Heat Therapy

Question 1

Increased Physiological Responses to Body Systems and Structures w/ Local Heat Application

1. Blood Flow:
2. Capillary Permability:
3. Elasticity of non-elastic tissues
4. Metabolism
5. Vasodilation
6. Edema

Answer 1

1. Blood Flow: dilatation of arteries
2. Capillary Permability: increased capillary pressure
3. Elasticity of non-elastic tissues: increased extensibility of collagen tissues
4. Metabolism: for every 10C increase in tissue temp, rate of cellular oxidation increases 2-3x
5. Vasodilation: activation of axon reflex and spinal cord reflex, release of vasoactive agents (bradykinin, histamine, prostaglandin)
6. Edema: increased capillary permeability

Question 2

Decreased Physiological Responses of Body systems and structures to local Heat Application

1. Joint Stiffness
2. Muscle Strength
3. Muscle Spasm
4. Pain

Answer 2

1. Joint Stiffness - increased extensibility of collagen and decreased viscosity
2. Muscle Strength - decreased function of glycolitic process
3. Muscle Spasm - decreased firing of afferents of ms spindles and increased firing of Ib GTO fibers reduces alpha-MN activity and thus decreases tonic extrafusal activity
4. Pain - presynaptic inhibition of A delta and C fibers via activation of A beta fibers (gate theory), disruption of pain spasm cycle

Question 3

Thermal Agents: Thermotherapy Local Effects

Answer 3

• Increased:
  
  • Blood flow,
  • capillary permeability,
  • elasticity of non-elastic tissues, metabolism,
  • vasodilation,
  • edema (capillary permeability).
• Decreased:
  
  • Joint stiffness,
  • muscle strength,
  • muscle spasm,
  • pain.

Question 4

Thermal Agents: Thermotherapy - General Effects

Answer 4

• Increased:
  
  • CO,
  • metabolic rate,
  • HR, RR,
  • vasodilation
• Decreased:
  
  • BP,
  • muscle activity,
  • blood to internal organs,
  • blood to resting muscle, SV

Question 5

Thermal Agents: General Indications

Answer 5

• P! modulation
• Increase connective tissue extensibility
• Reduce or eliminate soft tissue inflammation and swelling
• Accelerate reate of tissue healing
• Reduce or eliminate soft tissue and joint restriction
• Muscle spasm
• Preparation for ES; massage or A/PROM

Question 6

Thermal Agents: Contraindications/Precautions

Answer 6

• Contraindications
  
  • Acute and early subacute traumatic and inflammatory conditions
  • Decreased circulation
  • Decreased sensation
  • Deep vein thromophlebitis
  • Impaired cognitive function
  • Malignant tumors
  • Tendency toward hemorrhage or edema
  • Very young or old patients
  • Specific with each modality
• Precautions:
  
  • Cardiac insuffficiency
  • Edema
  • Impaired circulation
  • Impaired thermal regulation
  • Metal in tx site
  • Pregnancy
  • Areas where topical agents have been recently applied
  • Demyelinated nerves
  • open wounds

Question 7

Thermal Agents: Hot Pack - Indications

Answer 7

• Conduction
• Relaxation
• P! relief
• ↑ blood flow
• Facilitate healing
• ↓ muscle spasm
• Prepare joints/muscles for exercise

Question 8

Thermal Agents: Hot Pack - Contraindications

Answer 8

• Pregnancy
• Lack of intact sensation
• Vascular insufficiency
• Hemorrhage or potential hemorrhage
• Malignancy
• Acute inflammation
• Infection
• After application of heat rubs

Question 9

Thermal Agents: Hot Pack - Application

Answer 9

• Stored in water 70-75 C (165-170 F)
• 6-8 layers of towels (hot pack cover = 2-3 layers of towels
• Position pt for comfort - Do not have body weight directly on top of hot pack
• Provide pt with call bell
• Check skin after 5 minutes
• Treatment time = 20-30 minutes