Share this article on:

Water Immersion in the Treatment of Exertional Hyperthermia: Physical Determinants


Medicine & Science in Sports & Exercise: September 2014 - Volume 46 - Issue 9 - p 1727–1735
doi: 10.1249/MSS.0000000000000292
Basic Sciences

Purpose We examined the effect of differences in body surface area-to-lean body mass ratio (A D/LBM) on core temperature cooling rates during cold water immersion (CWI, 2°C) and temperate water immersion (TWI, 26°C) after exercise-induced hyperthermia.

Methods Twenty male participants were divided into two groups: high (315.6 ± 7.9 cm2·kg−1, n = 10) and low (275.6 ± 8.6 cm2·kg−1, n = 10) A D/LBM. On two separate occasions, participants ran on a treadmill in the heat (40.0°C, 20% relative humidity) wearing an impermeable rain suit until rectal temperature reached 40.0°C. After exercise, participants were immersed up to the nipples (arms remained out of the water) in either a CWI (2°C) or a TWI (26°C) circulated water bath until rectal temperature returned to 37.5°C.

Results Overall rectal cooling rates were significantly different between experimental groups (high vs low A D/LBM, P = 0.005) and between immersion conditions (CWI vs TWI, P < 0.001). Individuals with a high A D/LBM had an approximately 1.7-fold greater overall rectal cooling rate relative to those with low A D/LBM during both CWI (high: 0.27°C·min−1 ± 0.10°C·min−1 vs low: 0.16°C·min−1 ± 0.10°C·min−1) and TWI (high: 0.10°C·min−1 ± 0.05°C·min−1 vs low: 0.06°C·min−1 ± 0.02°C·min−1). Further, the overall rectal cooling rates during CWI were approximately 2.7-fold greater than during TWI for both the high (CWI: 0.27°C·min−1 ± 0.10°C·min−1 vs TWI: 0.10°C·min−1 ± 0.05°C·min−1) and the low (CWI: 0.16°C·min−1 ± 0.10°C·min−1 vs TWI: 0.06°C·min−1 ± 0.02°C·min−1) A D/LBM groups.

Conclusion We show that individuals with a low A D/LBM have a reduced rectal cooling rate and take longer to cool than those with a high A D/LBM during both CWI and TWI. However, CWI provides the most effective cooling treatment irrespective of physical differences.

Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, ON, CANADA

Address for correspondence: Glen P. Kenny, Ph.D., 125 University Private, Room 367, Montpetit Hall, Ottawa, Ontario K1N 6N5, Canada; E-mail:

Submitted for publication October 2013.

Accepted for publication January 2014.

© 2014 American College of Sports Medicine