Thermotherapy

Question 1

What are the different ways to apply thermotherapy?

Answer 1

• Moist hot packs (hydrocollator)
• Warm Whirlpool
• Paraffin
• Fluidotherapy
• Contrast bath
• Heat lamps
• (topical counterirritants)

Question 2

What are the mechanisms of heat transfer for thermotherapy?

Answer 2

Conduction, Convection, Radiation and Conversion

Question 3

What is conduction?

Answer 3

• Direct contact

– Heat (or cold) applied directly to the skin

Question 4

What are examples of conduction?

Answer 4

– Hydrocollator packs

– Paraffin bath

Question 5

What is convection?

Answer 5

Air or water particles move across the body part causing heating (or cooling)

Question 6

What are examples of convection?

Answer 6

– Whirlpool

– Fluidotherapy

Question 7

What is radiation?

Answer 7

• Transfer of heat from a warmer surface to

a cooler though air.

Question 8

What is an example of radiation thermotherapy?

Answer 8

-Infrared lamps

Question 9

What is conversion?

Answer 9

Heat generated from another energy form.

Question 10

What are examples of conversion thermotherapy?

Answer 10

– Ultrasound

– Diathermy

Question 11

What does recent evidence say about superficial heat?

Answer 11

Recent evidence says not just superficial
• Heating of
– Skin and small joints
– Deeper muscles: quadriceps, hamstring?
– Sub Q fat and skin pain makes deep heating
difficult
• NBCE
– Still “deep heat” for US and diathermy
– Other EPAs by name (hot pack, paraffin, etc)

Question 12

What does thermotherapy help with?

Answer 12

• Pain relief
• Causes a calming or sedating effect
• Spasm reduction
• Increased mobility

Question 13

How does thermotherapy reduce spasm?

Answer 13

– Decreasing gamma motor neuron activity

Question 14

How does thermotherapy increase mobility?

Answer 14

– Decreased joint viscosity
– Decreased viscoelasticity of muscle, tendon, and
ligaments

Question 15

Thermotherapy may be better than ______ at creating an analgesic effect

Answer 15

Ibuprofen

Question 16

_____ duration low level heat can be

beneficial in the treatment of low back pain

Answer 16

Long

Question 17

Shorter duration moist heat may help

reduce ________ pain

Answer 17

Myofacial

Question 18

What are the indications for thermotherapy?

Answer 18

• Decrease pain
– Neck, back, shoulder
• Decrease muscle spasm
• Osteoarthritis
• Rheumatoid arthritis

Question 19

What are the contraindications for thermotherapy?

Answer 19

• Areas of impaired heat sensation
• Malignancy
• Thrombophlebitis
• Hemorrhage
• Abdomen, pelvis, low back in pregnancy
• Acute inflammation/inflammatory
conditions
• Confused and unreliable patients

Question 20

What are the precautions for thermotherapy?

Answer 20

• Impaired circulation
• Over wounds
• Severe cardiac insufficiency
• Over superficial metal implants
• May cause decreased motor skill and
reaction time
• Can increase fever

Question 21

What is the temperature of the hydrocollator?

Answer 21

158-169 degrees F or 70-70 degrees C

Question 22

How many layers of towels do you need between the patient and the hot packs?

Answer 22

6-8

Question 23

T/F: The patient is allowed to lay on the heat packs.

Answer 23

FALSE

Question 24

Maximum Whirlpool

Temperature by Body Part: Wrist and Hand

Answer 24

112 F

Question 25

Maximum Whirlpool | Temperature by Body Part: Foot and Ankle

Answer 25

110 F

Question 26

Maximum Whirlpool | Temperature by Body Part: Elbow

Answer 26

108 F

Question 27

Maximum Whirlpool | Temperature by Body Part: Knee

Answer 27

106 F

Question 28

Maximum Whirlpool | Temperature by Body Part: Thigh

Answer 28

104 F

Question 29

Temperature of water MUST be _____ if the size of the body area being treated is_______.

Answer 29

Lower, Bigger

Question 30

Describe the Paraffin-Dipping technique

Answer 30

``` • Application – Check area for contraindications – Remove all jewelry, watches, etc – Wash extremity with soap and water – Dip extremity into paraffin wait until shiny – Re-dip 6-10 times – Place extremity into a plastic bag – Apply toweling to hold heat in – Tx time: 30 minutes – Remove toweling, plastic, bag, and wax. – Return wax to paraffin bath ```

Question 31

Describe the Paraffin-Immersion technique

Answer 31

``` • Application – Check for contraindications – Remove jewelry, watches, etc. – Wash extremity – Dip extremity until shiny – Redip 6-10 times – On 10th time place extremity back into paraffin bath for duration of treatment – Tx time 30 minutes – Remove from bath and return wax – Watch for burns ```

Question 32

Describe the Paraffin-Brushing technique

Answer 32

``` • Application – Check for contraindications – Remove jewelry, watches, etc. – Use a standard paint brush to apply paraffin – 7-10 layers – Wrap or cover in plastic and layer of towels – Tx time: 30 minutes – Remove towel, plastic, and wax. – Return wax to paraffin bath ```

Question 33

How do you use fluidotherapy?

Answer 33

``` • Application: – Check for contraindications – Position patient comfortably – Place injured area into machine – Use toweling at the interface between machine and body segment – Tx time: 30 minutes – Can do active exercises within machine ```

Question 34

Inverse square law

Answer 34

Intensity varies with the inverse square of the distance between the bulb and the skin – E.g. Change from 20 cm to 10 cm = ½ distance – Inverse of ½ = 2 – Square of 2 is 4 – Therefore 4X more heat with half the perpendicular distance

Question 35

The cosine law

Answer 35

Intensity of heat decreases with change from perpendicular – E.g. Rotate 30 degrees from perpendicular – Cosine of 30 degrees = 86 – Therefore intensity of heat at 30 degrees is 86% of original intensity

Question 36

What phase is contrast bath used for?

Answer 36

Subacute phase

Question 37

T/F: Contrast bath is good for the treatment of swelling?

Answer 37

False; – Does not cause pumping of capillaries unless active | exercise

Question 38

Is contrast bath a deep or superficial modality?

Answer 38

Superficial; Length of treatment does not allow for deep penetration

Question 39

What are examples of topical counterirritants?

Answer 39

Biofreeze, Icy Hot, Ben Gay, etc.

Question 40

How are topical counterirritants thought to inhibit pain?

Answer 40

Thought that A-delta and c-afferent fibers | inhibit pain