Class 2

Question 1

Hot applications produce _________________________.

Answer 1

physiological responses which are attempts by body to eliminate heat.

Question 2

The effects produced by hot applications depend on?

Answer 2

• Type of modality
• Temperature of the modality
• Duration of the application
• Location of the application
• Condition of the patient.

Question 3

What does warm to do the tissues?

Answer 3

Raises target tissue temperature to 33 – 38 degrees C

Question 4

What does hot do to the tissues?

Answer 4

Raises target tissue temperature to above 38 degrees C

Question 5

The PRIMARY RESPONSE of the body to HEAT is _____________________.

Answer 5

PASSIVE DERIVATION

• In area that has been heated, superficial blood vessels dilate - VASODILATION allows blood to move towards skins surface which allows heat to escape.
• Hydrostatic pressure will decrease in blood vessels that are dilated.
• Blood will move passively down pressure gradient from other parts of body (areas of higher hydrostatic pressure) towards dilated blood vessels
(lower hydrostatic pressure) in heated area.
• Blood will move passively from congested area or from core towards area which has been heated.
• Resulting increase in blood flow in area can be seen as redness of skin. This is known as PASSIVE HYPEREMIA.

Question 6

what are the PHYSIOLOGICAL EFFECTS of LOCAL HEAT?

Answer 6

• Passive derivation & passive hyperemia: increased local circulation via vasodilation
• Increased local tissue temperature & metabolism
• Decreased PAIN, muscle spasm
• Direct effects on soft tissue structures: mediated through nervous system. Heat increases fascial excursion, decreases joint stiffness.
• Sedation/relaxation with optimal temperatures
• Increased local sweat production leading to detoxification
• Reflex effects on organs
• Local blood pressure decreases (through vasodilation)
Note: with more systemic/extensive heat treatments heart rate & breathing rate may increase

Question 7

What does Passive derivation and passive hyperemia both do?

Answer 7

increased local circulation via vasodilation

Question 8

What are Direct effects on soft tissue structures?

Answer 8

mediated through nervous system. Heat increases fascial excursion, decreases joint stiffness.

Question 9

With more systemic/extensive heat treatments heart rate and breathing rate may_______________.

Answer 9

increase

Question 10

What are indications for heat?

Answer 10

• Chronic pain, chronic muscle spasms
• Chronic elevated resting tension
• Trigger points (use pre and post treatment)
• Chronic stage of injury repair
• Warm chilled patient
• Before very cold treatment
• Pre- or post-massage treatment
• For sedation where there is general stress and tension (larger applications, especially full body heat)
• Encourage sweating & detoxification (full body treatments)
• Heat applications over sacrum or abdomen may alleviate menstrual cramping, intestinal cramping or mild diarrhea in some patients

Question 11

What are local heat treatments?

Answer 11

• Fomentations (alternating hot towels/hot compress, thermophore, paraffin wax, hydrocollator)
• Hydrocollator
• Thermophore
• Paraffin wax
• Alternating Hot Towels (hot compress)
• Hot foot bath
• Hot arm bath

Question 12

What is fomentation?

Answer 12

Hot moist compress either encased in or covered
with dry layer that provides prolonged heat

Question 13

What is Hydrocollator?

Answer 13

Clay or silica-gel filled pack soaked in hot water to provide prolonged, moist heat. (ITB’s, hyperkyphosis (across chest)

Question 14

How is Hydrocollator used?

Answer 14

• Pack must be wrapped in 3 – 5 layers of towels or in hydrocollator cover. As pack cools down, towels can be removed one at a time to prolong heat
• Heavy & provide intense heat; may be contraindicated for certain conditions where there is fragile bone or unstable joints in treatment
area.
• Duration 10 – 20 minutes

Question 15

What is a Thermophore?

Answer 15

• A fomentation that creates deep moist electric heat. Flannel cover traps moisture from air

Question 16

How is Thermophore used?

Answer 16

• Do not roll up or fold thermophore, other than to hang it up. Gently wash flannel cover in cold water when appropriate. Always cover pack with pillow
case for hygienic reasons
• Duration 10 – 20 minutes

Question 17

What is Paraffin wax?

Answer 17

Is used for smaller treatment areas such as scar, adhesions or over specific area of tension e.g. tendon, ITB, joint.

Question 18

How is Paraffin wax used?

Answer 18

• Wax units contain paraffin wax that is maintained at therapeutic temperature.
• If wax unit is unplugged, please note that plugging it back in, will heat it up to temperature higher than therapeutic temperature to self-sterilize. Use caution & wait 10 min before using.
• 8 – 10 layers of wax are either painted on treatment area using silicone pastry brush/paint brush or strips of paper towel are dipped in unit & applied to skin. To treat foot, elbow or hand with wax it’s better to have to patient “dip” body part into wax unit carefully.
• First layer of wax is largest to create seal.
• Wax application must be covered in saran wrap, followed by towel & then an additional heat source & is left on for 10 – 20 minutes.