Superficial Heating Modalities Flashcards by JOANN ENRICKE BALBOA

effects of heat

hemodynamic effects
neuromuscular effects
metabolic effects
altered tissue extensibility

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neuromuscular effects of heat

inc nerve conduction velocity

inc pain threshold

altered muscle strength

dec firing rate

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inc NVC by 2m/s every 1C rise

dec conduction latency of nerves

inc nerve conduction velocity

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direct: gating effect

indirect: dec ischemia and muscle spasm

inc pain threshold

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initial 30 mins application of heat

dec muscle strength

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> 30 mins

muscle strength normalizes

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dec firing rate of type II muscle spindle efferents and gamma efferents

firing rate of type 1b (gto)

dec firing rate

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inc temp –> inc tissue extensibility

altered tissue extensibility

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change in organization of collagen and viscoelasticity of the fibers

soft tissue heating prior to stretching

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tissue heating is maintained at

40-45 C for 5-10 min

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Methods of Heat Gain

Conduction

Convection

Radiation

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superficial heating modalities

hmp

pwb

fluidotherapy

irr

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usually made of bentonite covered in canvas; non bentonite are made up of chemical heating pads

hot moist pack (hmp)

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storing of hmp

stored in hmp tank

initial heating: 2 hours
reheat between uses: 30 mins

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duration of hmp

15-20 mins

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wrapping of hmp

6-8 layers of dry towels

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new terry cloth

equivalent to 4 layers

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old terry cloth

equivalent to 1-2 layers

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inexpensive, easy application

advantages of hmp

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declining heating pattern

requires toweling

radial heat distrib

no limb movement allowed

disadvantages of hmp

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warm, melted paraffin wax; low specific heat and thermal conductivity

advantageous to irregularly contoured areas

paraffin wax bath (pwb)

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ratio of paraffin wax to mineral oil

6:1 or 7:1

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methods of pwb

dip and wrap
dip immersion
paint/brush method

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dip and wrap method

6-10 dips

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dip immersion method

20 mins

intensity of pwb

mild comfortable moist warmth

duration of pwb

20-30 mins

inexpensive, easy application, circumferential heating

advantages of pwb

declining heating pattern, requires toweling, no limb movement

disadvantages of pwb

dry heating agent; cabinet w finely ground cellulose particles made from corn cobs

fluidotherapy

heat transfer method of fluidotherapy

convection

constant heating pattern, circumferential heating, free limb movement

advantages of fluidotherapy

expensive, limited to extremities, bulky device

disadvantages of fluidotherapy

IR lamps emit electromagnetic radiation with a wavelength of 770 to 10^6 nm lying between the visible light and microwaves

Infrared Radiation

laws in applying radiation

lambert's cosine/right angle law inverse square law law of grotthuss draper/principle of chemical activation arndt-schultz principles bunsen-roscoe law of reciprocity

optimum radiation occurs when the source is perpendicular to the center of the surface to be radiated

lambert's cosine law/right angle law

use the head perpendicularly

practical application of lambert's cosine law/right angle law

intensity of radiation is inversely proportional to the distance squared I = 1/d^2

inverse square law

appropriate distance of the machine for treatment

practical application of inverse square law

waves must be absorbed to be beneficial (induce chemical processes)

law of grotthuss draper/principle of chemical activation

ensure proper absorption of radiation

practical application of law of grotthuss draper/principle of chemical activation

there is an optimal amount of energy absorption per unit time for beneficial results to be expected

arndt-schultz principle

dosage determination (intensity = warmth)

practical application of arndt-schultz principle

intensity and duration of the dose radiate energy is inversely proportional

bunsen-roscoe law of reciprocity

adjustment of parameters in treatment

practical application of bunsen-roscoe law of reciprocity

from a glowing source like tungsten or carbon filament material

luminous IRR

from a non glowing source like carborundum w metal reflector

non luminous IRR

absorption and angle of rays of IRR

perpendicular

distance of luminous IRR

45-60 cm / 18-24” (24-36”)

pre heating of luminous IRR

no pre heating; must be used immediately OR 5 mins warm up

distance of non luminous IRR

74-91 cm / 29-36” (30-42”)

pre heating of non luminous IRR

5-10 mins

intensity of luminous and non luminous IRR

mild, comfortable, dry warmth

duration of IRR

15-30 [20] minutes

penetration of luminous IRR

1-3 mm

penetration of non luminous IRR

0.1 mm

epidermis and dermis absorption

luminous IRR

stratum corneum absorption

non luminous IRR

vigorous rise in temp

luminous IRR

small and gradual rise in temp

non luminous IRR

more perspiration

luminous IRR

less perspiration

non luminous IRR

does not require any contact, area can be easily observed, can be used to treat larger areas

advantages of IRR vs HMP/PWB

need for localizer to prevent dispersion of radiation heat, dry heat may be uncomfortable to pts, dehydration d/t excessive perspiration

disadvantages of IRR vs HMP/PWB

subacute and chronic conditions pain muscle spasm stiff structures (tissue extensibility) accelerate tissue healing (circulation and enzymatic activities)

indications to ALL superficial heating modalities

pressure sores adjunct to electrical stimulation to dec skin impedance psoriasis

indications to IRR

recent or potential hemorrhage thrombophlebetis malignant tumor metal in area

contraindications of ALL superficial heating mod

acute dermal conditions superficials metals in the area erythema ab igne over the eyes cardiac insufficiency

contraindications spec to IRR

Acute injury / inflammation Pregnancy Impaired circulation Poor thermoregulation Edema Cardiac insufficiency Metal close to area Over open wound Over areas with topical counterirritants Demyelinated nerves Impaired sensation Impaired mentation Psoriasis (if contagious)

precautions of ALL superficial heating mod

too much perspiration

precaution spec to IRR

burn injuries. blister formation

adverse effects of heat

docu for hmp.pwb and fluidotherapy

on in x to

temp for cold wanter in contrast bath

10-18 C (50-64 F)

docu for IRR

at on in x to

hydrotherapy approach using cold and warm water

contrast bath

temp for warm water in contrast bath

38-44 C (100-111 F)

technique of contrast bath

hot 3-4 min --> cold 1 min repeat cycle for 5-6 times; 25-30 min end with warm water

More vigorous circulatory effect Good contact for distal extremities Provides pain control without aggravating the edema Allows movement in water for better circulatory effects

advantages of contrast bath

Limb is in independent position Some cannot tolerate cold immersion Evidence from research evaluating the effects of contrast baths is lacking

disadvantages of contrast bath

docu of contrast bath

contrast bath on in x for warm x for cold x to