Cryotherapy

Question 1

Physiological Effects

Answer 1

• Decrease metabolic rate (reduces tissue damage from secondary hypoxia and enzyme activity)
• Vasoconstriction and decreased blood flow
• Increased blood viscosity
• Stimulation of sensory nerves
• Reduced nerve conduction velocity

Question 1

Cryotherapy

Answer 1

To progressively decrease the subcutaneous temperature through local body cooling via the application of substance that results in transfer of heat away from the tissue

Question 2

Therapeutic Effects?

Answer 2

• Pain Relief
• Reduce inflammation and swelling
• Limits secondary tissue damage due to hypoxia
• Reduced muscle spasm due to reduced pain
• Increase range of motion due to reduction in swelling

Question 3

Contraindications/ precautions

Answer 3

• Circulatory insufficiency
• Existing conditions that could be exacerbated:
  Areas recently treated with radiotherapy
  Haemorrhagic disorders
  Severe organ states e.g. cardiac failure
  Skin conditions, open wounds, etc.
• Sensory loss
• Unable to communicate
• Hypersensitive patients (precaution)
• Angina (can be aggravated by cooling)

Question 4

Ice Burns

Answer 4

Mild: Characterised by erythema and skin tenderness a few hours after treatment.

Severe: Bruising and damage to neural tissue that can last for > 3 weeks.

Question 5

Ice Reaction Test

Answer 5

Test by either performing an ice cube massage for a minimum of 30 seconds OR
Apply an ice pack and examine local response under the pack after 5 minutes

Contraindication: excessive redness, swollen mark or a systemic reaction, including increased blood pressure or heart rate.

Question 6

Application: Immersion

Answer 6

• Temperature is controlled by varying the proportions of ice-to-water
• Water of 16-18°C can usually be tolerated for 15-20 minutes
  Lower temperatures (i.e. 5°C) require intermittent immersion usually around 1 minute

Question 6

Commercial cold packs/ ice packs Application

Answer 6

Need to be wrapped in a towel prior to application

Question 7

Ice Towels Application

Answer 7

Towels placed in a mixture of water/ice then wrung out. Repeated applications every 2-3 mins

Question 8

Cryocuffs Application

Answer 8

Ice/water mixture applied to the body via a sleeve that introduces simultaneous compression

Question 9

Ice massage Application

Answer 9

Ice is frozen into a cup for massage over a local area. Ice is kept moving over the body part

Question 10

Monitoring

Answer 10

Observe skin and ask patient regarding the temperature
* Be careful of superficial nerves
* Check for adverse reactions
At the start of Rx
After 5 minutes; then regularly
After Rx
* Adverse reactions include:
Excessive redness
swollen mark
systemic reaction (including increased blood pressure/ heart rate)
* Document and refer for medical Rx if required