Infrared thermal imaging based study of localized cold stress induced thermoregulation in lower limbs: The role of age on the inversion time

Confounding factors in peripheral thermal recovery time after active cooling

OBJECTIVES

The effectiveness of normal physiological thermoregulation complicates differentiation between pathologic changes in medical thermography associated with peripheral artery disease and a number of other clinical conditions. In this study we investigate a number of potential confounding factors to the thermal recovery rate after active limb cooling, with the main focus on age and sex.

APPROACH

The source data consists of 53 healthy individuals with no diagnosed cardiovascular disease or reported symptoms and with a mean age of 38.4 (± 12.1) years. The sample population was further divided into male (N = 14) and female groups (N = 39). The thermal recovery time was measured using two thermal cameras from both lower limbs on plantar and dorsal sides. The active cooling was achieved using moldable cold pads placed on the plantar and dorsal side of the lower limb. The recovery was measured until the temperature had reached a stable level. The recovery time was determined from an exponential fit to the measured data.

RESULTS

The correlation between the thermal recovery time constant and age varied from low to moderate linear correlation (0.31 ≤ ⍴ ≤ 70), depending on the inspected region of interest, with a higher statistically significant correlation in the medial regions. The contralateral limb temperature differences or the thermal time constants did not have statistically significant differences between the male and female sexes. Further, the secondary metrics such as participant's body mass, body-mass index, or systolic blood pressure had low or no correlation with the thermal recovery time in the study group.

CONCLUSION

The thermal recovery time constant after active cooling appears as a relatively independent metric from the majority of the measured potential confounding factors. Age should be accounted for when performing thermal recovery measurements. However, dynamic thermal imaging and its methodologies require further research and exploration.

Assessment of chronic limb threatening ischemia using thermal imaging

OBJECTIVES

Current chronic limb threatening ischemia (CLTI) diagnostics require expensive equipment, using ionizing radiation or contrast agents, or summative surrogate methods lacking in spatial information. Our aim is to develop and improve contactless, non-ionizing and cost-effective diagnostic methods for CLTI assessment with high spatial accuracy by utilizing dynamic thermal imaging and the angiosome concept.

APPROACH

Dynamic thermal imaging test protocol was suggested and implemented with a number of computational parameters. Pilot data was measured from 3 healthy young subjects, 4 peripheral artery disease (PAD) patients and 4 CLTI patients. The protocol consists of clinical reference measurements, including ankle- and toe-brachial indices (ABI, TBI), and a modified patient bed for hydrostatic and thermal modulation tests. The data was analyzed using bivariate correlation.

RESULTS

The thermal recovery time constant was on average higher for the PAD (88%) and CLTI (83%) groups with respect to the healthy young subjects. The contralateral symmetry was high for the healthy young group and low for the CLTI group. The recovery time constants showed high negative correlation to TBI (ρ = -0.73) and ABI (ρ = -0.60). The relation of these clinical parameters to the hydrostatic response and absolute temperatures (|ρ|<0.3) remained unclear.

CONCLUSION

The lack of correlation for absolute temperatures or their contralateral differences with the clinical status, ABI and TBI disputes their use in CLTI diagnostics. Thermal modulation tests tend to augment the signs of thermoregulation deficiencies and accordingly high correlations were found with all reference metrics. The method is promising for establishing the connection between impaired perfusion and thermography. The hydrostatic modulation test requires more research with stricter test conditions.

Infrared thermal imaging-based skin temperature response during cupping at two different negative pressures

Cupping therapy can relieve muscle fatigue and pain after exercise by increasing blood flow at the treatment site, which may lead to dynamic changes of the local skin temperature. This study aimed to analyze the effect of cupping on local skin temperature under two different negative pressures using infrared thermography (IRT). Cupping therapy was performed on the forearms of 22 healthy subjects using the negative pressures of − 0.03 and − 0.04 MPa. IRT was used to record the dynamic changes in skin temperature before, during, and after cupping. Both cupping pressures induced a non-linear skin temperature response: temperature decreased first and then increased during cupping, while it first increased and then decreased after cupping. A significant difference was noted between the two negative pressure groups in the maximum temperature increment after cupping (P < 0.001). Compared with the basal temperature before cupping, the maximum increase in skin temperature after cupping in the − 0.03 and − 0.04 MPa groups was 0.92 and 1.42 °C, respectively. The findings of this study can lay the foundation evaluating the curative effect of cupping based on IRT and provide an objective reference for selecting the cupping negative pressure.

Regions of interest selection and thermal imaging data analysis in sports and exercise science: a narrative review

OBJECTIVE

Infrared thermography (IRT) is a non-invasive, contactless and low-cost technology that allows recording of the radiating energy that is released from a body, providing an estimate of its superficial temperature. Thanks to the improvement of infrared thermal detectors, this technique is widely used in the biomedical field to monitor the skin temperature for different purposes (e.g. assessing circulatory diseases, psychophysiological state, affective computing). Particularly, in sports and exercise science, thermography is extensively used to assess sports performance, to investigate superficial vascular changes induced by physical exercise, and to monitor injuries. However, the methods of analysis employed to treat IRT data are not standardized, and hence introduce variability in the results.

APPROACH

This review focuses on the methods of analysis currently used for thermal imaging in sports and exercise science.

MAIN RESULTS

Firstly, the procedures employed for the selection of regions of interest (ROIs) from anatomical body districts are reviewed, paying attention also to the potentialities of morphing algorithms to increase the reproducibility of thermal results. Secondly, the statistical approaches utilized to characterize the temperature frequency and spatial distributions within ROIs are investigated, showing their strengths and weaknesses. Moreover, the importance of employing tracking methods to analyze the temporal thermal oscillations within ROIs is discussed. Thirdly, the capability of employing procedures of investigation based on machine learning frameworks on thermal imaging in sports science is examined.

SIGNIFICANCE

Finally, some proposals to improve the standardization and the reproducibility of IRT data analysis are provided, in order to facilitate the development of a common database of thermal images and to improve the effectiveness of IRT in sports science.