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Modalities > Modalities Ch. 12 > Flashcards

Modalities Ch. 12 Flashcards

1
Q

what is cryotherapy

A

use of ice for therapeutic functions

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2
Q

cryotherapy beyond immediate care

A

misconceptions
awesome for immediate care
useful beyond immediate care

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3
Q

cryotherapy techniques

-5 major categories

A 
immediate care
post-immediate care
surgical adjunct
cryosurgery
miscellaneous techniques
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4
Q

post-immediate care cryotherapy

  • primary benefit
  • why start therapeutic exercise as early as possible?
A

primary
-decrease pain
-decrease muscle spasm
why start earlier?
-proper exercise speeds the healing process
-lack of exercise may result in permanent injury

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5
Q

post-immediate care precautions

A

too vigorous exercise may result in permanent disability
optimum healing depends on balance between
-returning to full normal function as quickly as possible
-protect injury from overstress and further injury

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6
Q

major cryotherapeutic techniques used during post-immediate care

A 
cryokinetics - exercises
cryostretch
connective tissue stretch
cold compression devices
contrast baths
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7
Q

what happens when cold is applied

A 
decreased temperature
tissue destruction
effonts on inflammation
decreased metabolism
decreased and increased pain
decreased muscle spasm
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8
Q

temperature change and gradients

A

immediately after cold application, heat begins moving from the tissue into the cold device
tissue destroyed with severe cooling
–4 to -94 F
tissue is usually cooled to a surface temperature of 33-50F

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9
Q

decreased temperature

A

gradient continues when the cold modality is removed
deep tissue continues to cool after the modality is removed
-as a result of the gradient and heat conduction

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10
Q

temperature gradients within the modality

A

shake cold packs and stir water baths every 5 min. to break up gradient

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11
Q

effects on inflammation

A

many think one benefit of acute injury cryotherapy is to decrease inflammation
probably not true for two reasons
-inflammation is necessary for resolution of the injury
-little research has been done on the acute inflammatory response

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12
Q

decreased metablolism

A

direct relationship between tissue temperature and metabolism

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13
Q

effects on pain

A

cold is the most effective and underused physical modality for pain
clear evidence
by numbing a muscle or joint, active exercise can be used earlier in the rehabilitation process

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14
Q

three types of pain

A

cold pain
residual pain
reinjury pain

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15
Q

cold temp

A

no physiological reason related to increased healing

can be adapted to

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16
Q

efforts to minimize cold pain during immersion

A 
development of neoprene toe cap
-eliminates toe pain, which accounts for 50% of pain during immersion
refraining from using cryokinetics
-unfortunate
-pain is both temporary and short lived
using warmer water
-treatment is less effective
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17
Q

decreased muscle spasm

A

muscle spasm is not muscle cramping

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18
Q

muscle cramp

A

seizes

-contracts really strongly

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19
Q

muscle spasm

A

muscle tightness

adhesions in the muscle

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20
Q

how muscle spasms are decreased

A

decreased by cold applications
-specific mechanism unknown
three mechanisms suggested

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21
Q

three mechanisms of muscle spasms relief

A

decreasing nerve conduction
breaking pain-spasm-pain cycle
removing cause of spasm

22
Q

when is using cold to diminish muscle spasm effective?

A

when combined with stretching

-cryostretch

23
Q

cryostretch technique

A

cold application until numb
combination of static stretch and isometric contraction
re-numb

24
Q

increased tissue stiffness

A

cold tissue more stiff so more resistant to movement
some feel this contraindicates exercise after cryotherapy, fearing tissues will tear
-fine motor skills are hindered, but gross motor movement is not

25
Q

decreased arthrogenic muscle inhibition

A

reverse injury-induced inhibition

may facilitate muscle activity above normal

26
Q

circulatory response

A

increased and/or decreased blood flow proposed
artitrary explanations for an increase in blood flow
confusion a result of inappropriate application of CIVD concept
ample evidence that cryotherapy decreases blood flow

27
Q

CIVD

A

Cold-Induced Vasodilation
popular thought
some claim that CIVD increased blood flow more than heat

28
Q

increased rate of healing

A

owing to exercise, not cold

  • exercise increases blood flow far more than either heat or cold
  • exercise stimulates healing in other ways as well
29
Q

conclusions

A

no increase in blood flow
purpose of cold applications post-immediate care is to facilitate rehab
exercise improves healing

30
Q

physiological effects

A

memorize page 226 - table 12.1

31
Q

recovery cryotherapy

A

used often to help athletes recover after activity
scientists struggle explain why the technique is beneficial
-technique is gaining momentum

32
Q

recovery cryotherapy methods

A

whole body cryotherapy (WBC)
cold water immersion (CWI)
both techniques were first used for immediate care

33
Q

why use recovery therapy?

