Heat Modalities Flashcards
Superficial heating agents
Hot packs Paraffin Fluidotherapy Warm Whirlpool **Conduction or Convection** heats skin and underlying tissue to depths of < 2cm
Deep Heating agents
US
Diathermy
Conversion
heats tissue b/w 2-5 cm in depth
Thermotherapy
application of therapeutic heat to the body
What happens with each 1.8 F rise in skin temp
cellular metabolic rate increases ~13%
increases cells demand for O2—more nutrients available for heating
What happens if you use heat too soon?
can cause cell damage due to hypoxia- demands oxygen on already suffocating cells
Vascular Effects
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
What two things cause vasodilation?
Histamine
Prostaglandins
What does heat do for pain?
increase analgesia of sensory nerves
decreases pain
gate control theory
What does heat do for muscle spasm?
decreases muscle spasm
decreases muscle spindle sensitivity
increases delivery of oxygen to area
What does heat do for inflammation and nerve conduction velocity?
increase inflammation
increase NCV
increased activity of A-delta
Principles of HEAT
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
Key points to Heating
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
Rebound Vasoconstriction
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
Mottling
warning sign that skin temperature are increased too quickly
Indications of superficial heat
subacute and chronic inflammation/pain/muscle spasm
decreased ROM
reduction in jt contractures
hematoma resolution
Contraindications of superficial heat
acute injuries
impaired circulation
poor thermal regulation
infection
Dry heat
heating pad
does not increase skin temp as rapidly
Moist heat packs
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
Moist heat packs are what kind of modality
superficial heat modality
transfer heat via conduction to overlying tissue
can maintain heat level 30-45 min max at 15
indications of heat packs
sub-acute or chronic inflammatory reduction of sub-acute or chronic pain decrease ROM hematoma resolution reduction of jt contractures
contraindications of heat packs
acute conditions PVD impaired circulation poor thermal regulation impaired sensation impaired cognition
Warm Whirlpools
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
WWP’s assist in what
muscle relaxation–never exceed 115
20-30 min
indications of WWPs
decreased ROM subacute or chronic inflammatory conditions PVD peripheral nerve injuries promote muscle relaxation
contraindications WWPs
Acute injuries
fever
pts needing postural support
skin conditions
contrast therapy
repeated alternation of cryotherapy and thermotherapy
requires substantial fluctuations in temp–greater they are greater heat transfer
contrast baths
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
typical hot to cold ratio for time
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
parameters of CBs
length of tx=20 min
ratio=1 min cold: 3-4 hot
4-5 cycles
indications CBs
ecchymosis removal edema removal sub-acute or chronic inflammatory impaired circulation pain reduction increasing jt ROM
contraindications of CBs
acute injuries
hypersensitivity to cold
contraindications to WP use, Cold, Heat
Paraffin Bath
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
indications for PB
sub-acute to chronic inflammatory conditions
limitation of motion after immobilization
contraindications of PB
open wounds skin infection sensory loss PVD acute injuries
