minute session of \"real\" or \"sham\" 10 Hz rTMS over the side of the motor cortex corresponding to the hand on the painful side, even if the pain was not experienced in the hand itself. Results and discussion: The percentage pain reduction was significantly greater following real than sham rTMS (−22.9% v −7.8%, p = 0.0002), confirming that motor cortex rTMS was able to induce antalgic effects. These effects were significantly influenced by the origin and the site of pain. For pain origin, results were worse in patients with brainstem stroke, whatever the site of pain. This was consistent with a descending modulation within the brainstem, triggered by the motor corticothalamic output. For pain site, better results were obtained for facial pain, although stimulation was targeted on the hand cortical area. Thus, in contrast to implanted stimulation, the target for rTMS procedure in pain control may not be the area corresponding to the painful zone but an adjacent one. Across representation plasticity of cortical areas resulting from deafferentation could explain this discrepancy. Finally, the degree of sensory loss did not interfere with pain origin or pain site regarding rTMS effects. Conclusion: Motor cortex rTMS was found to result in a significant but transient relief of chronic pain, influenced by pain origin and pain site. These parameters should be taken into account in any further study of rTMS application in chronic pain control.

Purpose Acute hypoxia alters the threshold for sensation of cutaneous thermal stimuli. We hypothesised that hypoxia-induced alterations in cutaneous temperature sensation may lead to modulation of the perception of temperature, ultimately influencing behavioural thermoregulation and that the magnitude of this effect could be influenced by daily physical training. Methods Fourteen men were confined 10 days to a normobaric hypoxic environment (P I O 2  = 88.2 ± 0.6 mmHg, corresponding to 4175 m elevation). Subjects were randomly assigned to a non-exercising (Live-high, LH, N  = 6), or exercising group (Live-high Train-high, LH-TH, N  = 8) comprised of 1-h bouts of cycle ergometry, twice daily, at a work-rate equivalent to 50% hypoxic peak power output. A subset of subjects ( N  = 5) also completed a control trial under normoxic conditions. The thermal comfort zone (TCZ) was determined in normoxia, and during hypoxic confinement days 2 (HC2) and 10 (HC10) in both groups using a water-perfused suit in which water temperature was regulated by the subjects within a range, they deemed thermally comfortable. Mean skin temperature and proximal–distal temperature gradients (two sites: forearm-fingertip, calf-toe) were recorded each minute throughout the 60-min protocol. Results The average width of the TCZ did not differ between the control group (9.0 ± 6.9 °C), and the LH and LH-TH groups on days HC2 (7.2 ± 4.2 °C) and HC10 (10.2 ± 7.5 °C) of the hypoxic exposure ( p  = 0.256). T ¯ SK was marginally higher on HC2 (35.9 ± 1.0 °C) compared to control (34.9 ± 0.8 °C, p  = 0.040), but not on HC10 (35.6 ± 1.0 °C), reflecting the responses of hand perfusion. Conclusion There was a little systematic effect of hypoxia or exercise training on TCZ magnitude or boundary temperatures.

Purpose Exercise-induced muscle damage (EIMD) has recently been shown to increase heat strain during exercise heat stress (HS), and represents a risk factor for exertional heat illness (EHI). We hypothesised that a repeated bout of EIMD blunts the increase in rectal temperature ( T re ) during subsequent endurance exercise in the heat. Methods Sixteen non-heat-acclimated males were randomly allocated to EIMD ( n  = 9) or control (CON, n  = 7). EIMD performed a downhill running treatment at −10 % gradient for 60 min at 65 % V . O 2max in 20 °C, 40 % RH. CON participants performed the same treatment but at +1 % gradient. Following treatment, participants rested for 30 min, then performed HS (+1 % gradient running for 40 min at 65 % V . O 2max in 33 °C, 50 % RH) during which thermoregulatory measures were assessed. Both groups repeated the treatment and subsequent HS 14 days later. Isometric quadriceps strength was assessed at baseline, and 48 h post-treatment. Results The decrease in leg strength 48 h post-EIMD trial 1 (−7.5 %) was absent 48 h post-EIMD trial 2 (+2.9 %) demonstrating a repeated bout effect. Final T re during HS was lower following EIMD trial 2 (39.25 ± 0.47 °C) compared with EIMD trial 1 (39.59 ± 0.49 °C, P  < 0.01), with CON showing no difference. Thermal sensation and the T re threshold for sweating onset were also lower during HS on EIMD trial 2. Conclusion The repeated bout effect blunted the increase in heat strain during HS conducted after EIMD. Incorporating a muscle-damaging bout into training could be a strategy to reduce the risk of EHI and improve endurance performance in individuals undertaking heavy exercise with an eccentric component in the heat.