Abstract
This experiment investigates the validity of six thermometers with different measuring sensors, operation and site of application, to estimate core temperature (Tc) in comparison to an ingestible thermometric sensor based on quartz crystal technology. Measurements were obtained before, during and after exercise in the heat, controlling the presence of air-cooling and skin sweating. Twelve well-trained men swallowed the ingestible thermometer 6 h before the trial. After pre-exercise resting measurements at 20 °C, subjects entered a heat chamber held at 40 °C. Exercise in the heat consisted of 60 min of pedalling on cycle ergometer at 90% of the individually determined first ventilatory threshold. Results reveal that wind and skin sweat invalidate the use of skin infrared thermometry to estimate Tc during exercise in the heat. However, better Tc estimations were obtained in wind-restricted situations. We detected important differences between same-technology devices but different models and brands. In conclusion, there are important limitations to assess Tc accurately using non-invasive thermometers during and after exercise in the heat. Because some devices showed better validity than others did, we recommended using tympanic Braun®, and non-contact skin infrared Medisana® or Visiofocus® in wind-restricted and no sweat conditions to estimate Tc during exercise in the heat.
Similar content being viewed by others
References
Bach, A. J. E., I. B. Stewart, A. E. Disher, and J. T. Costello. A comparison between conductive and infrared devices for measuring mean skin temperature at rest, during exercise in the heat, and recovery. PLoS ONE 10:e0117907, 2015.
Bach, A. J. E., I. B. Stewart, G. M. Minett, and J. T. Costello. Does the technique employed for skin temperature assessment alter outcomes? A systematic review. Physiol Meas 36:R27–R51, 2015.
Bernard, V., E. Staffa, V. Mornstein, and A. Bourek. Infrared camera assessment of skin surface temperature—effect of emissivity. Phys Med 29:583–591, 2013.
Bland, J. M., and D. G. Altman. Agreement between methods of measurement with multiple observations per individual. J Biopharm Stat 17:517–582, 2007.
Casa, D. J., S. M. Becker, M. S. Ganio, C. M. Brown, S. W. Yeargin, M. W. Roti, J. Siegler, J. A. Blowers, N. R. Glaviano, R. A. Huggins, L. E. Armstrong, and C. M. Maresh. Validity of devices that assess body temperature during outdoor exercise in the heat. J Athl Train 42:333–342, 2007.
Casa, D. J., J. K. DeMartini, M. F. Bergeron, D. Csillan, E. R. Eichner, R. M. Lopez, M. S. Ferrara, K. C. Miller, F. O’Connor, M. N. Sawka, and S. W. Yeargin. National Athletic Trainers’ association position statement: Exertional heat illnesses. J Athl Train 50:986–1000, 2015.
Coso, J. D., R. Aguado-Jimenez, and R. Mora-Rodriguez. Infrared tympanic thermometry in a hot environment. Int J Sports Med 29:713–718, 2008.
Daanen, H. A. M., S. Racinais, and J. D. Périard. Heat acclimation decay and re-induction: A systematic review and meta-analysis. Sport Med 48:409–430, 2018.
de Andrade Fernandes, A., P. R. dos Santos Amorim, C. J. Brito, A. G. de Moura, D. G. Moreira, C. M. A. Costa, M. Sillero-Quintana, and J. C. B. Marins. Measuring skin temperature before, during and after exercise: A comparison of thermocouples and infrared thermography. Physiol Meas 35:189–203, 2014.
Fernández-Elías, V. E., A. Martínez-Abellán, J. M. López-Gullón, R. Morán-Navarro, J. G. Pallarés, E. De la Cruz-Sánchez, and R. Mora-Rodriguez. Validity of hydration non-invasive indices during the weight cutting and official weigh-in for Olympic combat sports. PLoS ONE 9:e95336, 2014.
Formenti, D., N. Ludwig, M. Gargano, M. Gondola, N. Dellerma, A. Caumo, and G. Alberti. Thermal imaging of exercise-associated skin temperature changes in trained and untrained female subjects. Ann Biomed Eng 41:863–871, 2013.
Ganio, M. S., C. M. Brown, D. J. Casa, S. M. Becker, S. W. Yeargin, B. P. McDermott, L. M. Boots, P. W. Boyd, and L. E. Armstrong. Maresh CM Validity and reliability of devices that asses body temperature during indoor exercise in the heat. J Athel Train 44:124–135, 2009.
Gasim, G. I., I. R. Musa, M. T. Abdien, and I. Adam. Accuracy of tympanic temperature measurement using an infrared tympanic membrane thermometer. BMC Res Notes 6:194, 2013.
Giavarina, D. Understanding bland altman analysis. Biochem Med 25:141–151, 2015.
Hildebrandt, C., C. Raschner, and K. Ammer. An overview of recent application of medical infrared thermography in sports medicine in Austria. Sensors 10:4700–4715, 2010.
Hunt, A. P., A. J. E. Bach, D. N. Borg, J. T. Costello, and I. B. Stewart. The systematic bias of ingestible core temperature sensors requires a correction by linear regression. Front Physiol 8:260, 2017.
Hunt, A. P., D. C. Billing, M. J. Patterson, and J. N. Caldwell. Heat strain during military training activities: The dilemma of balancing force protection and operational capability. Temperature 3:307–317, 2016.
Irwin, R. S., C. M. Lilly, P. H. Mayo, and J. M. Rippe. Irwin and Rippe’s intensive care medicine. New York: Wolters Kluwer, 2018.
