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Physical Agent Modalities > Cryotherapy > Flashcards

Cryotherapy Flashcards

1
Q

Conduction

A

Heat transfer between two materials in physical contact

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2
Q

Convection

A

Heat transfer through circulation of specific medium consisting of a different temperature

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3
Q

Evaporation

A

Cooling that occurs when a liquid is changed to gas

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4
Q

Cryotherapy

A

Application of any substance to the body that lowers the temperature of the tissue
Penetrates 1 to 2 cm

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5
Q

Indications for cryotherapy

A

Acute or subacute inflammation
Acute pain, strain, or pain
Acute swelling
Myofascial trigger points
Muscle guarding
Muscle spasm
Acute contusion
Bursitis
Tenosynovitis
Tendinitis
Delayed onset muscle soreness
Post exercise edema/pain
Arthritic exacerbations or flare-ups
Spasticity
Post exercise to maintain soft tissue elongation

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6
Q

Cryotherapy contraindications

A

Areas with impaired circulation
Peripheral vascular disease
Hypersensitivity to cold
Skin anesthesia
Open wounds or skin conditions
Infections
Hypertension
Impaired sensation or mentation
Patients with a history of frostbite or systematic cold injury
Those diagnosed with cold urticaria, cryoglobulinermia, or Raynaud’s disease

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7
Q

Cold pack penetration depth

A

0.5-1 cm

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8
Q

Ice massage penetration depth

A

1 cm

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9
Q

PRICE

A

Position, rest, ice, compression, elevation

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10
Q

Position

A

Position extremity to avoid further injury or instability
Partially immobilize injured area

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11
Q

Rest

A

Avoid activities that would stress injured area to point of pain
Allow gentle ROM and movement without pain
Isometric exercises without pain to facilitate healing

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12
Q

Ice (in PRICE)

A

Apply ice in cycles of 10-15 minutes on and 1 to 2 hours off
Protect skin and limit cold application to 10-15 minutes

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13
Q

Compression (in PRICE)

A

Apply compression wrap to provide support and decrease edema

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14
Q

Elevation (in PRICE)

A

Position extremity above level of the heart to avoid increased hydrostatic pressure and swelling

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15
Q

Abstraction

A

Cold is applied to the skin which is warmer than the ice pack which causes heat to be removed

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16
Q

Biophysiological effects of heat or cold are dependent on what?

A

Rate and intensity of the cooling agent
Duration that modality is applied
Volume of treatment area
Thermal conductivity of the area (amount of adipose tissue)
Application techniques and methods of applying cold agents

17
Q

Thermal conductivity

A

Rate at which the tissue transfers heat by conduction and efficiency of tissue to conduct heat

18
Q

Tissue conductivity variation

A

Muscle has a high water content and conducts heat more efficiently than adipose tissue
Adipose tissue require longer exposure for the same effects

  • Damage to skin/tissue may occur before desired physiological effects are achieved
  • Patients with minimal adipose tissue may respond to cold application quicker with more systemic effects
19
Q

Changes in muscle cooling as compared to other tissues

A

Muscle temperature changes are more gradual than skin and superficial tissues

Intermittent cooling may allow muscle to reach lower temperatures while reducing damage to skin and tissue

20
Q

What does hypothermia or systematic cold injury occur?

A

Core body temperature decreases to 95 degrees F or less

21
Q

Frostbite

A

Direct tissue freezing leads to cellular ice crystal formation with cellular dehydration and microvascular occulsion after rewarming of tissues
Occurs when skin temperature drops below 24 F

22
Q

At what temperature will tissue damage occur

A

Can occur if tissue temperature is cooled to 59 F

23
Q

Analgesia

A

Absence of sensibility to pain leading to relief of pain without loss of consciousness
Occurs at approximately 80.6 degrees F in 10-20 minutes
Higher intensity application like ice massage require less time and should be discontinued with analgesia is reached

24
Q

Stages of perception of analgesia

A

Cold
Burning
Aching
Analgesia

25
Q

Application of cold for post-op patients

A

Less intense cold 3 to 4 times daily for 20-30 minutes in combination with compression and elevation

26
Q

Impact of cold on nerve conduction

A

Decreases nerve conduction velocity within 5 minutes of application
Cold applied for 5 minutes will take approximately 15 minutes to reverse the effect on nerves
20-minute application will take 30 minutes to reverse effect on nerves

27
Q

Hemodynamic effect of cold

A

Inhibits production of histamines and prostaglandins which leads to vasoconstriction
Decreased lymphatic and venous drainage
Decreased delivery of leukocytes and phagocytes
Blood viscosity thickens which decreased blood flow and decreases available oxygen to tissue
Edema decreases

28
Q

Impact of cold on metabolism

A

Metabolic rate decreases
Decreased inflammation

29
Q

Impact of cold on muscle

A

Decreased spasticity due to decrease in motor neuron activity may facilitate movement
Decreased local temperature
Decreased muscle excitability
Extreme anesthetic effect
Increased stiffness

30
Q

Application of cold for edema

A

Follow PRICE protocol
Apply cold to injured area for 20 to 30 minutes every 2 hour period for the first 6 to 24 hours after trauma

31
Q

Application of cold packs

A

Wrap cold pack in a thin towel or cover area with a paper towel
Bandage wraps or other elastic wraps can be used to hold cold pack in place
Monitor skin to prevent tissue damage

32
Q

Application of ice massage

A

Use to anesthetize a relatively small area or disrupt pain cycle of a trigger point
Position patient comfortably and drape area with towel to catch melting ice
Move ice in small, rhythmic circles with direct contact on the skin
Numbness generally occurs within a 3 to 10 minute time frame
Do not exceed 10 minutes

33
Q

Precautions for cold exposure

A

Exposure for longer than 20 minutes can lead to tissue damage or death
Extended application of cold may cause temporary or permanent nerve damage of changes in nerve conduction
When patient reports numbness, this indicates analgesia and removed protective sensation
- Caution from overuse or reinjury to area
Sensitivity to cold indicated by itching, hives, sweating, and development of wheals with reddened borders and blanched centers
Do not test for grip/pinch strength or fine motor manipulation after application of cold

Physical Agent Modalities (14 decks)

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