Passive heat acclimation improves skeletal muscle contractility in humans

Influence of local temperature on motor unit behavior during rapid contractions in humans

PURPOSE

The rate of torque development (RTD) is temperature dependent, but the temperature effects on motor unit behavior during rapid contractions remain largely unknown. This study aimed to clarify the influence of local limb temperature on motor unit behavior and RTD during rapid contractions in humans.

METHODS

Ten healthy male participants rested in a sitting position while immersing their right lower leg in water at different temperatures (Hot: ~43 °C, Neutral: ~33 °C, and Cold: ~10 °C) for 20 min each. The participants then completed a series of voluntary isometric contractions of dorsiflexors while maintaining water immersion in each temperature condition. Specifically, they were instructed to perform two maximal voluntary contractions (MVC) followed by six rapid-hold contractions. High-density surface electromyography was recorded from the tibialis anterior muscle and decomposed into individual motor unit spike trains.

RESULTS

We found that the late RTD (from 0 to 150 ms after the torque onset) was significantly lower in Cold than in the other conditions even when normalized by MVC torque. The motor unit discharge rate at recruitment was significantly higher in Cold (51.4 ± 4.1 pps) than in Hot (42.0 ± 3.8 pps), while the recruitment threshold decreased with the temperature (Cold: 23.9 ± 2.7%, Neutral: 29.2 ± 2.5%, Hot: 36.2 ± 2.4% of MVC). The temperature-induced changes in the late RTD were significantly related to the changes in recruitment time and recruitment threshold.

CONCLUSION

These findings suggest that local cooling induces earlier motor unit recruitment and higher discharge rate, mitigating the decrease in RTD.

Effects of repeated use of post-exercise infrared sauna on neuromuscular performance and muscle hypertrophy

Purpose

The aim of this study was to investigate whether regular use of infrared sauna (IRS) after training can promote neuromuscular performance and positive changes in body composition during a 6-week training period.

Methods

Forty female team sport athletes were pair-matched into two groups: IRS (n = 20) and control (CON; n = 20). Physical performance tests, body composition and hypertrophy measurements (dual-energy x-ray absorptiometry and ultrasound of m. vastus lateralis) were performed PRE and POST a 6-week strength and power training period, involving 2-3 sessions per week. Performance tests included a 20 m sprint, squat jump (SJ), countermovement jumps with body weight (CMJ) as well as with 15, 25, and 50% additional load (CMJ15%, CMJ25%, and CMJ50%), and a maximal isometric leg press (MVC). Participants in the IRS-group used IRS (10 min, 50℃) after training three times per week.

Results

Training improved neuromuscular performance and muscle hypertrophy in both groups (p < 0.05). Following the discovery of an interaction effect for CMJ15% height (p = 0.002) and peak power (p = 0.010), post hoc tests revealed higher jump height POST-IRS (p = 0.006) and PRE-CON (p = 0.023) compared to PRE-IRS, and higher peak power POST-IRS (p = 0.002) compared to PRE-IRS. Furthermore, an interaction effect was observed for 5 m split time of the 20 m sprint (p = 0.020), but no differences were found between groups and timepoints. There were no interactions for the hypertrophy measures.

Conclusion

Incorporating post-exercise IRS bathing does not significantly impact hypertrophy gains, but might boost long-term power production capabilities.

Effect of home-based hot bathing on exercise-induced adaptations associated with short-term resistance exercise training in young men

This study investigated whether home-based bathing intervention (HBBI) improve muscle strength gain and protect cardiovascular function by short-term resistance training (RT). Thirty-one healthy young men measured the maximum voluntary isometric contraction (MVC) of knee extensor, electrically evoked knee extension torque, and mean arterial pressure (MAP). Then, participants were divided into three groups with matching MVC: shower without bathing (control, n = 10), thermoneutral bathing (36°C-bathing, n = 10), and hot bathing (40°C-bathing, n = 11), and conducted 2 weeks of HBBI. Following familiarization for HBBI, participants completed 2 weeks of HBBI and acute RT (five sessions of three sets of 10 isometric knee extension at 60% MVC). Baseline neuromuscular and cardiovascular function was assessed again following completion of the 2 weeks of intervention. MVC was non-significantly increased after the RT period in 40°C-bathing with large effect size (partial η2 = 0.450). The electrically evoked knee extension torque (10/100-Hz ratio) was significantly increased after the RT period in control (p = 0.020). MAP did not alter due to bathing intervention and RT (all p > 0.05). HBBI improved muscle strength without RT-induced alteration of peripheral muscle condition. Shower without bathing reduced muscle strength gain but increased peripheral muscle condition. Short-term RT does not adversely affect the cardiovascular function, regardless of HBBI.

Development and feasibility testing of a new device for home-based leg heat therapy in patients with lower extremity peripheral artery disease

People with symptomatic lower extremity peripheral artery disease (PAD) suffer from severe leg pain, walking impairment, and reduced quality of life, but few effective treatments are available. Emerging evidence suggests that regular heat therapy (HT) may improve cardiovascular and physical function in patients with PAD. However, the lack of accessible, practical modalities for unsupervised HT, especially for elderly individuals, has hindered clinical implementation. The goals of this study were to design and assess the feasibility of a portable leg HT system for elderly patients with PAD. Building on a cryotherapy water-circulating device used in sports recovery, we developed a new prototype system consisting of a single-touch controller unit integrating a heater, water pump, and air pump, and leg sleeves with inner-layer water-circulating pads and an outer layer of inflatable bladders. The system was designed to ensure efficient heat transfer through gentle pneumatic inflation, adapting to varying limb dimensions. Safety features included temperature sensors with auto shut-off and a built-in timer. The prototype's feasibility and safety were evaluated in a single-arm pilot trial with six symptomatic patients with PAD, who were asked to apply the therapy daily for 90 minutes for 12 weeks. Primary outcomes included completion rates, safety, and device usability. Secondary outcomes were changes in blood pressure, 6-minute walk distance, calf strength, sit-to-stand performance, and quality of life. Participants underwent a 90-minute supervised treatment session with the prototype HT units to assess the acute physiological responses before starting the 12-week intervention. Leg HT gradually increased leg skin temperature from 33.8 ± 0.8°C to 38.7 ± 0.7°C at 90 minutes and reduced arterial blood pressure, with mean reductions of 13 mm Hg in systolic and 12 mm Hg in diastolic blood pressure after treatment. All participants completed the 12-week program without serious adverse events, indicating that leg HT is safe and well-tolerated. The 6-minute walk distance improved by an average of 32 m, coupled with increased calf muscle strength and reduced time for the sit-to-stand test. Improvements were also observed in self-reported walking speed and quality of life. This study represents the first step in developing a portable leg heating system for elderly patients with PAD, demonstrating that home-based leg HT is feasible and safe. However, further engineering refinements are needed to enhance portability, simplify application, and encourage long-term adherence. Developing methods to track compliance with the treatment regimen will be crucial for the success of this unsupervised, home-based therapy.

Effects of thermal interventions on skeletal muscle adaptations and regeneration: perspectives on epigenetics: a narrative review

Recovery methods, such as thermal interventions, have been developed to promote optimal recovery and maximize long-term training adaptations. However, the beneficial effects of these recovery strategies remain a source of controversy. This narrative review aims to provide a detailed understanding of how cold and heat interventions impact long-term training adaptations. Emphasis is placed on skeletal muscle adaptations, particularly the involvement of signaling pathways regulating protein turnover, ribosome and mitochondrial biogenesis, as well as the critical role of satellite cells in promoting myofiber regeneration following atrophy. The current literature suggests that cold interventions can blunt molecular adaptations (e.g., protein synthesis and satellite cell activation) and oxi-inflammatory responses after resistance exercise, resulting in diminished exercise-induced hypertrophy and lower gains in isometric strength during training protocols. Conversely, heat interventions appear promising for mitigating skeletal muscle degradation during immobilization and atrophy. Indeed, heat treatments (e.g., passive interventions such as sauna-bathing or diathermy) can enhance protein turnover and improve the maintenance of muscle mass in atrophic conditions, although their effects on uninjured skeletal muscles in both humans and rodents remain controversial. Nonetheless, heat treatment may serve as an important tool for attenuating atrophy and preserving mitochondrial function in immobilized or injured athletes. Finally, the potential interplay between exercise, thermal interventions and epigenetics is discussed. Future studies must be encouraged to clarify how repeated thermal interventions (heat and cold) affect long-term exercise training adaptations and to determine the optimal modalities (i.e., method of application, temperature, duration, relative humidity, and timing).

The effects of acute hot-water immersion on force steadiness and motor unit discharge rate variability in young, healthy adults

This study examined the effects of core and muscle temperature on force steadiness and motor unit discharge rate (MUDR) variability after a hot-water immersion session. Fifteen participants (6 women; 25 ± 6 years) completed neuromuscular assessments before and after either 42 °C (hot) or 36 °C (control) water immersion. Force steadiness was measured during knee extension, while HD-sEMG signals were recorded from vastus lateralis and medialis for MUDR variability analysis. Following water immersion, force steadiness decreased by 0.11% (p < 0.05; d = 0.38) and MUDR variability increased by 1.25% (p < 0.01; d = 0.57) potentially driven by increased muscle temperature. Elevated core temperature did not further affected these changes.

