Cold Immersion Research Articles

Effects of acupuncture and transcutaneous electrical nerve stimulation on cold-induced pain in normal subjects

The effects of acupuncture, transcutaneous electrical nerve stimulation (TENS) at high (100 Hz) and low (8 Hz) frequency and placebo on pain induced by cold immersion of the hand were studied in 46 young healthy male and female volunteers. Acupuncture produced significant elevations of pain threshold, while 100 Hz TENS or placebo had no effect. Eight Hertz TENS produced elevation of pain threshold with significant variation in response between individuals. There was some evidence that the L scale score of the Eysenck Personality Questionnaire predicted analgesic outcome for 8 Hz TENS. No significant relationship was found between baseline pain threshold or tolerance and personality variables.

Autonomic dysfunction in palmar hyperhidrosis

The autonomic (including sudomotor, baroreceptor, and vasomotor) functions were assessed in 3 groups of individuals, comprising normal, hyperhidrotic, and denervated subjects. The normal group had no palmar hyperhidrosis, with intact T2-3 ganglia, the hyperhidrotic group had palmar hyperhidrosis with intact T2-3 ganglia, and the denervated group had palmar hyperhidrosis treated with T2-3 ganglionectomy. Compared with both the normal and hyperhidrotic subjects, the denervated subjects had a much smaller sweating response of both the forehead, the upper chest region and the upper extremities, and a much greater sweating response of both the lateral lumbar and ventral thigh regions in response to body exercise. In addition, cardiovascular responses to either the Valsalva manoeuver, face immersion, or finger immersion were evaluated in these groups of subjects. When compared with those of either the normal or the denervated subjects, the hyperhidrotic subjects had less reflex bradycardia in response to either Valsalva manoeuver or face immersion. In contrast, when compared with those of either the normal or the denervated subjects, the hyperhidrotic subjects had a higher degree of cutaneous vasoconstriction in response to finger (or cold) immersion. The data indicate that the sympathetic fibers passing through the T2-3 ganglia play an important role in the elaboration or modulation of autonomic function elsewhere. Probably, the hyperhidrotic subjects have an over-functioning of the sympathetic nervous fibers which pass through the T2-3 ganglia, which leads to autonomic dysfunction. The autonomic dysfunctions observed in the hyperhidrotic subjects could be eliminated after the interruption of the excessive sympathetic activities passing through the T2-3 ganglia level. A preliminary report of this work was delivered at the 15th Congress of the Pan-Pacific Surgical Association, January 12–18, 1980 and the 12th World Congress of Neurology, September 20–25, 1981.

Familial resemblance in catecholamine changes to cold stress and maximal exercise.

Parents and children from 38 families were submitted to a cold-stress and maximal treadmill test. The number of subjects varied depending on the measurements. Plasma epinephrine and norepinephrine, blood pressure and heart rate were measured before, during and after a cold hand immersion test (in a water bath at 5 degrees C for 2 min), as well as before and after maximal exercise (modified Balke). Scores were adjusted for the effects of age and sex through multiple-regression procedures (age + sex + age X sex + age2 + age3), yielding residuals which were submitted to analysis. Characteristic variations during cold stress were observed. Maximal exercise yielded a mean aerobic power of 43 ml/kg min-1 (SD = 10), a mean maximal heart rate of 192 (SD = 10) and a mean maximal blood lactate of 65 mg/100 ml (SD = 23). Family resemblances in cold stress and maximal exercise adaptive reactions were investigated by comparison of between-family over within-family means of squares. In response to the cold stress, there were indications of family lines in induced changes for systolic blood pressure, epinephrine, and total catecholamines at 1 min after the test (p less than or equal to 0.05). Furthermore, parent-child correlations were significant and reached 0.38 for epinephrine, 0.28 for norepinephrine, and 0.34 for total catecholamines. Familial concentrations could not be detected before or 8 min after the cold stress. There are no indications of family resemblance in plasma catecholamine concentrations following exposure to maximal-exercise stress. It is concluded that genetic variation is probably contributing only moderately to catecholamine changes under cold stress and very little under exercise stress.

