Skin Temperature Of Extremities Research Articles

Cold Habituation Does Not Alter Thermal Responses or Manual Dexterity During Prolonged Cold Air Exposure

Background: Habituation is a pattern of cold acclimatization characterized by attenuated cold defense responses, including a reduction in peripheral vasoconstriction and subsequent increase in skin temperature (TSk) as well as a decrease in shivering thermogenesis. Habituation is achieved through repeated reductions in TSk, rather than deep body core temperature (TC), via exposure to prolonged cold air or brief cold-water immersion. Due to improvements in TSk, enhanced manual dexterity and peripheral cold injury risk reduction are purported benefits of cold habituation. Warfighters frequently operate in cold climates and experience decrements in manual dexterity and strength. These functional losses can negatively impact mission critical tasks and training exercises; however, the effectiveness of cold habituation as a potential countermeasure to alleviate the deleterious effects of prolonged cold exposure on peripheral temperatures, thermal comfort, and hand function is unclear. Purpose: To evaluate the influence of eight consecutive cold air exposures on the thermal (TC and TSk), perceptual (thermal comfort and sensation), and functional (manual dexterity and strength) responses to cold air. We hypothesized that TSk would be higher and perceptual responses and manual dexterity improved, following repeated cold exposure. Methods: Eight young adults (6 M/1 F/1 FTM; 21 ± 2 years; %BF 24.5 ± 7.0) underwent a 2-h cold air exposure (8 °C, ~50% RH) on 8 consecutive days wearing minimal clothing. On Day 0 (baseline exposure ~1 week prior) and Days 1 and 8 of repeated exposure, TC was recorded continuously via a telemetry pill used as a rectal suppository. Extremity (Thand and Tfinger) and mean weighted TSk (MWTSk) from 8 skin sites were recorded continuously. Thermal comfort (TC) and thermal sensation (TS) were recorded at 20 min intervals. Expired gases were collected at 20 min intervals and used to calculate metabolic heat production (MHP). Manual dexterity was assessed using the Purdue Pegboard and Minnesota Manual Dexterity Test (MMDT), and hand strength were measured before and at the end of cold exposure. Results: TC changed across time ( p < 0.05) but did not differ between days ( p > 0.05). MWTSk, Thand, and Tfinger decreased across time ( p < 0.05) but also did not differ between days ( p > 0.05). Mean and minimum whole-body TS and TC were not different between days ( p > 0.05). MHP increased across time ( p < 0.05) but did not differ between days ( p > 0.05). Purdue Pegboard, MMDT task performance, and hand strength did not differ between days ( p > 0.05). Conclusion: Eight consecutive days of cold air exposure does not augment extremity skin temperature, thermal comfort, or manual performance during prolonged cold conditions. Supported by U.S. Army Medical Research and Development Command, Military Operational Medicine Research Program; author views not offcial US Army or DoD policy. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Spinal cord electrical stimulation with neurophysiological monitoring for treatment of high-risk diabetic foot

To evaluate the clinical efficacy of a single-session implantation of spinal cord electrical stimulation with neurophysiological monitoring a spinal cord electrical stimulator under general anesthesia with neurophysiological monitoring for the treatment of high-risk diabetic foot. The clinical data of seven patients with high-risk diabetic foot who underwent spinal cord electrical stimulation in neurosurgery ward nine of Tianjin Huanhu Hospital from May 2022 to May 2023 were collected. The operation was performed under general anesthesia with the "C" arm X ray machine guidance and neurophysiological monitoring. The arterial diameter and peak flow rate of lower extremity, lower extremity skin temperature (calf skin temperature, foot skin temperature), visual analog scale (VAS), continuous distance of movement, blood glucose level and toe wound were compared between patients before and after surgery. A total of seven patients with high-risk diabetic foot were included. The diameters and peak flow rates of femoral artery, popliteal artery, anterior tibial artery, posterior tibial artery and dorsal foot artery in both lower limbs were significantly improved after surgery. All patients had different degrees of lower limb pain before operation. After operation, VAS score decreased significantly (1.1±0.9 vs. 6.8±3.4), the pain was significantly relieved, and the calf skin temperature and foot skin temperature were significantly higher than those before surgery [calf skin temperature (centigrade): 33.3±0.9 vs. 30.9±0.7, foot skin temperature (centigrade): 31.4±0.8 vs. 29.1±0.6], fasting blood glucose and postprandial blood glucose were significantly lower than those before surgery [fasting blood glucose (mmol/L): 7.6±1.4 vs. 10.5±1.2, postprandial blood glucose (mmol/L): 9.3±2.3 vs. 13.5±1.1], the differences were statistically significant (all P < 0.01). The lower limb movement of all seven patients was significantly improved after surgery, including one patient who needed wheelchair travel before surgery, and one patient who had intermittent claudication before surgery. Among them, one patient needed wheelchair travel and one patient had intermittent claudication before surgery. All patients could walk normally at 2 weeks after operation. Among the seven patients, two patients had the diabetic foot wound ulceration before surgery, which could not heal for a long time. One month after surgery, blood flow around the foot wound recovered and the healing was accelerated. The wound was dry and crusted around the wound, and the wound healed well. For diabetic high-risk foot patients who are intolerant to diabetic peripheral neuralgia and local anesthesia spinal cord electrical stimulation test, one-time implantation of spinal cord electrical stimulator under general anesthesia under neurophysiological monitoring can effectively alleviate peripheral neuralgia and other diabetic foot related symptoms, improve lower limb blood supply, and reduce the risk of toe amputation. Clinical practice has proved the effectiveness of this technique, especially for the early treatment of diabetic high-risk foot patients.

