Understanding thermoregulatory dysfunction and OT interventions to help people living with neurological conditions

Thermoregulation is the process that maintains the core temperature of the body, to ensure your organs and internal systems work best. Core temperature must be maintained within a narrow window of 36.5°C to 37.4°C to maintain optimal functioning of your body and brain. Any deviation from this makes it harder for your body to function.  

As long as your core temperature is maintained, your body temperature can vary a few degrees. In fact, your body has mechanisms in place to change body temperature to maintain the core temperature range. For example, shivering, generates heat when you’re cold, and sweating lowers body temperature when you’re overheated. These mechanisms, and many others, support normal thermoregulation to control both core and body temperature in varying environmental conditions. This is why you wouldn’t immediately turn red and succumb to hyperthermia when stepping out on a hot day, or go blue and immediately freeze with hypothermia on a cold day.  

Thermoregulatory dysfunction is a loss of capacity to control core and body temperature within the normal range, meaning individuals are likely to be seriously affected with extreme environmental temperatures. Unfortunately, this is common for people with neurological conditions, including multiple sclerosis, Parkinson’s disease, Huntington’s disease, multiple systems atrophy and others. Although not everyone with these conditions will experience thermoregulatory dysfunction.  

Thermoregulatory dysfunction can also affect people with the same condition differently. Some people find themselves unable to cool down in summer, heat up in winter, too hot in cold temperatures or too warm in cold temperatures. For some, this may occur in parts of the year, for others it is year-round, it can even change over the course of the year or multiple years. Many people with neurological conditions report thermoregulatory dysfunction worsens other symptoms, making mobility more challenging, fatigue hitting harder and recovery periods taking longer. Thermoregulatory dysfunction is often a symptom that fluctuates and does not always make logical sense. 

Everyone’s experience is unique, therefore support must be tailored to you.  

It’s stressful to constantly feel like you’ve stepped into a sauna or ice bath, and you can’t get out! 

Luckily, there are plenty of ways an occupational therapists (OTs) for neurological conditions can help: 

1. Simple strategies - OTs often start with simple strategies, like exploring clothing to suit the weather. They also consider your lifestyle and commonly accessed locations, which may impact your thermoregulation.  
2. Doctor and allied health referrals - OTs also review or recommend follow ups with your GP, neurologist or other allied health to see if there are other pharmaceutical or non-pharmaceutical interventions which can assist.  
3. Assistive technology (AT) – There are many ATs that can assist with heating and cooling body temperature. From specialised wearables, cooling bedding, to specialised sleep systems to help with thermoregulation overnight. With options available for home, work or in the community to support you wherever you are. An OT can discuss these options with you, find suitable suppliers and where possible, set up trials.
4. Access subsidies – Did you know you can access subsidies to offset electricity cost required to heat or cool your house? Depending on your circumstances, you may be eligible for the Thermoregulatory Dysfunction Energy Subsidy or Medicare Essential Medical Equipment Payment. Many MSWA Clients access these subsidies to support their thermoregulation management.
5. Funding schemes – MSWA OTs can help you navigate funding schemes to access thermoregulatory support options and AT.
6. Connect with others – MSWA OTs run regular group workshops on thermoregulation management where we cover all the above topics. Participants also benefit from hearing the experiences of others and finding out what works or what doesn’t work for them! 

MSWA Occupational Therapists provides both tailored individual sessions and supportive group sessions on  thermoregulation, thermoregulatory dysfunction, strategies to help and support in accessing funding.  

Too hot? Too cold? Get in touch and find out how MSWA’s Occupational Therapy services can help.