Influence of respiratory heat transfer on thermogenesis and heat storage after cold immersion.

1. Ten male subjects were cooled on three occasions to a rectal temperature of 35 degrees C by immersion to the neck in water at 11.3 degrees C. The subjects were rewarmed for 60 min, once by metabolic heat production alone (shivering), once by inhalation rewarming with spontaneous breathing of saturated air at 47 degrees C (control) and once by inhalation rewarming with ventilation regulated at 40 litres/min by respiring a controlled fraction of CO2 (hyperventilation). 2. Metabolic heat production was substantially reduced by inhalation rewarming (P less than 0.05), from 913 kJ when shivering to 766 kJ (control) and 613 kJ when hyperventilating. The fall in metabolic heat production was greater than the corresponding respiratory heat gain, which increased from a loss of 41 kJ when shivering to gains of 85 kJ (control) and 169 kJ (hyperventilation). 3. As differences in mean skin temperatures were small (less than 1.0 degrees C), it is concluded that the lower metabolic heat production in response to increased respiratory heat input must result from more rapid central temperature gains. This conclusion is supported by the relative values of rectal and tympanic temperatures. It was calculated that the percentage of the total heat supply which was donated to the core increased from 13% during shivering to 16% for the control and 23% in hyperventilation. Results imply that respiratory heat input is more efficient than metabolic heat production in elevating central temperature.

Measurement of plasma histamine: description of an improved method and normal values

The single isotopic-enzymatic assay of histamine was modified to increase its sensitivity and to facilitate measurement of plasma histamine levels. The modification involved extracting 3H-1-methylhistamine (generated by the enzyme N-methyltransferase acting on histamine in the presence of S-[methyl- 3H]-adenosyl- l-methionine) into chloroform and isolating the 3H-l-methylhistamine by thin-layer chromatography (TLC). The TLC was developed in acetone: ammonium hydroxide (95: I0), and the methylhistamine spot (R f= 0.50) was identified with an o phthalaldehyde spray, scraped from the plate, and assayed in a scintillation counter. The assay in plasma demonstrated a linear relationship from 200 to 5000 pg histamine /ml. Plasma always had higher readings than buffer, and dialysis of plasma returned these values to the same level as buffer, suggesting that the baseline elevations might be attributable to histamine. However, all histamine standard curves were run in dialyzed plasma to negate any additional influences plasma might exert on the assay. The arithmetic mean (± SEM) in normal plasma histamine was 3I8.4 ± 25 pglml (n = 5I), and the geometric mean was 280 ± 35 pg/ml. Plasma histamine was significantly elevated by infusion of histamine at 0.05 to 1.0 μg/kg/min or by cold immersion of the hand of a cold-urticaria patient. Therefore this modified isotopic-enzymatic assay of histamine is extremely sensitive, capable of measuring fluctuations in plasma histamine levels within the normal range, and potentially useful in analysis of the role histamine plays in human physiology.

Finger temperature after a finger-cooling test: influence of air temperature and smoking.

Skin temperature of one finger was measured before and after immersion of the gloved fingers of both hands in 16 degrees C water for 5 min [room temperature (Ta) 24 or 20 degrees C]. At Ta 24 degrees C, 23 of 25 normal nonsmokers (92%) had finger rewarming to above 24 degrees C in 12 min after cold immersion, at Ta 20 degrees C, only 1 of 12 (8%) had similar rewarming. Among 12 habitual smokers only 4 (33%) rewarmed above 24 degrees C (Ta 24 degrees C) following a 1-h abstinence from smoking, but 8 (67%) did so after a 24-h abstinence. Only 2 of these 8, however, did so in a retest 10 min after smoking a cigarette. The smokers were not tested at Ta 20 degrees C. We conclude that air temperature and cigarette smoking are important determinants of finger rewarming following a finger-cooling test.

