Development of a skin temperature map for dermatomes in individuals with spinal cord injury: a cross-sectional study

Abstract

Study design

Cross-sectional study.

Objective

The aim of this study was to map the skin temperature (Tsk) of individuals with SCI and compare able-bodied individuals, and among the groups to demonstrate the effects of differences in the levels of injury (paraplegia and tetraplegia with high and low injuries).

Setting

Outpatient clinic, Brazil.

Methods

Individuals with tetraplegia (n = 20), paraplegia (n = 21), and able-bodied (n = 11) individuals were recruited. A noncontact infrared thermometer (IRT) was used to measure three times the Tsk at the forehead, and at the C2 to S2 dermatomes. Core body temperature was measured at the axilla using the IRT and three other clinical thermometers.

Results

Autonomic regulation is impaired by the injury. A Tsk map was constructed for the three groups. Significant differences in the Tsk of dermatomes were observed when comparing individuals with SCI and the able-bodied at the following dermatomes: C3, C7, T2, T3, T8, T9, L1, L2, L4, and S2. When comparing individuals with tetraplegia and able-bodied individuals, the dermatomes that showed significant differences were C5, C6, C8, T1, T10, L3, and S1. Dermatomes C5–C7, and T5 showed significant differences between individuals with tetraplegia and those with paraplegia. For L5 and S1 in paraplegia significant differences were found when comparing high with low injury.

Conclusion

A Tsk map on dermatomes in individuals with SCI was implemented, and showed a significant difference between able-bodied. As temperature is a parameter for analyzing autonomic function, the study could benefit rehabilitation by providing baseline values when constructing clinical protocols.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

Fig. 1: Devices for the Tsk Measurements.

Data availability

The support to this study is available from the corresponding author upon reasonable request.

References

  1. 1.

    Griggs KE, Leicht CA, Price MJ, Goosey-Tolfrey VL. Thermoregulation during intermittent exercise in athletes with a spinal cord injury. Int J Sports Physiol Perform. 2015;10:469–75. https://doi.org/10.1123/ijspp.2014-0361.

    Article  PubMed  Google Scholar 

  2. 2.

    Maniar N, Bach AJE, Stewart IB, Costello JT. The effects of using diferente regions of interest on local and mean skin temperature. J Therm Biol. 2015;49–50:33–8. https://doi.org/10.1016/j.jtherbio.2015.01.008.

    Article  PubMed  Google Scholar 

  3. 3.

    van Marken Lichtenbelt WD, Westerterp-Plantenga MS, van Hoydonck P. Individual variation in the relation between body temperature and energy expenditure in response to elevated ambient temperature. Physiol Behav. 2001;73:235–42. https://doi.org/10.1016/s0031-9384(01)00477-2.

    Article  PubMed  Google Scholar 

  4. 4.

    Tang YL, He Y, Shao HW, Mizera I. Skin temperature oscillation model for assessing vasomotion of microcirculation. Acta Mechanica Sin. 2015;31:132–8. https://doi.org/10.1007/s10409-015-0011-y.

    Article  Google Scholar 

  5. 5.

    Priego Quesada JI, et al. Relationship between skin temperature and muscle activation during incremental cycle exercise. J Therm Biol. 2015;48:28–35. https://doi.org/10.1016/j.jtherbio.2014.12.005.

    Article  PubMed  Google Scholar 

  6. 6.

    Kofler M, Valls-Solé J, Vasko P, Boček V, Štetkárová I. Influence of limb temperature on cutaneous silent periods. Clin Neurophysiol. 2014;125:1826–33. https://doi.org/10.1016/j.clinph.2014.01.018.

    Article  PubMed  Google Scholar 

  7. 7.

    MacIntosh BR. Role of calcium sensitivity modulation in skeletal muscle performance. News Physiol Sci. 2003;18:222–5. https://doi.org/10.1152/nips.01456.2003.

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Farina D, Arendt-Nielsen L, Graven-Nielsen T. Effect of temperature on spike-triggered average torque and electrophysiological properties of low-threshold motor units. J Appl Physiol. 2005;99:197–203. https://doi.org/10.1152/japplphysiol.00059.2005.

    Article  PubMed  Google Scholar 

  9. 9.

    Drinkwater E. Effects of peripheral cooling on characteristics of local muscle. Med Sport Sci. 2008;53:74–88. https://doi.org/10.1159/000151551.

    Article  PubMed  Google Scholar 

  10. 10.

    Bittar CK, Cliquet A. Effects of quadriceps and anterior tibial muscles electrical stimulation on the feet and ankles of patients with spinal cord injuries. Spinal Cord. 2010;48:881–5. https://doi.org/10.1038/sc.2010.50.

    CAS  Article  PubMed  Google Scholar 

  11. 11.

    Gasim GI, Musa IR, Abdien MT, Adam I. Accuracy of tympanic temperature measurement using an infrared tympanic membrane thermometer. BMC Res Notes. 2013;6:194. https://doi.org/10.1186/1756-0500-6-194.

    Article  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Paes BF, Vermeulen K, Brohet RM, van der Ploeg T, de Winter JP. Accuracy of tympanic and infrared skin thermometers in children. Arch Dis Child. 2010;95:974–8. https://doi.org/10.1136/adc.2010.185801.

    CAS  Article  PubMed  Google Scholar 

  13. 13.

