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Santos BM, Santos WS, Solon IG, Garcia FS, Emilio-Silva MT, Jesus AA, Hiruma-Lima CA, Nascimento GC, Cárnio EC, Branco LGS. Orofacial anti-hypernociceptive effect of citral in acute and persistent inflammatory models in rats. Arch Oral Biol 2023; 152:105734. [PMID: 37244090 DOI: 10.1016/j.archoralbio.2023.105734] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/12/2023] [Accepted: 05/20/2023] [Indexed: 05/29/2023]
Abstract
Orofacial pain has significant psychological and physiological effects. Citral (3,7-dimethyl-2,6-octadienal) is the main component of Cymbopogon citratus (DC) Stapf, an herb with analgesic properties. Although citral has been considered a potent analgesic, its putative effects on orofacial pain are still unknown. OBJECTIVE The objective of this study is to test the hypothesis that citral modulates orofacial pain using two experimental models: formalin-induced hyperalgesia in the vibrissae area and during persistent temporomandibular hypernociception using Complete Freund's Adjuvant - CFA test. METHODS For the formalin test, citral (100 and 300 mg/kg, oral gavage) or its vehicle (Tween 80, 1 %) were given 1 h before the formalin injection subcutaneously (sc) into the vibrissae area. For the CFA model, we analyzed the prophylactic (100 mg/kg of citral by oral gavage, 1 h before CFA injection) and the chronic therapeutic (citral treatment 1-hour post-CFA injection and daily post-CFA injection) effect of citral or its vehicle in animals treated with CFA for 8 days. RESULTS Citral caused a decrease in formalin-induced local inflammation and the time spent performing nociceptive behavior in a dose-dependent fashion. Similarly, prophylactic and therapeutic citral treatment decreased the CFA-induced persistent mechanical hypernociception in the temporomandibular area. CONCLUSION Our data strengthen the notion that citral plays a powerful antinociceptive role by decreasing orofacial hypernociception in formalin and CFA models.
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Affiliation(s)
- Bruna M Santos
- Department of Basic and Oral Biology, Dental School of Ribeirão Preto, University of São Paulo, Avenida Do Café s/n, São Paulo, 14040-904 Ribeirão Preto, SP, Brazil; Department of General and Specialized Nursing Ribeirão Preto, College of Nursing - University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Wanderson S Santos
- Department of Basic and Oral Biology, Dental School of Ribeirão Preto, University of São Paulo, Avenida Do Café s/n, São Paulo, 14040-904 Ribeirão Preto, SP, Brazil
| | - Isabelly G Solon
- Department of Basic and Oral Biology, Dental School of Ribeirão Preto, University of São Paulo, Avenida Do Café s/n, São Paulo, 14040-904 Ribeirão Preto, SP, Brazil
| | - Felipe S Garcia
- Department of Basic and Oral Biology, Dental School of Ribeirão Preto, University of São Paulo, Avenida Do Café s/n, São Paulo, 14040-904 Ribeirão Preto, SP, Brazil
| | - Maycon T Emilio-Silva
- Department of Structural and Functional Biology (Physiology), Biosciences Institute, UNESP-São Paulo State University, CEP 18618-689 Botucatu, SP, Brazil
| | - Aline A Jesus
- Department of General and Specialized Nursing Ribeirão Preto, College of Nursing - University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Clélia A Hiruma-Lima
- Department of Structural and Functional Biology (Physiology), Biosciences Institute, UNESP-São Paulo State University, CEP 18618-689 Botucatu, SP, Brazil
| | - Glauce C Nascimento
- Department of Basic and Oral Biology, Dental School of Ribeirão Preto, University of São Paulo, Avenida Do Café s/n, São Paulo, 14040-904 Ribeirão Preto, SP, Brazil
| | - Evelin C Cárnio
- Department of General and Specialized Nursing Ribeirão Preto, College of Nursing - University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Luiz G S Branco
- Department of Basic and Oral Biology, Dental School of Ribeirão Preto, University of São Paulo, Avenida Do Café s/n, São Paulo, 14040-904 Ribeirão Preto, SP, Brazil.
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Almeida ANSD, Cunha DAD, Duarte BF, Guimarães BTDL, Lucena JA, Pernambuco LDA, Paes MCNDM, Cunha MDD, Balata PMM, Silva HJD. Effect of Vocal Therapy Associated With TENS in Women With Behavioral Dysphonia. J Voice 2022; 36:585.e27-585.e37. [PMID: 32863100 DOI: 10.1016/j.jvoice.2020.07.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aimed to investigate the effect of transcutaneous electrical nerve stimulation (TENS) associated with vocal therapy in women with behavioral dysphonia. METHOD Seventeen women with behavioral dysphonia were divided into an experimental group (n = 8) and a placebo group (n = 9). All were submitted to six sessions of vocal therapy, according to the Comprehensive Voice Rehabilitation Program. In the experimental group, therapy was associated with TENS (30 minutes) and in the placebo group, the electrodes were placed and the equipment remained off. The vocal handicap, the voice through the acoustic and auditory perception evaluation, the electrical activity, and the superficial temperature of the suprahyoid and infrahyoid muscles were evaluated. Pre and post data were compared by parametric and nonparametric tests. RESULTS There was a decreased in vocal handicap of the placebo group (P = 0.002) and a decreased in the percentage of electrical activity of the right (P = 0.036) and left (P = 0.017) infrahyoid muscles of the experimental group in vowel emission and sequential speech (P = 0.036). There was an increase in temperature in the right infrahyoid region in vowel emission (P = 0.027) and the temperature difference decreased quantitatively between the supra and infrahyoid regions in the experimental group. CONCLUSION TENS associated with vocal therapy reduced the electrical activity of the infrahyoid muscles and balance the temperature between the supra- and infrahyoid regions in women with behavioral dysphonia.
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Chudecka M, Dmytrzak A, Leźnicka K, Lubkowska A. The Use of Thermography as an Auxiliary Method for Monitoring Convalescence after Facelift Surgery: A Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063687. [PMID: 35329373 PMCID: PMC8955831 DOI: 10.3390/ijerph19063687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 12/02/2022]
Abstract
Although IR thermography is widely used in medical diagnostics, there are no reports that describe the use of IR thermography in the evaluation of post-plastic-surgery regeneration processes. The aim of the study was to evaluate the potential of thermography as a method which, among others, allows us to determine the location and extent of the inflammatory process, supporting the clinical evaluation of the patient’s convalescence after a facelift surgery using the SMAS technique. During the study and in order to monitor the convalescence process, the patient had a series of face thermograms performed before surgery and up to the 6th week after it. The healing process after surgery was multidirectional for the contralateral areas of the face, leading to thermal asymmetry lasting up to the 3rd week of convalescence. The lowest Tmean values for ROIs were recorded in week 3 of the study and then they gradually increased, in week 6 after surgery, to the following values: chin = 33.1 ± 0.72 °C; cheek left = 33.0 ± 0.26 °C; cheek right = 33.2 ± 0.51 °C; ZFL = 33.8 ± 0.45 °C; ZFR = 33.6 ± 0.74 °C; ZLL = 32.6 ±0.55 °C; ZLR = 32.3 ± 0.32 °C. The temperatures of these areas were still lower than the baseline values obtained before surgery by 0.5–1.4 °C. The usefulness of thermography in the evaluation of post-operative convalescence in facial plastic surgery procedures shows potential in the context of diagnostic assessment of the dynamics of changes in the healing process.
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Affiliation(s)
- Monika Chudecka
- Institute of Physical Culture Sciences, Faculty of Physical Education and Health, University of Szczecin, 71-065 Szczecin, Poland;
| | | | - Katarzyna Leźnicka
- Faculty of Physical Culture, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland;
| | - Anna Lubkowska
- Department of Functional Diagnostics and Physical Medicine, Faculty of Health Sciences, Pomeranian Medical University, 71-210 Szczecin, Poland
- Correspondence: ; Tel.: +48-91-4800914
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Facial skin temperature in acute stroke patients with delirium - A pilot study. J Neurol Sci 2021; 431:120036. [PMID: 34736122 DOI: 10.1016/j.jns.2021.120036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 12/19/2022]
Abstract
Facial skin temperature depends strongly on blood flow in small blood vessels in the skin. These are regulated by the sympathetic part of the autonomic nervous system. Delirium may pathophysiologically be associated to changes in the sympathetic part of the autonomic nervous system. In this observational study, we evaluated the influence of various exogenous and endogenous covariables on the regional facial temperatures in acute stroke patients with and without delirium. Facial thermography (FT) was performed using an infrared digital camera. Screening for delirium was done using the Confusion Assessment Method (CAM). Sixty-four patients were enrolled. Eight patients developed delirium. Sex and body temperature were positively associated to facial skin temperature, and so was ambient temperature but to an overall lesser magnitude. Stroke severity, diabetes, infection, facial palsy, facial sensory deficit, and physical activity did not influence facial skin temperature. Overall, there was no association between facial temperature and the occurrence of delirium except in one facial region, the medial palpebral commissure.