Effect of short-term thermal history on thermal comfort and physiological responses: A pilot study

The purpose of this study is to examine the effect of outdoor short-term thermal history on the thermal comfort and physiological responses of human in the indoor environment. We conducted a field study in 4 split air-conditioned dormitory buildings. A total of 345 valid datasets were collected from 62 participants. We investigated thermal comfort, physiological responses and adaptation behaviours. According to the indoor staying time, we clarified the participants into two groups, namely STN30 (indoor staying time less than 30 min) and ST30 (indoor staying time more than 30 min). We compared the thermal comfort responses and physiological responses between two indoor staying time groups. We determined the relationship between thermal sensation and physiological responses. Subjects had a higher percentage of warmer thermal sensation, thermal discomfort and cooler preference in STN30 than in ST30. The upper extremity skin temperature was highly correlated to operative temperature and was consistent in both ST30 and STN 30 groups under the same operative temperature. Participants with shorter indoor staying time had lower neutral temperature (1.1 °C) and lower preferred temperature. The upper extremity skin temperatures were significantly correlated to thermal sensation.

Comparison of clinical effect and muscle injury imaging between oblique lateral lumbar interbody fusion and transforaminal lumbar interbody fusion in the treatment of single-segment degenerative lumbar spinal stenosis

To compare the efficacy and muscle injury imaging between oblique lateral lumbar interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of single-segment degenerative lumbar spinal stenosis. The clinical data of 60 patients with single-segment degenerative lumbar spinal stenosis who underwent surgical treatment from January 2018 to October 2019 was retrospectively analyzed. The patients were divided into OLIF groups and TLIF group according to different surgical methods. The 30 patients in the OLIF group were treated with OLIF plus posterior intermuscular screw rod internal fixation. There were 13 males and 17 females, aged from 52 to 74 years old with an average of (62.6±8.3) years old. And 30 patients in the TLIF group were treated with TLIF via the left approach. There were 14 males and 16 females, aged from 50 to 81 years old with an average of (61.7±10.4) years old. General data including operative time, intraoperative blood loss, postoperative drainage volume, and complications were recorded for both groups. Radiologic data including disc height (DH), the left psoas major muscle, multifidus muscle, longissimus muscle area, T2-weighted image hyperintensity changes and interbody fusion or nonfusion were observed. Laboratory parameters including creatine kinase (CK) values on postoperative 1st and 5th days were analyzed. Visual analogue scale(VAS) and Oswestry disability index(ODI) were used to assess clinical efficacy. There was no significant difference in the operative time between two groups(P>0.05). The OLIF group had significantly less intraoperative blood loss and postoperative drainage volume compared to the TLIF group(P<0.01). The OLIF group also had DH better recovery compared to the TLIF group (P<0.05). There were no significant differences in left psoas major muscle area and the hyperintensity degree before and after the operation in the OLIF group (P>0.05). Postoperativly, the area of the left multifidus muscle and longissimus muscle, as well as the mean of the left multifidus muscle and longissimus muscle in the OLIF group, were lower than those in the TLIF group (P<0.05) .On the 1st day and the 5th day after operation, CK level in the OLIF group was lower than that in the TLIF group(P<0.05). On the 3rd day after operation, the VAS of low back pain and leg pain in the OLIF group were lower than those in the TLIF group (P<0.05). There were no significant differences in the ODI of postoperative 12 months, low back and leg pain VAS at 3, 6, 12 months between the two groups(P>0.05). In the OLIF group, 1 case of left lower extremity skin temperature increased after the operation, and the sympathetic chain was considered to be injured during the operation, and 2 cases of left thigh anterior numbness occurred, which was considered to be related to psoas major muscle stretch, resulting in a complication rate of 10% (3/30). In the TLIF group, one patient had limited ankle dorsiflexion, which was related to nerve root traction, two patients had cerebrospinal fluid leakage, and the dural sac was torn during the operation, and one patient had incision fat liquefaction, which was related to paraspinal muscle dissection injury, resulting in a complication rate of 13% (4/30). All patients achieved interbody fusion without cage collapse during the 6- month follow-up. Both OLIF and TLIF are effective in the treatment of single-segment degenerative lumbar spinal stenosis. However, OLIF surgery has obviously advantages, including less intraoperative blood loss, less postoperative pain, and good recovery of intervertebral space height. From the changes in laboratory indexes of CK and the comparison of the left psoas major muscle, multifidus muscle, longissimus muscle area, and high signal intensity of T2 image on imaging, it can be seen that the degree of muscle damage and interference of OLIF surgery is lower than that of TLIF.

