Thermographic imaging in sports and exercise medicine: A Delphi study and consensus statement on the measurement of human skin temperature

Effects of pre-exercise glycerol supplementation on dehydration, metabolic, kinematic, and thermographic variables in international race walkers

BACKGROUND

Due to the increase in global temperature, it is necessary to investigate solutions so that athletes competing in hot conditions can perform in optimal conditions avoiding loss of performance and health problems. Therefore, this study aims to evaluate the effect of pre-exercise glycerol supplementation during a rectangular test at ambient temperature mid (28.2ºC) on dehydration variables in international race walkers.

METHODS

Eight international male race walkers (age: 28.0 years (4.4); weight: 65.6 kg (6.6); height: 180.0 cm (5.0); fat mass: 6.72% (0.66); muscle mass: 33.3 kg (3.3); VO2MAX: 66.5 ml · kg-1·min-1 (1.9)) completed this randomized crossover design clinical trial. Subjects underwent two interventions: they consumed placebo (n = 8) and glycerol (n = 8) acutely, before a rectangular test where dehydration, RPE, metabolic, kinematic, and thermographic variables were analyzed before, during and after the test.

RESULTS

After the intervention, significant differences were found between groups in body mass in favor of the placebo (Placebo: -2.23 kg vs Glycerol: -2.48 kg; p = 0.033). For other variables, no significant differences were found.

CONCLUSION

Therefore, pre-exercise glycerol supplementation was not able to improve any dehydration, metabolic, kinematic, or thermographic variables during a rectangular test at temperature mid in international race walkers. Possibly, a higher environmental temperature could have generated a higher metabolic and thermoregulatory stress, generating differences between groups like other previous scientific evidence.

Post-operative osteopathic manipulative treatment of Morel-Lavallee syndrome assessed using infrared thermal imaging: A case report

INTRODUCTION

The Morel-Lavallee lesion (MLL) is a closed, degloving soft-tissue injury, wherein the skin and subcutaneous tissue are separated from the underlying fascia. This syndrome causes disruption of wound healing. Infrared thermography is a noninvasive and pain-free tool that can be used to evaluate scar and the influence of osteopathic manipulative treatment.

OBJECTIVE

To evaluate the influence of post-operative osteopathic manipulative treatment (OMT) of Morel-Lavallee lesions (MLL).

METHODS

During four osteopathic sessions on one volunteer patient, 28-year-old male, resulting in MLL of the left knee after motorcycle accident. The effects of OMT were assessed using an infrared thermal imaging camera and qualitative palpation examination of osteopathic dysfunction, scored on a scale of 1-4.

RESULTS

and discussion: Both scar and peri-scar area temperatures increased after OMT. The difference in temperature between the scar and the peri-scar area decreased after OMT. Increase in temperature was greater when the OMT was applied around the scar than when applied at a distance from the scar site. The palpation score for dysfunction of the MLL scar site decreased from 4/4 to 2/4 after the final session.

CONCLUSION

Several OMT sessions focusing on the MLL scar site appear necessary to obtain noteworthy results. OMT improved mobility and increased the temperature of the scar and the peri-scar area.

Exercise-induced changes in lower limbs skin temperature against plasma ATP among individuals with various type and level of physical activity

The objective of the study was to examine the lower limbs skin temperature (TSK) changes in response to exhaustive whole-body exercise in trained individuals in reference to changes in plasma adenosine triphosphate (ATP). Eighteen trained participants from distinct sport type ‒ endurance (25.2 ± 4.9 yr) and speed-power (25.8 ± 3.1 yr), and 9 controls (24,9 ± 4,3 yr) ‒ were examined. Lower limbs TSK and plasma ATP measures were applied in parallel in response to incremental treadmill test and during 30-min recovery period. Plasma ATP kinetics were inversely associated to changes in TSK. The first significant decrease in TSK (76-89% of V˙ O2MAX) occurred shortly before a significant plasma ATP increase (86-97% of V˙ O2MAX). During recovery, TSK increased, reaching pre-exercise values (before exercise vs. after 30-min recovery: 31.6 ± 0.4 °C vs. 32.0 ± 0.8 °C, p = 0.855 in endurance; 32.4 ± 0.5 °C vs. 32.9 ± 0.5 °C, p = 0.061 in speed-power; 31.9 ± 0.7 °C vs. 32.4 ± 0.8 °C, p = 0.222 in controls). Plasma ATP concentration did not returned to pre-exercise values in well trained participants (before exercise vs. after 30-min recovery: 699 ± 57 nmol l-1 vs. 854 ± 31 nmol l-1, p < 0.001, η2 = 0.961 and 812 ± 35 nmol l-1 vs. 975 ± 55 nmol l-1, p < 0.001, η2 = 0.974 in endurance and speed-power, respectively), unlike in controls (651 ± 40 nmol l-1 vs. 687 ± 61 nmol·l-1, p = 0.58, η2 = 0.918). The magnitude of TSK and plasma ATP response differed between the groups (p < 0.001, η2 = 0.410 for TSK; p < 0.001, η2 = 0.833 for plasma ATP). We conclude that lower limbs TSK change indirectly corresponds to the reverse course of plasma ATP during incremental exercise and the magnitude of the response depends on the level of physical activity and the associated to it long-term metabolic adaptation.

Indication of mixed glucose and fatty acid use by inferred brown adipose tissue activity in Samoans

OBJECTIVES

Despite the growing rates of global obesity and the known positive associations between brown adipose tissue (BAT) and cardiovascular health, little is known about the metabolic effects of BAT activity in Samoans, a population at high risk of obesity and type II diabetes. Here we assessed the potential effects of inferred BAT activity on metabolic health markers in Samoan adults exposed to mild cold.

METHODS

Using point-of-care finger prick technology we measured fasting glucose, total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) levels before and after 30 min of cold exposure among 61 individuals (38 females, 23 males, ages 31-54) from 'Upolu Island, Samoa. Respiratory quotient was measured by indirect calorimetry to determine substrate metabolism at room temperature and cold exposure.

RESULTS

Fasting glucose levels decreased significantly (p < .001) after cold exposure while neither total cholesterol (p = .88), HDL (p = .312), nor LDL (p = .089) changed. Respiratory quotient decreased significantly (p = .009) between exposures, suggesting an increased preference for lipid metabolism as a response to cold.

CONCLUSIONS

The observed effects of inferred BAT activity on biomarkers suggest BAT activity utilizes both glucose and lipid-derived fatty acids as fuel for thermogenesis. Our work provides evidence for the beneficial metabolic effects of BAT and emphasizes the need for the population-specific development of metabolic treatments involving BAT to ensure the successful and equitable minimization of extreme consequences of obesity and metabolic health.

The Effects of 2 Different Soft Tissue Mobilization Techniques on Delayed Onset Muscle Soreness in Male Recreational Athletes: A Single-Blinded Randomized Controlled Trial

CONTEXT

Soft tissue mobilization is frequently employed for delayed onset muscle soreness (DOMS) management. Foam roller and percussive massage are 2 popular soft tissue mobilization methods preferred by various professionals. However, their effects on DOMS symptoms are controversial and there are no studies comparing these 2 methods. The aim of the present study was to compare the acute effects of soft tissue mobilization with a foam roller or a percussive massage device on DOMS in young male recreational athletes.

DESIGN

A parallel, single-blinded, randomized controlled trial.

METHODS

Thirty-six participants (median [interquartile range 25/75]; age: 20.0 [19.3/21.0] y) were randomly allocated to percussive massage group (n = 12), foam roller group (n = 12), and control group (n = 12). First, a fatigue protocol targeting quadriceps femoris was performed. Then, participants received soft tissue mobilization with foam roller/percussive massage or rested for 10 minutes according to their groups. Pain and fatigue were evaluated by a visual analog scale, and the skin surface temperature of over the quadriceps femoris was measured with thermal camera imaging. Evaluations were performed at baseline, following fatigue protocol, at 24th hour, and at 48th hour. Changes from the baseline at 24th and 48th hours were compared between groups.

RESULTS

No significant between-group differences were observed at the assessments performed at 24th or 48th hour regarding the changes from baseline in pain (P value for 24th hour = .905, P value for 48th hour = .733), fatigue (P value for 24th hour = .895, P value for 48th hour = .606), or skin surface temperature measurements (P values for 24th hour = between .300 and .925, P values for 48th hour = between .311 and .750).

CONCLUSIONS

Soft tissue mobilizations applied with foam roller or percussive massage device do not seem to be superior to passive resting in alleviating DOMS symptoms in recreational athletes.

