Increase In Finger Temperature Research Articles

Cardiovascular Stress and Characteristics of Cold-Induced Vasodilation in Women and Men during Cold-Water Immersion: A Randomized Control Study.

Simple SummaryCold-induced vasodilation is a phenomenon that refers to a paradoxical increase in finger temperature that sometimes occurs during cold exposure. Differences between sexes in cold-induced vasodilation have been explored in only a handful of studies. These studies investigated finger skin temperature but did not evaluate toe skin temperature, blood flow in the fingers or toes, clothing, as well as potential underlying mechanisms of cutaneous vasomotion. On the whole, our knowledge on the potential impacts of sex differences on CIVD is limited and this may have important implications for workers and how they cope with exposure to cold environments. The aim of the study was to investigate and compare cold-induced vasodilation and other cardiovascular responses between genders, during exposure to different environmental conditions. The present study demonstrated that women experienced elevated cardiovascular strain and higher frequency of CIVD reactions, particularly in the toes, compared to their male counterparts during cold-water immersion.Background: Cold-induced vasodilation (CIVD) is a phenomenon that refers to a paradoxical increase in finger temperature that sometimes occurs during cold exposure. The aim of this study was to compare CIVD responses between women and men, during exposure to different environmental conditions. Methods: Seven men and seven women participated in a matched controlled study consisting of a familiarization protocol followed by three experimental sessions (cool (10.8 °C WBGT), thermoneutral (17.2 °C WBGT), and hot (27.2 °C WBGT)). In each session, participants were asked to immerse their left hand and foot in warm water (35 ± 1 °C) for five minutes. Thereafter, the left hand and foot were immersed in cold water (8 ± 1 °C) for 40 min. After that, the left hand and foot were removed from the water and participants remained seated for five minutes. Results: For a matched thermal stress, women experienced an elevated cardiovascular strain (heart rate and in some cases mean arterial pressure) and higher frequency of CIVD reactions (men: 31 vs. women: 60) in comparison to their male counterparts. Conclusions: The present study demonstrated that women experienced elevated cardiovascular strain and higher frequency of CIVD reactions, particularly in the toes, compared to their male counterparts during cold-water immersion.

Wireless Surface Electromyography and Skin Temperature Sensors for Biofeedback Treatment of Headache: Validation Study with Stationary Control Equipment

Background: The use of wearables and mobile phone apps in medicine is gaining attention. Biofeedback has the potential to exploit the recent advances in mobile health (mHealth) for the treatment of headaches. Objectives: The aim of this study was to assess the validity of selected wireless wearable health monitoring sensors (WHMS) for measuring surface electromyography (SEMG) and peripheral skin temperature in combination with a mobile phone app. This proof of concept will form the basis for developing innovative mHealth delivery of biofeedback treatment among young persons with primary headache. Methods: Sensors fulfilling the following predefined criteria were identified: wireless, small size, low weight, low cost, and simple to use. These sensors were connected to an app and used by 20 healthy volunteers. Validity was assessed through the agreement with simultaneous control measurements made with stationary neurophysiological equipment. The main variables were (1) trapezius muscle tension during different degrees of voluntary contraction and (2) voluntary increase in finger temperature. Data were statistically analyzed using Bland-Altman plots, intraclass correlation coefficient (ICC), and concordance correlation coefficient (CCC). Results: The app was programmed to receive data from the wireless sensors, process them, and feed them back to the user through a simple interface. Excellent agreement was found for the temperature sensor regarding increase in temperature (CCC .90; 95% CI 0.83-0.97). Excellent to fair agreement was found for the SEMG sensor. The ICC for the average of 3 repetitions during 4 different target levels ranged from .58 to .81. The wireless sensor showed consistency in muscle tension change during moderate muscle activity. Electrocardiography artifacts were avoided through right-sided use of the SEMG sensors. Participants evaluated the setup as usable and tolerable. Conclusions: This study confirmed the validity of wireless WHMS connected to a mobile phone for monitoring neurophysiological parameters of relevance for biofeedback therapy.

