Superficial Cold Modalities Flashcards
Hemodynamic effect has initial ___ and late ___
decrease in blood flow, increase
explain initial decrease in blood flow (4)
- Makes blood viscous ○ Reduce blood flow - Decrease production of vasodilator ○ Histamine and prostaglandin ○ Less lumen ○ Vasoconstriction - Direct: Smooth muscle contraction => vasoconstriction - Indirect: DRG => Reflex activation of sympathetic adrenergic neurons => vasoconstriction
explain Later increase in blood flow
- Cold induced vasodilation
- Temperature lowers then rises which causes vasodilation
- Hunting response
○ Alternating cold and hot
○ Protective mechanism
○ Prolonged vasoconstriction deprives them of oxygen
explain gate control theory
a beta and a alpha fibers are stimulated in order to activate inhibitory interneuron in the substantia gelatinosa that will inhibit impulses from a delta and c fibers from reaching the second order neuron
How many mins application for decreased ncv
5 mins or more
cold is more effective on which fibers for decreasing nerve conduction velocity
a alpha
how does cold increase pain threshold
decreasing ncv, spasm is reduced
how does cold reduce edema
○ Reduction of blood flow
○ Reduction of free nerve ending compression
○ Less pain
how long for application of cold for increase in strength of muscles
< 5 mins
how long for application of cold to decrease strength
> 5-30 mins
why do muscles decrease in strength with long periods of cold
○ Reduce blood flow
○ Lower ncv
○ Increased viscosity of muscle components
Stiffness of tissues
cold reduces spasticity. t or f.
True
How long should cold be applied to reduce spasticity
10-30 mins
how does cold reduce spasticity
- Lowering activity of gamma motor neuron activity
- Lowering afferent spindle and GTO activity
Long application needed for facilitation of muscle contraction. T or F.
False
How does cold facilitate muscle contraction
- Facilitates alpha motor neuron
- Facilitates tone
when we use cold or hot modalities, pain is completely eliminated. T or F.
False
Cold is recommended when healing is delayed. T or F.
False
How does cold decrease metabolic rate
- Inhibits of cartilage degrading enzymes for OA
○ Collagenase, elastase, hyaluronidase and protease- Reduces level of histamine in blood for RA
Methods of heat loss
conductio, convection, evaporation, respiration
uses for cryotherapy (9)
- Inflammation
- Edema control
- Reduce DOMS
- Pain control
- Modification of spasticity
- Symptom management in multiple sclerosis
○ Feel fatigue in warm temperatures - Facilitation
- Cryokinetics (w exercise)
- Cryostretch
Purpose of cryokinetics and cryostretch
- Reduce soreness
how to heal acute burns
- Apply flowing cool water
why is cold used with Joint mobilization or deep friction massage
desensitizes patient for the uncomfortable aspect
contraindications (7)
Cold hypersensitivity/cold-unduced urticaria
Cold intolerance
Cryoglobulinemia
Paroxysmal cold hemoglubinuria
Raynaud’s disease
Regenerating peripheral nerve
Area with vascular disorder
Precautions (5)
- Over superficial main branch of nerve (do not compress)
- Open wound
○ Make sure you do not impede blood flow - Hypertension
- Poor sensation
Extreme ages of patients
- Open wound
signs of - Cold hypersensitivity/cold-unduced urticaria
cold hives
signs of cold intolerance
○ Severe pain
○ Numbness
○ Discoloration
signs of cryoglobulinemia
○ Aggrevation of proteins
○ Impairs circulation
○ No circulation
○ ischemia
signs of - Paroxysmal cold hemoglubinuria
○ Hemoglobin is released in urine
Signs of Raynaud’s disease
○ Affects small arteries
○ Ischemic reactions
○ Vasospasm of small arteries
CBAN
cold, burning, numbing, ching
PRICES
protection, rest, ice, compression, elevation, support
POLICE
protection, optimal loading, ice, compression, elevation
Cold packs storage and duration of application
- Stored in freezer at -5 degrees
- Duration: 10-20 mins
ice packs duration of application
10-20 mins
ice massage is time consuming. t or f
true for large areas
in ice massage skin shouldn’t drop below ___ degrees
15
vapocoolant spray evolution
ethyl chloride=> fluorimethane => spray at stretch, instant ice and pain ease
components of spray at stretch, instant ice and pain ease
11133- pentafluorpropane
1112- tetrafluoroethane
how to apply vapocoolant spray
○ Upright and angles at 30 degrees
○ 30-45 cm away from skin
○ 10 cm per second
○ For trigger points over muscle (follow fibers)
○ Increase rom
§ 2-3 sprays
§ If additional is needed, warm area first
quick icing or brief icing is used to facilitate which fibers
a delta and c fibers
quick icing is used for hypertonic muscles. t or f.
false, used for hypotonic or flaccid muscles
a-icing
three swipes of ice
c-icing
hold ice for 3-5 seconds thrice
chemical cold packs storage
-12 to -9 degrees
application period of chemical cold packs
10-12 mins
chemical cold packs
2 substances one in small one in large bag
ice towels duration
10-15 mins
cold bath temp
13-18 degrees
cold whirlpool temp
10-16 degrees
cold whirpool time
5-15 mins
documentation
cryotherapy using technique on body area in position x duration to rationale
