Cryotherapy

Question 1

What is the cryostatic method?

Answer 1

A method of cooling tissues with a stationary application.

Question 2

What are the parameters of an ice pack application?

Answer 2

•  Temperature: 23-32ºF (-5 to 0ºC)  
•  Time: 20-30 mins 
•  Intermittent: better for reducing 
    edema or bleeding 
•  Insulation: No

Question 3

What are the parameters of a cold pack application?

Answer 3

• Temperature: 33-50ºF (1-10ºC) or below
• Time: 20-30 mins: 30 mins to avoid frostbite
• Insulation: Yes

Question 4

What are the parameters of an ice massage application?

Answer 4

• Temperature: 23-32ºF (-5 to 0ºC)
• Time: numbness or up to 30 mins
• Insulation: No
• 5 x 5 inch area
• Progress through stages
• End when numb or up to 15-30 mins
• Follow with: soft tissue procedure, exercise, manipulation

Question 5

What are the indications for ice massage?

Answer 5

• Numbness prior to manipulation/soft tissue procedure

* Muscle trauma with hemorrhage, inflammation, edema

Question 6

What are the contraindication for ice massage?

Answer 6

• History of frostbite in the treatment area
• Open wounds; bony areas without tissue insulation
• General Contraindications and Precautions

Question 7

What are the stages of ice massage?

Answer 7

• Cold: 1-3 mins
• Burning/aching: 4-7-mins
• Aching: 8-15 mins
• Numbness: 15-30 mins

Question 8

What are the parameters of an intermittent cold with stretch application?

Answer 8

• Temperature: 23-32ºF (-5 to 0ºC)
• Time: 20-30 mins: varies
• Insulation: No

Question 9

What is the procedure for an intermittent cold with stretch application?

Answer 9

• Position patient for stretch
• Apply Gebauer’s Instant Ice onto the skin overlying the
trigger point
• 18-24 in (46-60 cm) from the
skin surface
• Use sweeping stokes from:
• Origin to insertion
• Follow direction of muscle
fibers at 4 in/sec (10 cm/sec)
• Stretch the muscle containing trigger point
• Repeat procedure 3 to 4 times
• Apply hot pack to muscle after stretch for 5-15 mins
• After hot pack have patient contract involved muscle
against light resistance

Question 10

What are the indications for intermittent cold with stretch application?

Answer 10

• Myofascial trigger points
• Muscle spasm / muscle stretching
• Decreased joint range of motion

Question 11

What are the contraindications and precautions for intermittent cold with stretch application?

Answer 11

• Contact with eyes or delicate mucous membranes

* History of frostbite in treatment area

Question 12

What are the parameters of a contrast hot/cold application?

Answer 12

• Uses both superficial heat and cold in immediate
succession

• Usually reserved for contrast baths … but also effective
using hot packs and cold packs or other sources of
superficial heat and cold

Question 13

How does does Passive contrast hot/cold application effect tissues?

Answer 13

• Controversial Effects: “passive vascular exercise”
• Stimulates blood flow
• Reduces edema
• Promotes soft tissue healing
• Limited to peripheral blood vessels only

Question 14

How does does Active contrast hot/cold application effect tissues?

Answer 14

• Voluntary muscle contraction that produce joint
movements have been shown to have a therapeutic
vascular and lymphatic pumping action

Question 15

What does passive contrast hot/cold treat?

Answer 15

•  Subacute and chronic traumatic inflammatory conditions 
•  Transition from cold in acute to 
    heat in subacute-chronic 
•  Sinus and congestive headaches, 
    on feet or hands

Question 16

What does active contrast hot/cold treat?

Answer 16

• blood flow and edema: vascular and lymphatic pumping
  * Musculoskeletal conditions such as:
  * arthritis of peripheral joints
  * joint sprains
  * muscular strains
  * Impaired venous circulation and indolent ulcers

Question 17

What are the contraindications for passive and active contrast hot/cold treatments?

Answer 17

• Small vessel disease secondary to diabetes,
arteriosclerotic endarteritis or Buerger’s disease
• The risks of both heat and cold apply
• Edema is less likely to occur because of the cold cycle

Question 18

What are the indications for passive and active contrast hot/cold treatments?

Answer 18

• Patients who are not good judges of temperature sensation

* Very young or very old: thermoregulation problems

Question 19

What are the temperature ranges for therapeutic hot and cold applications?

Answer 19

• Hot: 104-107ºF (40-42ºC)

* Cold: 50-60ºF (10-15ºC)

Question 20

What is the most common used time interval for hot/cold applications?

Answer 20

Most common in the literature: 3:1 (20-30 mins)