Purpose
This study evaluated the effect of forearm or hand warming versus bare hand conditions
to improve cold-induced symptoms and skin temperatures in hand trauma patients.
Methods
Adults with symptoms of cold intolerance at least 3 months following hand trauma and
age-/sex-matched controls were included. Testing sessions (bare hand, hand warming,
forearm warming) were completed in a climate laboratory with continuous temperature
monitoring. Outcomes included physical findings (skin temperature) and self-report
symptoms (thermal comfort, pain).
Results
Eighteen participants (9 hand trauma patients, 9 control subjects) underwent testing.
More severe cold intolerance was associated with higher Disabilities of the Arm, Shoulder,
and Hand scores. With bare hands, skin temperatures changed significantly from baseline
to cold exposure and to rewarming. Hand trauma patients had the lowest skin temperatures
with cold exposure in the injured digits (14.3°C ± 3.5°C) compared with the contralateral
uninjured (16.9°C ± 4.1°C) digits. Compared with bare hands, wearing gloves significantly
increased the minimum temperature during cold exposure and the maximum temperature
after rewarming. Patients reported higher pain with cold exposure. All participants
reported significantly more comfort with less coldness with forearm and hand warming.
Conclusions
There was cold response variability in hand trauma patients and control subjects.
Hand trauma patients had greater changes in skin temperature during cold exposure
that improved with glove warming. Continuous temperature monitoring identified subtle
physiological changes associated with cold-induced pain and with warming interventions.
Type of study/level of evidence
Therapeutic III.
Key words
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Article info
Publication history
Published online: November 09, 2018
Accepted:
September 28,
2018
Received:
November 9,
2017
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2019 by the American Society for Surgery of the Hand. All rights reserved.
