Contrast baths have been used for therapy for over 2,000 years. The basic concept is to alternate warm and cool water baths during a treatment session. It is believed that this will increase circulation better than just placing the limb in a warm water bath. However, there is little supportive evidence for this assertion. Further, for subjects with diabetes, with underlying impairments in their circulation, this may not work at all. Fourteen people with type 2 diabetes were compared to 14 age-matched controls. Skin blood flow of the foot (BF) was measured during 16 minutes of contrast baths at two different intervals: 3 minutes warm and 1 minute cold and 6 minutes warm and 2 minutes cold. In control subjects, warm and cold contrast baths with the ratio 3 minutes warm to 1 minute cold elicited significantly (p < 0.01) greater BF than placing the limb continuously in warm water or using a 6:2 ratio of warm to cold bath time. In control subjects, there was also a greater plantar than dorsal BF. For subjects with diabetes, there was no statistical difference between BF with contrast baths versus warm whirlpool; but in both cases BF was significantly less than that seen in control subjects under similar circumstances. There was also very little difference between BF on the plantar and dorsal aspects of the foot in the subjects with diabetes. Patients with diabetes do not show a vascular response to contrast bath therapy. The BF response to contrast temperatures may be a good diagnostic test for diabetic vascular impairment.
Objectives: To examine the effects of aging on the ability of contrast baths to increase the circulation in the skin of the foot compared with immersion in a continuous warm water bath of the same temperature as the warm component of the contrast bath.Methods: A laser Doppler flow meter was used to assess skin blood flow on the dorsal and plantar aspects of the foot during immersion in a warm bath (100ЊF (37.8ЊC)) compared with contrast baths with a ratio of 3 minutes of warm (100ЊF (37.8ЊC)) and 1 minute of cold (60ЊF (15.6ЊC)); the cycle was repeated for 16 minutes. Fourteen participants whose average age was 55.1 ± 9.1 years were examined and compared with 12 younger participants whose average age was 23.9 ± 5.8 years.Results: For both groups of participants, the use of alternating hot and cold bath temperatures elicited an increase in skin blood flow above that which was found with warm water immersion alone. The greatest response was in the younger participants. For the older participants, skin blood flow was approximately one-third less than that seen in the younger participants with either continuous warm water immersion or contrast baths. These same results were seen on the dorsal and plantar aspects of the foot, indicating diminished circulation in both areas with aging.Conclusion: We conclude that contrast baths do increase circulation in the skin in the foot of older individuals but the response was less than that of younger people.
PurposeTo reduce muscle spasms, inflammation, and wound healing times, contrast baths (or the alterations of hot and cold whirlpool immersions) can be utilized. The purpose of this study was to investigate the effectiveness of contrast baths in altering limb blood flow in people with type 2 diabetes versus control subjects. It was hypothesized that diabetic subjects would experience less of a beneficial increase in blood flow than controls. The efficacy of a second contrast bath protocol (6 minutes hot and 2 minutes cold) was also examined.MethodsThis study involved 14 type 2 diabetics (age 47 ± 9 years, height 174.0 ± 11.6 cm, weight 88.9 ± 12.4 kg) and 14 age-matched controls (age 44 ± 8 years, height 176.1 ± 15.2 cm, weight 83.2 ± 10.3 kg). The contrast bath protocols included four cycles of 3 minutes hot and 1 minute cold (3:1), two cycles of 6 minutes hot and 2 minutes cold (6:2), 15 minutes of cold water immersion, and 15 minutes of hot water immersion. Water for the hot and cold baths was obtained from separate whirlpools maintained at 37.8°C and 15.5°C, respectfully. Blood flow was measured on the dorsal aspect of a single foot during the four protocols utilizing a laser Doppler Flow meter. The data were collected by a MP 100 Biopac System and analyzed using Acknowledge 3.8.3 software. Data values were compared using ANOVA repeated measures; p values < .05 were considered statistically significant.ResultsControl subjects experienced a significant increase in dorsal pedal blood flow following implementation of the 3:1 protocol (p < .05). Diabetic subjects did not experience such significant changes (p > .05). The 6:2 protocol significantly changed dorsal pedal blood flow in control subjects (p < .05) but not in diabetic subjects (p > .05). In control subjects, the 6:2 protocol proved to be less effective at increasing dorsal pedal blood flow than the 3:1 protocol (p < .05).ConclusionsDiabetic subjects did not experience a significant increase in dorsal pedal blood flow during contrast bath therapy. This was likely due to vascular endothelial cell damage. Although the 6:2 protocol improved blood flow in control subjects, it was not as effective as the 3:1 protocol. Such findings support the ability of multiple-cycle contrast baths to increase blood flow versus constant temperature baths.
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