Thermal Modalities: Thermotherapy Flashcards
what are the haemodynamic responses to thermotherapy
vasodilation, increased BF
reflex relaxation of vascular smooth muscle via cutaneous receptors
dorsal root ganglion inhibits sympathetic neuron firing to decrease smooth muscle contraction
increased local release of chemical mediators
cutaneous vasodilation protects local area from tissue damage by convection
what are the neuromuscular responses to thermotherapy
increases nerve conduction velocity, increases firing rate of the GTO, decreases firing rate of muscle spindle
increased pain threshold, decreased strength and endurance
how does increased pain threshold with thermotherapy have an indirect effect
if there is vasodilation there’s better BF so you’re less likely to have ischemia and muscle spasms
what are the metabolic responses to thermotherapy
increased metabolic rate
increased rate of endothermic reactions beyond protein denature
shift of the O2-Hb dissociation curve to the right
increased O2 uptake and healing
increase in destructive processes like collagenase (break down of collagen)
what is the O2-Hb dissociation curve
a shift to the left would cause what
a shift to the right would cause what
the relationship of partial pressure of O2 available to Hb vs the saturation of Hb binding sites
left: Hb has a greater affinity for O2 so O2 won’t be released as easily to the tissues
right: Hb has a decreased affinity for O2 so O2 will be released more readily to the tissues
how to plastic changes occur in altered tissue extensibility with thermotherapy
by changing the organization and viscoelasticity of collagen
what are the indications for using thermotherapy
pain control, decrease joint stiffness, accelerate healing, increase tissue extensibility, psoriasis, dermal ulcers
how can thermotherapy help with psoriasis and dermal ulcers
psoriasis causes development of plaque and heat can be used to break down the plaque
heat can be used to accelerate the healing of dermal ulcers on the periphery and manage pain
what are the contraindications to thermotherapy
impaired sensation, acute injury/inflammation
over area of recent or potential hemorrhage (would cause increased bleeding)
in areas of thrombophlebitis (blood clot would travel)
malignancy
in areas of infection (infection can travel if heated)
what are the precautions to thermotherapy
poor circulation or thermal regulation
edema
cardiac insufficiency (increases cardiac demand)
metal (jewelry or staples are heat conductors and can lead to a burn)
altered mental state or poor communication skills
open wound (less insulation by subcutaneous tissue and contamination from paraffin wax)
topical counterirritants have been applied
why should you be cautious using heat if topical counterirritants have been applied
ointments create heat by creating a mild inflammatory reaction causing a heat barrier (cannot further dissipate heat)
how should you use heat on a pregnant person
what type of heat should pregnant people avoid
can apply heat to the back and localized places (feet or hands) because these are unlikely to raise core body temperature
heat that could increase maternal body temperature due to consequences in fetal malformations (hot tubs, saunas)
what are the adverse reactions to heat
burns, fainting, bleeding, skin and eye damage from irradiation
