Heat acclimation improves heat exercise tolerance and heat dissipation in individuals with extensive skin grafts

Zachary J. Schlader, Matthew S. Ganio, James Pearson, Rebekah A.I. Lucas, Daniel Gagnon, Eric Rivas, Karen J. Kowalske, Craig G. Crandall

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Burn survivors with extensive skin grafts have impaired heat dissipation and thus heat tolerance. This study tested the hypothesis that heat acclimation (HA) improves these factors in this population. Thirty-four burn survivors were stratified into highly [>40% body surface area (BSA) grafted, n = 15] and moderately (17-40% BSA grafted, n = 19) grafted groups. Nine healthy nonburned subjects served as controls. Subjects underwent 7 days of HA involving 90 min of exercise at ∼50% peak oxygen uptake in 40°C, 30% relative humidity. On days 1 and 7, subjects exercised in the heat at a fixed rate of metabolic heat production. Pre-HA, all controls and 18/19 subjects in the 17-40% group completed 90 min of exercise. Conversely, heat exercise tolerance was lower (P < 0.01) in the >40% group, with 7/15 subjects not completing 90 min of exercise. Post-HA, heat exercise tolerance was similar between groups (P = 0.39) as all subjects, except one, completed 90 min of exercise. Pre-HA, the magnitude of the increase in internal temperature during exercise occurred sequentially (P ≤ 0.03) according to BSA grafted (>40%: 1.6 ± 0.5°C; 17-40%: 1.2 ± 0.3°C; control: 0.9 ± 0.2°C). HA attenuated (P < 0.01) increases in internal temperature in the control (by 0.2 ± 0.3°C), 17-40% (by 0.3 ± 0.3°C), and >40% (by 0.3 ± 0.4°C) groups, the magnitude of which was similar between groups (P = 0.42). These data indicate that HA improves heat tolerance and dissipation in burn survivors with grafted skin, and the magnitude of these improvements are not influenced by the extent of skin grafting.

Original languageEnglish (US)
Pages (from-to)69-76
Number of pages8
JournalJournal of Applied Physiology
Issue number1
StatePublished - Jul 1 2015
Externally publishedYes


  • Burn injury
  • Heat adaptation
  • Heat loss
  • Heat tolerance
  • Hyperthermia
  • Skin grafting

ASJC Scopus subject areas

  • General Medicine


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