Duration limits for exposure for the whole body and extremities with a military extreme cold protection clothing ensemble at an ambient temperature of -40°C

ABSTRACT Manual performance and body temperature responses were assessed in a 1-h trial at an ambient temperature (TAMB) of −40°C for 7 male participants (32 ± 14 (mean ± SD) years) wearing a typical military extreme cold protection clothing ensemble. The purpose was to establish duration limited exposure (DLIM) for these conditions, and it was hypothesized that (i) core temperature (TCORE) would remain normothermic, whereas extremity skin temperature (TSK) would decrease; (ii) decrements of manual performance would be in proportion to decreases of hand TSK; and (iii) DLIM would be determined by the hand or foot TSK responses. Linear regression was employed to assess associations of manual performance scores and body temperatures with DLIM assessed using the Required Clothing Insulation (IREQ) model and extremity temperatures in ISO 11079–2007. Results showed TCORE remained at ~37.3°C, whereas there were significant (0.0001 < p < 0.05) decreases in extremity TSK. Associations between manual performance and hand TSK showed coefficients of determination (R2) ranging from 0.48 < R2 < 0.98; 0.00005 ≤ p ≤ 0.08. The DLIM for the whole-body ensemble ranged from 2.2 h to > 8 h, whereas the DLIM for the extremities was 0.56 ± 0.20 h for TSK decreasing 15°C. In conclusion, the hypotheses of a stable core temperature and decreases of extremity skin temperature giving decrements in manual performance were accepted as was the hypothesis that duration limits for exposure would be determined by extremity skin temperatures of the hand and foot.

Thermal Sensation in Older People with and without Dementia Living in Residential Care: New Assessment Approaches to Thermal Comfort Using Infrared Thermography.

The temperature of the indoor environment is important for health and wellbeing, especially at the extremes of age. The study aim was to understand the relationship between self-reported thermal sensation and extremity skin temperature in care home residents with and without dementia. The Abbreviated Mental Test (AMT) was used to discriminate residents to two categories, those with, and those without, dementia. After residents settled and further explanation of the study given (approximately 15 min), measurements included: tympanic membrane temperature, thermal sensation rating and infrared thermal mapping of non-dominant hand and forearm. Sixty-nine afebrile adults (60–101 years of age) were studied in groups of two to five, in mean ambient temperatures of 21.4–26.6 °C (median 23.6 °C). Significant differences were observed between groups; thermal sensation rating (p = 0.02), tympanic temperature (p = 0.01), fingertip skin temperature (p = 0.01) and temperature gradients; fingertip-wrist p = 0.001 and fingertip-distal forearm, p = 0.001. Residents with dementia were in significantly lower air temperatures (p = 0.001). Although equal numbers of residents per group rated the environment as ‘neutral’ (comfortable), resident ratings for ‘cool/cold’ were more frequent amongst those with dementia compared with no dementia. In parallel, extremity (hand) thermograms revealed visual temperature demarcation, variously across fingertip, wrist, and forearm commensurate with peripheral vasoconstriction. Infrared thermography provided a quantitative and qualitative method to measure and observe hand skin temperature across multiple regions of interest alongside thermal sensation self-report. As an imaging modality, infrared thermography has potential as an additional assessment technology with clinical utility to identify vulnerable residents who may be unable to communicate verbally, or reliably, their satisfaction with indoor environmental conditions.

