Alterations in deep tissue temperature around the knee after total knee arthroplasty: its association with knee motion recovery in the early phase.

PURPOSE: Cryotherapy has been employed to reduce postoperative inflammation for enhancement of the recovery of total knee arthroplasty (TKA). However, the clinical advantages in functional recovery after TKA remain controversial. This study was conducted to clarify the postoperative alterations in deep temperature around the knee and to evaluate the association between the temperature changes and functional recovery in the early phase after TKA. METHODS: Postoperative changes in deep temperature around the knee were evaluated with the probe that can measure subcutaneous tissue temperature at the depth of 1 cm in 28 patients with medial knee osteoarthritis undergoing unilateral TKA through medial parapatellar approach. The same rehabilitation protocol was provided without cryotherapy. Outcome assessment included knee range of motion (ROM) and 10-meter fast speed walking test. RESULTS: The operated knee showed a greater increase in deep temperature at postoperative days 1 and 2, followed by a gradual decrease by day 14 when the temperature was still higher than the baseline. When deep temperature change around the operated knee was calculated by subtracting the preoperative temperature from the highest postoperative one, significant association was found between deep temperature change and knee ROM recovery at day 14. The operated knees with more than 2°C increase in postoperative deep temperature resulted in poor ROM recovery. There was no association of deep temperature change with 10-meter fast speed walking test improvement at day 14 or ROM recovery at 1-year follow-up. CONCLUSIONS: This study has provided the first data on deep temperature alterations around the knee after TKA. More than 2°C increase in postoperative deep temperature could result in poor ROM recovery after TKA. The results may support establishment of adequate procedures of cryotherapy for early gain in knee motion after TKA.

17-3The effects of the high concentration carbon-dioxide water foot bath for patients after stroke: A within-subject comparison study / 日本温泉気候物理医学会雑誌

<b>Objectives:</b> The warm-water foot bathing is widely used as a clinical method for hemiplegic limb. Recent research have reported that the artificial high concentration carbon-dioxide (CO₂) water foot bathing have a potent vasodilative action. However, the definite effects of the artificial high concentration CO₂ water foot bath for hemiplegic limbs remain uncertain. We examined that the effects of the artificial high concentration CO₂ water foot bath for patients after stroke. <BR><b>Patients: </b>Three inpatients after stroke were recruited for this study. The age and duration after onset were 58.3 ± 21.4 years and 63.0 ± 38.9 months, respectively. Of the three patients (two males and one female), two were diagnosed with cerebral hemorrhage, one with cerebral infarction. <BR><b>Methods: </b>The artificial high concentration CO₂ water foot bath and tap water foot bath were prepared. The concentration of CO₂ water foot bath was approximately 1000-1,200 ppm, and both lower limbs (under the knee joint) were immersed in 38 °C water for 20 minutes. Foot bathing in tap water was also carried out under the same conditions in the another day. The following physiological data were measured before foot bathing and after the end of foot bathing. Not only the deep body temperature at axillary, the surface skin temperature at the front of femur, the calf of the leg and the dorsal foot, but also the muscle stiffness at triceps muscle of calf were evaluated. <BR><b>Results: </b>None of the subjects experienced discomfort before and after both the high concentration CO₂ water and the tap water foot bath. The physiological examination was completed safely in all subjects. The results were as follows: The deep body temperature and the surface skin temperature had increased, and the muscle stiffness had been relieved in the high concentration CO₂ water foot bath compared with the tap water bathing. The deep body temperature of the high concentration CO₂ water foot bath have risen from 36.4 °C to 36.9 °C, the surface-skin temperature of the front of femur (from 26.7 °C to 28.1 °C), the calf of the leg (from 29.5 °C to 31.9 °C) and the dorsal foot (from 29.9 °C to 32.3 °C) have risen, respectively. The muscle stiffness have been relieved from 55.3 to 51.8 before and after. There was no change that the tap water had increased in the deep body temperature and the surface-skin temperature, and the muscle stiffness had been relieved before and after. <BR><b>Conclusion:</b> These results suggested that the use of the high concentration CO₂ water foot bath was more effective in hyperthermia compared with the tap water. Furthermore, we considered that carbon dioxide had promoted to increase the skin and the muscle blood flow by vasodilative action to the arteriole, and use of the high concentration CO₂ water foot bath contribute to improve the circulatory dynamics for the hemiplegic limb. These findings may suggest that the use of the high concentration CO₂ water foot bath is an effective physiotherapy for circulatory dynamics treatment that might facilitate stroke rehabilitation

17-3 The effects of the high concentration carbon-dioxide water foot bath for patients after stroke: A within-subject comparison study / 日本温泉気候物理医学会雑誌