Factors Contributing to Heat Tolerance in Humans and Experimental Models

Understanding physiological mechanisms of tolerance to heat exposure, and potential ways to improve such tolerance, is increasingly important in the context of ongoing climate change. We discuss the concept of heat tolerance in humans and experimental models (primarily rodents), including intracellular mechanisms and improvements in tolerance with heat acclimation.

The effect of a 4-week, remotely administered, post-exercise passive leg heating intervention on determinants of endurance performance

PURPOSE

Post-exercise passive heating has been reported to augment adaptations associated with endurance training. The current study evaluated the effect of a 4-week remotely administered, post-exercise passive leg heating protocol, using an electrically heated layering ensemble, on determinants of endurance performance.

METHODS

Thirty recreationally trained participants were randomly allocated to either a post-exercise passive leg heating (PAH, n = 16) or unsupervised training only control group (CON, n = 14). The PAH group wore the passive heating ensemble for 90-120 min/day, completing a total of 20 (16 post-exercise and 4 stand-alone leg heating) sessions across 4 weeks. Whole-body (peak oxygen uptake, gas exchange threshold, gross efficiency and pulmonary oxygen uptake kinetics), single-leg exercise (critical torque and NIRS-derived muscle oxygenation), resting vascular characteristics (flow-mediated dilation) and angiogenic blood measures (nitrate, vascular endothelial growth factor and hypoxia inducible factor 1-α) were recorded to characterize the endurance phenotype. All measures were assessed before (PRE), at 2 weeks (MID) and after (POST) the intervention.

RESULTS

There was no effect of the intervention on test of whole-body endurance capacity, vascular function or blood markers (p > 0.05). However, oxygen kinetics were adversely affected by PAH, denoted by a slowing of the phase II time constant; τ (p = 0.02). Furthermore, critical torque-deoxygenation ratio was improved in CON relative to PAH (p = 0.03).

CONCLUSION

We have demonstrated that PAH had no ergogenic benefit but instead elicited some unfavourable effects on sub-maximal exercise characteristics in recreationally trained individuals.

The combined influences of local heat application and resistance exercise on the acute mRNA response of skeletal muscle

Introduction

The development and maintenance of the skeletal muscle is crucial for the support of daily function. Heat, when applied locally, has shown substantial promise in the maintenance of the muscle. The purpose of this study was to determine the combined effects of local heat application and acute resistance exercise on gene expression associated with the human muscle growth program.

Materials and methods

Participants (n = 12, 26 ± 7 years, 1.77 ± 0.07 m, 79.6 ± 15.4 kg, and 16.1 ± 11.6 %BF) completed an acute bilateral bout of resistance exercise consisting of leg press (11 ± 2 reps; 170 ± 37 kg) and leg extension (11 ± 1 reps; 58 ± 18 kg). Participants wore a thermal wrap containing circulating fluid (40°C, exercise + heat; EX + HT) during the entire experimental period and 4 h post-exercise, while the other leg served as an exercise-only (EX) control. Biopsies of the vastus lateralis were collected (Pre, Post, and 4hPost) for gene expression analyses.

Results

Intramuscular temperatures increased (Post, +2.2°C ± 0.7°C, and p < 0.001; 4hPost, +2.5°C ± 0.6°C, and p < 0.001) and were greater in the EX + HT leg post-exercise (+0.35°C ± 0.3°C, and p = 0.005) and after 4hPost (+2.1°C ± 0.8°C and p < 0.001). MYO-D1 mRNA was greater in the EX + HT leg vs. the EX (fold change = 2.74 ± 0.42 vs. 1.70 ± 0.28, p = 0.037). No other genes demonstrated temperature sensitivity when comparing both legs (p > 0.05). mRNA associated with the negative regulator, myostatin (MSTN), decreased post-exercise (p = 0.001) and after 4 h (p = 0.001). mRNA associated with proteolysis decreased post-exercise (FBXO32, p = 0.001; FOXO3a, p = 0.001) and after 4 h (FBXO32, p = 0.001; FOXO3a, p = 0.027).

Conclusion

The elevated transcription of the myogenic differentiation factor 1 (MYO-D1) after exercise in the heated condition may provide a mechanism by which muscle growth could be enhanced.

The Effects of Heat Therapy During Immobilization and Rehabilitation on Muscle Atrophy and Strength Loss at Return to Sports in Healthy Humans

Background

Animal research suggests that repeated heat exposures may stimulate skeletal muscle protein synthesis and downregulate protein degradation.

Hypothesis

Repeated heat exposures during ankle immobilization and rehabilitation would preserve human muscle strength and mass.

Study Design

Controlled laboratory study.

Methods

A total of 20 male participants (age, 33.6 ± 2.8 years; weight, 83.8 ± 9.2 kg; height, 182 ± 6 cm) underwent 4 weeks of supervised training, 2 weeks of single-lower leg immobilization, and 2 weeks of supervised rehabilitation before return to sports (RTS). Participants were split into 2 groups: (1) whole-body heat therapy (HEAT) and (2) sham treatment (SHAM) throughout the immobilization and rehabilitation periods. Measures of muscle strength (isometric and isokinetic), volume (magnetic resonance imaging and ultrasound), and muscle biopsies were obtained preimmobilization, postimmobilization, and at RTS.

Results

Maximal isometric strength of the plantarflexors was lower at RTS compared with preimmobilization in SHAM (P = .027) but not HEAT (P = .301). Isokinetic strength during a fatigue test was higher at RTS compared with preimmobilization in HEAT (P = .039) but not SHAM (P = .245). Pennation angle and muscle thickness were lower at postimmobilization compared with preimmobilization only in SHAM (P≤ .027). Muscle cross-sectional area decreased in soleus and both gastrocnemius medialis and lateralis (all P≤ .035) in SHAM, but only in gastrocnemius medialis in HEAT. There was a large (d = 0.91) but not significant (P = .054) decrease in the ratio of phosphorylated/total nuclear factor-kappa B (NFκB) from preimmobilization to postimmobilization in HEAT only. There was an increase in phosphorylated fork head box O proteins (FoxO) only in HEAT (P = .034), suggesting a decrease in FoxO activity. Caspase 3 expression increased from preimmobilization to postimmobilization in SHAM only (P = .004).

Conclusion

These results indicate that using heat therapy throughout immobilization and rehabilitation reduces skeletal muscle atrophy and maintains plantarflexor strength in healthy humans. Moreover, heat therapy may lead to the inactivation of the FoxO and NFκB signaling pathways involved in atrophy.

Clinical Relevance

Repeated heat exposures should be considered a novel therapeutic intervention to counteract muscle atrophy during immobilization.

Heat Attainment and Retention in Surfers with and without a Land-Based Warm-Up and Accompanying Passive Heat Retention

Surfing is a growing, high-participation recreational and competitive activity. It is relatively unique, being performed on, in, and through water with a range of temperatures. In other sports, warm-up and heat retention have proved useful at augmenting performance and ameliorating injury risk. Little work has been carried out examining this in surfing. The purpose of this work was to measure thermal profiles in surfers with and without warm-up and passive heat retention, and secondarily to assess any potential influence on free surfing. A repeated measures pre- and post- design was adopted whereby participants surfed in an artificial wave pool following an active warm-up combined with passive heat retention (experimental condition) and after no warm-up (control). Core body temperature was measured both occasions. Our results showed increases in core body temperature were greater for the experimental condition versus control (p = 0.006), and a time effect exists (p < 0.001)-in particular, a warm-up effect in the water itself was shown in both groups, possibly due to further activity (e.g., paddling) and wetsuit properties. Finally, performance trended to being superior following warm-up. We conclude that body warmth in surfers may be facilitated by an active warm-up and passive heat retention. In free surfing, this is associated with a trend towards better performance; it may also reduce injury risk.

Resistance Training in the Heat: Mechanisms of Hypertrophy and Performance Enhancement

ABSTRACT

Pryor, JL, Sweet, D, Rosbrook, P, Qiao, J, Hess, HW, and Looney, DP. Resistance training in the heat: Mechanisms of hypertrophy and performance enhancement. J Strength Cond Res 38(7): 1350-1357, 2024-The addition of heat stress to resistance exercise or heated resistance exercise (HRE) is growing in popularity as emerging evidence indicates altered neuromuscular function and an amplification of several mechanistic targets of protein synthesis. Studies demonstrating increased protein synthesis activity have shown temperature-dependent mammalian target of rapamycin phosphorylation, supplemental calcium release, augmented heat shock protein expression, and altered immune and hormone activity. These intriguing observations have largely stemmed from myotube, isolated muscle fiber, or rodent models using passive heating alone or in combination with immobilization or injury models. A growing number of translational studies in humans show comparable results employing local tissue or whole-body heat with and without resistance exercise. While few, these translational studies are immensely valuable as they are most applicable to sport and exercise. As such, this brief narrative review aims to discuss evidence primarily from human HRE studies detailing the neuromuscular, hormonal, and molecular responses to HRE and subsequent strength and hypertrophy adaptations. Much remains unknown in this exciting new area of inquiry from both a mechanistic and functional perspective warranting continued research.

