Exam 2: Cryotherapy and Thermotherapy Flashcards
What are the neuromuscular effects of cryotherapy
Elevates pain threshold and decreases sensation of pain Temporarily decreases spasticity and spasms Facilitates contraction in flaccid muscles
Neuromuscular Effects- Cold modalities elevate pain threshold and decrease sensation of pain due to the ______ mechanism and the slowing of ____ conduction velocity
gaiting, nerve
Neuromuscular Effects- Cold modalities temporarily decreases spasticity because _____ cooling can provide a window of 60-90 minutes for therapeutic activities
prolonged
Neuromuscular Effects- Cold modalities facilitates contraction in flaccid muscles but only a few _____ of cooling is appropriate. “____ ____” is not commonly used
seconds; quick icing
What are the metabolic effects of cold
Cold decreases local metabolic rate and can therefore slow inflammatory activity
What are the four main indications for the use of cryotherapy
inflammation, facilitation, acute edema, and pain control
When we use cryotherapy for pain control, what fibers are being blocked?
A delta
What are other general indications for cryotherapy
Symptom management of MS, spasticity, and crytokinetics/cryostretch
When you apply cryotherapy, what should you tell the patient to expect to feel
intense cold, burning, aching, and numbness
What are the advantages of cold/ice packs
Easy to use, inexpensive, time saver for PT, little skill needed, covers small and larger areas, can be applied to elevated limbs
What are the disadvantages of cold/ice packs
Pack is blocking the view of treatment area, packs may be too heavy, bad contact with contoured areas, longer time treatment than ice cup massage
Ice cup massages are used for (indirect/direct) contact with patients skin by making (small/large) overlapping circles for ______ minutes.
direct, small, 5-10
Controlled compression units are commonly used after _____ because they relieve pain, swelling, and blood loss. They also help the patient gain back ____
surgery, ROM
What temperature should controlled compression units be set at
10-15 degrees C 50-59 degrees F
If compression units are used intermittently, how often should the modality be applied
15 minutes every two hours
What two chemicals are vapocoolant sprays made from
ethyl chloride and fluori-methane
Vapocoolant sprays are often used to treat ____ __
trigger points
Vapocoolant sprays are applied in (parallel/perpendicular) strokes over affected muscles followed by (stretching/strengthening) of muscles
parallel and stretching
What are the contraindications for the use of cryotherapy
Cold hypersensitivity, cold intolerance, cryoglobulinemia, paraoxysmal cold cryoglobinuria, raynauds disease, over a regenerating peripheral nerve, or circulatory compromise
What is another term for cold hypersensitivity
cold-induced urticaria or hives
Which term is defined as precipitated/congealed blood proteins that impair circulation
cryoglobulinemia
What is the term used to describe hemoglobin from lysed RBCs shows up in urine
paraoxysmal cold cryoglobinuria
What are precautions of using cold modalities
over superficial nerves, over an open wound, hypertension, poor sensation/mentation, very young or very old patients
True or False: Therapeutic Heat is only superficial
False it can be deep too
What is the temperature range for therapeutic heat
40-45 degrees C 104-113 degrees F
(lower/upper) limit of temperature for therapeutic heat involves average basal metabolism
lower
(lower/upper) limit of temperature for therapeutic heat involves tissue damage
upper
_____ ____ is a heat modality that is only capable of raising the temperature of skin and superficial subcutaneous tissues
superficial heat
Superficial heat raises skin tissues about ___ degrees, raises tissue 1 cm deep ___ degrees, and raises tissue 2 cm deep ___ degrees
18 6 2
Is superficial heat dry or moist?
It can be both
Deep-heating agents increase the temperature of muscles and periarticular structures reaching depths of ____ cm
5
Heat is (never/sometimes/always) transferred from higher to lower temperatures
always
When applying cryotherapy/cold pack to a patient, does the temperature move from the cold pack to the patient or the patient to the cold pack?
