Objective: To investigate sympathetic vasomotor response of the hands to cold and warm stress on the foot with Digital Infrared Thermal Imaging (DITI) in normal healthy subjects.
Method: Fifteen healthy subjects were participated in this study. The DITI was taken during immersing right foot in cold and warm water bath. The thermal images of the dorsal hands were captured at the starting point and then every 5-minute up to 30 minutes. The ratio of temperature between the ending point (30T) and the starting point (0T) was calculated.
Results: In cold stress test, the mean 30T/0T ratio were 92.8⁑2.4% and 92.2⁑2.7% in the right and left hands, respectively. There were no statistically significant side to
side differences. The temperature of the each hand was significantly lowered at every 5 minutes interval (p＜0.05). In warm stress test, the mean 30T/0T ratio were 104.5⁑1.8% and 104.4⁑2.0% in the right and left hands, respectively. The temperature of each hand was significantly increased at the first 5 minutes (p＜0.05), and tended to increase until 10 minutes. After then, the temperature was not significantly changed until 30 miniutes.
Conclusion: We could identify the normal sympathetic vasomotor response to the cold and warm stress with DITI. It might be served as an useful baseline data for the identification of sympathetic dysfunction. (J Korean Acad Rehab Med 2002; 26: 223-227)
Objective: Reflex sympathetic dystrophy (RSD) is a syndrome of post-traumatic neuropathic pain in association with dystrophic changes and signs of sympathetic overactivity. Pain following spinal cord injury occurs frequently, but RSD is not usually considered as one of the common sources of pain. There have only been a few reports of RSD in spinal cord injured patients, although this condition is well-known in the painful upper extremity of hemiplegia due to stroke. The purpose of this study was to investigate the rate of occurrence, characteristic clinical features and more objective evaluation tools for the diagnosis of RSD in cervical cord injured patients.
Method: Thirty-two cervical cord injured patients were evaluated for hand pain, swelling, vasomotor changes and dystrophic skin or nail changes. The patients were evaluated with studies such as three phase bone scintigrathy, digital infrared thermographic imaging (DITI) and plain roentgenograms of the hands.
Results: Eighteen patients (56.3%) were diagnosed as RSD based on the clinical symptoms and findings of three phase bone scintigraphy. Characteristic symptoms were hand pain, edema and dystrophic skin or nail changes, in the order of frequency. In patients with spasticity of the upper extremity, the incidence of RSD was higher than in patients without spasticity.
Conclusion: We should consider RSD as a cause of upper extremity pain in cervical cord injured patients. This will lead to early diagnosis and treatment of the condition and it will be helpful in preventing various complications.
Objective: To investigate the regional differences of skin blood flow and to evaluate the effects of foot temperature on the severity of neuropathic pain and to predict the development of plantar foot ulceration by measuring of the temperature variations on the plantar surface of feet in the diabetic patients.
Method: We measured the temperature variations on plantar surface of the feet in controls (n=18) and diabetic patients with(n=20) or without(n=23) polyneuropathy. The surface temperature from the 3rd metatarsal head(MTH), greater toe(GT), heel, medial and lateral longitudinal arch(LA) was measured by Digital Infrared Thermographic Imaging(DITI).
Results: The mean foot temperature of diabetic patients with polyneuropathy was significantly increased compared to controls or diabetic patients without polyneuropathy(p＜0.001). The surface temperature readings of the GT, medial LA and the 3rd MTH tended to be increased in controls and patients with polyneuropathy. The mean plantar surface temperature was significantly increased according to the duration of diabetes mellitus(DM)(p＜0.05).
Conclusion: The results suggest that DITI provides a diagnostic modality in the prediction of neuropathic foot and increased risks of foot ulcer development in the diabetic patients.
Method: Each of the two methods of cryotherapy, cold-jet stream (CS) and cold-jet stream combined with infrared therapy (CSCI), was applied to the medial aspect of 32 volunteers' knees. The first phase was the required time that skin was dropped to 10oC with CS/CSCI. The second phase was the time for rewarming to 20oC without CS/CSCI. The third phase was the required time that skin dropped to 10oC again with CS/CSCI. The fourth phase was the time for re-warming to 20oC again without CS/CSCI.
Results: The required time which cold pain appeared after CS/CSCI were 51.3 sec and 62.3 sec, respectively, with significance (p＜0.01). In CS and CSCI, first phase was 71.6 sec and 90.7 sec, respectively, and third phase was 33.2 sec and 39.9 sec, respectively (p＜0.01). At second and fourth phases, it took 46.9 sec and 56.6 sec in CS (p＜0.01), and took 46.9 sec and 54.6 sec in CSCI (p＜0.01).
Conclusion: As compared with CS, CSCI delayed sensation time of cold pain and prolonged application time of CS at the knee. (J Korean Acad Rehab Med 2003; 27: 106-109)
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