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Hydrotherapy > Class 4 > Flashcards

Class 4 Flashcards

1
Q

What is cold hydrotherapy?

A

• Cold treatments in hydrotherapy do not “CHILL” patient, are used to cause reaction in body to potentially harmful stimulus
• Cold treatments may be short, moderate or prolonged in duration. Cold may be combined with friction to increase stimulus
• Water can be used at cool or cold temperatures OR ice can be used (cryotherapy)

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2
Q

What is retrostasis?

A

*PRIMARY RESPONSE of body to cold stimulus is RETROSTASIS:
• VASOCONSTRICTION of superficial blood vessels occurs.
• Blood is moved from skin (PERIPHERY) to CORE

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3
Q

What is active derivation?

A

*SECONDARY RESPONSE to a cold stimulus is ACTIVE DERIVATION
• Once cold stimulus/friction is removed, body will attempt to restore blood flow to cooled/frictioned skin by ACTIVELY moving blood towards cooled/frictioned peripheral tissues. It’s an active process because body has to WORK to move circulation from core/congested tissues towards cooled peripheral tissues.
• Blood is moved to cooled/frictioned tissues from either:
- deeper organs/core or
- from area of congestion in body
• Blood that is actively moved towards cooled/frictioned tissues brings fresh nutrients & oxygen to cooled tissues. Local metabolism is increased to maintain homeostasis
• Increase in blood flow to peripheral tissues is seen as redness of skin & is known as ACTIVE HYPEREMIA.

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4
Q

During Active Derivation Increase in blood flow to peripheral tissues is seen as redness of the skin and is known as ____________________.

A

active hyperemia

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5
Q

During Active Derivation blood is moved to the cooled/frictioned tissues from either?

A

• The deeper organs/core
or
• From area of congestion in body

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6
Q

What are physiological effects of local cold hydrotherapy ( primary responses)?

A

• RETROSTASIS: VASOCONSTRICTION of superficial blood vessels occurs. Blood is moved from skin (PERIPHERY) to CORE
• Decreased sweating
• Decreased local metabolism (tissue needs less oxygen)
• Decreased nerve conduction – decreased pain (ANALGESIA)
• Increased skin & muscle tone
• Decreased tissue temperature
• Increases blood flow to core organs

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7
Q

What are physiological effects of local cold hydrotherapy ( secondary response - active derivation)?

A

• ACTIVE DERIVATION: Blood flow leaves deeper organs (or congested area) & is actively moved back towards cooled skin shown as redness of skin (ACTIVE HYPEREMIA)
• Increased local metabolism as body attempts to re-warm area
• Increased digestive processes (for local abdominal cold treatments)
• Increased function of adrenal & thyroid glands
• Increased nutrition & elimination functions of skin
• Improved function of immune system

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8
Q

What are uses (indications) for cold treatments?

A
  1. Acute injury management
  2. Treatment of stubborn chronic conditions
  3. Other uses/indications for local cold applications of hydrotherapy include:
    • Poor skin tone
    • Sluggish digestion or constipation (local application of cold to abdomen)
    • Insomnia (local application to abdomen)
    • Poor immune system function
    • Spasticity
    • Hypothyroidism or sluggish organ function (prolonged treatment)
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9
Q

What is acute injury management?

A
  • Treatment of cardinal signs of inflammation
    • Inflammation is important part of healing process, is often excessive & non-specific to injury.
    • Injury causes VASODILATION & INCREASED PERMEABILITY of local blood vessels
    • BRIEF COLD/CRYOTHERAPY treatments applied regularly to injured area help to “contain” inflammatory process rather than stopping it.
    • Brief cold hydrotherapy applications or ice (cryotherapy) modalities are used because they cause RETROSTASIS (primary response of body to cold).
    • VASOCONSTRICTION in area minimizes excessive blood pooling at injury site (decreases SHARP)
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10
Q

What are contraindications to cold hydrotherapy?

A

• See lecture 1: C/I’s & cautions
• Fear, dislike of cold or any cold treatment
• Local – do not put cold hydrotherapy over abdomen if patient has diarrhea
• Hyperthyroidism (prolonged or extensive treatments)
• Caution with bony areas & superficial nerves where there is little tissue insulation
• Avoid placing cryotherapy over anterolateral neck
• Local Raynaud’s disease or phenomenon
• Patient is already chilled

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11
Q

What does the acronym PIER stand for?

A

Pressure
Ice
Elevation
Reduced activity

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12
Q

It’s possible that a patient will have an allergy when ice is in direct contact with the skin; to test for a negative reaction/allergy prior to a cryotherapy treatment. How is patch test performed?

A

1) Apply small amount of oil to patient’s skin & apply small piece of ice to area for several seconds.
2) Observe area for any allergy (raised bumps/wheals/rash) which indicates an allergy

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13
Q

When applying ice directly on the skin, duration of treatment will depend on patient’s feedback. IT IS VERY IMPORTANT TO _____________________________________________________.

A

EXPLAIN TO PATIENT WHAT THEY ARE LIKELY TO FEEL THROUGHOUT THE TREATMENT (CBAN)

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14
Q

What does the acronym CBAN stand for?

A

Cold
Burning
Achy
Numbness

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15
Q

What does the acronym CBAN stand for?

A

Cold
Burning
Achy
Numbness

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16
Q

Not every patient will experience all 4 sensations; nor will every
patient’s tissue become numb. After several minutes if patient is not reporting numbness ___________________________.

A

the treatment is ended

17
Q

What is the hunting response?