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Assessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: A cross-sectional study. PLoS Negl Trop Dis 2021; 15:e0009794. [PMID: 34555035 PMCID: PMC8491942 DOI: 10.1371/journal.pntd.0009794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/05/2021] [Accepted: 09/07/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Neuropathic pain (NP) is one of the main complications of leprosy, and its management is challenging. Infrared thermography (IRT) has been shown to be effective in the evaluation of peripheral autonomic function resulting from microcirculation flow changes in painful syndromes. This study used IRT to map the skin temperature on the hands and feet of leprosy patients with NP. METHODOLOGY/PRINCIPAL FINDINGS This cross-sectional study included 20 controls and 55 leprosy patients, distributed into 29 with NP (PWP) and 26 without NP (PNP). Thermal images of the hands and feet were captured with infrared camera and clinical evaluations were performed. Electroneuromyography (ENMG) was used as a complementary neurological exam. Instruments used for the NP diagnosis were visual analog pain scale (VAS), Douleur Neuropathic en 4 questions (DN4), and simplified neurological assessment protocol. The prevalence of NP was 52.7%. Pain intensity showed that 93.1% of patients with NP had moderate/severe pain. The most frequent DN4 items in individuals with NP were numbness (86.2%), tingling (86.2%) and electric shocks (82.7%). Reactional episodes type 1 were statistically significant in the PWP group. Approximately 81.3% of patients showed a predominance of multiple mononeuropathy in ENMG, 79.6% had sensory loss, and 81.4% showed some degree of disability. The average temperature in the patients' hands and feet was slightly lower than in the controls, but without a significant difference. Compared to controls, all patients showed significant temperature asymmetry in almost all points assessed on the hands, except for two palmar points and one dorsal point. In the feet, there was significant asymmetry in all points, indicating a greater involvement of the lower limbs. CONCLUSION IRT confirmed the asymmetric pattern of leprosy neuropathy, indicating a change in the function of the autonomic nervous system, and proving to be a useful method in the approach of pain.
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Abstract
OBJECTIVE The prevalence of peripheral arterial disease (PAD) is increasing worldwide. The ankle-brachial index (ABI) is considered the criterion standard of noninvasive screening, but it does have limitations. The present study aimed to clarify the clinical diagnostic potential of infrared thermography (IRT) compared with conventional noninvasive measurements for PAD. METHODS Patients were divided into two groups: the healthy control group (n = 93) and the PAD group (n = 164). Control participants had an ABI 0.9 to 1.4 and no former PAD diagnosis. The PAD group was divided into three subgroups based on ABI classifications and two subgroups based on toe pressure measurements. Investigators performed IRT using a standardized protocol with temperature measurements at five different foot sites. MAIN RESULTS Differences in skin temperatures between feet were greater (P < .001) in the PAD group than in healthy controls. In general, mean foot temperatures were lower in the PAD group than in controls but did not differ significantly among PAD subgroups based on ABI classifications or toe pressure measurements. CONCLUSIONS Infrared thermography effectively distinguished temperature differences between feet and thus might be diagnostically useful. However, because normal skin surface temperature varies among individuals, IRT alone cannot be recommended for evaluating PAD. However, it does have potential to provide additional information about circulation, subclinical infections, and the severity of vascular disease.
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Moreira A, Batista R, Oliveira S, Branco CA, Mendes J, Figueiral MH. Role of thermography in the assessment of temporomandibular disorders and other musculoskeletal conditions: A systematic review. Proc Inst Mech Eng H 2021; 235:1099-1112. [PMID: 34082627 DOI: 10.1177/09544119211023616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this review was to evaluate whether thermal imaging may constitute a reliable assessment method of musculoskeletal and temporomandibular disorders (TMD/MSD). A systematic review was conducted in the Pubmed, Scopus, Cochrane library, Web of Science, and Lilacs databases. The search terms were "musculoskeletal disorders,""temporomandibular disorders,""infrared thermography,""thermography," and "infrared imaging." The inclusion criteria were: studies published between January 1985 and January 2021, performed in humans, with sample size equal or greater than 20 patients, written in English, Portuguese, French and/or Spanish, and full text available. The exclusion criteria were: systematic reviews, case studies, and/or studies focused on pathologies beyond the review's domain. The risk of bias was evaluated using CASP 2018. A total of 2032 articles were retrieved. Of these, 25 studies met the inclusion criteria and were included to withdraw the following information: title, type of study, first author and year of publication, objective, number of participants, comparisons, and principal conclusions. No RCT were found. Despite some disparity, points of convergence among the majority of authors could be found. In general, healthy individuals show subtle thermal differences between contralateral homolog areas. Concerning orofacial structures, unilateral symptomatic individuals may show thermal differences equal or greater than 0.4°C. Infrared thermography accuracy in diagnosing TMD/MSD is still considered low to moderate. Despite some limitations, IRT might constitute a valuable supporting diagnostic tool in the medical field of TMD and MSD.
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Affiliation(s)
| | | | - Susana Oliveira
- Department of Prosthodontics, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Catarina Aguiar Branco
- Department of Temporomandibular Disorders and Occlusion, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Joaquim Mendes
- Department of Mechanics, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Maria Helena Figueiral
- Department of Prosthodontics, Faculty of Dental Medicine, University of Porto, Porto, Portugal
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Faria ISS, Amaral RS, Paula LVD, Salles PV. Use of thermography as an auxiliary method to diagnose orofacial pain: a case study. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/20212369521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Thermography is an auxiliary diagnostic method widely used to assess soft tissues and thus diagnose neuropathic or inflammatory pain. The objective of this paper was to report a case in which thermography was used as an auxiliary method to diagnose neuropathic pain. The patient in question is a 43-year-old woman with complaints of pain and sensitivity in the upper and lower left dental arches, particularly when consuming alcoholic beverages. The case was assessed with thermography, followed by the Cold Stress Test. The symmetry of the thermographic images and the localized changes helped rule out neuropathic problems and diagnose the orofacial inflammatory pain. The thermography was used as an auxiliary instrument to diagnose orofacial pain, proving to be efficient. Also, the thermography helped rule out changes originating in peripheral, small-fiber, and inflammatory neuropathies, aiding the patient’s differential diagnosis. The thermography also helped identify the thermo-anatomical points and, with the qualitative and quantitative analyses, noninvasively investigate the possible causes of the orofacial pain reported by the patient.
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Lubkowska A, Gajewska E. Temperature Distribution of Selected Body Surfaces in Scoliosis Based on Static Infrared Thermography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238913. [PMID: 33266229 PMCID: PMC7731444 DOI: 10.3390/ijerph17238913] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022]
Abstract
The purpose of the research was to assess the usefulness of thermography as a complementary method in musculoskeletal dysfunction, with particular emphasis on scoliosis. The children, aged 7–16, were classified into one of two groups: the study group—children with scoliosis (n = 20), and the reference group—healthy children (n = 20). All children underwent anthropometric tests, body mass index determination, four pictures each with a FLIR T1030sc HD thermal imaging camera, and measurement of spinal rotation with a scoliometer (Gima, Italy). There is a temperature differential (about 4 °C) within the upper and lower body in children. In healthy children, differences in temperature of contralateral areas of the body do not exceed 0.5 °C. Thermography is a useful and noninvasive method of assessing muscular tension disbalance in the course of scoliosis. In the case of scoliosis, the areas of the body with a significant thermal asymmetry of the surface are the upper back, thighs, and back of the lower legs. Due to the high positive correlation of the spinal rotation angle with the amount of thermal asymmetry, the areas that should be subjected to a detailed thermal assessment in the supplementary diagnosis of scoliosis using thermovision are the upper back, chest, thighs, and back of the lower legs.
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Affiliation(s)
- Anna Lubkowska
- Chair and Department of Functional Diagnostics and Physical Medicine, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 54 Żołnierska Str, 71-210 Szczecin, Poland
- Correspondence:
| | - Ewa Gajewska
- Department of Developmental Neurology, Poznan University of Medical Sciences, 49 Przybyszewskiego Str, 60-355 Poznan, Poland;
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Park TY, Son S, Lim TG, Jeong T. Hyperthermia associated with spinal radiculopathy as determined by digital infrared thermographic imaging. Medicine (Baltimore) 2020; 99:e19483. [PMID: 32176082 PMCID: PMC7220459 DOI: 10.1097/md.0000000000019483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
In general, in digital infrared thermographic imaging (DITI) of patients with unilateral spinal radicular pain, the thermal pattern of the extremities of the side of lesion shows hypothermia compared to the opposite, intact side. However, sometimes, DITI shows hyperthermia on the side of the lesion, and this variation can cause confusion. We compared the data of both hypothermia and hyperthermia patients to clarify the factors determining different thermal characteristics in spinal radiculopathy.We retrospectively collected data from patients who underwent DITI at a single center. The final cohort (n = 224) was allocated into 2 groups, a hypothermia group (n = 180) or a hyperthermia group (n = 44). We compared the various factors, including demographic factors and symptom-related factors, that might affect the results of DITI.Except the presence of trauma history (13.9% vs 31.8%, odds ratio 2.893, P = .008), no significant intergroup difference was found in baseline demographic factors, including age, gender, diabetes mellitus, spinal level of pathology, and intervention history. Among symptom-related factors, in the hyperthermia group, the symptom duration was shorter (10.64 weeks [95% confidence interval (CI) 8.36-13.04] vs 2.10 weeks [95% CI 1.05-3.53], P < .001) and Visual Analogue Scale (VAS) of radicular pain was higher (4.23 ± 1.29 vs 5.18 ± 1.40, P < .001) than in the hypothermia group. Also, in the regression analysis, significant factors for hyperthermia include the presence of trauma history, shorter symptom duration (cut-off value 2.50 weeks or less) and higher VAS of radicular pain (cut-off value 4.50 or more).In patients with trauma history, acute phase, and severe radicular pain, hyperthermia in DITI is not unusual and careful interpretation of the DITI results is necessary for proper diagnosis and treatment decisions in spinal radiculopathy.