Response of skin temperature, blood ammonia and lactate during incremental exercise until exhaustion in elite athletes

The study aimed to evaluate the lower limb skin temperature (Tsk) and blood concentrations of lactate (LA) and ammonia (NH3) during exercise and recovery. Eleven elite sprint athletes (25 ± 3.4 yrs) and 11 elite endurance athletes (24.45 ± 5.4 yrs) performed an incremental running test until exhaustion. Body composition was estimated using the DXA method. Thermograms of the anterior and posterior surfaces of the lower limbs were recorded at rest, before each test stage (every 3 min, starting from 10 km h-1 and increasing by 2 km h-1), and in the 5th, 10th, 15th, 20th, and 30th minute of recovery. Endurance athletes had a higher maximum oxygen uptake than sprint athletes (5.0 ± 0.7 vs 4.3 ± 0.4 l·kg-1, p = 0.018), lower percentage of lean content (79 ± 2 vs 83 ± 2%, p < 0.001), and a higher percentage of fat content in the lower limbs (17 ± 2 vs 12 ± 2%, p < 0.001). In both groups, a significant decrease in Tsk was observed compared to resting value (endurance athletes-31.5 ± 0.6 °C; sprint athletes-32.3 ± 0.6 °C), during exercise (p < 0.001) and rewarming during recovery (p < 0.001). However, endurance athletes had a lower Tsk than sprint athletes at the exhaustion point (30.0 ± 1.1 vs 31.6 ± 0.8 °C, p < 0.05) and the pattern of change in Tsk differed between groups (p < 0.001). Tsk in the endurance athletes group decreased throughout the exercise protocol and returned more rapidly to initial values during recovery, while Tsk in the sprint group stabilised between moderate intensity and exhaustion, recovering more slowly after exercise. Both LA (endurance athletes-max 10.2 ± 1.5; sprint athletes-max 10.1 ± 1.4 mmol⋅L-1, p < 0.001) and NH3 (endurance athletes-max 75.6 ± 11.5; sprint athletes-max 76.7 ± 9.0 mmol⋅L-1, p < 0.001) increased during exercise and decreased during recovery (p < 0.001). During exercise, lower levels and slower increases in LA were observed during exercise in the endurance athletes' group (p < 0.05). A negative correlation was revealed between Tsk and fat percentage (r = -0.43 to -0.71, p < 0.05). Tsk was positively correlated with LA during recovery (r = 0.43 to 0.48, p < 0.05), and negatively during recovery (r = -0.45 to -0.54, p < 0.05). Differences between groups in maximum aerobic capacity, the pattern of change in Tsk, and the correlation between Tsk and LA suggest that individuals who decrease less Tsk during exercise and higher Tsk during recovery are those with better aerobic capacity. In addition, athletes with less body fat dissipate heat from their tissues more efficiently.

Preliminary study of finger temperature recovery in patients with diabetes mellitus following cold stimulation

OBJECTIVE

To explore the difference in temperature recovery following cold stimulation between participants with and without diabetes mellitus (DM).

MATERIALS AND METHODS

The participants without (control group; n = 25) and with (DM group; n = 26) DM were subjected to local cold stimulation (10º C for 90 s). The thermal images of their hands were continuously captured using a thermal camera within 7 min following cold stimulation, and the highest temperature of each fingertip was calculated. According to the temperature values at different timepoints, the temperature recovery curves were drawn, and the baseline temperature (T-base), initial temperature after cooling (T0), temperature decline amplitude (T-range), and area under the temperature recovery curve > T0 (S) were calculated. Finally, symmetry differences between the two groups were analysed.

RESULTS

No statistical differences in the T-base, T0, and T-range were observed between the DM and control groups. After drawing the rewarming curve according to the temperature of the fingertips of the patients following cold stimulation, the S in the DM group was significantly lower than that in the control group (p < 0.05). Furthermore, the asymmetry of the base temperature of the hand was observed in the DM group.

CONCLUSIONS

Following cold stimulation, the patients with DM exhibited a different rewarming pattern than those without DM. Thus, cold stimulation tests under infrared thermography may contribute to the early screening of diabetic peripheral neuropathy in future.

Facial infrared thermography as an index of social anxiety

Previous research on physiological indices of social anxiety has offered unclear results. In this study, participants with low and high social anxiety performed five social interaction tasks while being recorded with a thermal camera. Each task was associated with a dimension assessed by the Social Anxiety Questionnaire for Adults (1 = Interactions with strangers. 2 = Speaking in public/Talking with people in authority, 3 = Criticism and embarrassment, 4 = Assertive expression of annoyance, disgust or displeasure, 5 = Interactions with the opposite sex). Mixed-effects models revealed that the temperature of the tip of the nose decreased significantly in participants with low (vs. high) social anxiety (p < 0.001), while no significant differences were found in other facial regions of interest: forehead (p = 0.999) and cheeks (p = 0.999). Furthermore, task 1 was the most effective at discriminating between the thermal change of the nose tip and social anxiety, with a trend for a higher nose temperature in participants with high social anxiety and a lower nose temperature for the low social anxiety group. We emphasize the importance of corroborating thermography with specific tasks as an ecological method, and tip of the nose thermal change as a psychophysiological index associated with social anxiety.

Thermoregulation during Field Exercise in Horses Using Skin Temperature Monitoring

Hyperthermia and exertional heat illness (EHI) are performance and welfare issues for all exercising horses. Monitoring the thermoregulatory response allows for early recognition of metabolic heat accumulation during exercise and the possibility of taking prompt and effective preventative measures to avoid a further increase in core body temperature (Tc) leading to hyperthermia. Skin temperature (Tsk) monitoring is most used as a non-invasive tool to assess the thermoregulatory response pre- and post-exercise, particularly employing infrared thermographic equipment. However, only a few studies have used thermography to monitor skin temperature continuously during exercise. This commentary provides an overview of studies investigating surface skin temperature mainly by infrared thermography (IRT) during exercise. The scientific evidence, including methodologies, applications, and challenges associated with (continuous) skin temperature monitoring in horses during field exercise, is discussed. The commentary highlights that, while monitoring Tsk is straightforward, continuous Tsk alone does not always reliably estimate Tc evolvement during field exercise. In addition, inter-individual differences in thermoregulation need to be recognized and accounted for to optimize individual wellbeing. With the ongoing development and application of advanced wearable monitoring technology, there may be future advances in equipment and modeling for timely intervention with horses at hyperthermic risk to improve their welfare. However, at this point, infrared thermographic assessment of Tsk should always be used in conjunction with other clinical assessments and veterinary examinations for a reliable monitoring of the welfare of the horse.

Botulinum Toxin A in the treatment of frostbite sequelae - results from a blinded, early-phase, comparative trial

INTRODUCTION

Freezing Cold Injuries (FCI) have been associated with long-term sequelae including vasospasm. The aims of the pilot study are to explore the research methodology and investigate the tolerability and safety of treatment with Botulinum Toxin-A (BTX-A) in FCI Sequelae.

METHODOLOGY

This pilot study tests the logistics, the treatment setting and the follow-up procedure in an early-phase, double-blinded, randomized, controlled trial study-design. The variables in the study were subjective symptoms, peripheral micro-vascularization/rewarming, somatosensory responsiveness, and generic measure of health status.

RESULTS

No major challenges or difficulties were noticed according to the protocol or the study methodology. The monitoring of tolerability and safety of treatment with BTX-A did not reveal any major unwanted and/or adverse reactions among the patients in the pilot study and no challenges occurred during data collection of endpoints. The study revealed an inaccuracy of the 2nd degree FCI diagnosis and uncover a need for relevant and sufficient clinical information for FCI classification.

CONCLUSIONS

This pilot study showed the study methodology with minor adjustments is feasible in a future full-scale clinical trial. The recruitment process needs to be more refined to ensure that the eligible study participants are a homogenous group of FCI patients.

Thermal profile classification of the back of sportive and sedentary healthy individuals

BACKGROUND

Infrared thermography (IRT) is a non-harmful, risk-free imaging technique and it has application for healthy and pathological population.

OBJECTIVE

The aim of this study is to evaluate the thermographic profiles of the back of sport practitioners from different disciplines and compare it with those of sedentary healthy individuals.

METHOD

The back of 160 healthy subjects were evaluated, and participants were grouped considering their sport practice: team sport (TS), individual sport (IS), weight training (WT), inactive (I). Three regions of interest were identified to analyze the cervical, thoracic and lumbar temperatures of the back.

RESULTS

The Multivariate analysis of variance (MANOVA) resulted significant showing statistical differences for the cervical (p < 0.001), dorsal (p = 0.0011), and lumbar areas (p = 0.0366). The Tukey post-hoc test for pairwise comparison showed statistically significant differences between groups. For the cervical area significance was found between the IN and WT group (p = 0.002), the IN and IS group (p < 0.001), IN and TS group (p = 0.020). The dorsal area resulted significant between the IN and WT group (p = 0.007), the IN and IS group (p < 0.001), IN and TS group. The lumbar area showed significant differences only between the IN and WT group and the IN and IS group (p = 0.043).

CONCLUSION

This study demonstrated that inactive individuals manifest a statistically significant higher temperature in the cervical, dorsal and lumbar area of the back compared to sportive individuals.

Relationship between aerobic fitness and lower limb skin temperature during cycling exercise testing among well-trained athletes and nonathletes: a cross-sectional study

Background

During prolonged physical exercise, the skin plays an important role in thermoregulation by dissipating heat to maintain core temperature. Moreover, thermal variation may be influenced by the physical fitness level of an individual. The aim of the present study was to determine the relationship between aerobic fitness and lower limb skin temperature during graded cycling exercise testing in well-trained athletes and nonathletes.

Methods

Twelve trained athletes (mean ± SD maximal oxygen consumption [VO2max], 52.44 ± 4.5 ml/kg/min) and 12 nonathletes (VO2max, 36.95 ± 4.9 ml/kg/min) participated in this study. The regional skin temperature over the lower limbs was monitored continuously during incremental exercise testing using a thermal camera, and cardio-respiratory parameters were assessed and recorded using a metabolic analyzer (K5, COSMED, Rome, Italy).

Results

The mean skin temperature of athletes at a high intensity of exercise was 27.23 ± 0.3 °C while that of nonathletes was 29.03 ± 0.44 °C, a difference that was statistically significant (p < 0.05). A negative correlation was observed between skin temperature and cardiovascular parameters (VO2max and heart rate) in athletes, while no such correlation was found among nonathletes.

Conclusion

The present study demonstrated a negative correlation between oxygen consumption and lower limb skin temperature in athletes, while the correlation was poor in nonathletes. This suggests that physical fitness level may influence the pattern of alterations in lower limb skin temperature, which supports the hypothesis that athletes exhibit better heat dissipation mechanisms than nonathletes.