A Comparison of Lidocaine and Bupivacaine Digital Nerve Blocks on Noninvasive Continuous Hemoglobin Monitoring in a Randomized Trial in Volunteers

Blood hemoglobin can be monitored continuously and noninvasively with a noninvasive spectrophotometric sensor (Masimo SpHb). The perfusion index (PI) of the finger is directly related to the clinical accuracy of SpHb. We evaluated those variables that influence PI without the influences of surgery and anesthesia. Based on our past studies, 12 awake adult volunteers were studied. A SpHb sensor was attached to the same finger of each hand. The temperature of each finger was measured via a skin surface probe. A digital nerve block (DNB) was performed with 1% lidocaine on one finger and 0.25% bupivacaine on the other finger of the opposite hand. SpHb, PI, and finger temperature were monitored continuously 30 minutes before and 3 to 4 hours after placement of the DNB. A random effects spline regression was used to flexibly model the outcomes before and after the DNB and to compare the effects of lidocaine and bupivacaine. The DNBs increased the PI for both lidocaine and bupivacaine (P < 0.0001) and finger temperature from both lidocaine (P < 0.0001) and bupivacaine (P = 0.02). The duration of action of bupivacaine was markedly longer than that of lidocaine (P < 0.0001). Between 45 and 75 minutes after insertion of the DNB, the PI with bupivacaine was substantially higher than that of lidocaine. The PI was directly related to changes in finger temperature and SpHb. During this time interval, 11 of the 12 volunteers receiving bupivacaine descriptively had increases in finger temperature ranging from no change to 6.1°C. In contrast, only 6 of the 12 lidocaine volunteers had increases in finger temperature ranging from no change to 4°C. Changes in PI were directly correlated with SpHb values (correlation coefficient = 0.7). A DNB increases PI and finger temperature. These increases lasted 2 to 3 hours longer with bupivacaine than lidocaine. The increases in PI were associated with slightly higher SpHb values. We conclude that the DNB induces increases in PI and temperature of the finger. Because of the close relationship between finger temperature, PI, and SpHb, consistently increasing finger temperature and PI could increase the accuracy of SpHb.

The Hyperthermic Effect of a Distal Volar Forearm Nerve Block: A Possible Treatment of Acute Digital Frostbite Injuries?

The authors have observed that carpal tunnel surgery nerve blocks consisting of subfascial distal volar forearm injection of 10 cc of 1% lidocaine with epinephrine result in fingers that appear hyperemic, warm, and numb in both median and ulnar nerve distributions. The purposes of this study were to (1) determine whether forearm nerve blocks in patients undergoing carpal tunnel releases result in an objective increase in finger temperature, and (2) document the location and duration of finger anesthesia. Thirty-nine patients undergoing unilateral carpal tunnel release were studied prospectively. An infrared thermometer was used to measure the temperature in the fingers of operative and nonoperative hands before and after injection of local anesthetic. The distal volar forearm block was performed using 10 cc of 1% lidocaine with 1:100,000 epinephrine deep to the forearm fascia between the median and ulnar nerves 1 cm proximal to the wrist crease. Before and after carpal tunnel release, bilateral finger temperatures were measured at hourly intervals. Statistical analysis included a one-sample test of proportions. The finger temperature of the operative hand was significantly warmer than the unoperated hand over the first 2 hours after the nerve block. Seventy-four percent of patients had a statistically significant increase in temperature. On average, the nerve block lasted 6.27 hours in the median nerve distribution and 5.78 hours in the ulnar nerve distribution. Forearm nerve blocks produce a chemical sympathectomy that provides a significant increase in skin temperature as a result of vasodilatation in most patients. They also provide prolonged finger numbness. This could be of clinical benefit in patients with acute finger frostbite injuries.

Autonomic nervous system state: the effect of general anaesthesia and bilateral tonsillectomy after unilateral infiltration of lidocaine

Autonomic nervous system (ANS) sensitively responds to intraoperative stress. Several indices characterizing the state and responses of autonomic signs to nociceptive stimuli have been introduced. This study evaluated the behaviour of ANS descriptors after induction, before and during tracheal intubation, and during bilateral tonsillectomies after random and blinded unilateral infiltration of lidocaine 1% until emergence from anaesthesia. Twelve patients undergoing bilateral tonsillectomy were anaesthetized with fentanyl and propofol (induction) and sevoflurane (maintenance). All patients were monitored throughout anaesthesia for middle finger temperature, non-invasive arterial pressure, heart rate (HR) and pulse rate (PR), state entropy (SE) and response entropy (RE), and surgical pleth index (SPI). New parameters complementing the above and characterizing the ANS state (ANSS) and responses are pulse-to-pulse interval (PPI), pulse plethysmographic amplitude (PPGA), ANSS, and an index based on maximal ANSS for the subject (ANSSI). Serial data were stored as 10 s averages into a laptop computer. Anaesthesia induction was associated with an increase in finger temperature to >30 degrees C within 10 min, whereas PPGA increased to their maximum levels within 5 min. Laryngoscopy and intubation were associated with transient autonomic responses in most patients. All autonomic signs indicated statistically significant sympathetic activation during saline-infiltrated tonsillectomies when compared with lidocaine-infiltrated sides (P<0001). Hypnotic measures (SE and RE) and finger temperatures did not differ between the sides. HR, PPI, PPGA, ANSS, ANSSI, SPI, and RE-SE detect autonomic responses to nociceptive stimuli and differentiate between tonsillectomies on locally anaesthetized tonsils from controls.

