Week 2: Cryotherapy & Thermotherapy Flashcards
Cryotherapy & Clinical Indications for it
use of cold for therapeutic purposes
- one of the most effective & least expensive for ACUTE INJURY
- PAIN MANAGEMENT
- REDUCE SWELLING
- FACILITATE MUSCLE RELAXATION
- LIMIT HYPOXIC TISSUE INJURY
Principle modes of energy transfer to remove heat by adding a cooling agent
- conduction
- convection
- evaporation
Thermal conductivity
measure of how efficiently a material or tissue conducts heat
- higher water content have better thermal conductivity than adipose
Thermal Conductivity levels (GOOD TO POOR)
metal> ice>water>bone>muscle>adipose tissue
T or F: ice bags/massage > cold water baths/frozen gel packs
TRUE
- ice is most effective type of cold bc it undergoes a phase change from solid to liquid so it causes a greater heat extraction
Conduction
transfer of heat by direct contact with molecules in the warmer area with those in the cooler area
Convection
heat removed by direct contact with moving fluid
- whirlpool where the cool water is circulating
- (W/o movement, it would be conduction)
Evaporation
heat energy is removed as a molecule changes from a liquid to a gas causing a cooling effect
- spray and stretch
Negative effects of cold
- affects muscle performance (short time <10- increase strength output) (long time decreases strength output)
- increase joint stiffness
- negative effects on proprioception
- increase tissue viscosity and decreased elasticity
Myofascial Pain Syndrome
sensory, motor, or autonomic pain symptoms caused by trigger points (muscular strain, postural imbalance, poor body mechanics)
- Tx: ice massage, spray and stretch, US, Estim
What to think about when selecting a cooling agent
which body area will be cooled
type of tissue
size of the area
Normal Sensations in response to cold
- intense cold
- burning
- aching
- numbness – what we want to get to when we get benefits
Cryotherapy Duration
IT DEPENDS BUT
- 20-30 min for conductive cooling
- intermittent cooling : 20 on- 10 off 2x
- repeated application: 30 min every 2 hrs
- ice massage 5-7 min
Ice Massage
- great for small, irregular area or trigger points
- good conductor bc ice to water
Types of cold compression units
- manual : cant control temp so thermometer.
- electric
Cold Urticaria
- histamine reaction to cold
- hive like rash
Raynaud’s
- Vasospasic disorder: cycles of pallor, cyanosis, rubor, numbness, tingling or burning from precipitating factors like cold exposure, emotional stress, caffeine and smoking
Paroxysmal cold hemoglobinuria
- hemoglobin released from lysed RBC– appears in urine
- following local or genetic cold exposure
T or F: cold over nerve regeneration or compromised circulation can benefit healing process
FALSE
- it impedes healing and can decrease blood flow to an already compromised area
hypertension and effects on cold
cold may cause transient increase in BP
Safe temp for therapeutic heat
104-113 degrees F
Superficial heat modalities hit what depth?
1-3 cm
- moist hot packs
- warm whirl pool
- Electric heating pads
Deep heat modalities hit what depth?
3-5 cm
- US
- diathermy
Neuromuscular effects of heat
- elevate pain threshold (thermal gate theory)
- break the pain spasm pain cycle
- alter nerve conduction velocity
- change muscle spindle firing rate by decreasing spasm and cycle
For the greatest effect, try to pair heat with _____
exercise
Connective tissue effects of heat
- increase elasticity
- increase muscle flexibility
- decrease viscosity
- decrease joint stiffness
Radiation
conversion of heat energy to electromagnetic radiation
Hydrocollator temp
158-167 degrees
towel layers
6-8
1 layer hot pack cover
2 towels
how long to treat with hot pack
10-30 min
hot pack use
- reduce pain
- reduce muscle spasm
- increase tissue extensibility
Advantages of hot packs
- ease of prep and application
- many sizes
- moist, comfortable heat
- relatively inexpensive
Disadvantages of hot packs
- no method of temp control once removed from regulated tank
- may be awk to secure on pt
- does not retain heat for >20 min
- passive intervention
- may leak and need to be discarded
Methods of Paraffin Wax
- dip & wrap (more practical)
- dip & re-immerse
disadvantage of paraffin wax
- cant exercise while in wax
