{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:34:50Z","timestamp":1793385290628,"version":"4.5.0"},"reference-count":37,"publisher":"National Athletic Trainers' Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:sec>\n          <jats:title>Objective:<\/jats:title>\n          <jats:p>To assess existing original research addressing the efficiency of whole-body cooling modalities in the treatment of exertional hyperthermia.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Data Sources:<\/jats:title>\n          <jats:p>During April 2007, we searched MEDLINE, EMBASE, Scopus, SportDiscus, CINAHL, and Cochrane Reviews databases as well as ProQuest for theses and dissertations to identify research studies evaluating whole-body cooling treatments without limits. Key words were <jats:italic>cooling<\/jats:italic>, <jats:italic>cryotherapy<\/jats:italic>, <jats:italic>water immersion<\/jats:italic>, <jats:italic>cold-water immersion<\/jats:italic>, <jats:italic>ice-water immersion<\/jats:italic>, <jats:italic>icing<\/jats:italic>, <jats:italic>fanning<\/jats:italic>, <jats:italic>bath<\/jats:italic>, <jats:italic>baths<\/jats:italic>, <jats:italic>cooling modality<\/jats:italic>, <jats:italic>heat illness<\/jats:italic>, <jats:italic>heat illnesses<\/jats:italic>, <jats:italic>exertional heatstroke<\/jats:italic>, <jats:italic>exertional heat stroke<\/jats:italic>, <jats:italic>heat exhaustion<\/jats:italic>, <jats:italic>hyperthermia<\/jats:italic>, <jats:italic>hyperthermic<\/jats:italic>, <jats:italic>hyperpyrexia<\/jats:italic>, <jats:italic>exercise<\/jats:italic>, <jats:italic>exertion<\/jats:italic>, <jats:italic>running<\/jats:italic>, <jats:italic>football<\/jats:italic>, <jats:italic>military<\/jats:italic>, <jats:italic>runners<\/jats:italic>, <jats:italic>marathoner<\/jats:italic>, <jats:italic>physical activity<\/jats:italic>, <jats:italic>marathoning<\/jats:italic>, <jats:italic>soccer<\/jats:italic>, and <jats:italic>tennis<\/jats:italic>.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Data Synthesis:<\/jats:title>\n          <jats:p>Two independent reviewers graded each study on the Physiotherapy Evidence Database (PEDro) scale. Seven of 89 research articles met all inclusion criteria and a minimum score of 4 out of 10 on the PEDro scale.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Conclusions:<\/jats:title>\n          <jats:p>After an extensive and critical review of the available research on whole-body cooling for the treatment of exertional hyperthermia, we concluded that ice-water immersion provides the most efficient cooling. Further research comparing whole-body cooling modalities is needed to identify other acceptable means. When ice-water immersion is not possible, continual dousing with water combined with fanning the patient is an alternative method until more advanced cooling means can be used. Until future investigators identify other acceptable whole-body cooling modalities for exercise-induced hyperthermia, ice-water immersion and cold-water immersion are the methods proven to have the fastest cooling rates.<\/jats:p>\n        <\/jats:sec>","DOI":"10.4085\/1062-6050-44.1.84","type":"journal-article","created":{"date-parts":[[2009,12,30]],"date-time":"2009-12-30T15:36:44Z","timestamp":1262187404000},"page":"84-93","source":"Crossref","is-referenced-by-count":199,"title":["Acute Whole-Body Cooling for Exercise-Induced Hyperthermia: A Systematic Review"],"prefix":"10.4085","volume":"44","author":[{"given":"Brendon P.","family":"McDermott","sequence":"first","affiliation":[{"name":"University of Connecticut, Storrs, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas J.","family":"Casa","sequence":"additional","affiliation":[{"name":"University of Connecticut, Storrs, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew S.","family":"Ganio","sequence":"additional","affiliation":[{"name":"University of Connecticut, Storrs, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca M.","family":"Lopez","sequence":"additional","affiliation":[{"name":"University of Connecticut, Storrs, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan W.","family":"Yeargin","sequence":"additional","affiliation":[{"name":"Indiana State University, Terre Haute, IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence E.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"University of Connecticut, Storrs, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl M.","family":"Maresh","sequence":"additional","affiliation":[{"name":"University of Connecticut, Storrs, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"issue":"3","key":"i1062-6050-44-1-84-McDermott1","series-title":"J Sport Rehabil","first-page":"163","article-title":"Recovery and return to activity following exertional heat stroke: considerations for the sports medicine staff.","volume":"16","author":"McDermott, B. P.","year":"2007","unstructured":"McDermott, B. P., D. J.Casa, M. S.Ganio, S. W.Yeargin, L. E.Armstrong, and C. M.Maresh. Recovery and return to activity following exertional heat stroke: considerations for the sports medicine staff.J Sport Rehabil2007. 16 (3):163\u2013181."