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Affiliation(s)
- Tae Yoon Park
- Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine
| | - Seong Son
- Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine
| | - Tae Gyu Lim
- Department of Neurosurgery, Andong Medical Group Hospital, South Korea
| | - Taeseok Jeong
- Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine
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Infrared thermography of the crânio-cervico-mandibular complex in wind and string instrumentalists. Int Arch Occup Environ Health 2020; 93:645-658. [PMID: 32020282 DOI: 10.1007/s00420-020-01517-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 01/04/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Musculoskeletal disorders can be common in wind and string instrumentalists. The musical gesture technique associated to musical performance can promote an asymmetrical isometric contraction with the hyperactivity of specific muscular groups and the overload of articular surfaces which can cause discomfort or pain. The aim of this investigation was to assess specific anatomical regions of interest within the cranio-cervico-mandibular complex in order to determine and evaluate the presence of muscular hyperactivity associated to musical performance. METHODS An infrared imaging camera, FLIR®, was used to record the regions of interest in wind (n = 48) and string instrumentalists (n = 29). Bilateral temperature differences were considered as thermal asymmetries with a conventional threshold of 0.3 ºC to distinguish pathological from healthy states. The regions of interest (ROI) were the anterior triangle of the neck, the sternocleidomastoid and trapezius muscles regarding the postural and stabilizing muscles of the head and neck. On the orofacial region, the anatomical sites were the anterior temporal muscle, the masseter muscle and the temporomandibular joint. A Pearson chi-square test was performed to compare the assessed areas. RESULTS Between 30-37% of all participants showed ROI in an asymmetric pattern. The most affected sites were the temporal muscle and the TMJ for both groups. The anterior triangle of the neck showed statistical differences (p = 0.044) between string and wind instrumentalists, while the temporal (p = 0.034) and trapezius muscle (p = 0.028) when comparing large and small mouthpieces of brass instruments. Although female participants showed a higher prevalence of asymmetrical patterns regarding the ROI, no statistical differences were found between genders. CONCLUSIONS Infrared thermography exhibited significant differences between wind and string instruments within the CCMC. Regarding the issue of occupational health in performing arts, it is an advantage being able to quantify asymmetrical patterns sites of the CCMC to understand the underlying physiological responses to repetitive movements, overloading and muscular hyperactivity that occur during musical performance.
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Superficial temperature and pain tolerance in patients with chronic low back pain. J Bodyw Mov Ther 2019; 23:583-587. [DOI: 10.1016/j.jbmt.2019.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 05/04/2019] [Indexed: 11/20/2022]
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Haddad DS, Brioschi ML, Baladi MG, Arita ES. A new evaluation of heat distribution on facial skin surface by infrared thermography. Dentomaxillofac Radiol 2016; 45:20150264. [PMID: 26891669 DOI: 10.1259/dmfr.20150264] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this study was to identify the facial areas defined by thermal gradient, in individuals compatible with the pattern of normality, and to quantify and describe them anatomically. METHODS The sample consisted of 161 volunteers, of both genders, aged between 26 and 84 years (63 ± 15 years). RESULTS The results demonstrated that the thermal gradient areas suggested for the study were present in at least 95% of the thermograms evaluated and that there is significant difference in temperature between the genders, racial group and variables "odontalgia", "dental prothesis" and "history of migraine" (p < 0.05). Moreover, there was no statistically significant difference in the absolute temperatures between ages, and right and left sides of the face, in individuals compatible with the pattern of normality (ΔT = 0.11°C). CONCLUSIONS The authors concluded that according to the suggested areas of thermal gradients, these were present in at least 95% of all the thermograms evaluated, and the areas of high intensity found in the face were medial palpebral commissure, labial commissure, temporal, supratrochlear and external acoustic meatus, whereas the points of low intensity were inferior labial, lateral palpebral commissure and nasolabial.
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Affiliation(s)
- Denise S Haddad
- 1 Oral Radiology Division, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marcos L Brioschi
- 2 Clinical Hospital, School of Medicine, University of São Paulo (HCFMUSP), Pain Center, HCFMUSP, São Paulo, Brazil
| | - Marina G Baladi
- 1 Oral Radiology Division, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Emiko S Arita
- 1 Oral Radiology Division, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Ryu SJ, Zhang HY. Neurilemmoma of Deep Peroneal Nerve Sensory Branch : Thermographic Findings with Compression Test. J Korean Neurosurg Soc 2015; 58:286-90. [PMID: 26539275 PMCID: PMC4630363 DOI: 10.3340/jkns.2015.58.3.286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 07/15/2014] [Accepted: 08/13/2014] [Indexed: 11/27/2022] Open
Abstract
We report a case of neurilemmoma of deep peroneal nerve sensory branch that triggered sensory change with compression test on lower extremity. After resection of tumor, there are evoked thermal changes on pre- and post-operative infrared (IR) thermographic images. A 52-year-old female presented with low back pain, sciatica, and sensory change on the dorsal side of the right foot and big toe that has lasted for 9 months. She also presented with right tibial mass sized 1.2 cm by 1.4 cm. Ultrasonographic imaging revealed a peripheral nerve sheath tumor arising from the peroneal nerve. IR thermographic image showed hyperthermia when the neurilemoma induced sensory change with compression test on the fibular area, dorsum of foot, and big toe. After surgery, the symptoms and thermographic changes were relieved and disappeared. The clinical, surgical, radiographic, and thermographic perspectives regarding this case are discussed.
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Affiliation(s)
- Seung Jun Ryu
- Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ho Yeol Zhang
- Department of Neurosurgery, National Health Insurance Corporation Ilsan Hospital, Yonsei University College of Medicine, Goyang, Korea
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Symons FJ, Byiers B, Hoch J, Dimian A, Barney C, Feyma T, Beisang A. Infrared Thermal Analysis and Individual Differences in Skin Temperature Asymmetry in Rett Syndrome. Pediatr Neurol 2015; 53:169-72. [PMID: 26003587 PMCID: PMC4522200 DOI: 10.1016/j.pediatrneurol.2015.03.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 03/15/2015] [Accepted: 03/17/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE We evaluated the feasibility of using a portable infrared thermal camera to quantify the degree of thermal dysregulation (cold hands/feet) and test for naturally occurring within-patient skin temperature asymmetry in Rett syndrome. PROCEDURES Infrared thermal images were acquired passively from 15 patients (mean age = 13.7 years, range 4-47) with clinical diagnoses of Rett. Images were acquired using a FLIR T400 infrared thermal camera (still images recorded at 5 Hz, resolution of 320 × 240 pixels, thermal sensitivity = 0.05 °C; capture session lasted approximately 3 minutes). The infrared thermal camera was orthogonal to the body part (hands, feet) and positioned approximately 1 meter from the skin's surface. RESULTS There were large intraindividual left/right differences in temperature. Seven (47%) and eight (53%) patients had statistically significant (P <0.05) left/right asymmetries between hands (mean difference = 0.87 °C, standard deviation = 1.21) and feet (mean difference = 1.73 °C, standard deviation = 3.03), respectively. Coders were reliable (intraclass correlations 0.97-0.99) on temperatures and selection of anatomical regions of interest. CONCLUSIONS The degree of thermal asymmetry may reflect prolonged activity of the sympathetic nervous system and individual differences in sympathetic regulation. As clinical trials emerge and endpoints are considered, portable infrared thermal camera may provide one noninvasive means of evaluating changes in sympathetic regulation.