Passive heating-induced changes in muscle contractile function are not further augmented by prolonged exposure in young males experiencing moderate thermal stress

Background: We investigated the impact of 1) passive heating (PH) induced by single and intermittent/prolonged hot-water immersion (HWI) and 2) the duration of PH, on muscle contractile function under the unfatigued state, and during the development of muscle fatigue. Methods: Twelve young males volunteered for this study consisting of two phases: single phase (SP) followed by intermittent/prolonged phase (IPP), with both phases including two conditions (i.e., four trials in total) performed randomly: control passive sitting (CON) and HWI (44-45°C; water up to the waist level). SP-HWI included one continuous 45-min bath (from 15 to 60 min). IPP-HWI included an initial 45-min bath (from 15 to 60 min) followed by eight additional 15-min baths interspaced with 15-min breaks at room temperature between 75 and 300 min. Intramuscular (Tmu; measured in the vastus lateralis muscle) and rectal (Trec) temperatures were determined. Neuromuscular testing (performed in the knee extensors and flexors) was performed at baseline and 60 min later during SP, and at baseline, 60, 90, 150 and 300 min after baseline during IPP. A fatiguing protocol (100 electrical stimulations of the knee extensors) was performed after the last neuromuscular testing of each trial. Results: HWI increased Tmu and Trec to 38°C-38.5°C (p < 0.05) during both SP and IPP. Under the unfatigued state, HWI did not affect electrically induced torques at 20 Hz (P20) and 100 Hz (P100). However, it induced a shift towards a faster contractile profile during both SP and IPP, as evidenced by a decreased P20/P100 ratio (p < 0.05) and an improved muscle relaxation (i.e., reduced half-relaxation time and increased rate of torque relaxation; p < 0.05). Despite a reduced voluntary activation (i.e., -2.63% ± 4.19% after SP-HWI and -5.73% ± 4.31% after IPP-HWI; condition effect: p < 0.001), HWI did not impair maximal isokinetic and isometric contraction torques. During the fatiguing protocol, fatigue index and the changes in muscle contractile properties were larger after HWI than CON conditions (p < 0.05). Finally, none of these parameters were significantly affected by the heating duration. Conclusion: PH induces changes in muscle contractile function which are not augmented by prolonged exposure when thermal stress is moderate.

Cyclooxygenase inhibition does not blunt thermal hyperemia in skeletal muscle of humans

Acute heat exposure increases skeletal muscle blood flow in humans. However, the mechanisms mediating this hyperemic response remain unknown. The cyclooxygenase pathway is active in skeletal muscle, is heat sensitive, and contributes to cutaneous thermal hyperemia in young healthy humans. Therefore, the purpose of this study was to test the hypothesis that cyclooxygenase inhibition would attenuate blood flow in the vastus lateralis muscle during localized heating. Twelve participants (6 women) were studied on two separate occasions: 1) time control (i.e., no ibuprofen); and 2) ingestion of 800 mg ibuprofen, a nonselective cyclooxygenase inhibitor. Experiments were randomized, counter-balanced, and separated by at least 10 days. Pulsed short-wave diathermy was used to induce unilateral deep heating of the vastus lateralis for 90 min, whereas the contralateral leg served as a thermoneutral control. Microdialysis was utilized to bypass the cutaneous circulation and directly measure local blood flow in the vastus lateralis muscle of each leg via the ethanol washout technique. Heat exposure increased muscle temperature and local blood flow (both P < 0.01 vs. baseline). However, the thermal hyperemic response did not differ between control and ibuprofen conditions (P ≥ 0.2). Muscle temperature slightly decreased for the thermoneutral leg (P < 0.01 vs. baseline), yet local blood flow remained relatively unchanged across time for control and ibuprofen conditions (both P ≥ 0.7). Taken together, our data suggest that inhibition of cyclooxygenase-derived vasodilator prostanoids does not blunt thermal hyperemia in skeletal muscle of young healthy humans.NEW & NOTEWORTHY Acute heat exposure increases skeletal muscle blood flow in humans. However, the mechanisms mediating this hyperemic response remain unknown. Using a pharmacological approach combined with microdialysis, we found that thermal hyperemia in the vastus lateralis muscle was well maintained despite the successful inhibition of cyclooxygenase. Our results suggest that cyclooxygenase-derived vasodilator prostanoids do not contribute to thermal hyperemia in skeletal muscle of young healthy humans.

The reliability of a portable steam sauna pod for the whole-body passive heating of humans

INTRODUCTION

Passive heating is receiving increasing attention within human performance and health contexts. A low-cost, portable steam sauna pod may offer an additional tool for those seeking to manipulate physiological (cardiovascular, thermoregulatory and sudomotor) and perceptual responses for improving sporting or health profiles. This study aimed to 1) report the different levels of heat stress and determine the pods' inter-unit reliability, and 2) quantify the reliability of physiological and perceptual responses to passive heating.

METHOD

In part 1, five pods were assessed for temperature and relative humidity (RH) every 5 min across 70 min of heating for each of the 9 settings. In part 2, twelve males (age: 24 ± 4 years) completed two 60 min trials of passive heating (3 × 20 min at 44 °C/99% RH, separated by 1 week). Heart rate (HR), rectal (Trectal) and tympanic temperature (Ttympanic) were recorded every 5 min, thermal comfort (Tcomfort) and sensation (Tsensation) every 10 min, mean arterial pressure (MAP) at each break period and sweat rate (SR) after exiting the pod.

RESULTS

In part 1, setting 9 provided the highest temperature (44.3 ± 0.2 °C) and longest time RH remained stable at 99% (51±7 min). Inter-unit reliability data demonstrated agreement between pods for settings 5-9 (intra-class correlation [ICC] >0.9), but not for settings 1-4 (ICC <0.9). In part 2, between-visits, high correlations, and low typical error of measurement (TEM) and coefficient of variation (CV) were found for Trectal, HR, MAP, SR, and Tcomfort, but not for Ttympanic or Tsensation. A peak Trectal of 38.09 ± 0.30 °C, HR of 124 ± 15 b min-1 and a sweat loss of 0.73 ± 0.33 L were reported. No between-visit differences (p > 0.05) were observed for Trectal, Ttympanic, Tsensation or Tcomfort, however HR (+3 b.min-1) and MAP (+4 mmHg) were greater in visit 1 vs. 2 (p < 0.05).

CONCLUSION

Portable steam sauna pods generate reliable heat stress between-units. The highest setting (44 °C/99% RH) also provides reliable but modest adjustments in physiological and perceptual responses.

Influence of temperature on twitch potentiation following submaximal voluntary contractions in human plantar flexor muscles

This study aimed to clarify the influence of temperature on post-activation twitch potentiation, a possible indicator of fast-twitch fiber activation during a preceding voluntary contraction. Ten healthy males immersed their left lower leg in water of different temperatures (cold: 0°C, neutral: 32-35°C, hot: ~43°C) for 20 min each. In each temperature condition, they performed submaximal (10%-50% of maximal voluntary contraction torque measured before water immersion) and maximal plantar flexions. Immediately after each voluntary contraction, twitch contractions were evoked with supramaximal stimulation of the posterior tibial nerve. The magnitude of twitch potentiation, defined as a percent increase in twitch torque following a voluntary contraction, increased with the intensity of the preceding voluntary contraction. The magnitude of twitch potentiation after the maximal voluntary contraction was smaller in Cold than in the other temperature conditions. However, temperature had no influence on the relative magnitude of twitch potentiation following the submaximal contractions. In addition, there was no difference in electromyographic activity between the gastrocnemius and soleus muscles in any temperature conditions. Collectively, the temperature dependence was not observed when using twitch potentiation or electromyographic amplitude as an indicator of fast-twitch fiber activation during brief submaximal voluntary contractions.

Skeletal muscle oxidative adaptations following localized heat therapy

Repeated heat treatment has been shown to induce oxidative adaptations in cell cultures and rodents, but similar work within human models is scarce. This study investigated the effects of 6 weeks of localized heat therapy on near-infrared spectroscopy-(NIRS) derived indices of muscle oxidative and microvascular function. Twelve physically active participants (8 males and 4 females, age: 34.9 ± 5.9 years, stature: 175 ± 7 cm, body mass: 76.7 ± 13.3 kg) undertook a 6-week intervention, where adhesive heat pads were applied for 8 h/day, 5 days/week, on one calf of each participant, while the contralateral leg acted as control. Prior to and following the intervention, the microvascular function was assessed using NIRS-based methods, where 5 min of popliteal artery occlusion was applied, and the reperfusion (i.e., re-saturation rate, re-saturation amplitude, and hyperemic response) was monitored for 2 min upon release. Participants also performed a 1-min isometric contraction of the plantar flexors (30% maximal voluntary contraction), following which a further 2 min interval was undertaken for the assessment of recovery kinetics. A 20-min time interval was allowed before the assessment protocol was repeated on the contralateral leg. Repeated localized heating of the gastrocnemius did not influence any of the NIRS-derive indices of microvascular or oxidative function (p > 0.05) following 6 weeks of treatment. Our findings indicate that localized heating via the use of adhesive heat pads may not be a potent stimulus for muscle adaptations in physically active humans.

