The applications of infrared thermography in health and sports
The rising interest in thermography and its applications in the world of physical activity and health has led to an improvement in the scientific evidence related to the most appropriate methodology for using this tool.
Thermography has experienced particular growth in the area of health sciences. From its first applications in medicine (Barnes et al. 1964), where its main use was as a diagnostic tool, until the current development of technology, a great advance has been experienced. Thanks to better systems, with greater precision and resolution, and new analysis methods, the spectrum of thermography applications has been extended to the areas of health and sports.
Its application in medicine as triage in different pathologies has been investigated with very good results, as is the case of screening for acute appendicitis in the emergency room (Ramirez-GarciaLuna et al. 2020). Technology has evolved since the 1960s when thermography was used to diagnose breast cancer with a high percentage of false positives. Currently, the analysis models have been improved, increasing their effectiveness for this purpose (Allugunti, V. R., 2022). In Figure 1, it can be seen how research in thermography and medicine suffered a decline in the years 1990 to 2000 due to these false positive results in breast cancer. However, thanks to the improvement of the technology, the number of investigations has multiplied, both in clinical thermography and in its sports application:
Although at ThermoHuman we defend the position that thermography is not a diagnostic tool by itself, it can be a great ally in supporting diagnosis and triage to facilitate the understanding of acute physiological processes of tissue injury. This is possible due to the methodology of asymmetries from the first image and the other metrics that complement the ThermoHuman software with the continued use of imaging (Figure 2).
Thermography as diagnostic support in the applications
In this sense, from the first image, and using the metric of asymmetries, thermography can report on the state of the tissues and the metabolic processes that the body is undergoing, based on the thermographic patterns, as we can see in Figure 3:
Figure 3. Types of thermal response depending on the lesion
In these articles you can see how the ThermoHuman team uses thermography to improve the screening of information in the diagnostic process:
Improvement in the diagnosis of appendicitis with abdominal thermal asymmetry
Identification of pathologies in the feet through the asymmetric response of body temperature
Fracture screening by difference in asymmetry of body regions
Triage in the emergency department according to the asymmetry of the lesion
The thermal behavior of muscle injury
Detection of regions at risk of injury in thermography applications.
Another application in health and sports, which can be carried out from the first image thanks to the asymmetry metric, is the detection of regions at risk of injury. Whether due to an active metabolic process in an area with greater work demand or due to a region that does not have adequate activation, thermography will allow the identification of regions at risk of injury.
This application is very useful for the prevention of injuries, but it also allows in the initial evaluation of the preseason or in the transfer period to evaluate the players to detect regions with previous problems or with risk markers such as varicose veins.
In general, the regions with hyperthermia, which are related to greater physiological demand, will be our focus of attention. Due to the requirement of the body to maintain homeostasis in its systems, if we find a region that does not maintain thermal balance, we will monitor these signals. (Figure 4)
Figure 4. Identification and decision-making in an injury prevention process
At ThermoHuman we have several scientific and empirical investigations on how asymmetries affect the risk of injury, summarized in:
Muscle injury reduction results using thermography
The application of thermography to podiatry
Injury follow-up
From the second image of the same individual, and with the frequent collection of images, we will be able to carry out a follow-up. When we use the application of detecting regions with risk of injury, we identify that a region is out of its thermal pattern of behavior and we can thus act to reduce the alarm, as in the case of figure 4.
Injury monitoring, as shown in Figure 5, is one of the most robust and proven applications. Due to the direct relationship of thermography with the physiological behavior of the tissues, we can control the processes of inflammation/joint effusion, hypothermic asymmetries occurring in muscle injury and their return to equilibrium and the regulation of the nervous system in the face of neuropathies.
Figure 5. Muscle injury in the right biceps femoris and return to competition when the thermal asymmetry disappears.
From the ThermoHuman team we have many examples of clinical cases that deal with the follow-up of injuries and their return to sports practice or daily life:
Thermography, GPS and basketball: a case study of an ankle sprain.
The complex fracture: clinical case of thermography
The evolution of ACL injury in athletes
Return to competition after muscle injury
Evolution of neuropathies in the foot in combination with plantar pressures
Recovery Prescription
It is the newest application of thermography and is aimed at the high-performance sports field.
This new application appears thanks to the metrics of the coefficient of variation and we can see it in Figure 6. It allows us to identify, from the collection of successive images, individuals with hyperthermic or hypothermic behavior in a global way when performing a group evaluation after the competition. Thanks to this analysis, we can select individualized recovery strategies adapted to the thermal response of the athlete.
Figure 6. Post-competition thermal profile of a soccer team with different responses: normothermic, hyperthermic and hypothermic.
From the ThermoHuman team we are working to generate scientific evidence of our empirical application of the coefficient of variation for post-exercise recovery, in these articles you have the first information:
Measure local fatigue during resistance exercise with thermography.
Thermal response to cardiovascular exercise
Post-exercise temperature and recovery: cool down or warm up?
Conclusions
Infrared thermography is a technology with enormous potential for application in health and sports sciences. With a very incipient scientific life, where the field of research and development is relatively recent for sports and health.
All these applications are reliable due to the objective ability of the technology through analysis methods such as those provided by thermographic information management software.
References
- Barnes RB, Gershon-Cohen J, Brueschke EE, Haberman JD. Application of Thermography to Clinical Medicine. Med Biol Illus. 1964 Jul;14:175-83.
- Ramirez-GarciaLuna, J. L., Vera-Bañuelos, L. R., Guevara-Torres, L., Martínez-Jiménez, M. A., Ortiz-Dosal, A., Gonzalez, F. J., & Kolosovas-Machuca, E. S. Infrared thermography of abdominal wall in acute appendicitis: Proof of concept study. Infrared Physics & Technology. 2020 Sep;105:103165.
- Allugunti, V. R. (2022). Breast cancer detection based on thermographic images using machine learning and deep learning algorithms. International Journal of Engineering in Computer Science, 4(1), 49-56.
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ThermoHuman has had the support of the Funds of the European Union and the Community of Madrid through the Operational Programme on Youth Employment. Likewise, ThermoHuman within the framework of the Export Initiation Program of ICEX NEXT, had the support of ICEX and the co-financing of the European Regional Development Fund (ERDF). 