Myotendinous Thermoregulation in National Level Sprinters after a Unilateral Fatigue Acute Bout-A Descriptive Study

In the last decade there has been a growing interest in infrared thermography in the field of sports medicine in order to elucidate the mechanisms of thermoregulation. The aim of this study was to describe bilateral variations in skin temperature of the anterior thigh and patellar tendon in healthy athletes and to provide a model of baseline tendon and muscle thermoregulation in healthy sprinters following a unilateral isokinetic fatigue protocol. Fifteen healthy national-level sprinters (eleven men and four women), with at least 3 years of athletic training experience of 10-12 h/week and competing in national-level competitions, underwent unilateral isokinetic force testing and electrostimulation in which their body temperature was measured before, during, and after the protocol using an infrared thermographic camera. ANOVA detected a significant difference in the time × side interaction for patellar temperature changes (p ≤ 0.001) and a significant difference in the time/side interaction for quadriceps temperature changes (p ≤ 0.001). The thermal challenge produces homogeneous changes evident in quadriceps areas, but not homogeneous in tendon areas. These data show that metabolic and blood flow changes may depend on the physical and mechanical properties of each tissue. Future research could be conducted to evaluate the predictive value of neuromuscular fatigue in the patellar tendon and quadriceps after exercise in order to optimize post-exercise recovery strategies.

Pressure pain sensitivity, thermographic changes, function, life and sleep quality in patients with unilateral rotator cuff injury: A case-control study

INTRODUCTION-AIM

This study aimed to assess pressure pain sensitivity, thermographic changes, functional status, quality of life, and sleep in individuals with unilateral shoulder pain due to rotator cuff tear and compare these parameters with the unaffected side and asymptomatic individuals.

MATERIAL-METHOD

Thirty-two patients with unilateral rotator cuff injury and 32 volunteers without shoulder problems were included. Pain was evaluated using a visual analogue scale, pressure pain sensitivity with a digital algometer, thermographic changes with a thermal camera, upper extremity function through the Disabilities of the Arm, Shoulder, and Hand Disability Questionnaire, sleep quality using the Pittsburgh Sleep Quality Index, and quality of life using SF-36.

RESULTS

Pressure pain sensitivity of the deltoideus, supraspinatus, and subscapularis muscles in the affected limb was lower than in the unaffected limb (p = 0.027, p = 0.005, p < 0.001). Conversely, pressure sensitivity of the deltoideus, biceps brachii, and subscapularis muscles was higher in the patient group (p = 0.008, p = 0.042, p < 0.001). Furthermore, a decrease in temperature was observed in all patients, except for the trapezius muscles of the affected side (p < 0.05).

CONCLUSION

This study sheds light on altered pressure pain sensitivity and thermographic changes in individuals with unilateral shoulder pain due to rotator cuff tear. Additionally, the study highlights impairments in functional status, quality of life, and sleep in these individuals, emphasizing the broader impact of such injuries. Targeted interventions based on these findings have the potential to enhance overall well-being and functional outcomes for affected individuals.

LEVEL OF EVIDENCE

Level III, Case-control study, prognosis study.

Neuromuscular electrical stimulation during maximal voluntary contraction: a Delphi survey with expert consensus

PURPOSE

The use of electrical stimulation to assess voluntary activation of muscle/s is a popular method employed in numerous exercise science and health research settings. This Delphi study aimed to collate expert opinion and provide recommendations for best practice when using electrical stimulation during maximal voluntary contractions.

METHODS

A two-round Delphi study was undertaken with 30 experts who completed a 62-item questionnaire (Round 1) comprising of open- and closed-ended questions. Consensus was assumed if ≥ 70% of experts selected the same response; such questions were removed from the subsequent Round 2 questionnaire. Responses were also removed if they failed to meet a 15% threshold. Open-ended questions were analysed and converted into closed-ended questions for Round 2. It was assumed there was no clear consensus if a question failed to achieve a ≥ 70% response in Round 2.

RESULTS

A total of 16 out of 62 (25.8%) items reached consensus. Experts agreed that electrical stimulation provides a valid assessment of voluntary activation in specific circumstances, such as during maximal contraction, and this stimulation can be applied at either the muscle or the nerve. Experts recommended using doublet stimuli, self-adhesive electrodes, a familiarisation session, real-time visual or verbal feedback during the contraction, a minimum current increase of + 20% to ensure supramaximal stimulation, and manually triggering stimuli.

CONCLUSION

The results of this Delphi consensus study can help researchers make informed decisions when considering technical parameters when designing studies involving electrical stimulation for the assessment of voluntary activation.

Can the inner eye canthus temperature be used as an alternative method to measure core temperature in sleep-deprived individuals?

Core temperature is used in several situations, including studies on biological rhythms and circadian markers of physical performance. Measuring the inner eye canthus (Tco) temperature is a method proposed to identify core temperature, but it has shown little concordance in physical exercise situations and has not yet been used in studies with measurements taken throughout the day. The objective of this study was to compare the measurements and daily behavior of Tco obtained by infrared thermography with rectal temperature (Tre) during a prolonged waking protocol. Eleven male individuals participated in the study, who remained in the laboratory for at least 38 h using an actigraph to determine the wakefulness time and were monitored during the entire period. The Tre and Tco measurements were performed every 3 h. The ANOVA was used for repeated measurements followed by Bonferroni's post-hoc test to find the limits of concordance/proximity, while the Bland and Altman method and the Intraclass Correlation Coefficient were used to establish the reliability between the pairs. The significance level adopted was p < 0.05. The results demonstrate significant differences, low levels of concordance and unsatisfactory reliability levels between Tco and Tre at all 13 analyzed moments, in addition to not showing measurement reliability when all data are used together with the 143 temperature measurements. Daily behavior analysis shows moments with similar behavior with an increase in Tco and Tre, but at other times the behavior was the opposite, with a decrease in one measurement and an increase in the other. Based on the results presented, it is not recommended to use the inner eye canthus temperature as a substitute for rectal temperature for measuring core temperature at different times of the day or in sleep-deprived individuals.

Thermal resting pattern and acute skin temperature response to exercise in older adults: Role of cardiorespiratory fitness

BACKGROUND

Infrared thermography is a growing area of interest in sports science due to the potential of skin temperature (Tsk) measurements to provide valuable information from rest to exercise. However, limited research exists on Tsk in older adults and the impact of factors such as sex and cardiorespiratory fitness (CRF) on Tsk. This study aims to investigate Tsk at rest and after acute exercise in older adults and assess whether sex or CRF influences Tsk.

METHODS

Ninety-two participants (41 women, 68.48 ± 3.01 years) were examined with a thermographic camera in a conditioned room (23.02 ± 3.01 °C) at rest and after a graded protocol. The Tsk of 25 regions of interest (ROIs) were extracted and analysed.

RESULTS

Men had higher overall Tsk at rest in 76% of ROIs, showing significant differences (p < 0.010) in six specific ROIs, independent of CRF. Both sexes had similar Tsk responses after graded exercise, with increases in distal parts (1.06 ± 0.50 °C), decreases in proximal parts (-0.62 ± 0.42 °C), and stable central Tsk (0.23 ± 0.59 °C). Increases in lower limb Tsk were significantly associated with CRF in men and women (β = 0.438, p = 0.001, and β = 0.535, p < 0.001, respectively), explaining 17% and 27% of the variance, respectively.

CONCLUSIONS

This study demonstrates a sex-specific effect on resting Tsk in older adults, suggesting that sex-specific Tsk patterns should be considered when analysing Tsk in this population. Additionally, the association between increases in lower limb Tsk and CRF suggests that Tsk could be a promising predictor of CRF in older adults.

Determination of the Effects of a Series of Ten Whole-Body Cryostimulation Sessions on Physiological Responses to Exercise and Skin Temperature Behavior following Exercise in Elite Athletes

The present study investigated the effects of a series of 10 whole-body cryostimulation (WBC) sessions (3 min; -110 °C) on physiological and thermal responses to a submaximal exercise test in 17 elite athletes. Participants performed an exercise test twice at similar levels of intensity before and after a series of ten WBC sessions. Before and during the test, each participant's oxygen uptake (VO2), heart rate (HR), internal temperature (Ti), and skin temperature in selected areas of the skin were measured, and the mean arterial pressure (MAP), physiological strain index (PSI), and mean skin temperature (Tsk) were calculated. The results show that during exercise, increases in Ti and the PSI were significantly lower after the WBC sessions, and although there were no significant changes in HR or the MAP, the Tsk was significantly higher. Following exercise, an increase in skin temperature asymmetry over the lower-body muscles was detected. A series of WBC sessions induced a tendency toward a decrease in temperature asymmetry over the thigh muscles. In conclusion, a series of ten WBC sessions does not induce significant modifications in physiological variables but does influence the PSI and Ti during exercise. Moreover, a series of ten WBC sessions influences the distribution of skin temperature and the magnitude of temperature asymmetries in the early phase of recovery.

Best Practices for Body Temperature Measurement with Infrared Thermography: External Factors Affecting Accuracy

Infrared thermographs (IRTs) are commonly used during disease pandemics to screen individuals with elevated body temperature (EBT). To address the limited research on external factors affecting IRT accuracy, we conducted benchtop measurements and computer simulations with two IRTs, with or without an external temperature reference source (ETRS) for temperature compensation. The combination of an IRT and an ETRS forms a screening thermograph (ST). We investigated the effects of viewing angle (θ, 0-75°), ETRS set temperature (TETRS, 30-40 °C), ambient temperature (Tatm, 18-32 °C), relative humidity (RH, 15-80%), and working distance (d, 0.4-2.8 m). We discovered that STs exhibited higher accuracy compared to IRTs alone. Across the tested ranges of Tatm and RH, both IRTs exhibited absolute measurement errors of less than 0.97 °C, while both STs maintained absolute measurement errors of less than 0.12 °C. The optimal TETRS for EBT detection was 36-37 °C. When θ was below 30°, the two STs underestimated calibration source (CS) temperature (TCS) of less than 0.05 °C. The computer simulations showed absolute temperature differences of up to 0.28 °C and 0.04 °C between estimated and theoretical temperatures for IRTs and STs, respectively, considering d of 0.2-3.0 m, Tatm of 15-35 °C, and RH of 5-95%. The results highlight the importance of precise calibration and environmental control for reliable temperature readings and suggest proper ranges for these factors, aiming to enhance current standard documents and best practice guidelines. These insights enhance our understanding of IRT performance and their sensitivity to various factors, thereby facilitating the development of best practices for accurate EBT measurement.