Effect of hot water immersion on acute physiological responses following resistance exercise

Purpose: Hot water immersion (HWI) is a strategy theorised to enhance exercise recovery. However, the acute physiological responses to HWI following resistance exercise are yet to be determined. Methods: The effect of HWI on intramuscular temperature (IMT), muscle function, muscle soreness and blood markers of muscle cell disruption and inflammatory processes after resistance exercise was assessed. Sixteen resistance trained males performed resistance exercise, followed by either 10 min HWI at 40°C or 10 min passive recovery (PAS). Results: Post-intervention, the increase in IMT at all depths was greater for HWI compared to PAS, however this difference had disappeared by 1 h post at depths of 1 and 2 cm, and by 2 h post at a depth of 3 cm. There were no differences between groups for muscle function, muscle soreness or any blood markers. Conclusion: These results suggest that HWI is a viable means of heat therapy to support a greater IMT following resistance exercise. Recovery of muscle function and muscle soreness is independent of acute changes in IMT associated with HWI.

The independent effects of local heat application on muscle growth program associated mRNA and protein phosphorylation

The development and maintenance of skeletal muscle is crucial for the support of daily function. Recent evidence suggests that genes coded for proteins associated with the human muscle growth program (myogenic and proteolytic genes) are sensitive to local heat application. Therefore, the purpose of this investigation was to determine the effect of 4 h of local heat application to the vastus lateralis at rest on acute phosphorylation (mTORSer2448, p70-S6K1Thr389, and 4E-BP1Thr47/36) and gene expression changes for proteins associated with the muscle growth program. Intramuscular temperature of the HOT limb was 1.2 ± 0.2 °C higher than CON limb after 4 h of local heating. However, this local heat stimulus did not influence transcription of genes associated with myogenesis (MSTN, p = 0.321; MYF5, p = 0.445; MYF6, p = 0.895; MEF2a, p = 0.809; MYO-G, p = 0.766; MYO-D1, p = 0.118; RPS3, p = 0.321; and RPL-3L, p = 0.577), proteolysis (Atrogin-1, p = 0.573; FOXO3a, p = 0.452; MURF-1, p = 0.284), nor protein phosphorylation (mTORSer2448, p = 0.981; P70-S6K1Thr389, p = 0.583; 4E-BP1Thr37/46, p = 0.238) associated with the muscle growth program. These findings suggest little to no association between the local application of heat, at rest, and the activation of the observed muscle growth program-related markers.

Active Heat Acclimation Does Not Alter Muscle-Tendon Unit Properties

PURPOSE

Heat acclimation (HA) is recommended before competing in hot and humid conditions. HA has also been recently suggested to increase muscle strength, but its effects on human's muscle and tendon mechanical properties are not yet fully understood. This study investigated the effect of active HA on gastrocnemius medialis (GM) muscle-tendon properties.

METHODS

Thirty recreationally active participants performed 13 low-intensity cycling sessions, distributed over a 17-d period in hot (HA = ~38°C, ~58% relative humidity; n = 15) or in temperate environment (CON = ~23°C, ~35% relative humidity; n = 15). Mechanical data and high-frame rate ultrasound images were collected during electrically evoked and voluntary contractions pre- and postintervention. Shear modulus was measured at rest in GM, and vertical jump performance was assessed.

RESULTS

Core temperature decreased from the first to the last session in HA (-0.4°C ± 0.3°C; P = 0.015), while sweat rate increased (+0.4 ± 0.3 L·h -1 ; P = 0.010), suggesting effective HA, whereas no changes were observed in CON (both P ≥ 0.877). Heart rate was higher in HA versus CON and decreased throughout intervention in groups (both P ≤ 0.008), without an interaction effect ( P = 0.733). Muscle-tendon unit properties (i.e., maximal and explosive isometric torque production, contractile properties, voluntary activation, joint and fascicular force-velocity relationship, passive muscle, and active tendon stiffness) and vertical jump performance did not show training ( P ≥ 0.067) or group-training interaction ( P ≥ 0.232) effects.

CONCLUSIONS

Effective active HA does not alter muscle-tendon properties. Preparing hot and humid conditions with active HA can be envisaged in all sporting disciplines without the risk of impairing muscle performance.

Heart Rate and Body Temperature Evolution in an Interval Program of Passive Heat Acclimation at High Temperatures (100 ± 2 °C) in a Sauna

Heat exposure provokes stress on the human body. If it remains constant, it leads to adaptations such as heat acclimation. This study aims to observe the evolution of heart rate (HR), core temperature (Tcore), and skin temperature (Tskin) in an intervallic program of exposure to extreme heat. Twenty-nine healthy male volunteers were divided into a control group (CG; n = 14) and an experimental group (EG; n = 15). EG experienced nine sessions (S) of intervallic exposure to high temperatures (100 ± 2 °C), whereas CG was exposed to ambient temperatures (22 ± 2 °C). HR, Tskin, and Tcore were monitored in S1, 4, 5, 8, and 9. An important increase in HR occurred in the S4 compared to the rest (p < 0.05) in EG. A lower HR was discovered in S8 and S9 compared to S4 and in S9 in relation to S1 (p < 0.05) in EG. EG experiences a gradual decrease in Tcore and Tskin, which was detected throughout the assessments, although it was only significant in the S8 and S9 (p < 0.05). Interval exposure to heat at 100 ± 2 °C elicits stress on the human organism, fundamentally increasing Tcore, Tskin, and FC. This recurring stress in the full program caused a drop in the thermoregulatory response as an adaptation or acclimation to heat.

Heat acclimation reduces the effects of whole-body hyperthermia on knee-extensor relaxation rate, but does not affect voluntary torque production

PURPOSE

This study investigated the effects of acute hyperthermia and heat acclimation (HA) on maximal and rapid voluntary torque production, and their neuromuscular determinants.

METHODS

Ten participants completed 10 days of isothermic HA (50 °C, 50% rh) and had their knee-extensor neuromuscular function assessed in normothermic and hyperthermic conditions, pre-, after 5 and after 10 days of HA. Electrically evoked twitch and octet (300 Hz) contractions were delivered at rest. Maximum voluntary torque (MVT), surface electromyography (EMG) normalised to maximal M-wave, and voluntary activation (VA) were assessed during brief maximal isometric voluntary contractions. Rate of torque development (RTD) and normalised EMG were measured during rapid voluntary contractions.

RESULTS

Acute hyperthermia reduced neural drive (EMG at MVT and during rapid voluntary contractions; P < 0.05), increased evoked torques (P < 0.05), and shortened contraction and relaxation rates (P < 0.05). HA lowered resting rectal temperature and heart rate after 10 days (P < 0.05), and increased sweating rate after 5 and 10 days (P < 0.05), no differences were observed between 5 and 10 days. The hyperthermia-induced reduction in twitch half-relaxation was attenuated after 5 and 10 days of HA, but there were no other effects on neuromuscular function either in normothermic or hyperthermic conditions.

CONCLUSION

HA-induced favourable adaptations to the heat after 5 and 10 days of exposure, but there was no measurable benefit on voluntary neuromuscular function in normothermic or hyperthermic conditions. HA did reduce the hyperthermic-induced reduction in twitch half-relaxation time, which may benefit twitch force summation and thus help preserve voluntary torque in hot environmental conditions.

Increases in muscle temperature by hot water improve muscle contractile function and reduce motor unit discharge rates

PURPOSE

Examine the effects of 42°C hot-water immersion on muscle contraction function and motor unit discharge rates. Voluntary and evoked contraction assessments were examined first with a concomitant increase in the core and muscle temperature, and thereafter with increased muscle temperature but cooled core temperature.

METHODS

Fifteen participants (24.9 ± 5.6 years) performed neuromuscular assessments before, after, and ~15-min after either 90-min of 42°C (hot) or 36°C (control) water immersion. Maximal voluntary contraction (MVC) assessment of knee extension was performed along with surface electromyography (sEMG) (vastus lateralis and medialis [VL, VM]) and voluntary activation level (VAL). Resting evoked twitch was elicited for peak torque and time to peak torque analysis. In addition, the VL and VM motor unit discharge rates (MUDR) were measured.

RESULTS

After hot-water immersion (core temperature ↑1°C; muscle temperature ↑2.4°C), MVC torque and VAL decreased (p < 0.05). The sEMG (VL and VM) and peak twitch torque did not change (p > 0.05), while time to peak torque decreased (p = 0.007). The VL and VM MUDR decreased, showing a time effect, after both water immersion conditions (36 and 42°C) (p > 0.001). Fifteen minutes after the hot-water immersion (core temperature at baseline; muscle temperature ↑1.4°C), MVC torque returned to baseline, but VAL remained lower. The sEMG (VL and VM) remained unchanged. Peak twitch torque increased (p < 0.002) and time to peak torque remained lower (p = 0.028). The MUDR remained lower after both water immersion conditions (p < 0.05).

CONCLUSION

Increased core temperature evoked by 42°C hot-water immersion decreases MVC torque and VAL. However, a passive increase in muscle temperature improved evoked muscle contractile function (i.e., time to peak torque [after] and peak twitch torque [~15 min after]). Moreover, a passive increase in muscle temperature reduced the required MUDR to attain the same torque.