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Affiliation(s)
- Frank J. Symons
- Department of Educational Psychology, University of Minnesota,Center for Neurobehavioral Development, University of Minnesota
| | - Breanne Byiers
- Department of Educational Psychology, University of Minnesota,Center for Neurobehavioral Development, University of Minnesota
| | - John Hoch
- Department of Educational Psychology, University of Minnesota,Center for Neurobehavioral Development, University of Minnesota
| | - Adele Dimian
- Department of Educational Psychology, University of Minnesota
| | - Chantel Barney
- Gillette Children’s Specialty Healthcare, Saint Paul, Minnesota
| | - Timothy Feyma
- Gillette Children’s Specialty Healthcare, Saint Paul, Minnesota
| | - Arthur Beisang
- Gillette Children’s Specialty Healthcare, Saint Paul, Minnesota
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The quantitative sensory testing is an efficient objective method for assessment of nerve injury. Maxillofac Plast Reconstr Surg 2015; 37:13. [PMID: 26317084 PMCID: PMC4544621 DOI: 10.1186/s40902-015-0013-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 04/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study evaluated Somatosensory evoked potentials (SEP), Quantitative sensory testing (QST), and thermography as diagnostic methods for nerve injury. METHODS From 2006 through 2011, 17 patients (mean age: 50.1 years) from OOOO Hospital who sought care for altered sensation after dental implant treatment were identified. The mean time of objective assessment was 15.2 months after onset. RESULTS SEP of Inferior alveolar nerve(IAN) was 15.87 ± 0.87 ms on the normal side and 16.18 ± 0.73 ms on the abnormal side. There was delayed N20 latency on the abnormal side, but the difference was not statistically significant. In QST, the abnormal side showed significantly higher scores of the current perception threshold at 2 KHz, 250 Hz, and 5 Hz. The absolute temperature difference was 0.55°C without statistically significance. CONCLUSION These results indicate that QST is valuable as an objective method for assessment of nerve injury.
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Morrison SA, Gorjanc J, Eiken O, Mekjavic IB. Finger and Toe Temperature Responses to Cold After Freezing Cold Injury in Elite Alpinists. Wilderness Environ Med 2015; 26:295-304. [PMID: 25754904 DOI: 10.1016/j.wem.2014.12.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 12/17/2014] [Accepted: 12/30/2014] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess whether previous freezing cold injuries (FCI) would affect digit skin temperatures and rewarming rates during a follow-up cold stress test protocol. DESIGN Nonrandomized control trial. METHODS Twenty elite alpinists participated; alpinists with previous FCI requiring digit amputations (injured, INJ: n = 10 total, n = 8 male) were compared with ability-matched, uninjured alpinists (control, CON: n = 10, all male). Digit skin temperature was measured using infrared thermography as an index of peripheral digit perfusion after a cold stress test, which consisted of 30 minutes of immersion in 8°C water. RESULTS The INJ alpinists' injured toes were warmer (approximately 6%) than their uninjured toes immediately after cold immersion (95% CI, 0.01°C to 1.00°C; P = .05); there were no differences between the rates of rewarming of injured and uninjured toes (INJ, 0.5° ± 0.1°C/min; CON, 0.7° ± 0.3°C/min; P = .16). Although the INJ alpinists had colder injured fingers immediately after the 35°C warm bath compared with their own uninjured fingers (32.2° ± 2.0°C vs 34.5° ± 0.5°C; P = .02), there were no differences observed between the rates of rewarming of injured and uninjured fingers after cold exposure (INJ, 1.1° ± 0.2°C/min; CON, 1.3° ± 0.5°C/min; P = .22). CONCLUSIONS Even after FCI that requires digit amputation, there is no evidence of different tissue rates of rewarming between the injured and uninjured fingers or toes of elite alpinists.
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Affiliation(s)
- Shawnda A Morrison
- Environmental Physiology and Ergonomics Laboratory, Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia (Drs Morrison and Mekjavic).
| | - Jurij Gorjanc
- Department of Surgery, Hospital of the Brothers of St. John of God, St.Veit/Glan, Austria (Dr Gorjanc)
| | - Ola Eiken
- Department of Environmental Physiology, School of Technology and Health, Royal Institute of Technology, Stockholm, Sweden (Dr Eiken)
| | - Igor B Mekjavic
- Environmental Physiology and Ergonomics Laboratory, Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia (Drs Morrison and Mekjavic)
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Gatt A, Formosa C, Cassar K, Camilleri KP, De Raffaele C, Mizzi A, Azzopardi C, Mizzi S, Falzon O, Cristina S, Chockalingam N. Thermographic patterns of the upper and lower limbs: baseline data. Int J Vasc Med 2015; 2015:831369. [PMID: 25648145 PMCID: PMC4310239 DOI: 10.1155/2015/831369] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 12/22/2014] [Indexed: 11/18/2022] Open
Abstract
Objectives. To collect normative baseline data and identify any significant differences between hand and foot thermographic distribution patterns in a healthy adult population. Design. A single-centre, randomized, prospective study. Methods. Thermographic data was acquired using a FLIR camera for the data acquisition of both plantar and dorsal aspects of the feet, volar aspects of the hands, and anterior aspects of the lower limbs under controlled climate conditions. Results. There is general symmetry in skin temperature between the same regions in contralateral limbs, in terms of both magnitude and pattern. There was also minimal intersubject temperature variation with a consistent temperature pattern in toes and fingers. The thumb is the warmest digit with the temperature falling gradually between the 2nd and the 5th fingers. The big toe and the 5th toe are the warmest digits with the 2nd to the 4th toes being cooler. Conclusion. Measurement of skin temperature of the limbs using a thermal camera is feasible and reproducible. Temperature patterns in fingers and toes are consistent with similar temperatures in contralateral limbs in healthy subjects. This study provides the basis for further research to assess the clinical usefulness of thermography in the diagnosis of vascular insufficiency.
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Affiliation(s)
- Alfred Gatt
- Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta ; Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent ST4 2DF, UK
| | - Cynthia Formosa
- Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta ; Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent ST4 2DF, UK
| | - Kevin Cassar
- Faculty of Medicine and Surgery, University of Malta, Msida MSD 2080, Malta
| | - Kenneth P Camilleri
- Centre for Biomedical Cybernetics, University of Malta, Msida MSD 2080, Malta
| | | | - Anabelle Mizzi
- Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta
| | - Carl Azzopardi
- Centre for Biomedical Cybernetics, University of Malta, Msida MSD 2080, Malta
| | - Stephen Mizzi
- Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta
| | - Owen Falzon
- Centre for Biomedical Cybernetics, University of Malta, Msida MSD 2080, Malta
| | - Stefania Cristina
- Centre for Biomedical Cybernetics, University of Malta, Msida MSD 2080, Malta
| | - Nachiappan Chockalingam
- Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta ; Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent ST4 2DF, UK
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Rossignoli I, Benito PJ, Herrero AJ. Reliability of infrared thermography in skin temperature evaluation of wheelchair users. Spinal Cord 2014; 53:243-248. [PMID: 25420493 DOI: 10.1038/sc.2014.212] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 10/17/2014] [Accepted: 10/24/2014] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Test-retest reliability analysis segmented by body parts. OBJECTIVES To examine the reliability of infrared thermography (IRT) in wheelchair users (WCUs), as a noninvasive and risk-free technique to detect the natural thermal radiation emitted by human skin and to allow subsequent interpretations of temperature distributions. SETTING Research Center on Physical Disability of Valladolid, ASPAYM Castilla y León Foundation, Spain. METHODS Twenty-four manual WCUs (22 men, 2 women) participated in this study. Skin temperature (Tsk) of 16 and 20 areas of the front and rear upper body, respectively, were measured using an infrared camera. Two thermographic images were recorded in each session during two days separated by 24 h. Results were analyzed using descriptive statistics, intraclass correlation coefficients, coefficients of variation and side-to-side skin temperature differences (δTsk). RESULTS The intraclass correlation coefficient produced values ranging from 15 to 95 for the various regions of interest. The coefficient of variation ranged between 1.05-6.18%. The mean Tsk of the front upper body was 31.92 °C, and that of the rear upper body was 31.77 °C. The total δTsk was 0.09±0.44°C, r=0.583. CONCLUSION The reliability of IRT varies depending on the analyzed areas. IRT is a noninvasive and noncontact technique that allows measuring the temperature of the skin, with which to advance in WCU research.