Plasma free and sulfate conjugated catecholamine levels during acute physiological stimulation in man

The responses of plasma free and sulfate-conjugated catecholamines to acute physiological stimulation was examined in normal male subjects. Catecholamines were measured with a sensitive radioenzymatic assay incorporating simultaneous hydrolysis of sulfate conjugates and O-methylation of free norepinephrine and epinephrine. Following 20 minutes recumbency after venepuncture 30 ± 3% of norepinephrine and 16 ± 5% of epinephrine was in the free form. Free catecholamines generally increased during standing, cold immersion and isometric handgrip, but sulfates did not change. Bicycle ergometry markedly increased free catecholamines which rapidly returned to basal levels at the end of exercise. In contrast, sulfated norepinephrine decreased substantially with exercise in all subjects but returned to basal levels 3 minutes after stopping exercise. Epinephrine sulfate varied considerably between subjects but showed a similar, although smaller, fall with exercise. Thus, during physiological stimulation, which caused increases in free norepinephrine and epinephrine levels in plasma, the only consistent change in sulfated catecholamines was a marked fall in norepinephrine sulfate after bicycle exercise. This may indicate saturation of sulfotransferase activity, substrate inhibition or impaired tissue conjugation.

Studies of peripheral nerve conduction velocities in vibrating tool operators

Vibrating tools such as chain-saws, rock-drills, grinders and tie-tampers have been widely used in many kinds of industries in Japan, causing vibration syndrome among the operators. As is well-known, the syndrome includes disorders of the peripheral circulation in the hands, e.g. Raynaud's phenomenon, and of the peripheral and central nervous systems. As the result of preventive countermeasures to the syndrome during the last decade, the picture of the syndrome has been partly changing especially for the patients among the state forestry workers; for example, the prevalence of the peripheral nerve disorders has been relatively increasing compared with that of Raynaud's phenomenon. Peripheral nerve disorders such as numbness, paresthesia and hypesthesia in the upper limbs tend to be usually cumulative and irreversible. The disorders are very important problem of vibration syndrome from the standpoint of treatment and prevention, though there are only a few reports of the study on the disorders using electrophysiological methods. In order to make objectively clear the peripheral nerve disorders, 236 male vibrating tool operators (= Group V) were examined. The following nerve conduction velocities were measured: (1) Maximal motor nerve conduction velocities (MCV) of the median and ulnar nerves in the forearm. (2) Sensory nerve conduction velocities (SCV) of the median and ulnar nerves in the forearm and palm. (3) Residual latency (RL) of the median and ulnar nerves. Besides, working conditions and complaints relevant to vibration syndrome were examined by using questionnaires. MCVs, SCVs and RLs that were outside of mean +/- 2 S.D. of the control group (= Group C), consisting of 30 healthy men, were evaluated as abnormal. The obtained results led to the following conclusions: (1) All MCVs, SCVs and RLs of Group V were significantly less than those of the control group. In Group V, prevalence of the abnormality in each of forearm SCVs was higher than that in each of MCVs of the corresponding nerves. (2) The difference between the median and ulnar SCV in the palm and the respective SCV in the forearm of each subject was significantly greater for Group V than Group C. (Palm-forearm difference) (3) The difference between the forearm and palmar SCV of the ulnar nerve and the respective velocities of the median nerve was statistically greater for Group V than for Group C. (Ulnar-median difference) (4) Ulnar SCV in the palm of Group V was significantly related to the total operating hours of vibrating tools. (5) There was no significant relation between all the nerve conduction velocities and the white finger attack. But a significant relation was noticed between the prevalence of the abnormal values of ulnar SCV in the palm and the peripheral circulatory function score computed from the data of nail press test and cold immersion test.

