Influence of self-induced hypnosis on thermal responses during immersion in 25 degrees C water.

The efficacy of self-induced post-hypnotic suggestion to improve thermogenic responses to head-out immersion in 25 degrees C water was evaluated in 12 males. An on-line computerized system permitted the change in body heat storage to be used as the independent variable and immersion time as the dependent variable. Test-retest reliability was good, exhibiting a coefficient of variation of less than 5% for exposure time. Immersion profiles consisted of the following: rest until 200 kJ of heat were lost, leg exercise at VO2 approximately 1.5 L.min-1 to regain 200 kJ, rest until 100 kJ were lost, and repeat the exercise to regain 100 kJ. A control immersion was done prior to two 1-h hypnotic training sessions. A second immersion (hypnotic) occurred within 24 h after training. There were no differences in rates of heat production, heat loss, mean skin temperature, or rectal temperature between control and hypnotic immersions. Individual hypnotic susceptibility scores did not correlate with changes in thermal status. Ratings of perceived exertion during exercise were similar for both immersions, but perceived sensation of cold was lower during the second rest period of the hypnotic immersion. Three subjects used images of warm environments during their hypnotic immersion and lost heat at a faster rate than during control immersions. These results indicate that brief hypnotic training did not enhance the thermogenic response to cool water immersion.     

Probability of survival during accidental immersion in cold water

BACKGROUND: Estimating the probability of survival during accidental immersion in cold water presents formidable challenges for both theoreticians and empirics. A number of theoretical models have been developed assuming that death occurs when the central body temperature, computed using a mathematical model, falls to a certain level. This paper describes a different theoretical approach to estimating the probability of survival. METHOD: The human thermal model developed by Wissler is used to compute the central temperature during immersion in cold water. Simultaneously, a survival probability function is computed by solving a differential equation that defines how the probability of survival decreases with increasing time. The survival equation assumes that the probability of occurrence of a fatal event increases as the victim's central temperature decreases. Generally accepted views of the medical consequences of hypothermia and published reports of various accidents provide information useful for defining a "fatality function" that increases exponentially with decreasing central temperature. RESULTS: The particular function suggested in this paper yields a relationship between immersion time for 10% probability of survival and water temperature that agrees very well with Molnar's empirical observations based on World War II data. DISCUSSION: The method presented in this paper circumvents a serious difficulty with most previous models--that one's ability to survive immersion in cold water is determined almost exclusively by the ability to maintain a high level of shivering metabolism.     

Thermal and metabolic responses of high and low fat women to cold water immersion.

BACKGROUND: At rest during cold exposure, the amount of body fat plays an important role in the maintenance of core temperature. High fat (HF) individuals would therefore have an advantage as compared with their low fat (LF) counterparts. Since females usually have a higher amount of body fat than males they are expected to maintain core temperature at a lower energy cost. METHODS: The purpose of the present investigation was to dichotomize female subjects by percent fat (LF = 20.5 +/- 2%, n = 6 vs. HF = 30 +/- 3%, n = 6) to elucidate the thermal and metabolic responses during acute exposure to 17 degrees C water for 120 min. The following variables were measured: rectal temperature (Tre; degrees C), mean skin temperature (Tsk; degrees C), oxygen consumption (VO2; ml x kg(-1) x min(-1)), and tissue insulation (I; degrees C x m2 x W(-1)). The experiment-wise error rate was set a priori at p = 0.05. RESULTS: Unexpectedly, only one of the variables demonstrated a main effect for fat (p < 0.05). Tre demonstrated a significant (p < 0.05) group by time interaction. However, Tsk and I demonstrated a main effect for time (p < 0.05). While VO2 demonstrated an increase across time, these changes were non-significant (p > 0.05). It appears that the HF group demonstrated a similar thermal (I and Tsk) and metabolic (VO2) response as compared with the LF counterparts. However, the LF groups maintained a lower Tre as compared with the HF subjects. Perhaps leaner subjects or colder water temperatures would elucidate the value of body fat in females, and demonstrate a differential response with respect to females varying in percent body fat.     

