WK2- Cryo and Thermal Modalities Flashcards
Define cryotherapy.
The use of cold for therapeutic purposes
What are the principle ways of energy transfer for heating and cooling agents ?
Conduction: transfer of heat by direct contact
Convection: Heat transfer by direct contact with moving fluid or particles
Evaporation: Heat removed as a molecule when changing from liquid to gas.
True or False. Tissues with higher water content have better thermal conductivity than adipose tissue.
True
Classify the following in order of decreasing thermal conductivity: Air, Metal, Ice, Bone, Muscle, Fat, Water
Metal, Ice, Water, Bone, Muscle, Fat, Air
Which cryotherapy intervention is the most effective type of cold ?
Ice, due to its solid to liquid phase change which causes greater heat extraction.
What are the positive effects of cold on tissues ?
Decreases bleeding, reduces inflammation, elevates the pain threshold, Reduces skeletal muscle spasm
What are the negative effects of cold on tissues ?
Affects muscle performance: in the short term increases muscle performance, long term reduces it
Increases joint stiffness
Increases tissue viscosity and decreased elasticity
What are the hemodynamic effects of cryotherapy ?
decreased blood flow due to vasoconstriction with short duration cold ( 15 minutes or less )
if cold is left too long then may vasodilate vessel
Describe the effects of cold therapy on edema and inflammation.
effects microcirculation and metabolism, decreasing oxygen demand
decreases capillary dysfunction
decreases venule diameter
reduce accumulation of leukocytes
reduce intramuscular presure
What are the effects of cryotherapy on peripheral nerves ?
cold decreases conduction velocity and synaptic activity of peripheral nerves both sensory and motor. Raises pain tolerance, affects muscle performance.
In areas of superficial neural tissue, cold may cause neuropraxia, and axonotmesis
True or False. Cold therapy increases propioception.
false
What are the clinical indications for use of cryotherapy ?
Swelling, pain, Muscle spasm/hypertonicity, Tissue Injury
In acute MSK conditions what can accompany cryotherapy to control pain, inflammation and loss of function ?
compression
Describe the process in how cooling the skin can elevate the pain threshold and reduce pain.
cold stimulate thermal A-delta fibers and may override pain signals from C fibers
Increases threshold for depolarization
Slows nerve conduction velocity
Extreme cold can block nerve conduction
Is cold effective in diminishing DOMS ?
NO!
What are the normal sensations that you as a PT can educate your patients on when receiving cryotherapy ?
intense cold, burning, aching, numbness
For how long should a PT apply cryotherapy ?
20-30 minutes for conductive cooling generally
10 min on 10 min off x2
Repeated applications of cooling 30 min every 2 hours
Ice massage for 5-7 minutes
What are some different methods for cold therapy ?
frozen peas, ice massage, ice or cold pack, ice/cold bath, commerical cold pack or gel, cold compression units, vapocoolant sprray
For any agent that goes under _____ F a towel should be used.
30 F
For colder temperatures of an ice bath (longer/shorter) durations should be used.
shorter
True or False. Cold gels function the same as typical cooling agents.
False, they only provide the sensation of coldness
What are the contraindications to cold therapy ?
Cold Urticaria: Redness, swelling, wheals-raised areas of skin that are blanched; systemically; general swelling, flushing face, sharp drop in BP, increased HR, syncope
Cryoglobulinemia: abnormal blood proteins precipitate and form a gel when exposed to low temperatures; may result in ishemia or gangrene; found in those with multiple myeloma, certain viral and bacterial infections, SLE, other rheumatic diseases
Raynaud’s: cycles of pallor, cyanosis, rubor, and normal color digits with numbness, tingling, or burning
Paroxysmal Cold Hemoglobinuria: hemoglobin released from RBCs and appears in the urine
Poor circulatory areas
What are the common precautions to cold therapy ?
HTN: cold may cause increase in BP
Hypersensitivity, Impaired circulation, thermoregulatory disorder
Open Wounds
Superifical peripheral nerve areas
Psychological aversion to cold
What are the essentials when documenting cold treatment:
type of cold, duration, site of application including side, position of patient, use of concurrent compression or elevation, change in skin appearance, patient response, adverse response