Post-exercise, passive heat acclimation with sauna or hot-water immersion provide comparable adaptations to performance in the heat in a military context

To mitigate the effects of heat during operations in hot environments, military personnel will likely benefit from heat acclimation (HA) conducted prior to deployment. Using post-exercise, passive heating, 25 participants completed a 5 d HA regime in sauna (70 °C, 18% RH) or hot-water immersion (HWI) (40 °C) for ≤40 min, preceded and followed by a heat stress test (1-h walking at 5 km.h^-1 in 33 °C, 77% RH in military uniform (20 kg) before an incremental ramp to exhaustion). Fifteen completed both regimes in a randomised, cross-over manner. While performance did not significantly improve (+14%, [-1, 29], p = .079), beneficial adaptations were observed for mean exercising core temperature (-0.2 °C, [-0.2, -0.2], p <.001), skin temperature (-0.2 °C, [-0.2, -0.2], p = 035) and heart rate (-8 bpm, [-6, -10], p<.001) in both conditions. Post-exercise, passive HA of either modality may benefit military units operating in the heat.Practitioner summary: Strategies are required to prevent health and performance impairments during military operations upon arrival in hot environments. Using a randomised, cross-over design, participants completed five-day passive, post-exercise heat acclimation using sauna or hot-water immersion. Both regimes elicited beneficial albeit modest heat adaptations.Abbreviations: HA: heat acclimation; HST: heat stress test; HWI: hot-water immersion; RH: relative humidity.

Skeletal muscle angiogenic, regulatory, and heat shock protein responses to prolonged passive hyperthermia of the human lower limb

Passive hyperthermia induces a range of physiological responses including augmenting skeletal muscle mRNA expression. This experiment aimed to examine gene and protein responses to prolonged passive leg hyperthermia. Seven young participants underwent 3 h of resting unilateral leg heating (HEAT) followed by a further 3 h of rest, with the contralateral leg serving as an unheated control (CONT). Muscle biopsies were taken at baseline (0 h), and at 1.5, 3, 4, and 6 h in HEAT and 0 and 6 h in CONT to assess changes in selected mRNA expression via qRT-PCR, and HSP72 and VEGFα concentration via ELISA. Muscle temperature (T_m) increased in HEAT plateauing from 1.5 to 3 h (+3.5 ± 1.5°C from 34.2 ± 1.2°C baseline value; P < 0.001), returning to baseline at 6 h. No change occurred in CONT. Endothelial nitric oxide synthase (eNOS), Forkhead box O1 (FOXO-1), Hsp72, and VEGFα mRNA increased in HEAT (P < 0.05); however, post hoc analysis identified that only Hsp72 mRNA statistically increased (at 4 h vs. baseline). When peak change during HEAT was calculated angiopoietin 2 (ANGPT-2) decreased (-0.4 ± 0.2-fold), and C-C motif chemokine ligand 2 (CCL2) (+2.9 ± 1.6-fold), FOXO-1 (+6.2 ± 4.4-fold), Hsp27 (+2.9 ± 1.7-fold), Hsp72 (+8.5 ± 3.5-fold), Hsp90α (+4.6 ± 3.7-fold), and VEGFα (+5.9 ± 3.1-fold) increased from baseline (all P < 0.05). At 6 h T_m were not different between limbs (P = 0.582; CONT = 32.5 ± 1.6°C, HEAT = 34.3 ± 1.2°C), and only ANGPT-2 (P = 0.031; -1.3 ± 1.4-fold) and VEGFα (P = 0.030; 1.1 ± 1.2-fold) differed between HEAT and CONT. No change in VEGFα or HSP72 protein concentration were observed over time; however, peak change in VEGFα did increase (P < 0.05) in HEAT (+140 ± 184 pg·mL^-1) versus CONT (+7 ± 86 pg·mL^-1). Passive hyperthermia transiently augmented ANGPT-2, CCL2, eNOS, FOXO-1, Hsp27, Hsp72, Hsp90α and VEGFα mRNA, and VEGFα protein.

New developments in translational microcirculatory research

Microvascular disease plays a critical role in systemic end-organ dysfunction, and treatment of microvascular pathologies may greatly reduce cardiovascular morbidity and mortality. The Call for Papers collection: New Developments in Translational Microcirculatory Research highlights key advances in our understanding of the role of microvessels in the development of chronic diseases as well as therapeutic strategies to enhance microvascular function. This Mini Review provides a concise summary of these advances and draws from other relevant research to provide the most up-to-date information on the influence of cutaneous, cerebrovascular, coronary, and peripheral microcirculation on the pathophysiology of obesity, hypertension, cardiovascular aging, peripheral artery disease, and cognitive impairment. In addition to these disease- and location-dependent research articles, this Call for Papers includes state-of-the-art reviews on coronary endothelial function and assessment of microvascular health in different organ systems, with an additional focus on establishing rigor and new advances in clinical trial design. These articles, combined with original research evaluating cellular, exosomal, pharmaceutical, exercise, heat, and dietary interventional therapies, establish the groundwork for translating microcirculatory research from bench to bedside. Although numerous studies in this collection are focused on human microcirculation, most used robust preclinical models to probe mechanisms of pathophysiology and interventional benefits. Future work focused on translating these findings to humans are necessary for finding clinical strategies to prevent and treat microvascular dysfunction.

Local passive heating administered during recovery impairs subsequent isokinetic knee extension exercise performance

BACKGROUND: Passive heating has attracted attention as a potentially promising recovery modality in sports. However, investigations of passive heating have yielded only inconsistent results for exercise performance. OBJECTIVE: To investigate the acute effects of local passive heating administered between repeated bouts of isokinetic exercise. METHODS: The experiment was a randomized crossover study. There was a total of three visits including a familiarization visit. During the remaining two visits, eleven healthy men performed three bouts of nine sets of isokinetic knee extensions using their dominant single-leg (30 repetitions/set, 180∘/sec). A 15 min recovery, during which a local passive heating pad at control (CON) or heating (HT) was applied to the rectus femoris, was afforded after the 3rd and 6th sets (Recovery 1 and 2). Isokinetic exercise performance, as assessed by peak torque, total work, and average power was analyzed using two-way repeated-measures ANOVA. RESULTS: Following Recovery 1 and 2, isokinetic exercise performance, as assessed by peak torque, total work, and average power was reduced in Set 4 (p< 0.001, p< 0.001, p= 0.080) and Set 7 (p< 0.001, p< 0.001, p= 0.009) in the HT group relative to the CON group. Electromyography analysis revealed that signal amplitude was lower in the HT group in Set 4 (p< 0.001) subsequent to Recovery 1, and that firing frequency was higher in Set 7 (p= 0.002) in the HT group after Recovery 2. Furthermore, EMG time-frequency maps from one representative participant showed that following Recovery 1 and 2 peak energy decreased during the first five repetitions in Set 4 and 7. CONCLUSIONS: Local passive heating administered during recovery decreased subsequent performance of isokinetic knee extensors, muscle activation ability and increased firing frequency maintaining force output. Therefore, local passive heating is not an appropriate acute recovery strategy for isokinetic exercises.

Acute Effect of Exposure to Extreme Heat (100 ± 3 °C) on Lower Limb Maximal Resistance Strength

The aim of this study was to evaluate the acute effect of a single dry sauna bath lasting twelve minutes on the indirect determination of the one maximum repetition (1RM) leg press among trained and untrained participants. Thirty young men participated in the study, a trained group (TG; n = 15; age: 20.97 ± 0.44 years) and an untrained group (UG; n = 15; age: 21.03 ± 0.11 years). Subjects in the TG had performed resistance training for at least two years before the beginning of the experiment. All participants performed two indirect tests of their one maximum repetition leg press on two different days, with a rest period of three weeks between tests. Additionally, anthropometric, body composition, blood pressure, body temperature, and rated perceived exertion were evaluated. On the second testing day, all of the participants took a dry sauna bath lasting 12 min immediately before performing the leg press test. In the second evaluation (pre-heating in the sauna), the UG experienced increases in absolute RM (178.48 ± 56.66 to 217.60 ± 59.18 kg; p < 0.05; R = 0.798), relative RM (2.65 ± 0.61 to 3.24 ± 0.58 kg·g body mass^-1; p < 0.05; R = 0.798), and muscular RM (5.64 ± 1.20 to 6.77 ± 1.14 kg·kg muscle mass^-1; p < 0.05; R = 0.797). The TG also increased their values on the second day in absolute RM (284.96 ± 62.41 to 314.92 ± 1.04 kg; p < 0.01; R = 0.886), in relative RM (3.61 ± 0.88 to 3.99 ± 1.85 kg*kg body mass^-1; p < 0.01; R = 0.886), and muscular RM (7.83 ± 1.69 to 8.69 ± 1.85 kg·kg muscle mass^-1; p < 0.01; R = 0.854). A passive, extreme-heat sauna bath lasting 12 min taken immediately before a relative maximum repetition test seems to provoke clear positive responses for the development of strength.