The influence of ethnicity on thermosensitivity during cold water immersion

PURPOSE: This investigation evaluated the influence of ethnicity, Caucasian (CAU) vs. African American (AA), on thermosensitivity and metabolic heat production (HP) during cold water immersion (20 degrees C) in 15 CAU (22.7 +/- 2.7 yr) vs. 7 AA (21.7 +/- 2.7 yr) males. METHODS: Following a 20-min baseline period (BASE), subjects were immersed in 20 degrees C water until esophageal temperature (Tes) reached 36.5 degrees C or for a maximum pre-occlusion (Pre-OCC) time of 40 min. Arm and thigh cuffs were then inflated to 180 and 220 mm Hg, respectively, for 10 min (OCC). Following release of the inflated cuffs (Post-OCC), the slope of the relationship between the decrease in Tes and the increase in HP was used to define thermosensitivity (beta). RESULTS: ANOVA revealed no significant difference in thermosensitivity between CAU and AA (CAU = 3.56 +/- 1.54 vs. AA = 2.43 +/- 1.58 W.kg(-1). degrees C(-1)). No significant differences (p > 0.05) were found for Tsk (CAU = 24.2 +/- 1.1 vs. AA = 25.1 +/- 1.1 degrees C) or HP (p > 0.05; CAU = 2.5 +/- 0.8 vs. AA = 36.5 +/- 1.8 W.kg(-1)). However, a significant (p < 0.05) main effect for ethnicity for Tes was observed (CAU = 36.7 +/- 1.8 vs. AA = 36.5 +/- 1.8 degrees C). CONCLUSION: These data suggest, despite a differential response in Tes between AA and CAU groups, the beta of HP during cold water immersion is similar between CAU and AA. Therefore, these data demonstrate that when faced with a cold challenge, there is a similar response in HP between CAU and AA that is accompanied by a differential response in Tes.     

Breath-hold time during cold water immersion: effects of habituation with psychological training

INTRODUCTION: The loss of the conscious control of respiration on whole body cold water immersion (CWI) can result in the aspiration of water and drowning. Repeated CWI reduces the respiratory drive evoked by CWI and should prolong breath-hold time on CWI (BHmax(CWI)). Psychological skills training (PST) can also increase BHmax(CWI) by improving the ability of individuals to consciously suppress the drive to breathe. This study tested the hypothesis that combining PST and repeated CWI would extend BHmax(CWI) beyond that seen following only repeated CWI. METHODS: There were 20 male subjects who completed two 2.5-min, head-out breath-hold CWI (BH1 and BH2) in water at 12 degrees C. Following BH1, subjects were matched on BHmax(CWI) and allocated to a habituation (HAB) group or a habituation plus PST group (H+PST). Between BH1 and BH2 both experimental groups undertook five 2.5-min CWI on separate days, during which they breathed freely. The H+PST also received psychological training to help tolerate cold and suppress the drive to breathe on immersion to extend BHmax(CWI). RESULTS: During BH1, mean BHmax(CWI) (+/- SD) in the HAB group was 22.00 (10.33) s and 22.38 (10.65) s in the H+PST. After the five free-breathing CWI, both groups had a longer BHmax(CWI) in BH2. The HAB group improved by 14.13 (20.21) s, an increase of 73%. H+PST improved by 26.86 (24.70) s, a 120% increase. No significant differences were identified between the groups. CONCLUSION: Habituation significantly increases BHmax on CWI, the addition of PST did not result in statistically significant improvements in BHmax(CWI), but may have practical significance.     

The effect of clothing on the initial responses to cold water immersion in man

The protection provided by three clothing assemblies against the cold shock response was investigated. Nine healthy male volunteers each undertook three two minute head-out immersions into stirred water at 10 degrees C. The subjects wore a different clothing assembly for each immersion, these were: a) Swimming trunks only; b) Conventional clothing (equivalent to RN No 8s); c) Conventional clothing plus windproof/shower-proof clothing (RN foul-weather clothing Mk III). The cardiac, ventilatory and thermal responses of the subjects were examined before and during the immersions. No significant differences were found between the magnitude of the responses recorded on immersion when conventional clothing or foul-weather clothing were worn. Mean skin temperature was lower (P less than 0.05) and respiratory frequency and minute ventilation were higher (P less than 0.05) on immersion in swimming trunks compared to the other two conditions. It is concluded that when policies for the use of immersion protective clothing are being formulated, consideration should be given to all of the potentially hazardous responses associated with cold water immersion.     