Effects of Maximal Eccentric Trunk Extensor Exercise on Lumbar Extramuscular Connective Tissue: A Matched-Pairs Ultrasound Study

Recently, it has been shown that the extramuscular connective tissue (ECT) is likely involved in delayed onset muscle soreness (DOMS). Therefore, the aim of the present study was to investigate the effects of maximal trunk extension eccentric exercise (EE) on ECT thickness, self-reported DOMS, ECT stiffness, skin temperature, and possible correlations between these outcomes. Healthy adults (n = 16, 29.34 ± 9.87 years) performed fatiguing EE of the trunk. A group of highly active individuals (TR, n = 8, > 14 h of sport per week) was compared with a group of less active individuals (UTR, n = 8, < 2 h of sport per week). Ultrasound measurements of ECT thickness, stiffness with MyotonPro and IndentoPro, skin temperature with infrared thermography, and pain on palpation (100 mm visual analog scale, VAS) as a surrogate for DOMS were recorded before (t0), immediately (t1), 24 h (t24), and 48 h (t48) after EE. ECT thickness increased after EE from t0 to t24 (5.96 mm to 7.10 mm, p = 0.007) and from t0 to t48 (5.96 mm to 7.21 mm, p < 0.001). VAS also increased from t0 to t24 (15.6 mm to 23.8 mm, p < 0.001) and from t0 to t48 (15.6 mm to 22.8 mm, p < 0.001). Skin temperature increased from t1 to t24 (31.6° Celsius to 32.7° Celsius, p = 0.032) and t1 to t48 (31.6° Celsius to 32.9° Celsius, p = 0.003), while stiffness remained unchanged (p > 0.05). Correlation analysis revealed no linear relationship between the outcomes within the 48-hour measurement period. The results may confirm previous findings of possible ECT involvement in the genesis of DOMS in the extremities also for the paraspinal ECT of trunk extensors. Subsequent work should focus on possible interventions targeting the ECT to prevent or reduce DOMS after strenuous muscle EE.

Is my wound infected? A study on the use of hyperspectral imaging to assess wound infection

Introduction

Clinical signs and symptoms (CSS) of infection are a standard part of wound care, yet they can have low specificity and sensitivity, which can further vary due to clinician knowledge, experience, and education. Wound photography is becoming more widely adopted to support wound care. Thermography has been studied in the medical literature to assess signs of perfusion and inflammation for decades. Bacterial fluorescence has recently emerged as a valuable tool to detect a high bacterial load within wounds. Combining these modalities offers a potential objective screening tool for wound infection.

Methods

A multi-center prospective study of 66 outpatient wound care patients used hyperspectral imaging to collect visible light, thermography, and bacterial fluorescence images. Wounds were assessed and screened using the International Wound Infection Institute (IWII) checklist for CSS of infection. Principal component analysis was performed on the images to identify wounds presenting as infected, inflamed, or non-infected.

Results

The model could accurately predict all three wound classes (infected, inflamed, and non-infected) with an accuracy of 74%. They performed best on infected wounds (100% sensitivity and 91% specificity) compared to non-inflamed (sensitivity 94%, specificity 70%) and inflamed wounds (85% sensitivity, 77% specificity).

Discussion

Combining multiple imaging modalities enables the application of models to improve wound assessment. Infection detection by CSS is vulnerable to subjective interpretation and variability based on clinicians' education and skills. Enabling clinicians to use point-of-care hyperspectral imaging may allow earlier infection detection and intervention, possibly preventing delays in wound healing and minimizing adverse events.

Association between physical demands, skin temperature and wellbeing status in elite football players

The demanding nature of elite football requires players to be closely monitored to ensure optimal performance and minimize injury risk. This study aimed to evaluate the relationship between physical demands, skin temperature, and well-being status in 30 elite football players over a 12-week competitive period. Thermography assessments, weekly Well-being questionnaires, and daily training and match load recordings were used to gather data. Results indicated that along the microcycles there was a decrease in high-intensity accelerations and decelerations distance completed, while maintaining other high-intensity actions. Furthermore, it was found that high-intensity movements contribute to the generation of thermal asymmetries in the thighs; the adductor thermal asymmetry showed a positive relationship with stress and muscle soreness, the knee thermal asymmetry had a positive relationship with fatigue and a negative relationship with rest and quality of rest, and finally the hamstrings muscles exhibited significant differences between the thermal asymmetry groups, with the high asymmetry completing less high intensity actions than the low asymmetry group. In conclusion, this study highlights the interconnections between physical demands, skin temperature, and well-being in elite football players and provides valuable insights for coaches and trainers in their efforts to optimize performance and health.

Medical ozone on hamstring injury in a professional athlete assessed by thermography: a clinical case report

Injuries associated with the hamstring muscles in the running athlete are increasingly investigated due to the economic and functional consequences associated with them. Although hardly used in the treatment of sports injuries, medical ozone is effective and very well tolerated in the treatment of musculoskeletal pain, it was decided to add a series of medical ozone infiltrations to the treatment. The evolution of the case was recorded by medical thermography, in addition to measuring pain intensity (visual analog scale) and functional capacity (toe touch test). Pain intensity (visual analog scale) decreased from seven at baseline to two at the end of treatment (after two ozone infiltrations, one weekly). Mobility of the damaged area (toe touch test) improved from a distance of 8 cm at baseline to 0 cm at the end of treatment. Regarding medical thermography, after the first and second infiltration of ozone, the temperature rose to a significant increase in perfusion from baseline from 31.2 to 31.8 °C and from 31.2 to 32 °C, respectively. These results suggest the possible interest of medical ozone as an adjuvant treatment for the recovery of sports tendinopathies and encourage us to carry out further studies.

Can infrared thermography serve as an alternative to assess cumulative fatigue in women?

Muscle fatigue can limit performance both in sports and daily life activities. Consecutive days of exercise without a proper recovery time may elicit cumulative fatigue. Although it has been speculated that skin temperature could serve as an indirect indicator of exercise-induced adaptations, it is unclear if skin temperature measured by infrared thermography (IRT) could be an outcome related to the effects of cumulative fatigue. In this study, we recruited 21 untrained women and induced cumulative fatigue in biceps brachii over two consecutive days of exercise. We measured delayed onset muscle soreness (DOMS, using a numeric rate scale), maximal strength (using a dynamometer), and skin temperature (using IRT) in exercise and non-exercise muscles. Cumulative fatigue reduced muscle strength and increased DOMS. Skin temperature in the arm submitted to cumulative fatigue was higher for minimum and mean temperature, being asymmetrical in relation to the control arm. We also observed that the variations in the minimum and mean temperatures correlated with the strength losses. In summary, skin temperature measured by IRT seems promising to help detect cumulative fatigue in untrained women, being useful to explain strength losses. Future studies should provide additional evidence for the potential applications not only in trained participants but also in patients that may not be able to report outcomes of scales or precisely report DOMS.

Acute physiological responses to a pyramidal exercise protocol and the associations with skin temperature variation in different body areas

This study aimed to examine the skin temperature (Tsk) variations in five regions of interest (ROI) to assess whether possible disparities between the ROI's Tsk could be associated with specific acute physiological responses during cycling. Seventeen participants performed a pyramidal load protocol on a cycling ergometer. We synchronously measured Tsk in five ROI with three infrared cameras. We assessed internal load, sweat rate, and core temperature. Reported perceived exertion and calves' Tsk showed the highest correlation (r = -0.588; p < 0.01). Mixed regression models revealed that the heart rate and reported perceived exertion were inversely related to calves' Tsk. The exercise duration was directly associated with the nose tip and calf Tsk but inversely related to the forehead and forearm Tsk. The sweat rate was directly related to forehead and forearm Tsk. The association of Tsk with thermoregulatory or exercise load parameters depends on the ROI. The parallel observation of the face and calf Tsk could indicate simultaneously the observation of acute thermoregulatory needs and individual internal load. The separate Tsk analyses of individual ROI appear more suitable to examine specific physiological response than a mean Tsk of several ROI during cycling.

