Almandil M.1, Alajmi M.2, Alshammeri N.2, Alotaibi S.2, Aldefeeri N.2
1Kuwait University, Faculty of Allied Health Sciences, Physical Therapy Department, Kuwait, Kuwait, 2Ministry of Health, Kuwait, Kuwait
Background: Conductive heat and cold therapies are widely used in the clinical setting. They have been used for their circulatory, neuromuscular, metabolic and elastic effects on tissues. Therapists have used them to decrease pain, edema, stiffness, improve circulation and in managing other symptoms. The use of these modalities is not recommended for patients complaining of hypertension, heart pathology or vascular diseases. However, the rationale for the precautions or contraindications are based on speculations and unsupported scientific evidence.
Purpose: This study aims at examining the effect of 15 minutes application of localized heat and cold therapy on blood pressure, respiratory rate (RR) oxygen saturation (O2Sat), heart rate (HR), skin (Skt) and core (CorT) temperature in healthy subjects. It is hypothesized that hot pack (HP), cold pack (CP), and wax (WX) will result in increased values of all the measured variables.
Methods: Design: Same subject repeated measures experimental design.
Sample: 42 healthy subjects from Health Sciences Centre in Kuwait.
Procedure: Subjects attended 3 sessions and received randomly one of the following modalities; HP, CP, or WX. All modalities were applied on the elbow joint for 15 minutes. Occupation, age, height, weight & health habits were recorded on the first visit. Systolic (SysP), diastolic pressure (DiaP), HR, RR, Skt, CorT, were measured before and immediately after each intervention. Lab temperature and humidity were monitored during the experiment.
Analysis: One-way ANOVA and Chi-Square were used to analyze the data in SPSS 20.
Results: Participants age ranged between 24-55 years. Main analysis revealed significant change in SkT with the three modalities, increase with HP (3.56 ±3.18C°), increase with WX (2.94±1.77 C°), and decreased after CP (-7.61±4.83 C°). HP was the only modality that resulted in increase in SysP (p=0.00), DiaP (p=0.02) and in O2Sat (p=0.00). None of the modalities resulted in increase in CorT or RR.
Conclusion(s): The insignificant changes in the vital signs recorded in this study, negates the risks associated with the use of CP and WX on patients with heart pathology. However, the case is not the same with HP, as the noted increase in SysP and DiaP may involve systematic load exerted by the poorly functioning heart muscle.
As such, it could be inferred that applying WX or CP to patients with heart pathology may not be as alarming as using HP. The changes in the physiologic indicators following HP justifies the need for precautionary actions.
Findings warrant further research on large body parts such as the back, and the replication of the study on patient population.
Implications: The recorded increase in SysP may not have a detrimental effect on healthy subjects, but could result in unwanted load on the heart musculature in patients suffering from hypertension or unstable blood pressure. Monitoring patients during the treatment and recording outcome could safeguard patients against undesirable complications.
Funding acknowledgements: The work was self funded
Topic: Electrophysical & isothermal agents
Ethics approval: The study was approved by the ethical committee FAHS.
All authors, affiliations and abstracts have been published as submitted.