Renal, endocrine, and cardiovascular responses during head-out water immersion in legless men.

BACKGROUND: The hydrostatic pressure gradient during head-out water immersion (HOI) causes a blood shift from the legs into the thoracic cavity to stretch the receptors in the cardiac atria and results in a diuresis in hydrated subjects. The present study was conducted to examine whether the HOI-induced diuresis and related circulatory and hormonal changes were attenuated in the subjects who had no legs (legless men). METHODS: Two legless men served as the subjects. They lost both legs 15 and 17 yr ago by accidents and were otherwise healthy. Six normal males participated as controls. The experimental protocol was consisted of a 1-h control, a 3-h HOI (water temperature, 34.5 degrees C) and a 1-h recovery. RESULTS: Average urine flow (0.6 ml x min(-1)), urinary excretion of sodium (90 microeq x min(-1)), and osmolal clearance (1.4 ml x min(-1)) of the legless subjects increased in the first h of immersion to 0.7 ml x min(-1), 139 microeq x min(-1), and 1.8 ml x min(-1), respectively. These values remained elevated during HOI, however, the magnitude of the increase was smaller compared with the control subjects. Plasma arginine vasopressin was significantly (p < 0.05) decreased from 1.0+/-0.4 microU x 100 ml(-1) to 0.4+/-0.2 microU x 100 ml(-1) during HOI in the normal subjects, but was not in the legless subjects (from 0.5 at control period to 0.4 microU x 100 ml(-1) during HOI). A concurrent reduction of aldosterone and plasma renin activity was observed with an increase in atrial natriuretic peptide during HOI in both subject groups, however, the magnitude of the changes was smaller in the legless subjects compared with the control subjects. Similarly, the average increase in cardiac output during HOI in the legless subjects (by 17%) was less compared with the control subjects (by 31%). CONCLUSION: The magnitude of renal, endocrine, and cardiovascular changes in response to HOI in the legless subjects were less than in control subjects, but the responses were qualitatively similar. Accordingly, we suggest that the cephalad blood expansion during immersion is not only due to translocation of blood from the legs but also the abdominal region.     

Metabolic responses to prolonged work during treadmill and water immersion running

The primary aim of this study was to compare the physiological responses to prolonged treadmill (TM) and water immersion to the neck (WI) running at threshold intensity. Ten endurance runners performed TM and WI running VO2max tests. Subjects completed submaximal performance tests at ventilatory threshold (Tvent) intensities under TM and WI conditions and responses at 15 and 42 minutes examined. VO2 was lower in WI (p<0.05) at maximal effort and Tvent. The Tvent VO2 intensities interpolated from the TM and WI VO2max tests were performed in both TM (i.e., TM@TM(tvent),TM@WI(tvent), corresponding to 77.6 and 71.3% respectively of TM VO2max) and WI conditions (i.e., WI@TM(tvent), WI@WI(tvent), corresponding to 85.5% and 78.2% respectively of WI VO2max). Each of the dependent variables was analyzed using a 3-way repeated measures ANOVA (2 conditions X 2 exercise intensities X 7 time points during exercise). VO2max values were significantly lower in the WI (52.4(5.1) ml.kg(-1) min(-1)) versus TM (59.7(6.5) ml.kg(-1) min(-1)) condition. VO2 during submaximal tests were similar during the TM and WI conditions. HR and [BLa] responses to exercise at and above WI(tvent) were similar during short-term exercise, but values tended to be lower during prolonged exercise in the WI condition. There were no statistical differences in VE responses in the 2 conditions, however as with HR and [BLa] an upward trend was noted with TM exercise over the 42 minute duration of the tests. RPE at WI(tvent) was similar for TM and WI exercise sessions, however, RPE at TM(tvent) was higher during WI compared to TM running. Cardiovascular drift was observed during prolonged TM but not WI running. Results suggest differences in metabolic responses to prolonged submaximal exercise in WI, however it can be used effectively for cross training.     