Cold Immersion Tests for Vibration Disease through Four Seasons

Cold Immersion Tests for Vibration Disease through Four Seasons

Cold Immersion Tests for Vibration Diseases under Various Room Temperatures

Cold Immersion Tests for Vibration Diseases under Various Room Temperatures

Thermographic Findings of Patients with "White Fingers" by the Cold Immersion Test (at 10℃ for 3 Minutes)

Thermographic Findings of Patients with "White Fingers" by the Cold Immersion Test (at 10℃ for 3 Minutes)

A peripheral vascular insufficiency test using photocell plethysmography.

A preliminary laboratory study seeking an objective test for vascular insufficiency of the fingertips (Raynaud's syndrome) is described. In a limited number of subjects, circulatory changes in the vascular bed of one hand were examined by photocell plethysmography while the opposite had was immersed in ice water. The time to complete recovery after cessation of the cold stimulus was significantly longer with primary Raynaud's patients than with the control subjects (p = 0.0045). The analysis of another parameter, the relative change in pulse amplitude during cold immersion, was confounded by age and sex differences between the Raynaud's and the control group. A follow-up investigation of the application of this technique to a population of vibration-exposed chipper and grinder and control workers is in progress.

Enhancement of calorigenic response to cold and to norepinephrine in physically trained rats.

Calorigenic response to cold and to norepinephrine (NE: 4 microgram . kg-1 . min-1) in physically fit (SW) rats was compared with control (CT) and cold-acclimated (CA) rats. Physical fitness was obtained by daily 3-hr swimming in water at 36 degree C for 6-8 weeks. Resting heart rate (HR) was significantly less in SW rats. Cold immersion (in water at 18 degree C up to the neck) increased oxygen consumption (VO2) significantly in CA and SW compared to CT rats (p less than 0.01). Cold immersion decreased colonic temperature (Tco1) in all groups. Despite the increased calorigenic response, SW rats cooled as quickly as CT rats in cold water. Body weight and skinfold thickness were significantly less in SW than in CT rats (p less than 0.01). Compared with CT rats, average weight of the interscapular BAT was significantly less in SW rats (p less than 0.05). Infusion of NE significantly increased VO2, Tco1, HR and mean aortic pressure in anesthetized rats. The increase in VO2 was significantly greater in CA (p less than 0.01) and SW (p less than 0.05) than in CT rats. Tco1 increased significantly in CA (p less than 0.05) and slightly in SW compared to CT animals.

Reactions to hand cooling in workers occupationally exposed to cold.

Ten men occupationally exposed to cold and ten office workers participated in the study. Reactions to immersion of the hands in cold water (+ 10 degrees C) for 2 min were studied during the following 30 min at two different ambient temperatures, 10 and 20 degrees C. Hand skin temperature was recorded in thermograms, and the subjects rated cold sensation and pain. Considerable interindividual differences in hand skin temperature reaction were found in both groups. On the average the occupationally exposed workers had a somewhat higher hand skin temperature than the office workers during the recovery period in the 10 degrees C ambient temperature, although the difference did not reach significance. The office workers rated significantly greater cold sensation as a result of the cold immersion, especially during an ambient temperature of 10 degrees C, and the frequency of pain ratings was higher for this group. The results suggest that cooling among the occupationally exposed workers at work was not severe enough to produce physiological adaptations, although some psychological adaptation was indicated.

Effect of heparin and cold immersion on burn edema

Effect of heparin and cold immersion on burn edema

The effect of immediate and delayed cold immersion on burn edema formation and resorption.

Massive wound edema after a burn may impair healing and help to convert partial to full-thickness injury. Cold treatment (usually by immersion) has been reported to decrease wound edema and is useful in first-aid treatment of burns. Reliable quantitative data have been lacking and frequently a superficial burn has been studied. Since cold by decreasing peripheral blood flow could actually be harmful to a deep burn, especially if applied late, we measured the effect of cold immediately and 2 minutes postburn on edema formation and resorption in a deep second-degree burn in sheep hindlimbs. We used Dichromatic Absorptiometry, a noninvasive, reliable method for measuring tissue fluid, to quantitate edema. Immediate application of cold by immersion in 15 degrees C saline for 30 minutes reduced the edema of a deep second-degree burn and did not impair resorption rate compared with control limbs, fluid content returning to baseline after 1 week. Cold treatment beginning 2 minutes after the burn did not decrease edema formation and did impair resorption. Fifteen per cent of the edema fluid was still present 1 week postburn, suggesting further injury to the burn wound vasculature with use of cold immersion 2 minutes postburn.

