To investigate changes in the core temperature and body surface temperature in patients with incomplete spinal cord injuries (SCI). In incomplete SCI, the temperature change is difficult to see compared with complete spinal cord injuries. The goal of this study was to better understand thermal regulation in patients with incomplete SCI.
Fifty-six SCI patients were enrolled, and the control group consisted of 20 healthy persons. The spinal cord injuries were classified according to International Standards for Neurological Classification of Spinal Cord Injury. The patients were classified into two groups: upper (neurological injury level T6 or above) and lower (neurological injury level T7 or below) SCIs. Body core temperature was measured using an oral thermometer, and body surface temperature was measured using digital infrared thermographic imaging.
Twenty-nine patients had upper spinal cord injuries, 27 patients had lower SCIs, and 20 persons served as the normal healthy persons. Comparing the skin temperatures of the three groups, the temperatures at the lower abdomen, anterior thigh and anterior tibia in the patients with upper SCIs were lower than those of the normal healthy persons and the patients with lower SCIs. No significant temperature differences were observed between the normal healthy persons and the patients with lower SCIs.
In our study, we found thermal dysregulation in patients with incomplete SCI. In particular, body surface temperature regulation was worse in upper SCIs than in lower injuries. Moreover, cord injury severity affected body surface temperature regulation in SCI patients.
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Method: 15 healthy adults were recruited as subjects. We applied two hot packs to the lumbar region for two consecutive days. On the first day, the body part was on the top of hot pack and on the second day, the hot pack was placed over the body part. We measured peak skin temperature, skin temperature elevation, time required to peak skin temperature, skin temperature after 20 minutes and visual analogue scale(VAS) of subjective feeling of heat (hot).
Results: In the peak skin temperature, the means were 44.4⁑0.70oC and 42.7⁑ 0.99oC in the supine and prone position, respectively. In the skin temperature elevation, the means were 11.2⁑1.1oC and 9.5⁑1.6oC, respectively. In the time required to peak skin temperature elevation, the means were 6'49"⁑15" and 10'33"⁑ 15", respectively. In the skin temperature after 20 minutes, the means were 42.4⁑ 0.7oC and 41.6⁑0.8oC, respectively. In the VAS of subjective feeling of heat (hot), the means were 8.66⁑1.11 and 5.72⁑1.48, respectively.
Conclusion: The patient's position is one of the important factors in determining temperature elevation. Therefore, it should be considered during application of the hot pack.
Objective: The purpose of this study was to determine the difference of temperature effects on the nerve conduction variables and to obtain correction factors for temperature in demyelinated and normal peripheral nerves.
Method: The compound muscle action potentials (CMAPs) were recorded with wrist stimulation during cooling and warming in 10 control subjects and 13 subjects with demyelinating neuropathies. The temperature of cooling and warming were 18oC and 40oC, respectively. The time of cooling and warming were 60 minutes and composed of successive 4 sessions of 15 minutes. The skin temperature of thenar area, latency, amplitude, duration, and area of CMAPs were measured before and after each session of 15 minutes of cooling or warming.
Results: The time constants of parameters of CMAPs were of higher tendency in cooling than in warming. The time constants of latency of CMAP were higher in subjects with demyelinating neuropathy than in controls (p＜0.05): 33.3⁑4.0 minutes versus 27.2⁑2.2 minutes in cooling; 30.0⁑7.8 minutes versus 19.6⁑3.3 minutes in warming. The temperature correction factor of latency of CMAPs was 0.23⁑0.03 msec/oC in control and 0.33⁑0.06 msec/oC in subjects with demyelinating neuropathies (p＜0.05).
Conclusion: When studying a subject with demyelinating neuropathies, we should warm the extremity for more sufficient time than in normal subject, or may applicate a differenct temperature correction factors.
Objective: This study was designed to assess the influences of skin temperature and age on latency and amplitude of the sympathetic skin response (SSR).
Method: We examined the sympathetic skin responses in 77 normal subjects aged 25 to 73 years. With stimulation of both median nerve and both tibial nerve at the wrist and ankle, the SSRs were recorded from both palms and soles simulaneously. To determine the effects of skin temperature change on SSR, we examined the SSRs in 12 healthy subjects before and after heating. The heat was applied on right forearm by infra-red lamp.
Results: The mean latency and the mean amplitude of SSR with stimulation of the right median nerve at the wrist were 1.47 sec and 6.08 mV at the right palm, 1.50 sec and 6.07 mV at the left palm, 1.95 sec and 3.38 mV at right sole, and 1.95 sec and 3.09 mV at left sole. There was no side-to-side difference in the latency and the amplitude. Regardless of the site of stimulation, latency was longer at the sole than at the palm, and amplitude was greater at the palm than at the sole (p＜0.05). The latency of the SSR was positively correlated with the age of subjects (p＜0.05), and the amplitude was negatively correlated with the age of subjects (p＜0.05). At higher skin temperature, the latency of SSR was shortened and the amplitude was reduced significantly (p＜0.05).
Conclusion: The amplitude of the SSR decreases with aging and the latency increases with aging. As the skin temperature rises, the latency and amplitude show tendency to decrease. We suggest that the skin temperature and age are important factors to be considered carefully in assessing the SSR parameters.
The purposes of this study are to investigate the effect of the cold air application in the skin and intraarticular temperature changes and to observe the rebound temperature changes after cooling.
