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Comparing Exertional Heat Illness Risk Factors Between Patients and Controls

Completed
Conditions
Exertional Heat Illness
Interventions
Other: Heat Tolerance Assessment
Registration Number
NCT05303142
Lead Sponsor
University of Portsmouth
Brief Summary

The arduous nature of military training and operations require personnel to encounter high heat load, e.g., during intense physical exertion, particularly in the heat. These conditions reduce operational effectiveness and expose personnel to a risk of incapacitation and death from exertional heat illness (EHI). The primary aim of this study is to compare putative 'chronic' EHI risk factors between a cohort who have suffered a history of EHI and a control cohort with no EHI history. The secondary aim is to examine the influence of these EHI risk factors on thermoregulation during a standard heat tolerance assessment.

Detailed Description

Military training and operations present a risk of incapacitation and death from Exertional Heat Illness (EHI). However, widely accepted EHI risk factors are absent in almost half of all United Kingdom (UK) military EHI cases, indicating that a significant number of EHI cases in military personnel involve alternative risk factors. Risk factors for EHI can been classified along a spectrum ranging from acute (e.g. recent poor sleep) to chronic (e.g. low fitness), with the role of chronic risk factors supported by the observation that individuals who have suffered an EHI are at a substantially increased risk of subsequent EHI. The primary aim of this study is to compare putative 'chronic' EHI risk factors (e.g. composition of gastrointestinal (GI) microbiome, infection and inflammation, trait-like psychological factors) between a cohort who have suffered a history of EHI and a control cohort with no EHI history. The secondary aim is to examine the influence of these EHI risk factors on thermoregulation during a standard heat tolerance assessment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
95
Inclusion Criteria

Individuals with a history of EHI:

  • Previous EHI episode
  • Normal resting ECG
  • Male or female
  • 18 - 40 years

Control participants:

  • No previous history of EHI
  • Normal resting ECG
  • Male or female
  • 18 - 40 years
Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Control participants without a history of EHIHeat Tolerance AssessmentMatched control participants with no history of EHI. They will be matched to the experimental group for parameters that are known to influence thermoregulatory responses to exercise heat-stress. 1. Relative aerobic fitness (V̇O2max; ml∙kg-1∙min-1) 2. Body mass (kg) 3. Body surface area (m2) 4. Age 5. Sex
Individuals with a history of EHIHeat Tolerance AssessmentService personnel who have a history of EHI.
Primary Outcome Measures
NameTimeMethod
Circulating ZonulinBaseline

Measured using ELISA

Diversity of gastrointestinal microbiotaBaseline

Measured in stool sample. Assessed by beta diversity score.

Circulating Interleukin 6Post Heat Tolerance Assessment (within 15 minutes of test end)

Measured using ELISA

Abundance of gastrointestinal microbiotaBaseline

Measured in stool sample. Assessed at level of phylum.

Detection of sexually transmitted pathogensBaseline

Assessed from urine sample. Measured using cobas CT/NG assays.

Detection of respiratory pathogensBaseline

Assessed from throat swab. Measured using Allplex assays.

Detection of gastrointestinal pathogensBaseline

Assessed from stool swab. Measured using Allplex.

Circulating Claudin 3Post Heat Tolerance Assessment (within 15 minutes of test end)

Measured using ELISA

Circulating C-Reactive ProteinPost Heat Tolerance Assessment (within 15 minutes of test end)

Measured using ELISA

Circulating lipopolysaccharide binding proteinPost Heat Tolerance Assessment (within 15 minutes of test end)

Measured using ELISA

Circulating intestinal fatty acid binding proteinPost Heat Tolerance Assessment (within 15 minutes of test end)

Measured using ELISA

Gastrointestinal illness symptomology questionnaireImmediately post Heat Tolerance Assessment

Visual analogue scale (0-10). Higher scores indicate worse symptomology

Respiratory illness symptomology, measured by Jackson common cold questionnaireBaseline

Higher scores indicate worse symptomology

Sleep quality and quantity, measured by Pittsburgh Sleep Quality IndexBaseline -3 days

Higher scores indicate worse sleep

Motivation, measured by Motivation scaleBaseline -3 days
State-trait anxiety, measured by state-trait anxiety inventory form Y-2Baseline -3 days
Risk taking, measured by the risk-taking inventoryBaseline -3 days
Stress, measured by perceived stress scaleBaseline -3 days
Mental readinessBaseline

Visual analogue scale (0-100). Higher scores indicate a lower state of mental readiness.

StressBaseline

Visual analogue scale (0-100). Higher scores indicate a greater state of stress.

Resilience, measured by the Connor-Davidson resilience scaleBaseline -3 days
Core temperatureRate of rise from 30 to 60 minutes (or test termination if earlier) of Heat Tolerance Assessment

Measured using a rectal thermistor.

Secondary Outcome Measures
NameTimeMethod
Heat rateAt 5 minute intervals during the Heat Tolerance Assessment
Sweat rateDuring Heat Tolerance Assessment

Determined from change in nude body mass during the heat tolerance assessment

Rating of Perceived ExertionAt 15 minute intervals during Heat Tolerance Assessment

6-20 Borg scale. Higher scores indicate higher perceived exertion

Skin TemperatureDuring Heat Tolerance Assessment

Weighted mean skin temperature

Thermal comfortAt 15 minute intervals during Heat Tolerance Assessment

Modified 9 point Gagge scale. Higher scores indicate worse comfort.

Thermal sensationAt 15 minute intervals during Heat Tolerance Assessment

Modified 9 point Gagge scale. Higher scores indicate hotter sensation

Trial Locations

Locations (1)

University of Portsmouth

🇬🇧

Portsmouth, Hampshire, United Kingdom

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