Modified Full-Endoscopic Interlaminar Discectomy via an Inferior Endplate Approach for Lumbar Disc Herniation: Retrospective 3-Year Results from 321 Patients

Percutaneous endoscopic interlaminar discectomy (PEID) is a widely used minimally invasive procedure that shows satisfying outcomes for the treatment of L5-S1 and even L4-5 disc herniation. PEID can be divided into direct and indirect approaches according to the established method of the working channel. The direct approach mainly uses the puncture needle directly through the intervertebral space into the intervertebral disc under indirect vision and insertion of the guidewire into the puncture needle to guide the dilator and into the working channel to retract the ligamentum flavum, dural sac, and nerve roots. This approach requires a skilled puncture technique, given the high risk of damage to the nerve roots and dural sac. Therefore, we improved this interlaminar access procedure, placing the puncture target at the inferior endplate and performing preoperative epidurography to expose the spinal nerve roots and dural sac after the puncture needle was passed through the ligamentum flavum. We then positioned the puncture needle at the posterior edge of the superior centrum. Finally, we inserted the working sleeve for the operation. This approach is convenient and effectively reduces the learning curve andintraoperative complications. Here we introduce theprocedure and report the safety and efficacy of full-endoscopic interlaminar discectomy via an inferior endplate approach for the treatment of lumbar disc herniation. We performed full-endoscopic interlaminar discectomy via the inferior endplate approach in 321 patients who met our inclusion criteria between May 2014 and May 2017. All operations were completed under local anesthesia. Under fluoroscopic guidance, we performed epidurography to expose the spinal nerve roots and dural sac. The working sleeve and endoscope were then introduced into the inferior endplate of the superior centrum. Herniated disc material was removed using forceps and a laser under clear endoscopic visualization. We retrospectively evaluated the 321 patients with more than 30 months (range, 12-48 months) of follow-up. The therapeutic effects were assessed using scores of the visual analog scale (VAS), Oswestry disability index (ODI), Macnab standard, and infrared thermal imaging. The mean VAS score for radicular pain improved from 6.3 ± 1.01 preoperatively to 1.01 ± 0.35 at the final follow-up (P < 0.01). The mean ODI score improved from 85.5 ± 12 preoperatively to 12.4 ± 3.7 at the final follow-up (P < 0.01). According to the MacNab standard, the excellent and good outcome scores were 96.5%. The infrared thermal imaging scores indicated significantly improved skin temperature of both lower extremities at 1 week after surgery compared with the preoperation temperature (P < 0.01). The inferior endplate approach for percutaneous endoscopic interlaminar discectomy provides a safe and effective alternative for the treatment of lumbar disc herniation.

A comparative study on the treatment of degenerative lumbar spondylolisthesis by oblique interbody fusion and minimally invasive transforminal lumbar interbody fusion

