Cryotherapy

Question 1

what is cryotherapy?

Answer 1

the therapeutic use of cold in rehab medicine

Question 2

what are some clinical indications for cryotherapy?

Answer 2

control inflammation + edema
control pain
reduce spasticity
control symptoms of MS
facilitate movement + ROM

Question 3

what domain of the ICF model does cryotherapy directly affect?

Answer 3

body structures and functions

Question 4

how does cryotherapy directly decrease the heat and edema associated with inflammation?

Answer 4

by decreasing the blood flow

Question 5

true or false: if the temperature of an area is elevated, the area is probably still inflamed and will benefit from cryotherapy

Answer 5

true

Question 6

how long does it take for tissue temperature to remain normal and all acute inflammation to resolve?

Answer 6

48-72 hours

Question 7

why is it important to be cautious of prolonged temperature?

Answer 7

local infection

Question 8

applying cryotherapy for how many minutes can control pain for 1 or more hours after treatment?

Answer 8

10-15 minutes

Question 9

how can the use of cryotherapy provide neuro physiological effects?

Answer 9

gates pain transmission by blocking cutaneous nociceptors (pain receptors) + decrease nerve velocity A-delta fibers (pain pathways)

Question 10

can the use of cryotherapy provide hemodynamic physiological effects

Answer 10

vasoconstriction: limits swelling and secondary pain

Question 11

what are some types/application techniques of cryotherapy?

Answer 11

cold pack
ice cup massage
controlled cold compression units
vapocoolant sprays
frozen wet towels
ice water bucket
contract baths
LAB

Question 12

what are cold packs?

Answer 12

gel composed of silica (or mixture of saline and gelatin) with a vinyl cover that conform to your body
stored in a cooling unit or freezer at -5 deg C (23 deg F)

Question 13

what are ice packs?

Answer 13

crushed ice placed in a plastic bag, offer more aggressive cooling than cold packs at the same temperature because of the higher specific heat of ice vs gel

Question 14

what is the proper application technique of cold packs?

Answer 14

10-20 minutes (no longer than 30 minutes) with application repeated every 1 to 2 hours

Question 15

why should cold packs not be placed longer than 30 minutes?

Answer 15

after 30 minutes, vasodilation occurs rather than vasoconstriction as a warming mechanism

Question 16

how does a controlled cold compression unit work?

Answer 16

pumps cold water and air into a sleeve that is wrapped around a patient’s body part + compression is applied intermittently inflating the sleeve with air

Question 17

when is a controlled cold compression unit most often used?

Answer 17

directly post surgery to control post op edema and inflammation

Question 18

true or false: a controlled cold compression unit is more effective than ice or compression alone in the reduction of reducing swelling and pain

Answer 18

true

Question 19

what stage of healing does a controlled compression unit affect?

Answer 19

proliferative phase
(assists patient in regaining ROM faster)

Question 20

what are some pros of ice cup massages?

Answer 20

cost effective and quick

Question 21

what are some cons of ice cup massages?

Answer 21

messy + water can cause infection

Question 22

what are some pros of ice water immersion/bucket?

Answer 22

full coverage of contact area (greater surface area)

Question 23

what are some cons of ice water immersion/bucket?

Answer 23

limited application locations (hand/wrist + foot/ankle)
tolerance issue

Question 24

why are vapocoolant sprays used?

Answer 24

used to achieve brief and rapid cutaneous cooling by evaporation to allow for stretch
USED PRIMARILY to reduce muscle spasms and desensitizing trigger points for athletes

Question 25

what are some pros of vapocoolant sprays for athletes?

Answer 25

can return an athlete quickly to the game to relieve acute pain or cramping sensation and allow stretching

Question 26

what are some cons of vapocoolant sprays?

Answer 26

chemicals are volatile, flammable, chlorofluorocarbon can damage the ozone layer, and can be dangerous if inhaled
do not frost skin, spray from a distance! and do not spray into open wounds!

Question 27

what is cryokinetics?

Answer 27

application of ice ASAP post injury til numbness
allows painfree exercise during period of numbness until sensation returns (3-5 minutes)
used frequently in athletics to minimize loss of playing time

Question 28

what is cryostretch?

Answer 28

vapocoolant spray used as a cooling agent

Question 29

what are some contraindications for using cryotherapy?

Answer 29

cold hypersensitivity
cold intolerance
cryoglobulinemia
paroxysmal cold hemoglobinuria
Raynaud’s disease
over a regenerative peripheral nerve or area of circulatory compromise

Question 30

what are some precautions for using cryotherapy?

Answer 30

over the superficial main branch of a nerve
over an open wound
hypertension: transient increases in BP
patients with poor sensation/mentation
very young or old patients

Question 31

what are some adverse effects of cryotherapy?

Answer 31

tissue death-prolonged vasoconstriction (frostbite)
nerve damage
unwanted vasodilation (distal extremities after 15 minutes of cryotherapy = cold induced vasodilation after 20 minutes)