Cryotherapy Flashcards
What is cryotherapy used for in rehab settings (6)
- Control inflammation
- Control pain
- Control edema
- Reduce spasticity
- Control symptoms of MS
- Facilitate movement
What body systems does cryotherapy exert an effect on (3)
- Hemodynamic
- Neuromuscular
- Metabolic
What does cryotherapy cause in the hemodynamic system
Immediate vasoconstriction of blood vessels which causes a decrease in blood flow
How does cryotherapy cause vasoconstriction (4)
- Increases blood viscosity
- Decreases release of histamine and prostaglandins
- Smooth muscle contractions
- Increases sympathetic adrenergic activity
True or False:
Blood flow will increase when cryotherapy is applied eventually
True
Why does blood flow eventually increase
Due to vasodilation caused by the body trying to increase the temperature of the tissue to prevent death of the area
What is erythema
Reddening of the skin secondary to cold application
What causes erythema
Increase in oxyhemoglobin concentration in the blood
Which way does cryotherapy cause the oxygen hemoglobin dissociation curve to move
To the left
What are the 4 stages of cold
CBAN
What does CBAN stand for
Cold (intense)
Burning
Aching
Numbness
What does cryotherapy do to nerve conduction
Decreases nerve conduction velocity
How long does it take 5 minutes of cooling to be reversed
15 minutes
How long does it take 20 minutes of cooling to be reversed
30 minutes or more
Which type of fibers are most affected by cryotherapy
Myelinated and small diameter fibers
Which type of fibers are least affected by cryotherapy
Unmyelinated and large diameter fibers
What are the effects of cryotherapy on the neuromuscular system (4)
- Decreased nerve conduction velocity
- Increased pain threshold
- Altered muscle strength
- Facilitation of muscle contraction
How does cryotherapy increase pain threshold (3)
- Counter irritant via gate control
- Sensory NCV inhibition
- Reduced muscle spasm
True or False:
Isometric strength increases directly after 5 minutes of cooling
True
What happens to isometric strength after 30 minutes of cooling
Initially strength is decreased but after an hour it starts to increase to greater than precooling strength
How does cryotherapy decrease spasticity
Decreases gamma motor neuron, afferent spindle, and golgi tendon organ activity
How long does it take cryotherapy to reduce spasticity
10-30 minutes of cooling
How does brief application of cryotherapy facilitate muscle contraction
May stimulate alpha motor neurons in patients with upper motor neuron lesions for a few moments
What is the effect of cryotherapy on the metabolic system
Decrease metabolic rate
What does cryotherapy limit
Secondary injury
How does cryotherapy reduce secondary injury (2)
- Metabolically
2. Chemically
How does cryotherapy reduce secondary injury metabolically
Lowers the amount of oxygen needed to meet or be below that of the oxygen available which decreases metabolism
How does cryotherapy reduce secondary injury chemically
Decreases permeability which prevents leakage of protein rich fluid into tissue
What are indications for cryotherapy (7)
- Immediate care of musculoskeletal injuries
- Edema control
- Pain control
- Modification of spasticity
- Symptom management in MS
- Emergency care for small burns
- Limitations in ROM secondary to pain
What are contraindictions for cryotherapy (9)
- Impaired circulation
- Cold hypersensitivity
- Raynuad’s disease
- Hypertension
- Over regeneration of peripheral nerve
- Paroxysmal cold hemoglobinuria
- Cryoglobulinemia
- Decreased cold sensitivity
- Open wound after 40-72 hours
What is the maximum depth of penetration of cryotherapy
1 cm
What is an ice pack
Crushed ice in leak proof container generally around 30 F
What are commercial ice packs
Plastic filled with hydrated gel
What temperature are commercial ice packs stored at
0-12 F for 30 minutes minimum
What is more effective at lowering body temperature ice packs or commercial ice packs
Ice pack do to the phase change
What is ice massage
Application of cold by rubbing ice over a part of the body
What are cold baths/ice immersion
Placing a body part to be treated in water ranging from cold to icy temperature is varied
For ice immersion what is considered cool temperature
67-80 F (19-27 C)
For ice immersion what is considered cold temperature
55-67 F (13-19 C)
For ice immersion what is considered very cold temperature
32-55 F (0-13 C)
What are cryokinetics
Application of cryotherapy to a part so to numb the part prior to active exercise
What does a patient need to be able to distinguish between with cryokinetics (3)
- Pre-existing pain
- Ice induced pain
- Exercise induced pain
What is controlled cold compression
A nylon sleeve that connects via a tube to a one gallon cooler/jug in which cool water flows from cooler to sleeve
What is the temperature of the water in controlled cold compression
50-77 F
