{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:43:38Z","timestamp":1791413018352,"version":"4.3.3"},"reference-count":41,"publisher":"National Athletic Trainers' Association","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Context:\u2003<\/jats:title>\n                    <jats:p>Ideal and acceptable cooling rates in hyperthermic athletes have been established in average-sized participants. Football linemen (FBs) have a small body surface area (BSA)-to-mass ratio compared with smaller athletes, which hinders heat dissipation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:\u2003<\/jats:title>\n                    <jats:p>To determine cooling rates using cold-water immersion in hyperthermic FBs and cross-country runners (CCs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:\u2003<\/jats:title>\n                    <jats:p>Cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:\u2003<\/jats:title>\n                    <jats:p>Controlled university laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients or Other Participants:\u2003<\/jats:title>\n                    <jats:p>Nine FBs (age = 21.7 \u00b1 1.7 years, height = 188.7 \u00b1 4 cm, mass = 128.1 \u00b1 18 kg, body fat = 28.9% \u00b1 7.1%, lean body mass [LBM] = 86.9 \u00b1 19 kg, BSA = 2.54 \u00b1 0.13 m2, BSA\/mass = 201 \u00b1 21.3 cm2\/kg, and BSA\/LBM = 276.4 \u00b1 19.7 cm2\/kg) and 7 CCs (age = 20 \u00b1 1.8 years, height = 176 \u00b1 4.1 cm, mass = 68.7 \u00b1 6.5 kg, body fat = 10.2% \u00b1 1.6%, LBM = 61.7 \u00b1 5.3 kg, BSA = 1.84 \u00b1 0.1 m2, BSA\/mass = 268.3 \u00b1 11.7 cm2\/kg, and BSA\/LBM = 298.4 \u00b1 11.7 cm2\/kg).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention(s):\u2003<\/jats:title>\n                    <jats:p>Participants ingested an intestinal sensor, exercised in a climatic chamber (39\u00b0C, 40% relative humidity) until either target core temperature (Tgi) was 39.5\u00b0C or volitional exhaustion was reached, and were immediately immersed in a 10\u00b0C circulated bath until Tgi declined to 37.5\u00b0C. A general linear model repeated-measures analysis of variance and independent t tests were calculated, with P &amp;lt; .05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s):\u2003<\/jats:title>\n                    <jats:p>Physical characteristics, maximal Tgi, time to reach 37.5\u00b0C, and cooling rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:\u2003<\/jats:title>\n                    <jats:p>Physical characteristics were different between groups. No differences existed in environmental measures or maximal Tgi (FBs = 39.12\u00b0C \u00b1 0.39\u00b0C, CCs = 39.38\u00b0C \u00b1 0.19\u00b0C; P = .12). Cooling times required to reach 37.5\u00b0C (FBs = 11.4 \u00b1 4 minutes, CCs = 7.7 \u00b1 0.06 minutes; P &amp;lt; .002) and therefore cooling rates (FBs = 0.156\u00b0C\u00b7min\u22121 \u00b1 0.06\u00b0C\u00b7min\u22121, CCs = .255\u00b0C\u00b7min\u22121 \u00b1 0.05\u00b0C\u00b7min\u22121; P &amp;lt; .002) were different. Strong correlations were found between cooling rate and body mass (r = \u22120.76, P &amp;lt; .001), total BSA (r = \u22120.74, P &amp;lt; .001), BSA\/mass (r = 0.73, P &amp;lt; .001), LBM\/mass (r = 0.72, P &amp;lt; .002), and LBM (r = \u22120.72, P &amp;lt; .002).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:\u2003<\/jats:title>\n                    <jats:p>With cold-water immersion, the cooling rate in CCs (0.255\u00b0C\u00b7min\u22121) was greater than in FBs (0.156\u00b0C\u00b7min\u22121); however, both were considered ideal (\u22650.155\u00b0C\u00b7min\u22121). Athletic trainers should realize that it likely takes considerably longer to cool large hyperthermic American-football players (&amp;gt;11 minutes) than smaller, leaner athletes (7.7 minutes). Cooling rates varied widely from 0.332\u00b0C\u00b7min\u22121 in a small runner to only 0.101\u00b0C\u00b7min\u22121 in a lineman, supporting the use of rectal temperature for monitoring during cooling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4085\/1062-6050-52.7.08","type":"journal-article","created":{"date-parts":[[2017,9,22]],"date-time":"2017-09-22T13:12:16Z","timestamp":1506085936000},"page":"902-909","source":"Crossref","is-referenced-by-count":9,"title":["Cold-Water Immersion Cooling Rates in Football Linemen and Cross-Country Runners With Exercise-Induced Hyperthermia"],"prefix":"10.4085","volume":"52","author":[{"given":"Sandra Fowkes","family":"Godek","sequence":"first","affiliation":[{"name":"The HEAT Institute of West Chester University, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine E.","family":"Morrison","sequence":"first","affiliation":[{"name":"The HEAT Institute of West Chester University, 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Chapel Hill, NC: National Center for Catastrophic Sport Injury Research;2014."},{"issue":"4","key":"2020060411282835300_i1062-6050-52-10-902-b16","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/S0735-6757(96)90048-0","article-title":"Whole-body cooling of hyperthermic runners: comparison of two field therapies","volume":"14","author":"Armstrong","year":"1996","journal-title":"Am J Emerg Med"},{"issue":"1","key":"2020060411282835300_i1062-6050-52-10-902-b17","doi-asserted-by":"crossref","first-page":"84","DOI":"10.4085\/1062-6050-44.1.84","article-title":"Acute whole-body cooling for exercise-induced hyperthermia: a systematic review","volume":"44","author":"McDermott","year":"2009","journal-title":"J Athl Train"},{"issue":"2","key":"2020060411282835300_i1062-6050-52-10-902-b18","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1249\/MSS.0000000000000409","article-title":"Effectiveness of cold water immersion in the treatment of exertional heat stroke at the 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Nutr Exerc Metab"},{"key":"2020060411282835300_i1062-6050-52-10-902-b31","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1001\/archinte.1916.00080130010002","article-title":"A formula to estimate the approximate surface area if height and weight be known","volume":"17","author":"DuBois","year":"1916","journal-title":"Arch Intern Medicine"},{"issue":"2","key":"2020060411282835300_i1062-6050-52-10-902-b32","doi-asserted-by":"crossref","first-page":"124","DOI":"10.4085\/1062-6050-44.2.124","article-title":"Validity and reliability of devices that assess body temperature during indoor exercise in the heat","volume":"44","author":"Ganio","year":"2009","journal-title":"J Athl Train"},{"issue":"3","key":"2020060411282835300_i1062-6050-52-10-902-b33","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1152\/jappl.1973.35.3.371","article-title":"Cooling rates of young people swimming in cold water","volume":"35","author":"Sloan","year":"1973","journal-title":"J Appl 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