Journal of sport and health science · 2026
Thermophysiological response of adults to long-distance running in different ACSM environmental risk conditions: A systematic review and meta-analysis.
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Blackman Chelsea, Bellenger Clint, Périard Julien, Wakim Daniel, Chalmers Samuel
Аннотация
BACKGROUND: The American College of Sports Medicine (ACSM) provides recommendations for exertional heat illness risk assessment in different environmental conditions. The objectives of this study were to explore the thermal and cardiovascular responses of individuals performing self-paced running time trials equal to or greater than 5 km in different environmental risk categories, as determined by the ACSM extreme heat policy.
METHODS: MEDLINE, PubMed, Scopus, and SPORTDiscus were systematically searched. Eligible studies included self-paced running (of at least 5 km) and reported core temperature and environmental conditions. Studies were sub-grouped according to the ACSM risk categorization (low/green (≤22.2°C Wet-bulb globe temperature (WBGT)), moderate/yellow (22.3‒25.6°C, WBGT), high/orange (25.7‒27.8°C, WBGT), or very-high/red (≥27.9°C, WBGT)). Meta-analyses (for each risk category) for pooled aggregate data were conducted using the common-effect inverse-variance model followed by a meta-regression to identify statistical differences between the risk categories.
RESULTS: Forty-three studies (48 participant groups) were included with environmental risk conditions ranging from low, moderate, high, and very-high. The high-risk category had the highest end core temperature (39.50°C; 95% confidence interval (95%CI): 39.44‒39.55°C), although only the low and high risk groups were significantly different (p = 0.026). Skin temperature was significantly greater in all risk groups when compared to low risk (all p ≤ 0.008) and highest in the very-high risk category (35.46°C; 95%CI: 35.38‒35.55°C). High risk resulted in a significantly greater heart rate (185 beats/min; 95%CI: 184‒186 beats/min; p = 0.022) than moderate (181 beats/min; 95%CI: 180-182 beats/min) risk. Percentage body mass loss was highest in the very-high risk group (1.8%; 95%CI: 1.7-1.9%), but there was not a significant difference between the risk groups (all p > 0.05).
CONCLUSION: Descriptive meta-analyses revealed that the thermoregulatory and cardiovascular strain was typically greater in the higher risk categories. However, risk thresholds were not consistently distinct according to the meta-regressions for core temperature, heart rate, % body mass loss, and time-trial performance.
METHODS: MEDLINE, PubMed, Scopus, and SPORTDiscus were systematically searched. Eligible studies included self-paced running (of at least 5 km) and reported core temperature and environmental conditions. Studies were sub-grouped according to the ACSM risk categorization (low/green (≤22.2°C Wet-bulb globe temperature (WBGT)), moderate/yellow (22.3‒25.6°C, WBGT), high/orange (25.7‒27.8°C, WBGT), or very-high/red (≥27.9°C, WBGT)). Meta-analyses (for each risk category) for pooled aggregate data were conducted using the common-effect inverse-variance model followed by a meta-regression to identify statistical differences between the risk categories.
RESULTS: Forty-three studies (48 participant groups) were included with environmental risk conditions ranging from low, moderate, high, and very-high. The high-risk category had the highest end core temperature (39.50°C; 95% confidence interval (95%CI): 39.44‒39.55°C), although only the low and high risk groups were significantly different (p = 0.026). Skin temperature was significantly greater in all risk groups when compared to low risk (all p ≤ 0.008) and highest in the very-high risk category (35.46°C; 95%CI: 35.38‒35.55°C). High risk resulted in a significantly greater heart rate (185 beats/min; 95%CI: 184‒186 beats/min; p = 0.022) than moderate (181 beats/min; 95%CI: 180-182 beats/min) risk. Percentage body mass loss was highest in the very-high risk group (1.8%; 95%CI: 1.7-1.9%), but there was not a significant difference between the risk groups (all p > 0.05).
CONCLUSION: Descriptive meta-analyses revealed that the thermoregulatory and cardiovascular strain was typically greater in the higher risk categories. However, risk thresholds were not consistently distinct according to the meta-regressions for core temperature, heart rate, % body mass loss, and time-trial performance.