Objective To compare the efficacy of oblique lumbar interbody fusion (OLIF) and minimally invasive interbody fusion (MI-TLIF) for degenerative lumbar spondylolisthesis. Methods Data of 40 patients with I-II degree single level degenerative lumbar spondylolisthesis from January 2018 to December 2018 were retrospectively analyzed. According to the operation procedure, they were divided into two groups: OLIF group and MI-TLIF group, and each group had 20 patients. There were 15 males and 5 females in the OLIF group, aged 50.3±8.8 years; and there were 13 males and 7 females in the MI-TLIF group, aged 51.7±8.7 years. According to the Meyerding's grade system, there were 16 patients of type I in the OLIF group and 15 cases in the MI-TLIF group; and there were 4 patients of type II in the OLIF group and 5 cases in the MI-TLIF group. The operation time, intra-operative hemorrhage, postoperative drainage, recessive blood loss and albumin loss were recorded. The CRP and ESR on the third day after operation, the VAS score and ODI score before and after operation were recorded. The lumbar lordosis (LL), fused segmental lordosis (FSL) and disc height (DH) before and after operation were recorded. The time of getting out of bed and walking and the hospital stay were recorded. Paired t-test was used to analyze the data. Results Forty patients successfully underwent the operation. The operation time of OLIF group was 96±20 min, with intraoperative blood loss of 61±32 ml and postoperative drainage volume of 18±8 ml. The operation time of MI-TLIF group was 132±26 min, with intraoperative blood loss of 262±102 ml and postoperative drainage volume of 95±42 ml; and there was statistical difference between the two groups (t=4.901, 8.404, 8.064; P< 0.001). On the third day after operation, the occult blood loss was 139±47 ml in the OLIF group and 486±192 ml in the MI-TLIF group; the albumin loss was 4.2±1.9 g/L in the OLIF group and 10.2±3.9 g/L in the MI-TLIF group; CRP was 34±11 mg/L in the OLIF group and 106±39 mg/L in the MI-TLIF group; ESR was 41±15 mm/1 h in the OLIF group and 71±24 mm/1 h in the MI-TLIF group, and there all were statistical differences between the two groups (t=7.838, 6.184, 7.983, 4.675; P< 0.001). The VAS scores were 2.2±1.5, 1.8±1.3 and ODI scores were 14%±11%, 59%±17%, respectively. There was no significant difference between the two groups. The LL were 33.41°±9.25°, 32.07°±9.54°, FSL were 11.59°±5.09°, 10.61°±4.56° and DH were 10.35±2.30 mm, 10.85±1.85 mm, respectively. There was no significant difference between the two groups. The follow-up time was 13.5±2.3 months in the OLIF group and 14.1±2.8 months in the MI-TLIF group. Three patients in the MI-TLIF group had radiation pain in the lower extremity on the third day after operation, which relieved after NSAID drugs and mannitol treatment. In the group of OLIF, the skin temperature of the left lower extremity increased in 1 case on the first day after operation, in which sympathetic chain injury was considered, and the patient recovered after 2.5 months; in the group of OLIF, the numbness in the front of the left thigh and the weakness of flexion of the hip was found in 3 cases, in which the edema or injury of the psoas major muscle was considered. Conclusion Compared with MI-TLIF in the treatment of I, II degree single segment degenerative lumbar spondylolisthesis, OLIF has the advantages of shorter operation time, less intraoperative and postoperative blood loss, lower inflammation index, earlier time to get out of bed and shorter hospital stay. However, the outcomes of the two surgeries were similar. Key words: Lumbar vertebrae; Spondylolysis; Spinal fusion; Surgical procedures, minimally invasive

Efficacy and safety of ucha-shinki-hwan on korean patients with cold hypersensitivity in the hands and feet: Study protocol clinical trial (SPIRIT Compliant).

Cold hypersensitivity in the hands and feet (CHHF) is a common complaint in Asian female population especially in Korea. Due to the symptoms of CHHF the quality of individual's daily life can be degraded. Ucha-Shinki-Hwan (UCHA) is widely used in the treatment of various diseases including CHHF by harmonizing Yin and Yang, and improving the vitality of whole body. However, the efficacy of UCHA as a treatment option of CHHF has not been assessed in trials. Thus, we aimed to investigate the efficacy and safety of UCHA in Korean women with CHHF through this trial. This study will be an exploratory, randomized, double-blind, placebo-controlled, parallel-group, multicenter trial. Korean women aged 19 to 59 years who complaint with CHHF will be enrolled from 5 university affiliated Korean medicine hospitals. A total of 164 subjects will be randomly assigned to a treatment group (UCHA) or a placebo group at a 1:1 ratio. The subjects will receive 2.5 g of either UCHA or placebo three times a day for 8 weeks. The primary outcome will be evaluated with the visual analog scale score of CHHF. The secondary outcome measures will be changes in skin temperature in extremities as measured by using a thermometer and the Korean version of the World Health Organization Quality of Life Scale Abbreviated Version. This study will be the first trial to explore the efficacy and safety of UCHA for CHHF patient. This will provide meaningful clinical information on herbal medicine treatment of CHHF and a clinical evidence for planning a full randomized clinical trial. The authors report no competing interests. This study is registered at ClinicalTrials.gov, ID: NCT03790033. Registered on (31 December 2018) PROTOCOL VERSION:: The final approved version of the trial protocol is V1.3. (25 January 2019).

WITHDRAWN: Modified Full-Endoscopic Interlaminar Diskectomy via an Inferior End Plate Approach for Lumbar Disk Herniation: Retrospective 3-Year Results from 321 Patients

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Effect of long-term indoor thermal history on human physiological and psychological responses: A pilot study in university dormitory buildings

