Hydration and Cooling Strategies for Paralympic Athletes : Applied Focus: Challenges Athletes May Face at the Upcoming Tokyo Paralympics.

PURPOSE OF REVIEW: Effective thermoregulation is paramount for optimizing athletic performance and minimizing the risk of heat illness when exercising, especially in hot conditions. Para-athletes can face unique challenges in regard to thermoregulation and hydration, especially when travel is involved.

RECENT FINDINGS: For example, athletes with spinal cord injuries (SCI) have an impaired ability to thermoregulate due to a decreased sweat rate and ability to dissipate heat, thus making vigorous activity in the heat a challenge. These factors may put the athlete at risk for the following: dehydration, overheating, heat exhaustion and stroke, an inability to complete training sessions or competition, cramping, and impaired cognitive function/decision-making, which can lead to increased risk for injury. Therefore, fluid and cooling needs should be periodized and individualized according to the athlete's needs and impairment type. Strategies for cooling, and developing hydration plans for para-athletes will be reviewed.