Different conditions of cold water immersion test for diagnosing hand-arm vibration syndrome

Abstract

The cold water immersion test with finger skin temperature (FST) measurement is used to assess vascular disorders in hand-arm vibration syndrome (HAVS). The test method is currently being standardized within the International Organization for Standardization (ISO) in which a water temperature of 12°C for 5 min of hand immersion and an option of using a waterproof hand covering during immersion are proposed. It is necessary to evaluate the diagnostic significance of the test with FST measurement under different conditions to provide a proper management of HAVS patients. The aim of this article is to review research findings of this test with FST measurement and discuss test conditions influencing the results and diagnostic significance.Different conditions were employed, and the test results were shown to be influenced by water temperature, immersion time and other conditions such as room temperature, season, ischemia during immersion, and evaluation parameters. These factors need to be considered in the standardization of the cold water immersion test with FST measurement. It has been mentioned that a high water temperature, a short immersion time and other conditions should be chosen to expose a subject to minimal suffering during the test. A water temperature between 10°C and 15°C and a 5 min immersion might be suitable for the cold water immersion test. The reported sensitivity and specificity evaluating rewarming to the initial temperature for the test using a water temperature of 12°C and a 3 min immersion are 58% and 100%, respectively; these are low but similar to those for tlie water immersion test at 10°C. Therefore, the proposed cold water immersion test at 12°C for 5 min by the ISO (Draft International Standard) is the focus of much interest, and further studies are needed to obtain sufficient data for evaluating the diagnostic significance of the test. At present, the test needs to be used together with a test battery.

Prevalence of Cold Sensitivity in Patients with Hand Pathology

“…Because of environmental exposures and cold surroundings, it is difficult to avoid exposure to cold air; however, patients may avoid cold water immersion by substituting warmer water temperatures. Multiple studies of cold sensitivity and clinical evaluations of vascular disorders in the hand have used cold water immersion as a cold stimulus [8, 11, 24, 28]. In our cold chamber laboratory, we are able to control air temperature and humidity and have initiated an investigation to evaluate the responses with cold air exposure compared to cold water immersion as a cold stimulus.…”

Detection of inflammation from finger temperature profile in rheumatoid arthritis

“…Ring [36] used a cooling time of 60 s in water temperature from 0 to 20°C for Raynaud's phenomenon. Laskar and Harada [40] proposed the cold water immersion test for diagnosing hand-arm vibration syndrome in temperature 10°C and 15°C in immersion time 1, 5, and 10 min. When the infrared measurement technique was applied to our population with our cold provocation test in water 0°C for 5 s, there was a tendency for the mean Tmax-Tmin temperatures to be lower by 4-5°C.…”

A Study on the Reliability Test of a Lithium Battery in Medical Electric Wheelchairs for Vulnerable Drivers

“…The sample battery was immersed in a water tank of 1 M, and the battery was observed for 30 minutes. However, it was confirmed that the protection circuit against flooding was operating normally because no fire or explosion occurred [15,16].…”