Modalities

Question 1

Cold Pack Indications - 5

Answer 1

Acute/sub-acute inflammation, swelling 
Pain 
Spasticity management 
Following exercise and stretching 
Mild burns

Question 2

Cold Pack Precautions - 6

Answer 2

Over superficial main branch of a nerve
Over an open wound
Hypertension
Poor Sensation
Poor Mentation
Very Young and Very old Patients

Question 3

Cold Pack Contraindications - 7

Answer 3

Cold Hypersensitivity
Cold Intolerance
Cryoglobulinemia
Paroxysmal cold globulinemia (anemia due to premature red blood cell destruction)
Raynaud’s disease or phenomenon
Over a regenerating peripheral nerve
Over an area of circulatory compromise or PVD

Question 4

Hot Pack Indications

Answer 4

Increase Collagen Extensibility
Pain Control
Increased Pain Threshold
Increased metabolic rate (increase oxygen uptake and accelerate healing at cellular level).
increased ROM and decreased joint stiffness

Question 5

Hot Pack Contraindications - 6

Answer 5

Acute inflammatory conditions
Impaired circulation
Thrombophlebitis
Decreased sensation/mentation
Malignancy
IR over eyes

Question 6

Hot Pack Precautions - 10

Answer 6

Acute Injury or Inflammation
Pregnancy
Impaired Circulation
Poor thermal regulation
Edema
Cardiac Insufficiency
Metal in the Area
Over an Open Wound
BenGay/Icy Hot type lotions (counterirritants)
Demyelinated Nerves

Question 7

Cold Pack Questions to ask patients prior to treatment - 4

Answer 7

Do you have any unusual responses to cold
Do you have any nerve damage
Do you have any numbness in this extremity
Do you have poor circulation

Question 8

What must you assess prior to the use of a cold pack?

Answer 8

Test Sensation (light touch, hot, cold)
Skin temperature and color

Question 9

What should you monitor during cold treatment?

Answer 9

Skin integrity, color, and look

time, location of cold pack, response to treatment.

Question 10

What are indications for contrast bath?

Answer 10

chronic pain and edema that doesn’t go away with other modalities

Question 11

How do you apply contrast bath?

Answer 11

First: warm 98-100* for 3-4 mins
Then: cool 50-60* for 1 min
Repeat 5-6 times for total treatment of 25-30 minutes; monitor temp with thermometer

Question 12

Contraindications for contrast bath? (2)

Answer 12

maceration around a wound

bleeding

Question 13

Precautions for contrast bath?

Answer 13

impaired sensation/mentation, infection in the area, recent skin grafts

Question 14

For non-thermal effects with US, what duty cycle is standard?

Answer 14

20% duty cycle

Question 15

Superficial thermal US: What frequency and what intensity?

Answer 15

3 Mhz @ 0.5 W/cm2

Question 16

Deep thermal US: What frequency and what intensity?

Answer 16

1 Mhz @ 1.5-2 W/cm2

Question 17

What are the stages of sensation with cryotherapy?

Answer 17

cold (1-3min)
achy/burning (4-7min)
analgesia (8-15min)
numb (15-30min)