Acute Effects of Varied Back Squat Activation Protocols on Muscle-Tendon Stiffness and Jumping Performance

ABSTRACT

Krzysztofik, M, Wilk, M, Pisz, A, Kolinger, D, Tsoukos, A, Zając, A, Stastny, P, and Bogdanis, GC. Acute effects of varied back squat activation protocols on muscle-tendon stiffness and jumping performance. J Strength Cond Res 37(7): 1419-1427, 2023-Intensity, movement velocity, and volume are the principal factors to successfully use postactivation performance enhancement. Therefore, 15 resistance-trained volleyball players completed 3 different back squat configurations as a conditioning activity (CA) in randomized order: (a) 3 sets of 3 repetitions at 85% 1RM (HL); (b) a single set of back squats at 60% 1RM until 10% mean velocity loss (VB); (c) and 2 sets of back squats at 60% 1RM until 10% mean velocity loss (2VB) on subsequent countermovement jump performance, Achilles tendon, and vastus lateralis stiffness with concomitant front thigh skin surface temperature assessment. The measurements were performed 5 minutes before the CA and at 2, 4, 6, 8, and 10 minutes. The jump height was significantly increased in the second minute and at peak, post-CA compared with baseline for all conditions ( p = 0.049; ES = 0.23 and p < 0.001; ES = 0.37). Skin surface temperature was significantly increased for all post-CA time points compared with baseline in the 2VB condition ( p from <0.001-0.023; ES = 0.39-1.04) and in the fourth minute and at peak post-CA in HL condition ( p = 0.023; ES = 0.69 and p = 0.04; ES = 0.46), whereas for the VB condition, a significant decrease in peak post-CA was found ( p = 0.004; ES = -0.54). Achilles tendon stiffness was significantly decreased for second, fourth, eighth, 10th, and peak post-CA in comparison to baseline for all conditions ( p from p = 0.004-0.038; ES = -0.47 to -0.69). Vastus lateralis stiffness was significantly decreased for peak post-CA compared with baseline for all conditions ( p = 0.017; ES = -0.42). We recommend using a single set of barbell squats with a 10% velocity loss as a mechanism of fatigue control to acutely improve jump height performance and avoid unnecessary increases in training volume.

Thermal responses induced by nitrogen and forced convection based partial-body cryostimulation

Partial Body Cryostimulation (PBC) involves a very cold air flow directed to the body of subjects with minimal clothing. PBC is performed in a rapid timeframe, inside an on-purposed designed cryo-cabin. Recently, cryo-cabins have been built with different energy systems, however a validation study on relative thermal responses is missing. This study was aimed at comparing thermal responses following a PBC in an electrically powered cryo-cabin based on forced convection or into a standard nitrogen-fueled cryo-cabin. In a randomized crossover fashion, thirty-six subjects (F=20; M=16) underwent both cryo-exposures lasting 150 s each. Thermal responses were assessed before and immediately after completing each PBC session. Mixed model analysis of variance revealed a significantly colder temperature after electric PBC in all the body regions (except for the thighs) with respect to a standard nitrogen based PBC (F: 16.4 ± 1.4 vs 18 ± 5.8 °C; M: 16.4 ± 1.7 vs 20.9 ± 4 °C). Moreover, a significant lower thermal discomfort was perceived at the end of electric PBC as compared to that one felt following standard PBC. For the first time, the safety and thermo-effectiveness of an electric cryo-cabin based on forced convection was ensured. This methodology can be viable for practitioners of PBC and clinicians.

Skin Temperature of Acupoints in Health and Primary Dysmenorrhea Patients: A Systematic Review and Meta-Analysis

Objective

Dysmenorrhea is a common clinical condition and some studies shown that the skin temperature of some acupoints changes in primary dysmenorrhea (PD) patients. This study aimed to evaluate the changes in skin temperature at specific acupoints in PD patients and healthy subjects.

Methods

The literature for assessing skin temperature at acupoints in PD patients and healthy subjects was searched in eight databases. The literatures obtained from the search was independently screened by two authors, and the quality of the included articles was evaluated using the consensus checklist of the Thermographic Imaging in Sports and Exercise Medicine (TISEM) and the Newcastle-Ottawa Scale (NOS) scale. The skin temperature of the relevant acupoints or the difference between the left and right acupoints of the same name was used as the outcome during any period of menstruation. Finally, the meta-analysis was performed using RevMan 5.4.1 software to evaluate the changes in skin temperature in the related acupoints.

Results

Seven eligible studies were included, which included 328 patients with PD and 279 healthy subjects. The results of the meta-analysis revealed a significant difference in skin temperature around the Sanyinjiao (SP6)(MD: 0.04, 95% CI: 0.00, 0.08), Xuehai (SP 10)(MD: -0.07, 95% CI:-0.11, -0.02) and Taixi (KI 3)(MD: 0.06, 95% CI:0.01, 0.11) acupoints between PD and healthy subjects. PD patients also showed a difference in skin temperature at the Taixi (KI 3)(MD: 0.14, 95% CI:0.04, 0.24), Shuiquan (KI 5)(MD: 0.11, 95% CI: 0.03,0.19), Taichong (LR 3)(MD: -0.10, 95% CI: -0.19,-0.01), Diji (SP 8)(MD: -0.09, 95% CI: -0.16, -0.01), and Xuehai (SP 10)(MD: -0.14, 95% CI: -0.23, -0.06) acupoint areas at different times of menstruation compared to that of healthy subjects, as revealed by the subgroup analysis.

Conclusion

Primary dysmenorrhea patients showed some differences in the skin temperature of the special acupoints are as Sanyinjiao (SP6), Diji (SP 8), Xuehai (SP 10), Shuiquan (KI 5), Taichong (LR 3), and Taixi (KI 3) compared with healthy subjects.

Registration Number

CRD42022381387.

Heated environment offsets the cardiovascular responses to prolonged rowing exercise in competitive athletes

Prolonged rowing exercise sessions are often prescribed considering competitive training schedules, and under hostile environments (e.g., heated ambient). The study aimed to investigate the effect of heat stress (HS) on physical performance, Lactate concentration ([Lac]), and cardiorespiratory responses during prolonged exercise sessions in competitive rowers. Twelve rowers performed preliminary exercise tests (2-km test and five-step incremental lactate test) to assess the target workload intensity corresponding to a 2.5 mmol^.L^-1 of [Lac]. On two separate days, participants were enrolled in two exercise sessions of 12 km in a rowing machine under HS (∼30 °C) and thermal comfort (TC 22 °C) conditions. Heart rate (HR), stroke volume (SV), cardiac output (CO), oxygen uptake (VO₂), [Lac], and the rating of perceptual exertion (RPE) were obtained. From baseline, HS increased the maximum temperature of the face compared to TC. Workload and VO₂ reduced while RPE increased at 9- and 12-km of rowing exercise under HS compared to TC. From baseline to the last stage of exercise, HS shifted SV downwards and HR upwards compared to TC. Consequently, CO did not change between thermal conditions (TC vs. HS). Therefore, HS provokes a cardiovascular drift during prolonged rowing in comparison to TC. The last stages of prolonged rowing sessions under HS seem to be critical to physical performance and relative perceptual of effort in rowers.

Knee skin temperature response of patients with bilateral patellofemoral syndrome before and after heat and cold stress

Patellofemoral Pain Syndrome is characterized by the presence of pain in the front area of the knee, which occurs when performing common activities such as climbing stairs, and bending the knees, among others. The objective of this research was to evaluate the detection capability of infrared thermography in patients with Patellofemoral Pain Syndrome, in the baseline state, as well as after the application of thermal stress. The investigation was conducted in 48 patients, who were subdivided into four groups (n = 12). Two subgroups were healthy patients and two with Patellofemoral Pain Syndrome. For the diagnosis of the syndrome, a manual evaluation was performed using the Zohlen test and Q angle measurement. Subsequently, cold stress was applied for 10 min to a healthy subgroup and an experimental subgroup. The remaining two subgroups were subjected to heat stress for 15 min. Thermographic images of the lower extremities were acquired at seven time points, at baseline, immediately after application of thermal stress and then every 3 min until 15 min were completed. It was observed that patients presented Patellofemoral Pain Syndrome bilaterally. After statistical analysis, it was found that there were no significant differences in baseline temperature between the groups. However, for heat stress, a higher temperature was observed in the group with Patellofemoral Pain Syndrome (p < 0.05) in the recovery period, and in the case of cold stress, only a lower temperature in the left knee immediately after the application. In conclusion, it is not possible to detect patellofemoral syndrome bilaterally in the baseline state by thermography and neither is it evident in cold stress. However, after heat stress, thermal recovery is lower for the PFPS group, so it would be susceptible to detection.

Joint Response to Exercise Is Affected by Knee Osteoarthritis: An Infrared Thermography Analysis

Infrared thermography can be used to evaluate the inflammation characterizing the joint environment of OA knees, but there is limited evidence on the response to physical exercise. Identifying the response to exercise of OA knees and the influencing variables could provide important information to better profile patients with different knee OA patterns. Sixty consecutive patients (38 men/22 women, 61.4 ± 9.2 years) with symptomatic knee OA were enrolled. Patients were evaluated with a standardized protocol using a thermographic camera (FLIR-T1020) positioned at 1 m with image acquisition of an anterior view at baseline, immediately after, and at 5 min after a 2-min knee flexion-extension exercise with a 2 kg anklet. Patients' demographic and clinical characteristics were documented and correlated with the thermographic changes. This study demonstrated that the temperature response to exercise in symptomatic knee OA was affected by some demographic and clinical characteristics of the assessed patients. Patients with a poor clinical knee status presented with a lower response to exercise, and women showed a greater temperature decrease than men. Not all evaluated ROIs showed the same trend, which underlines the need to specifically study the different joint subareas to identify the inflammatory component and joint response while investigating knee OA patterns.

Body surface profile in ambient and hot temperatures during a rectangular test in race walker champions of the World Cup in Oman 2022

There is current interest in infrared thermography as a method to assess changes in body surface temperature to determine thermoregulatory mechanisms, especially in endurance sports. The aim of this study was to evaluate the effect of two environmental temperatures (17 and 28°C) on body surface temperature in different anterior and posterior aspects of the body during a rectangular test in international walkers of the Spanish National Team. Three international walkers performed a rectangular test, where body temperature was measured at rest, and after the 5th, 10th and 15th run using an infrared thermographic camera in room temperatures at 17 and 28°C. In addition, oxygen consumption was measured simultaneously. ANOVA detected a group × time interaction in the chest and abdomen (right and left), left back and right calf (p = < 0.05), with a trend in the right hamstring (p = 0.053) when comparing 17°C and 28°C. ANOVA detected no significant group × time interaction (p = 0.853) but there was a significant group effect (p = 0.022). The eleven degrees increase in ambient temperature (17 to 28°C) produces changes in almost all anatomical zones, but not homogeneously in international walkers during a rectangular test. This indicates that metabolic and blood flow changes are different depending on the anatomical zone measured.