Objectives: The warm-water foot bathing is widely used as a clinical method for hemiplegic limb. Recent research have reported that the artificial high concentration carbon-dioxide (CO2) water foot bathing have a potent vasodilative action. However, the definite effects of the artificial high concentration CO2 water foot bath for hemiplegic limbs remain uncertain. We examined that the effects of the artificial high concentration CO2 water foot bath for patients after stroke. Patients: Three inpatients after stroke were recruited for this study. The age and duration after onset were 58.3 ± 21.4 years and 63.0 ± 38.9 months, respectively. Of the three patients (two males and one female), two were diagnosed with cerebral hemorrhage, one with cerebral infarction. Methods: The artificial high concentration CO2 water foot bath and tap water foot bath were prepared. The concentration of CO2 water foot bath was approximately 1000-1,200 ppm, and both lower limbs (under the knee joint) were immersed in 38 °C water for 20 minutes. Foot bathing in tap water was also carried out under the same conditions in the another day. The following physiological data were measured before foot bathing and after the end of foot bathing. Not only the deep body temperature at axillary, the surface skin temperature at the front of femur, the calf of the leg and the dorsal foot, but also the muscle stiffness at triceps muscle of calf were evaluated. Results: None of the subjects experienced discomfort before and after both the high concentration CO2 water and the tap water foot bath. The physiological examination was completed safely in all subjects. The results were as follows: The deep body temperature and the surface skin temperature had increased, and the muscle stiffness had been relieved in the high concentration CO2 water foot bath compared with the tap water bathing. The deep body temperature of the high concentration CO2 water foot bath have risen from 36.4 °C to 36.9 °C, the surface-skin temperature of the front of femur (from 26.7 °C to 28.1 °C), the calf of the leg (from 29.5 °C to 31.9 °C) and the dorsal foot (from 29.9 °C to 32.3 °C) have risen, respectively. The muscle stiffness have been relieved from 55.3 to 51.8 before and after. There was no change that the tap water had increased in the deep body temperature and the surface-skin temperature, and the muscle stiffness had been relieved before and after. Conclusion: These results suggested that the use of the high concentration CO2 water foot bath was more effective in hyperthermia compared with the tap water. Furthermore, we considered that carbon dioxide had promoted to increase the skin and the muscle blood flow by vasodilative action to the arteriole, and use of the high concentration CO2 water foot bath contribute to improve the circulatory dynamics for the hemiplegic limb. These findings may suggest that the use of the high concentration CO2 water foot bath is an effective physiotherapy for circulatory dynamics treatment that might facilitate stroke rehabilitation

Effect of Acupuncture Stimulation Combined with Extreme Infra-red Rays Radiation on Both Skin Surface and Deep Temperature / 全日本鍼灸学会雑誌

To investigate the effect of acupuncture treatment combined with extreme infra-red rays radiation, we measured both skin surface and deep temperature at the stimulated area and peripheral site. The subjects were seven healthy volunteers with no problems involving the skin or autonomic nervous system. Acupuncture stimulation was performed on the Subject's back in combination with extreme infra-red rays radiation. The skin surface and deep temperature were measured at both the stimulated area and peripheral site (sole of the foot) using a thermistor temperature sensor and deep tissue thermometer during stimulation. We also measured temperature at those sites during extreme infrared rays radiation without acupuncture stimulation as a control study. Acupuncture stimulation combined with extreme infra-red rays radiation on the subject's back increases both surface and deep temperature at both the stimulated area and the peripheral site (sole of the foot), while the radiation alone had no effect on the temperature at the peripheral site. We suggested that acupuncture treatment combined with extreme infra-red rays radiation was useful to increase skin surface and deep temperature not only at the stimulated area but also at the peripheral site.

A Basic Study on Microwave-assisted Acupuncture / 全日本鍼灸学会雑誌

Introduction:<br>The mechanism of moxa-needle therapy is unknown to us in spite of its significant effect. We observed variations in the temperature of the moxa-needle and that of the microwave-applied needle.<br>Method:<br>Chinese needles of the said two types were inserted into meat specimens (3×3×2cm) nd a house rabbit to the depth of 1.0cm and 1.5cm, respectively, and temperature was taken by a thermister around the needles at the depth of 15, 10, 5, and 1.0mm, respectively.<br>Effect:<br>1. In the moxa-needle, the temperature went up mainly at the top surface of the specimen or the surface of rabbit skin.<br>2. In the microwave-applied needle, from the beginning the temperature increased and as it plateaued, the heat was transmitted to the needle tip.<br>3. Typical temperature curve of the rabbit was found rather flat as compared with the same of meat specimen.<br>Conclusion:<br>1. In the moxa-needle, a rise in the temperature was limited under the subcutaneous area, it was not transmitted to the acupoint.<br>2. In the microwave-applied needle, it elevated the temperature around the needel; therefore, we believe that it stimulated the acupoint greatly.<br>3. In the light of the foregoing observations, it may be concluded that the microwave-assisted acupuncture would be significantly useful.