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Cold hypersensitivity in hand injured patients (completed)

Cold hypersensitivity is considered the major reason for disability after severe hand injuries. No treatment is established and knowledge about the prognosis for improvement as well as use of recommended self-management strategies is lacking.

Illustration: colourbox

About the project

Cold hypersensitive hand injured patients’ request strategies to reduce cold hypersensitivity and manage cold exposed activities.  They are also concerned about the prognosis for improvement, especially those who are exposed to cold at work.

At present, information to cold hypersensitive hand injured patients is mainly based on knowledge of normal physiology and clinical experiences. The PhD project explores the natural history of cold hypersensitivity and interventions to reduce cold-associated symptoms.


  • To study the prognosis for improvements in cold hypersensitivity after the first postoperative year.
  • To explore the use of self-management strategies 12 and 24 months after injury
  • To evaluate the effect of a home treatment program based on a classical conditioning procedure


Cold hypersensitivity is a common condition in hand injured patients and implies pain, numbness, stiffness and aching in injured fingers at exposure to mild cold stimulus. Air condition, environmental temperatures around 15ºC and handling and preparing cold food may be sufficient to elicit symptoms impairing hand function. Researchers disagree whether the condition improves over years or not and there  is no well documented curative treatment. Current health care practice is to advice the patients to avoid cold, use heat remedies or protect their hands with hand wears. However, documentation of the patients’ use and usability of recommended strategies is scarce.


In three sub-projects, data is collected over one (treatment), two (strategies) and three (development and changes) years respectively, using quantitative longitudinal study-designs.

Cold hypersensitivity and data related to activity and participation are measured by questionnaires. Improvement in finger-skin sensibility is regarded as a prognostic factor and is measured using Semmes Weinstein monofilaments. Cold stress test is used to measure changes in rewarming-pattern after treatment.


  1. Cold hypersensitivity in hand-injured patients: Prognosis for improvements one to three years after injury.
  2. Cold-associated self-management strategies in cold hypersensitive hand-injured patients. A prospective study with two years follow-up.
  3. Home treatment of cold hypersensitivity in hand injured patients using a classical conditioning procedure.


  • Sophie Minde Ortopedi A/S
  • Rikshospitalet, Oslo University Hospital
  • Faculty of Medicine, University of Oslo


  • Oslo University hospital

Project start and finish

  • 2012-2015


  • Vaksvik T. Cold hypersensitivity after complex hand injuries: longitudinal changes and self-management strategies. PhD Thesis 2016. Institute of Health and Society, Faculty of Medicine, University of Oslo.  ISBN978-82-8333-110-3
  • Vaksvik T, Ruijs A, Røkkum M, Holm I. Evaluation of a home treatment programfor cold hypersensitivity using a classical conditioning procedure in patientswith hand and arm injuries. J Hand Ther. 2016 Jan-Mar;29(1):14-22. doi:10.1016/j.jht.2015.09.002.
  • Vaksvik T, Røkkum M, Haugstvedt JR, Holm I. Small-to-moderate decreases incold hypersensitivity up to 3 years after severe hand injuries: A prospectivecohort study. J Plast Surg Hand Surg. 2016 Apr;50(2):74-9. doi:10.3109/2000656X.2015.1089877.
  • Vaksvik T. Translation and cross-cultural adaptation of the McCabe Cold Sensitivity Severity scale (CSS) and Potential Work Exposure scale (PWES) to Norwegian. Hand Therapy. 2015;20(2):64-67.
  • Vaksvik T, Kjeken I, Holm I. Self-management strategies used by patients who are hypersensitive to cold following a hand injury. A prospective study with two years follow-up. J. Hand Ther. 2015;28(1):46-52.
  • Stavenes AB, Bolstad IH, Sveen U, Vaksvik T. The Childrens’ Hand-use Experience Questionnaire (CHEQ) – en oversettelse og pågående innholdsvalidering. Ergoterapeuten 2013(6).
  • Reigstad O, Vaksvik T, Lutken T, Berg J. The PRWHE form in Norwegian--assessment of hand and wrist afflictions. Tidsskr. Nor. Laegeforen. 2013;133(20):2125-2126.
  • Vaksvik T, Hetland K, Rokkum M, Holm I. Cold hypersensitivity 6 to 10 years after replantation or revascularisation of fingers: consequences for work and leisure activities. J. Hand Surg. Eur. Vol. 2009;34(1):12-17.
  • Vaksvik T., Røkkum M., Holm I (2008). Cold hypersensitivity, activity and participation in patients with replanted/revascularised hands. Abstract. The Journal of hand Surgery, J. Hand Surg. Eur. Vol. 2008;33E, Supplement 1, p 222
Published Feb. 4, 2014 1:30 PM - Last modified Aug. 29, 2016 10:24 AM



Detailed list of participants