Cryotherapy Flashcards
In cryotherapy, heat transfer occurs through which mode
Conduction
Cryo is a Greek word meaning
Cold
What is cryotherapy
The practice of using cold for therapeutic purposes
The use of superficial cryo- agents and to lower soft tissue temperature and reduce swelling
What is Cryo- kinetics
Therapeutic application of cold combined with exercise
Cryotherapy is also known as
Ice application 
Cryotherapy cools the surface by:
Withdrawing heat and NOT by adding cold
(2nd law of thermodynamics)
Cryotherapy’s worldwide usage and spread is due to its
Effectiveness, convenience, easy application, and low cost
Cold therapy can be administered in 3 physical states of matter
Gaseous (spray)
Liquid (cold bath)
Solid (ice pack or ice cubes)
Almost all cryo-agents transfer heat through conduction except
Vapocoolant spray
Thermoconductivity of fat, skin, muscle
Fat K=0.45
Skin K=0.21
Muscle K=0.42
Subject to change according to environment
Ice is believed to control pain by:
-Promoting local anesthesia
- decreases edema
- Decreases nerve conduction velocities
- decreases cellular metabolism
- Decreases local blood flow
Ice is believed to control pain by
Promoting local anesthesia by:
Decreasing edema, nerve conduction velocity‘s, cellular metabolism, and local blood flow which promotes pain relief
The effect of cryotherapy depends on:
The method
the duration
temperature of the ice
depth of a subcutaneous fat
Methods of application for cryotherapy
Where is ice massage applied to
Small body area
Purpose of ice massage
Facilitate muscle activity
Ice massage treatment time
5-10 minutes until area is numb
What is being applied in ice massage
Ice lollipop
Ice cube wrapped in a towel
Ice massage is applied in ______________ motion
Circular
Structure of the ice pack
Semi-gel substance (silica usually) on the inside covered by a durable plastic layer
How is the ice pack applied
Directly to the skin wrapped with a wet towel
average treatment time for ice pack
10-20 minutes
Not advisable to place ice pack UNDER the treated area. Why?
Excessive cooling and local ischemia
Describe the rate of cooling for ice packs
The rate of initial cooling is rapid but decreases as a film of water forms between the pack and the skin
Why is there a damp towel placed between the skin and the ice pack
Ensure that the contact temperature remains at about zero Celsius
What are ice baths applied for
Extremities
What are ice baths
Immersion in water that contains ice cubes
Therapeutic temperature of ice baths
10 to 15°C
Treatment time of ice baths
15 to 20 minutes
What are ice towels applied for
Large body areas to lower the temperature
What are ice towels
Towels that are placed into flaked ice and water and then applied on the area
Treatment time for ice towels and replacement time
Applied for around 20 minutes and replaced every 2 to 3 minutes as it warms up rapidly
Disadvantage of ice towels
Warms up rapidly
Advantage of ice towels
Good for irregular shape
Patient can perform exercises while the treatment is on
Evaporating sprays offer what kind of cooling
Superficial, very rapid cooling through evaporation
True or false
There is no temperature change below the epidermis when using the evaporating sprays
True
When are Evaporating sprays are effective
Myofascial pain
How is the area sprayed using evaporating sprays
Area is sprayed in short strokes of five seconds, with few seconds in between
The nozzle is usually held 45 cm from the skin in a right angle
Physiological effects of cooling
What are the cooling effects
How does cooling affect Cell activity
Slow down chemical processes and enzymatic activity
Decreased metabolic rate
Decreased oxygen demand
Limit cell death due to hypoxia
How does cooling affect blood flow
-Immediate vasoconstriction to prevent heat loss
-Reduce water leaks into interstitial space
-Aggregation of platelets & red blood cells; formation of occlusion masses
-simulation of thermal receptors
- Change in activity of precapillary sphincter’s
How does cooling effect collagen
Becomes stiffer
True or false
Cryotherapy is better than heat therapy if you want to increase collagen extensibility
False
The opposite
How does cooling effect neurological changes
Muscle spindle sensitivity drops as a result of decreasing firing rate
Inhibition in the excitatory stimuli in the Anterior horn in spinal cord
Immediate and temporary increase in muscle tone due to the excitation of motor neurons
In case of muscle spasticity, ice cubes are used before exercise to
Decrease hypertonicity that with movement may cause fracture
How does cooling cause pain relief
Increases pain threshold
Stimulates alpha – Delta fibers to reduce the number and velocity of nerve impulses
Release of endorphine and encephalis 
How does cooling affect muscle performance
Break pain/spasm cycle
Reduced pain leads to increased ROM
Reduction in metabolism rate
Improvement in performance after one hour of applying ice
What is pain/spasm cycle
How does cooling reduce muscle spasticity
Decrease activity of deep tendon reflex
Diminished gamma motor neuron activity and reduce muscle spindle discharge thus reducing spasticity
Reduce clonus
Ice cube stroking enhance motor unit activity
How does cooling affect tissue healing
How does cooling reduce injuries
How does cooling reduce edema
Vasoconstriction
Changes in vascular wall permeability
Inhibits fluid accumulation in interstitial space
What gives the best outcome for acute injury in cryotherapy
What is Lewis Hunting reaction
Cold induced vasodilation
Stages of body response to cold therapy
Body response to cold depends on
Therapeutic uses of cryotherapy
Make sure you understand this diagram

Treatment guidelines
Contraindications to cryotherapy application

Adverse effects of cryotherapy to watch out for
Erythema/excessive redness
Cold induced nerve palsy (nerve damage)
Systemic reaction (Increase blood pressure and heart rate)
Tenderness a few hours after application
Bruises that last up to three weeks
What is skin erythema
The skin is red and bright in color (Blood tends to hold on oxygen, more oxyhemoglobin)
Heat or cold
Acute inflammation
Cold
Heat or cold
Chronic inflammation
Heat
Heat or cold
Edema/swelling
Cold
Heat or cold
Pain
Both
Heat or cold
Spasm
Both, cold better
Heat or cold
Area treated around the hip
Heat because patients don’t prefer cold on that area
