Prevention of Cold Injuries during Exercise

John W. Castellani, Ph.D., FACSM; Andrew J. Young, Ph.D., FACSM; Michel B. Ducharme, Ph.D.; Gordon G. Giesbrecht, Ph.D.; Ellen Glickman, Ph.D., FACSM; Robert E. Sallis, M.D., FACSM


March 01, 2010

In This Article

Evidence Classification

This Position Stand presents an evidence-based review based on a criteria scale proposed by the American Academy of Family Physicians. This scale is called the Strength of Recommendation Taxonomy (SORT). Table 1 presents the SORT. Recommendations are given a grade of A, B, or C based on patient- or disease-oriented outcomes. The SORT can be accessed from the American Family Physician Web site, The reader should be cognizant that classifying evidence using this taxonomy heavily emphasizes outcome-based treatments. However, outcome-based research on medical effects of exposure to cold is limited by the ethical constraints that preclude the design of studies that use frostbite or severe hypothermia as an outcome in human volunteer subjects.