Thermotherapy

Question 1

What is thermodynamics?

Answer 1

the branch of physics concerned with the relationship between heat and other forms of energy

Question 2

What is the 1st law of thermodynamics?

Answer 2

Law of conservation of energy: “Energy cannot be created or destroyed”

Question 3

What is the 2st law of thermodynamics?

Answer 3

Heat energy transfer is directional: heat travels from high to low temperatures

Question 4

The amount of heat energy within a substance depends on what?

Answer 4

1.   Speed of particles (kinetic energy)
2.   Number of particles (mass)
3.   Capacity of particles to store heat (specific heat capacity)

Question 5

Let us consider the use of hot pack. During application, the thermal energy stored in the hot pack is transferred to both the targeted soft tissue and to the air surroundings both of them. Which law of thermodynamics is this in accordance with?

Answer 5

The first law, called law of conservation of energy, states that energy cannot be created nor destroyed

Question 6

The heat contained in paraffin wax, which is greater than that of the target soft tissue, is transferred to the latter during therapy. Which law of thermodynamic is this in accordance with?

Answer 6

The second law stipulates that heat energy transfer always occur in one direction only, i.e., from the warmest to the coldest substance.

Question 7

What is the difference between heat and temperature?

Answer 7

heat is energy and that temperature is a measure of it.

Question 8

Heat transfer equation:

Answer 8

Calories = mass x Δt x specific heat

Question 9

What is specific heat?

Answer 9

the capacity of its particles to store heat (its specific heat capacity).

Question 10

Is it correct to say that of two hot packs with the same temperature, say 70°C (158°F), the one with the larger mass (1,500 g vs. 1,000 g) will contain a greater amount of heat than the other?

Answer 10

YES, because the amount of heat (q) a material or substance possesses is directly related to its mass, as evidenced by the formula q = m ×Δt° × c, where m is the mass of the hot pack in this case.

Question 11

Baseline temperature of human tissues:

Answer 11

82º-96ºF

Question 12

Optimal temperature for therapeutic tissue heating​ effect=

Answer 12

104°-113°F (40º and 45ºC)

Question 13

Heat nocioception input starts at what temperature?

Answer 13

113 and over (45º C)

Question 14

What is the thermal conductivity of subcutanoeus fat?

Answer 14

0.45

Question 15

Why is that applying a hot pack at 50°C (122°F) directly over the skin will cause severe pain and burn, whereas applying paraffin wax of the same temperature will feel comfortable and not burn the skin?

Answer 15

The answer lies in the fact that compared with water, paraffin has a much lower capacity to retain or store (c = 0.45 vs. 1.00) and conduct heat (k = 0.59 vs. 1.42) to the soft tissues.

Question 16

Why is it that if you immerse one hand in a Fluidotherapy air chamber of a given temperature and the other in a paraffin bath of the same temperature, the paraffin bath feels hotter than the air chamber?

Answer 16

It is because paraffin wax holds approximately 2 times more heat (c = 0.45 vs. 0.24) and conducts heat approximately 30 times faster (k = 0.59 vs. 0.02) than air.

Question 17

Conduction:

Answer 17

Physical contact of 2 solid substances. Ex. hot pack.

Question 18

Convection:

Answer 18

Physical Contact of gas or fluid against a solid substance.

(fluidotherapy, hydrotherapy, paraffin bath)

Question 19

What is the difference between free convection and forced convection?

Answer 19

Free convection: heating of the solid substance induces solely by the temperature difference between the two substances. Ex. Still water hydrotherapy

Forced convection: caused when the motion of the fluid or gas is imposed externally by means of a fan (Fluid therapy) or a turbine (hydrotherapy).

Question 20

Radiation:

Answer 20

Air Contact between Agent and Tissue. Is the propagation of energy in the form of rays or waves. Ex. Shortwave, Diathermy.

Question 21

Evaporation:

Answer 21

Liquid to gaseous state when contact with tissue. Ex. vapocoolant spray (cryotherapy)

Question 22

vapocoolant spray (cryotherapy) uses what type of heat transfer?

