How elite athletes with a spinal cord injury sweat - An exploratory observational study

Introduction Sweat response and thermoregulation in individuals with spinal cord injury (SCI) may be impaired depending on the level and completeness of the lesion (Grossmann et al., 2021; Price, 2006). This is particularly problematic for athletes and may ultimately lead to decreased performance. This exploratory observational study collected data on sweat response in elite athletes with SCI during exercise. We also explored the feasibility of collecting these data in the field. Methods: Elite athletes with SCI were measured during indoor performance tests (n = 10) or training sessions (n = 5). Parameters collected included core body temperature (Tc), heart rate, urine specific gravity, fluid intake, sweat rate, and sweat electrolyte concentration. Differences in parameters were evaluated for sex, lesion level (tetraplegia versus paraplegia), motor impairment (complete versus incomplete), and sport type (endurance versus team/skill). Results 15 athletes (median (Q1-Q3) age 30 (28-36) years, three females, 11 with a complete lesion) were included. Measurements could be successfully performed on most athletes. Average Tc was 37.7 (37.3-37.8) °C and average heart rate 126 (100-146) bpm. Dehydration, defined as a urine specific gravity > 1.020 ng/ml, was prevalent in six athletes before exercise and in five athletes after exercise. Fluid intake and electrolyte concentrations were similar between groups. Sweat rate was lower in athletes with a tetraplegia (-0.04 (-0.23-0.37) versus 0.51 (0.38-0.73) l/h, p = 0.02, r = 0.60) and in team/skill athletes (0.12 (-0.13-0.33) versus 0.52 (0.42-0.73) l/h, p = 0.008, r = 0.68). Discussion/Conclusion The measurement methods used in this study are straightforward and relatively easy to perform in the field. Our results suggest that there is room for improvement in the hydration status of elite athletes with SCI, especially prior to exercise. Optimization of fluid intake and thermoregulation requires personalized strategies based on lesion characteristics and type of sport. References Grossmann, F., Flueck, J. L., Perret, C., Meeusen, R., & Roelands, B. (2021). The thermoregulatory and thermal responses of individuals with a spinal cord injury during exercise, acclimation and by using cooling strategies – A systematic review. Frontiers in Physiology, 12, Article 636997. https://doi.org/10.3389/fphys.2021.636997 Price, M. J. (2006). Thermoregulation during exercise in individuals with spinal cord injuries. Sports Medicine, 36(10), 863-879. https://doi.org/10.2165/00007256-200636100-00005