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Physical Agent > Cryotherapy > Flashcards

Cryotherapy Flashcards

1
Q

what are the uses of cryotherapy?

A

Control inflammation
Reduce pain
Reduce edema
Reduce spasticity

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2
Q

what is the hemodynamic effect of cold?

A

initial decrease in blood flow

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3
Q

what is involved in the initial decrease in blood flow after cold is applied?

A
  • Vasoconstriction → contraction of smooth muscle in vessel walls
  • Decreased production of vasodilator mediators → Histamines & Prostaglandin
  • Increased sympathetic adrenergic activity
  • Vasoconstriction near & distal to cold application
  • Increase blood viscosity
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4
Q

what is involved in decreased capillary permeability after cold is applied?

A

Decreased fluid in interstitial space → can reduce any new edema

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5
Q

what is rebound vasodilation (Hunting Response)?

A
  • Reduce cold induced injury if cold for prolonged period (injure tissues)
  • Highly debated prob false
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6
Q

what does applying cryotherapy do nerve conduction ?

A

decreases it so when the area becomes numb & conduction can’t be brought to spinal cord

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7
Q

what effect do cooler temps have on sodium channels?

A

delayed inactivation of sodium channels & subsequently prolong the time of depolarization

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8
Q

what neurovascular within the body experience the greatest effect from applying cryotherapy?

A

Greatest effect on myelinated small fibers
A-Delta nociceptive fibers

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9
Q

what does cold have the smallest effect on within the body?

A

Smallest effect on large unmyelinated fibers

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10
Q

how does applying cryotherapy reduce pain & increase pain threshold?

A
  • Counter irritation via control theory (stopping nerve conduction)
  • Sensory nerve conduction slowing
  • Cold depresses the excitability of free nerve endings & peripheral nerve fibers → increasing the pain threshold
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11
Q

what occurs to muscle strength after cooling for a short period?

A
  • Immediate increase in isometric strength (cooling for 5 min or less)
  • Motor nerve excitability
  • Increased motivation
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12
Q

why is there a decrease in strength after prolong cooling?

A
  • Reduced blood flow to muscles
  • Slowing of motor nerve conduction velocity
  • Increased muscle viscosity
  • Increased joint or muscle stiffness
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13
Q

why is there decreased spasticity after applying cryotherapy?

A

Reduction in Gamma Motor Neuron Activity
Decreased muscle spindles activity & golgi tendon organs
Prolonged effects may last up to 30 min

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14
Q

how does cryotherapy decrease metabolic rate?

A
  • Decreased collagenase, elastase, hyaluronidase, protease & histamine w/ reduction in joint temp
  • Decreased rate of cellular oxidation (reduce inflammation)
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15
Q

how does cryotherapy control acute inflammation?

A
  • Decrease tissue temp slows rate of chemical reaction
  • Decrease blood flow via vasoconstriction
  • Increase blood viscosity
  • Decrease capillary permeability
    Reduces movement of fluid form capillary to interstitial tissues
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16
Q

how does cryotherapy control edema?

A

Reduces histamine (which is a vasodilator) this causes vasoconstriction

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17
Q

what is the gate control theory?

A

Activation of cutaneous thermal receptors which gate keep nociception at spinal cord

18
Q

how can the application of cold affect patients with motor neuron lesions?

A
  • Application of cold for 5 minutes can decrease DTR/MSR
  • Application of cold for 15-30 min can decrease resistance to stretch making it easier to participate in functional activities
19
Q

what is cryokinetics?

A

Application of a cooling agent to reduce pain & allow exercise & ROM ASAP

20
Q

what is cryostretch?

A

Apply cold to reduce muscle spasm, allowing greater increase in ROM w/ stretching

21
Q

what are the contradictions to cryotherapy?

A

Cold Hypersensitive (Cold induced ulcers)
Cold Intolerance
Cryoglobulinemia
Paroxysmal Cold Hemoglobinuria
Reynaurd’s Disease/ Phenomena
Regenerating Peripheral Nerver
Area w/ impaired sensation
Area w/ compromised circulation or Peripheral Vascular Disease

22
Q

why is one with cold hypersensitive be a contradiction?