The influence of gender and menstrual phase on thermosensitivity during cold water immersion

BACKGROUND: This investigation evaluated the influence of gender and phase of menstrual cycle [follicular (FOL: days 2-6) and luteal (LUT: days 19-24) phases] on thermosensitivity and metabolic heat production (HP) during cold water immersion (20 degrees C) in 10 females (22.4 +/- 2.8 yr) and 16 males (22.4 +/- 2.9 yr). METHODS: Following a 20-min baseline period (BASE), subjects were immersed until esophageal temperature (Tes) reached 36.5 degrees C or for a maximum pre-occlusion (Pre-OCC) time of 40 min. An arm and thigh cuff were then inflated to 180 and 220 mmHg, respectively, for 10 min (OCC). Following release of the inflated cuffs (Post-OCC), the slope (beta) of the relationship between the decrease in Tes and the increase in HP was used to quantify thermosensitivity. RESULTS: ANOVA revealed no significant difference in thermosensitivity between phases of the menstrual cycle or between men and women (FOL = -2.76, LUT = -3.05, Males = -3.24 W x kg(-1) x degrees C(-1)). A significant (p < 0.05) main effect for gender for HP, and a significant (p < 0.05) main effect for menstrual phase for mean skin temperature (Tsk) were observed. CONCLUSIONS: These data suggest, despite gender differences in HP, that the thermosensitivity of HP during cold water immersion is similar between males and females and is not influenced by menstrual cycle phase. Therefore, these data indicate that when faced with a cold challenge, women respond similarly to men in both phases of their menstrual cycle.     

Peripheral and central blood flow in man during cold, thermoneutral, and hot water immersion.

Cardiovascular reflexes were studied during immersion in water to the chest. Cardiac output (CO) was determined by acetylene rebreathing; forearm muscle and subcutaneous blood flow by 133Xe-clearance; and cutaneous blood flow by laser Doppler. Measurements were taken in a) control situation (CTR) (subject sitting dry); b) immersed in thermoneutral (NWI); c) in cold (CWI); and d) in hot water (HWI). The overall trend was that water immersion per se increased stroke volume (SV), but mostly during NWI and CWI, where heart rate (HR) was decreased by 15%; during HWI, HR increased by 32%, the temperature effect evidently overriding the immersion effect. Insignificant increases in CO were seen in NWI and HWI (18% and 44%), and no effect in CWI. Arterial pressure and total peripheral resistance (TPR) increased significantly in CWI due to an increase in peripheral vascular resistance, while significant decreases in TPR and CPR were observed in HWI and tendencies to decreases were found in NWI.     

Breath-hold performance during cold water immersion: effects of psychological skills training

INTRODUCTION: Accidental cold water immersion (CWI) is a significant cause of death, particularly in those who are immersed in rough water or forcibly submerged such as in a ditched and inverted helicopter. The marked reduction in maximal breath-hold time associated with CWI, part of the 'cold shock' response, significantly increases the risk of drowning. However, the response is highly variable between subjects. This experiment tested the hypothesis that part of this variability is due to psychological factors. METHODS: There were 32 subjects who completed 2 2.5-min, head-out immersions in 11 degrees C water, separated by 7 d. Between immersions, subjects were matched on initial maximum breath-hold time on immersion (BHwater) and allocated to either a psychological intervention group (PIG) or control group (CG). PIG (n=16) subjects each undertook a psychological skills intervention comprising 4 interlinked training sessions covering goal-setting, arousal regulation, mental imagery, and positive self-talk; CG (n=16) continued normal daily activity. RESULTS: Psychological intervention significantly increased BHwater on immersion in the PIG vs. the CG [mean (SD); CG BHwater immersion 1:24.01 (6.72) s; immersion 2: 21.34 (16.31) s; PIG: BHwater immersion 1: 24.66 (14.60) s; immersion 2: 44.25 (31.63) s]. The difference in maximum voluntary BHwater between immersion 1 and 2 in the PIG averaged 19.59 s, equating to an 80% increase following psychological intervention. CONCLUSION: Psychological influences may account for a significant amount of the variability in the respiratory responses during CWI, and may be a key factor in determining the chances of survival following accidental immersion.     