Short-term foot warming impacts foot sensitivity and body sway differently in older adults

BACKGROUND

Aging is accompanied by loss of foot skin sensitivity and reduced postural control. Increasing foot temperature can improve both skin sensitivity and postural control in adults. However, it remains unclear whether similar effects can be observed in older adults.

RESEARCH QUESTION

Can foot warming improve postural control in older adults, similar to observations in younger adults?

METHODS

Two foot warming protocols were conducted in 18 older adults (14 women, 4 men) to increase foot temperature by using infrared radiation to (1) warm the plantar aspect and (2) the skin of the entire foot and ankle area. We assessed the foot skin sensitivity before and after warming, considering tactile stimulation and center of pressure (CoP) displacement during 30-s standing with eyes open and closed.

RESULTS AND SIGNIFICANCE

Both foot warming protocols led to similar increases in skin temperature (∼6 °C) compared to the basal condition, but only warming the entire foot and ankle area increased foot sensitivity for the different regions assessed. No main effects or interactions were found for CoP variables in response to the two warming protocols. The short-term effects identified after warming the entire foot and ankle region suggest that this might be a strategy to improve skin sensitivity in older adults as observed in younger adults, but this was not the case for CoP. Future research should clarify whether the magnitude and long-lasting effects of warming could be determinant of CoP results.

Infrared Thermography in Symptomatic Knee Osteoarthritis: Joint Temperature Differs Based on Patient and Pain Characteristics

The aim of this study was to evaluate osteoarthritis (OA) patients with infrared thermography to investigate imaging patterns as well as demographic and clinical characteristics that influence knee inflammation. Forty patients with one-sided symptomatic knee OA were included and evaluated through knee-specific PROMs and the PainDETECT Questionnaire for neuropathic pain evaluation. Thermograms were captured using a thermographic camera FLIR-T1020 and temperatures were extracted using the software ResearchIR for the overall knee and the five ROIs: medial, lateral, medial patella, lateral patella, and suprapatellar. The mean temperature of the total knee was 31.9 ± 1.6 °C. It negatively correlated with age (rho = −0.380, p = 0.016) and positively correlated with BMI (rho = 0.421, p = 0.007) and the IKDC objective score (tau = 0.294, p = 0.016). Men had higher temperatures in the knee medial, lateral, and suprapatellar areas (p = 0.017, p = 0.019, p = 0.025, respectively). Patients with neuropathic pain had a lower temperature of the medial knee area (31.5 ± 1.0 vs. 32.3 ± 1.1, p = 0.042), with the total knee negatively correlating with PainDETECT (p = 0.045). This study demonstrated that the skin temperature of OA symptomatic knees is influenced by demographic and clinical characteristics of patients, with higher joint temperatures in younger male patients with higher BMI and worst objective knee scores and lower temperatures in patients affected by neuropathic pain.

Thermography and rasterstereography as a combined infrared method to assess the posture of healthy individuals

The demand for noninvasive methods to assess postural defections is increasing because back alterations are more common among the healthy population. We propose a combined infrared method of rasterstereography and thermography to assess the back without harmful effects. This study aims to provide reference data on rasterstereography and thermography to evaluate the back of a healthy population and to further study the correlation between these two methods. This cross-sectional research involved 175 healthy individuals (85 males and 90 females) aged 22 to 35 years. There is a large Cohen's d effect size in the cervical depth (males = 43.77 ± 10.96 mm vs. females = 34.29 ± 7.04 mm, d = 1.03), and in the lumbar lordosis angle (males = 37.69 ± 8.89° vs. females = 46.49 ± 8.25°, d = - 1.03). The back temperature was different for gender in the cervical area (males = 33.83 ± 0.63 °C vs. females = 34.26 ± 0.84 °C, d = - 0.58) and dorsal area (males = 33.13 ± 0.71 °C vs. females = 33.59 ± 0.97 °C, d = - 0.55). Furthermore, in the female group there was a moderate correlation of lumbar temperature with lumbar lordosis angle (r = - 0.50) and dorsal temperature with shoulders torsion (r = 0.43). Males showed a moderate correlation for vertebral surface rotation RMS with cervical (r = - 0.46), dorsal (r = - 0.60), and lumbar (r = - 0.50) areas and cervical temperature with shoulders obliquity (r = 0.58). These results highlight a possible correlation between rasterstereography and thermography, which may elucidate the underlying mechanics of spinal alterations and thermal muscle response. Our findings may represent reference data for other studies using noninvasive methods to assess postural alterations.

The peripheral vascular responses in non-freezing cold injury and matched controls

NEW FINDINGS

What is the central question of this study? Does non-freezing cold injury (NFCI) alter normal peripheral vascular function? What is the main finding and its importance? Individuals with NFCI were more cold sensitive (rewarmed more slowly and felt more discomfort) than controls. Vascular tests indicated that extremity endothelial function was preserved with NFCI and that sympathetic vasoconstrictor response might be reduced. The pathophysiology underpinning the cold sensitivity associated with NFCI thus remains to be identified.

ABSTRACT

The impact of non-freezing cold injury (NFCI) on peripheral vascular function was investigated. Individuals with NFCI (NFCI group) and closely matched controls with either similar (COLD group) or limited (CON group) previous cold exposure were compared (n = 16). Peripheral cutaneous vascular responses to deep inspiration (DI), occlusion (PORH), local cutaneous heating (LH) and iontophoresis of acetylcholine and sodium nitroprusside were investigated. The responses to a cold sensitivity test (CST) involving immersion of a foot in 15°C water for 2 min followed by spontaneous rewarming, and a foot cooling protocol (footplate cooled from 34°C to 15°C), were also examined. The vasoconstrictor response to DI was lower in NFCI compared to CON (toe: 73 (28)% vs. 91 (17)%; P = 0.003). The responses to PORH, LH and iontophoresis were not reduced compared to either COLD or CON. During the CST, toe skin temperature rewarmed more slowly in NFCI than COLD or CON (10 min: 27.4 (2.3)°C vs. 30.7 (3.7)°C and 31.7 (3.9)°C, P < 0.05, respectively); however, no differences were observed during the footplate cooling. NFCI were more cold-intolerant (P < 0.0001) and reported colder and more uncomfortable feet during the CST and footplate cooling than COLD and CON (P < 0.05). NFCI showed a decreased sensitivity to sympathetic vasoconstrictor activation than CON and greater cold sensitivity (CST) compared to COLD and CON. None of the other vascular function tests indicated endothelial dysfunction. However, NFCI perceived their extremities to be colder and more uncomfortable/painful than the controls.

Can Adipose Tissue Influence the Evaluation of Thermographic Images in Adolescents?

Infrared thermography (IRT) is a technology easy to use for clinical purposes as a pre-diagnostic tool for many health conditions. However, the analysis process of a thermographic image needs to be meticulous to make an appropriate decision. The adipose tissue is considered a potential influence factor in the skin temperature (Tsk) values obtained by IRT. This study aimed to verify the influence of body fat percentage (%BF) on Tsk measured by IRT in male adolescents. A total of 100 adolescents (16.79 ± 0.97 years old and body mass index of 18.41 ± 2.32 kg/m²) was divided into two groups through the results of a dual-energy X-ray absorptiometry analysis: obese (n = 50, %BF 30.21 ± 3.79) and non-obese (n = 50, %BF 11.33 ± 3.08). Thermograms were obtained by a FLIR T420 infrared camera and analyzed by ThermoHuman^® software version 2.12, subdividing the body into seven regions of interest (ROI). The results showed that obese adolescents presented lower mean Tsk values than the non-obese for all ROIs (p < 0.05), with emphasis on the global Tsk (0.91 °C) and anterior (1.28 °C) and posterior trunk (1.18 °C), with "very large" effect size values. A negative correlation was observed in all the ROI (p < 0.01), mainly in the anterior (r = -0.71, p < 0.001) and posterior trunk (r = -0.65, p < 0.001). Tables of thermal normality were proposed for different ROIs according to the classification of obesity. In conclusion, the %BF affects the registered Tsk values in male Brazilian adolescents assessed by IRT.

Accuracy of Thermographic Imaging in the Early Detection of Pressure Injury: A Systematic Review

OBJECTIVE

To verify the accuracy of thermographic images in the early detection of pressure injury (PI) in adult patients.

DATA SOURCES

Between March 2021 and May 2022, researchers searched 18 databases for relevant articles using nine keywords. In total, 755 studies were evaluated.

STUDY SELECTION

Eight studies were included in the review. Studies were included if they evaluated individuals older than 18 years who were admitted to any healthcare setting; were published in English, Spanish, or Portuguese; examined the accuracy of thermal imaging in the early detection of PI, including suspected stage 1 PI or deep tissue injury; and they compared the region of interest to another area or control group, or to the Braden Scale or Norton Scale. Animal studies and reviews, studies with contact infrared thermography, and those including stages 2, 3, 4, and unstageable PIs were excluded.

DATA EXTRACTION

Researchers examined sample characteristics and assessment measures related to image capture, including environmental, individual, and technical factors.

DATA SYNTHESIS

Across the included studies, sample sizes ranged from 67 to 349 participants, and patients were followed up for periods ranging from a single assessment up to 14 days, or until the appearance of a PI, discharge, or death. Evaluation with the infrared thermography identified temperature differentials between regions of interest and/or in comparison with risk assessment scales.

CONCLUSIONS

Evidence on the accuracy of thermographic imaging in the early detection of PI is limited.

