Coris Eric E, Walz Stephen M, Duncanson Robert, Ramirez Arnold M, Roetzheim Richard G
University of South Florida College of Medicine, Department of Family Medicine, Division of Sports Medicine, Tampa, FL 33612, USA.
South Med J. 2006 Apr;99(4):340-5. doi: 10.1097/01.smj.0000209285.96906.0f.
Heatstroke is the third leading cause of death in athletics, and an important cause of morbidity and mortality in exercising athletes. There is no current method, however, for identifying milder forms of heat illness. In this pilot study, we sought to develop and provide initial validation for a Heat Illness Symptom Index scale (HISI) that would facilitate research in the assessment of milder forms of heat illness in athletes.
The study was designed as a multimodal prospective observational study of Division I football players during twice daily practices in southern Florida. We developed a 13-item scale that assessed symptoms that are suspected to occur during milder forms of heat illness. The resultant scale was assessed for reliability using Cronbach's alpha, and was assessed for construct validity by correlating scale scores with factors that are known to be related to heat illness. HISI scores, as well as data on perceived exertion, player position, and pre and post practice weights were collected from 95 athletes participating in late summer football practices. A total of 557 athlete sessions were analyzed.
The mean score on the heat illness symptom scale was 12.1 (SD 13.8) and the median value was 8.0. Cronbach's alpha confirmed suitable internal consistency of the scale when assessed separately for each of the five morning practices (alpha = 0.91, 0.88, 0.82, 0.92, 0.85). There were statistically significant correlations of the scale score with weight loss during practice (P = 0.006), rating of perceived exertion (P = 0.005), player position (P < 0.0001), and ambient heat index (P = 0.02) as hypothesized.
This pilot study provides initial validation for a novel symptom-based tool for use in assessing mild forms of heat illness in an athletic population. Further validation studies of the instrument, and correlating symptom scores with measures of core temperature, are needed and planned.
中暑是运动员死亡的第三大主要原因，也是运动中运动员发病和死亡的重要原因。然而，目前尚无识别较轻形式热疾病的方法。在这项初步研究中，我们试图开发一种热疾病症状指数量表（HISI）并进行初步验证，该量表将有助于对运动员较轻形式热疾病评估的研究。
本研究设计为对佛罗里达州南部第一分区橄榄球运动员每日两次训练期间的多模式前瞻性观察研究。我们开发了一个包含13个条目的量表，用于评估疑似在较轻形式热疾病期间出现的症状。使用克朗巴哈系数评估所得量表的信度，并通过将量表分数与已知与热疾病相关的因素进行关联来评估结构效度。从95名参加夏末橄榄球训练的运动员中收集了HISI分数，以及关于主观用力程度、球员位置和训练前后体重的数据。共分析了557个运动员训练时段。
热疾病症状量表的平均分数为12.1（标准差13.8），中位数为8.0。当对五个上午训练时段分别进行评估时，克朗巴哈系数证实该量表具有合适的内部一致性（系数分别为0.91、0.88、0.82、0.92、0.85）。如假设的那样，量表分数与训练期间体重减轻（P = 0.006）、主观用力程度评分（P = 0.005）、球员位置（P < 0.0001）和环境热指数（P = 0.02）之间存在统计学显著相关性。
这项初步研究为一种用于评估运动员较轻形式热疾病的新型基于症状的工具提供了初步验证。需要并计划对该工具进行进一步的验证研究，并将症状分数与核心体温测量值进行关联。