},{"issue":"3","key":"i1062-6050-44-1-84-Binkley1","series-title":"J Athl Train","first-page":"329","article-title":"National Athletic Trainers' position statement: exertional heat illnesses.","volume":"37","author":"Binkley, H. M.","year":"2002","unstructured":"Binkley, H. M., J.Beckett, D. J.Casa, D. M.Kleiner, and P. E.Plummer. National Athletic Trainers' position statement: exertional heat illnesses.J Athl Train2002. 37 (3):329\u2013343."},{"issue":"3","key":"i1062-6050-44-1-84-Armstrong1","series-title":"Med Sci Sports Exerc","first-page":"556","article-title":"American College of Sports Medicine position stand: exertional heat illnesses during training and competition.","volume":"39","author":"Armstrong, L. E.","year":"2007","unstructured":"Armstrong, L. E., D. J.Casa, D.Millard-Stafford, D.Moran, S. W.Pyne, and W. O.Roberts. American College of Sports Medicine position stand: exertional heat illnesses during training and competition.Med Sci Sports Exerc2007. 39 (3):556\u2013572."},{"key":"i1062-6050-44-1-84-Casa1","series-title":"NATA News","first-page":"24","article-title":"Inter-Association Task Force on Exertional Heat Illnesses consensus statement.","author":"Casa, D. J.","year":"2003","unstructured":"Casa, D. J., J.Almquist, S.Anderson, et al. Inter-Association Task Force on Exertional Heat Illnesses consensus statement.NATA News62003. 24\u201329."},{"issue":"6","key":"i1062-6050-44-1-84-Casa2","series-title":"Curr Sports Med Rep","first-page":"309","article-title":"Exertional heat stroke in competitive athletes.","volume":"4","author":"Casa, D. J.","year":"2005","unstructured":"Casa, D. J., L. E.Armstrong, M. S.Ganio, and S. W.Yeargin. Exertional heat stroke in competitive athletes.Curr Sports Med Rep2005. 4 (6):309\u2013317."},{"key":"i1062-6050-44-1-84-Casa3","series-title":"Exertional Heat Illnesses","first-page":"29","article-title":"Exertional heatstroke: a medical emergency.","author":"Casa, D. J.","year":"2003","unstructured":"Casa, D. J. and L. E.Armstrong. Exertional heatstroke: a medical emergency.In:Armstrong, L. E.Exertional Heat Illnesses. Champaign, IL:Human Kinetics. 2003. 29\u201356."},{"issue":"3","key":"i1062-6050-44-1-84-Casa4","series-title":"J Strength Cond Res","first-page":"462","article-title":"Survival strategy: acute treatment of exertional heat stroke.","volume":"20","author":"Casa, D. J.","year":"2006","unstructured":"Casa, D. J., J. M.Anderson, L. E.Armstrong, and C. M.Maresh. 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Accessed April 8, 2007."},{"issue":"4","key":"i1062-6050-44-1-84-Armstrong2","series-title":"Am J Emerg Med","first-page":"355","article-title":"Whole-body cooling of hyperthermic runners: comparison of two field therapies.","volume":"14","author":"Armstrong, L. E.","year":"1996","unstructured":"Armstrong, L. E., A. E.Crago, R.Adams, W. O.Roberts, and C. M.Maresh. Whole-body cooling of hyperthermic runners: comparison of two field therapies.Am J Emerg Med1996. 14 (4):355\u2013358."},{"issue":"6","key":"i1062-6050-44-1-84-Kielblock1","series-title":"S Afr Med J","first-page":"378","article-title":"Body cooling as a method for reducing hyperthermia: an evaluation of techniques.","volume":"69","author":"Kielblock, A. J.","year":"1986","unstructured":"Kielblock, A. J., J. P.Van Rensburg, and R. M.Franz. 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Ice-water immersion and cold-water immersion provide similar cooling rates in runners with exercise-induced hyperthermia.J Athl Train2002. 37 (2):146\u2013150."},{"issue":"4","key":"i1062-6050-44-1-84-Proulx1","series-title":"J Appl Physiol","first-page":"1317","article-title":"Effect of water temperature on cooling efficiency during hyperthermia in humans.","volume":"94","author":"Proulx, C. I.","year":"2003","unstructured":"Proulx, C. I., M. B.Ducharme, and G. P.Kenny. Effect of water temperature on cooling efficiency during hyperthermia in humans.J Appl Physiol2003. 94 (4):1317\u20131323."},{"issue":"11","key":"i1062-6050-44-1-84-Scott1","series-title":"Aviat Space Environ Med","first-page":"956","article-title":"Warming by immersion or exercise affects initial cooling rate during subsequent cold water immersion.","volume":"75","author":"Scott, C. G.","year":"2004","unstructured":"Scott, C. G., M. B.Ducharme, F.Haman, and G. P.Kenny. Warming by immersion or exercise affects initial cooling rate during subsequent cold water immersion.Aviat Space Environ Med2004. 75 (11):956\u2013963."},{"issue":"2","key":"i1062-6050-44-1-84-Clapp1","series-title":"J Sci Med Sport","first-page":"160","article-title":"Rapid cooling techniques in joggers experiencing heat strain.","volume":"4","author":"Clapp, A. J.","year":"2001","unstructured":"Clapp, A. J., P. A.Bishop, I.Muir, and J. L.Walker. Rapid cooling techniques in joggers experiencing heat strain.J Sci Med Sport2001. 4 (2):160\u2013167."},{"issue":"10","key":"i1062-6050-44-1-84-Hart1","series-title":"Can Med Assoc J","first-page":"1146","article-title":"Exertional heat stroke: the runner's nemesis.","volume":"122","author":"Hart, L. E.","year":"1980","unstructured":"Hart, L. E., B. P.Egier, A. G.Shimizu, P. J.Tandan, and J. R.Sutton. 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