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Affiliation(s)
- I Rossignoli
- Medical and Scientific Department, International Paralympic Committee, Bonn, Germany.,Laboratory of Exercise Physiology, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Technical University of Madrid, Madrid, Spain.,Research Center on Physical Disability, ASPAYM Castilla y León Foundation, Valladolid, Spain
| | - P J Benito
- Laboratory of Exercise Physiology, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Technical University of Madrid, Madrid, Spain
| | - A J Herrero
- Research Center on Physical Disability, ASPAYM Castilla y León Foundation, Valladolid, Spain
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Fong SSM, Ng SSM, Luk WS, Chung JWY, Leung JCY, Masters RSW. Effects of a 6-month Tai Chi Qigong program on arterial hemodynamics and functional aerobic capacity in survivors of nasopharyngeal cancer. J Cancer Surviv 2014; 8:618-26. [PMID: 24908587 DOI: 10.1007/s11764-014-0372-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 05/23/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Shirley S M Fong
- Institute of Human Performance, University of Hong Kong, Pokfulam, Hong Kong, China,
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Thermal body patterns for healthy Brazilian adults (male and female). J Therm Biol 2014; 42:1-8. [DOI: 10.1016/j.jtherbio.2014.02.020] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Revised: 02/27/2014] [Accepted: 02/27/2014] [Indexed: 11/19/2022]
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Bernard V, Staffa E, Mornstein V, Bourek A. Infrared camera assessment of skin surface temperature – Effect of emissivity. Phys Med 2013; 29:583-91. [DOI: 10.1016/j.ejmp.2012.09.003] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 09/25/2012] [Accepted: 09/28/2012] [Indexed: 11/16/2022] Open
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Comparison of paraspinal cutaneous temperature measurements between subjects with and without chronic low back pain. J Manipulative Physiol Ther 2013; 36:44-50. [PMID: 23380213 DOI: 10.1016/j.jmpt.2012.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 01/24/2012] [Accepted: 03/01/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the effects of chiropractic manipulative treatment on paraspinal cutaneous temperature (PCT) for subjects with chronic low back pain and compare these PCT findings to subjects without chronic low back pain. METHODS Two groups were created, a symptomatic treatment group (subjects with chronic low back pain, n = 11, 7 males, 4 females) and an asymptomatic, nontreatment group (asymptomatic subjects, n = 10, 6 males, 4 females). Outcomes included the modified Oswestry questionnaire and PCT measurements in the prone position after an 8-minute acclimation period. The treatment group received 9 chiropractic spinal instrument-based manipulative treatments over 2 weeks. Reevaluation was done 2 weeks after the initial evaluation for both groups. RESULTS The preintervention Oswestry results (29.8% ± 11.8%) for the treatment group were higher than the asymptomatic group (10.2% ± 10.6%). The postintervention Oswestry results for the treatment group were 14.20 % ± 11.5%. The resulting Cohen's effect size of the spinal manipulation on the Oswestry evaluation is 0.58. The preintervention PCT showed higher temperature for the nontreatment group compared with the treatment group. Comparing the levels associated with low back pain, the nontreatment group PCT was stable, varying from 0.01°C to 0.02°C, whereas the treatment group PCT varied from 0.10°C to 0.18°C. The treatment group postintervention PCT showed an increase in temperature after the 9 visits; however, this did not reach the values of the asymptomatic group. CONCLUSION The PCT readings for subjects with chronic low back pain were lower than the asymptomatic, nontreatment group. The PCT temperature of the treatment group increased after 9 treatments.
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Reliability of infrared thermometric measurements of skin temperature in the hand. J Hand Ther 2013; 25:358-61; quiz 362. [PMID: 22975739 DOI: 10.1016/j.jht.2012.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 06/11/2012] [Accepted: 06/11/2012] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Clinical measurement study. INTRODUCTION Skin temperature asymmetries (STAs) are used in the diagnosis of complex regional pain syndrome (CRPS), but little evidence exists for reliability of the equipment and methods. PURPOSE This study examined the reliability of an inexpensive infrared (IR) thermometer and measurement points in the hand for the study of STA. METHODS ST was measured three times at five points on both hands with an IR thermometer by two raters in 20 volunteers (12 normals and 8 CRPS). RESULTS ST measurement results using IR thermometers support inter-rater reliability: intraclass correlation coefficient (ICC) estimate for single measures 0.80; all ST measurement points were also highly reliable (ICC single measures, 0.83-0.91). CONCLUSIONS The equipment demonstrated excellent reliability, with little difference in the reliability of the five measurement sites. These preliminary findings support their use in future CRPS research. LEVEL OF EVIDENCE Not applicable.
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Christensen J, Vaeth M, Wenzel A. Thermographic imaging of facial skin--gender differences and temperature changes over time in healthy subjects. Dentomaxillofac Radiol 2012; 41:662-7. [PMID: 22554986 DOI: 10.1259/dmfr/55922484] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To assess changes in facial skin temperature over time, to identify sources of variation related to skin temperature and to evaluate interobserver reproducibility in measurements of the thermograms. METHODS 62 volunteers (32 females, 30 males, mean age 23.4, range 19.5-29.5 years) underwent thermography of the face (left and right side lateral images) on four occasions with approximately 2 months between each session. Three observers recorded the images and marked regions of interest (ROIs) in each image using dedicated software. Smoking, exercise habits and use of oral contraceptives were recorded. RESULTS A significant difference between sessions (≤1 °C, p<0.001) and between observers (≤0.11 °C, p<0.001) was identified. The difference between sides was not significant (≤0.07 °C, p=0.7). None of the interactions between side, session and observer were significant. Smoking, exercise habits and oral contraceptive intake were not significant impact factors when included as covariates in the analysis (p>0.1). ROI temperature was significantly higher in males than in females (0.7 °C, p<0.001). A mixed model analysis of variance showed that observer had little impact on the expected standard deviation, whereas session and subject had a greater impact. CONCLUSIONS Face temperature is symmetrical and varies over time. The non-significant difference between sides is highly reproducible, even between observers.
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Affiliation(s)
- J Christensen
- Department of Oral Radiology, School of Dentistry, Aarhus University, Vennelyst Boulevard 9, 8000 Aarhus C, Denmark.
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Perez RSGM, Keijzer C, Bezemer PD, Zuurmond WWA, de Lange JJ. Predictive value of symptom level measurements for complex regional pain syndrome type I. Eur J Pain 2012; 9:49-56. [PMID: 15629874 DOI: 10.1016/j.ejpain.2004.04.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2003] [Accepted: 04/14/2004] [Indexed: 11/30/2022]
Abstract
The validity with respect to presence or absence of CRPS I according to Veldman's criteria was assessed for measured pain, temperature, volume differences and limitations in range of motion. Evaluated were 155 assessments of 66 outpatients, initially diagnosed with CRPS I, but many of them not so on follow up visits. Pain was measured with VAS and McGill, temperature by infrared thermometry, volume differences by water displacement volumeters and limitations in range of motion by universal goniometers. Sensitivity, specificity, positive and negative predictive value of the measurement instruments at different cut-off points was calculated. Combined symptom scores were evaluated in a similar fashion. High sensitivity was found for the VAS, McGill, and range of motion. The specificity was overall lower, but highest values were obtained for volume differences. The positive predictive value was good for all measurement instruments. Negative predictive value was lower, especially for measurement of temperature and volume asymmetries. If sensitivity and specificity are equally important, VAS>3 cm, McGill>6 words, temperature difference>or=0.4 degrees C, volume difference>6.5% and ROM limitation>15% provide the best results. Using these cut off values, the highest value of sensitivity and of sensitivity and specificity combined, was found for a combination of VAS, McGill and ROM. The highest value of specificity was found for different combinations of 3, 4 and 5 instruments, all containing the VAS. We conclude that the measured pain, temperature, volume and range of motion can be used as diagnostic indicators for establishing presence or absence of CRPS I.
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Affiliation(s)
- R S G M Perez
- Department of Anesthesiology, VU University medical center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
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Kim JH, Lee LK, Lee WD, Lee JU, Kim MY, Kim B, Kim J. Temporal Changes in Skin Temperature Caused by Wet and Dry Heat in Healthy Volunteers. J Phys Ther Sci 2012. [DOI: 10.1589/jpts.24.1209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Ju-Hyun Kim
- Department of Physical Therapy, Graduate School, Yongin University
| | - Lim-Kyu Lee
- Department of Physical Therapy, Graduate School, Yongin University
| | - Won-Deok Lee
- Department of Physical Therapy, Graduate School, Yongin University
| | - Jeong-Uk Lee
- Department of Physical Therapy, Graduate School, Yongin University
| | - Mee-Young Kim
- Department of Physical Therapy, Graduate School, Yongin University
| | - Bokyung Kim
- Department of Physiology, Institute of Functional Genomics, School of Medicine, Konkuk University
| | - Junghwan Kim
- Department of Physical Therapy, College of Public Health and Welfare, Yongin University
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Rahmanian-Schwarz A, Schiefer JL, Amr A, Rothenberger J, Schaller HE, Hirt B. Thermoregulatory response of anterolateral thigh flap compared with latissimus dorsi myocutaneous flap: An evaluation of flaps cutaneous flow and velocity due to thermal stress. Microsurgery 2011; 31:650-4. [DOI: 10.1002/micr.20950] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2011] [Accepted: 07/20/2011] [Indexed: 11/09/2022]
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Marasco PD, Kim K, Colgate JE, Peshkin MA, Kuiken TA. Robotic touch shifts perception of embodiment to a prosthesis in targeted reinnervation amputees. ACTA ACUST UNITED AC 2011; 134:747-58. [PMID: 21252109 DOI: 10.1093/brain/awq361] [Citation(s) in RCA: 182] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Existing prosthetic limbs do not provide amputees with cutaneous feedback. Tactile feedback is essential to intuitive control of a prosthetic limb and it is now clear that the sense of body self-identification is also linked to cutaneous touch. Here we have created an artificial sense of touch for a prosthetic limb by coupling a pressure sensor on the hand through a robotic stimulator to surgically redirected cutaneous sensory nerves (targeted reinnervation) that once served the lost limb. We hypothesize that providing physiologically relevant cutaneous touch feedback may help an amputee incorporate an artificial limb into his or her self image. To investigate this we used a robotic touch interface coupled with a prosthetic limb and tested it with two targeted reinnervation amputees in a series of experiments fashioned after the Rubber Hand Illusion. Results from both subjective (self-reported) and objective (physiological) measures of embodiment (questionnaires, psychophysical temporal order judgements and residual limb temperature measurements) indicate that returning physiologically appropriate cutaneous feedback from a prosthetic limb drives a perceptual shift towards embodiment of the device for these amputees. Measurements provide evidence that the illusion created is vivid. We suggest that this may help amputees to more effectively incorporate an artificial limb into their self image, providing the possibility that a prosthesis becomes not only a tool, but also an integrated body part.
