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  1. Willmott AGB, Hayes M, James CA, Gibson OR, Maxwell NS
    Temperature (Austin), 2019 Sep 19;7(2):178-190.
    PMID: 33015245 DOI: 10.1080/23328940.2019.1664370
    Athletes exercising in heat stress experience increased perceived fatigue acutely, however it is unknown whether heat acclimation (HA) reduces the magnitude of this perceptual response and whether different HA protocols influence the response. This study investigated sensations of fatigue following; acute exercise-heat stress; short- (5-sessions) and medium-term (10-sessions) HA; and between once- (ODHA) and twice-daily HA (TDHA) protocols. Twenty male participants (peak oxygen uptake: 3.75 ± 0.47 L·min-1) completed 10 sessions (60-min cycling at ~2 W·kg-1, 45°C/20% relative humidity) of ODHA (n = 10) or non-consecutive TDHA (n = 10). Sensations of fatigue (General, Physical, Emotional, Mental, Vigor and Total Fatigue) were assessed using the multi-dimensional fatigue scale inventory-short form pre and post session 1, 5 and 10. Heat adaptation was induced following ODHA and TDHA, with reductions in resting rectal temperature and heart rate, and increased plasma volume and sweat rate (P 
  2. Gibson OR, James CA, Mee JA, Willmott AGB, Turner G, Hayes M, et al.
    Temperature (Austin), 2020;7(1):3-36.
    PMID: 32166103 DOI: 10.1080/23328940.2019.1666624
    International competition inevitably presents logistical challenges for athletes. Events such as the Tokyo 2020 Olympic Games require further consideration given historical climate data suggest athletes will experience significant heat stress. Given the expected climate, athletes face major challenges to health and performance. With this in mind, heat alleviation strategies should be a fundamental consideration. This review provides a focused perspective of the relevant literature describing how practitioners can structure male and female athlete preparations for performance in hot, humid conditions. Whilst scientific literature commonly describes experimental work, with a primary focus on maximizing magnitudes of adaptive responses, this may sacrifice ecological validity, particularly for athletes whom must balance logistical considerations aligned with integrating environmental preparation around training, tapering and travel plans. Additionally, opportunities for sophisticated interventions may not be possible in the constrained environment of the athlete village or event arenas. This review therefore takes knowledge gained from robust experimental work, interprets it and provides direction on how practitioners/coaches can optimize their athletes' heat alleviation strategies. This review identifies two distinct heat alleviation themes that should be considered to form an individualized strategy for the athlete to enhance thermoregulatory/performance physiology. First, chronic heat alleviation techniques are outlined, these describe interventions such as heat acclimation, which are implemented pre, during and post-training to prepare for the increased heat stress. Second, acute heat alleviation techniques that are implemented immediately prior to, and sometimes during the event are discussed. Abbreviations: CWI: Cold water immersion; HA: Heat acclimation; HR: Heart rate; HSP: Heat shock protein; HWI: Hot water immersion; LTHA: Long-term heat acclimation; MTHA: Medium-term heat acclimation; ODHA: Once-daily heat acclimation; RH: Relative humidity; RPE: Rating of perceived exertion; STHA: Short-term heat acclimation; TCORE: Core temperature; TDHA: Twice-daily heat acclimation; TS: Thermal sensation; TSKIN: Skin temperature; V̇O2max: Maximal oxygen uptake; WGBT: Wet bulb globe temperature.
  3. Che Muhamed AM, Atkins K, Stannard SR, Mündel T, Thompson MW
    Temperature (Austin), 2016;3(3):455-464.
    PMID: 28349085 DOI: 10.1080/23328940.2016.1182669
    This study examined the thermoregulatory and circulatory responses, and exercise performance of trained distance runners during exercise in the heat (31°C) at varying relative humidity (RH). In a randomized order, 11 trained male distance runners performed 5 60 min steady-state runs at a speed eliciting 70% of VO2max in RH of 23, 43, 52, 61 and 71%. This was followed immediately with an incremental exercise test to volitional exhaustion. Core (Tre) and mean skin temperature (T¯sk), cardiac output (Q), heart rate (HR), and stroke volume (SV) were recorded at regular intervals. A significant (P = 0.003) main effect was detected for RH on mean body temperature (Tb), with a significantly higher Tb detected during steady-state exercise in the 61 and 71% RH compared to that in the 23% RH. During the steady-state exercise, no differences were detected in whole body sweat loss (P = 0.183). However, a significant main effect of RH was observed for HR and SV (P = 0.001 and 0.006, respectively) but not Q (P = 0.156). The time to exhaustion of the incremental exercise test was significantly reduced at 61 and 71% RH compared with 23% RH (P = 0.045 and 0.005, respectively). Despite an increase in dry heat loss, a greater thermoregulatory and circulatory stress was evident during steady-state exercise at 61 and 71% RH. This ultimately limits the capacity to perform the subsequent incremental exercise to exhaustion. This study highlighted that in a warm environment, the range of the prescriptive zone progressively narrows as RH increases.
