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Brendon P. McDermott, Douglas J. Casa, Susan W. Yeargin, Matthew S. Ganio, Lawrence E. Armstrong and Carl M. Maresh


To describe the current scientific evidence of recovery and return to activity following exertional heat stroke (EHS).

Data Sources:

Information was collected using MEDLINE and SPORTDiscus databases in English using combinations of key words, exertional heat stroke, recovery, rehabilitation, residual symptoms, heat tolerance, return to activity, and heat illness.

Study Selection:

Relevant peer-reviewed, military, and published text materials were reviewed.

Data Extraction:

Inclusion criteria were based on the article’s coverage of return to activity, residual symptoms, or testing for long-term treatment. Fifty-two out of the original 554 sources met these criteria and were included in data synthesis.

Data Synthesis:

The recovery time following EHS is dependent on numerous factors, and recovery length is individually based and largely dependent on the initial care provided.


Future research should focus on developing a structured return-to-activity strategy following EHS.

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Shu-Hui Yeh, Hsiu-Ling Lai, Chiu-Yueh Hsiao, Li-Wei Lin, Yu-Kuan Chuang, Yu-Ying Yang and Kuender D. Yang


Moderate physical activity has been shown to promote immunity. Different moderate physical activities may have different effects on immunity. This study investigated the impacts of a 12-week regular music aerobic exercise (MAE) program on leukocyte distribution, lymphocyte subsets, and lymphocyte polarization.


The study used a case-control design with pretest and posttest. Forty-seven middle-age women were recruited for this study. Three participants dropped out, 22 completed the 12-week MAE program, and the other 22 participants who had heat-intolerance or limited schedule eligibility were enrolled as the control group without the MAE exercise.


Results showed that the MAE exercise for 12 weeks didn’t change red blood cells or total leukocytes but increased lymphocyte counts. The women in MAE group revealed significant increases (P ≤ 0.01) of CD3CD4, CD3CD8, and CD4CD25 cells, associated with Treg polarization showing enhanced FoxP3 but not T-bet, Gata-3, or RORγT expression (P < .01). The control group without exercise revealed insignificant change of lymphocyte subsets or lymphocyte polarization.


This study shows that MAE increases specific lymphocyte subsets and enhances Treg cell differentiation. It is suggested to encourage moderate physical activity of music aerobic exercise to enhance lymphocyte function of middle-aged women.

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Margaret C. Morrissey, Michael R. Szymanski, Andrew J. Grundstein and Douglas J. Casa

, Epstein, & Shapiro, 1981 ; Ganio et al., 2015 ; Leibowitz, Seidman, Laor, Shapiro, & Epstein, 1991 ; Roskind, Petrofsky, Lind, & Paletta, 1978 ). Patients with third-degree burns covering 40–55% of their body surface area have been shown to be at greater risk for heat intolerance ( Ganio et al., 2015

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Ed Maunder, Andrew E. Kilding, Christopher J. Stevens and Daniel J. Plews

. 2018 ; 27 ( 5 ): 962 – 976 . doi:10.1016/j.cmet.2018.04.014 10.1016/j.cmet.2018.04.014 29719234 2. Lim CL , Pyne D , Horn P , et al . The effects of increased endurance training load on biomarkers of heat intolerance during intense exercise in the heat . Appl Physiol Nutr Metab . 2009 ; 34

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Byron Lai, Katie Cederberg, Kerri A. Vanderbom, C. Scott Bickel, James H. Rimmer and Robert W. Motl

intervention period. Thirty-seven studies (80.4%; 37/46) excluded people with MS based on either preexisting primary (e.g., cardiovascular, metabolic, or pulmonary diseases) or secondary (e.g., infections, bone or joint problems, or extreme heat intolerance) conditions. SCI Demographics Studies for people with

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Bareket Falk, Panagiota Klentrou, Neil Armstrong, Thomas Rowland and Han C.G. Kemper

, Baranowski T . Physical activity, adiposity and obesity among adolescents . Pediatr Exerc Sci . 1994 ; 6 : 348 – 60 . doi:10.1123/pes.6.4.348 10.1123/pes.6.4.348 17. Bar-Or O , Blimkie CJ , Hay JA , MacDougall JD , Ward DS , Wilson WM . Voluntary dehydration and heat intolerance in