    Chiappini E, et al. Performance of non-contact infrared thermometer for detecting febrile children in hospital and ambulatory settings. J Clin Nurs. 2011;20:1311–8. https://doi.org/10.1111/j.1365-2702.2010.03565.x.

    Article  PubMed  Google Scholar 

  14. 14.

    Apa H, et al. Clinical accuracy of tympanic thermometer and noncontact infrared skin thermometer in pediatric practice An alternative for axillary digital thermometer. Pediatr Emerg Care. 2013;29:992–7. https://doi.org/10.1097/PEC.0b013e3182a2d419.

    Article  PubMed  Google Scholar 

  15. 15.

    Kirshblum SC, et al. International standards for neurological classification of spinal cord injury (Revised 2011). J Spinal Cord Med. 2011;34:535–46. https://doi.org/10.1179/204577211X13207446293695.

    Article  PubMed  PubMed Central  Google Scholar 

  16. 16.

    von Elm E, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014;12:1495–9. https://doi.org/10.1016/j.ijsu.2014.07.013.

    Article  Google Scholar 

  17. 17.

    Gatt A, et al. Thermographic patterns of the upper and lower limbs: baseline data. Int J Vasc Med. 2015;1–9. https://doi.org/10.1155/2015/831369.

  18. 18.

    Ayres B, White J, Hedger W, Scurr J. Female upper body and breast skin temperature and thermal comfort following exercise. Ergonomics. 2013;56:1194–202. https://doi.org/10.1080/00140139.2013.789554.

    CAS  Article  PubMed  Google Scholar 

  19. 19.

    Alexander J, et al. Delayed effects of a 20-min crushed ice application on knee joint position sense assessed by a functional task during a re-warming period. Gait Posture. 2018;62:173–8. https://doi.org/10.1016/j.gaitpost.2018.03.015.

    Article  PubMed  Google Scholar 

  20. 20.

    Rossignoli I, Fernández-Cuevas I, Benito PJ, Herrero AJ. Relationship between shoulder pain and skin temperature measured by infrared thermography in a wheelchair propulsion test. Infrared Phys Technol. 2016;76:251–8. https://doi.org/10.1016/j.infrared.2016.02.007.

    Article  Google Scholar 

  21. 21.

    Benton RL, et al. Transcriptomic screening of microvascular endothelial cells implicates novel molecular regulators of vascular dysfunction after spinal cord injury. J Cereb Blood Flow Metab. 2008;28:1771–85. https://doi.org/10.1038/jcbfm.2008.76.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  22. 22.

    Matos-Souza JR, et al. Impact of adapted sports activities on the progression of carotid atherosclerosis in subjects with spinal cord injury. Arch Phys Med Rehabil. 2016;97:1034–7. https://doi.org/10.1016/j.apmr.2015.11.002.

    Article  PubMed  Google Scholar 

  23. 23.

    Guyton AC, Hall JE. Hall textbook of medical physiology. 9th ed. Toronto, ON, Canada: Harcourt Canada, Limited; 1995. Ch. 73, p. 825–35.

  24. 24.

    Popa C, et al. Vascular dysfunctions following spinal cord injury. J Med Life. 2010;3:275–85.

    PubMed  PubMed Central  Google Scholar 

  25. 25.

    Jan YK, Brienza DM, Boninger ML, Brenes G. Comparison of skin perfusion response with alternating and constant pressures in people with spinal cord injury. Spinal Cord. 2011;49:136–41. https://doi.org/10.1038/sc.2010.58.

    Article  PubMed  Google Scholar 

  26. 26.

    Hopman MT, Nommensen E, van Asten WN, Oeseburg B, Binkhorst RA. Properties of the venous vascular system in the lower extremities of individuals with paraplegia. Paraplegia. 1994;32:810–6. https://doi.org/10.1038/sc.1994.128.

    CAS  Article  PubMed  Google Scholar 

  27. 27.

    Krassioukov AV, et al. Assessment of autonomic dysfunction following spinal cord injury: rationale for additions to International Standards for Neurological Assessment. J Rehabil Res Dev. 2007;44:103–12. https://doi.org/10.1682/jrrd.2005.10.0159.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank the CNPq—National Council for Science and Technological Development #140215/2014–0 and FAPESP #2016/50253-0—São Paulo Research Foundation.

Author information

Affiliations

Authors

Contributions

JRT was the principal researcher of this research, who performed data collection, analyzed the results and discussion of the data. RAT was the co-author and assistant researcher, who assisted in the elaboration of the proposed method, in the interpretation and discussion of the data, and in data collection. MB performed the statistical analyses. CAF was the co-author, who assisted in the preparation of the manuscript, statistical analyses, discussion of data, and proofreading of the manuscript. ACJ was the academic advisor, who proposed the initial concept of this paper and provided guidance and assistance in the development and execution of the research. Each author has contributed substantially to the research, preparation, and production of the paper and approves of its submission to the Journal.

Corresponding author

Correspondence to Janaina R. Tancredo.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest

Ethics statement

We certify that all applicable institutional and government regulations concerning the ethical use of human volunteers were followed during the course of this research. This work has been approved by the Ethics Committee and consent forms have been signed by all participants.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Tancredo, J.R., Tambascia, R.A., Borges, M. et al. Development of a skin temperature map for dermatomes in individuals with spinal cord injury: a cross-sectional study. Spinal Cord (2020). https://doi.org/10.1038/s41393-020-0471-1

Download citation

Search