Vibration syndrome diagnosis using a cooling test verified by computerized photoplethysmography

Abstract

This study addresses the problem of vibration syndrome diagnosis by means of a cooling test verified by photoplethysmography. Measurement was taken on a small area on the fingertip plexus in which many arterio-venous anastomoses are present. In the opinion of many authors, flow disorders in this area are more typical for developing vibration syndrome than changes in the micro vessels. The study group comprised 128 subjects (58 women aged 40.9 ± 5.4 years and 70 men aged 38.7 ± 8.8 years) exposed to vibration. The control group consisted of 41 people (20 women aged 39.6 ± 7.3 years and 21 men aged 39.3 ± 6.4 years) who were not exposed to vibration. The patients were examined by a questionnaire and then a vibration perception threshold test and a cooling test were performed. The cooling test was verified both visually and using the computer method. Measurement data (S1, S2 and A) for each patient were obtained from averaging three pulse graphs. We departed from an average of 60 graphs (and more), the standard established in the literature, because of the cooling test specification, which causes huge thermodynamic parameter changeability in the plexus mass of the small finger under pulse waves coming one after another. A longer measurement time will reflect the thermal drift of the tested area in a direction to compensate for the reduced temperature. In the control group, all subjects showed an increase in planimetric indicators during the cooling test verified by computerized photoplethysmography. In the study group visual verification of the cooling test was positive in eight cases (6.2%) and the vibration perception threshold test was positive in seven cases (5.5%), but in computerized photoplethysmography the planimetric indicators decreased after cooling in 87 (67.4%) cases. Computer photoplethysmography is highly specific and shows greater sensitivity in detecting preclinical forms of vascular-type vibration syndrome when compared with palesthesiometry, the visually verified cooling test and the questionnaire. The proposed test enables the detection of vascular disorders in the prodromal period and gives time for preventive measures to be taken.