Unit 2: Cryotherapy Flashcards
Cryotherapy
“Cold” Therapy
-Used for treatment of acute injures or trauma by applying a substance to lower or withdraw heat from body tissue
-Therapeutically, superficial cold techniques effect tissue to depths of 1-2 cm
Biophysical Responses to Cryotherapy
-Hemodynamic
-Metabolic
Hemodynamic Response (Biophysical Responses to Cryotherapy)
The tissue undergoes vasoconstriction with vessels constricting
Metabolic Response (Biophysical Responses to Cryotherapy)
Tissue expending less amount of energy and decreasing the amount of inflammation during the healing process
Transmission of Cooling
-Conduction: Direct contact to the tissue surface (ex. cold pack)
-Evaporation: When liquid is changed to gas (ex. cold sprays (ethyl chloride)
-Convection: Cold whirlpool
Superficial Cooling is most often used to treat…
-Neuromuscular Conditions
-Musculoskeltal Conditions
-Acute Injuries
Temperature changes and biophysical effects are related to…
-Time of exposure
-Method used to cool tissue
-Conductivity of tissue (Type of tissue)
-Depth of tissue
Use and Effects of Cryotherapy
-Inflammation Control
-Edema Control
-Pain Control
-Modification of Spasticity
-Cryostretch
Inflammation Control
-Control acute inflammation and accelerate recovery from tissue trauma
-Decrease blood flow and capillary permeability
-Decrease temperature
-Impede movement of fluid from capillaries to interstitial spaces
-Decrease pain
Edema Control
-Edema is associated with acute inflammation
RICE
-R:est
-I:ce
-C:ompression
-E:levation
(not as effective with edema caused by immobilization or poor circulation
Lowered tissue temperature provides (Pain Control)
Analgesic effect (decreased nerve conduction velocity)
Increased pain threshold (Pain Control)
Blocks transmission of painful stimuli to higher centers of brain
Pain Control
-Interrupts pain-spasm-pain cycle
-Alleviates underling problem causing pain (inflammation)
Modification of Spasticity
-Decreased gamma motor neuron activity
-Decreased afferent spindle and gogli tendon
organ activity
-Temporary effect: 30 minute application = 60 minute effect (allows time for therapeutic intervention)
Sequence of cooling/what the patient will feel…
COLD > BURNING > ACHING > NUMB
-Intense Cold with skin reddening (hyperemia)
-Burning sensation
-Deep Aching feeling
-Analgesia (10-20 minutes) Numbness
Treatment Variables
-Time 5 minutes to 45 minutes
-Depth of penetration to be achieved } Client tolerance
-Amount of adipose tissue, fluid
-Location of targeted tissue
Types of Cryotherapy
-Commercial cold packs
-Ice Packs, ice bags, crushed ice
-“Slush” ice (part alcohol and water)
-Ice Massage
-Cold Ice Water Immersion Baths
-Ice Towels
-Cold Compression Unit
-Vapocoolant Spray
Advantages of Cold/Ice Packs
-Conform to affected area
-Can target large areas and multiple sites
-Can combine with elevation
-Can hold in place with ace wrap or compression
wrap
-Average treatment time: 10-20 minutes with close monitoring of the skin
Advantages of Ice Massage
-Used most often to anesthetize localized areas
-Medium Used: Ice cubes, Frozen water (paper cups), Commercial Unit
-Treatment Time: 5-10 minutes or analgesia
Purpose of Vapocoolant Sprays
-Intended for topical use to cause a chemical reaction which cools skin
-Affect superficial layers of the skin and help with reducing muscle spams and pain.
-Often used for sports injuries.
Indications for use of Cryotherapy
-Acute injury inflammation – most common } Edema
-Post exercise edema and pain
-Arthritic flare
-Musculoskeletal conditions
-Acute bursitis or tendonitis
-Spasticity
-Pain secondary to muscle spasm
Precautions/Contraindications for Cryotherapy
-Cold hypersensitivity (urticaria)
-Cold intolerance
-Cryoglobulinemia
-Raynaud’s Phenomenon
-Application over regenerating peripheral nerve
-Application over area with circulatory compromise or peripheral vascular disease
-Frostbite
Cold Hypersensitivity
-Vascular skin reaction
-Slightly elevated patches (reddened or paler than surrounding skin)
-Decreased blood pressure
-Syncope
-Severe itching
Cold Intolerance
-Severe pain
-Numbness
-Color changes
-Hypersensitivity
Cryoglobulinemia
-Uncommon
-Abormal blood protein
-Idiopathic or associated with multiple
myeloma, systemic lupus, RA
-Blood in urine
-May result in ischemia/gangrene
Raynauds Disease
-Disease: Idiopathic
-Phenomenon: (more common) cyanosis due to some other disorder
-Characterized by sudden pallor and cyanosis followed by redness of the skin of the digits
-Precipitated by cold or emotional stress
Precautions for Cryotherapy
-Open wounds
-Patients with hypertension
-Patients with poor sensation and mentation
-The very young or very old
Adverse Effects of Cryotherapy
-Tissue Death
-Frostbite
-Nerve Damage
Sequence of Events for Application of Cryotherapy
-Assess patient (set treatment goals)
-Determine if cryotherapy is appropriate
-Determine if contraindicated
-Select appropriate cooling agent
-Explain to patient: Purpose, Procedure and Expected sensation
-Apply appropriate cooling agent
-Assess outcome of treatment
-Documentation
Documentation
-Area of body treated
-Type of cooling agent
-Treatment duration
-Patient position
-Response to treatment
Types of questions the therapist should ask a patient
to determine whether contraindications for cryotherapy were present?
-Do you have any nerve damage in this area?
-Do you have any numbness or tingling in the
limb?
-Frost bite
-Ryanauds
-Hypersensitivity
TEST SENSATION
Cold should NOT be applied to regenerating peripheral nerves. Why?…………
Cryotherapy should NOT be applied to an area with impaired circulation