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Affiliation(s)
- Paul D Marasco
- Neural Engineering Centre for Artificial Limbs, Rehabilitation Institute of Chicago, 345 E. Superior St. Rm. 1309 Chicago, IL 60611, USA.
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Sacharuk VZ, Lovatel GA, Ilha J, Marcuzzo S, Pinho ASD, Xavier LL, Zaro MA, Achaval M. Thermographic evaluation of hind paw skin temperature and functional recovery of locomotion after sciatic nerve crush in rats. Clinics (Sao Paulo) 2011; 66:1259-66. [PMID: 21876984 PMCID: PMC3148474 DOI: 10.1590/s1807-59322011000700023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 04/12/2011] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Peripheral nerves are often damaged by direct mechanical injury, diseases, and tumors. The peripheral nerve injuries that result from these conditions can lead to a partial or complete loss of motor, sensory, and autonomic functions, which in turn are related to changes in skin temperature, in the involved segments of the body. The aim of this study was to evaluate the changes in hind paw skin temperature after sciatic nerve crush in rats in an attempt to determine whether changes in skin temperature correlate with the functional recovery of locomotion. METHODS Wistar rats were divided into three groups: control (n = 7), sham (n = 25), and crush (n = 25). All groups were subjected to thermographic, functional, and histological assessments. RESULTS ΔT in the crush group was different from the control and sham groups at the 1st, 3rd and 7rd postoperative days (p<0.05). The functional recovery from the crush group returned to normal values between the 3rd and 4th week post-injury, and morphological analysis of the nerve revealed incomplete regeneration at the 4th week after injury. DISCUSSION This study is the first demonstration that sciatic nerve crush in rats induces an increase in hind paw skin temperature and that skin temperature changes do not correlate closely with functional recovery.
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Affiliation(s)
- Viviane Z Sacharuk
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Van Bodegraven Hof EAM, Groeneweg GJ, Wesseldijk F, Huygen FJPM, Zijlstra FJ. Diagnostic criteria in patients with complex regional pain syndrome assessed in an out-patient clinic. Acta Anaesthesiol Scand 2010; 54:894-9. [PMID: 20528779 DOI: 10.1111/j.1399-6576.2010.02251.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Specific criteria have been described and accepted worldwide for diagnosing patients with complex regional pain syndrome (CRPS). Nevertheless, a clear-cut diagnosis cannot be confirmed in a number of cases. AIM The objective of this study was to investigate the effectiveness of the described diagnostic criteria used by several clinical disciplines. METHODS We included 195 patients who were referred to our pain clinic within a period of 1 year. Data were collected on patient characteristics, signs, symptoms, disease-related medication, and the background of the referring clinicians. RESULTS The Harden and Bruehl criteria were confirmed in 95 patients (49%). These patients used a higher than average number of analgesics, opiates, and anti-oxidants, and frequently received prescriptions for benzodiazepines instead of anti-depressants. The mean disease duration was 29 +/- 4.6 months and the mean visual analogue score for pain was 8.1 +/- 0.19. A subgroup of patients had a colder temperature in the affected extremity compared with the unaffected extremity. This subgroup showed a longer disease duration and higher visual analogue scale pain. CONCLUSION The diagnostic criteria used to determine CRPS should be further improved. A large number of referred patients experienced substantial pain, without receiving adequate medication. Disease-related medication is unrelated to CRPS-specific disease activity. Knowledge of underlying mechanisms is warranted before an adequate pharmaceutical intervention can be considered.
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Luz SCTD, Oliveira TPD, Andrade MCD, Ávila AOV, Rosa FJBDL. Adaptação à prótese híbrida de extremidade superior: estudo termográfico de um caso. FISIOTERAPIA E PESQUISA 2010. [DOI: 10.1590/s1809-29502010000200014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O objetivo do estudo foi verificar, por meio de termografia, a adaptação à prótese híbrida de extremidade superior de um sujeito do sexo masculino, 42 anos, amputado proximal de braço esquerdo. Imagens termográficas foram captadas por uma câmara de infravermelho imediatamente após a retirada da prótese, que vinha sendo usada por 8 horas ininterruptas, e 20 minutos de repouso mais tarde, quando foi alcançado equilíbrio térmico em ambiente a 21°C. As imagens foram adquiridas nos planos frontal anterior, sagital direito e esquerdo, tendo sido definidas e analisadas regiões de interesse em cada uma. Os resultados mostram que as temperaturas das regiões avaliadas reduziram-se em média 0,79°C (p<0,05) após a estabilização térmica. Na região do tórax e na axila contralateral ao coto, por onde passa o tirante de fixação da prótese, constataram-se elevadas temperaturas, coincidindo com queixa de desconforto do sujeito e indicando atrito; temperatura mais alta no ombro anterior homolateral à amputação caracterizou sobrecarga; e baixa temperatura no segmento residual à amputação indicou pouca circulação, assinalando dificuldade de adaptação. Os resultados sugerem que a avaliação termográfica pode contribuir para identificar desconforto de amputados com prótese de membro superior e ser utilizada no acompanhamento de sua reabilitaçao; no caso, sugere-se ainda o desenvolvimento de materiais de modo a aumentar o conforto na fixação das próteses de extremidade superior.
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Ya'ish F, Cooper JP, Craigen MA. "Mood rings": a new method of objective clinical assessment of peripheral nerve injuries. HAND SURGERY : AN INTERNATIONAL JOURNAL DEVOTED TO HAND AND UPPER LIMB SURGERY AND RELATED RESEARCH : JOURNAL OF THE ASIA-PACIFIC FEDERATION OF SOCIETIES FOR SURGERY OF THE HAND 2010; 15:173-176. [PMID: 21089191 DOI: 10.1142/s0218810410004795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Revised: 06/11/2010] [Accepted: 06/14/2010] [Indexed: 05/30/2023]
Abstract
The clinical assessment of patients with peripheral nerve injury is primarily dependent on subjective clinical examination. We aimed to assess whether a thermotropic liquid crystal ring (TLC-ring) could provide the basis for an objective assessment of peripheral nerve injury by detecting temperature changes in the digits innervated by the damaged nerve. A group of patients with known median, ulnar or both digital nerve injuries were compared against a control group. TLC-rings, marketed to the general public as "mood rings", were applied to the affected and unaffected digits and the colour change recorded. Areas with nerve damage showed a statistically significant difference in colour response to those without damage. This study establishes the ability of TLCs to detect cutaneous temperature changes associated with peripheral nerve injuries. Further studies and improvements are needed to refine TLC as an acute assessment tool for peripheral nerve injuries.
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Affiliation(s)
- F Ya'ish
- South Birmingham Hand Trauma Unit, Trauma and Orthopaedics Department, Selly Oak Hospital, Birmingham, UK.
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Groeneweg JG, Huygen FJPM, Niehof SP, Wesseldijk F, Bussmann JBJ, Schasfoort FC, Stronks DL, Zijlstra FJ. No recovery of cold complex regional pain syndrome after transdermal isosorbide dinitrate: a small controlled trial. J Pain Symptom Manage 2009; 38:401-8. [PMID: 19515530 DOI: 10.1016/j.jpainsymman.2008.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Revised: 10/03/2008] [Accepted: 10/08/2008] [Indexed: 10/20/2022]
Abstract
The microcirculation appears to be impaired in cold chronic complex regional pain syndrome (CRPS). This double-blind, placebo-controlled, randomized trial investigated the effect of the nitric oxide (NO) donor isosorbide dinitrate (ISDN) on the peripheral blood flow in patients with chronic CRPS. Twenty-four patients received 1% ISDN in Vaseline or a placebo ointment applied to the dorsum of the affected hand four times daily for 10 weeks. The patients participated in a physical therapy program to improve activity. The primary outcome measure was blood distribution in the affected extremity, which was determined by measuring the skin temperature using videothermography. We also measured NO and endothelin-1 concentrations in blister fluid, pain using the visual analog scale, and activity limitations using an upper limb activity monitor and the Disabilities of Arm Shoulder and Hand Questionnaire. ISDN failed to produce a significant improvement in temperature asymmetry in chronic cold CRPS patients, and it did not result in the expected reduction in pain and increase in activity compared with placebo either. There may be other central or peripheral factors contributing to the disturbed vasodynamics in cold chronic CRPS that are not influenced by NO substitution. This study does not show an improvement of the regional blood distribution by ISDN in the involved extremity of patients with cold-type CRPS.
