Heat Modalities

Question 1

Superficial heating agents

Answer 1

Hot packs
Paraffin
Fluidotherapy
Warm Whirlpool
**Conduction or Convection**
heats skin and underlying tissue to depths of < 2cm

Question 2

Deep Heating agents

Answer 2

US
Diathermy
Conversion
heats tissue b/w 2-5 cm in depth

Question 3

Thermotherapy

Answer 3

application of therapeutic heat to the body

Question 4

What happens with each 1.8 F rise in skin temp

Answer 4

cellular metabolic rate increases ~13%

increases cells demand for O2—more nutrients available for heating

Question 5

What happens if you use heat too soon?

Answer 5

can cause cell damage due to hypoxia- demands oxygen on already suffocating cells

Question 6

Vascular Effects

Answer 6

vasodilation of skin blood vessels
increased delivery oxygen
increased delivery of WBCs
increased delivery of chemical mediators 
increased capillary permeability
increased lymphatic/venous return
increased removal of metabolic waste

Question 7

What two things cause vasodilation?

Answer 7

Histamine

Prostaglandins

Question 8

What does heat do for pain?

Answer 8

increase analgesia of sensory nerves
decreases pain
gate control theory

Question 9

What does heat do for muscle spasm?

Answer 9

decreases muscle spasm
decreases muscle spindle sensitivity
increases delivery of oxygen to area

Question 10

What does heat do for inflammation and nerve conduction velocity?

Answer 10

increase inflammation
increase NCV
increased activity of A-delta

Question 11

Principles of HEAT

Answer 11

Muscle spasm and tissue elasticity

• most muscular tissue not significantly heated by superficial agents
• extensibility of collagen increased along with plasticity of and deformation capabilities of other tissues

Question 12

Key points to Heating

Answer 12

during first 5 minutes, a rapid increase in skin temp. occurs due to skin absorbing heat from hot pack by conduction
after 7-10=gradient evens out–may lose warmth
after 20 min=treatment at constant intensity

Question 13

Rebound Vasoconstriction

Answer 13

vessels which were maximally vasodilated begin to constrict–body’s response to save the underlying tissue by sacrificing the superficial layers which may end in burns

Question 14

Mottling

Answer 14

warning sign that skin temperature are increased too quickly

Question 15

Indications of superficial heat

Answer 15

subacute and chronic inflammation/pain/muscle spasm
decreased ROM
reduction in jt contractures
hematoma resolution

Question 16

Contraindications of superficial heat

Answer 16

acute injuries
impaired circulation
poor thermal regulation
infection

Question 17

Dry heat

Answer 17

heating pad

does not increase skin temp as rapidly

Question 18

Moist heat packs

Answer 18

used on localized areas that cant be treated in water
not as effective over irregular areas
more comfortable than dry heat
burns less likely than dry heat
temp range= 160-170 F

Question 19

Moist heat packs are what kind of modality

Answer 19

superficial heat modality
transfer heat via conduction to overlying tissue
can maintain heat level 30-45 min max at 15

Question 20

indications of heat packs

Answer 20

sub-acute or chronic inflammatory
reduction of sub-acute or chronic pain
decrease ROM
hematoma resolution
reduction of jt contractures

Question 21

contraindications of heat packs

Answer 21

acute conditions
PVD
impaired circulation
poor thermal regulation
impaired sensation
impaired cognition

Question 22

Warm Whirlpools

Answer 22

in cold, greater the area the warmer the water should be–opposite in heat: greater the body area the cooler the water should be
want to avoid hyperthermia

Question 23

WWP’s assist in what

Answer 23

muscle relaxation–never exceed 115

20-30 min

Question 24

indications of WWPs

Answer 24

decreased ROM
subacute or chronic inflammatory conditions
PVD
peripheral nerve injuries
promote muscle relaxation

Question 25

contraindications WWPs

Answer 25

Acute injuries
fever
pts needing postural support
skin conditions

Question 26

contrast therapy

Answer 26

repeated alternation of cryotherapy and thermotherapy

requires substantial fluctuations in temp–greater they are greater heat transfer

Question 27

contrast baths

Answer 27

can be either stationary baths or running WWPs
causes cycling of vasoconstriction to vasodilation
theory: stimulates pumping action
increasing peripheral blood flow
increasing venous/lympatic return
decreases pain
doesnt seem to affect subcutaneous tissue > 1cm

Question 28

typical hot to cold ratio for time

Answer 28

3:1 or 4:1 can end on hot or cold cycle depending on what you are looking to achieve or what they will be doing following treatment
subacute=cold
chronic=warm

Question 29

parameters of CBs

Answer 29

length of tx=20 min
ratio=1 min cold: 3-4 hot
4-5 cycles

Question 30

indications CBs

Answer 30

ecchymosis removal
edema removal
sub-acute or chronic inflammatory 
impaired circulation
pain reduction
increasing jt ROM

Question 31

contraindications of CBs

Answer 31

acute injuries
hypersensitivity to cold
contraindications to WP use, Cold, Heat

Question 32

Paraffin Bath

Answer 32

7 parts paraffin wax and 1 part mineral oil
commonly used for hand and wrist
118-126 F
small irregular areas
best used in chronic inflammatory conditions

Question 33

indications for PB

Answer 33

sub-acute to chronic inflammatory conditions

limitation of motion after immobilization

Question 34

contraindications of PB

Answer 34

open wounds
skin infection
sensory loss
PVD
acute injuries