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The effect of cooling prior to and during exercise on exercise performance and capacity in the heat: a meta-analysis
  1. Christopher James Tyler1,
  2. Caroline Sunderland2,
  3. Stephen S Cheung3
  1. 1Department of Life Sciences, University of Roehampton, London, UK
  2. 2School of Science and Technology, Nottingham Trent University, Nottingham, England, UK
  3. 3Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
  1. Correspondence to Dr Christopher James Tyler, Department of Life Sciences, University of Roehampton, Danebury Avenue, London, SW15 4JD, UK; Chris.Tyler{at}


Exercise is impaired in hot, compared with moderate, conditions. The development of hyperthermia is strongly linked to the impairment and as a result various strategies have been investigated to combat this condition. This meta-analysis focused on the most popular strategy: cooling. Precooling has received the most attention but recently cooling applied during the bout of exercise has been investigated and both were reviewed. We conducted a literature search and retrieved 28 articles which investigated the effect of cooling administered either prior to (n=23) or during (n=5) an exercise test in hot (wet bulb globe temperature >26°C) conditions. Mean and weighted effect size (Cohen's d) were calculated. Overall, precooling has a moderate (d=0.73) effect on subsequent performance but the magnitude of the effect is dependent on the nature of the test. Sprint performance is impaired (d=−0.26) but intermittent performance and prolonged exercise are both improved following cooling (d=0.47 and d=1.91, respectively). Cooling during exercise has a positive effect on performance and capacity (d=0.76). Improvements were observed in studies with and without cooling-induced physiological alterations, and the literature supports the suggestion of a dose–response relationship among cooling, thermal strain and improvements in performance and capacity. In summary, precooling can improve subsequent intermittent and prolonged exercise performance and capacity in a hot environment but sprint performance is impaired. Cooling during exercise also has a positive effect on exercise performance and capacity in a hot environment.

  • Exercise Physiology
  • Thermoregulation

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