The present study aimed to explore the effect of long-term indoor thermal history on the psychological and physiological responses of occupants. Based on a field study, 465 and 345 data sets were obtained from healthy students in naturally ventilated (NV) and split air-conditioned (SAC) dormitory buildings, respectively. The physiological and psychological responses were explored. Physical variables were measured by calibrated instruments; the psychological response was rated by occupants through questionnaires; physiological measurement included four upper extremity skin temperatures (i.e., finger, wrist, hand and forearm), heart rate, systolic blood pressure, and diastolic blood pressure. The results indicated that indoor thermal history had no significant effect on physiological response (i.e., upper extremity skin temperatures, blood pressure, and heart rate), and induced psychological adaptation. The neutral temperature of the NV group was 26.2 °C, 0.7 °C higher than that of the SAC group (25.7 °C). The upper limit of 90% acceptable temperature range was 28 °C for the NV group, 0.7 °C higher than that of the SAC group (27.3 °C). Compared to the SAC group, a warm long-term indoor thermal history of the NV group produced a shift to higher neutral temperature and higher acceptable temperature. The clothing adjustment of NV group was more sensitive to indoor temperature than the SAC group.

Body temperature and cold sensation during and following exercise under temperate room conditions in cold-sensitive young trained females.

We evaluated cold sensation at rest and in response to exercise‐induced changes in core and skin temperatures in cold‐sensitive exercise trained females. Fifty‐eight trained young females were screened by a questionnaire, selecting cold‐sensitive (Cold‐sensitive, n = 7) and non‐cold‐sensitive (Control, n = 7) individuals. Participants rested in a room at 29.5°C for ~100 min after which ambient temperature was reduced to 23.5°C where they remained resting for 60 min. Participants then performed 30‐min of moderate intensity cycling (50% peak oxygen uptake) followed by a 60‐min recovery. Core and mean skin temperatures and cold sensation over the whole‐body and extremities (fingers and toes) were assessed throughout. Resting core temperature was lower in the Cold‐sensitive relative to Control group (36.4 ± 0.3 vs. 36.7 ± 0.2°C). Core temperature increased to similar levels at end‐exercise (~37.2°C) and gradually returned to near preexercise rest levels at the end of recovery (>36.6°C). Whole‐body cold sensation was greater in the Cold‐sensitive relative to Control group during resting at a room temperature of 23.5°C only without a difference in mean skin temperature between groups. In contrast, cold sensation of the extremities was greater in the Cold‐sensitive group prior to, during and following exercise albeit this was not paralleled by differences in mean extremity skin temperature. We show that young trained females who are sensitive to cold exhibit augmented whole‐body cold sensation during rest under temperate ambient conditions. However, this response is diminished during and following exercise. In contrast, cold sensation of extremities is augmented during resting that persists during and following exercise.

Using Upper Extremity Skin Temperatures to Assess Thermal Comfort in Office Buildings in Changsha, China.

Existing thermal comfort field studies are mainly focused on the relationship between the indoor physical environment and the thermal comfort. In numerous chamber experiments, physiological parameters were adopted to assess thermal comfort, but the experiments’ conclusions may not represent a realistic thermal environment due to the highly controlled thermal environment and few occupants. This paper focuses on determining the relationships between upper extremity skin temperatures (i.e., finger, wrist, hand and forearm) and the indoor thermal comfort. Also, the applicability of predicting thermal comfort by using upper extremity skin temperatures was explored. Field studies were performed in office buildings equipped with split air-conditioning (SAC) located in the hot summer and cold winter (HSCW) climate zone of China during the summer of 2016. Psychological responses of occupants were recorded and physical and physiological factors were measured simultaneously. Standard effective temperature (SET*) was used to incorporate the effect of humidity and air velocity on thermal comfort. The results indicate that upper extremity skin temperatures are good indicators for predicting thermal sensation, and could be used to assess the thermal comfort in terms of physiological mechanism. In addition, the neutral temperature was 24.7 °C and the upper limit for 80% acceptability was 28.2 °C in SET*.

Электротепловая аналогия свойств кожи и фильтра низких частот: взаимосвязь колебаний температуры и кожного кровотока в области конечностей

Электротепловая аналогия свойств кожи и фильтра низких частот: взаимосвязь колебаний температуры и кожного кровотока в области конечностей

Lower extremity skin temperature and intramuscular response to whole body vibration (731.6)