James, C. A., A. J. Richardson, P. W. Watt, and N. S. Maxwell. Reliability and validity of skin temperature measurement by telemetry thermistors and a thermal camera during exercise in the heat. J Therm Biol 45:141–149, 2014.
Kistemaker, J., E. Den Hartog, and H. Daanen. Reliability of an infrared forehead skin thermometer for core temperature measurements. J Med Eng Technol 30:252–261, 2006.
Mairiaux, P., J. C. Sagot, and V. Candas. Oral temperature as an index of core temperature during heat transients. Eur J Appl Physiol Occup Physiol 50:331–341, 1983.
Marins, J. C. B., D. G. Moreira, S. P. Cano, M. S. Quintana, D. D. Soares, A. de Andrade Fernandes, F. S. da Silva, C. M. A. Costa, and P. R. dos Santos Amorim. Time required to stabilize thermographic images at rest. Infrared Phys Technol 65:30–35, 2014.
Mora-Rodriguez, R. Influence of aerobic fitness on thermoregulation during exercise in the heat. Exerc Sport Sci Rev 40:79–87, 2012.
Mora-Rodríguez, R., J. G. Pallarés, J. M. López-Gullón, Á. López-Samanes, V. E. Fernández-Elías, and J. F. Ortega. Improvements on neuromuscular performance with caffeine ingestion depend on the time-of-day. J Sci Med Sport 18:338–342, 2015.
Moran, D. S., and L. Mendal. Core temperature measurement. Sport Med 32:879–885, 2002.
Pallarés, J. G., R. Moran-Navarro, J. Fernando Ortega, V. Emilio Fernandez-Elias, and R. Mora-Rodriguez. Validity and reliability of ventilatory and blood lactate thresholds in well-trained cyclists. PLoS ONE 11(9):e0163389, 2016.
Périard, J. D., G. J. S. Travers, S. Racinais, and M. N. Sawka. Cardiovascular adaptations supporting human exercise-heat acclimation. Auton Neurosci 196:52–62, 2016.
Purssell, E., A. While, and B. Coomber. Tympanic thermometry–normal temperature and reliability. Paediatr Nurs 21:40–43, 2009.
Quesada, J. I. Application of infrared thermography in sports science. Cham: Springer, 2017. https://doi.org/10.1007/978-3-319-47410-6.
Quesada, J. I., M. R. Kunzler, and F. P. Carpes. Methodological aspects of infrared thermography in human assessment. In: Application of infrared thermography in sports science, edited by J. I. Quesada. Cham: Springer, 2017, pp. 49–79. https://doi.org/10.1007/978-3-319-47410-6_3.
Quesada, J. I., N. Martínez, R. M. Cibrián, A. Psikuta, S. Annaheim, R. M. Rossi, J. M. Corberán, P. Pérez-Soriano, and R. Salvador. Effect of perspiration on skin temperature measurements by infrared thermography and contact thermometry during aerobic cycling. Infrared Phys Technol 72:68–76, 2015.
Racinais, S., J. M. Alonso, A. J. Coutts, A. D. Flouris, O. Girard, J. González-Alonso, C. Hausswirth, O. Jay, J. K. W. Lee, N. Mitchell, G. P. Nassis, L. Nybo, B. M. Pluim, B. Roelands, M. N. Sawka, J. E. Wingo, and J. D. Périard. Consensus recommendations on training and competing in the heat. Scand J Med Sci Sports 25:6–19, 2015.
Sawka, M. N., L. M. Burke, E. R. Eichner, R. J. Maughan, S. J. Montain, and N. S. Stachenfeld. American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc 39:377–390, 2007.
Sawka, M. N., and K. B. Pandolf. Physical exercise in hot climates: physiology, performance, and biomedical issues. In: Medical aspects of harsh environments. Textbooks of military medicine, edited by K. Pandolf, and R. Burr. Washington, D.C.: Office of the Surgeon General, United States Army, 2001, pp. 87–133.
Steck, L. N., E. M. Sparrow, and J. P. Abraham. Non-invasive measurement of the human core temperature. Int J Heat Mass Transf 54:975–982, 2011.
Stewart, K. J., K. L. Turner, A. C. Bacher, J. R. DeRegis, J. Sung, M. Tayback, and P. Ouyang. Are fitness, activity, and fatness associated with health-related quality of life and mood in older persons? J Cardiopulm Rehabil 23:115–121, 2003.
Taylor, N. A. S., M. J. Tipton, and G. P. Kenny. Considerations for the measurement of core, skin and mean body temperatures. J Therm Biol 46:72–101, 2014.
Teunissen, L. P. J., A. de Haan, J. J. de Koning, and H. A. M. Daanen. Telemetry pill versus rectal and esophageal temperature during extreme rates of exercise-induced core temperature change. Physiol Meas 33:915–924, 2012.
Acknowledgments
We thank José Fajardo Rodríguez and Javier Sánchez Prieto for their excellent technical assistance with laboratory apparatus and assistance to the athletes. We also acknowledge the dedicated effort, commitment and professionalism of the selected group of athletes who took part in this research.
Author information
Authors and Affiliations
Corresponding author
Additional information
Associate Editor Jane Grande-Allen oversaw the review of this article.
Rights and permissions
About this article
Cite this article
Morán-Navarro, R., Courel-Ibáñez, J., Martínez-Cava, A. et al. Validity of Skin, Oral and Tympanic Temperatures During Exercise in the Heat: Effects of Wind and Sweat. Ann Biomed Eng 47, 317–331 (2019). https://doi.org/10.1007/s10439-018-02115-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10439-018-02115-x