Potential role of passively increased muscle temperature on contractile function

Declines in muscle force, power, and contractile function can be observed in older adults, clinical populations, inactive individuals, and injured athletes. Passive heating exposure (e.g., hot baths, sauna, or heated garments) has been used for health purposes, including skeletal muscle treatment. An acute increase in muscle temperature by passive heating can increase the voluntary rate of force development and electrically evoked contraction properties (i.e., time to peak twitch torque, half-relation time, and electromechanical delay). The improvements in the rate of force development and evoked contraction assessments with increased muscle temperature after passive heating reveal peripheral mechanisms’ potential role in enhancing muscle contraction. This review aimed to summarise, discuss, and highlight the potential role of an acute passive heating stimulus on skeletal muscle cells to improve contractile function. These mechanisms include increased calcium kinetics (release/reuptake), calcium sensitivity, and increased intramuscular fluid.

Faster early rate of force development in a warmer muscle: an in vivo exploration of fascicle dynamics and muscle-tendon mechanical properties

While heat exposure has been shown to increase the rate of force development (RFD), the underlying processes remain unknown. This study investigated the effect of heat on gastrocnemius medialis (GM) muscle-tendon properties and interactions. Sixteen participants performed electrically-evoked and voluntary contractions combined with ultrafast ultrasound under thermoneutral (CON: 26°C, core temperature 37.0±0.3°C, muscle temperature 34.0±1.1°C) and passive heat exposure (HOT: 47°C, core temperature 38.4±0.3°C, muscle temperature 37.0±0.8°C) conditions. Maximal voluntary force was unchanged while voluntary activation decreased (-4.6±8.7%, P=0.038) in HOT. Heat exposure increased RFD before 100 ms from contraction onset (+48.2±62.7%; P=0.013), without further changes after 100 ms. GM fascicle dynamics during electrically-evoked and voluntary contractions remained unchanged between conditions. Joint velocity at a given force was higher in HOT (+7.1±6.6%; P=0.004), while the fascicle force-velocity relationship was unchanged. Passive muscle stiffness and active tendon stiffness were lower in HOT than CON (P≤0.030). This study showed that heat-induced increases in early RFD may not be attributed to changes in contractile properties. Late RFD was unaltered, probably explained by decreased soft tissues' stiffness in heat. Investigations are required to explore the possible influence of neural drive and motor unit recruitment in the enhancement of explosive strength elicited by heat exposure.

The Heat Shock Connection: Skeletal Muscle Hypertrophy and Atrophy

Skeletal muscle is an integral tissue system that plays a crucial role in the physical function of all vertebrates and is a key target for maintaining or improving health and performance across the lifespan. Based largely on cellular and animal models, there is some evidence that various forms of heat stress with or without resistance exercise may enhance skeletal muscle growth or reduce its loss. It is not clear whether these stimuli are similarly effective in humans or meaningful in comparison to exercise alone across various heating methodologies. Furthermore, the magnitude by which heat stress may influence whole body thermoregulatory responses and the connection to skeletal muscle adaptation remains ambiguous. Finally, the underlying mechanisms, which may include interaction between relevant heat shock proteins and intracellular hypertrophy and atrophy related factors, remain unclear. In this narrative mini-review we examine the relevant literature regarding heat stress alone or in combination with resistance exercise emphasizing skeletal muscle hypertrophy and atrophy across cellular and animal models, as well as human investigations. Additionally, we present working mechanistic theories for heat shock protein mediated signaling effects regarding hypertrophy and atrophy related signaling processes. Importantly, continued research is necessary to determine the practical effects and mechanisms of heat stress with and without resistance exercise on skeletal muscle function via growth and maintenance.

Impact of climatic conditions projected at the World Cup in Qatar 2022 on repeated maximal efforts in soccer players

This study aimed to investigate the relationship between the climatic conditions predicted for the 2022 FIFA World Cup in Qatar and the capacity for repeated maximum effort (RSA), of soccer players. Twenty-four semi-professional soccer players participated in the study. The exercise test consisted of ten 6-second maximal efforts on a cycloergometer. A 90-second passive rest interval was used. Mechanical parameters were recorded in each repetition, and biochemical parameters at rest and even repetitions. The test was performed in a Weiss Technik WK-26 climate chamber under two different conditions: (1) thermoneutral (TNC - 20.5 °C; 58.7% humidity); (2) predicted for the 2022 World Cup in Qatar (QSC - 28.5 ± 1.92 °C; 58.7 ± 8.64% humidity). Significantly higher mean maximum power values were recorded in the second repetition under QSC conditions (1731,8 ± 214,4 W) (p = 0.025). A significantly longer time to reach maximum power was also recorded under TNC conditions compared to QSC conditions in repetition 2 (1,32 ± 0,33 s), (1,05 ± 0,29 s) (p = 0.016) and 6 (1,41 ± 0,48 s), (1,17 ± 0,25) (p = 0.036). There was a significantly higher rate of power loss, between repetition 2 (p = 0.023) and 4 (p = 0.043) under QSC conditions, compared to TNC. Considering the biochemical parameters, a significantly higher pO2 concentration was registered under QSC conditions in the 10th repetition (p = 0.006). The ambient temperature during exercise should be taken into account to determine the anaerobic exercise capacity of the athletes. At higher temperatures, there is a greater capacity for maximal effort, in terms of maximal power achieved, but with a greater decrease in performance.

Effects of 24 h Compression Interventions with Different Garments on Recovery Markers during Running

Compression and temperature manipulation are discussed as strategies to improve performance markers and recovery in sports. Here, we investigate the effects of compression stockings made with fabric, either combined or not with heating and cooling substances, on variables related to running performance and recovery. Ten trained runners (mean ± standard deviation age 45 ± 9 years old, body mass 69 ± 7 kg, height 166 ± 4 cm) with no experience of using compression garments performed an intense running session of 10 km, then wore a stocking for 24 h (randomized; without compression, compression, compression with camphor, and compression with menthol), and were evaluated on the following day, after running 5 km. The different types of compression stockings used 24 h before exercise did not affect running kinematics (p > 0.14), skin temperature (p > 0.05), heart rate (p > 0.12; mean value of maximal heart rate 156 bpm), comfort perception (p = 0.13; mean value of 7/10 points), or perception of recovery (p = 0.13; mean value of 7/10 points). In general, there were no effects of 24 h pre-exercise lower leg compression, including those treated with menthol and camphor applications on running kinematics, skin temperature, heart rate, or recovery perception in athletes undertaking consecutive running exercises.

Thermotherapy Effects on Healthy and Type 2 Diabetes Human Skeletal Muscle Myoblast Cell Lines

Diabetes mellitus is a chronic metabolic disease characterized by elevated blood glucose levels with associated disordered carbohydrate and lipid metabolism. Type 2 diabetes (T2D) specifically has been shown to cause a decrease in skeletal muscle mass due to oxidative stress. This study investigated a treatment option for T2D through thermotherapy on healthy (HSMM) and T2D (D-HSMM) human skeletal muscle cells. The goals were to determine the effects of thermotherapy, long-term (chronic) and short-term (acute), on HSMM and D-HSMM cell viabilities and oxidative stress. HSMM and D-HSMM cells were grown to confluency, harvested, and counted to determine density. Acute and chronic heat treatments were applied to both cell lines. The chronic treatment consisted of a 30-minute exposure to 40°C, three times a week for three weeks; the acute treatment was a one-time exposure. Oxidative stress assays and cell viabilities were tested 24 hours after heat treatments. Results indicated no significant effect on the cell viability of HSMM and D-HSMM cells. The acute treatment had a significant increase (p ≤ 0.05) of MDA concentration compared to the chronic treatment. The chronic treatment had a significant increase (p ≤ 0.05) in catalase activity compared to the acute treatment. The SOD activity had no significant change (p > 0.05) between the chronic and acute treatments. In conclusion, acute thermotherapy may not be beneficial for skeletal muscle cells due to the observed increase in oxidative stress, especially in the D-HSMM cells.

Heat Reacclimation Using Exercise or Hot Water Immersion

INTRODUCTION

The aim of this study was to compare the effectiveness of exercise versus hot water immersion heat reacclimation (HRA) protocols.

METHODS

Twenty-four participants completed a heat stress test (HST; 33°C, 65% RH), which involved cycling at a power output equivalent to 1.5 W·kg-1 for 35 min whereby thermophysiological variables were measured. This was followed by a graded exercise test until exhaustion. HST1 was before a 10-d controlled hyperthermia (CH) heat acclimation (HA) protocol and HST2 immediately after. Participants completed HST3 after a 28-d decay period without heat exposure and were then separated into three groups to complete a 5-d HRA protocol: a control group (CH-CON, n = 8); a hot water immersion group (CH-HWI, n = 8), and a controlled hyperthermia group (CH-CH, n = 8). This was followed by HST4.

RESULTS

Compared with HST1, time to exhaustion and thermal comfort improved; resting rectal temperature (Tre), end of exercise Tre, and mean skin temperature (Tsk) were lower; and whole body sweat rate (WBSR) was greater in HST2 for all groups (P < 0.05). After a 28-d decay, only WBSR, time to exhaustion, and mean Tsk returned to pre-HA values. Of these decayed variables, only WBSR was reinstated after HRA; the improvement was observed in both the CH-CH and the CH-HWI groups (P < 0.05).

