预降温对高温环境下体能训练者生理指标和运动效能影响的Meta分析

Effects of precooling on physiological indicators and exercise performance in aerobic athletes: A meta-analysis

  • 摘要:
      背景  高温环境下持续有氧运动可增加中暑和受伤的风险,预降温成为研究热点。
      目的  系统评价预降温对高温环境下体能训练者生理指标与运动效能的影响,为军事体能训练预降温策略的制定提供依据。
      方法  采用主题词与自由词检索相组合的方式,在PubMed、The Cochrane Library、Elsevier、Embase、Web of Science、Scopus、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库等中英文数据库中检索文献,根据纳入和排除标准筛选文献、提取数据,并采用PEDro量表完成文献质量评价。运用Stata16.0软件对数据进行Meta分析。
      结果  最终纳入15篇英文文献、2篇中文文献,质量评分为6.2 ± 0.4。共纳入333例研究对象,男性238例、女性95例,15项研究显示年龄为20 ~ 32.6岁、1项年龄为18 ~ 35岁、1项未提及年龄,均为无热习服的长期运动人员。预降温与无降温运动后心率值比较的异质性检验I2=0 (P=0.794),Meta分析结果显示合并效用量MD=-0.25(95% CI:-0.44 ~ -0.07) (Z=-2.662, P=0.008),提示预降温减缓运动后心率升高;预降温与无降温核心体温变化值比较的异质性检验I2=75.2% (P<0.001),Meta分析结果显示合并效用量MD=-1.27(95% CI:-1.85 ~ -0.69) (Z=-4.278, P<0.001),提示预降温对减缓核心体温升高速度有效;预降温与无降温热感觉值比较的异质性检验I2=52.3% (P=0.040),Meta分析结果显示合并效用量-0.31(95% CI:-0.80 ~ 0.18) (Z=-1.233, P=0.217),表明预降温对运动后热感觉值无显著影响;预降温与无降温出汗率比较的异质性检验结果显示I2=71.0% (P<0.001),Meta分析结果显示合并效用量MD=-0.48(95% CI:-0.95 ~ 0) (Z=-1.971, P=0.049),表明预降温对降低运动出汗率影响显著。纳入研究的原始数据显示除3项研究未对运动效能进行评估、1项研究提示预降温差异不明显,其余研究均显示预降温措施对运动效能有促进作用。
      结论  预降温对提高运动成绩与效果、减缓体温升高速率、降低运动中暑发生率与危害性具有一定效果。

     

    Abstract:
      Background  Sustained aerobic exercise in high temperature environments can increase the risk of heat stroke and injury, and precooling has become a hot topic of research.
      Objective  To systematically evaluate the effects of precooling on the physiological indexes and exercise performance of physical trainers in a hyperthermic environment and provide references for the development of precooling strategies for military physical training.
      Methods  A combination of subject-word and free-word search was used to search the literature in Chinese and English databases such as PubMed, The Cochrane Library, Elsevier, Embase, Web of science, Scopus, China Knowledge Network (CNKI), China Biomedical Literature Database (CBM), and Wanfang database. The literature was screened according to the inclusion and exclusion criteria, then the data were extracted, and the PEDro scale was used to complete the literature quality evaluation. The data were meta-analyzed using Stata 16.0 software.
      Results  Totally 15 English articles and 2 Chinese articles with a quality evaluation score of 6.235 ± 0.437 were finally included, with 333 study subjects, 238 males and 95 females, 15 studies showing a mean age of 20-32.6 years, 1 study with age of 18-35 years, and 1 not mentioned, all of whom were long-term exercisers without heat-access clothing. The test of heterogeneity I2 was 0, with P value of 0.794 for the comparison of heart rate values after exercise with precooling or without cooling, and the results of meta-analysis showed a combined utility measure of MD was -0.25 (95% CI: -0.44 to -0.07) (Z=-2.662, P=0.008), suggesting that precooling slowed the increase in heart rate after exercise; the comparison of core body temperature change values between precooling and without cooling by heterogeneity test was I2=75.2% (P<0.001), and meta-analysis showed combined utility of MD=-1.27 (95% CI: -1.85 to -0.69) (Z=-4.278, P<0.001), suggesting that precooling was effective in slowing the rate of increase in core body temperature; Heterogeneity test for comparison of precooling and without cooling thermal sensation showed I2=52.3% (P=0.040), and the results of meta-analysis showed a combined utility of MD=-0.31 (95% CI: -0.80 to 0.18) (Z=-1.233, P=0.217), indicating that the difference between precooling and post-exercise thermal sensation was not statistically significant; the results of the heterogeneity test comparing precooling and no-cooling sweating rate showed I2=71.0% (P<0.001), and meta-analysis results showed a combined utility measure MD= -0.48 (95% CI: -0.95 to 0) (Z=-1.971, P=0.049), indicating a significant effect of precooling on reducing exercise sweat rate. The raw data including in this studies showed that precooling measures contributed to exercise performance except for three studies that did not assess exercise performance and one study that suggested a non-significant difference in precooling.
      Conclusion  Pre-cooling is effective in improving athletic performance and effectiveness, slowing the rate of body temperature increase, and reducing the incidence and hazards of exercise heat stroke.

     

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