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cryotherapy Flashcards

1
Q

what is cryotherapy

A

the therapeutic application of any material or substance that results in WITHDRAWAL of HEAT from the body,

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2
Q

Withdrawal of heat from the body causes

A

lowering tissue temp locally and, under some specific applications, the whole-body core temp.

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3
Q

modes of heat transfer

A

conduction
convection
evaporation

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4
Q

What are considerations with application

A
  • type of agent
  • method of delivery
  • dosimetry
  • precautions/ contraindications
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5
Q

What are types of cryotherapy

A

ice packs, ice cups, gel packs, chemical packs, cyropressure units/cryocuff, vapocoolant sprays, cryohydrotherapy, cooling suits

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6
Q

indications for cryotherapy

A

abnormal tone, acute or chronic pain, acute or subacute inflammation, bursitis, muscle spasm, musculoskeletal trauma, myofascial trigger points, tendonitis, tenosynovitis

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7
Q

local skin temperature is used to what?

A

estimate stage of healing and use of cold

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8
Q

If skin temp. elevated equals what

A

use of cold

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9
Q

normal skin temp equals

A

cold discontinued to prevent impeding healing process/ impair circulation

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10
Q

If the skin temp is elevated greater then 72 hour what should you suspect

A

infection… refer to MD

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11
Q

uses of cryotherapy

A
  • inflammtion control
  • edema control
  • pain control
  • modification of spasticity- prolonged icing
  • symptom management in MS- cooling vest
  • facilitation
  • cryokinetics and cryostretch
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12
Q

Applying cold immediately after injury or during acute inflammatory phase of healing to control what?

A

bleeding
edema
pain
accelerate recovery

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13
Q

Applied after clotting has occurred and therefore has no effect on what ?

A

hemorrhaging

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14
Q

can limit and reduce edema formation if applied soon after injury (<5 min) occurs by?

A

slowing of metabolic rate and decrease secondary tissue damage

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15
Q

if provided later than 5 mins post trauma the effect on inflammatory process is

A

no effect

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16
Q

if provided later than 5 mins post trauma the effect are

A

counterirritant and antispasmotic agent

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17
Q

how is cryotherapy a counterirritant ?

A
  • increased cold receptor activity
  • decrease nerve conduction velocity
  • decreased pain
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18
Q

how is cryotherapy a antispasmotic agent

A
  • decreased gamma motoneuron activity
  • decreased muscle spindle activity
  • decreased spasm/spasticity
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19
Q

what are the causes of warmth and redness

A

inflammation

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20
Q

causes of coolness & pallor

A

poor circulation

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21
Q

how to control edema with cryotherapy?

A
  • cold for 15 mins (20 on extremities)

- applications at least an hour away

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22
Q

edema control with acute inflammation includes

A

RICE

compression with elastic wrap & elevation above heart

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23
Q

decrease in tissue temp by cryotherapy can indirectly/directly do what

A

decrease sensation of pain

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24
Q

CT directly & rapidly modifies sensation of pain by

A

gating pain transmission through activity of cutaneous thermal receptors producing analgesic effect