Enhancement of the finger cold-induced vasodilation response with exercise training

Cold-induced vasodilatation (CIVD) is a cyclical increase in finger temperature that has been suggested to provide cryoprotective function during cold exposures. Physical fitness has been suggested as a potential factor that could affect CIVD response, possibly via central (increased cardiac output, decreased sympathetic nerve activity) and/or peripheral (increased microcirculation) cardiovascular and neural adaptations to exercise training. Therefore, the purpose of this study was to investigate the effect of endurance exercise training on the CIVD response. Eighteen healthy males trained 1 h d(-1) on a cycle ergometer at 50% of peak power output, 5 days week(-1) for 4-weeks. Pre, Mid, Post, and 10 days after the cessation of training and on separate days, subjects performed an incremental exercise test to exhaustion (.VO(2peak)) and a 30-min hand immersion in 8 degrees C water to examine their CIVD response. The exercise-training regimen significantly increased .VO(2peak) (Pre: 46.0 +/- 5.9, Mid: 52.5 +/- 5.7, Post: 52.1 +/- 6.2, After: 52.6 +/- 7.6 ml kg(-1) min(-1); P < 0.001). There was a significant increase in average finger skin temperature (Pre: 11.9 +/- 2.4, After: 13.5 +/- 2.5 degrees C; P < 0.05), the number of waves (Pre: 1.1 +/- 1.0, After: 1.7 +/- 1.1; P < 0.001) and the thermal sensation (Pre: 1.7 +/- 0.9, After: 2.5 +/- 1.4; P < 0.001), after training. In conclusion, the aforementioned endurance exercise training significantly improved the finger CIVD response during cold-water hand immersion.

Music may reduce anxiety during invasive procedures in adolescents and adults

A block randomised controlled trial was conducted. Patients in the music (test) group listened to selected sedative music using headphones throughout the root canal treatment procedure. The control group subjects wore headphones but without the music. Anxiety was measured before the study and at the end of the treatment procedure. Patients' heart rate, blood pressure and finger temperature were measured before the study and every 10 min until the end of the root canal treatment procedure. The results revealed that there were no significant differences between the two groups for baseline data and procedure-related characteristics, except for gender. The subjects in the music group, however, showed a significant increase in finger temperature and a decrease in anxiety score over time compared with the control group. The effect size for state anxiety and finger temperature was 0.34 and 0.14, respectively. Relaxing music administered through headphones to subjects during root canal treatment decreased the procedure-related anxiety of the patients and significantly increased finger temperature, but does not significantly affect blood pressure and heart rate over the procedure.

Randomised controlled trial of music on state anxiety and physiological indices in patients undergoing root canal treatment

The purpose of this randomised investigator-blind controlled trial is to examine the effects of music on the state anxiety and physiological indices among patients undergoing root canal treatment. Randomised controlled trial. Purposive sampling was used to recruit 44 adult subjects. The subjects were randomly assigned to the treatment and the control group. There were 22 subjects in each group. Subjects in the music group listened to selected sedative music using headphones throughout the root canal treatment procedure. The control group subjects worn headphones but without the music. Using a repeated measures design with a single pretest and five posttests, the subjects' heart rate, blood pressure and finger temperature were measured before the study and every 10 minutes until the end of the root canal treatment procedure. Anxiety was measured before the study and at the end of the treatment procedure. The results revealed that there were no significant differences between the two groups for baseline data and procedure-related characteristics, except for gender. However, the subjects in the music group showed a significant increase in finger temperature and a decrease in anxiety score over time compared with the control group. The effect size for state anxiety and finger temperature was 0.34 and 0.14 respectively. The findings provide evidence for nurses and dentists that the use of soothing music for anxiety reduction in patients undergoing root canal treatment procedures is supported by research findings.

