Cold Modalities Flashcards
(57 cards)
Conduction
Heat loss or gain through direct contact
-dependent on temp difference b/w 2 surfaces; time of exposure
ice massage, cold packs, cold spray, ice immersion, contrast baths, paraffin bath, cryo cuff
Convection
Heat loss or gain through movement of fluid or air b/w regions of unequal temp
-dependent on differences in temp, time, size of area
Whirlpool, fluidotherapy
Radiation
emission of energy
- may be emitted from a source (heat lamp) absorbed by body
- infrared lamps, laser, UV lamps
Conversion
changing from one energy form into another
-US: converts acoustic energy to thermal energy
US, diathermy
Cryotherapy
describes application of cold modalities that have a temp range b/w 32-65 F
-heat removed from body and absorbed by modality of choice
What are thermal agents?
represent a transfer of heat energy to or away from tissue—unidirectional
Fundamental principle of heat transfer?
one object must have a higher temperature than the other
What factors effect depth and duration of treatment?
subcutaneous tissue thickness–primary limiting factor
external towel insulating used
use of a compression wrap
depth of target tissue–diminish with depth
Effects of adipose tissue
as adipose thickness increases, the cooling time required to produce a standard temp effect increases
Ice and compression
better changes in tissue temperature reduction
elastic wrap more effective at reducing intramuscular tissue temp–acute injuries
Primary rationale for use of cryotherapy
to lower metabolic rate of a tissue
most beneficial effect of cold application is the reduction of secondary metabolic injury by suffocating cells’ need for oxygen.
Tissue metabolic rate
each 1.8F decreases in tissue temperature results in 13% decrease in tissues metabolic rate
Cellular Response effects from Cold Mods
decrease in cell metabolism resulting in decrease need for oxygen
Blood and fluid dynamics effects from Cold Mods
vasoconstriction
decreased blood flow to area
decreased hydrostatic pressure
decreased capillary permeability:decreases edema formation lessening mechanical pressure on nerves reducing pain
Inflammation effects from Cold Mods
decrease inflammation
decrease release of inflammatory mediators
decreased prostaglandin synthesis
decreased capillary permeability (histamine)
Nerve conduction effects from Cold Mods
decreased afferent NCV
decreased threshold of afferent nerve endings
Muscle Spasm effects from Cold Mods
decrease sensitivity of muscle spindle
—relaxes muscle and spasm relieved
How does Cold Mods affect pain perception & transmission
interrupts pain transmission (stimulates large diameter A-beta nerve fibers)
decreases nerve conduction velocity
reduces muscles spasm
reduces or limits edema
Indications for Cold Modalities
acute injury or inflammation
acute or chronic pain
post-surgical pain and inflammation
acute or chronic muscle spasm
Contraindications to Cold Modalities
Cold allergy Cardiac or respiratory involvement PVD/circulatory insufficiency uncovered open wounds advanced diabetes Raynaud's phenomenon prolonged application over superficial nerve
R.I.C.E.
Rest-protect area from further injury
Ice
Compression- decreased pressure gradient b/w arteries and tissues (distal to proximal)
-improves heat transfer to modality
Elevation- decreased hydrostatic pressure and improve venous and lymphatic return
What will you feel during cold application?
Cold
Burning
Aching
Numbness
*Doesn’t always occur in this order; repeated use lessens effects
Frostbite
usually due to whole body exposure or immersion
**Cold packs can cause these so be mindful
S&S of Frostbite
fading of redness normally associated with cold application, white pallor skin, extreme pain, unresponsive or slow responding nail beds
–injury risk increases once skin temp reaches 55F
