Thermovisual evaluation of the behavior of skin surface temperature following cryostimulation of the forearm in healthy adultsThermovisual evaluation of the behavior of skin surface temperature following cryostimulation of the forearm in healthy adults

Zbigniew Śliwiński, Jan Talar

Zbigniew Śliwiński, Jan Talar – Thermovisual evaluation of the behavior of skin surface temperature following cryostimulation of the forearm in healthy adults. Fizjoterapia Polska 2001; 1(2); 155-160

Abstract
Introduction. The authors describe the impact of local cryotherapy on the human organism and the operating principles of the thermoregulation center. The article also contains information on thermovision. The research results presented here involve change in skin suface temperature in the upper limbs following chilling only one forearm by liquid nitrogen vapors for 2 minutes. Material and methods. 18 healthy volunteers (13 women, 5 men) were tested with the consent of the Bioethics Committee at the Bydgoszcz Academy of Medicine. Skin temperature changes were evaluated using an Agema 570 thermovision camera. A KS-1 apparatus manufactured by Hans-Sped (Głogów, Poland) was used for cryostimulation. Results. The results confirm that chilling one limb evokes changes in the other limb also. The temperature in the chilled limb after a two-minute administration did not achieve the initial values 5 minutes after conclusion of cryostimulation. In the limb which did not receive cryostimulation the temperature leveled out within 2 minutes after conclusion of stimulation, despite an initial drop. Intensive perfusion brought about a statistically significant increase in temperature to values higher than initial, in several cases, however, increased temperature was observed after conclusion of cryostimulation. This mechanism is not fully explained. Conclusions. The temperature increase in the untreated arm after conclusion of cryostimulation indicates that the thermoregulatory mechanism is operating properly, defending the organism against heat loss by increasing the blood supply to the limb. Cold reduced the sensitivity of smooth muscles to sympathetic stimuli and the effect of catecholamine, and this facilitates blood supply to the limbs. Cryostimulation to only one limb in healthy persons induces contralateralization of the consensual reflex, as shown by temperature changes on the skin of the limb not subjected to cryotherapy. This would seem to be associated with the arousal of cold thermoreceptors due to the reduction in skin temperature, which in turn leads to bioelectric arousal of the brain by the activating portion of the reticular network in the mesencephalon.

Key words:
Cryostimulation, thermoregulation, thermovision

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Thermovisual evaluation of vascular behavior in the paretic upper limb after local cryostimulation in stroke patients

Zbigniew Śliwiński, Piotr Plaza

Zbigniew Śliwiński, Piotr Plaza – Thermovisual evaluation of vascular behavior in the paretic upper limb after local cryostimulation in stroke patients. Fizjoterapia Polska 2002; 2(2); 112-117

Abstract
Background. Stroke is the third most common cause of death, one of the most common causes of handicap, and the most common cause of disability among persons older than 40. Each year 4.6 million people around the world die from strokes, including 3.2 million in developing countries and 1.2 million in highly industrialized countries. In view of the high morbidity rate and the serious consequences of stroke, in the form of limb paresis, the authors decided to use a thermovision camera to check vascular reactions in the paretic limb by evaluating temperature changes on the skin subsequent to cryostimulation by liquid nitrogen vapors. Material and methods. Our research involved 28 patients with an average age of 61.3 years. The procedure was performed on the forearm of the paretic upper limb, which was cooled for 6 minutes (from the hand to the elbow cavity, the dorsal surface and the palm surface). Thermovision images were made 5 times for each patient. Results. The authors observed that as a result of the procedure the temperature of the cooled limb went down 12°C, and 2.6°C in the other limb. Conclusions. The results cannot be easily interpreted. In the authors’ opinion, the temperature reduction in the limb that was not cooled results from contralateralization of the consensual reflex. The present study is a preliminary report describing the phenomenon we observed.