A

Vascular skin reaction to cryotherapy
Smooth elevated patches which are more red or pale than surrounding tissue
Often very itchy
May be local or widespread

23
Q

what is cryoglobulinemia?

A
  • Aggravation or serum proteins in distal circulation when distal extremity is cooled
  • Proteins can form gel which can impair circulation & result in ischemia
24
Q

why is paroxysmal cold hemoglobinuria a contradiction to cold?

A
  • Hemoglobin from RBS is released into urine in response to exposure ti cold
  • Often seen in patients w/ Autoimmune Hemolytic Anemia
25
Q

why is it dangerous to apply cryotherapy to someone w/ Regenerating peripheral nerves or over area w/ impaired sensation?

A

May delay nerve regeneration
Can not tell you if they are getting too cold

26
Q

what is a precaution to cryotherapy?

A

Over main branch of nerve
Over an open wound
Hypertension
Poor sensation or mentation
Very young or very old patients

27
Q

what are some adverse effects of cryotherapy?

A
  • Cold Induced Urticaria
  • Tissue death
  • Nerve damage
28
Q

what should a patient expect during cryotherapy?

A

Cold → cold sensation (occurs withing 3 min)
Burning → burning sensation (occurs b/w 2-7 min)
Aching → Aching sensation (occurs b/w 2-7 min)
Numb → Local Numbness or analgesia (occurs b/w 5-12 min)

29
Q

what are the parameters for cryotherapy?

A

10-20 min

30
Q

what are the advantages to ice pack/cold pack?

A

Easy to use
Inexpensive
Low Level of skill required
Covers moderate to large area
Can be applied to elevated limb

31
Q

what are the disadvantage to ice pack/cold pack?

A

Must be removed from area to inspect skin
Can be heavy & pt may not tolerate resting weight
May be difficult to contour along small areas

32
Q

what are the advantages to ice cup/ ice massage?

A

Treatment area can be observed during application
Good for small & or irregular areas
Short duration
Inexpensive
Can apply to elevated limb

33
Q

what are the disadvantages to ice cups/ ice massage?

A

Time consuming for large area
Active participation required (time consuming)

34
Q

what is a cold compression unit commonly used for?

A

control edema & inflammation

35
Q

when is cold immersion indicated?

A

acute & subacute conditions when you want to exercise during treatment

36
Q

what is the general procedure for cryotherapy?

A

Determine which cryotherapy to use
Intro
Explain procedure & reason (relate to function)
Expectations:
CBAN
Decrease in pain/inflammation/spasticity
Possible adverse reactions
Screen for contraindications
Much will come from records
May have to do sensation testing
Inspect area to be treated
Have pt remove jewelry & clothes from area
Check sensation (hot/cold)

37
Q

what is the procedure for cold pack/ Ice pack?

A

Wrap cold pack or ice pack in a towel (can use pillowcase over cold pack)
Position patient comfortably & elevate area if edema is present
Apply cold pack to area to be treated → be sure to secure w/ wrap or bandage to make sure it is in good contact
Provide pt w/ call bell & timer
Check skin after 5 min to ensure no adverse event
If apply for 30 min, check every 10 min after initial 5 min check
Check again at end to note any adverse reactions
Interventions

38
Q

what is the procedure for ice massage?

A

Place towel around treatment area to absorb any dripping water
Continue ice massage for 5-10 min or until numb
Check treatment area for any adverse reactions
Intervention

39
Q

what is the procedure for cold compression?

A

Cover limb w/ stocking or towel
Wrap sleeve around an area to be treated
Elevate treatment area above heart

40
Q

what is the procedure for cold whirlpool?

A
  • Turn on turbine, adjust aeration, agitation & direction of the water being pumped
  • Instruct pt to keep away from all parts
  • Pad edge of tank w/ toweling, warn patient that water is cold, then put body part in water
  • Check patient’s response verbally & visually about every 2 min. Remind them to tell you if area starts hurting or if sensation is lost
41
Q

what is the documentation for cryotherapy?

A

Area
Type of cryotherapy
Treatment duration
Patient positioning
Response
Intervention / parameters

Physical Agent (10 decks)

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