  4. Willmott AGB, Gibson OR, James CA, Hayes M, Maxwell NS
    Temperature (Austin), 2018;5(2):162-174.
    PMID: 30377634 DOI: 10.1080/23328940.2018.1426949
    The aim of this experiment was to quantify physiological and perceptual responses to exercise with and without restrictive heat loss attire in hot and temperate conditions. Ten moderately-trained individuals (mass; 69.44±7.50 kg, body fat; 19.7±7.6%) cycled for 30-mins (15-mins at 2 W.kg-1 then 15-mins at 1 W.kg-1) under four experimental conditions; temperate (TEMP, 22°C/45%), hot (HOT, 45°C/20%) and, temperate (TEMPSUIT, 22°C/45%) and hot (HOTSUIT, 45°C/20%) whilst wearing an upper-body "sauna suit". Core temperature changes were higher (P<0.05) in TEMPSUIT (+1.7±0.4°C.hr-1), HOT (+1.9±0.5°C.hr-1) and HOTSUIT (+2.3±0.5°C.hr-1) than TEMP (+1.3±0.3°C.hr-1). Skin temperature was higher (P<0.05) in HOT (36.53±0.93°C) and HOTSUIT (37.68±0.68°C) than TEMP (33.50±1.77°C) and TEMPSUIT (33.41±0.70°C). Sweat rate was greater (P<0.05) in TEMPSUIT (0.89±0.24 L.hr-1), HOT (1.14±0.48 L.hr-1) and HOTSUIT (1.51±0.52 L.hr-1) than TEMP (0.56±0.27 L.hr-1). Peak heart rate was higher (P<0.05) in TEMPSUIT (155±23 b.min-1), HOT (163±18 b.min-1) and HOTSUIT (171±18 b.min-1) than TEMP (151±20 b.min-1). Thermal sensation and perceived exertion were greater (P<0.05) in TEMPSUIT (5.8±0.5 and 14±1), HOT (6.4±0.5 and 15±1) and HOTSUIT (7.1±0.5 and 16±1) than TEMP (5.3±0.5 and 14±1). Exercising in an upper-body sauna suit within temperate conditions induces a greater physiological strain and evokes larger sweat losses compared to exercising in the same conditions, without restricting heat loss. In hot conditions, wearing a sauna suit increases physiological and perceptual strain further, which may accelerate the stimuli for heat adaptation and improve HA efficiency.
  5. James CA, Willmott AGB, Dhawan A, Stewart C, Gibson OR
    Temperature (Austin), 2022;9(4):357-372.
    PMID: 36339092 DOI: 10.1080/23328940.2021.1997535
    This study investigated the effect of heat stress on locomotor activity within international field hockey at team, positional and playing-quarter levels. Analysis was conducted on 71 matches played by the Malaysia national men's team against 24 opponents. Fixtures were assigned to match conditions, based on air temperature [COOL (14 ± 3°C), WARM (24 ± 1°C), HOT (27 ± 1°C), or VHOT (32 ± 2°C), p 25°C) on pacing within international hockey. These are the first data demonstrating the effect of air temperature on locomotor activity within international men's hockey, notably that increased air temperature impairs high-intensity activities by 5-15%. Higher air temperatures compromise high-speed running distances between matches in hockey.
  6. James CA, Hayes M, Willmott AGB, Gibson OR, Flouris AD, Schlader ZJ, et al.
    Temperature (Austin), 2017;4(3):314-329.
    PMID: 28944273 DOI: 10.1080/23328940.2017.1333189
    In cool conditions, physiologic markers accurately predict endurance performance, but it is unclear whether thermal strain and perceived thermal strain modify the strength of these relationships. This study examined the relationships between traditional determinants of endurance performance and time to complete a 5-km time trial in the heat. Seventeen club runners completed graded exercise tests (GXT) in hot (GXTHOT; 32°C, 60% RH, 27.2°C WBGT) and cool conditions (GXTCOOL; 13°C, 50% RH, 9.3°C WBGT) to determine maximal oxygen uptake (V̇O2max), running economy (RE), velocity at V̇O2max (vV̇O2max), and running speeds corresponding to the lactate threshold (LT, 2 mmol.l(-1)) and lactate turnpoint (LTP, 4 mmol.l(-1)). Simultaneous multiple linear regression was used to predict 5 km time, using these determinants, indicating neither GXTHOT (R(2) = 0.72) nor GXTCOOL (R(2) = 0.86) predicted performance in the heat as strongly has previously been reported in cool conditions. vV̇O2max was the strongest individual predictor of performance, both when assessed in GXTHOT (r = -0.83) and GXTCOOL (r = -0.90). The GXTs revealed the following correlations for individual predictors in GXTHOT; V̇O2maxr = -0.7, RE r = 0.36, LT r = -0.77, LTP r = -0.78 and in GXTCOOL; V̇O2maxr = -0.67, RE r = 0.62, LT r = -0.79, LTP r = -0.8. These data indicate (i) GXTHOT does not predict 5 km running performance in the heat as strongly as a GXTCOOL, (ii) as in cool conditions, vV̇O2max may best predict running performance in the heat.
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