title: Self-reported effects of cold temperature exposure in persons with tetraplegia.
abstract: Cervical spinal cord injury (tetraplegia) is known to interrupt sympathetic vasculature control, thereby preventing shunting of blood from the periphery to central organs when exposed to cold temperatures. As a result, persons with tetraplegia are at risk to develop hypothermia. However, information regarding the discomfort experienced during the cooler months (late fall, winter, early spring) is overwhelmingly anecdotal. It is not known, with any certainty, how those with tetraplegia perceive cold and if discomfort in colder environments restricts them from performing activities that they routinely would perform.
  
  
  
  Prospective, two-group, self-report surveys.
  
  
  
  VA Medical Center and Kessler Institute for Rehabilitation.
  
  
  
  Forty-four subjects with tetraplegia; 41 matched non-SCI controls.
  
  
  
  Tetraplegic and control groups responded "yes" or "no" when asked whether cold seasonal temperatures allowed comfort or negatively affected participation in routine activities.
  
  
  
  Percentage of responses of tetraplegia compared to controls was different as to whether they felt cold when others in the same room were comfortable (82 vs. 24%; χ2= 28.2, P < 0.0001), felt comfortable outdoors (17 vs. 43%; χ2= 6.8, P = 0.009), or whether cold negatively affected bathing routines (55 vs. 15%; χ2= 14.8, P = 0.0001), keeping physician appointments (46 vs. 12%; χ2= 11.3, P = 0.0008), thinking clearly (41 vs. 7%; χ2= 12.9, P = 0.0003), and completing usual work duties (46 vs. 10%; χ2= 13.3, P = 0.0003).
  
  
  
  Cold seasonal temperatures have a reported greater negative impact on personal comfort and ability to perform vital activities in persons with tetraplegia than that of non-SCI controls. These findings highlight the need to address thermoregulatory impairment in persons with tetraplegia.
authors.affiliation: a VA RR&D National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center , Bronx , NY , USA.|e New York Institute of Technology, Department of Physical Therapy , School of Health Professions , Old Westbury , NY , USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Handrakis
authors.affiliation: a VA RR&D National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center , Bronx , NY , USA.
authors.forename: Dwindally
authors.initials: D
authors.lastname: Rosado-Rivera
authors.affiliation: a VA RR&D National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center , Bronx , NY , USA.
authors.forename: Kamaldeep
authors.initials: K
authors.lastname: Singh
authors.affiliation: a VA RR&D National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center , Bronx , NY , USA.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Swonger
authors.affiliation: a VA RR&D National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center , Bronx , NY , USA.
authors.forename: Frank
authors.initials: F
authors.lastname: Azarelo
authors.affiliation: a VA RR&D National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center , Bronx , NY , USA.
authors.forename: Alex T
authors.initials: AT
authors.lastname: Lombard
authors.affiliation: a VA RR&D National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center , Bronx , NY , USA.|b Medical Service, James J. Peters VA Medical Center , Bronx , NY , USA.|c Department of Medicine , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.|d Department of Rehabilitation Medicine , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Spungen
authors.affiliation: f Kessler Institute for Rehabilitation , West Orange , NJ , USA.|g Department of Physical Medicine and Rehabilitation , Rutgers New Jersey Medical School , Newark , NJ , USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Kirshblum
authors.affiliation: a VA RR&D National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center , Bronx , NY , USA.|b Medical Service, James J. Peters VA Medical Center , Bronx , NY , USA.|c Department of Medicine , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.|d Department of Rehabilitation Medicine , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Bauman
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003080:Cold Temperature; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011782:Quadriplegia / Q000503:physiopathology*; D013697:Thermosensing
keywords: Activities of daily living; Hypothermia; Quadriplegia; Quality of life; Self report; Spinal cord injuries