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25
used in conjunction with joint mobs to
reduce possibility of pain and swelling
26
used in conjunction with deep friction massage before and after to
reduce pain and irritation
27
used in conjunction with electrical
stimulation
28
used in conjunction with exercise to
decrease residual swelling
29
used in conjunction with RICE to
decrease swelling
30
hemodynamic effects of cold
initial decrease in bold flow
31
Neuromuscular effects of cold
- decreased nerve conduction velocity - increased pain threshold - altered muscle strength - decreased spasticity - facilitation of muscle contraction
32
metabolic effect of cold
decreased metabolism & enzyme activity
33
during hemodynamic, cold causes activation of cutaneous cold receptors by directly stimulating ?
smooth muscle of the blood vessel walls to contract
34
hemodynamic triggers reflex activation/depolarization of
sympathetic adrenergic nerve fibers
35
hemodynamic leads to the release of neurotransmitter
norepinephrine, on the adrenergic receptors of smooth muscles surrounding blood vessels
36
during hemodynamic there is a decrease in production of
vasodilator mediators (histamine & prostaglandin)
37
during hemodynamic, cold causes a decrease in
cell metabolism
38
Cold induced vasodilation
initial decrease in blood flow, later increase in blood flow
39
during hemodynamic there a decreased in what after trauma/injury
secondary cell hypoxia
40
during hemodynamic cold causes an increase or decrease in blood viscosity
increase
41
how is there an increase in blood viscosity during hemodynamic
-reduced flow protects other areas from excessive decreases in temp and stabilizes core body temp
42
effects of neuromuscular causes a decrease in
NCV in proportion to degree and duration of temp changes
43
Therapeutic effect of neuromuscular
- decrease in NCV - Elevation of pain threshold - decrease in apsticity - change in muscle force generation
44
neuromuscular causes elevation of pain threshold by
- decrease sensation of pain | - stim of cold receptors: increased sensory input blood stimuli to brain cortex
45
neuromuscular can cause counter irritation via the gating control mechanism and interrupts what
pain-spasm- pain cycle and decreases muscle spasm, sensory NCV, edema
46
neuromuscular decreases spasticity by
a reflex reaction to stimulation of cutaneous cold receptors
47
neuromuscular decreases spasticity initially by
decrease in gamma motor neuron activity
48
neuromuscular decreases spasticity later by
decrease in afferent spindle and golgi tendon organ activity
49
neuromuscular change in muscle force generation with ice massage <5 min increases in
isometric strength
50
neuromuscular change in muscle force generation with cooling 30+ mins by initial decrease in
isometric force for 1 hour and then increase for > 3 hours to greater than pre-cooling strength
51
strength testing should be performed when to cryotherapy ?
before application
52
Brief application of cold (few seconds) causes
facilitation of muscle contraction
53
Cold facilitates Alpha motor neuron activity to produce
contraction in flaccid muscle which is a result of an upper motor neuron dysfunction
54
Metabolic effects of cold decrease
in rate of all metabolic activities, including those involved in inflammation and healing
55
Should CT be considered for OA and RA
yes
56
During RA, cold decreased what
histamine in blood
57
at joint temp <86, there is a decrease in
activity in cartilage degrading enzymes
58
Cartilage degrading enzymes include
- collagenase - Elastase - Hyaluronidase - protease
59
causes of the primary effects of cooling effects
- vasocontriction - Increase cold receptor activity - Decreased gamma motor neuron activity
60
causes of vasoconstriction
- decreases swelling | - decreases nerve compression via reduction in edema formation
61
causes of increased cold receptor activity
- decrease pain | - aids in decreasing spasticity
62
causes decreased gamma motor neuron activity
decreases spasm/ spasticity
63
Contraindication of cryotherapy
- cold allergy/ hypersensitivity aka cold urticaria - cold intolerance - raynaud's disease/ phenomenon - cryoglobulinemia - paroxysmal cold hemoglobinuria - over regenerating peripheral nerves - over areas of circulatory compromise or PVD - Inability ot discriminate cold
64
Raynaud's disease/ phenomenon
vessels already in chronic state of vasoconstriction/ vasospasm; further application can lead to ischemic necrosis
65
Cryoglobulinemia
aggregation of serum proteins in small distal vessels after cold applications that can impair circulation and cause gangrene
66
Paroxysmal cold hemoglobinuria can be signaled by
blood in urine
67
multiple sclerosis is aggravated by
generalized heating (warm environments/ activities)
68
peripheral cooling for MS
decreases tremor
69
cooling vests for MS improve what and reduce what
improve: strength, visual function, postural stability reduce: fatigue
70
what demonstrated as much importance as use of cryotherapy in IMMEDIATE post ACL reconstruction edema control
compression
71
what demonstrated a significantly lower tissue temperature than ice pack
ice massage
72
lower temperature was seen in a shorter period of time with what over an ice pack
ice massage
73
What are expected physiological response to cryotherapy
- short term skin redness - anesthesia - analgesia
74
Typical sequence of sensation to CT
- intense cold - burning - aching - analgesia - numbness
75
Precautions
- over superficial main branch of nerves - hypertension - very young/old pt - poor sensation or mentation - over open wound - use of vapocoolant sprays- may be inflammable or harmful to ozone layer
76
Adverse effects of cryotherapy
tissue death or dame
77
temp of tissue damage
<15C (59 F)
78
temp of freezing/frostbite
4 to 10 C (39 to 50 F)
79
optimum mins of cryotherapy to achieve vasoconstriction
10-20
80
documentation of cryotherapy include
- area treated - cooling agent - treatment duration - Patient positioning - response to intervention

exam and Intervention II (6 decks)

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