Cryotherapy

Question 1

What is cryotherapy?

Answer 1

application of any substance to the body that removes heat from the body, resulting in decreased tissue temperature

Question 2

What are the effects of cryotherapy?

Answer 2

1) Hemodynamic
2) Metabolic
3) Neuromuscular

Question 3

What are the hemodynamic effects of cryotherapy?

Answer 3

vasoconstriction if applied <15-20min. If repeating after initial 20 min, 2 reps of 10min on 10 min off lowers blood flow significantly more than a single 20 min on.

Question 4

What are the metabolic effects of cryotherapy?

Answer 4

decreased rate of all metabolic reactions (inflammation, healing).
NOT RECOMMENDED WHEN HEALING IS DELAYED because it may further impair recovery

Question 5

What are the neuromuscular effects of cryotherapy?

Answer 5

decreases nerve conduction velocity
increases pain threshold
alters muscle strength 
decreases spasticity 
facilitates muscle contraction

Question 6

Ice massage vs Ice pack vs Cold whilrlpool?

Answer 6

ice massage cools muscle faster than an icepack.

ice pack and cold whirlpool for 20 min decreased muscle temperature at the same rate.

Question 7

Will addition of compression help with swelling?

Answer 7

24 hours after injury: compression > ice water > ice pack

4 days after injury: compression = ice water> ice pack

Question 8

how to apply a cold pack

Answer 8

inexpensive
use a moist towel between the pack and the skin surface
secure with a strap so the area is well supported 15 min.

Question 9

how to apply ice message

Answer 9

utilize for small areas
the ice is rubbed over skin using small overlapping circles
10x15cm area = 5-10min
cold, burning, aching, analgesia

Question 10

how to apply cold baths

Answer 10

ensures circumferential contact
10-18 degrees C
lower temp = shorter duration

Question 11

vapocoolant spray

Answer 11

trigger points
locate treatment area
position pt comfortably
maintain muscle stretch unidirectional

Question 12

controlled-cold compression units

Answer 12

can be adjusted to select temperatures

Question 13

Guidelines for Cryotherapy

Answer 13

• cold packs in freezer for at least 2 hours before initial use and for 30 min between uses.
• assess patient (especially sensation) test skin for hypersensitivity
• establish a POC with goals, if a modality is chosen then choose the appropriate application
• pt should be positioned for comfort for the entire treatment
• use a thin wet or dry towel for skin protection
• administered 10-30min
• reassess to see if it was effective
• avoid stressing the injured site for 1-2 hours following treatment

Question 14

What factures influence response to cold therapy?

Answer 14

• temperature difference between objects
• time of exposure
• thermal conductivity
• type and size of cooling agent
• activity level
• ability of cooling agent to maintain its temperature

Question 15

Contraindications to cryotherapy

Answer 15

• cold hypersensitivity (usual responses to cold? get a rash when cold? sever pain, numbness, and color changes in your fingers when exposed to cold?) (uticaria, cryoglobulinemia, raynaud’s disease or phenomenon)
• over areas of compromised circulation or PVD
• over regenerating peripheral nerves (any nerve damage in this area? and numbness or tingling?)
• paroxysmal cold hemoglobininuria (blood in your urine after being cold?)

Question 16

precautions

Answer 16

• over superficial peripheral nerves
• over open wound
• HTN
• poor sensation or mentation
• very young or very old

Question 17

using cryotherapy for acute inflammation

Answer 17

• if applied 1st 2 days will reduce pain and edema and shorten recovery time
• sooner applied = greater potential benefit
• local skin temp used to estimate healing and indicate cryotherapy
• elevated tmp –> still inflammed –> use cryo
• normal –> inflammation resolved –> D/C cryo
• acute inflammation not resolved within 48-72 hours –> could be infected. refer to physician –> once resolved, stop cryo to avoid impeding healing process

Question 18

using cryotherapy for edema control

Answer 18

• should be applied as soon as possible after acute trauma
• is most effective if applied with compression and elevation
• not effective for controlling edema by immobility and poor circulation- here compression, elevation, heat, exercise, and message