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Therapeutic Modalities > Cold Modalities > Flashcards

Cold Modalities Flashcards

1
Q

Conduction

A

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

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2
Q

Convection

A

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

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3
Q

Radiation

A

emission of energy

  • may be emitted from a source (heat lamp) absorbed by body
  • infrared lamps, laser, UV lamps
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4
Q

Conversion

A

changing from one energy form into another
-US: converts acoustic energy to thermal energy
US, diathermy

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5
Q

Cryotherapy

A

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

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6
Q

What are thermal agents?

A

represent a transfer of heat energy to or away from tissue—unidirectional

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7
Q

Fundamental principle of heat transfer?

A

one object must have a higher temperature than the other

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8
Q

What factors effect depth and duration of treatment?

A

subcutaneous tissue thickness–primary limiting factor
external towel insulating used
use of a compression wrap
depth of target tissue–diminish with depth

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9
Q

Effects of adipose tissue

A

as adipose thickness increases, the cooling time required to produce a standard temp effect increases

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10
Q

Ice and compression

A

better changes in tissue temperature reduction

elastic wrap more effective at reducing intramuscular tissue temp–acute injuries

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11
Q

Primary rationale for use of cryotherapy

A

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.

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12
Q

Tissue metabolic rate

A

each 1.8F decreases in tissue temperature results in 13% decrease in tissues metabolic rate

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13
Q

Cellular Response effects from Cold Mods

A

decrease in cell metabolism resulting in decrease need for oxygen

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14
Q

Blood and fluid dynamics effects from Cold Mods

A

vasoconstriction
decreased blood flow to area
decreased hydrostatic pressure
decreased capillary permeability:decreases edema formation lessening mechanical pressure on nerves reducing pain

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15
Q

Inflammation effects from Cold Mods

A

decrease inflammation
decrease release of inflammatory mediators
decreased prostaglandin synthesis
decreased capillary permeability (histamine)

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16
Q

Nerve conduction effects from Cold Mods

A

decreased afferent NCV

decreased threshold of afferent nerve endings

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17
Q

Muscle Spasm effects from Cold Mods

A

decrease sensitivity of muscle spindle

—relaxes muscle and spasm relieved

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18
Q

How does Cold Mods affect pain perception & transmission

A

interrupts pain transmission (stimulates large diameter A-beta nerve fibers)
decreases nerve conduction velocity
reduces muscles spasm
reduces or limits edema

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19
Q

Indications for Cold Modalities

A

acute injury or inflammation
acute or chronic pain
post-surgical pain and inflammation
acute or chronic muscle spasm

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20
Q

Contraindications to Cold Modalities

A 
Cold allergy
Cardiac or respiratory involvement
PVD/circulatory insufficiency
uncovered open wounds
advanced diabetes
Raynaud's phenomenon
prolonged application over superficial nerve
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21
Q

R.I.C.E.

A

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

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22
Q

What will you feel during cold application?

A

Cold
Burning
Aching
Numbness

*Doesn’t always occur in this order; repeated use lessens effects

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23
Q

Frostbite

A

usually due to whole body exposure or immersion

**Cold packs can cause these so be mindful

24
Q

S&S of Frostbite

A

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

25
Q

Cold Packs: types

A

plastic bags fileld with ice
reusable gel packs
controlled cold therapy units-cryo cuffs
chemical or instant cold packs

26
Q

Cold pack insulation layers

A

use if:
blood flow to area is compromised
nerve or cold intolerance
raynaud’s phenomenon

27
Q

Ice Packs

A

most commonly used
–flaked and crushed ice works bests, cubed also used but doesn’t conform as easily

when combined with compression wrap, greater decreases in skin temperature~ 20 min
at rest skin temp can remain below pre-app level for over an hr
greater decrease in jt vs muscle

28
Q

How to make ice pack?

