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Cold Stress Effects on Exposure Tolerance and Exercise Performance

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ABSTRACT

Cold weather can have deleterious effects on health, tolerance, and performance. This paper will review the physiological responses and external factors that impact cold tolerance and physical performance. Tolerance is defined as the ability to withstand cold stress with minimal changes in physiological strain. Physiological and pathophysiological responses to short‐term (cold shock) and long‐term cold water and air exposure are presented. Factors (habituation, anthropometry, sex, race, and fitness) that influence cold tolerance are also reviewed. The impact of cold exposure on physical performance, especially aerobic performance, has not been thoroughly studied. The few studies that have been done suggest that aerobic performance is degraded in cold environments. Potential physiological mechanisms (decreases in deep body and muscle temperature, cardiovascular, and metabolism) are discussed. Likewise, strength and power are also degraded during cold exposure, primarily through a decline in muscle temperature. The review also discusses the concept of thermoregulatory fatigue, a reduction in the thermal effector responses of shivering and vasoconstriction, as a result of multistressor factors, including exhaustive exercise. © 2016 American Physiological Society. Compr Physiol 6:443‐469, 2016.

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Figure 1. Figure 1. Mechanisms of how cold‐water immersion induces autonomic conflict and cardiac arrhythmias. Dual stimulation of a bradycardic and tachycardic cardiac response caused by the diving and cold shock responses, respectively, places the heart in conflict leading to arrhythmias when breath holding ceases. Arrhythmias are more prevalent in individuals with predisposing factors. The magnitude of these responses can vary due to water temperature, clothing, and cold habituation. Adapted, with permission, from Ref. (212).
Figure 2. Figure 2. Survival time during immersion as a function of water temperature. Below the solid line, survival is likely; above the dashed line, survival is unlikely. The 50% mortality rate is indicated in the space between the two survival curves. Adapted, with permission, from Ref. (182).
Figure 3. Figure 3. WCT Index in Fahrenheit and Celsius. Frostbite times are for exposed facial skin. Top chart is from the U.S. National Weather Service; bottom chart is from the Meteorological Society of Canada/Environment Canada.
Figure 4. Figure 4. Summary of possible mechanisms that impact maximal oxygen uptake and aerobic performance in a cold environment.
Figure 5. Figure 5. Changes in maximal work time, heart rate, and maximal oxygen uptake during combined arm and bicycling exercise as a function of core temperature (esophageal temperature) and muscle (vastus lateralis) temperature. Subjects either swam in cold water (13‐15°C) or pedaled on a cycle ergometer before arm/leg exercise to induce changes in core and muscle temperatures. Adapted, with permission, from Ref. (15).
Figure 6. Figure 6. Muscle blood flow as a function of water temperature during three levels of activity (rest, oxygen uptakes of 1 and 3 L·min−1). Exercise was performed on a bike ergometer. Redrawn, with permission, from Ref. (200).
Figure 7. Figure 7. The effect of cold muscle on the force‐velocity relationship during cycling exercise. Muscle temperature was changed passive exposure to 0 and 46°C water for 30 to 45 min. The leftward shift in the force‐velocity curve in the cold muscle demonstrates that at any given force output, the velocity generated during cycle ergometry is less. Redrawn, with permission, from Ref. (60).
Figure 8. Figure 8. Tissue and skin temperatures associated with decrements in manual dexterity.
Figure 9. Figure 9. The change in metabolic heat production versus mean body temperature before (circles) and after (triangles) 84 h of sleep restriction and energy deficit during 180‐min cold air exposure (10°C). A shift to the left in this relationship suggests a central attenuation of the shivering response due to the multiple stressors. From (36).


Figure 1. Mechanisms of how cold‐water immersion induces autonomic conflict and cardiac arrhythmias. Dual stimulation of a bradycardic and tachycardic cardiac response caused by the diving and cold shock responses, respectively, places the heart in conflict leading to arrhythmias when breath holding ceases. Arrhythmias are more prevalent in individuals with predisposing factors. The magnitude of these responses can vary due to water temperature, clothing, and cold habituation. Adapted, with permission, from Ref. (212).


Figure 2. Survival time during immersion as a function of water temperature. Below the solid line, survival is likely; above the dashed line, survival is unlikely. The 50% mortality rate is indicated in the space between the two survival curves. Adapted, with permission, from Ref. (182).


Figure 3. WCT Index in Fahrenheit and Celsius. Frostbite times are for exposed facial skin. Top chart is from the U.S. National Weather Service; bottom chart is from the Meteorological Society of Canada/Environment Canada.


Figure 4. Summary of possible mechanisms that impact maximal oxygen uptake and aerobic performance in a cold environment.


Figure 5. Changes in maximal work time, heart rate, and maximal oxygen uptake during combined arm and bicycling exercise as a function of core temperature (esophageal temperature) and muscle (vastus lateralis) temperature. Subjects either swam in cold water (13‐15°C) or pedaled on a cycle ergometer before arm/leg exercise to induce changes in core and muscle temperatures. Adapted, with permission, from Ref. (15).


Figure 6. Muscle blood flow as a function of water temperature during three levels of activity (rest, oxygen uptakes of 1 and 3 L·min−1). Exercise was performed on a bike ergometer. Redrawn, with permission, from Ref. (200).


Figure 7. The effect of cold muscle on the force‐velocity relationship during cycling exercise. Muscle temperature was changed passive exposure to 0 and 46°C water for 30 to 45 min. The leftward shift in the force‐velocity curve in the cold muscle demonstrates that at any given force output, the velocity generated during cycle ergometry is less. Redrawn, with permission, from Ref. (60).


Figure 8. Tissue and skin temperatures associated with decrements in manual dexterity.


Figure 9. The change in metabolic heat production versus mean body temperature before (circles) and after (triangles) 84 h of sleep restriction and energy deficit during 180‐min cold air exposure (10°C). A shift to the left in this relationship suggests a central attenuation of the shivering response due to the multiple stressors. From (36).
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John W. Castellani, Michael J. Tipton. Cold Stress Effects on Exposure Tolerance and Exercise Performance. Compr Physiol 2015, 6: 443-469. doi: 10.1002/cphy.c140081