A

• Hunting response occurs in response to PROLONGED & EXTREME COLD temperatures (e.g. winter temperatures) or DIRECT ICE applications (longer than 12 - 15 min).
• HUNTING RESPONSE is a PROTECTIVE MECHANISM which causes superficial blood vessels to INTERMITTENTLY VASODILATE & VASOCONSTRICT.
• Allows superficial tissues that are cooled to very low temperature to maintain perfusion, avoiding cold-induced cellular damage/frostbite & replenishing oxygen & nutrients to cooled tissues.
• WE DON’T APPLY ICE/GEL PACKS FOR MORE THAN 10 min AT A TIME & THEREFORE DON’T USUALLY ENCOUNTER HUNTING RESPONSE.

18
Q

Ice is applied at regular intervals. What is the process and what are the results?

A

• Treating an acute injury we apply ice massage for several minutes (C.B.A.N.) or gel pack for 10 min followed by 30–50 minutes break before repeating ice application.
• Ice creates regular retrostasis in inflamed tissues whilst break allows some perfusion of superficial tissues via active derivation to occur.
6. MUST BE MINIMUM OF 10 DEG DIFFERENCE IN
TEMP BETWEEN SKIN & COLD OR ICE APPLICATION TO CREATE REACTION

19
Q

What is Static cryotherapy (gel packs, ice packs, ice bandage)?

A

• 10 minutes duration. MUST be applied with COLD WET towel between skin & ice pack/gel pack. Oiling skin lightly is recommended.

20
Q

How to use Gel packs and Ice packs?

A

Use ice bag (or bag of frozen vegetables) or reusable gel pack. Ensure if you are using a bag of ice chips that you remove air pockets from the ice.

21
Q

What is ice bandage and how is it used?

A

Gel pack or ice bag applied with pressure using tensor bandage or wrap. Tension of elastic wrap should be enough to provide adequate compression without too much pressure (use capillary refill test to ensure circulation is intact)

22
Q

What is Dynamic ice massage and how is it applied?

A

• Popsicle/ice cube or cryocup (plastic or Styrofoam)
• Most effective for muscle spasm, contusion & other minor
well-localized areas
• Lightly oil skin first
• Use towel to wipe any drips of water as you ice, pat dry
& re-drape when treatment is complete
Duration: CBAN

23
Q

What is cold compress and how is it applied?

A

• Cold alternating towels are applied to body in same way as the hot compresses
• These compresses are renewed frequently (every 1-5 min) in order to maintain retrostasis & can be applied for 5-10 min.

Indications:
• used in conjunction with full body heat treatment
• headache or headache prevention (placed on back of neck or forehead)
• used after heat treatment to restore tone to skin
• ideal for patients who may not tolerate very cold or ice treatments
• Used with patients who have an ice allergy
• Good for treating seniors where cold is indicated but ice is too intense;
• Used to treat acute inflammation or injury where the weight or pressure of ice or an
ice pack is too painful

24
Q

What is a cold arm bath, how is it applied, & what are the effects/uses?

A

Submerge hands & forearms in a cold or cool water for 45 sec–2 min or until mild aching is felt. Pat dry & ensure arms stay warm after treatment is complete

Effects:
Strengthens body & helps to prevent illness.
Very stimulating
Decongests head, sinuses
Stimulates circulation in arms
Revitalizes body

Uses:
Headaches, nose bleeds
Tired, achy arms and hands
Sleepiness, lethargy
Acute injuries to hand, forearm
Acute flare up of arthritis

25
Q

What is a cold foot bath, how is it applied and what are the effects/uses?

A

Submerge feet & lower legs (ideally up to proximal calf) in cold or cool water for 45 sec–2 min or until mild aching is felt. Pat dry & ensure feet stay warm after treatment is complete

Effects:
Strengthens body & helps prevent illness.
Can be sleep-inducing
Decongests head, chest, pelvic areas
Stimulates circulation in legs
Revitalizes body

Uses:
Headaches, nose bleeds
Tired, achy feet & legs
Heavy menstrual flow (cool is best)
Insomnia
Depressed immune system
Acute injuries to foot, ankle, Acute flare up of arthritis (e.g. gout)
Mild low blood pressure

26
Q

What are the 3 types of ice immersion?

A

• snow walking
• water treading
• dew walking

27
Q

What is snow walking (ice immersion)?

A

d/w: Snow walking
Indicated for chronic headaches, weariness & fatigue,
excessive foot perspiration. Walk barefoot in snow (fresh powder snow) beginning with few seconds & building up to 3 min. Ensure feet are warmed up afterwards with socks, being
rubbed dry or a brisk walk.

28
Q

What is water treading (ice immersion)?

A

d/w: Water treading
Indicated for problems falling asleep, mild poor circulation,
hot flashes, vascular headaches, sensitivity to weather
changes, congestion, anxiety, sluggish metabolism
Stork walk in cold water for 1–5 min. Water should
reach just distal to knees (basin of water, bathtub, sea,
lake, water treading pit or river). Can be done seated.
Wipe off water & put on socks before walking or resting.

29
Q

What is dew walking (ice immersion)?

A

d/w: Dew walking
Indicated for mild poor circulation, morning fatigue Strengthens immune system, improves circulation
Begin with warm feet & walk for 5–10 min in
dew-moistened grass. Finish with warm socks/bed rest

30
Q

C/Is for water treading/dew walking/snow walking include?

A

coldness, chills, cold feet, menstruation, urinary infection, acute bladder & kidney conditions, severe arterial circulatory conditions.

Hydrotherapy (4 decks)

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