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Modalities > Superficial Heat Modalities > Flashcards

Superficial Heat Modalities Flashcards

1
Q

Superficial vs deep heat

A

superficial ( CONDUCTION OR CONVECTION

Deep (2 - 5 cm):

  • ultrasound
  • diathermy
  • –> CONVERSION
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2
Q

Fore every 1.8 deg F rise in skin temp

A

cellular metabolic rate increases by 13%

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3
Q

Local Effects of superficial heat

A

increase cell metabolic rate

  • -> increasing cell demand for Oxygen
  • —-> more nutrients available for healing
    • using heat too soon after injury can cause cell damage due to HYPOXIA
  • -> increasing oxygen demands on already suffocating cells causes further damage
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3
Q

Vascular Effects

A
  • vasodilation of skin bv
  • increase delivery of oxygen
  • increase delivery of WBC
  • increase delivery of chemical mediators

heat –> mild inflammatory rxn –> release of chemical mediators:
- histamine + prostoglandins ==> vasodilation

  • increase capillary permeability
  • increase lymphatic/venous return
    ===> engorges area = NOT for acute phase
  • increase removal of metabolic wastes
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4
Q

Vascular Effects

A
  • vasodilation of skin bv
  • increase delivery of oxygen
  • increase delivery of WBC
  • increase delivery of chemical mediators

heat produces mild inflammatory rxn –> release of chemical mediators:
- histamine + prostoglandins ==> vasodilation

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5
Q

Effects on Pain

A
  • increase analgesia of sensory nerves

- decrease pain via gate control theory

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6
Q

Effects on Inflammation

A

increases inflammation

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7
Q

effects on muscle spasm

A
  • decrease muscle spasm
  • decrease muscle spindle sensitivity
  • increase delivery of oxygen to the area
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8
Q

neuromuscular effects

A
  • elevation of pain threshold
  • alters nerve conduction velocity
  • change mm spindle firing (relaxation)
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9
Q

connective tissue effects

A

IMPROVES plastic deformation of tissue

LESS likely to change shape

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10
Q

tissue elasticity

A
  • extensibility of collage is increased
  • plasticity of and deformation capabilities increased
  • –> assist this with gentle stretching (low load, long duration)
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11
Q

rebound vasoconstriction

A

mechanism of heat dissipation:
previously vasodilated vessels constrict after 20min to save underlying tissue by sacrificing superficial layers (burns) after tx at a constant intensity
rxn is slowed/decreased by keeping hot pack on past point of evening temperature gradient to get the maximum benefit over the time period

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12
Q

mottling

A

warning sign that skin temp are rising too quickly

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13
Q

Indications for Superficial Heat

A
  • subacute / chronic inflammation
  • subacute / chronic pain
  • subacute / chronic muscle spasm
  • decreased ROM
  • reduction of joint contractures
  • hematoma resolution (post acute stage)
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14
Q

Contraindicaitons of Superficial Heat

A
  • acute injuries
  • impaired circulaiton
  • poor thermal regulation
  • anesthetic areas
  • impaired sensation
  • impaired cognitiion
  • fx
  • post surgical
  • neoplasms
  • infection (increases spread through body)
  • systemic infection
  • elderly / kids (more difficulty controlling their own body temps or sensing the temp, may burn unknowingly)
  • abnormal proliferation of cells, uncontrolled/progressive tumor
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15
Q

USE HEAT (over cold) if….

A
  • body feels cold
  • no sensitivity to light/mod touch
  • no swelling increase
  • selling does not increase with activity
  • pain does NOT limit ROM
  • acute inflammatory stage is over
  • pt no longer improves with cold
16
Q

dry heat

A
  • does not increase skin temp as rapidly as moist heat
  • does Not make good contact with skin directly
  • burns more likely (no decrease in heat)
  • possible fires
17
Q

moist heat packs

A
  • canvas pouches of silica gel
  • kept in hot water 160-170 deg F (kills off bacteria but can burn!)
  • CONDUCTION heat transfer
  • can maintain therapeutic heat level for 30-40 min
  • max heating potential at 15 min
  • 20-30 min tx duration
  • insulate packs with 5-7 layers
  • layers should not be compressed
    —-> allow air pockets to remain = more insulation
    if lay on pack…
    —-> increasing heat conduction
    ——> decrease capillary flow (via body wt)
    ——–> less release of heat from body
    =========> increased chance of burning
  • check on pt ever 5 min (look for mottling)
  • used for localized areas or areas that can’t be tx in water
  • not as effective over irregular areas
  • various sizes
  • more comfortable than dry heat
  • increase skin temp more rapidly than dry heat
    • -> vasodilation of bv increase flow to area –> cool tissue
  • average temp rise: ~3.8 deg C at ~1cm
  • direct relaxation of tissue (<1cm)
  • secondary relaxation of deeper tissues by relaxation of superficial motor and sensory nerves
18
Q

warm whirlpools

A

TEMP: 100-105 or 110 deg F
- more body area in water ==> colder it should be (avoid hyperthermia)
[for CWP…more body = warmer it should be –> avoid hypothermia]

Benefits: assist in promoting muscular relaxation

  • turbulence of water
  • -> sedative and analgesic effect on sensory nerves

tx duration: 20-30min

19
Q

indications for wwp

A
  • (primarily) decreased ROM and
  • muscle relaxation
  • peripheral vascular disease (neutral temp)
  • peripheral nerve injuries (avoid extreme tens)
20
Q

Contraindications for WWP

A
  • fever
  • pts needing postural support
  • skin conditions
21
Q

Contrast Therapy

A

alternation of cyrotherapy and thermotherapy

theory: stimulates pumping action (from vasoconstriction and dilation)
- increases peripheral blood flow
- increases venous / lymphatic return
- decreases pain/spasm –> more ROM

  • subacute or chronic conditions
    —> remove edema and ecchymosis
  • 3 or 4: 1 hot to cold ratio
    ex: 3 min hot, 1 min cold
    Hot: 105-110 deg F
    Cold: 50-60 deg F
    ~ 20 min tx time
    ~3-5 cycles
  • end with what you start with
  • can end on either hot or cold
    cold:
  • subacute
  • proprioceptive follow up activity
    warm:
  • chronic
  • relaxing end-note
22
Q

Effects of contrast bath on injury response cycle

A
  • not clear
  • does NOT appear to affect subcutaneous tissue deeper than 1 cm
  • increased circulation in tx extremity
  • removes edema (unclogging vasculature)
  • increases jointROM
  • decreases pain
23
Q

Indications for Contrast

A
  • ecchymosis removal
  • edema removal
  • sub acute or chronic inflammatory conditions
  • impaired circulation
  • pain reduction
  • increasing joint ROM
24
Q

Contraindications

A
  • acute injuries
  • hypersensitivity to cold
  • contraindications for WP, cold, heat
25
Q

Paraffin bath

A

1 parts wax: 1 part mineral oil
lower specific heat than water - feels cooler = able to tolerate higher temps
— UE: 118-126 deg F
— LE: 113- 121 deg F (circulation is less efficient)
- used for tx of small, irregular areas
- may increase articular temp by 6.3 deg F

  • best used for chronic inflammatory conditions
  • heat + moisturizes skin
  • 6-12 layers (dry between dips)
  • more layers = more insulation = more temp

tx time: 15-20 min

26
Q

indications for paraffin bath

A
  • sub acute or chronic inflammatory conditions

- limitation of motion after immobilization (tendon repairs)

27
Q

contraindications

A
  • open wounds
  • skin infections
  • sensory loss
  • peripheral vascular disease
  • acute injuries
  • normal heat contraindications

Modalities (11 decks)

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