title: Validity and reliability of devices that assess body temperature during indoor exercise in the heat.
abstract: BACKGROUND
  When assessing exercise hyperthermia outdoors, the validity of certain commonly used body temperature measuring devices has been questioned. A controlled laboratory environment is generally less influenced by environmental factors (eg, ambient temperature, solar radiation, wind) than an outdoor setting. The validity of these temperature measuring devices in a controlled environment may be more acceptable.
  
  
  OBJECTIVE
  To assess the validity and reliability of commonly used temperature devices compared with rectal temperature in individuals exercising in a controlled, high environmental temperature indoor setting and then resting in a cool environment.
  
  
  METHODS
  Time series study.
  
  
  METHODS
  Laboratory environmental chamber (temperature = 36.4 +/- 1.2 degrees C [97.5 +/- 2.16 degrees F], relative humidity = 52%) and cool laboratory (temperature = approximately 23.3 degrees C [74.0 degrees F], relative humidity = 40%).
  
  
  METHODS
  Fifteen males and 10 females.
  
  
  METHODS
  Rectal, gastrointestinal, forehead, oral, aural, temporal, and axillary temperatures were measured with commonly used temperature devices. Temperature was measured before and 20 minutes after entering the environmental chamber, every 30 minutes during a 90-minute treadmill walk in the heat, and every 20 minutes during a 60-minute rest in mild conditions. Device validity and reliability were assessed with various statistical measures to compare the measurements using each device with rectal temperature. A device was considered invalid if the mean bias (average difference between rectal and device temperatures) was more than +/-0.27 degrees C (+/-0.50 degrees F).
  
  
  METHODS
  Measured temperature from each device (mean and across time).
  
  
  RESULTS
  The following devices provided invalid estimates of rectal temperature: forehead sticker (0.29 degrees C [0.52 degrees F]), oral temperature using an inexpensive device (-1.13 degrees C [-2.03 degrees F]), temporal temperature measured according to the instruction manual (-0.87 degrees C [-1.56 degrees F]), temporal temperature using a modified technique (-0.63 degrees C [-1.13 degrees F]), oral temperature using an expensive device (-0.86 degrees C, [-1.55 degrees F]), aural temperature (-0.67 degrees C, [-1.20 degrees F]), axillary temperature using an inexpensive device (-1.25 degrees C, [-2.24 degrees F]), and axillary temperature using an expensive device (-0.94 degrees F [-1.70 degrees F]). Measurement of intestinal temperature (mean bias of -0.02 degrees C [-0.03 degrees F]) was the only device considered valid. Devices measured in succession (intestinal, forehead, temporal, and aural) showed acceptable reliability (all had a mean bias = 0.09 degrees C [0.16 degrees F] and r >or= 0.94]).
  
  
  CONCLUSIONS
  Even during laboratory exercise in a controlled environment, devices used to measure forehead, temporal, oral, aural, and axillary body sites did not provide valid estimates of rectal temperature. Only intestinal temperature measurement met the criterion. Therefore, we recommend that rectal or intestinal temperature be used to assess hyperthermia in individuals exercising indoors in the heat.
authors.affiliation: University of Connecticut, Storrs, CT 06269, USA. matthew.ganio@uconn.edu
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Ganio
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Brown
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Casa
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Becker
authors.forename: Susan W
authors.initials: SW
authors.lastname: Yeargin
authors.forename: Brendon P
authors.initials: BP
authors.lastname: McDermott
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Boots
authors.forename: Paul W
authors.initials: PW
authors.lastname: Boyd
authors.forename: Lawrence E
authors.initials: LE
authors.lastname: Armstrong
authors.forename: Carl M
authors.initials: CM
authors.lastname: Maresh
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001365:Axilla; D001823:Body Composition; D015992:Body Mass Index; D001833:Body Temperature Regulation / Q000502:physiology*; D004423:Ear; D004780:Environment, Controlled; D004784:Environmental Monitoring; D004869:Equipment Safety; D015444:Exercise / Q000502:physiology*; D005260:Female; D005334:Fever / Q000175:diagnosis*; D005546:Forehead; D006358:Hot Temperature; D006801:Humans; D008297:Male; D009055:Mouth; D011336:Probability; D012007:Rectum; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013817:Thermography / Q000295:instrumentation / Q000379:methods*; D013821:Thermometers; D055815:Young Adult