Cold immersion recovery responses in the diabetic foot with neuropathy

Manish Bharara, Vijay Viswanathan, Jonathan E. Cobb

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


The aim of this article was to investigate the effectiveness of testing cold immersion recovery responses in the diabetic foot with neuropathy using a contact thermography system based on thermochromic liquid crystals. A total of 81 subjects with no history of diabetic foot ulceration were assigned to neuropathy, non neuropathy and healthy groups. Each group received prior verbal and written description of the test objectives and subsequently underwent a comprehensive foot care examination. The room temperature and humidity were consistently maintained at 24°C and less than 50%, respectively, with air conditioning. The right foot for each subject was located on the measurement platform after cold immersion in water at 18-20°C. Whole-field thermal images of the plantar foot were recorded for 10 minutes. Patients with diabetes with neuropathy show the highest 'delta temperature', that is difference between the temperature after 10-minute recovery period and baseline temperature measured independently at all the three sites tested, that is first metatarsal head (MTH), second MTH and heel. This clinical study showed for the first time the evidence of poor recovery times for the diabetic foot with neuropathy when assessing the foot under load. A temperature deficit (because of poor recovery to baseline temperature) suggests degeneration of thermoreceptors, leading to diminished hypothalamus-mediated activity in the diabetic neuropathic group.

Original languageEnglish (US)
Pages (from-to)562-569
Number of pages8
JournalInternational Wound Journal
Issue number4
StatePublished - Oct 2008


  • Cold immersion
  • Diabetic foot
  • Liquid crystal thermography
  • Recovery rate
  • Thermometry
  • Ulcer

ASJC Scopus subject areas

  • Surgery
  • Dermatology


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