Document Type : Original Articles
School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Background:Contrast bath is a thermal agent that is used as alternative heat and cold water on a target limb. Type 2 diabetes mellitus in long term leads to vascular insufficiency. It seems that contrast bath is useful for patients with diabetes mellitus due to the increase in blood flow and vascular pumping. The purpose of this study is to investigate the effect(s) of contrast bath on circulation of contralateral lower limb in women with type 2diabetes mellitus compared to healthy subjects.Methods:Fifteen diabetic females aged between 30-60 years, who were diagnosed with type 2 diabetes, and 30 matched control females participated in this research. The oral temperature, skin temperature of the first web space of the foot, and the pulse of dorsalis pedis artery were measured and recorded. These results were evaluated prior to, immediately and 10 minutes after the contrast bath. The contrast bath protocol included the immersion of the right foot in the warm bath (38-440C) for four minutes and then in the cold bath (10-180C) for one minute. These processes were repeated five times as the total duration of the intervention was 24 minutes. The treatment was started and terminated with warm water. Repeated measures and independent t-test were used for data analysis.Results:The dorsalis pedis pulse was significantly higher at all times of the measurements except between immediately post the contrast bath and after 10 minutes of applying it in the diabetic group (P=0.58). The results of the skin temperature measurement demonstrated incremental changes in the healthy and the diabetic groups. The oral temperature at all times was not significantly different in the normal and the diabetic groups (P > 0.05).Conclusion:The results of this study showed that contrast bath can increase circulation in the contralateral limb. However, its influence on superficial and deep blood flow is uncertain.
- Stanton DB, Bear-Lehman J, Graziano M, Ryan C. Contrast baths: what do we know about their use? J Hand Ther. 2003;16(4):343-6. Epub 2003/11/08.
- Belanger AY. Therapeutic Electrophysical Agents: Evidence Behind Practice Author: Alain Yvan Belanger, Publisher: Lippincott Williams. 2009.
- Cotts BE, Knight KL, Myrer JW, Schulthies SS. Contrast-bath therapy and sensation over the anterior talofibular ligament. Journal of Sport Rehabilitation. 2004:114-21.
- Janssen RG, Schwartz DA, Velleman PF. A randomized controlled study of contrast baths on patients with carpal tunnel syndrome. Journal of Hand Therapy. 2009;22(3):200-8.
- Breger Stanton DE, Lazaro R, Macdermid JC. A systematic review of the effectiveness of contrast baths. J Hand Ther. 2009;22(1):57-69; quiz 70. Epub 2008/10/24.
- Martins A, Sa V. Variation of skin temperature during and after contrast bath therapy. Rev Andal Med Deporte. 2011;4:129-34.
- Shih C-Y, Lee W-L, Lee C-W, Huang C-H, Wu Y-Z. Effect of time ratio of heat to cold on brachial artery blood velocity during contrast baths. Physical therapy. 2012;92(3):448-53.
- Petrofsky J, Lohman E, 3rd, Lee S, de la Cuesta Z, Labial L, Iouciulescu R, et al. Effects of contrast baths on skin blood flow on the dorsal and plantar foot in people with type 2 diabetes and age-matched controls. Physiother Theory Pract. 2007;23(4):189-97. Epub 2007/08/10.
- Petrofsky J, Lohman E, Lee S, Cuesta Zdl, Labial L, Iouciulescu R, et al. The effects of aging on the skin blood response to warm, cold, and contrast warm and cold baths. Physical & Occupational Therapy in Geriatrics. 2007;25(3):19-33.
- Petrofsky J, Berk L, Al-Nakhli H. The influence of autonomic dysfunction associated with aging and type 2 diabetes on daily life activities. Exp Diabetes Res. 2012;2012:657103. Epub 2012/05/09.
- American Diabetes A. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2010;33(Suppl 1):S62-S9.
- Scott Petrofsky J, Besonis C, Rivera D. Circulatory response to hydrotherapy and dry heat in individuals with type 2 diabetes. International Journal of Therapy and Rehabilitation. 2005;12(11):491-7.
- Petrofsky J, Lee S. The effects of type 2 Diabetes and aging on Vascular Endothelial and Autonomic Function. Medical Science Review. 2005;11(6):CR247-CR54.
- Vozarova B, Weyer C, Bogardus C, Ravussin E, Tataranni PA. Differences in oral temperature and body shape in two populations with different propensities for obesity. Ann N Y Acad Sci. 2002;967:516-21. Epub 2002/06/25.
- Eklund B, Kaijser L. Effect of regional alphaâand betaâadrenergic blockade on blood flow in the resting forearm during contralateral isometric handgrip. The Journal of Physiology. 1976;262(1):39-50.
- Non-Contact Thermometers for Detecting Fever: A Review of Clinical Effectiveness. Ottawa ON: 2014 Canadian Agency for Drugs and Technologies in Health.; 2014 Nov 20.
- Lawson L, Bridges EJ, Ballou I, Eraker R, Greco S, Shively J, et al. Accuracy and precision of noninvasive temperature measurement in adult intensive care patients. American Journal of Critical Care. 2007;16(5):485-96.
- Ison JW. Palpation of dorsalis pedis pulse. Jama. 1968;206(12):2745. Epub 1968/12/16.
- Mowlavi A, Whiteman J, Wilhelmi B, Neumeister M, McLafferty R. Dorsalis pedis arterial pulse: palpation using a bony landmark. Postgraduate Medical Journal. 2002;78(926):746-7.
- Ludbrook J, Clarke AM, Mc KJ. Significance of absent ankle pulse. British medical journal. 1962;1(5294):1724-6. Epub 1962/06/23.
- Lawson IR, Ingman SR, Masih Y, Freeman B. Reliability of palpation of pedal pulses as ascertained by the kappa statistic. Journal of the American Geriatrics Society. 1980;28(7):300-3. Epub 1980/07/01.
- Mazerolle SM, Ganio MS, Casa DJ, Vingren J, Klau J. Is oral temperature an accurate measurement of deep body temperature? A systematic review. J Athl Train. 2011;46(5):566-73. Epub 2011/01/01.
- Petrofsky J. A method of measuring the interaction between skin temperature and humidity on skin vascular endothelial function in people with diabetes. J Med Eng Technol. 2011;35(6-7):330-7. Epub 2011/07/09.
- Fiscus KA, Kaminski TW, Powers ME. Changes in lower-leg blood flow during warm-, cold-, and contrast-water therapy. Arch Phys Med Rehabil. 2005;86(7):1404-10. Epub 2005/07/09.
- Myrer JW, Measom G, Durrant E, Fellingham GW. Cold- and hot-pack contrast therapy: subcutaneous and intramuscular temperature change. J Athl Train. 1997;32(3):238-41. Epub 1997/07/01.