Previously established research has shown that whole body vibration (WBV) is effective at increasing intramuscular temperature (IMT) of the medial gastrocnemius (MG) at 26Hz. A “reaction” of itching and redness to WBV has been noted in prior research, but is not reported in all subjects. The purpose of this study was to determine if WBV affects skin and MG IMT differently in those exhibiting this reaction vs those with no reaction when performing a standard static semi‐squat WBV protocol. 60 subjects were screened, 10 exhibited a reaction; 6 had no reaction. Subjects completed two 5x60s bouts of WBV (26Hz, 4mm amplitude) on an oscillating platform with 15s rest between bouts. Skin and IMT were taken pre, mid (after 5 min vibration), and post 10 min of vibration. There was no difference in starting temperatures for skin or MG IMT. No significant change in skin or MG IMT of the non‐reactive group. Reactive group had significant increases in skin temperature (pre‐mid p&lt;.0001, 2.32°C; pre‐post p&lt;.0001, 2.57°C) and MG IMT (pre‐mid p&lt;.0001, 1.5°C, mid‐post p&lt;.004, 0.95°C, pre‐post p&lt;.0001, 2.46°C). In conclusion, WBV exerts its effects upon reactive and non‐reactive groups differently. This difference could be due to histamine release due to WBV. Future research should be conducted to determine how WBV affects skin and muscle temperature or blood flow response.Grant Funding Source: None

Development and Application of the Sleeve-type Restraints for Intensive Care Unit Patients

Purpose: The purpose of this study was to develop sleeve-type restraints and to compare the sleeve-type and conventional wrist restraints. Methods: Forty four pairs of intensive care unit (ICU) patients and their families participated in the experiment. The nurses applied sleeve-type restraints to the patients in the experimental group, and wrist restraints to the control group. The trained research assistant measured ROMs, skin temperature, edema, and skin lesions of both upper extremities (UEs) before, 24, 48, and 72 hours after the restraints applied. The emotional response of family was measured 72 hours after the restraints applied. Thirty one ICU nurses evaluated the efficiency of both types of restraints. Results: Compared to the control group, changes of ROMs, edema, and skin abrasions on both U/Es of the experimental group indicated a significant difference in physical side effects. The emotional response scores of the experimental group were significantly lower than those of the control group. The mean efficiency scores for the sleeve-type restraints were significantly higher than those for the wrist restraints. Conclusion: The results indicate that the sleeve-type restraints are better than wrist restraints with respect to physical side effects, emotional responses of family members, and application efficiency.

A systematic review on the role of extremity skin temperature as a non-invasive marker for hypoperfusion in critically ill adults in the intensive care setting

Review Question/Objectives The objective of this review is to critically appraise, synthesise and present the best available evidence on extremity skin temperature as a noninvasive marker of hypoperfusion in critically ill adult patients. More specifically, the objective is to determine: The accuracy and reliability of extremity skin temperature as a marker of hypoperfusion in critically ill adults. The review aims to answer the following questions: How accurate and reliable is extremity skin temperature as a noninvasive marker of hypoperfusion in critically ill adults? In this review, extremity skin temperature will be defined as the surface temperature at the feet, lower legs, hands or forearms. Hypoperfusion will be defined as the decrease in blood flow through an organ or tissue, as may occur duringlow-flow perfusion states commensurate with hypovolaemic shock. Inclusion Criteria: Types of participants: This review will consider studies that include male and female critically ill adult patients (defined as age 18 and above) admitted to the intensive care setting. Patients with either a medical or surgical diagnosis will be included. However, this review will exclude patients with pre-existing medical history of peripheral vascular disease (PVD), diabetes mellitus (DM), ischemic heart disease (IHD) and stroke. Types of interventions: The review will consider studies that evaluate the role of extremity skin temperature monitoring in the diagnosis of hypoperfusion. Skin temperature monitored subjectively via touch or palpation and objectively via skin temperature monitoring devices will both be analysed in this review for its potential to be a marker for hypoperfusion. Types of outcome measures: This review will consider studies that include the following outcome measures: The relationship between extremity skin temperature and pathological events such as sepsis, organ failure, mortality and adverse events. The relationship between extremity skin temperature measurements and conventional markers of perfusion.

A systematic review on the role of extremity skin temperature as a non-invasive marker for hypoperfusion in critically ill adults in the intensive care setting.