Evaluation of predictive formulae for determining metabolic rate during cold water immersion

Five models predicting shivering thermogenesis on the basis of steady state skin and core temperature were evaluated: Hayward et al., Stolwijk and Hardy,; Nadel et al.,; Timbal et al., and Brown and Brengelmann, using the empirical data derived from a cold water immersion study by Morrison et al. A residual analysis indicated that all models generated substantial errors of prediction. The best overall predictors were expressions suggested by Hayward et al., while the predictive equation of Nadel et al. ranked second. Derivation of personal coefficients significantly improved the prediction of all models and a subsequent modification of the standard models, adding temperature derivative terms, further reduced the magnitude of the error. An analysis of the residuals indicated that peripheral and core temperatures should be weighted according to the characteristics of thermosensitive neural structures in these regions.     

Patterns of skin temperature and surface heat flow in man during and after cold water immersion

The region of the lateral thorax, previously identified as an area of high heat transfer during cold water immersion, was investigated using heat flow discs and thermography to determine values of local heat flow and surface temperature before, during and after immersion. The effect of different positions of the arms on local heat flow from the torso was also investigated. No large site-to-site variation in local heat flow was detected for immersion in water temperatures in the range 18.7-24 degrees C. When the arms were positioned close to the torso, there was a decrease in local heat flow and an increase in local surface temperatures. Thermographic examinations revealed local regions of elevated temperature after the arms were briefly held against the body in the post-immersion stage. In this circumstance, erroneous results can follow from the assumption that an elevated surface temperature always constitutes a signal of increased regional heat flow.     

Status of human hemodynamics during water immersion in different postures of immersion

Central and peripheral hemodynamics was investigated in 16 essentially healthy volunteers who performed a routine tilt test or a tilt test in water immersion. Unlike tilt tests carried out before water immersion, the supine to up-right transfer in water did not change cardiac rhythm, cardiac output, leg blood flow or other circulation parameters. The fact that there are no posture-related circulation changes in water immersion suggests that the horizontal and upright positions in water can be viewed as hemodynamically similar.     

Physiological responses during two types of exercise performed on land and in the water

BACKGROUND: The purpose of this study was to compare heart rate (HR) and oxygen consumption (VO2) for similar upright exercises performed on land (LN) and in water (WA). METHODS: Setting and participants: apparently healthy, females (n=12; 20.0+/-1.6 yrs) completed legs only, and arms and legs exercises in WA (30.0+/-0.0 C) and LN (273+/-2.1 C). Intervention: exercise cadence/intensity increased each 3 min to evoke comparable, relative exercise HRs on LN and WA for each participant. Experimental design: three-way (Environment X Type of exercise X Intensity) repeated measures ANCOVAs with pace as the covariate were calculated for VO2 and HR. Linear and multiple regressions were determined. Measures: HR, VO2, and pace were measured for the final steady state minute of all levels of the independent variables. Resting HR and blood pressure were measured pre- and postexercise. RESULTS: There was a significant main effect due to environment for VO2. There was not a significant main effect of environment for HR because the pace of exercise was adjusted in the water so that similar "relative" workloads (ie., intensities, assessed from monitoring HR) were given to each participant. HR and VO2 were greater for arms and legs exercise, and were greater at increased exercise intensities. No interactions were present among the independent variables. When WA exercise was performed at HR levels comparable to HR during land exercise, WA VO2 were 2-6 ml.kg(-1).min(-1) greater than LN VO2. CONCLUSIONS: Participants were at a >VO2 in WA, but would not know this from monitoring their HRtraining. During WA exercise, the HR-VO2 regression line was shifted to the right. Results of the regression analyses showed that VO2 was a significant predictor of HR. HRtraning predicted using these equations indicated that HRtraining during upright water exercise should be decreased by approximately 7-13 beats.min(-1) for legs only water exercise and arms/legs water exercise to attain intensities comparable to LN exercise.     

