Does the surface temperature of the hand pre- and post-exam predict testing performance?

Abstract

Physiological stress, such as that associated with taking university exams, takes many forms and that stress may be associated with changes in heart rate or skin temperature. It was hypothesized that pre- and post-exam heart rate and hand temperatures could be measures of stress that are predictive of university exam scores. An infrared thermal camera (FLIR C5) was used to collect images immediately before and immediately after (pre- and post-) three standardized anatomy exams taken by pre-health science student volunteers (n=30) that were part of their normal curriculum. Thermal images of the right hand (anterior-palmar and dorsal surface) were collected 30 cm above the skin with standardized spacing between the digits at the following eight anatomical locations: center of wrist, center of metacarpals I and III, center of each of the two phalanges of digit I, and at the center of each of the three phalanges of digit III. After thermal imaging, the skin temperature at each location was measured by using the FLIR Ignite software. Statistical significance was analyzed using repeated measures mixed effects models which included a random subject effect. Tukey’s HSD test was used for investigating pairwise comparisons with p<0.05 considered significant. The stress of the exam was associated with a predictably significant decrease in heart rate from 103.3 ± 17.1 pre-exam to a post exam value of 96.4 ± 15.7 (beats/minute). Anterior hand surface temperature in the middle of metacarpal III Pre-Exam (33.8±1.2 C) and center of wrist (32.6±1.1 C) were significantly warmer than the other hand locations. Post-Exam temperature at the middle of metacarpal III Pre-Exam (34.3±0.9 C) and center of wrist (33.4±1.0 C) were also significantly warmer than the other hand locations. The end of the two digits were significantly cooler than most other locations examined. Posterior hand surface temperature Pre-Exam was significantly cooler on the surface of proximal (29.4±2.4 C) and medial (29.5±2.7 C) locations on the third finger relative to all other hand locations including the end of the digit. Post-Exam posterior hand surface temperatures on the proximal surface on the middle of phalanx III was 31.9±1.7 and cooler than five other posterior surface locations. Relative to pre-exam skin temperature, post exam skin temperature increased significantly at all eight locations on the anterior and posterior surfaces of the hand indicative of vasodilation and improved blood flow, although temperatures of the anterior and posterior surface of the hand were not significantly different. While all subjects completed the same anatomy exams on the same day at the same time, differences were observed in exam score with exam #1 (43.6±5.9) and exam #3 (41.7±6.7) slightly but significantly more difficult than exam #2 (45.8±5.2). Exam score was not significantly correlated with surface temperature of the anterior or posterior location in either the pre- or post-exam conditions. In conclusion, although post-exam heart rate was significantly lower and skin temperature is significantly higher post-exam, skin surface temperature of the hand cannot be used to predict exam score and does not appear to be a viable way to evaluate physiological stress. Winona State University Foundation This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

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