Haemodynamic monitoring is the cornerstone of critical care management. The adequacy of peripheral perfusion has been used as a determinant of cardiovascular system status. Poor cardiac function leads to increased vascular resistance, contributing to reduced tissue perfusion, and it is said to cause a large temperature gradient between the core and the skin. Consequently, skin temperature at the extremities has been proposed as a "proxy" to assess peripheral perfusion. However, this has not been investigated in a systematic way, hence the need for a systematic review of the literature. The objective of this review is to present the best available evidence on extremity skin temperature as a non-invasive marker of hypoperfusion in critically ill adult patients. A comprehensive search of major databases was performed to ensure all studies meeting the inclusion criteria were retrieved. The search strategy aimed to find both published and unpublished studies, published in English language, from 1969 to 2010. Randomised controlled trials, quasi-experimental studies, non-randomised controlled trials, and before and after studies that investigate the role of skin temperature as a marker of hypoperfusion were included. Observational, correlational studies were included due to the lack of studies with high level of evidence.Male and female critically ill adult patients (aged 18 years and above) admitted to the intensive care setting.The review considered studies that evaluate the role of extremity skin temperature monitoring in the diagnosis of hypoperfusion. Skin temperature monitored subjectively via touch or palpation and objectively via skin temperature monitoring devices.Measures of skin temperature (e.g. toe temperature, core-peripheral temperature, etc.) and markers of perfusion (e.g. cardiac output, mean arterial pressure, heart rate, central venous pressure, etc.). Eligibility of papers were assessed independently by the two reviewers. Ten studies were assessed for methodological quality with a modified Critical Appraisal Checklist. After this process, five were selected. A newly-developed data extraction tool was used to gather specific information from the selected studies. Due to the heterogeneity of the studies' methodology, the results of this systematic review were presented in a narrative summary. There were three studies which support the use of extremity skin temperature as a marker of hypoperfusion and two studies which do not support the use. These results reveal the apparent lack of consensus in the studies as to whether or not extremity skin temperature is an accurate and reliable marker of hypoperfusion. The use of extremity skin temperature as a "proxy" for hypoperfusion cannot be validated or recommended due to the paucity of definitive evidence.The review is unable to provide a definitive recommendation to guide clinical practice in this area. Nonetheless, the assessment of extremity skin temperature may be feasible in the general wards for identifying patients at risk because of its ease of use and non-invasive nature.Higher quality research should be conducted to determine if extremity skin temperature has a putative role as a non-invasive marker of hypoperfusion in critically ill adults.

A comparison of whole body vibration and moist heat on lower extremity skin temperature and skin blood flow in healthy older individuals

SummaryBackgroundTissue healing is an intricate process that is regulated by circulation. Heat modalities have been shown to improve skin circulation. Recent research supports that passive vibration increases circulation without risk of burns. Study purpose is to compare and determine effects of short duration vibration, moist heat, and a combination of the two on skin blood flow (SBF) and skin temperature (ST) in elderly, non-diabetic individuals following short-term exposure.Material/MethodsTen subjects, 3 female and 7 male (55–73 years of age), received two interventions over three days: 1 – Active vibration, 2 – passive vibration, 3 – moist heat, 4 – moist heat combined with passive vibration (MHPV), 5 – a commercial massaging heating pad, and 6 – no intervention. SBF and ST were measured using a MOOR Laser Doppler before and after the intervention and the third measurement were taken 10 minutes following.ResultsMean SBF following a ten-minute intervention were significantly different in the combination of moist heat and passive vibration from the control, active vibration, and the commercial massaging heating pad. Compared to baseline measurements, this resulted in mean SBF elevation to 450% (at conclusion of 10 minutes of intervention) and 379% (10 minutes post). MHPV (p=0.02) showed significant changes in ST from the commercial massaging heating pad, passive vibration, and active vibration interventions.ConclusionsSBF in the lower legs showed greatest increase with MHPV. Interventions should be selected that are low risk while increasing lower extremity skin blood flow.

PREVENTION OF NEUROLOGICAL COMPLICATIONS IN CORRECTION SURGERY FOR SEVERE SPINAL DEFORMITIES

Objective. To assess the efficacy of neurological complication prevention by multimodal intraoperative monitoring of spinal cord functioning. Material and Methods. Results of intraoperative spinal cord monitoring in 457 patients during spine correction surgery for grade IV scoliosis with application of the third-generation segmental instrumentation were analyzed. The magnitude of scoliotic curvature exceeded 80 degrees in 353 patients. All patients underwent continuous intraoperative monitoring of lower extremity skin temperature. Out of them, in 45 patients somatosensory evoked potentials were recorded, and in 41 patients intraoperative Stagnara wake-up test was performed. Results. Neurological complications were registered in 4 patients as lower atonic paraplegia which accompanied with rapid rise in lower extremity skin temperature more than by 1 °C during spinal deformity correction. In two of them SSEP recording showed a sharp decrease in the amplitude of potential waves up to their complete disappearance. Skin temperature monitoring of lower extremities did not revealed significant changes in patients without neurological complications. Conclusion. Multimodal intraoperative monitoring of the spinal cord function should be performed in patients with high risk of neurological complications after surgical correction of spinal deformity.