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Affiliation(s)
- J George Groeneweg
- Pain Treatment Centre, Erasmus Medical Center, Rotterdam, The Netherlands.
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Toda K. Questions about New Diagnostic Criteria for Complex Regional Pain Syndrome. PAIN MEDICINE 2009; 10:598-9; author reply 600. [DOI: 10.1111/j.1526-4637.2009.00587.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Groeneweg G, Huygen FJPM, Niehof SP, Wesseldijk F, Bussmann JBJ, Schasfoort FC, Stronks DL, Zijlstra FJ. Effect of tadalafil on blood flow, pain, and function in chronic cold complex regional pain syndrome: a randomized controlled trial. BMC Musculoskelet Disord 2008; 9:143. [PMID: 18937830 PMCID: PMC2575214 DOI: 10.1186/1471-2474-9-143] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2008] [Accepted: 10/20/2008] [Indexed: 12/30/2022] Open
Abstract
Background This double-blind, randomized, controlled trial investigated the effect of the phosphodiesterase-5 inhibitor tadalafil on the microcirculation in patients with cold Complex Regional Pain Syndrome (CRPS) in one lower extremity. Methods Twenty-four patients received 20 mg tadalafil or placebo daily for 12 weeks. The patients also participated in a physical therapy program. The primary outcome measure was temperature difference between the CRPS side and the contralateral side, determined by measuring the skin temperature with videothermography. Secondary outcomes were: pain measured on a Visual Analogue Scale, muscle force measured with a MicroFet 2 dynamometer, and level of activity measured with an Activity Monitor (AM) and walking tests. Results At the end of the study period, the temperature asymmetry was not significantly reduced in the tadalafil group compared with the placebo group, but there was a significant and clinically relevant reduction of pain in the tadalafil group. Muscle force improved in both treatment groups and the AM revealed small, non-significant improvements in time spent standing, walking, and the number of short walking periods. Conclusion Tadalafil may be a promising new treatment for patients that have chronic cold CRPS due to endothelial dysfunction, and deserves further investigation. Trial Registration The registration number in the Dutch Trial Register is ISRCTN60226869.
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Affiliation(s)
- George Groeneweg
- Department of Anesthesiology, subdivision Pain Treatment Centre, Erasmus MC, Rotterdam, the Netherlands.
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Harden RN, Gagnon CM, Gallizzi M, Khan AS, Newman D. Residual Limbs of Amputees Are Significantly Cooler than Contralateral Intact Limbs. Pain Pract 2008; 8:342-7. [DOI: 10.1111/j.1533-2500.2008.00216.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zaproudina N, Varmavuo V, Airaksinen O, Närhi M. Reproducibility of infrared thermography measurements in healthy individuals. Physiol Meas 2008; 29:515-24. [PMID: 18401069 DOI: 10.1088/0967-3334/29/4/007] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Vasodilative effect of isosorbide dinitrate ointment in complex regional pain syndrome type 1. Clin J Pain 2008; 24:89-92. [PMID: 18180642 DOI: 10.1097/ajp.0b013e318156db3b] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In complex regional pain syndrome type 1 (CRPS1) vascular changes occur from the initial, inflammatory event onto the trophic signs during chronicity of the disease, resulting in blood flow disturbances and marked temperature changes. Pharmacotherapeutic treatment is generally inadequate. AIM To determine whether local application of the nitric oxide donor isosorbide dinitrate (ISDN) could cause vasodilation and thereby improve tissue blood distribution in the affected extremity. METHODS In a pilot study, 5 female patients with CRPS1 in one hand were treated with ISDN ointment 4 times daily during 10 weeks. As a primary objective videothermography was used to monitor changes in blood distribution in both the involved and contralateral extremities. RESULTS Patients treated with ISDN showed an increase of 4 degrees C to 6 degrees C in mean skin temperature of the cold CRPS1 hands, reaching values similar to that of the contralateral extremities within 2 to 4 weeks time, suggesting normalization of blood distribution. This was confirmed by an improvement in skin color. In 3 patients the Visual Analog Scale pain declined, whereas in the other 2 patients the Visual Analog Scale pain was unchanged over time. CONCLUSIONS In this pilot study, topical application of ISDN seems to be beneficial to improve symptoms for patients with cold type CRPS1, but further study is needed.
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Ciuman R, Mohr C, Kröger K, Dost P. The forearm flap: assessment of functional and aesthetic outcomes and quality of life. Am J Otolaryngol 2007; 28:367-74. [PMID: 17980766 DOI: 10.1016/j.amjoto.2006.10.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Revised: 10/29/2006] [Accepted: 10/31/2006] [Indexed: 11/24/2022]
Abstract
PURPOSE Microvascular surgery frequently represents the only possibility to reach satisfactory cosmetic and functional outcomes after tumor resection in the head and neck. We present the functional and aesthetic outcomes and quality of life (QOL) of our patients who underwent a forearm flap transfer. PATIENTS AND METHODS Thirty-one patients who were operated on in the departments of oral and maxillofacial surgery and otorhinolaryngology of the University of Essen participated in the study. Grip power, pinch power, and range of motion at the wrist as well as that in the metacarpophalangeal joints were measured. A sensory assessment including 2-point discrimination, temperature discrimination, and documentation of numbness, paresthesia, and scar pain was performed. The changes in hemodynamics were evaluated with digital optical blood pressure measurement and digital electronic pulse oscillography. Aesthetic satisfaction was investigated with an ordinal scale. Forearm circumference and hair growth on the flap were documented. Quality of life was evaluated with the EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire version 3) and H&N35 (Head and Neck Module) after medical treatment and wound healing. RESULTS Strength, range of motion, and forearm circumference measurements showed no impairment in comparison with the opposite forearm. Subjective sensory disturbances were found in 31% of the patients but were all regarded as nondisturbing. On the split-thickness graft at the forearm, diminished sensory function could be proven and missing temperature discrimination was revealed in 93%. Evaluation of the hemodynamics showed clinical unremarkable vascularization changes, although slight differences were detectable in the collective. Female (64%) and male (77%) patients rated the aesthetic outcome in their forearm in most cases as good. Hair growth on the transplant could be observed, but it decreased with time and disturbed only a few patients in the oral cavity (14%). In comparison with normative data from a general German population, the QOL assessment showed that patients with tumors stated a similar QOL with regained emotional, cognitive, social, and role functioning. There were significant differences in the symptom scales and single items of the EORTC QLQ-C30 and H&N35. In comparison with a collective of patients with tumors of the oral cavity that were treated with various therapies, no difference was detectable. CONCLUSIONS Correct planning and elevation presupposed, there will be no clinically relevant finding in strength, motion, and hemodynamics in the forearm and hand after free forearm flap transfer. Sensory findings are present after the operation but decrease with wound healing or are nondisturbing. In this study, the patients with tumors judged the aesthetic result in their forearm in most cases as good. They stated a high QOL with regained emotional, cognitive, social, and role functioning, although they perceived symptoms caused by the tumor and therapy.
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Ya'ish FMM, Cooper JP, Craigen MAC. Thermometric diagnosis of peripheral nerve injuries. Assessment of the diagnostic accuracy of a new practical technique. ACTA ACUST UNITED AC 2007; 89:933-9. [PMID: 17673589 DOI: 10.1302/0301-620x.89b7.18968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The diagnosis of nerve injury using thermotropic liquid crystal temperature strips was compared blindly and prospectively against operative findings in 36 patients requiring surgical exploration for unilateral upper limb lacerations with suspected nerve injury. Thermotropic liquid crystal strips were applied to affected and non-affected segments in both hands in all subjects. A pilot study showed that a simple unilateral laceration without nerve injury results in a cutaneous temperature difference between limbs, but not within each limb. Thus, for detection of a nerve injury, comparison was made against the unaffected nerve distribution in the same hand. Receiver operating characteristic curve analysis showed that an absolute temperature difference > or = 1.0 degrees C was diagnostic of a nerve injury (area under the curve = 0.985, sensitivity = 100%, specificity = 93.8%). Thermotropic liquid crystal strip assessment is a new, reliable and objective method for the diagnosis of traumatic peripheral nerve injuries. If implemented in the acute setting, it could improve the reliability of clinical assessment and reduce the number of negative surgical explorations.
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Affiliation(s)
- F M M Ya'ish
- Trauma & Orthopaedic Department, University Hospital Birmingham, UK.
