Thermal Effectiveness of Different IR Radiators Employed in Rheumatoid Hand Therapy as Assessed by Thermovisual Examination

We conducted a thermovisual comparison of mean hand surface temperature changes upon local heating with two different IR sources. Sixty‐six patients with rheumatoid arthritis (47 women and 19 men; average age, 56.1 ± 8.6 years) were subjected to topical heat therapy for one hand with either the standard IR radiator (SIR) or the water filter IRA (wIRA). The surface temperature of the dorsal side of both hands was measured, and thermal images were taken before and up to 2 h after treatment. At 1 min after treatment, SIR application increased the surface skin temperature of the heated hand from 31.5 ± 1.9 to 35.0 ± 1.9°C (P < 0.05), while wIRA increased it from 32.1 ± 1.6 to 34.2 ± 1.1°C (P < 0.05). Constant decline in temperature was observed immediately after treatment, with the temperatures reaching baseline in about 30 and 120 min after wIRA and SIR treatment, respectively. Similar temperature changes were observed in the heated hands for wIRA and SIR, except at 1 min after treatment. Changes in the untreated hands indicated contralateral reaction. The temperature of the warmed hand showed a correlation to the body mass index.

[1]  L. A. Koman,et al.  Measurement of hand microvascular blood flow with isolated cold stress testing and laser Doppler fluxmetry. , 1993, The Journal of hand surgery.

[2]  Effects of Hot and Cold Packs on Motor Performance of Normal Hands , 1997 .

[3]  B Fagrell,et al.  Dynamics of Skin Microcirculation in Humans , 1985, Journal of cardiovascular pharmacology.

[4]  T. V. Vliet Vlieland,et al.  Non-drug therapies in early rheumatoid arthritis. , 2009, Best practice & research. Clinical rheumatology.

[5]  V. Robertson,et al.  The effect of heat on tissue extensibility: a comparison of deep and superficial heating. , 2005, Archives of physical medicine and rehabilitation.

[6]  D. Woolley,et al.  Collagenase at sites of cartilage erosion in the rheumatoid joint. , 1977, Arthritis and rheumatism.

[7]  G. Holloway,et al.  Laser Doppler measurement of cutaneous blood flow. , 1977, The Journal of investigative dermatology.

[8]  Georg Heinze,et al.  Systemic effects of low-intensity laser irradiation on skin microcirculation in patients with diabetic microangiopathy. , 2002, Microvascular research.

[9]  W. Siems,et al.  Pain and mobility improvement and MDA plasma levels in degenerative osteoarthritis, low back pain, and rheumatoid arthritis after infrared A-irradiation. , 2010, Acta biochimica Polonica.

[10]  A. Joseph Threlkeld,et al.  Osteoarthritis. Effects on synovial joint tissues. , 1988, Physical therapy.

[11]  D. Sessler,et al.  Skin-surface temperature gradients correlate with fingertip blood flow in humans. , 1990, Anesthesiology.

[12]  M. Stewart Researches into the Effectiveness of Physiotherapy in Rheumatoid Arthritis of the Hand , 1996 .

[13]  J. Wessel The effectiveness of hand exercises for persons with rheumatoid arthritis: a systematic review. , 2004, Journal of hand therapy : official journal of the American Society of Hand Therapists.

[14]  B. Dellhag,et al.  Effect of active hand exercise and wax bath treatment in rheumatoid arthritis patients. , 1992, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[15]  Emmanuel Coudeyre,et al.  Non-drug treatment (excluding surgery) in rheumatoid arthritis: clinical practice guidelines. , 2009, Joint, bone, spine : revue du rhumatisme.

[16]  P. Vaupel,et al.  Wassergefilterte Infrarot-A-Strahlung versus Fango-Paraffin-Packung: Temperaturprofile bei lokoregionaler Wärmetherapie , 1996 .

[17]  D. Avdić,et al.  Physical and exercise therapy for treatment of the rheumatoid hand. , 2001, Arthritis and rheumatism.

[18]  E. Henley,et al.  Comparison of in vivo temperatures produced by hydrotherapy, paraffin wax treatment, and Fluidotherapy. , 1980, Physical therapy.

[19]  G. Hoffmann Principles and working mechanisms of water-filtered infrared-A (wIRA) in relation to wound healing , 2007, GMS Krankenhaushygiene interdisziplinar.

[20]  J. Fedorczyk The role of physical agents in modulating pain. , 1997, Journal of hand therapy : official journal of the American Society of Hand Therapists.

[21]  G. Cheing,et al.  Effects of deep and superficial heating in the management of frozen shoulder. , 2008, Journal of rehabilitation medicine.

[22]  P. Tugwell,et al.  Thermotherapy for treating rheumatoid arthritis. , 2002, The Cochrane database of systematic reviews.

[23]  I. Drysdale,et al.  Investigation into the affectivity on cutaneous blood perfusion of different application time lengths of cold hydrotherapy , 2006 .

[24]  K. Brandt The importance of nonpharmacologic approaches in management of osteoarthritis. , 1998, The American journal of medicine.

[25]  J. Lehmann,et al.  Effect of therapeutic temperatures on tendon extensibility. , 1970, Archives of physical medicine and rehabilitation.

[26]  J. Jacobs,et al.  The effect of local heat and cold therapy on the intraarticular and skin surface temperature of the knee. , 1992, Arthritis and rheumatism.

[27]  T. Nagasaka,et al.  Partitional measurement of capillary and arteriovenous anastomotic blood flow in the human finger by laser-Doppler-flowmeter , 2004, European Journal of Applied Physiology and Occupational Physiology.

[28]  V. Wright,et al.  Pain and rheumatoid arthritis. , 1985, Annals of the rheumatic diseases.

[29]  E. D. Harris,et al.  The influence of temperature and fibril stability on degradation of cartilage collagen by rheumatoid synovial collagenase. , 1974, The New England journal of medicine.

[30]  A. Eken,et al.  Current Status of Complementary and Alternative Medicine in the Treatment of Rheumatic Disease Pain , 2009 .

[31]  Bryan F. Jones,et al.  A reappraisal of the use of infrared thermal image analysis in medicine , 1998, IEEE Transactions on Medical Imaging.

[32]  Nisha Charkoudian,et al.  Skin blood flow in adult human thermoregulation: how it works, when it does not, and why. , 2003, Mayo Clinic proceedings.

[33]  J. Lehmann,et al.  Therapeutic heat and cold. , 1975, Clinical orthopaedics and related research.

[34]  J P Cooke,et al.  Sex differences in control of cutaneous blood flow. , 1990, Circulation.

[35]  M. Devlin,et al.  The therapeutic use of local heat and cold. , 1986, Canadian family physician Medecin de famille canadien.

[36]  Scott F Nadler,et al.  The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. , 2004, Pain physician.

[37]  T. V. Vliet Vlieland,et al.  Rehabilitation of people with rheumatoid arthritis. , 2003, Best practice & research. Clinical rheumatology.

[38]  R W Nolan,et al.  Body composition and skin temperature variation. , 1990, Journal of applied physiology.

[39]  P. Vaupel,et al.  Wassergefilterte Infrarot-A-Strahlung versus konventionelle Infrarotstrahlung: Temperaturprofile bei lokoregionaler Wärmetherapie , 1995 .

[40]  M. Fransen When is physiotherapy appropriate? , 2004, Best practice & research. Clinical rheumatology.

[41]  M. Liang,et al.  The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. , 1988, Arthritis and rheumatism.

[42]  J. Rasker,et al.  Treating arthritis with locally applied heat or cold. , 1994, Seminars in arthritis and rheumatism.