Cold sensitivity test for individuals with non-freezing cold injury: the effect of prior exercise

Extreme Physiology & Medicine

Michael J Tipton¹  Frank StC Golden¹  Clare M Eglin¹ 

[1] Department of Sport and Exercise Science, Extreme Environments Laboratory, University of Portsmouth, Portsmouth PO1 2ER, UK

关键词: Exercise;    Laser Doppler;    Infrared thermography;    Skin temperature;    Blood flow;    Cold challenge;   

Others  :  820163
DOI  :  10.1186/2046-7648-2-16

 received in 2012-11-23, accepted in 2013-02-22,  发布年份 2013

【 摘 要 】

Background

One of the chronic symptoms of non-freezing cold injury (NFCI) is cold sensitivity. This study examined the effects of prior exercise on the response to a cold sensitivity test (CST) in NFCI patients with the aim of improving diagnostic accuracy.

Methods

Twenty three participants, previously diagnosed with NFCI by a Cold Injuries Clinic, undertook two CSTs. Participants either rested (air temperature 31°C) for approximately 80 min (prior rest condition (REST)) or rested for 30 min before exercising gently for 12 min (prior exercise condition (EX)). Following REST and EX, the participants placed their injured foot, covered in a plastic bag, into 15°C water for 2 min; this was followed by spontaneous rewarming in 31°C air for 10 min.

Results

The great toe skin temperature (T_sk) before immersion averaged 32.5 (3.4)°C in both conditions. Following immersion, the rate of rewarming of the great toe T_sk was faster in EX compared to REST and was higher 5 min (31.7 (3.4)°C vs. 29.8 (3.4)°C) and 10 min (33.8 (4.0)°C vs. 32.0 (4.0)°C) post-immersion. Over the first 5 min of rewarming, changes in the great toe T_sk correlated with the changes in skin blood flow (SkBF) in EX but not the REST condition. No relationship was observed between T_sk in either CST and the severity of NFCI as independently clinically assessed.

Conclusions

Exercise prior to the CST increased the rate of the toe T_sk rewarming, and this correlated with the changes in SkBF. However, the CST cannot be used in isolation in the diagnosis of NFCI, although the EX CST may prove useful in assessing the severity of post-injury cold sensitivity for prognostic and medico-legal purposes.

【 授权许可】

   
2013 Eglin et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

【 参考文献 】

• [1]Oakley EH: The hidden enemy: non-freezing cold injury since the Falklands Conflict. In Proceedings of the NATO, TRO, HFM-168 Symposium on “Soldiers in Cold Environment”: 20–22 April 2009. NATO, TRO: Helsinki, Finland; 2009. KN2-1-7
• [2]Imray C, Grieve A, Dhillon S: Cold damage to the extremities: frostbite and non-freezing cold injuries. Postgrad Med J 2009, 85:481-488.
• [3]Imray CH, Oakley EH: Cold still kills: cold-related illnesses in military practice freezing and non-freezing cold injury. J R Army Med Corps 2005, 151:218-222.
• [4]Marcus P: “Trench foot” caused by the cold. Br Med J 1979, 1(6163):622.
• [5]Laden GD, Purdy G, O’Rielly G: Cold injury to a diver’s hand after a 90-min dive in 6 degrees C water. Aviat Space Environ Med 2007, 78:523-525.
• [6]Fraser IC, Loftus JA: “Trench foot” caused by the cold. Br Med J 1979, 1(6169):1017.
• [7]Cattermole TJ: The epidemiology of cold injury in Antarctica. Aviat Space Environ Med 1999, 70:135-140.
• [8]Mills WJ Jr, Mills WJ 3rd: Peripheral non-freezing cold injury: immersion injury. Alaska Med 1993, 35:117-128.
• [9]King RC, Parrish JA, Allibone A: Trench-foot in peacetime England. Br Med J 1958, 1(5079):1099-1102.
• [10]Ramstead KD, Hughes RG, Webb AJ: Recent cases of trench foot. Postgrad Med J 1980, 56:879-883.
• [11]Williams GL, Morgan AE, Harvey JS: Trench foot following a collapse: assessment of the feet is essential in the elderly. Age Ageing 2005, 34:651-652.
• [12]Ungley CC, Blackwood W: Peripheral vasoneuropathy after chilling “immersion foot and immersion hand”. Lancet 1942, 2:447-451.
• [13]Ungley CC, Channell GD, Richards RL: The immersion foot syndrome. 1946. Wilderness Environ Med 2003, 14:135-141.
• [14]Eglin CM, Golden FS, Tipton MJ: Increasing the reproducibility of a cold sensitivity test for non-freezing cold injury. In Proceedings of the 11th International Conference on Environmental Ergonomics: 22–26 May 2005. Edited by Holmer I, Kuklane K, Gao C. Lund: Lund University; 2005:274-277.
• [15]Thomas JR, Oakley EH: Nonfreezing cold injury. In Medical Aspects of Harsh Environments. Edited by Pandolf KB, Burr RE. Virginia: Office of the Surgeon General, US Army; 2001:467-490.
• [16]Golden F, Eglin C, Laight D, Tipton M: Non-Freezing Cold Injury: Its Nature and Assessment. Report. Portsmouth: University of Portsmouth, Department of Sport and Exercise Science; 2003.
• [17]Eglin C, Golden FS, Tipton MJ: Classification of non-freezing cold injury in patients: an interim report. In Proceedings of the 13th International Conference on Environmental Ergonomics: 2–7 August 2009; Boston. Edited by Castellani JW, Endrusick TL. Australia: University of Wollongong; 2009:172-176. Proceedings of the 13th International Conference on Environmental Ergonomics: 2–7 August 2009
• [18]Foerster J, Kuerth A, Niederstrasser E, Krautwald E, Pauli R, Paulat R, Eweleit M, Riemekasten G, Worm M: A cold-response index for the assessment of Raynaud’s phenomenon. J Dermatol Sci 2007, 45:113-120.
• [19]Foerster J, Wittstock S, Fleischanderl S, Storch A, Riemekasten G, Hochmuth O, Meffert B, Meffert H, Worm M: Infrared-monitored cold response in the assessment of Raynaud’s phenomenon. Clin Exp Dermatol 2006, 31:6-12.
• [20]Burgess JE, Macfarlane F: Retrospective analysis of the ethnic origins of male British army soldiers with peripheral cold weather injury. J R Army Med Corps 2009, 155:11-15.
• [21]DeGroot DW, Castellani JW, Williams JO, Amoroso PJ: Epidemiology of U.S. Army cold weather injuries, 1980–1999. Aviat Space Environ Med 2003, 74:564-570.
• [22]Iampietro PF, Goldman RF, Buskirk ER, Bass DE: Response of Negro and white males to cold. J Appl Physiol 1959, 14:798-800.
• [23]Jackson RL, Roberts DE, Cote RA, McNeal P, Fay JT, Sharp MW, Kraus E, Rahman SA, Hamlet MP: Psychological and Physiological Responses of Blacks and Caucasians to Hand Cooling. Report No: T20-89. Natick: US Army Research Institute of Environmental Medicine; 1989.
• [24]Rennie D, Adams T: Comparative thermoregulatory responses of Negroes and white persons to acute cold stress. J Appl Physiol 1957, 11:201-204.
• [25]Daanen HA: Finger cold-induced vasodilation: a review. Eur J Appl Physiol 2003, 89:411-426.
• [26]Launay JC, Savourey G: Cold adaptations. Ind Health 2009, 47:221-227.