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Lee JG, Kim SG, Lim KJ, Choi KC. Thermographic assessment of inferior alveolar nerve injury in patients with dentofacial deformity. J Oral Maxillofac Surg 2007; 65:74-8. [PMID: 17174767 DOI: 10.1016/j.joms.2005.11.098] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2005] [Accepted: 11/11/2005] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the injury and recovery of the inferior alveolar nerve in orthognathic patients at 1 and 4 weeks after surgery using electronic thermography. MATERIALS AND METHODS Twenty subjects with Class III dentofacial deformity were studied. All patients underwent bilateral sagittal split ramus osteotomy. To image the temperature of the face, 1 anteroposterior view and 1 lateral view were taken from both the right and left sides. Similar images were taken at 1 and 4 weeks after surgery. The control was the presurgical temperature of the 20 patients who showed unilateral or bilateral nerve damage after surgery. RESULTS In the patients with unilateral nerve damage (n = 14), on the anteroposterior views, the temperatures of the mentum on the 2 sides differed by 0.64 degrees C at 1 week after surgery, and the difference decreased to 0.23 degrees C at 4 weeks after surgery. On the lateral images, the differences in temperature between the mentum areas were 0.10 degrees C at 1 week and 0.27 degrees C at 4 weeks after surgery. In the patients with bilateral nerve injury (n = 6), on the anteroposterior views, the temperatures of the mentum on the 2 sides differed by 0.20 degrees C at 1 week after surgery and 0.13 degrees C after 4 weeks. On the lateral views, the differences were 0.18 degrees C at 1 week and 0.34 degrees C at 4 weeks after surgery. Using the repeated measurement analysis method, the anteroposterior view showed statistically significant results in the patients with unilateral nerve damage. CONCLUSION The infrared body temperature method is an objective method that can be applied as a supplemental diagnostic method for inferior alveolar nerve injury.
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Affiliation(s)
- Joon-Gil Lee
- Graduate Student, Department of Oral and Maxillofacial Surgery, College of Dentistry, Chosun University, GwangJu City, Korea
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Bharara M, Cobb JE, Claremont DJ. Thermography and thermometry in the assessment of diabetic neuropathic foot: a case for furthering the role of thermal techniques. INT J LOW EXTR WOUND 2007; 5:250-60. [PMID: 17088601 DOI: 10.1177/1534734606293481] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There are currently 3 established techniques employed routinely to determine the risk of foot ulceration in the patient with diabetes mellitus. These are the assessment of circulation, neuropathy, and foot pressure. These assessments are widely used clinically as well as in the research domain with an aim to prevent the onset of foot ulceration. Routine neuropathic evaluation includes the assessment of sensory loss in the plantar skin of the foot using both the Semmes Weinstein monofilament and the biothesiometer. Thermological measurements of the foot to assess responses to thermal stimuli and cutaneous thermal discrimination threshold are relatively uncommon. Indeed, there remains uncertainty regarding the importance of thermal changes in the development of foot ulcers. Applications of thermography and thermometry in lower extremity wounds, vascular complications, and neuropathic complications have progressed as a result of improved imaging software and transducer technology. However, the uncertainty associated with the specific thermal modality, the costs, and processing times render its adaptation to the clinic. Therefore, wider adoption of thermological measurements has been limited. This article reviews thermal measurement techniques specific to diabetic foot such as electrical contact thermometry, cutaneous thermal discrimination thresholds, infrared thermography, and liquid crystal thermography.
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Affiliation(s)
- M Bharara
- Academic Biomedical Engineering Research Group, Bournemouth University, Bournemouth, UK.
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Thermography of hands after a radial forearm flap has been harvested. EUROPEAN JOURNAL OF PLASTIC SURGERY 2006. [DOI: 10.1007/s00238-006-0050-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Previous reports recommended using skin temperature as a guide to monitor neuropathic feet during their rehabilitation course. However, the diagnostic usefulness was limited because of poor thermal measurement and procedures. The purpose of this study was to propose a standardized protocol to quantify foot temperature. METHODS An infrared image system was used to measure skin temperature. The first experiment was conducted on 16 healthy volunteers to study temperature variation with respect to time. This study mapped out six subregions of anatomic interest over the sole, and average temperature values for each were studied. The second experiment was conducted on 62 diabetic patients, with and without sympathetic skin response (SSR), to study proposed sole temperature normalization with respect to forehead temperature for clinical diagnosis. RESULTS In the first experiment, the temperature in each plantar subregion varied as a function of time. In the sole area, the highest temperature was noted in the arch region (29.3 +/- 0.9 degrees C). The toes had the lowest temperature value (26.2 +/- 1.2 degrees C) in all areas. Equilibrium was reached after 15 minutes for the mean plantar temperature (27.8 +/- 1.0 degrees C). In the second experiment, the diabetic patients without SSR had a slightly higher mean plantar temperature (27.6 +/- 1.8 degrees C) than those with SSR (26.8 +/- 2.2 degrees C), but the difference was not statistically significant (p > 0.05). The SSR-absent group (0.19) and the SSR-present group (0.24) had significant differences in their normalized temperatures as proposed (p < 0.05). CONCLUSIONS The mean temperature of the entire plantar area was found to be more stable than the individual subregions, serving as a more practical indicator for thermoregulatory functions. The study also found that the overall mean plantar temperature stabilized after 15 minutes, and, thus, this time was recommended for clinical thermographic measurements. The normalized temperature may have more useful application than the plantar absolute temperature, as exemplified by the better correlation in diabetic feet. The mean plantar temperature, the wait time to start measurement, and the proposed normalization are believed to play important roles in neuropathic foot disorders.
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Affiliation(s)
- Pi-Chang Sun
- Division of Physical Medicine and Rehabilitation, Taoyuan Veteran Hospital, Taoyuan, Taiwan
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Fikáčková H, Navrátilová B, Dylevský I, Navrátil L, Jirman R. Assessment of the effect of non invasive laser on the process of healing of an extraction wound by infrared thermography: preliminary study. J Appl Biomed 2003. [DOI: 10.32725/jab.2003.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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The Clinical Evaluation of East-West Medical Management for Central Poststroke Pain. J Pharmacopuncture 2001. [DOI: 10.3831/kpi.2001.4.2.095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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McGimpsey JG, Vaidya A, Biagioni PA, Lamey PJ. Role of thermography in the assessment of infraorbital nerve injury after malar fractures. Br J Oral Maxillofac Surg 2000; 38:581-584. [PMID: 11092769 DOI: 10.1054/bjom.2000.0524] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We studied 45 patients with malar fractures who had some degree of infraorbital nerve deficit. Thermographic facial images failed to show any substantial changes in the temperature profiles of the affected and the normal control sides in relation to reco very of their facial sensation. Although some patients who had thermography on the day of injury showed significant temperature differences between the affected and the normal sides, these differences were probably the result of the acute inflammatory ch anges caused by the injury. We suggest that infrared thermography has little place in the assessment of infraorbital nerve deficits.
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Affiliation(s)
- J G McGimpsey
- Professor of Dental Surgery, Department of Oral Surgery, Oral Medicine and Oral Pathology, The Queen's University of Belfast, School of Dentistry, Belfast, Northern Ireland, UK
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Zhu WP, Xin XR. Study on the distribution pattern of skin temperature in normal Chinese and detection of the depth of early burn wound by infrared thermography. Ann N Y Acad Sci 1999; 888:300-13. [PMID: 10842641 DOI: 10.1111/j.1749-6632.1999.tb07964.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Conduct basic research of the distribution pattern of skin temperature and estimate the wound depth in normal Chinese in the early stage of burn injury by using technical thermography. METHODS (1) Two hundred twenty-three volunteers from the electrical power system were randomly chosen: 138 males and 85 females, mean age 42.5 +/- 8.8, and mean weight 65.37 +/- 9.7 kg. (2) Thermovision 470 Pro camera of AGEMA Corporation, Sweden, was used. (3) A total of 29,882 values of skin temperature from all over the body were classified, compared, and statistically analyzed. RESULTS The difference in temperature on the y-axis of the body is relatively significant, from 0 to 9 degrees C. The difference in temperature on the x-axis of the body is relatively invariable. CONCLUSIONS The depth of early burn wound can be detected by using infrared thermography, which is an objective, fast, non-touching, and noninvasive method.
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Affiliation(s)
- W P Zhu
- Department of Burn and Reconstruction, Shanghai Power Hospital, China
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Nahabedian MY, McGibbon BM. Thermal injuries in autogenous tissue breast reconstruction. BRITISH JOURNAL OF PLASTIC SURGERY 1998; 51:599-602. [PMID: 10209462 DOI: 10.1054/bjps.1998.0209] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We report on four patients with partial and full thickness burns following autogenous tissue breast reconstruction. Three burns were confined to the flap and one burn involved the flap and rim of adjacent skin. Heat sources included a heating pad (n = 3) and sunlight through a bathing suit (n = 1). The injuries occurred from 6 days to 4 years following the reconstruction. The burns were the result of impaired thermoregulatory capacity of transplanted tissue. All wounds healed with local wound care or debridement and skin grafting.
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Affiliation(s)
- M Y Nahabedian
- Johns Hopkins Hospital, Division of Plastic Surgery, Baltimore, MD, USA
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