Wheelchair athletes with spinal cord injuries (WA) face challenges to thermal homeostasis, including reduced cutaneous vasoaction and sweat production. The purpose of this study was to evaluate the efficacy of local cooling to reduce heat strain in WA. Six elite, endurance-trained male WA (33 +/- 3 yr, 64 +/- 4 kg) performed three strenuous exercise tests in a hot-humid environment (32.9 +/- 0.1 degrees C, 75 +/- 3% RH) by pushing a racing chair on a stationary roller (30 min, 16.5 km.h-1, 704-766 W metabolic heat) while wearing shorts and socks. The three treatments involved an ice-packet vest (V) (0.14 m2 of skin surface), a refrigerated headpiece (H) (0.16 m2), or no cooling (C) (control). The vest and headpiece offered potential cooling of 388 W and 266 W. Mean body heat storage for trials V (117 +/- 26 W), H (117 +/- 22 W), and C (164 +/- 40 W) were statistically similar, partly because V (117 +/- 47 W) and H (75 +/- 59 W) cooled inefficiently (30 and 28%, respectively). Repeated measure ANOVA indicated no significant between-treatment differences (P > 0.05) for any variable in trials V, H, and C. We concluded that local cooling during V and H was ineffective because heat storage decreased, but was not prevented.