Effect of Whole-, Upper-, and Lower-Body High-Intensity Rowing Exercise on Skin Temperature Measured by Thermography

Purpose: Despite the growing works analyzing exercise-induced thermoregulatory adjustments through thermography, the skin temperature (Tsk) response of the same muscle groups underwent to different exercise demands has not been investigated. This study analyzed the behavior of Tsk of the same muscle groups when exercised with different demands in rowing. Methods: Eighteen men underwent three performance tests on a rowing ergometer: whole-body 2,000 m test (RT_WB), upper-body (RT_UB), and lower-body (RT_LB) tests. In each condition, thermograms were recorded before (pre), immediately after test (post), and at 10 (REC₁₀), 20 (REC₂₀), and 30 (REC₃₀) minutes post-exercise recovery. Tsk was measured at the pectoral (control body region), upper back, quadriceps, brachial biceps, and forearm. Results: Pectoral-Tsk reduced comparably in response to all testing conditions (p < .05). Upper back-Tsk decreased post (p < .001) and returned to baseline in the RT_UB (REC₁₀, p = 1.0) and RT_WB (REC₃₀, p = .128), while remained reduced in the RT_LB (p < .001). Quadriceps-Tsk reduced post (p < .05) and returned to baseline in the RT_WB and RT_LB at REC₁₀ (p = 1.0), remaining reduced in the RT_UB during recovery (p < .05). Regarding the upper limbs, Tsk increased more markedly in the RT_UB versus RT_WB during the recovery period (p < .05); in the RT_LB, biceps-Tsk remained below baseline over time (p < .05), whereas the forearm-Tsk was restored at REC₁₀ (p = 1.0). Conclusion: Manipulating the muscle groups involved in rowing alters the Tsk response within equal ROI. Exercise-induced Tsk changes can reflect local hemodynamic and thermoregulatory adjustments.

Radial artery pulse wave velocity: a new characterization technique and the instabilities associated with the respiratory phase and breath-holding

Objective. Pulse wave velocity (PWV) is a key diagnostic parameter of the cardiovascular system's state. However, approaches aimed at PWV characterization often suffer from inevitable drawbacks. Statistical results demonstrating how closely PWV in the radial artery (RA) and the respiration phase correlate, as well as RA PWV evolution during breath-holding (BH), have not yet been presented in the literature. The aims of this study are (a) to propose a simple robust technique for measuring RA PWV, (b) to reveal the phase relation between the RA PWV and spontaneous breathing, and (c) to disclose the influence of BH on the RA PWV.Approach.The high-resolution remote breathing monitoring method Sorption-Enhanced Infrared Thermography (SEIRT) and the new technique aimed at measuring RA PWV described in this paper were used synchronously, and their measurement data were processed simultaneously.Main results. Spontaneous breathing leaves a synchronous 'trace' on the RA PWV. The close linear correlation of the respiration phase and the phase of concomitant RA PWV changes is statistically confirmed in five tested people (Pearson's r is of the order of 0.5-0.8, P < 0.05). The BH appreciably affects the RA PWV. A phenomenon showing that the RA PWV is not indifferent to hypoxia is observed for the first time.Significance.The proposed technique for RA PWV characterization has high prospects in biomedical diagnostics. The presented pilot study deserves attention in the context of the mutual interplay between respiratory and cardiovascular systems. It may also be useful in cases where peripheral pulse wave propagation helps assess respiratory function.

Infrared thermography for the evaluation of adolescent and juvenile idiopathic scoliosis: A systematic review

INTRODUCTION

Adolescent and Juvenile Idiopathic Scoliosis are a three-dimensional spine deformity characterized by a muscle alteration of the convex and concave sides of the scoliosis, which can be evaluated with different non-invasive and radiation-free methods such as infrared thermography. The objective of the present review is to assess infrared thermography as a potential method to evaluate alterations of the scoliosis.

MATERIALS AND METHODS

A systematic review was performed by collecting articles from PubMed, Web of Science, Scopus, and Google Scholar, published from 1990 to April 2022, on the use of infrared thermography to evaluate adolescent and juvenile idiopathic scoliosis. Relevant data were collected in tables, and the primary outcomes were discussed narratively.

RESULTS

Of the 587 articles selected, only 5 were in line with the objective of this systematic review and were eligible for the inclusion criteria. The findings of the selected articles corroborate the applicability of infrared thermography as an objective method to assess the thermal differences of the muscles between the convex and concave sides of scoliosis. The overall quality of the research was uneven in the reference standard method and assessment of measures.

CONCLUSION

Infrared thermography is providing promising results to discriminate thermal differences in scoliosis evaluation, albeit there are still some concerns about considering it as a diagnostic tool for scoliosis evaluation because specific recommendations for collecting data are not met. We propose additional recommendations to existing guidelines to perform thermal acquisition to reduce errors and provide the best results to the scientific community.

An exploratory, intra- and interindividual comparison of the deep neural network automatically measured calf surface radiation temperature during cardiopulmonary running and cycling exercise testing: A preliminary study

Non-invasive and contactless infrared thermography (IRT) measurements have been claimed to indicate acute neural, cardiovascular, and thermoregulatory adaptations during exercise. Due to challenging comparability, reproducibility, and objectivity, investigations considering different exercise types and intensities, and automatic ROI analysis are currently needed. Thus, we aimed to examine surface radiation temperature (T_sr) variations during different exercise types and intensities in the same individuals, ROI, and environmental conditions. Ten healthy, active males performed a cardiopulmonary exercise test on a treadmill in the first week and on a cycling ergometer the following week. Respiration, heart rate, lactate, rated perceived exertion, the mean, minimum, and maximum T_sr of the right calf (CT_sr (°C)), and the surface radiation temperature pattern (CP_sr) were explored. We executed two-way rmANOVA and Spearman's rho correlation analyses. Across all IRT parameters, mean CT_sr showed the highest association to cardiopulmonary parameters (E.g., oxygen consumption: r_s = -0.612 (running); -0.663 (cycling); p < .001). A global significant difference of CT_sr was identified between all relevant exercise test increments for both exercise-types (p < .001; η²_p = .842) and between both exercise-types (p = .045; η²_p = .205). Differences in CT_sr between running and cycling significantly appeared after a 3-min recovery period, whereas lactate, heart rate, and oxygen consumption were not different. High correlations between the CT_sr values extracted manually and the CT_sr values processed automatically by a deep neural network were identified. The applied objective time series analysis enables crucial insights into intra- and interindividual differences between both tests. CT_sr variations indicate different physiological demands between incremental running and cycling exercise testing. Further studies applying automatic ROI analyses are needed to enable the extensive analysis of inter- and intraindividual factors influencing the CT_sr variation during exercise to allow determine the criterion and predictive validity of IRT parameters in exercise physiology.

Can Data-Driven Supervised Machine Learning Approaches Applied to Infrared Thermal Imaging Data Estimate Muscular Activity and Fatigue?

Surface electromyography (sEMG) is the acquisition, from the skin, of the electrical signal produced by muscle activation. Usually, sEMG is measured through electrodes with electrolytic gel, which often causes skin irritation. Capacitive contactless electrodes have been developed to overcome this limitation. However, contactless EMG devices are still sensitive to motion artifacts and often not comfortable for long monitoring. In this study, a non-invasive contactless method to estimate parameters indicative of muscular activity and fatigue, as they are assessed by EMG, through infrared thermal imaging (IRI) and cross-validated machine learning (ML) approaches is described. Particularly, 10 healthy participants underwent five series of bodyweight squats until exhaustion interspersed by 1 min of rest. During exercising, the vastus medialis activity and its temperature were measured through sEMG and IRI, respectively. The EMG average rectified value (ARV) and the median frequency of the power spectral density (MDF) of each series were estimated through several ML approaches applied to IRI features, obtaining good estimation performances (r = 0.886, p < 0.001 for ARV, and r = 0.661, p < 0.001 for MDF). Although EMG and IRI measure physiological processes of a different nature and are not interchangeable, these results suggest a potential link between skin temperature and muscle activity and fatigue, fostering the employment of contactless methods to deliver metrics of muscular activity in a non-invasive and comfortable manner in sports and clinical applications.

Relationship between Repeated Sprint Ability, Countermovement Jump and Thermography in Elite Football Players

Football is a very demanding sport which requires players to exert maximum effort, producing fatigue and eventually injuries. Thermography can be used to detect fatigue and prevent its consequences through thermal asymmetries in the bilateral body areas; however, its adequacy for elite footballers has not been widely studied. Therefore, the objective of the present investigation was to determine the suitability of thermography to detect fatigue in male football players. For this reason, twenty participants were gathered into a pair of subgroups (low [<0.2 °C] vs. high thermal asymmetry [≥0.2 °C]) based on a thermography session of the lower limbs (thighs, calves, and hamstrings). After the thermography session, players performed CMJs before and after an RSA test (6 × 30 m/20″). A mixed two-way analysis of variance and Bonferroni post hoc pairwise comparisons were undertaken to analyse the results. No significant differences (p > 0.05) were found in any of the RSA test variables between low and high thermal asymmetry groups for thighs and calves. On the other hand, the low thermal asymmetry hamstring group reported a smaller percentage difference in sprints for the first sprint (%Diff) and a larger percentage difference in sprints two and three with respect to the best sprint (%Best). For CMJs, the low thermal asymmetry hamstring group reported significantly higher values post-RSA test, indicating better performance. Accordingly, thermography can provide information about performance in CMJ and RSA tests through hamstring asymmetries over 0.2 °C. Meanwhile, larger asymmetries than 0.2 °C in calves and thighs do not seem to be related to performance in these tests; therefore, coaches should consider if it is optimal to align players with high hamstring asymmetries.