Key words:
Stroke, Cryostimulation, thermovision, vascular behavior

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Body equilibrium assessment in patients with degenerative changes after whole-body cryostimulation connected with physiotherapy

Marek Kiljański, Zbigniew Śliwiński, Wojciech Kufel, Wojciech Kiebzak, Marek Woszczak

Marek Kiljański, Zbigniew Śliwiński, Wojciech Kufel, Wojciech Kiebzak, Marek Woszczak – Body equilibrium assessment in patients with degenerative changes after whole-body cryostimulation connected with physiotherapy. Fizjoterapia Polska 2007; 7(3); 286-298

Abstract
Background. The authors present the results obtained in a group of 126 participants. The aim of the study was to determine whether a four-week program of physiotherapy including whole-body cryostimulation, applied in patients with degenerative changes in the spine, influences their body equilibrium and pain sensation. Material and methods. The examined group comprised 66 patients with degenerative changes in the lumbar spine, while the control group consisted of 60 participants. Apart from an individually designed rehabilitation program, each patient participated in 20 sessions of whole-body cryostimulation. The measurement of lumbosacral spine mobility and the assessment of pain sensation using the Visual Analogue Scale (VAS) were performed before the first and after the last session. Moreover, after the first, tenth and twentieth session of general cryostimulation, measurements on a stabilometric platform were conducted. The healthy participants, who were qualified as the control group, underwent tests on the stabilometric platform after one session in the cryogenic chamber. The aim of these tests was to compare the differences in the stabilogram curve in healthy individuals and patients with degenerative changes in the lumbar spine. The effect of cryostimulation procedures on pain sensation and mobility of the lumbosacral spine was assessed. Additionally, the effect of cryogenic temperatures on body equilibrium was studied. Results. The comparison of the results, obtained before the procedure and after completing the therapy indicates that general cryostimulation in a physiotherapeutic program for patients with degenerative changes in the lumbar spine contributes to relaxation of excessively tense muscles. Conclusions. The use of whole body cryostimulation in patients with degenerative changes in the lumbosacral spine, combined with a properly designed and managed physiotherapeutic program, decreases pain sensation in a statistically significant way. The application of cryogenic temperatures, combined with physiotherapeutic program, favourably affect patient body equilibrium.
Słowa kluczowe
physiotherapy, spine, cryostimulation, coordination, stabilometric platform
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Thermovisual evaluation of temperatures of the upper limbs following cryostimulation in post-stroke patients

Zbigniew Śliwiński, Piotr Płaza, Krzysztof Gieremek, Wojciech Kufel, Beata Michalak, Bartłomiej Halat, Grzegorz Śliwiński, Magdalena Wilk

Zbigniew Śliwiński, Piotr Płaza, Krzysztof Gieremek, Wojciech Kufel, Beata Michalak, Bartłomiej Halat, Grzegorz Śliwiński, Magdalena Wilk – Thermovisual evaluation of temperatures of the upper limbs following cryostimulation in post-stroke patients. Fizjoterapia Polska 2008; 8(1); 23-34

Abstract
Background. Cerebral stroke is a very serious life-threatening condition regardiess of the clinical picture at the onset. In most cases cerebral stroke is a consequence of systemic vascular diseases such as atherosclerosis or hypertension. Material and methods. The study group comprised 103 patients, including 52 post-stroke patients with a paretic upper limb and 51 healthy participants. The group of stroke patients included 18 women and 34 men, while the healthy group consisted of 41 women and 10 men. The mean age of the male patients was 55.6 and of the female patients 66.1 years. The mean age of the control group was 37.2 years. Local cryostimulation was applied to the hand and forearm of the paretic limb in the stroke patients and to the hand the forearm of the right upper limb in the healthy group. The limb was exposed to cold for 6 minutes. The temperatures were measured using an Agema 570 thermovision camera.Results. Subjecting only one forearm to cryotherapy procedures results in a decrease in temperature. In the post-stroke patients the return to the basseline value after the procedure was more rapid. This is possibly connected with more efficient mechanisms protecting the body against loss of warmth, since in this group temperature values were higher. In the control group the temperature in the non-cooled limb decreases by an average of 1.6 st.C, compared to only 1.3 st.C in the stroke patients. Conclusions. The temperatures of an area in the forearm exposed to 6 minutes of cryotherapy were different in the post-stroke patients and in the healthy controls. This is probably attributable to stroke-related brain damage. Contralateralization, i. e. the decline of temperature in the non-cooled limb, occurred both in the post-stroke patients and in the healthy controls. Temperature decreases produced by the exposure of limbs to cold were higher in the stroke patients than in the healthy participants. The temperature returned to baseline more rapidly in the post-stroke patients. The temperature in the cooled limb dod not return to, or exceed, baseline value fifteen minutes after the procedure.
Key words:
cerebral stroke, cryostimulation, thermovision, vascular play
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