The complementary effects of galvanic current electrical stimulation associated with conservative treatment to increase vasodilation in patients with Raynaud’s phenomenon: a randomized trial

2020 ◽  
Vol 34 (5) ◽  
pp. 595-606 ◽  
Author(s):  
Rosa María Tapia-Haro ◽  
Mª Carmen García-Ríos ◽  
Sonia Toledano-Moreno ◽  
Antonio Casas-Barragán ◽  
Adelaida Mª Castro-Sánchez ◽  
...  
Keyword(s):  
Blood Flow ◽  
Electrical Stimulation ◽  
Conservative Treatment ◽  
Upper Limb ◽  
Central Sensitization ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Artery Blood Flow ◽  
Galvanic Current ◽  
Temperature Recovery

Objective: To analyze the effectiveness of an electrotherapy intervention with galvanic current on symptoms associated with Raynaud’s phenomenon. Design: Single-blind randomized controlled trial, parallel design (1:1 ratio) and intention-to-treat analysis. Setting: Virgen de las Nieves Hospital, Granada, Spain. Subjects: Thirty-four participants with Raynaud’s phenomenon, with a mean (SD) age of 43.43 (17.62) years. Interventions: The patients were randomly assigned to a control group with conservative treatment (anti-inflammatory, vasodilatory and analgesic drugs) or an intervention group that received conservative treatment and vasodilatory electrical stimulation during seven weeks, three times/week for a total of 20 sessions. Main measures: The primary outcome was the number of attacks. Secondary outcomes were pain, peripheral blow flow, oxygen saturation, upper limb disability, central sensitization, pain catastrophizing and temperature recovery. All outcomes were assessed at baseline, posttreatment and at two months of follow-up. Results: The galvanic current electrotherapy group showed significantly greater improvements in the number of attacks (mean difference = 26.3, 95% confidence interval (CI) = 14.4 to 38.3), pre-cold stress pain (95% CI = 0.6 to 2.4), radial artery blood flow (95% CI = −7.8 ⩾  x ⩽ 1.3), ulnar artery blood flow (95% CI = −8.63 to 0.60), oxygen saturation (95% CI = −1.7 ⩾  x ⩽ −0.29), upper limb disability (95% CI = 1.1 to 22.3), central sensitization (95% CI = 6.7 to 18.2) and temperature recovery (95% CI = −5.7 ⩾  x ⩽ −0.32) than the conservative treatment group. Conclusion: This study suggests that a complementary treatment with galvanic current in combination to conservative approach is superior to conservative applied as isolate, in reducing the clinical manifestations and disability in Raynaud’s phenomenon.

Digital and radial artery blood flow in patients with Raynaud's phenomenon in response to nifedipine

1987 ◽  
Vol 1 (6) ◽  
pp. 403-408 ◽  
Author(s):  
R.H. Morgan ◽  
J.V. Psaila ◽  
W.T. Davies ◽  
G. Carolan ◽  
J.P. Woodcock
Keyword(s):  
Blood Flow ◽  
Radial Artery ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Artery Blood Flow

Impaired transient vasodilation and increased vasoconstriction to digital local cooling in primary Raynaud's phenomenon

2011 ◽  
Vol 301 (2) ◽  
pp. H324-H330 ◽  
Author(s):  
Matthieu Roustit ◽  
Sophie Blaise ◽  
Claire Millet ◽  
Jean-Luc Cracowski
Keyword(s):  
Blood Flow ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Topical Anesthesia ◽  
Sensory Nerves ◽  
Local Cooling ◽  
Doppler Flowmetry ◽  
Percentage Decrease ◽  
Significant Difference ◽  
And Gender

Raynaud's phenomenon (RP) is defined as episodic ischemia of the extremities in response to cold. Although the structure of skin capillaries is normal in primary RP, some data suggest impairment of microvascular function. We aimed at testing whether digital skin blood flow was lower in RP than in controls while cooling locally. We further evaluated the contribution of sensory nerves in the response. We recruited 21 patients with primary RP and 20 healthy volunteers matched on age and gender. After a 10-min baseline at 33°C, skin temperature was cooled at 15 or 24°C during 30 min on the forearm and the finger while monitoring perfusion with a custom-design laser Doppler flowmetry probe. Perfusion was also assessed after topical anesthesia. Blood flow was expressed as cutaneous vascular conductance (CVC). Data were subsequently expressed as area above the curve (AAC0–30) of the percentage decrease from baseline CVC (%BL). CVC on the dorsum of the finger was lower in RP patients compared with controls at 15°C (AAC0–30 were 106,237.2 and 69,544.3%BL·s, respectively; P = 0.02) and at 24°C (AAC0–30 were 86,915 and 57,598%BL·s, respectively; P = 0.04) whereas we observed no significant difference on the finger pad and the forearm. Topical anesthesia increased CVC in patients with RP ( P = 0.05), whereas it did not affect reactivity in controls ( P = 0.86). Our study shows exaggerated skin microvascular vasoconstriction to local cooling on the dorsum of the finger in primary RP compared with controls. Part of this abnormal response in primary RP depends on sensitive nerves.

The effect of captopril on cutaneous blood flow in patients with primary Raynaud's phenomenon

1987 ◽  
Vol 117 (6) ◽  
pp. 751-758 ◽  
Author(s):  
M.H.A. RUSTIN ◽  
N.E. ALMOND ◽  
J.A. BEACHAM ◽  
R.J. BROOKS ◽  
D.P. JONES ◽  
...  
Keyword(s):  
Blood Flow ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Cutaneous Blood Flow ◽  
Primary Raynaud’S Phenomenon ◽  
Cutaneous Blood

Electroacupuncture Therapy for Arthralgia and Raynaud's Phenomenon in a Patient with Systemic Lupus Erythematosus

2010 ◽  
Vol 28 (1) ◽  
pp. 49-51 ◽  
Author(s):  
Nozomi Donoyama ◽  
Norio Ohkoshi
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Visual Analogue Scale ◽  
Lupus Erythematosus ◽  
Analogue Scale ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Systemic Lupus ◽  
Cold Provocation ◽  
Temperature Recovery ◽  
The Right

A 45-year-old woman with systemic lupus erythematosus presented with multiple arthralgia, coldness in fingers and toes, and Raynaud's phenomenon. Electroacupuncture (EA) therapy was performed in two courses (14 treatment sessions) 1 month apart. A needle was inserted in the proximal (or medial) side of the painful joint and another needle was inserted in the distal (or lateral) side of the same joint and a 50 Hz stimulus was applied (3 s bursts with 1 s gaps) for 15 min. A visual analogue scale was used to evaluate pain intensity. Cold provocation testing was conducted before and after EA sessions to determine the vasomotor response. Visual analogue scale scores were lower after EA sessions than before. Before starting EA, the skin temperature of the right mid fingertip was 27.9°C and that of the left mid fingertip was 28.3°C. In contrast, after the EA sessions, the skin temperature of the right mid fingertip was 34.8°C and that of the left mid fingertip was 34.7°C. In the last EA session, the patient reported that the cold in her fingers and toes had eased and Raynaud's phenomenon, in which nail colour tone changed from white to red, had disappeared. In the cold-provocation test, before EA, the temperature recovery rates of mid fingertips after cold exposure reached over 80% in 20 min. In contrast, after EA had been completed, the temperature recovery rate exceeded 80% in 10 min, thus the delay of temperature recovery was alleviated.

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