Thermotherapy

Question 1

what is thermotherapy used for?

Answer 1

-Control pain
-increase tissue extensibility
-Increase circulation

Question 2

what are the local effects of thermotherapy?

Answer 2

Superficial heat stimulation of cutaneous thermoreceptors → release of bradykinin & NO → smooth muscle relaxation → vasodilation

Question 3

what are the global effects of thermotherapy?

Answer 3

Cutaneous thermoreceptors also project to the DRG, where they synapse w/ sympathetic neurons in lateral grey horn of the spinal cord, inhibiting firing & decreasing sympathetic output → Smooth muscle Relaxation

Question 4

what conditions would benefit from distal, blood flow?

Answer 4

Peripheral Artery Disease
Ulcer

Question 5

what does applying heat do to nerve conduction speed?

Answer 5

Applying heat causes an increase in speed

Question 6

how does the change in firing speed occur when heat is applied?

Answer 6

Lessens the stimulus threshold of muscle spindles & decreasing gamma efferent firing rate

Question 7

how does applying heat increase a patient’s pain threshold?

Answer 7

Increased activity of superficial thermoreceptors causing a gating effect at spinal cord level & increase in blood flow

Question 8

what does heat do to muscle strength?

Answer 8

Decrease in muscle strength for 30 min after applying heat
Don’t apply heat before a treatment if looking to test strength

Question 9

what does applying heat do to the metabolic system?

Answer 9

increase in tissue temp shifts oxygen hemoglobin dissociation curve to right making more oxygen available for tissue repair

Question 10

why does heat only work on superficial muscle/tendon?

Answer 10

heat goes 6cm

Question 11

how can superficial heat aid in pain control?

Answer 11

• Gating of pain through cutaneous thermoreceptors
• Increase in blood flow via vasodilation
• Heat modalities are relaxing & pain can be influenced by stress

Question 12

how does superficial heat help to increase ROM?

Answer 12

• Increase soft tissue temp which increase tissue extensibility
• Best when tissue is maintained at 40-45°C w/ low load prolonged stretch is applied during the heat period & while the tissue is cooling

Question 13

how does superficial heat help to decrease joint stiffness?

Answer 13

Increased tissue extensibility & viscoelasticity of capsule & ligamentous tissue

Question 14

how does superficial heat accelerate healing?

Answer 14

• Increase in circulation & increased oxygen availability to tissues
• Most beneficial during proliferation stage

Question 15

what are the 4 contraindications for thermotherapy?

Answer 15

-Recent or potential hemorrhage
- Thrombophlebitis / DVT/ Blood clot
- Impaired sensation/mentation
- Malignant tissue/cancer

Question 16

what are some conditions that may caution you before thermotherapy?

Answer 16

-Acute injury or inflammation
-pregnacy
-Impaired circulation or poor thermoregulation
-edema
-cardiac insufficiency
-metal in treatment area
-over open wound or where topical meds been applied
-demyelinanted nerves

Question 17

what are some adverse reactions to thermotherapy?

Answer 17

-Burns
-Fainting
-Bleeding

Question 18

what are the advantages of a moist hot pack?

Answer 18

Easy
Cheap
Low level of skill
Cover large area
Can use at home

Question 19

what are some disadvantages of a moist hot pack?

Answer 19

Must remove to observe area
Hot packs can be heavy
Not good for small or hard contact area

Question 20

why may one elect to use a paraffin bath?

Answer 20

Good for heating distal extremities b/c it can maintain good contact w/ irregularly contoured area

Question 21

what are advantages of a paraffin bath?

Answer 21

Good contact w/ contoured area
Easy to use

Question 22

what are some disadvantages of paraffin bath?

Answer 22

Messy & time consuming
Risk of cross contamination

Question 23

how many layers should a hot pack be wrapped in?

Answer 23

Wrap hot pack in 6-8 layers of dry towels
Hot pack covers = 3 layers
Towel if doubled = 2 layers
Single towel on bottom

Question 24

how long after a hot pack is applied should you check the skin?

Answer 24

5 min

Question 25

what are the parameters for a hot pack?

Answer 25

15-30min

Question 26

what are the parameters for paraffin?

Answer 26

15-20min