CONCLUSION

The data suggest that HRA protocol may not be necessary for cardiovascular and thermal adaptations within a 28-d decay period, as long as a 10-d CH-HA protocol has successfully induced these physiological adaptations. For sweat adaptations, a 5-d CH or HWI-HRA protocol can reinstate the lost adaptations.

Short-term heat acclimation preserves knee extensor torque but does not improve 20 km self-paced cycling performance in the heat

Purpose

This study investigated the effect of 5 days of heat acclimation training on neuromuscular function, intestinal damage, and 20 km cycling (20TT) performance in the heat.

Methods

Eight recreationally trained males completed two 5-day training blocks (cycling 60 min day⁻¹ at 50% peak power output) in a counter-balanced, cross-over design, with a 20TT completed before and after each block. Training was conducted in hot (HA: 34.9 ± 0.7 °C, 53 ± 4% relative humidity) or temperate (CON: 22.2 ± 2.6 °C, 65 ± 8% relative humidity) environment. All 20TTs were completed in the heat (35.1 ± 0.5 °C, 51 ± 4% relative humidity). Neuromuscular assessment of knee extensors (5 × 5 s maximum voluntary contraction; MVC) was completed before and after each 20TT and on the first and last days of each training block.

Results

MVC torque was statistically higher after 5 days of HA training compared to CON (mean difference = 14 N m [95% confidence interval; 6, 23]; p < 0.001; d = 0.77). However, 20TT performance after 5 days of HA training was not statistically different to CON, with a between-conditions mean difference in the completion time of 68 s [95% confidence interval; − 9, 145] (p = 0.076; d = 0.35).

Conclusion

Short-term heat acclimation training may increase knee extensor strength without changes in central fatigue or intestinal damage. Nevertheless, it is insufficient to improve 20 km self-paced cycling performance in the heat compared to workload-matched training in a temperate environment. These data suggest that recreationally trained athletes gain no worthwhile performance advantage from short-term heat-training before competing in the heat.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00421-021-04744-y.

Effect of Handgrip Training in Extreme Heat on the Development of Handgrip Maximal Isometric Strength among Young Males

The aim of this study was to evaluate the acute and adaptive effects of passive extreme heat (100 ± 3 °C) exposition in combination with a strength training protocol on maximal isometric handgrip strength. Fifty-four untrained male university students participated in this investigation. Twenty-nine formed the control group (NG) and 25 the heat-exposed group (HG). All the participants performed a 3-week isotonic handgrip strength training program twice a week with a training volume of 10 series of 10 repetitions with 45-s rest between series, per session. All the subjects only trained their right hand, leaving their left hand untrained. HG performed the same training protocol in hot (100 ± 3 °C) conditions in a dry sauna. Maximal isometric handgrip strength was evaluated each training day before and after the session. NG participants did not experience any modifications in either hand by the end of the study while HG increased maximal strength values in both hands (p < 0.05), decreased the difference between hands (p < 0.05), and recorded higher values than the controls in the trained (p < 0.05) and untrained (p < 0.01) hands after the intervention period. These changes were not accompanied by any modification in body composition in either group. The performance of a unilateral isotonic handgrip strength program in hot conditions during the three weeks induced an increase in maximal isometric handgrip strength in both hands without modifications to bodyweight or absolute body composition.

Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies

A rise in body core temperature and loss of body water via sweating are natural consequences of prolonged exercise in the heat. This review provides a comprehensive and integrative overview of how the human body responds to exercise under heat stress and the countermeasures that can be adopted to enhance aerobic performance under such environmental conditions. The fundamental concepts and physiological processes associated with thermoregulation and fluid balance are initially described, followed by a summary of methods to determine thermal strain and hydration status. An outline is provided on how exercise-heat stress disrupts these homeostatic processes, leading to hyperthermia, hypohydration, sodium disturbances, and in some cases exertional heat illness. The impact of heat stress on human performance is also examined, including the underlying physiological mechanisms that mediate the impairment of exercise performance. Similarly, the influence of hydration status on performance in the heat and how systemic and peripheral hemodynamic adjustments contribute to fatigue development is elucidated. This review also discusses strategies to mitigate the effects of hyperthermia and hypohydration on exercise performance in the heat by examining the benefits of heat acclimation, cooling strategies, and hyperhydration. Finally, contemporary controversies are summarized and future research directions are provided.

The Role of Skeletal Muscles in Exertional Heat Stroke Pathophysiology

The active participation of skeletal muscles is a unique characteristic of exertional heat stroke. Nevertheless, the only well-documented link between skeletal muscle activities and exertional heat stroke pathophysiology is the extensive muscle damage (e. g., rhabdomyolysis) and subsequent leakage of intramuscular content into the circulation of exertional heat stroke victims. Here, we will present and discuss rarely explored roles of skeletal muscles in the context of exertional heat stroke pathophysiology and recovery. This includes an overview of heat production that contributes to severe hyperthermia and the synthesis and secretion of bioactive molecules, such as cytokines, chemokines and acute phase proteins. These molecules can alter the overall inflammatory status from pro- to anti-inflammatory, affecting other organ systems and influencing recovery. The activation of innate immunity can determine whether a victim is ready to return to physical activity or experiences a prolonged convalescence. We also provide a brief discussion on whether heat acclimation can shift skeletal muscle secretory phenotype to prevent or aid recovery from exertional heat stroke. We conclude that skeletal muscles should be considered as a key organ system in exertional heat stroke pathophysiology.

Hyperthermia reduces electromechanical delay via accelerated electrochemical processes

The present study aimed to determine the effect of hyperthermia on both electrochemical and mechanical components of the electromechanical delay (EMD), using very-high-frame-rate ultrasound. Electrically evoked peak twitch force, EMD, electrochemical (D_m; i.e., delay between stimulation and muscle fascicle motion), and mechanical (T_m; i.e., delay between fascicle motion and force production onset) components of EMD were assessed in 16 participants. Assessments were conducted in a control ambient environment (CON; 26°C, 34% relative humidity) and in a hot ambient environment (HOT; 46-50°C, 18% relative humidity, after ∼127 min of heat exposure). Following heat exposure, gastrocnemius medialis temperature was 37.0 ± 0.6°C in HOT vs. 34.0 ± 0.8°C in CON (P < 0.001). EMD was shorter (9.4 ± 0.8 ms) in HOT than in CON (10.8 ± 0.6 ms, P < 0.001). Electrochemical processes were shorter in HOT than in CON (4.0 ± 0.8 ms vs. 5.5 ± 0.9 ms, respectively, P < 0.001), whereas mechanical processes were unchanged (P = 0.622). These results demonstrate that hyperthermia reduces electromechanical delay via accelerated electrochemical processes, whereas force transmission along the active and passive parts of the series elastic component is not affected following heat exposure. The present study demonstrates that heat exposure accelerates muscle contraction thanks to faster electrochemical processes. Further investigations during voluntary contractions would contribute to better understand how these findings translate into motor performance.NEW & NOTEWORTHY Hyperthermia (targeted core temperature: 38.5°C) reduces the time between gastrocnemius medialis stimulation and the onset of plantar flexor force production in vivo. This reduction in electromechanical delay is concomitant to an earlier motion of muscle fascicle compared with thermoneutral environment. However, hyperthermia has no impact on the duration of force transmission along aponeurosis and tendon, thereby reflecting different effects of heat exposure on contractile and elastic properties of the muscle-tendon unit.

Six weeks of localized heat therapy does not affect muscle mass, strength and contractile properties in healthy active humans

PURPOSE

Animal and human studies have shown that repeated heating may induce skeletal muscle adaptations, increasing muscle strength. The aim of this study is to investigate the effect of 6 weeks of localized heating on skeletal muscle strength, volume and contractile properties in healthy humans.

METHODS

Fifteen active participants (8 males/7 females, 35 ± 6 years, 70 ± 14 kg, 173 ± 7 cm, average training of 87 min per week) were subjected to 6 weeks of single-leg heat therapy. Heat pads were applied for 8 h/day, 5 days/week, on one randomly selected calf of each participant, while the contralateral leg acted as control. The heat pads increased muscle temperature by 4.6 ± 1.2 °C (p < 0.001). Every 2 weeks, participants were tested for morphological (MRI), architectural (ultrasound), contractile (electrically evoked twitch), and force (isometric and isokinetic) adaptations.

RESULTS

Repeated localized heating did not affect the cross-sectional area (p = 0.873) or pennation angle (p = 0.345) of the gastrocnemius muscles; did not change the evoked peak twitch amplitude (p = 0.574) or rate of torque development (p = 0.770) of the plantar flexors; and did not change maximal voluntary isometric (p = 0.214) or isokinetic (p = 0.973) plantar flexor torque.

CONCLUSION

Whereas previous studies have observed improved skeletal muscle function following whole-body and localized heating in active and immobilized humans, respectively, the current data suggested that localized heating may not be a potent stimulus for muscle adaptations in active humans.