Including arm exercise during a cold water immersion recovery better assists restoration of sprint cycling performance

Sprint (high‐intensity) exercise performance is reduced when immediately preceded by cold water immersion (CWI). We aimed to investigate whether this performance effect could be attenuated by combining an active recovery (arm exercise) with hip‐level CWI, and whether this attenuation may be related to an effect on core temperature (T_core). Participants (n = 8) completed three Wingate tests before (Ex1) and after (Ex2) four different 30‐min recovery interventions: CWI at 15 °C (CW15), arm exercise during CWI at 15 °C (CW15+AE), arm exercise during thermoneutral immersion at 34 °C (TW34+AE) and non‐immersed arm exercise (AE). After AE and TW34+AE, performance during Ex2 was not different from Ex1; while after CW15+AE and CW15, performance was reduced by 4.9% and 7.6%, respectively. Arm exercise maintained T_core during recovery in CW15+AE, while it declined to a larger extent upon commencement of Ex2 (?0.9 °C) when compared with CW15 (?0.6 °C). This suggests similar leg muscle cooling during recovery in CW15 and CW15+AE. Without any other significant effects (e.g., on blood lactate), these data suggest that the improvement in sprint performance following an active CWI recovery, over CWI alone, may be related to maintained T_core and its effect on neurophysiological mechanisms that drive muscle activation, but not by reduced muscle cooling.     

Plasma volume and endocrine responses to water immersion with intermittent positive-pressure breathing in men

The effect of intermittent positive-pressure breathing (PB), induced by expiring against a resistance of 12.5 mm Hg, on plasma volume and endocrine responses to standing water immersion, was studied in seven male subjects, 28-49 years of age. The men were immersed to the neck (35 +/- 0.5 degrees C) for 90 min with PB from 30 to 60 min. Compared to control values, the hematocrit and hemoglobin concentration decreased (p less than 0.001) during immersion while plasma osmolality was unchanged, indicating an isotonic increase in plasma volume (hemodilution) which peaked after 75 min at +15.5% of the preimmersion plasma volume. This hemodilution was not significantly affected by PB. Plasma renin activity and vasopressin and aldosterone concentrations decreased progressively throughout immersion (p less than 0.001) and were unaffected by PB. The magnitude of these hormonal decreases was accentuated by preexisting, presyncopal symptoms in four subjects. It is concluded that intermittent PB as 12.5 mm Hg failed to compensate for the negative-pressure breathing of standing subjects immersed in water to the neck.     

Muscle oxygen supply during cold face immersion in breath-hold divers and controls

INTRODUCTION: The human diving reflex is characterized by bradycardia, decreased cardiac output, and peripheral vasoconstriction, and has an oxygen-conserving effect both at rest and during exercise. However, the resultant time course and extent of muscle desaturation is unknown. METHODS: We used near-infrared spectroscopy to continuously measure the decrease in tissue oxygen saturation (StO2) in the calf muscle during a series of breath-holds. Subjects were seven trained divers (TD) and eight untrained controls (UC). Other measured variables included arterial blood pressure, heart rate, and arterial oxygen saturation (SaO2). Each subject performed five maximal apneas during face immersion in cold water with 2-min recovery intervals between breath-holds. RESULTS: On average, total apnea time for TD was significantly longer than for UC (772.6 +/- 40.9 s vs. 499.1 +/- 118.2 s, respectively). Further, TD had a more pronounced decrease in StO2 than UC (70.6 +/- 15.3% for TD vs. 87.9 +/- 6.1% UC for the fifth and longest apnea). When values for the two groups were compared at the mean breakpoint time for UC, there was no difference in StO2 and SaO2 remained at baseline. By contrast, at the same time point in all five apneas, UC experienced simultaneous, significantly larger reductions in SaO2 and StO2. DISCUSSION: These data indicate that TD have an attenuated diving reflex compared with UC at the same breath-hold times (the breakpoint for UC). In addition, muscle desaturation occurs earlier than arterial desaturation in both groups; the fact that this effect was less pronounced in TD suggests a training effect. This study provides further evidence for the oxygen-conserving effect of the human diving reflex in maintaining the oxygen supply of vital organs.