specific modalities during different phases of healing Flashcards
cryotherapy function during inflammatory phase
reduce pain, may help decrease swelling
compression function during inflammatory phase
decrease swelling
electrical stimulation function during inflammatory phase
reduce pain
in the inflammatory phase should you use ice or heat
ice
in the fibroblastic phase, is it okay to use heat?
yes, can provide pain relief
what kind of compression should you use in fibroblastic repair phase? what does it do?
intermittent
facilitate removal of injury by-products
function of e-stim during fibroblastic repair phase
assist eliciting muscle contraction
pain modulation
are deep or superficial heating modalities more effective
deep
conduction
heat transfer from warmer object to cooler object through direct molecular interaction of objects in physical contact
examples of conduction
hot pack, cold pack, paraffin, ice massage, cryo cuff
convection
energy transfer by movement of air/fluid from a warmer area to a cooler area or moving past a body part
examples of convection
hot/cold whirlpool, fluidotherapy
how does vapocoolant spray work?
cools the skin by evaporation
*only causes changes in skin temperature
conversion
heating that occurs when nonthermal energy is absorbed into tissue and transformed into heat
does conversion require direct contact?
no, but it does require a medium
examples of conversion
ultrasound, diathermy
radiation
transfer of heat from warmer object to a cooler object through the transmission of electromagnetic energy without heating an intervening medium
cryokinetics
application of cold modalities in conjunction with exercise
cryostretch
application of cold modalities in conjunction with stretching
large surface area cold application decreases… (4)
metabolic rate, pulse rate, respiratory rate, and venous BP
large surface area cold application increases… (5)
blood flow to internal organs, cardiac output, stroke volume, arterial BP, shivering
local cold application decreases… (6)
blood flow
muscle strength
spasticity
muscle spasm
capillary permeability
elasticity
local cold application increases… (4)
muscle strength
blood viscosity
pain threshold
joint stiffness
what body tissue exhibits temperature change the fastest with cold/hot application? slowest?
skin is fastest
muscle/joints is slowest
cold urticaria
erythema of the skin with wheal formation associated with severe itching due to histamine reaction
rayneauds
- exaggerated vasoconstriction in response to cold or emotional stress
- hyperactivation of synthetic NS
what are some adverse effects of cryotherapy? (4)
unwanted vasodilation, nerve damage, frost bite, tissue death
what are some precautions for cryotherapy? (5)
hypertension
impaired temp sensation
open wounds
over superficial nerves
very old/young
what are some contraindications for cryotherapy? (6)
cold hypersensitivity
cold intolerance
cryoglobulinemia
over PVD
impaired temp sensation
raynaud’s
what are some factors that influence response to cold therapy?
- temp difference between cold object and soft tissue
- exposure time
- thermal conductivity of area being cooled
- type of cooling agent
- total surface area
cold packs description
casing filled with silica gel
what temp are cold packs maintained at?
0-10 degrees F
treatment time for cold packs
10-20 minutes
ice pack description
crushed ice folded in damp towel or plastic bag with towel
ice pack treatment time
10-20 minutes
ice towels description
towels soaked in ice slush
ice towels treatment time
10-15 minutes (but towels have to be replaced when they warm up… every 45-60 seconds)
ice massage description
ice cylinder is formed by freezing water in paper cup. it is then used to massage a small area
ice massage stages
cold, burning, aching, numbness
ice massage treatment
5-10 minutes
T or F: cryotherapy units can be manual or electronic
T
cryotherapy temperature
10-25 degrees C
T or F: cryotherapy units can be used safely for longer durations
T
primary uses of vapocoolant spray
reduce muscle spasm, desensitize trigger points
* application is followed by stretching or massage
ice bath temp for adequate tissue cooling
13-18 degrees C
what is a disadvantage of ice baths?
limb is in a dependent position
general heat application increases…
cardiac output
metabolic rate
pulse rate
respiratory rate
vasodilation
general heat application decreases…
BP
muscle activity
blood to internal organs
blood to resting muscles
stroke volume
small surface area heat application increase…
Blood flow
capillary permeability
elasticity
metabolism
vasodilation
edema
small surface area heat application decreases…
joint stiffness
muscle strength
muscle spasm
pain
superficial thermotherapy can prepare patients for… (3)
e-stim
massage
passive/active exercise
precautions for superficial thermotherapy (6)
cardiac insifficency
edema
impaired circulation
impaired thermal regulation
metal in treatment site
open wounds
contraindications for use of superficial thermotherapy
decreased circulation or sensation
DVT
impaired cognition
tumors
very young/old pts
inflammation
hot pack treatment time
20-30 minutes
hot pack temperature
165-170 degrees F
for irregularly shaped areas such as the hand what heating agent may be a good option?
paraffin bath
contraindications for paraffin
allergic rash
open wounds
recent scars/sutures
skin infection
muscle is a good ____ of heat while adipose acts as an ______
conductor
insulator
viscosity
a liquid’s resistance to flowing
increasing heat ____ viscosity
decreases
cohesion
tendency of water molecules to adhere to one another
buoyancy
upward force of water on an immersed body or body part which is equal to the weight of the water that it displaces
hydrostatic pressure
circumferential water pressure exerted on an immersed body part
water density is proportional to _____.
depth
the deeper you go, the more dense the water
contrast bath
alternating immersion in hot and cold water
*effectiveness is under scrutiny
for contrast bath, you do warm for ____ minutes and cold for ____ minute for a total treatment time of _______
4
1
20-30
what should you document with regards to modalities?
- patient position
- vital signs (if necessary)
- modality
- condition, duration, location
- patient response
- changes in pt condition
- other treatments performed with modality
