Training Practices and Heat Acclimation Responses of a Hand-Cyclist With Complex Regional Pain Syndrome: A Case Study

To describe the training practices and isothermic heat acclimation (HA) of a competitive hand-cyclist with complex regional pain syndrome type I preparing for a world speed-record attempt in a hot environment.

A 53-year-old male hand-cyclist with complex regional pain syndrome type I completed a 16-week training program, followed by 9 consecutive days of isothermic HA. Incremental exercise tests were conducted 9 weeks into training to characterize physiological capacity and training intensity distribution. Heat tolerance tests (2 × [4 min at 70, 100, 120, 150 W, and maximum effort]) were performed pre-HA and post-HA in an environmental chamber (33 °C, 40% relative humidity). Core temperature (Tcore), weighted mean skin temperature (WMTskin), heart rate (HR), power output (PO), rating of perceived exertion (RPE), and thermal sensation (TS) were measured.

After 9 weeks of training, PO at the second lactate threshold increased by 10.7% and peak PO by 17.6%. Compared with pre-HA, post-HA heat tolerance tests demonstrated lower exercising HR (mean -7 beats per minute) and reduced perceptual strain (median RPE and TS reduced by 2.5 and 1.9 arbitrary units, respectively). Self-selected mean PO during maximal efforts increased by 9.9% to 44.2% post-HA. The Tcore (+0.22 °C) and WMTskin (+1.1 °C) were higher post-HA.

Moderate-term isothermic HA reduced cardiovascular and perceptual strain and improved self-regulated performance in a hand-cyclist with complex regional pain syndrome type I. Reduced perceptual strain was greater than in previous research and may allow the participant to improve exercise performance/capacity. Findings support the use of HA in this athlete's preparation for competition in a hot environment and the cautious, individualized application of HA in similar contexts.