A

anecdotal
psychological benefit
looking for every advantage to improve performance

34
Q

problems, precautions, and contraindications

A 
frostbite
chilblains
nerve palsy
cold hypersensitivity/allergies
vasospastic disorders
cold-induced pain
35
Q

frostbite

A

cell damage, blood vessel damage
cold modality left on >1 hour or combined with pressure
gel packs

36
Q

chilblains

A

inflammatory condition caused by mild frostbite

  • reddish purple skin that is swollen and may burn or itch
  • resolves in a fwe days or weeks
  • no permanent damage
37
Q

nerve palsy

A

most common during treatment of the later fibular head
controversy over actual cause: cold, compression or combination
recommendation: be careful when applying cold and compression to areas where large nerves are superficially located
peroneal, ulnar nerves

38
Q

cold hypersensitivity/allergies

A

many forms
most common is cold urticaria - allergic anaphylactic reaction
causes wheals to form soon after the treatment which subside in 10-30 minutes
treatment
-antihistamine
-avoid precipitation conditions
-use alternate method
severity of reaction lessens with further cold therapy

39
Q

vasospastic disorders

A

improper dilation
ischemic necrosis
Raynaud’s Phenomenon: local functional changes in peripheral circulation as a result of Raynaud’s disease or other condition
skin turns pale or cyanotic, then red - may go back and forth

40
Q

cold-induced pain

A

some athletes simply cannot tolerate pain of cold therapy, especially immersion
do not force therapy; try alternate methods

41
Q

contraindications

A 
specific diseases
-Raynaud's
-cold hypersensitivity
-cold urticaria
cardiac and respiratory disorders
compromised or impaired local circulation or innervation (anesthetic skin)
uncovered open wounds
infection
advanced diabetes
lupus - immune system disorder
42
Q

precautions

A

no application >1 hour
major superficial nerves
be careful when applying a commercial ice pack more than 5-10 minutes
do not apply a gel ice pack under an elastic bandage
be careful when athlete is performing exercises that cause pain following cold applications
be careful when using cryotherapy when treating a person who
-is hypertensive
-is paralyzed
-has coronary artery disease
-has a rheumatoid condition

43
Q

progression of cold sensation

A

cold, pain, tingling, numbness
or
cold, burning, aching, analgesia
potentially due to…
-differing conduction velocities of different nerve types
or
-nerve endings as they temporarily cease to function resulting from decreased blood flow
cold therapy causes analgesia - not anesthesia (loss of sensation)
better word is hypalgesia (decrease in pain)

44
Q

cryokinetics

A

cold + movement
commonly used for acute sprains to greatly reduce rehab time
systematic combination of cold-induced hypalgesia and progressive, graded exercise

45
Q

application of cryokinetics

A 
numb the body part
-immersion preferred and most common
-may also use ice massage, ice packs
use pain as a guide
exercise the body part
-only while area is numb
activity should be progressive
-begin with simple ROM
46
Q

cryokinetics and numbness

A

numbness usuallylasts 2-5 minutes
re-numb area, repeat exercise
repeat about 5 times

47
Q

contrast bath

A

alternating immersion in hot and cold water baths
supposedly causes alternating vasodilation and vasoconstriction
sort of creates a pump

48
Q

contrast bath flaws

A

edema reduction
-picked up by lymphatic system which does not have vasoconstriction/vasodilation
tissue temperature change
-not very significant
capillaries and lymph vessels do not vasodilate
cryokinetics more effective

49
Q

lymphedema pumps

A

pump forces air or chilled water into sleeve, applying pressure to the joint
sleeve intermittently inflates and deflates
changes in pressure force lymphatic and venous drainage from extremity and reduce edema
cryokinetics is preferred for edema reduction
-“pump rate” is greater with cryokinetics
cryokinetics offers additional benefits of active exercise

50
Q

application types

A 
ice bags
cold gel packs
chemical cold packs
ice immersion
cold whirlpool
ice massage
Cryo Cuff
GameReady

Modalities (16 decks)

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