The Effect of Improvisation-Assisted Desensitization, and Music-Assisted Progressive Muscle Relaxation and Imagery on Reducing Pianists' Music Performance Anxiety

The purpose of this study was to investigate the effects of two music therapy approaches, improvisation-assisted desensitization, and music-assisted progressive muscle relaxation and imagery on ameliorating the symptoms of music performance anxiety (MPA) among student pianists. Thirty female college pianists (N = 30) were randomly assigned to one of two conditions: (a) improvised music-assisted desensitization group (n = 15), or (b) music-assisted progressive muscle relaxation (PMR) and imagery group (n = 15). All participants received 6 weekly music therapy sessions according to their assigned group. Two lab performances were provided; one before and one after the 6 music therapy sessions, as the performance stimuli for MPA. All participants completed pretest and posttest measures that included four types of visual analogue scales (MPA, stress, tension, and comfort), the state portion of Spielberger's State-Trait Anxiety Inventory (STAI), and the Music Performance Anxiety Questionnaire (MPAQ) developed by Lehrer, Goldman, and Strommen (1990). Participants' finger temperatures were also measured. When results of the music-assisted PMR and imagery condition were compared from pretest to posttest, statistically significant differences occurred in 6 out of the 7 measures-MPA, tension, comfort, STAI, MPAQ, and finger temperature, indicating that the music-assisted PMR and imagery treatment was very successful in reducing MPA. For the improvisation-assisted desensitization condition, the statistically significant decreases in tension and STAI, with increases in finger temperature indicated that this approach was effective in managing MPA to some extent. When the difference scores for the two approaches were compared, there was no statistically significant difference between the two approaches for any of the seven measures. Therefore, no one treatment condition appeared more effective than the other. Although statistically significant differences were not found between the two groups, a visual analysis of mean difference scores revealed that the music-assisted PMR and imagery condition resulted in greater mean differences from pretest to posttest than the improvisation-assisted desensitization condition across all seven measures. This result may be due to the fact that all participants in the music-assisted PMR and imagery condition followed the procedure easily, while two of the 15 participants in the improvisation-assisted desensitization group had difficulty improvising.

Cold-induced vasodilatation is not homogenous or generalizable across the hand and feet

Cold-induced vasodilatation (CIVD), a paradoxical cyclical increase in finger temperature upon cold exposure, is assumed to serve against cold injury. Most existing research has focused on hand and finger responses, yet most cold injuries occur in the feet. We investigated if CIVD responses of one finger can predict the responses of other fingers, and also whether the fingers could predict CIVD responses of the feet and toes. Ten subjects immersed their left hand up to the wrist in 8 degrees C water for 30 min. They passively rewarmed for 15 min, followed by immersion of the left foot to the ankle in 8 degrees C water for 30 min. Digit temperature at the edge of the nail bed was recorded on all fingers and toes and on the hand and feet. In all subjects, toe and foot temperature gradually decreased exponentially from approximately 31 to approximately 9 degrees C. No subject exhibited CIVD in any toe or on the foot itself. Eight subjects exhibited CIVD (>1 degrees C temperature increase) in at least one digit of the hand, but no consistent pattern existed in finger response to cold. No subject had strong (>2.0 degrees C) CIVD in all fingers. Five had strong CIVD in some but not all digits, with magnitudes ranging 1.4-7.5 degrees C, while three had weak (<2 degrees C) CIVD in some but not all digits. Four exhibited asynchronous CIVD in the fingers, with cycles beginning at different times. We conclude that CIVD is highly variable across the fingers, and is not a generalizable response across digits or limbs.

Vascular effects of a modified cold pressor test in spinal cord injured and able-bodied men

The vascular reflex responses of the hands of ten spinal cord injured (SCI) men (sensory and motor complete) to a modified cold pressor test were compared to ten age-matched, able-bodied men. The skin temperature of the left index finger was measured before, during, and after the immersion of the feet in ice water for 20 seconds. The heart rate and blood pressure were measured 5 minutes before and 15 minutes after the cold stimulus. The able-bodied subjects showed an immediate vasoconstriction and fall in finger temperature after cold stimulation of the feet, followed by vasodilation and an increase in finger temperature (p < .0001), whereas, the SCI subjects did not show any change in finger temperature during this test. Prior to application of the cold stimulus, the SCI subjects had a significantly low diastolic blood pressure compared with the diastolic blood pressure of able-bodied subjects, which “normalized” after the cold stimulus. These data support the concept that regulation of vascular tone occurs at both spinal and supraspinal levels.