A

Fill bag, squeeze air out, twist and tie at top

29
Q

Advantages of ice bag

A

quick and easy
effective transmission of cold (quickest to cool skin)
conforms to body parts
athletes can take them to go

30
Q

Disadvantages of ice bags

A

ice machines are expensive
ice bags add up in price
ice machines=lots of space

31
Q

Cold Compression Therapy Units

A

combines static external compression with cold application—ankles, knees, shldrs

less tissue cooling compared to ice pack
need to keep body part elevated

32
Q

Advantages of CCT

A

RICE principle
Reusable
Circumferential compression

33
Q

Disadvantages of CCT

A

Price to purchase
Set up
Can mainly only treat extremities

34
Q

Tx parameters

A

15-30 min
Be careful of frostbite because it can be used on and off continuously
example: game ready

35
Q

Reusable cold packs

A

stored in freezer

silica, water, and antifreeze component

36
Q

Advantages of reusable cold packs

A

cost effective due to reuse

37
Q

Disadvantages of reusable cold packs

A

risk of frostbite
poor conformity to body contours
break open easily

38
Q

instant cold packs

A

two chemical separated in pack when barrier is broken chemical reaction occurs

39
Q

Adv. of instant cold packs

A

portable in med kits

small and can be wrapped on easily on sidelines

40
Q

Disadv of instant cold packs

A

one time use
looses cooling properties quickly
chemicals are caustic to skin
expensive over time

41
Q

Ice Massage

A

delivered to small evenly shaped areas

42
Q

Indications for Ice Massage

A 
muscle spasm/strains
contusions
minor injuries to localized areas
subacute injury or inflammation
chronic pain
43
Q

Adv. ice massage

A

convenient for pt to perform in ATR or home
cost effective
time effective

44
Q

Disadv. ice massage

A

can not effectively cover large areas
messy
not effective in reducing swelling due to lack of compression. (wrap and elevate after treatment to reduce swelling)

45
Q

How does ice massage work?

A

stimulates large diameter nerves inhibiting transmission of pain
fill cups with ice and freeze
tx area=no larger than 3x size of cup
5-10 min
may be painful or counterproductive with acute injury

46
Q

Contraindications Ice Massage

A 
where pressure is contraindicated
suspected fractures
uncovered open wounds
circulatory insufficiency
cold allergy
47
Q

Ice Immersion (Ice buckets)

A

temp range of 40-50F
very uncomfortable due to immersion of fingers and toes
-cold penetrates to bone level due to small circumference of digits
nail beds sensitive to cold

48
Q

Ice Immersion effects on injury response cycle

A

same as general effects of cold
intensity of cold is greater secondary to greater surface area in contact with cold
hydrostatic pressure w/in capillaries is increased in limb due to dependent position–use AROM

49
Q

As you increase area being treated:

A

increase the water temperature
prevents hypothermia
you wouldnt do full body immersion at 45 F

50
Q

Indications for ice immersion

A

acute injury or inflammation
acute or chronic pain
post-surgical pain and edema

51
Q

Contraindications ice immersion

A 
cardiac or respiratory involvement
uncovered open wounds
circulatory insufficiency
cold allergy
anesthetic skin
adv. diabetes
52
Q

Whirlpools

A

effective to apply heat/cold to irregularly shaped areas

energy transferred via convection

53
Q

cryokinetics

A

use of cold modalities with mvmt
used to improve ROM while decreasing pain
allows inflammatory response to be more effective

54
Q

Whirlpools indications

A

decreased ROM
subacute or chronic inflammatory conditions
PVD
Peripheral nerve injuries

55
Q

Whirlpool contraindications

A

very acute conditions where turbulence of water would cause pain/irritation
Fever (hot whirlpool)
Pts require postural support

56
Q

Cryostretch indications

A

trigger points
muscle spasm
decreased ROM
acute pain

57
Q

Cryostretch contraindications

A 
allergy to spray
acute and or post surgical injury
open wounds
normal cold contraindications
contraindications to passive stretching

Therapeutic Modalities (12 decks)

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