Exercise Core Body Temperature is Adequately Regulated Following Spinal Cord Injury: A Meta-Analysis

Introduction Prolonged exercise in the heat elevates core body temperature, which impairs endurance performance and poses increased risks of heat illness (American College of Sports Medicine et al., 2007). Like the able-bodied athletes, athletes with spinal cord injury (SCI) not only face similar heat strain when exercise training and competition occur in hot and humid environments, but also their thermoregulatory capabilities are uniquely challenged. Traumatic damage to the spinal cord, especially with resultant tetraplegia or high paraplegia is associated with a significant malfunction of the sympathetic pathways (Walter & Krassioukov, 2018). Following SCI, the afferent pathways from the periphery to the thermoregulatory effectors in the hypothalamus are disrupted, accounting for the abnormal physiological control during physical activities and exercise (Walter & Krassioukov, 2018). During continuous submaximal exercise in temperate and warm conditions (20-30°C), athletes with SCI show elevated core body temperature, and this increase in core body temperature is more evident in athletes with high level lesion when traumatic damage occurs above T6 (Price, 2016; Price & Trbovich, 2018). This alteration of sympathetic nervous system activity below the lesion level also impairs sweating, increasing susceptibility of heat illness (Price, 2016). Athletes with SCI are therefore considered to be under a greater risk of hyperthermia when compared to the able-bodied athletes (Lepretre, Goosey-Tolfrey, Janssen, & Perret, 2016). A growing number of studies however reported that thermoregulation in persons with SCI during exercise was more dynamic than traditionally believed. Evidence for this possibility has been revisited by Price and Trbovich (2018). Briefly, persons with paraplegia appear to show similar exercise core body temperature responses compared to the able-bodied in temperate and warm environments, while persons with tetraplegia appear to show greAbstract