Cold urticaria: release into the circulation of histamine and eosinophil chemotactic factor of anaphylaxis during cold challenge.

Patients with idiopathic acquired cold-induced urticaria were evaluated for the release of the preformed mast-cell mediators of immediate-type hypersensitivity during a study in which one arm was immersed in ice water while the other arm remained as a control. Blood specimens were obtained from each arm serially over a one-hour interval, and serum speciments were assessed for histamine, eosinophil chemotactic factor of anaphylaxis, and complement components. Levels of histamine and eosinophil chemotactic factor rose in the arm subjected to cold immersion for three minutes, with peak values occurring between two and five minutes and returning to base line by 30 minutes. No changes occurred in the control arm or in the immersed arm of normal subjects. Assessment of the classical and alternative complement pathways showed no abnormalities. This initial observation of release of eosinophil chemotactic factor of anaphylaxis in vivo along with histamine assigns the mast cell a central role in cold urticaria.

Some factors influencing the vasomotor response to cold pressor stimulation.

ABSTRACTThe purpose of the present experiment was to investigate the effect of initial level of vasomotor tonus, as measured by pulse‐wave amplitude, on the cutaneous blood‐volume response to a 1‐min cold immersioa of an extremity. The design included 3 test sessions, I wk apart, in which room temperature was set at either 32°C, 22°C, or 12°C. Pulse‐wave amplitude and blood volume of the left thumb were recorded plethysmographically. Room temperature manipulated the state of the peripheral vasculature successfully, with subjects at 12°C having smaller pulse‐wave amplitudes than at 32°C, during rest, It has been specifically hypothesized that when subjects were more constricted at rest, as at 12°C, the response to cold immersion would be an increase in blood volume, and when they were more dilated, as at 32°C, that the response would he a drop in blood volume, while subjects at 22°C would fall in between. It was further hypothesized that should CP habituation occur over the 3 sessions, it would be seen as a smaller drop for the 32°C and 22°C sessions and a smaller volume increase for the 12°C sessions. Both hypotheses were supported by the data. The results indicate that the magnitude and direction of change in cutaneous vascular systems depends on prestimulus tonus, and that the response to cold stress is not strictly stimulus bound, but that is dependent equally as much upon initial level of tonus. Habituation is seen as a decrease in response magnitude, regardless of direction.

Cold Immersion and Swimming

AbstractExperiments to indicate the effects on survival after immersion in water of such factors as subcutaneous fat, exercise and clothing are described. The causes of sudden death in water are discussed and advice is given on action to be taken to preserve life after immersion.

Cardiovascular effects of cold pressor tests, 40 degrees head-up tilt, and smoking on smokers and non-smokers.

Cardiovascular responses to various stress tests have been studied in 13 nonsmokers, 16 moderate (20 cigarettes per day) and 13 heavy (40 cigarettes per day) smokers before and after cigarette smoking. Intra-arterial, pressure, ECG, respiration, and skin temperature were continuously monitored and recorded on tape. Dye dilution cardiac outputs were measured in some of the subjects. The analog data were analyzed on a digital computer using A-D conversion. Blood pressure, heart rate and cardiac output were not different in smokers and nonsmokers before and after smoking. Hyperreactor response to cold immersion by Hines' criteria was extremely frequent (30 percent to 58 percent) in all subjects with the use of continuous pressure measurement. A composite of maximal response, time of return and the area under the pressure curve is suggested for better definition of the cold pressor response. Presyncopal reactions during 40° head-up tilt were more frequent in heavy smokers after smoking.