Influence of high-energy laser therapy to the patellar tendon on its ligamentous microcirculation: An experimental intervention study

Laser therapeutic applications, such as the use of high energy lasers (HILT), are widely used in physical therapy, but basic studies on the mechanisms of action of HILT on tendinous/ligamentous tissue are largely lacking. The aim of this study was to investigate microcirculatory changes of the patellar tendon by HILT. 21 healthy volunteers were included in the present investigation. Before and after HILT, as well as 10 minutes later, the microcirculation was measured by noninvasive laser Doppler and white light spectroscopy (O2C device). Tissue temperature was recorded at the measurement time points using thermography. Blood flow increased significantly by 86.38 arbitrary units (AU; p < 0.001) after the intervention and by 25.76 AU (p < 0.001) at follow-up. Oxygen saturation increased by 20.14% (p < 0.001) and 13.48%, respectively (p < 0.001), whereas relative hemoglobin decreased by 6.67 AU and 7.90 AU, respectively. Tendon temperature increased by 9.45° and 1.94° Celsius, respectively. Acceleration of blood flow by improving the flow properties of erythrocytes and platelets may have caused the results. HILT could be a therapeutic perspective for tendon pathologies with impaired microcirculation, although further studies are needed to validate the experimental results.

Intra- and inter-session reliability and repeatability of an infrared thermography device designed for materials to measure skin temperature of the triceps surae muscle tissue of athletes

Background

Infrared thermography devices have been commonly applied to measure superficial temperature in structural composites and walls. These tools were cheaper than other thermographic devices used to measure superficial human muscle tissue temperature. In addition, infrared thermography has been previously used to assess skin temperature related to muscle tissue conditions in the triceps surae of athletes. Nevertheless, the reliability and repeatability of an infrared thermography device designed for materials, such as the Manual Infrared Camera PCE-TC 30, have yet to be determined to measure skin temperature of the triceps surae muscle tissue of athletes.

Objective

The purpose was to determine the procedure's intra- and inter-session reliability and repeatability to determine skin temperature within the Manual Infrared Camera PCE-TC 30 thermography device in the triceps surae muscle tissue of athletes, which was initially designed to measure the superficial temperature of materials.

Methods

A total of 34 triceps surae muscles were bilaterally assessed from 17 healthy athletes using the Manual Infrared Camera PCE-TC 30 thermography device to determine intra- (at the same day separated by 1 h) and inter-session (at alternate days separated by 48 h) reliability and repeatability of the skin temperature of the soleus, medial and lateral gastrocnemius muscles. The triceps surae complex weas measured by a region of interest of 1 cm² through five infrared thermography images for each muscle. Statistical analyses comprised intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change (MCD), systematic error of measurement, correlation (r), and Bland-Altman plots completed with linear regression models (R ²).

Results

Intra- and inter-session measurements of the proposed infrared thermography procedure showed excellent reliability (ICC_(1,2) = 0.968-0.977), measurement errors (SEM = 0.186-0.232 °C; MDC = 0.515-0.643 °C), correlations (r = 0.885-0.953), and did not present significant systematic error of measurements (P > 0.05). Adequate agreement between each pair of measurement moments was presented by the Bland-Altman plots according to the limits of agreement and non-significant linear regression models (R ² = 0.000-0.019; P > 0.05).

Conclusions

The proposed procedure to determine skin temperature within the Manual Infrared Camera PCE-TC 30 thermography device presented excellent intra- and inter-session reliability and repeatability in athletes' triceps surae muscle tissue. Future studies should consider the SEM and MDC of this procedure to measure the skin temperature of soleus, medial, and lateral gastrocnemius muscles to promote triceps surae muscle prevention and recovery in athletes.

Skin temperature normalizes faster than pressure pain thresholds, pain intensity, and pain distribution during recovery from eccentric exercise

INTRODUCTION

Acute musculoskeletal injuries have diverse symptomatology and a multidimensional recovery process, including changes in swelling, redness, hyperalgesia, and expanded pain distribution. In a small proportion of cases, the tissue heals, although these symptoms persist, reflecting altered peripheral and central pain mechanisms. However, the otherwise healthy multidimensional recovery process following damage and pain is less than clear. The objective was to assess mechanical muscle hyperalgesia, skin temperature, and pain intensity and distribution during the recovery process in response to eccentric exercise in the hamstring muscles.

METHODS

Twenty-four healthy males participated in four sessions (Day-0, Day-2, Day-4, and Day-7). Exercise-induced muscle soreness was induced on Day-0 by five sets of 20 repetitions of an eccentric exercise involving the hamstrings on the dominant leg. Each session included assessments of thermography, pressure pain thresholds (PPTs), pain intensity, and area of exercise-induced pain.

RESULTS

Decreased PPTs (P < 0.005), higher pain intensity (P < 0.001), and a larger area of pain (P < 0.001) were displayed on Day-2 and Day-4 than Day-0. Skin temperature decreased on Day-2 than Day-0 (P < 0.01) and returned to baseline assessments by Day-4, despite lower temperature than the contralateral tight (P < 0.01). Further, there was a positive correlation between pain intensity and area on Day-2 and Day-4 (P < 0.005), but no for changes in skin temperature.

CONCLUSION

Thermographic changes and pain-related variables altered following eccentric exercise demonstrate different recovery times. These results provide insights into potential mechanisms and measures that can be used to assess recovery from exercise-induced damage.

Can Skin Temperature Be Altered After Different Magnitudes of Eccentric Exercise-Induced Muscle Damage?

Purpose: This study aimed to assess skin temperature (Tsk) changes after different magnitudes of exercise-induced muscle damage (EIMD) of the elbow flexor muscles and investigate whether Tsk is related to indirect markers of EIMD. Methods: Thirty healthy active men were randomly allocated to the mild (MiDG) (n = 15) or moderate (MoDG) (n = 15) muscle damage group. Muscle damage in elbow flexor muscles was induced by 10 (for MiDG) or 30 (for MoDG) maximal eccentric isokinetic contractions at 60 degrees/s. Tsk, maximal voluntary isometric contraction (MVIC), delayed-onset muscle soreness (DOMS), plasma creatine kinase (CK) activity, range of motion (ROM), and pressure pain threshold (PPT) were measured before and up to 72 hr after EIMD. Results: Tsk increased only immediately after EIMD (p < .05; f = 1.44) in the MoDG (4.2%) and MiDG (4.6%), returning to near baseline values 30 min after EIMD and remaining so thereafter. In addition, there was no intergroup difference (p > .05) at any of the times analyzed, or correlation between Tsk and most indirect markers of EIMD. Conclusions: In conclusion, Tsk should not be considered an indirect marker of mild or moderate muscle damage in active men, since alterations in this variable last less than 30 min after damaging exercise and showed no correlation with most indirect markers of EIMD.

GIP Affects Hepatic Fat and Brown Adipose Tissue Thermogenesis but Not White Adipose Tissue Transcriptome in Type 1 Diabetes

CONTEXT

Glucose-dependent insulinotropic polypeptide (GIP) has been proposed to exert insulin-independent effects on lipid and bone metabolism.

OBJECTIVE

We investigated the effects of a 6-day subcutaneous GIP infusion on circulating lipids, white adipose tissue (WAT), brown adipose tissue (BAT), hepatic fat content, inflammatory markers, respiratory exchange ratio (RER), and bone homeostasis in patients with type 1 diabetes.

METHODS

In a randomized, placebo-controlled, double-blind, crossover study, 20 men with type 1 diabetes underwent a 6-day continuous subcutaneous infusion with GIP (6 pmol/kg/min) and placebo (saline), with an interposed 7-day washout period.

RESULTS

During GIP infusion, participants (26 ± 8 years [mean ± SD]; BMI 23.8 ± 1.8 kg/m2; glycated hemoglobin A1c 51 ± 10 mmol/mol [6.8 ± 3.1%]) experienced transiently increased circulating concentrations of nonesterified fatty acid (NEFA) (P = 0.0005), decreased RER (P = 0.009), indication of increased fatty acid β-oxidation, and decreased levels of the bone resorption marker C-terminal telopeptide (P = 0.000072) compared with placebo. After 6 days of GIP infusion, hepatic fat content was increased by 12.6% (P = 0.007) and supraclavicular skin temperature, a surrogate indicator of BAT activity, was increased by 0.29 °C (P < 0.000001) compared with placebo infusion. WAT transcriptomic profile as well as circulating lipid species, proteome, markers of inflammation, and bone homeostasis were unaffected.

CONCLUSION

Six days of subcutaneous GIP infusion in men with type 1 diabetes transiently decreased bone resorption and increased NEFA and β-oxidation. Further, hepatic fat content, and supraclavicular skin temperature were increased without affecting WAT transcriptomics, the circulating proteome, lipids, or inflammatory markers.

Chronic and Acute Effects on Skin Temperature from a Sport Consisting of Repetitive Impacts from Hitting a Ball with the Hands

Valencian handball consists in hitting the ball with the hands and it may contribute to injury development on the hands. This study aimed to analyze skin temperature asymmetries and recovery after a cold stress test (CST) in professional players of Valencian handball before and after a competition. Thirteen professional athletes and a control group of ten physically active participants were measured. For both groups, infrared images were taken at the baseline condition; later they underwent a thermal stress test (pressing for 2 min with the palm of the hand on a metal plate) and then recovery images were taken. In athletes, the images were also taken after their competition. Athletes at baseline condition presented lower temperatures (p < 0.05) in the dominant hand compared with the non-dominant hand. There were asymmetries in all regions after their match (p < 0.05). After CST, a higher recovery rate was found after the game. The regions with the most significant differences in variation, asymmetries and recovery patterns were the index, middle and ring fingers, and the palm of the dominant hand. Taking into account that lower temperatures and the absence of temperature variation may be the consequence of a vascular adaptation, thermography could be used as a method to prevent injuries in athletes from Valencian handball.