Heat Therapy

Question 1

Physiological Effects (40-45°C)

Answer 1

• Increase metabolic rate (about 13% per 1°C)
• Vasodilation and increased blood flow
• Reduce blood and tissue fluid viscosity
• Increase collagen extensibility
• Stimulation of sensory nerves
• Effects are primarily superficial
• Excessive heat (>45°C) causes tissue damage (i.e. proteins denatured)

Question 2

Therapeutic Effects

Answer 2

• Pain Relief
• Reduced muscle spasm
• Increase range of motion
• Relaxation
• Facilitate clearance of chronic oedema
• Facilitate tissue healing

Question 3

Contraindication

Answer 3

• Conditions that can spread easily e.g. tumours, infections, etc.
• Circulatory insufficiency
• Existing conditions that could be exacerbated:
  Areas recently treated with radiotherapy
  Haemorrhagic disorders
  Severe organ states e.g. organ failure
  Skin conditions, open wounds, etc.
• Heat applied to eyes or testes
• Sensory loss
• Unable to communicate

Question 4

Thermal Sensitivity Test

Answer 4

Test the patient’s ability to discriminate hot from cold objects at site to be treated.
* Contraindication: inability to reliably discriminate hot from cold sensation.

Question 5

Warnings are mandatory prior to application of EPAs

Answer 5

1. What you are going to do (e.g. ice, heat, etc)
2. What the patient can expect to feel (e.g. comfortable warmth)
3. What are signs that something is wrong (e.g. excessive heat)
4. What are the dangers (e.g. risk of burn)

Question 6

3 step process to obtaining patient informed

Answer 6

1. Do you understand what I have said?
2. Do you have any questions?
3. Are you happy for me to proceed?

Question 7

Application

Answer 7

Select hot pack and wrap in cover / toweling so there is 1-2 cm between skin and pack.
* Mold hot pack to contours of skin
* Treatment time: 20 minutes
Check for any adverse reactions
Re-assess the patient
Document treatment.

Question 8

Monitoring

Answer 8

Observe skin and ask patient regarding the temperature of the pack

Check for adverse reactions
* At the start of Rx
* After 8 minutes; then regularly
* After Rx

Adverse reactions include:
* Excessive erythema (redness)
* Blistering
* Persistent pain

Treatment for adverse reactions:
* Cold water
* Refer for medical Rx if required

Question 9

Evidence

Answer 9

• Combination of heat and stretching is more effective than stretching alone for increasing range of motion. (Bleakly & Costello, 2013)