title: Physiologic and Perceptual Responses to Cold-Shower Cooling After Exercise-Induced Hyperthermia.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  To investigate the cooling effectiveness of a CS after exercise-induced hyperthermia.
  
  
  METHODS
  Randomized, crossover controlled study.
  
  
  METHODS
  Environmental chamber (temperature = 33.4°C ± 2.1°C; relative humidity = 27.1% ± 1.4%).
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  Rectal temperature, calculated cooling rate, heart rate, and perceptual measures (thermal sensation and perceived muscle pain).
  
  
  RESULTS
  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; t16 = 2.77, P = .01). Heart-rate changes were greater during CS (45 ± 20 beats per minute) compared with CON (27 ± 10 beats per minute; t16 = 3.32, P = .004). Thermal sensation was reduced to a greater extent with CS than with CON (F3,45 = 41.12, P < .001).
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Arkansas, Fayetteville;
authors.forename: Cory L
authors.initials: CL
authors.lastname: Butts
authors.affiliation: University of Arkansas, Fayetteville;
authors.forename: Brendon P
authors.initials: BP
authors.lastname: McDermott
authors.affiliation: Indiana State University, Terre Haute.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Buening
authors.affiliation: University of Arkansas, Fayetteville;
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Bonacci
authors.affiliation: University of Arkansas, Fayetteville;
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Ganio
authors.affiliation: University of Arkansas, Fayetteville;
authors.forename: J D
authors.initials: JD
authors.lastname: Adams
authors.affiliation: University of Arkansas, Fayetteville;
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Tucker
authors.affiliation: University of Arkansas, Fayetteville;
authors.forename: Stavros A
authors.initials: SA
authors.lastname: Kavouras
mesh_terms: D000328:Adult; D001831:Body Temperature / Q000502:physiology; D018592:Cross-Over Studies; D017679:Cryotherapy; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000502:physiology; D018882:Heat Stress Disorders / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D063806:Myalgia / Q000523:psychology; D010465:Perception / Q000502:physiology; D013697:Thermosensing / Q000502:physiology; D014867:Water; D055815:Young Adult
chemical_list: D014867:Water
keywords: exertional heat illness; heat stress; water dousing; whole-body cooling