Cryotherapy

Question 1

Hermodynamic effects (4)

Answer 1

1. Vasoconstriction- decrease blood flow

smooth muscle vessel contract

vasodilation due to decrease histamine/prostaglandin

2. Vasodilation- later, increase blood flow when cold applied longer and tissue reach 10 degrees C

(Cold Induced Vasodilation CIDV)

Hunting response: inhibition smooth muscles blood vessel walls by extreme cold

Cycling/alternating vasoconstriction/vasodilation

(axon reflex response)

Skin redness: decrease oxyhemoglobin dissociation (make o2 less available to tissues)

Question 2

Neurmuscular effects (5)

Answer 2

Decrease nerve conduction velocity- greatest affect myelinated small fibers (A-delta pain)

Cool 5=15 minutes reverse 20=30 minutes recover

Increased pain threshold- decreased pain sensation (gate-control), dicrease muscle spasm, conduction velocity, decrease post-injury edema

Altered muscle strength- brief=motor nerve excitability. longer=initially lower then increase after 1 hour >precool

Decreased spacticity- decreased gamma neuron activity decreased spindle and GTO activity (1-1.5 hrs)

Facilitation Muscle Contraction- facilitate alpha motor neuron activity produce contraction

Question 3

Metabolic effects

Answer 3

Decrease rate of metabolic reactions

Question 4

Uses of Cryotherapy (8)

Answer 4

Inflammation

Edema

Pain Control

Modification of spacicity

Symptom management of MS

Facilitation

Cryokinetics

Cryostretch

Question 5

Contraindications (7)

Answer 5

Cold hypersensitivity (cold induced urticaria)

Cold intolerance

Cryoglobulinemia: blood clotting

Paroxysmal cold cryoglobinuria: blood in urine

Raynauds disease/phemonenon

Over regenerating peripheral nerve

Over area circulatory compromise (peripheral vascular disease)

Question 6

Precautions (5)

Answer 6

Over superficial main branch of nerve: nerve conduction block

Over open wound: decrease circulation/metabolic rate

Hypertension

Poor sensation/mentation

Very young/old- impaired thermoregulation

Question 7

Adverse effects (4)

Answer 7

Tissue death

frost bite

Nerve damage

unwanted CIVD

Question 8

How cold causes…

Answer 8

Cold

Decrese vasodilation–>(histamine/prostaglandin)

Cutaneous thermoreceptors–>smooth muscle contract

/Spinal cord dorsal root ganglion—> Increase sympathetic adrenergic activation

–>vasoconstriction

–>increase blood viscocity

–> decrease blood flow