Psychological and physical reactions to whirlpool baths

Physical and psychological reactions to whirlpool baths were studied in a group of 40 healthy adult volunteers. Responses were measured after 10-min immersions in whirlpools under on and off conditions. Whirlpools and warm baths both induce increases in pulse and finger temperature, although a greater increase in finger temperature is associated with whirlpools. Both conditions produced increased feelings of well-being and decreased state anxiety. Whirlpool immersion resulted in a slight decrease in DSM III symptoms of anxiety. Immersion did not produce consistent significant changes in blood pressure, respiration rate, muscle tension, or pupil size. No changes emerged in anxiety, hostility, or depression on the Multiple Affect Adjective Checklist. Although whirlpools appear to be a popular form of recreation, this study reveals limited significant incremental relaxation beyond the effects due to warm water alone.

Effects of progressive muscle relaxation and music on stress as measured by finger temperature response.

Measured the efficacy of music, progressive muscle relaxation, and a combination of both variables on tension reduction. Ss were three sections (N = 76) of an introductory music class. Each section received either sedative music (M), progressive muscle relaxation (PMR), or both (M + PMR) as treatment. Vasoconstriction, or finger temperature, was used to measure stress level prior to and after the intervention. All three groups evidenced significant increases in finger temperature. There was no significant difference among treatment groups, although the M + PMR group's mean increase was greater than the grand mean, while the M and PMR groups' increases were below the grand mean.

The self-control of human peripheral (finger) temperature: An exploration of somatic maneuvers as aids to biofeedback training

The present investigation was based on the belief that somatic maneuvers deserve to be treated as independent variables in biofeedback research. Two experiments are reported in which the potency of somatic maneuvers was examined in the biofeedback induced self-control of human peripheral (finger) temperature. In Experiment 1, reliable increases in finger temperature were obtained only under those conditions in which subjects were permitted to engage in muscular maneuvers in addition to response contingent feedback. In Experiment 2, bidirectional changes (increases or decreases) in finger temperature were possible under these conditions. The theoretical and clinical implications of the data are briefly discussed.

Treatment Program for Borderline Hypertension among College Students: Relaxation, Finger Temperature Biofeedback, and Generalization

A single group outcome study of treatment for borderline hypertension was performed. 8 male college students, with elevated blood pressure, were identified through campus-wide, blood-pressure screening and were referred by the Health Center for a treatment program of general relaxation and biofeedback-induced relaxation. 4 undergraduate psychology majors conducted training sessions three times per week for each subject. On the basis of increases in finger temperature, it was concluded that relaxation was produced. Reductions in systolic pressure of 10 to 15 mm Hg were obtained in as few as 14 sessions, although greater reductions occurred with more training sessions. A follow-up, 5 mo. later, indicated the need to maintain the relaxation program for a longer duration. Suggestions were made for implementing this treatment program at other colleges and universities.

Voluntary increase in finger temperature in man in a cooling environment.

To test whether man can increase voluntarily skin temperature in a cool environment, 14 subjects (age 15--51) were studied. They came once or twice a week for five to eight sessions of 1 h. The room temperature of various sessions varied from 21.2 to 15.6 degrees C. Temperatures of six fingers were recorded using thermocouples. During trials to increase temperature, subjects were shown a dial indicating temperature of an index finger and were instructed to try to warm their hands. The trials were begun when skin temperatures were stable or were falling, indicating that vasoconstriction was occurring. They were preceded and followed by a rest period. The differences between changes in temperature during the trials and the rest periods were significant for the group of 14 subjects (p less than 0.01). In 10 subjects with individually significant results, differences between the trial and rest periods averaged 5.0 degrees C for 'the best' and 3.9 degrees C for 'the worst' finger. The maximum temperatures during the trials averaged 30.9 +/- 1.0 degrees C (mean +/- SE) in 'the best' finger. During later sessions, subjects were able to increase temperatures without seeing the dial. The results indicate that humans are able to increase voluntarily cutaneous finger blood flow in a cool environment.