Hot and Cold Flashcards
Heat ( Thermo therapy) Indications
- decrease pain and stiffness
- alleviate muscle spasms
- Increase ROM + tissue extensibility
- increase blood flow ( promote tissue healing
Precautions Heat
- Cardiac insufficiency
- Edema
- Decreased sensation
- Decreased mental status
- Impaired circulation
- Impaired thermal regulation
- Metal in treatment area
- Open wounds
- Demyelinated nerves
Contraindications Heat - 6
- Acute inflammatory conditions
- No sensation
- DVT
- Impaired cognitive function
- Malignant tumor in area of application
- Tendency toward hemorrhage- high level blood thinner
Moist Hot packs:
method and delivery ( what to do with it)
conduction
delivery: must be wrapped in 6-8 layers ( hydrocollator layers =2)
Parrafin Bath
method
good for this population
contraindications
Conduction
GOOD patients with arthritis just NOT active RA (inflammation)
contraindications parrafin bath -4
allergic rash,
open wounds,
recent scars,
skin infections
Whirlpool method
convention
whirlpool precautions-3
decreased sensation, decreased cognition, recent skin graft
whirlpool contraindications-1
open wound
Fluidotherapy
method, general tx thing
Convection
Can perform exercises while receiving heat
Tx time: 20 mins
Fluidotherapy
precautions
decreased sensation,
decreased cognition
Fluidotherapy
contraindicatoins
Cancer,
Open wounds,
Infections,
severe artery disease
cold therapy indications
- ↓ pain
- Reduce inflammation or swelling
- Alleviate muscle spasm
- Reduce spasticity
- Management in multiple sclerosis
- Cryostretch
cold therapy physiological effects
Used in acute trauma
Decreases cellular metabolism
Decreases pain/
increases pain threshold
Increases joint stiffness
Decreases nerve conduction velocity
Cold application blanching of skin due to
vasoconstriction
hyperemia around edge of contact area in normal tissue due to
decreased rate of oxyhemoglobin dissociation
Cold-induced vasodilation happens when and why
Increased redness after 15 mins = more blood flow to extremities
Cold urticarial:
redness of skin with hives and severe itching
adverse rxn to cold
Histamine reaction
puffy eyes, flushed face, breathing problems
severe = anaphalxysis ( decreased BP with increased HR) with fainting
Raynaud’s Disease
blood vessels narrow in response to cold
pale then bluish color
treatment
1. just avoid cold
2. meds (Calcium channel blockers and phospondiesterse inhibitors )
contraindications cold therapy
Cold hypersensitivity (urticarial)
Cold intolerance
Cryoglobulinemia
Peripheral vascular disease
Severe impaired temperature sensation
Raynaud’s diseases
Paroxysmal cold hemoglobinuria
Over regenerating peripheral nerves
Cold precautions
Hypertension
Impaired temperature sensation
Open wound
Over superficial nerve
Cognitive changes
Guidelines for cryptotherapy
duration of tx and post tx precautions
Duration: 10–30 minutes (longer if casts/bandages), ice massage can be shorter
Post-Treatment Precautions:Avoid excess stresses to area 1–2 hours post-treatment
Ice massage method
conduction
ice massage application
when is anesthesia achieved
Applied to area no larger than 4x6 inches
Each stroke covering ½ of previous stroke circle
Continue until anesthesia achieved generally 5-10 minutes
Ice massage pt. experience
cold, burning, aching, numbness
Vapo coolant method and goal
evaporation
reduce muscle spasm and/or desensitize trigger points
Vapo coolant application
1. how far away to spray what angle
2. passive stretch
3. active stretch
- spray from 18 to 24 inches away
at 30 * angle - Passively stretch after application, then apply moist heat
- Have patient perform active exercise
contrast bath
method and goal
conduction
pain modulation ( alt. btw vasodilation / vasoconstriction)
contrast bath indications
gets peripheral circulation system going
sprains,
strains
ratio of warm to cold
4 to 1
4 mins warm , 1 minute cold
when would you end with warm ( contrast bath)
pain modulation
typically end on warm
when would you end with cold ( contrast bath)
REDUCE EDEMA
how long are contrast baths
25 to 30 mins
what is short wave diathermy
wave energy that produces deep heat w/in tissues ( 5 cm)
which type of diathermy would help healing of wounds and diabetic ulcers
pulsed non thermal
Pulsed non thermal used for
Pain control
Decrease edema
Resolution of acute and chronic infections
Wound control and soft tissue healing
Continuous (Thermal) used for
Increased joint ROM
Pain management
Increased tissue healing
Contraindications to Diathermy
Pregnancy
Implanted neural or cardiac stimulators
contra for non pulsed diathermy
over ill organs
over metal things
contra for continous diathermy
open epiphyses
metal implant
malignancy
vulnerable area ( testes or eyes)
precautions to diathermy
near electronics, magnetics, metal
diathermy capacitive method
ELECTRIC FIELD METHOD
= High frequency alternating current flows from one plate to other thru patient
= particles oscillate and tissue temp increases
diathermy Inductive method
MAGNETIC FIELD METHOD
oscillating magnetic field = vibration increases tissue temp
collagen, fat, and bone = —— conductivity
low conductivity
muscle and synovial tissue = ——- conductivity
high conductivity
