Effective Cooling Strategies to Reduce Body Temperature in Individuals with Spinal Cord Injury

Individuals with spinal cord injury have reduced afferent input to the thermoregulatory center and lack sweating capacity and vasomotor control below the level of the spinal cord lesion. Limitations in heat loss capacity leads to excessive increases in core temperature, which in turn decreases exercise performance and increases the risk of heat-related illness. To prevent hyperthermia and improve exercise performance in hot environments, body cooling has been proposed. However, despite the interest and research into cooling strategies for able-bodied humans, less is known regarding the application of these cooling strategies in individuals with thermoregulatory impairment secondary to spinal cord injury. The purpose of this review was to describe effective cooling strategies to attenuate the increase in body temperature in humans with spinal cord injury in hot environments. Cooling strategies in individuals with spinal cord injury include external cooling, such as water immersion, water spraying, and cooling garments, as well as internal cooling strategy such as cold fluid ingestion. We discuss practical issues associated with each method. External cooling methods have been criticized for being impractical during sports competitions, although water immersion and cooling garments do reduce core temperature in individuals with spinal cord injury. However, ice ingestion has recently received considerable interest in studies on able-bodied humans. We propose ice ingestion as an effective cooling strategy for individuals with spinal cord injury.