Skin Temperature Assessment During Lumbar Sympathetic Blocks by Infrared Thermography.

Complex Regional Pain Syndrome (CRPS) is a pain disorder that can be triggered by injuries or surgery affecting most often limbs. Its multifaceted pathophysiology makes its diagnosis and treatment a challenging work. To reduce pain, patients diagnosed with CRPS commonly undergo sympathetic blocks which involves the injection of a local anesthetic drug around the nerves. Currently, this procedure is guided by fluoroscopy which occasionally is considered as little accurate. For this reason, the use of infrared thermography as a technique of support has been considered.In this work, thermal images of feet soles in patients with lower limbs CRPS undergoing lumbar sympathetic blocks were recorded and evaluated. The images were analyzed by means of a computer-aided intuitive software tool developed using MATLAB. This tool provides the possibility of editing regions of interest, extracting the most important information of these regions and exporting the results data to an Excel file.Clinical Relevance- The final purpose of this work is to value the potential of infrared thermography and the analysis of its images as an intraoperatory technique of support in lumbar sympathetic blocks in patients with lower limbs CRPS.

Association between physiological stress and skin temperature response after a half marathon.

OBJECTIVE: The objective of this study was to determine the association between skin temperature response and the physiological stress after a half marathon. APPROACH: Seventeen runners were measured 48 h before, 24 h before, 24 h after and 48 h after completing a half marathon. The measurements on each day of testing included blood markers (creatine kinase [CK] and glutamate oxaloacetate transaminase [GOT]), perception of pain and fatigue (using a visual analogue scale), skin temperature (using infrared thermography), and jump performance (using countermovement jump test). MAIN RESULTS: CK (p  < 0.001 and ES = 2.1), GOT (p  = 0.04 and ES = 1.3), and perception of fatigue and pain (p  < 0.001 and ES > 1.0) increased 24 h after the half marathon, whereas jump performance decreased (p  < 0.01 and ES = 0.4). No increase of skin temperature was observed in the tests after the competition and no regression model was able to predict physiological stress using skin temperature. Only a bivariate correlation was observed between the 24 h variation (pre-24 h) of CK and the skin temperature of the posterior upper limb (p  = 0.04 and r = 0.5), and between the 48 h variation (pre-48 h) of pain perceived and the skin temperature of the knee (p  < 0.01 and r = 0.6). SIGNIFICANCE: In conclusion, follow-up on basal skin temperatures does not seem to be an adequate method to detect physiological stress after a half marathon. In line with the observed results, we recommend caution when interpreting peaks in basal skin temperature in field sports assessments.

Validation of the thermophysiological model by Fiala for prediction of local skin temperatures.

The most complete and realistic physiological data are derived from direct measurements during human experiments; however, they present some limitations such as ethical concerns, time and cost burden. Thermophysiological models are able to predict human thermal response in a wide range of environmental conditions, but their use is limited due to lack of validation. The aim of this work was to validate the thermophysiological model by Fiala for prediction of local skin temperatures against a dedicated database containing 43 different human experiments representing a wide range of conditions. The validation was conducted based on root-mean-square deviation (rmsd) and bias. The thermophysiological model by Fiala showed a good precision when predicting core and mean skin temperature (rmsd 0.26 and 0.92 °C, respectively) and also local skin temperatures for most body sites (average rmsd for local skin temperatures 1.32 °C). However, an increased deviation of the predictions was observed for the forehead skin temperature (rmsd of 1.63 °C) and for the thigh during exercising exposures (rmsd of 1.41 °C). Possible reasons for the observed deviations are lack of information on measurement circumstances (hair, head coverage interference) or an overestimation of the sweat evaporative cooling capacity for the head and thigh, respectively. This work has highlighted the importance of collecting details about the clothing worn and how and where the sensors were attached to the skin for achieving more precise results in the simulations.