It moves from the patient to the cold pack, so the cold pack is drawing heat out of the tissue
What are the four modes of heat transfer
convection, radiation, conversion, conduction
Which mode of heat is transferred by direct contact between a circulating medium and another material of a different temperature
convection
A whirlpool is an example of which mode of heat transfer
convection
Which mode of heat is the transfer of energy from one material to another without another intervening medium or contact
Radiation
An infrared lamp is an example of which mode of heat transfer
radiation
Which mode of heat transfer involves the conversion of a nonthermal form of energy into heat
Conversion
Ultrasound or mechanical energy is an example of which mode of heat transfer
conversion
Which mode of heat transfer results when two different materials of different temperatures in contact with each other transfer energy by direct collision of their molecules
conduction
Hot packs and paraffin are examples of what mode of heat transfer
conduction
What are the 4 general effects of thermotherapy
Hemodynamic Neuromuscular Increased metabolic rate Increased tissue extensibility
The hemodynamic effects of thermotherapy cause _____
vasodilation
The neuromuscular effects of thermotherapy involves 1. changes in nerve conduction ____ and ___ rate 2. ____ pain threshold 3. changes is muscle ____
velocity and firing increased strength
What are the indications of thermotherapy/superficial heat
muscle spasms, joint stiffness, pain
What are the contraindications of thermotherapy
hemorrhage, thrombus, impaired sensation & mentation, malignancy
What are precautions of thermotherpay
inflammation pregnancy impaired circulation metal open wounds
Burns, fainting, bleeding, and skin/eye damage from IR are all _____ ____ of thermotherapy
adverse effects
What should we look for when checking for histological changes (burn potential)
mottled skin, severe redness, blisters
How many layers of towels should a hot pack be wrapped in?
6-8 or equivalent
Check on a patient __ minutes after applying a hot pack to inspect the area and remove the hot pack completely after ___ minutes
5; 15
paraffin, infrared lamps, and fluidotherapy are all other examples of _____
superficial heating agents
What are the effects of cryotherapy and thermotherapy on pain
Both decrease
What are the effects of cryotherapy and thermotherapy on muscle spasm
both decrease
What are the effects of cryotherapy and thermotherapy on blood flow
cryotherapy decreases it and thermotherapy increases it
What are the effects of cryotherapy and thermotherapy on edema formation
c: decreases T: increases
What are the effects of cryotherapy and thermotherapy on nerve conduction velocity
C: decrease T: increase
What are the effects of cryotherapy and thermotherapy on metabolic rate
C: decrease T: increase
What type are the effects of cryotherapy and thermotherapy on collagen extensibility
C: decrease T: increase
What type are the effects of cryotherapy and thermotherapy on joint stiffness
C: increase T: decrease
What type are the effects of cryotherapy and thermotherapy on spasticity
C: decrease T: no effect
______ is the therapeutic application of any material or substance that results in withdrawal of heat from the body which lowers tissue temperature locally, and in some instances the whole body core temperature
cryotherapy
what are some materials or substances used to accomplish cryotherapy
Cold pack, ice cup, cold compression unity, vapocoolant sprays, ice water
Hemodynamic effects of cold- Immediate _____ which reduces local blood flow. Reduced vasodilator mediators like _____ and prostaglandin. Reduced _____ rate by increased blood viscosity
vasoconstriction, histamine, circulatory
What is another name for the hunting response
cold-induced vasodilation (CIVD)
How long do you leave the application of a cold pack on a patient before the effects are no longer significant
15-20 minutes
what is the term that describes a reflexive vasodilation of blood vessels and an associated increase in tissue temperature after 15-20 minutes of cooling
Hunting’s response or cold induced vasodilation
true or false: The hunting response or CIVD is more likely to occur in proximal extremities
False, it is more likely in distal extremities
Application of cold should normally not exceed ____ minutes
15-20
What is the increased redness of skin seen wit the application of cold due to?
an increase in oxyhemoglobin in the blood