Comparison of Rectal and Gastrointestinal Core Temperatures During Heat Tolerance Testing

<i>Background and Objectives</i>: Military capability may be reduced in hot environments with individuals at risk of exertional heat stroke (EHS). Heat tolerance testing (HTT) can be used to indicate readiness to return to duty following EHS. HTT traditionally relies on rectal core tempe...

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Main Authors: Melissa J. Crowe, Michael T. Meehan, Rhondda E. Jones
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/6/1111
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author Melissa J. Crowe
Michael T. Meehan
Rhondda E. Jones
author_facet Melissa J. Crowe
Michael T. Meehan
Rhondda E. Jones
author_sort Melissa J. Crowe
collection DOAJ
description <i>Background and Objectives</i>: Military capability may be reduced in hot environments with individuals at risk of exertional heat stroke (EHS). Heat tolerance testing (HTT) can be used to indicate readiness to return to duty following EHS. HTT traditionally relies on rectal core temperature (T<sub>re</sub>) assessment via a rectal probe. This study investigated the use of gastrointestinal core temperature (T<sub>gi</sub>) as an alternative to T<sub>re</sub> during HTT. A secondary aim was to compare physiological factors between heat-tolerant and heat-intolerant trials. <i>Materials and Methods</i>: Australian Defence Force personnel undergoing HTT following known or suspected heat stroke volunteered (<i>n</i> = 23 cases participating in 26 trials) along with 14 controls with no known heat illness history. Confusion matrices enabled comparison of HTT outcome based on T<sub>gi</sub> and T<sub>re</sub>. The validity of T<sub>gi</sub> compared to T<sub>re</sub> during HTT was assessed using correlation and bias. Comparisons between heat-tolerant and intolerant trials were performed using non-parametric tests. <i>Results</i>: Although T<sub>gi</sub> correlated closely with T<sub>re</sub> (Spearman’s rank correlation <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>ρ</mi></mrow></semantics></math></inline-formula> = 0.893; median bias 0.2 °C) there was no consistent pattern in the differences between measures. Importantly, the two measures only agreed on heat tolerance outcome in 80% of trials with T<sub>gi</sub> failing to detect heat intolerance identified by T<sub>re</sub> in 6 of 8 trials. If T<sub>gi</sub> was relied upon for diagnostic outcome, return to duty may occur before full recovery. None of the assessed covariates were related to the difference between T<sub>re</sub> and T<sub>gi</sub>. In addition, resting heart rate and systolic blood pressure were significantly lower and body surface area to mass ratio significantly higher in heat-tolerant compared to intolerant trials. <i>Conclusions</i>: It is not recommended to rely on T<sub>gi</sub> instead of T<sub>re</sub> during HTT. Resting heart rate and systolic blood pressure findings point to the importance of aerobic exercise in conveying heat tolerance along with body composition.
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spelling doaj-art-b40cb753029e418c866429a3100dc35c2025-08-20T03:27:21ZengMDPI AGMedicina1010-660X1648-91442025-06-01616111110.3390/medicina61061111Comparison of Rectal and Gastrointestinal Core Temperatures During Heat Tolerance TestingMelissa J. Crowe0Michael T. Meehan1Rhondda E. Jones2College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, AustraliaCollege of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, AustraliaTropical Australian Academic Health Centre, Townsville, QLD 4811, Australia<i>Background and Objectives</i>: Military capability may be reduced in hot environments with individuals at risk of exertional heat stroke (EHS). Heat tolerance testing (HTT) can be used to indicate readiness to return to duty following EHS. HTT traditionally relies on rectal core temperature (T<sub>re</sub>) assessment via a rectal probe. This study investigated the use of gastrointestinal core temperature (T<sub>gi</sub>) as an alternative to T<sub>re</sub> during HTT. A secondary aim was to compare physiological factors between heat-tolerant and heat-intolerant trials. <i>Materials and Methods</i>: Australian Defence Force personnel undergoing HTT following known or suspected heat stroke volunteered (<i>n</i> = 23 cases participating in 26 trials) along with 14 controls with no known heat illness history. Confusion matrices enabled comparison of HTT outcome based on T<sub>gi</sub> and T<sub>re</sub>. The validity of T<sub>gi</sub> compared to T<sub>re</sub> during HTT was assessed using correlation and bias. Comparisons between heat-tolerant and intolerant trials were performed using non-parametric tests. <i>Results</i>: Although T<sub>gi</sub> correlated closely with T<sub>re</sub> (Spearman’s rank correlation <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>ρ</mi></mrow></semantics></math></inline-formula> = 0.893; median bias 0.2 °C) there was no consistent pattern in the differences between measures. Importantly, the two measures only agreed on heat tolerance outcome in 80% of trials with T<sub>gi</sub> failing to detect heat intolerance identified by T<sub>re</sub> in 6 of 8 trials. If T<sub>gi</sub> was relied upon for diagnostic outcome, return to duty may occur before full recovery. None of the assessed covariates were related to the difference between T<sub>re</sub> and T<sub>gi</sub>. In addition, resting heart rate and systolic blood pressure were significantly lower and body surface area to mass ratio significantly higher in heat-tolerant compared to intolerant trials. <i>Conclusions</i>: It is not recommended to rely on T<sub>gi</sub> instead of T<sub>re</sub> during HTT. Resting heart rate and systolic blood pressure findings point to the importance of aerobic exercise in conveying heat tolerance along with body composition.https://www.mdpi.com/1648-9144/61/6/1111exertional heat illnessheat tolerancebody temperaturegastrointestinal tractmilitary
spellingShingle Melissa J. Crowe
Michael T. Meehan
Rhondda E. Jones
Comparison of Rectal and Gastrointestinal Core Temperatures During Heat Tolerance Testing
Medicina
exertional heat illness
heat tolerance
body temperature
gastrointestinal tract
military
title Comparison of Rectal and Gastrointestinal Core Temperatures During Heat Tolerance Testing
title_full Comparison of Rectal and Gastrointestinal Core Temperatures During Heat Tolerance Testing
title_fullStr Comparison of Rectal and Gastrointestinal Core Temperatures During Heat Tolerance Testing
title_full_unstemmed Comparison of Rectal and Gastrointestinal Core Temperatures During Heat Tolerance Testing
title_short Comparison of Rectal and Gastrointestinal Core Temperatures During Heat Tolerance Testing
title_sort comparison of rectal and gastrointestinal core temperatures during heat tolerance testing
topic exertional heat illness
heat tolerance
body temperature
gastrointestinal tract
military
url https://www.mdpi.com/1648-9144/61/6/1111
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