Thermoregulation
Spinal cord injury (SCI) disrupts communication between the hypothalamic thermoregulatory centre and the body below the level of injury. A person with an SCI may quickly become overheated or chilled, so it is important to monitor for signs of temperature dysregulation.
Patterns of temperature dysregulation include:
- environmental exposure resulting in abnormally high or low temperature
- fever without infectious source; this is more common in the first weeks to months after injury
- exercise-induced hyperthermia (dissipating additional body heat produced with exercise).
It is vital to exclude medical causes for high or low temperature such as thromboembolic complications, and infections (e.g. infection of the chest, renal tract, wounds or other sources).
Management strategies
Managing thermoregulatory dysfunction requires a proactive and individualised approach. The following strategies may be incorporated into clinical care:
- maintain a controlled ambient environment using air-conditioning, particularly during seasonal extremes and periods of strenuous activity
- encourage the use of appropriate, layered clothing to allow for easy adjustment (donning or doffing) in response to temperature changes
- consider the use of specialised items, such as cooling vests where deemed safe and clinically appropriate
- maintaining frequent hydration
- closely monitor body temperature during exercise and adjust the intensity and duration as needed to ensure safety and prevent overheating.
There is an increased risk of burns when using heating or cooling devices due to impaired sensation post spinal cord injury.
Thermodysregulation
SCIRE Professional
Grossmann, F., Flueck, J., Perret, C., Meeusen, R., & Roelands, B. (2021). The thermoregulatory and thermal responses of individuals with a spinal cord injury during exercise, acclimation and by using cooling strategies: A systematic review. Frontiers in Physiology, 12, 636997. https://doi.org/10.3389/fphys.2021.636997
Krassioukov, A., Blackmer, J., Teasell, R. W., & Eng, J. J. (2014). Autonomic dysreflexia following spinal cord injury. In J. J. Eng, R. W. Teasell, W. C. Miller, D. L. Wolfe, A. F. Townson, J. T. C. Hsieh, S. J. Connolly, V. K. Noonan, E. Loh, A. McIntyre, & M. Querée (Eds.), Spinal cord injury rehabilitation evidence (Version 6.0, pp. 1–50). SCIRE Project.