Thermotherapy Flashcards
what is thermotherapy?
- application of any substance to the bod that adds heat resulting in increased tissue temperature
- can be superficial or deep
- decreases pain and muscle tonicity
- increases tissue temperature, blood flow fascilitates healing, metabolism and connective tissue extensibility
- a 1 degree increase in tissue temperature is associated with a 10% to 10% increase in local metabolism
- tissue temperature should be elevated 40-45 degrees for a therapeutic effect
- thermotherapy can be delivered by 3 mechanisms (conduction, convection, conversion)
- significant increase in pain relief after 8 hours of heated knee wrap at temps 38-40 deg C when compared to a control group
- significant pain relief with continuous low level heat therapy over 3 consecutive days when compared to a control group. similar to that obtained with max over the counter dose of oral ibuprofen
- found that topical heat applied directy to skin was superior to both acetominophen or ibuprofen at decreasing pain, muscle stiffness, lateral muscle flexibility, and disability. 2 days later still significant
how to apply conduction thermotherapy:
indication?precautions?adverse treatment effects?
- hydroculator pack/low level heat wrap/paraffin bath
- acute muscular pain/DOMS/menstrual pain
- diabetes mellitus/MS/PVD/SCI/Rheumatoid disease
- burns
how to apply convection thermotherapy:
indication?precautions?adverse treatment effects?
- fluidotherapy/hydrotherapy
- wound debridement
- no precautions
- infections/cardiovascular issues
how to apply conversion thermotherapy:
indication?precautions?adverse treatment effects?
- ultrasound/heat lamp/diathermy
- tendonitis/joint contractures/muscle spasms/OA
- pregancy/laminectomy sites/spinal cord/malignancy/vascular insufficiency/eyes/testes/heart/growth plates/anesthetic area/joint prosthesis/THR
- burns/increased pain/increased inflammation
What are the hemodynamic effects?
- vasodiltion
- increases blood flow
- superficial heating agents do not heat to the depth of most muscles to heat deep muscles, use exercise or deep heating modalities such as US or diathermy
- increase tissue temperature (40-45 degrees)
- facilitates tissue healing (increases circulation, enzymatic activity, increases availability of oxygen and nutrients to tissue, removes wastes)
- relaxes skeletal muscle
- decreases muscle spasms
- decreases pain and stiffness
What are the neuromuscular effects?
- increases nerve conduction velocity
- decreases conduction latency or sensory and motor nerves (increases by approximately 2cm/sec for every 1 deg increase in temperature)
- increase pain threshold
- changes in muscle strength- decreases during the initial 30 min then gradually recovers then increases to above
what are the metabolic effects?
- increases tissue metabolism
- increases collagen extensibility
How to apply moist hot pack
canvas/nylon case with hydrophillic silicate
stored in water 70-75 degreesC
pack covers entire area and secured in place
6-8 layers of material around it
patient should feel mild to moderate heat sensation
monitor patient and check area after 5 min
sign early change in color –> may be over heating
avoid having patients lie on with full body weight
how to apply paraffin wax
low melting point (54C)
low specific heat- does not feel as hot as water of the same temperature, resulting in decreased risk for burns
wash and dry segment, remove all jewelry, dip hand up to cm past wrist, remove, and repeat 8-10 times. place in plastic bag and wrap in towel for 10-20 min
how to apply electric heating pads
can cause skin damage if pt fell asleep while on it!!
how to apply wearable heat packs
can be worn up to 8 hours at a time (40C)
how to apply fluidotherapy
dry heat modality (convection)
work well for distal extremities
clean and dry extremity place in the sleeve and secure (38.8-47.8C) exercise within
contraindications
- over areas with a lack of intact sensation
- over areas of vascular disease or insufficiency
- over areas of recent hemorrhage (avoid recent bruises or bleeding in the past 48-74 hours)
- over areas of known malignancy
- over areas of acute inflammation
- over infected areas
- over areas where liniments or heat rubs have recently been applied
- thrombophlebitis
Precautions
- acute injury or inflammation
- pregnancy
- poor thermal regulation
- edema
- cardiac insufficiency
- meta in the area
- over an open wound
what pathophysiologic effects do cold and heat have in common? different?
common: decrease pain and spasm
different: metabolism, blood flow, inflammation, edema, and extensibility all are decreased by cold and increased by heat
