Establishing an indicator of the effectiveness of contrast bath for complex regional pain syndrome

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K10707
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58050:Fundamental of nursing-related
• Research Institution: Gifu University
• Principal Investigator: NISHIMOTO YUTAKA 岐阜大学, 医学部, 教授 (20208234)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 温冷交代浴 / 自律神経応答 / 心拍解析 / 皮膚温 / 末梢血管

Outline of Final Research Achievements

In order to demonstrate the effect of the hand contrast bath on complex regional pain syndrome (CRPS) and to propose the optimal temperature, the heart rate variability (HRV), skin temperature, and skin capillary blood flow were measured during the hot and cold bathing under various temperature of cold stimulation.
It was difficult to detect changes in HRV. Hand bath would not influence the whole body circulation. On the other hand, changes were detected in the blood flow velocity of the capillary of the skin depending on the surface temperature of the hand. After measuring capillary flow under room temperature as a control, capillary flow showed specific decrease in hot(42°C) water. It may be reflected a contribution of sympathetic nerve around arterioles against temperature stress. But after immersing cold water, capillary flow showed specific increase in the hot water. That will be because the contrast bath should be effective for hand circulation.

Free Research Field

整形外科学

Academic Significance and Societal Importance of the Research Achievements

従来、CRPSに対する温冷交代浴時の温度は定まらず、その機序は自律神経活動に関わることが推測されていたが、詳細不明である。今回心拍変動による自律神経活動は手の温冷交代浴の経過中有意な変化を認めることはなかったことから、体循環に影響を及ぼすことなく、細動脈レベルでの血管の収縮弛緩が影響していると推察される。また、温浴時の血流速度の測定から、単に温める時には血流が減少するのに対し、同じ温度でも冷浴後には血流速度の上昇を確認でき、温度の変化が交感神経に影響を与える可能性が示唆された。
CRPSに対する効果に対する懐疑的視点に対し、より客観的で臨床に即した有効な治療法の提示につながると期待される。