Self-reported effects of warm seasonal temperatures in persons with spinal cord injury

Abstract

Objective

Spinal cord injury (SCI) interrupts motor, sensory, and autonomic pathways, impairing mobility and increasing heat storage during warm seasonal temperatures due to compromised autonomic control of vasodilation and sweating and recognition of body temperature. Thus, persons with SCI are more vulnerable to hyperthermia and its adverse effects. However, information regarding how persons with SCI perceive warmer seasons and whether thermal discomfort during warmer seasons restricts routine activities remains anecdotal.

Design

Cross-sectional, self-report surveys.

Setting

VA Medical Center and Kessler Institute for Rehabilitation.

Participants

Three groups of 50 participants each: tetraplegia, paraplegia, and matched non-SCI controls.

Outcome Measures

Tetraplegia, paraplegia, and control groups responded “yes” or “no” when asked whether warm seasonal temperatures adversely affected comfort or participation in routine activities.

Results

The percentage of responses differed among tetraplegia, paraplegia, and control groups when asked if they required ≥20 min to cool down once overheated (44 vs. 20 vs. 12%; X²= 14.7, P < 0.001), whether heat-related discomfort limited their ability to go outside (62 vs. 34 vs. 32%; X²= 11.5, P = 0.003), if they needed to use a water-mister because of the heat (70 vs. 44 vs. 42%; X²= 9.8, P = 0.008), and if heat-related discomfort limited participation in social activities (40 vs. 20 vs. 16%; X²= 8.7, P = 0.01).

Conclusion

Warmer seasonal temperatures had a greater negative impact on reported comfort and daily activities of persons with SCI than non-SCI controls. Those with tetraplegia were most adversely affected. Our findings warrant increasing awareness and identifying interventions to address the vulnerability of persons with SCI to hyperthermia.

Keywords:

• Spinal cord injuries
• Quality of life
• Hyperthermia
• Body temperature regulation
• Tetraplegia

Acknowledgements

The authors would like to thank all our study participants for their time and effort and acknowledge the research staff of the VA RR&D National Center for Medical Consequences of Spinal Cord Injury, the Kessler Foundation, and the Kessler Institute for Rehabilitation for their contributions. We would also like to thank Dr. James B. Post and Ms. Melissa Veale at the James J. Peters Veterans Affairs Medical Center for their invaluable feedback during the construction of our thermal survey questions. We would like to acknowledge Zhen Ni Guan, PT, DPT, John Nulty, PT, DPT, MS, OCS, Marin Graham, PT, DPT and Patricia P. Leung, PT, DPT for their assistance in aspects of data collection for this study.

Disclaimer statements

Contributors None.

Funding Funding This study was supported by the Veterans Affairs Rehabilitation Research & Development Service, National Center for the Medical Consequences of Spinal Cord Injury (#B-2020C). We also wish to thank the James J. Peters Veterans Affairs Medical Center, Bronx, NY for their support.

Conflicts of interest No potential conflict of interest was reported by the author(s).