We recorded the changes of the skin surface and intraarticular temperatures of knees during and after the cold air application. The intraarticular temperature was measured by a temperature probe inserted into the knee joint cavity and the skin temperature by the infrared system. Eighteen healthy subjects were examined. The knee was cooled by a 5-minutes application of CRAis (Kyung-won Century, Korea) machine and the intraarticular and skin temperatures of knees were measured at every 0.5-minute during and after the cold therpy, then at every minute for 5 minutes, and every 5-minute for the next 110 minutes. We also evaluated the variables that might affect the skin and intraarticular temperature changes.
Results showed that the mean skin temperature dropped from 31.8℃ to 10.5℃ immediately after the cold air application for 5-minutes. The mean intraarticular temperature dropped from 33.9℃ to 30.0℃ after the cold air application for 5-minutes. Two hours after the initiation of treatment with cold air, the mean intraarticular temperatures did not recover to the baseline values(p＜0.01). No significant correlations were found between the body mass index with the intraarticular and surface temperatures of knees. A highly significant correlation was noted between the baseline skin surface and intraarticular temperatures(p＜0.01).
In conclusion, the reduction of the joint temperature by the cold air application using CRAis machine can be a useful treatment method for the synovitis of knees.
Purpose of this study is to evaluate the temperature lowering effects of the local cold air application on the skin surface and the muscle of different depth, and to observe whether the rebound rise of the temperature occurs after the cold air application.
Subjects were prepared in a relaxed prone position. Cold air of CRAis(Kyung-won Century, Korea) was applied to the gluteal area of 20 healthy subjects for 5 minutes. The skin and intramuscular temperatures were measured by a thermogram(Infrared system, Sweden) and digital thermometers(Barnant company, USA). The temperatures were measured before and 30 seconds after the cold air application, and then every 5 minutes for the next 110 minutes. The few variables were considered that might affect the temperature changes. The thermometer-probes were inserted into the outer quadrant of the gluteal muscle below 5 cm from the iliac crest with the depth of 2 cm, 4 cm, and 6 cm respectively. ANOVA was used for the analysis of the data. The resting temperature of the skin surface was 32.6⁑1.2℃, and the lowest temperature was 12.9⁑3.3℃ after 5 minutes of cold air application. The resting intramuscular temperatures with 2 cm, 4 cm, and 6 cm depth were 36.5⁑0.2℃, 36.9⁑0.2℃, and 37.1⁑0.2℃ respectively (p＜0.05). The lowest temperature in 2 cm, 4 cm, and 6 cm depth was 35.1⁑0.7℃, 36.2⁑0.4℃, and 36.9⁑0.3℃ respectively(p＜0.05). The mean duration to reach the lowest temperature was 20, 25, and 45 minutes respectively. The temperatures in the skin and the muscle with the depth of 2 cm, 4 cm, and 6 cm after 2 hours on cold air application were 32.2⁑1.1℃, 36.2⁑0.5℃, 36.6⁑0.3℃, and 36.9⁑0.3℃(p＜0.05) respectively. The temperatures in the skin and the muscle were significantly lower after 2 hours than before the cold air application(p＜0.05).
The change of skin surface temperature was more rapid than that of the muscle and the deeper the muscle was the lesser the temperature change. In conclusion, the effect of cold air application for 5 minutes lasts up to 2 hours and the rebound rise of the temperature due to reactive vasodilatation seems not to occur in the gluteal muscle.
Digital infrared thermal imaging(DITI) has been proposed as a diagnostic aid in patient with many disease entities, such as the cardiovascular, the neurologic, the musculoskeletal diseases and so on. Supporters of thermography state that normal patients have the normal thermograms and abnormal patients have the abnormal thermograms. The purpose of this study was to determine how much a cigarette will affect skin temperature change in the course of normal day's smoking.
Twenty one healthy smokers(mean age, 27.4⁑5.1 years old) and fourteen nonsmokers(mean age, 24.4⁑1.6 years old) took parts in the study. All were male. The cigarette consumption averaged 14.0 per day. Smokers maintained their smoking habit in the ambient temperature before on initial measurement and smoked a cigarette in the controlled laboratory room. Measurements were taken for 5 minutes, 1 hour and 2 hours afterward. The skin temperature of the face, the both palms and the both soles was measured using DorexⰒ digital infrared thermal imaging system.
In all sessions, the skin temperature was higher on the face and lower on the sole. There were no significant differences of skin temperature on both sides of body in all subjects(p＞0.05). The skin temperature of all measured parts was significantly lower in the smoking group before and 5 minutes after smoking(p＜0.01). There were no significant differences of skin temperature between smoker and nonsmoker after 1 hour of smoking(p＞0.01).
The role of skin temperature is very important in clinical neurophysiology but has often been neglected. In nerve conduction studies, lower normal temperature affects slower conduction velocities and increased nerve (sensory or mixed) action potential amplitudes. To determine the normal skin temperature in various parts of upper and lower extremities within close approximation of the nerve passages, the temperature was measured using PhysitempⰒ Model BAT-12 (Accuracy 0.1oC, Clifton, New Jersey, U.S.A.). Fifty-three neurophysiologically healthy adults (Age range, 22∼77 years old) were tested : upper extremity, 20 (male, 7 ; female, 13) ; lower extremity, 33 (male, 11 ; female, 22). The total points of skin temperature measurement were 21 : upper extremity, 10 ; lower extremity, 11. The skin temperature for the upper and lower extremities was 34.6⁑0.9oC (range, 32.6∼36.7oC) and 33.4⁑1.1oC (range, 28.1∼35.7oC), respectively. Although it is frequently time consuming, monitoring normal skin temperature will result in greater electrodiagnostic accuracy.
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