BPA Unit 2: Cryotherapy Flashcards
What is Conduction?
The transfer of heat by direct interaction of the molecules in the warmer areas with those in cooler areas
Decreasing the skin temp. to what is sufficent to produce local analgesia?
Lowing the skin to 56.5°F is sufficient
What is the skin temperature that can produce a 33% reduction in nerve conduction velocity?
50°F
What is Convection?
This occurs when there is direct contact between skin and moving fluid particles
What is Evaporation?
Vapocollant sprays are used for temporary pain relief before stretching muscles with active trigger points or muscles with local spasms. They transfer energy
What ar the biophysical principles of Cryotherapy?
- The resulting arteriolar vasoconstiction reduces bleeding
- The decreased in metabolism and vasoactive agents, which reduces inflammation and outward fluid filtration
- The pain threshold is elevated
What are the Hemodynamic Effects of Cryotherapy?
- Decrease in blood flow
- Edema reduction
What are the Peripheral Nerve Effects of Cryotheapy?
- Increases threshold for depolarization
- Slows nerve conduction velocity
- Extreme cold can block nerve conduction
What are the Neuromuscular effects of Cryotherapy?
- Decrease proprioception
- Spasticity reduction
–A reflex decrease in gamma-motorneuron activity through stimulation of cutaneous afferents
–A decrease in afferent spindle discharge by direct cooling of the muscle
If a person has pain, what are the physiological and therapeutic benefits/effects?
- Physiological: Decreased peripheral nerve conduction velocity, elevated pain threshold
- Therapeutic: Decreased pain
If a person has Injury/surgery, what are the physiological and therapeutic benefits/effects?
- Physiological: Decreased tissue metabolism; Hemodynamic changes (vasoconstriction, increased viscosity)
- Therapeutic: Decreased inflammation and improved healing; decreased swelling
If a person has Muscle spasms, what are the physiological and therapeutic benefits/effects?
- Physiological: Decreased muslce-spindle discharge
- Therapeutic: Decreased spasm
If a person has Spasticity, what are the physiological and therapeutic benefits/effects?
- Physiological: Decreased gamma-Motoneuron activity
- Therapeutic: Decreased muscle tone
What are the Clinical Indications for Cold Therapy?
- Acute injury or surgery
- Pain management
- Muscle spasms
- Myofascial pain syndrome
- Delayed-Onset Muscle Soreness (DOMS)
What are the Most approptiate forms of Cryotherapy?
- Cold Compression Device: provides cold and compression at the same time
- Vapocoolant Spray: Limited use, allows spray and stretch at the same time
- Ice Massage: Best for Small or localized areas
- Ice Bag: Convenient, can be given prior to leaving the clinic or patinet can make at home, big areas
- Cold Pack: Clinic use, can be molded to fit area, big areas
- Cold Immersion Bath/Whirlpool: More aggressive cooling, distal extremities, patient can perform exercise while receiving cold therapy
What is the typically temperature and total treatment time when using Cold Compression Device?
~50° F
- 10-20 min
This varies in pressure
What is the typically temperature and total treatment time when using Cold Packs?
< ~32°F
- 20-30 min
What is the typically temperature and total treatment time when using Cold Immersion Bath/Whirlpool?
50-65°F - Extremity
65-80°F - Whole Body
- 10-20 min
What is the typically temperature and total treatment time when using Ice Massage?
< ~32°F
- 5-10 min
What is the typically temperature and total treatment time when using Ice Bag/Pack?
< ~32°F
- 20-30 min
With this, there can be a weight on top, or this can be wrapped
What is the typically the total treatment time when using Vapocoolant Spray?
3 to 5 slow sweeps (10cm/sec)
Hold ~12in away
What it the typically patient sensation with Cryotherapy?
Cold -> Burning-> Aching -> Numbness
What are the Guildelines for Cryotherapy Application?
- Do a thorough evaluation
- Explain the procedure and expected benefits
- Explain sensory response: cold, burn, ache, numb
- Obtain permission
- Position patient comfortably and elevate the body part
- Apply cryotherapy
- Provide a bell or call system
- Check the treatment area post-treatment
For what purpose is indicated positioning the patient’s extremity elevated in the presence of joint swelling?
To decrease the capillary hydrostatic pressure
For which of the following methods of cryotherapy transfers via convection?
A. Ice Cup Treatment
B. Cold Whirlpool treatment
C. Cold Compression Treatment
D. Vapocoolant Spray Treatment
B. Cold Whirlpool Treatment
The patient complaints of significant pain and swelling due to recent right total knee replacement. Which of the following interventions is BEST to provide relief of the patients symptoms?
A. Cold Pack surrounding the knee x 20 min
B. Cold Pack (gel) surrounding the knee x 15 min
C. Cold Pack and compression surrounding the knee x 20 min
D. Ice Cup Massage to the area x 10 min
C. Cold Pack and compression surrounding the knee x 20 min
When Applying cold on the knee joint to decrease inflammation at the ACL, which of the treatment durations would be more indicated to safely take into consideration?
A. 15 min
B. 10 min
C. 35 min
D. 20 min
D. 20 min
Which of the following outcomes is MOST appropriate to assess effectiveness of cryotherapy treatment for edema due to an acute ankle sprain?
A. Volumentric Measurement
B. Modified Ashworth Scale (Spasticity Test)
C. MMT
D. Blood Pressure
A. Volumentric Measurement
Which of the following biophysical principles of Cold MOST appropriately describes why Cold is widely used in the management of acute trauma?
A. The resulting Arteriolar vasoconstriction
B. The increase of fluid filtration into interstitial tissue
C. The increase in tissue metabolism
D. The Lowering of the pain threshold
A. The resulting Arteriolar vasoconstriction
Cold makes the blood vessels smaller decreasing swelling in the area
Which of the following statements has the correct sensory response order that a patient SHOULD exerience during that an Ice Cup Massage Treatment?
A. Cold, Burning, Achy, Numbness
B. Cold, Burning, Numbness, Achy
C. Burning, Numbness, Achy, Cold
D. Achy, Cold, Burning, Numbness
A. Cold, Burning, Achy, Numbness