Answer 22

evaporation

Question 23

Types of moist thermothrapy agents:

Answer 23

hot pack and paraffin bath

Question 24

Types of dry thermothrapy agents:

Answer 24

fluidotherapy

Question 25

Application times of thermotherapy agents:

Answer 25

Hotpack: ~20 minutes

Paraffin: ~30 minutes

Fluidotherapy: ~30 minutes

Question 26

how many layers of toweling for a hot pack?

Answer 26

5-8 layers

Question 27

Screening for thermotherapy:

thermal discrimination testing scoring

Answer 27

4-5 = normal / slightly impaired (no restriction)

3 = moderately impaired (precaution)

1-2 = severely impaired (risk of harm)

0 = totally impaired (all thermal & electrophysical agents are contraindicated)

Question 28

When applying thermal agents when do the therapist checks the skin?

Answer 28

Always check skin before and after

Depending on agent, you should also check during application and at minimal, check in with your patient during the treatment time.

Question 29

Metabolic Biophysiological Response to thermotherapy:

Answer 29

vasodilation → increase blood flow and cell metabolism → enhanced soft tissue healing

Question 30

Musculoskeletal biophysiological response to thermotherapy:

Answer 30

increased viscoelastic properties and decreased joint viscosity → improves muscle flexibility and joint mobility → enhances tissue mobility

Question 31

Neuromuscular biophysiological response to thermotherapy:

Answer 31

decreases gamma motor activity → decreases alpha motor neuron activity → decreases muscle spasm

Question 32

Thermotherapy over skin area where sensation to heat is severely impaired?

Answer 32

Contraindicated

may cause cutaneous burn

Question 33

thermotherapy over a cancerous area?

Answer 33

contraindicated, enhance tumor growth and metastasis.

Question 34

thermotherapy over a thrombophlebitic area

Answer 34

contraindicated, dislodge blood clot, which may then circulate into the vessels of vital organs, causing serious circulatory problems and possibly death

Question 35

thermotherapy over the abdominal, pelvic, and low back areas of pregnant women

Answer 35

contraindicated, teratogenic effects on fetal development and growth caused by increased local or systemic maternal body temperature.

Question 36

thermotherapy over acute and severe inflammatory conditions

Answer 36

contraindicated, worsen the condition by aggravating the inflammatory response through increased blood flow resulting from heat application.

Question 37

thermotherapy in patients that are confused and unreliable

Answer 37

contraindicated

Question 38

thermotherapy over an area of impaired blood circulation

Answer 38

precaution, may cause tissue overheating because the treated area will not be able to cope with the demand for additional and cooler blood flow during treatment

Question 39

thermotherapy In patients presenting with severe cardiac insufficiency

Answer 39

precaution, may not being able to cope with the increased cardiac demand triggered by the heat-induced increase in blood circulation. Periodic monitoring of vital signs is advised during and after therapy.

Question 40

thermotherapy over superficial closed and open wounds, including grafted or burn wounds?

Answer 40

precaution

Question 41

thermotherapy over body areas with superficially located metal implants?

Answer 41

precaution, may cause internal soft tissue burns because metals absorb and conduct heat well. Use caution when applying hot pack and paraffin over such body areas.

Question 42

thermotherapy over areas in presence of demyelinated nerves

Answer 42

precaution

Question 43

thermotherapy on hand motor skills and reaction time

Answer 43

precaution, may delay reaction time and decrease tapping speed in healthy subjects. Inform patients that their hand motor skills may be impaired for a few hours following therapy.

Question 44

thermotherapy in cases of systemic infectious diseases:

Answer 44

precaution, —may increase core body temperature, which may increase fever

Question 45

thermotherapy In the presence of flammable anesthetics

Answer 45

precaution, may cause explosion

Question 46

°F to °C

Answer 46

Deduct 32, then multiply by 5, then divide by 9

Question 47

°C to °F

Answer 47

Multiply by 9, then divide by 5, then add 32

Question 48

thermotherapy on a patient who scores of 3/5 in the skin thermal discrimination test:

Answer 48

precaution

Question 49

thermotherapy on a patient who scores of 2/5 or 1/5 in the skin thermal discrimination test:

Answer 49

risk

Question 50

thermotherapy on a patient who scores of 0/5 in the skin thermal discrimination test:

Answer 50

no, contrainidicated for all thermal therapeutic agents