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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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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