Short-Term Repeated-Sprint Training in Hot and Cool Conditions Similarly Benefits Performance in Team-Sport Athletes

This study compared the performance and physiological adaptations of short-term repeated-sprint training in HOT [40°C and 40% relative humidity (RH)] and COOL (20°C and 40% RH) conditions in team-sport athletes. Twenty-five trained males completed five training sessions of 60 min over 7 days in HOT (n = 13) or COOL (n = 12) conditions, consisting of a submaximal warm-up and four sets of maximal sprints. Before and after the intervention, intermittent shuttle running performance was assessed in cool and repeated-sprint ability in hot conditions; the latter preceded and followed by neuromuscular function testing. During the repeated-sprint training sessions, skin (~8.4°C) and core (~0.17°C) temperatures were higher in HOT than COOL (p < 0.05) conditions. Shuttle running distance increased after both interventions (p < 0.001), with a non-significant (p = 0.131) but larger effect in HOT (315 m, d = 1.18) than COOL (207 m, d = 0.51) conditions. Mean (~7%, p < 0.001) and peak (~5%, p < 0.05) power during repeated-sprinting increased following both interventions, whereas peak twitch force before the repeated-sprint assessment was ~10% lower after the interventions (p = 0.001). Heart rate during the repeated-sprint warm-up was reduced (~6 beats.min^-1) following both interventions (p < 0.01). Rectal temperature was ~0.14°C lower throughout the repeated-sprint assessment after the interventions (p < 0.001), with larger effects in HOT than COOL during the warm-up (p = 0.082; d = -0.53 vs. d = -0.15) and repeated-sprints (p = 0.081; d = -0.54 vs. d = -0.02). Skin temperature (p = 0.004, d = -1.11) and thermal sensation (p = 0.015, d = -0.93) were lower during the repeated-sprints after training in HOT than COOL. Sweat rate increased (0.2 L.h^-1) only after training in HOT (p = 0.027; d = 0.72). The intensive nature of brief repeated-sprint training induces similar improvements in repeated-sprint cycling ability in hot conditions and intermittent running performance in cool conditions, along with analogous physiological adaptations, irrespective of the environmental conditions in which training is undertaken.

Skeletal Muscle Signaling Following Whole-Body and Localized Heat Exposure in Humans

This study identified the changes in hypertrophy/atrophy and mitochondrial-related signaling in human skeletal muscle following whole-body (WB) and localized single leg (SL) heat treatment. Nine active male participants were administered either 60 min of passive WB (44–50°C, 50% humidity) or SL (water-perfused suit at 49.5 ± 1.4°C) heat treatment at least 1 week apart in a counterbalanced order. The untreated leg during SL was considered as control (CON). Core, skin, and quadriceps muscle temperature were monitored throughout the experimental trials. Muscle microbiopsy samples were obtained prior to (PRE), and 30 min and 3 h post (POST) following heat treatment. Muscle temperature increased with time (p < 0.0001) in both WB and SL, with no differences between conditions (38.8 ± 0.5°C vs. 38.1 ± 0.6°C, p = 0.065). Core temperature increased only following WB, and was significantly higher compared with SL (39.1 ± 0.3°C vs. 37.1 ± 0.1, p < 0.0001). Compared with PRE, WB up-regulated the phosphorylation status of the majority of the Akt/mTOR pathway (Akt, mTOR, S6K1, rpS6, and p-eIF4E; p ≤ 0.050), with the exception of 4EBP1 (p = 0.139). WB also increased the mRNA of HSPs 72, 90, and 25 (all p < 0.021), and increased or tended to increase the phosphorylation of FOXO1 (p = 0.066) and FOXO3a (p = 0.038). In addition, most (NRF1, NRF2, COX2, and COX4-I2; all p ≤ 0.050), but not all (CS, Cyt c, and COX4-I1; p > 0.441) mRNA content indicative of mitochondrial biogenesis were increased following WB, with no changes evident in these parameters in SL or CON (all p > 0.090). These results indicate that 1 h of WB heat treatment enhanced anabolic (Akt/mTOR), mitochondrial, and cyto-protective signaling (HSP), with a concomitant possible inhibition of FOXO transcription factors.

High Thermoregulatory Strain During Competitive Paratriathlon Racing in the Heat

Purpose: Paratriathletes may display impairments in autonomic (sudomotor and/or vasomotor function) or behavioral (drinking and/or pacing of effort) thermoregulation. As such, this study aimed to describe the thermoregulatory profile of athletes competing in the heat. Methods: Core temperature (Tc) was recorded at 30-second intervals in 28 mixed-impairment paratriathletes during competition in a hot environment (air temperature = 33°C, relative humidity = 35%–41%, and water temperature = 25°C–27°C), via an ingestible temperature sensor (BodyCap e-Celsius). Furthermore, in a subset of 9 athletes, skin temperature was measured. Athletes’ wetsuit use was noted while heat illness symptoms were self-reported postrace. Results: In total, 22 athletes displayed a Tc ≥ 39.5°C with 8 athletes ≥40.0°C. There were increases across the average Tc for swim, bike, and run sections (P ≤ .016). There was no change in skin temperature during the race (P ≥ .086). Visually impaired athletes displayed a significantly greater Tc during the run section than athletes in a wheelchair (P ≤ .021). Athletes wearing a wetsuit (57% athletes) had a greater Tc when swimming (P ≤ .032), whereas those reporting heat illness symptoms (57% athletes) displayed a greater Tc at various time points (P ≤ .046). Conclusions: Paratriathletes face significant thermal strain during competition in the heat, as evidenced by high Tc, relative to previous research in able-bodied athletes and a high incidence of self-reported heat illness symptomatology. Differences in the Tc profile exist depending on athletes’ race category and wetsuit use.

Effects of repeated local heat therapy on skeletal muscle structure and function in humans

The purpose of the present study was to examine the effects of repeated exposure to local heat therapy (HT) on skeletal muscle function, myofiber morphology, capillarization, and mitochondrial content in humans. Twelve young adults (23.6 ± 4.8 yr, body mass index 24.9 ± 3.0 kg/m²) had one randomly selected thigh treated with HT (garment perfused with water at ~52°C) for 8 consecutive weeks (90 min, 5 days/wk) while the opposite thigh served as a control. Biopsies were obtained from the vastus lateralis muscle before and after 4 and 8 wk of treatment. Knee extensor strength and fatigue resistance were also assessed using isokinetic dynamometry. The changes in peak isokinetic torque were higher (P = 0.007) in the thigh exposed to HT than in the control thigh at weeks 4 (control 4.2 ± 13.1 Nm vs. HT 9.1 ± 16.1 Nm) and 8 (control 1.8 ± 9.7 Nm vs. HT 7.8 ± 10.2 Nm). Exposure to HT averted a temporal decline in capillarization around type II fibers (P < 0.05), but had no effect on capillarization indexes in type I fibers. The content of endothelial nitric oxide synthase was ~18% and 35% higher in the thigh exposed to HT at 4 and 8 wk, respectively (P = 0.003). Similarly, HT increased the content of small heat shock proteins HSPB5 (P = 0.007) and HSPB1 (P = 0.009). There were no differences between thighs for the changes in fiber cross-sectional area and mitochondrial content. These results indicate that exposure to local HT for 8 wk promotes a proangiogenic environment and enhances muscle strength but does not affect mitochondrial content in humans.NEW & NOTEWORTHY We demonstrate that repeated application of heat therapy to the thigh with a garment perfused with warm water enhances the strength of knee extensors and influences muscle capillarization in parallel with increases in the content of endothelial nitric oxide synthase and small heat shock proteins. This practical method of passive heat stress may be a feasible tool to treat conditions associated with capillary rarefaction and muscle weakness.

Could Heat Therapy Be an Effective Treatment for Alzheimer's and Parkinson's Diseases? A Narrative Review

Neurodegenerative diseases involve the progressive deterioration of structures within the central nervous system responsible for motor control, cognition, and autonomic function. Alzheimer's disease and Parkinson's disease are among the most common neurodegenerative disease and have an increasing prevalence over the age of 50. Central in the pathophysiology of these neurodegenerative diseases is the loss of protein homeostasis, resulting in misfolding and aggregation of damaged proteins. An element of the protein homeostasis network that prevents the dysregulation associated with neurodegeneration is the role of molecular chaperones. Heat shock proteins (HSPs) are chaperones that regulate the aggregation and disaggregation of proteins in intracellular and extracellular spaces, and evidence supports their protective effect against protein aggregation common to neurodegenerative diseases. Consequently, upregulation of HSPs, such as HSP70, may be a target for therapeutic intervention for protection against neurodegeneration. A novel therapeutic intervention to increase the expression of HSP may be found in heat therapy and/or heat acclimation. In healthy populations, these interventions have been shown to increase HSP expression. Elevated HSP may have central therapeutic effects, preventing or reducing the toxicity of protein aggregation, and/or peripherally by enhancing neuromuscular function. Broader physiological responses to heat therapy have also been identified and include improvements in muscle function, cerebral blood flow, and markers of metabolic health. These outcomes may also have a significant benefit for people with neurodegenerative disease. While there is limited research into body warming in patient populations, regular passive heating (sauna bathing) has been associated with a reduced risk of developing neurodegenerative disease. Therefore, the emerging evidence is compelling and warrants further investigation of the potential benefits of heat acclimation and passive heat therapy for sufferers of neurodegenerative diseases.