Thermal Agents - Cryotherapy Flashcards
Definitions
- Cryotherapy = ?
- Thermotherapy = ?
Cryotherapy
(a) Cryotherapy
- The therapeutic use of cold
(b) Thermotherapy
- The therapeutic use of heat
Definitions
- Superficial heating agents = ?
- Deep heating agents = ?
Cryotherapy
Superficial heating agents:
- Therapeutic use of heating agents typically used for pain control.
Deep heating agents:
- Energy conversion into heat as it passes through body tissues
Definitions
Amount of energy required to raise the temperature of a given weight of a material by a given number of degrees = ?
Cryotherapy
(e) Specific Heat
- Amount of energy required to raise the temperature of a given weight of a material by a given number of degrees
Effects of Cold
- Hemodynamic Effects = ?
- Metabolic Effects = ?
Cryotherapy
Effects of Cold:
(a) Hemodynamic Effects
Vasoconstriction
- Less than 15-20 minutes application
- Decreases release of vasodilator mediators
Cold-induced vasodilation (CIVD)
- Though to be due to sympathetic inhibition
- Hunting response: cyclic nature of extended cold
(b) Metabolic Effects
- Decreased metabolic rate
Effects of Cold
- Neuromuscular Effects = ?
- Altered muscle strength = ?
- Decreased spasticity = ?
Cryotherapy
(a) Neuromuscular Effects
Decreased nerve conduction velocity
- 5 min reverses in 15 minutes
- 20 minutes = 30+ minutes
Increased pain threshold
- Sensory input to block pain receptors (Gate Control Mechanism)
- Reduction of muscle spasm, nerve velocity, or edema
(b) Altered muscle strength
- Decreased motor nerve conduction velocity, muscle spindle sensitivity, and muscle strength when applied directly to the muscle.
- Increase after 5 minutes, decrease after 30 minutes
- Consider – strength testing compared to timing of ice
(c) Decreased spasticity
Four uses of Cryotherapy = ?
Cryotherapy
(a) Inflammation Control
- Pain, Microvessel bleeding, and DOMS
- 15 mins or less.
- Immediately after injury & during acute inflammatory phase.
(b) Edema Control:
- Extravasation and permeability
- Vasoconstriction vs vasodilation
- P.R.I.C.E.
- Acute Inflammation vs immobility, poor circulation
(c) Pain Control:
- Cutaneous thermoreceptors help block pain signals via gait control.
- Can help control pain spasm cycle.
(d) Muscle tone: Can reduce spasticity
- Needs to be applied for 30 mins for spasticity reduction
A technique that combines cryotherapy with exercise = ?
Cryotherapy
Cryokinetics:
(a) A technique that combines cryotherapy with exercise.
- Uses ice immersion, cold packs, or icemassage.
(b) Goal is to numb the injured part to the point of analgesia and then work toward achieving normal ROM through progressive active exercise.
(c) Exercises performed during periods of numbness should be pain-free and progressive in intensity,concentrating on both flexibility and strength.
Application of cooling agent prior to stretching = ?
Cryotherapy
Cryostretch:
- Application of cooling agent prior to stretching
- Reduce muscle spasm and allow for greater ROMwith stretching
- Cold pack after hot pack > hot pack alone
Contraindications of Cryotherapy = ?
Cryotherapy
Contraindications of Cryotherapy:
- Cold hypersensitivity (cold-induced urticaria)
- Cold intolerance
- Cryoglobulinemia - may be associated with multiple myeloma, systemic lupus erythematosus, rheumatoid arthritis, or other hyperglobulinemic states.
- Paroxysmal Cold Hemoglobinuria
- Raynaud’s disease or phenomenon
- Over-regenerating peripheral nerves
- Over an area with circulatory compromise or peripheral vascular disease
- Determine cause of edema
Precautions of cryotherapy = ?
Cryotherapy
Precautions of Cryotherapy:
- Over the superficial main branch of a nerve
- Over an open wound
- Hypertension
- Poor sensation or mentation
- Very young and very old patients
Adverse effects of cryotherapy = ?
Cryotherapy
Adverse Effects of Cryotherapy:
(a) Tissue death
- Most severe adverse effect
- Caused by prolonged vasoconstriction, ischemia, or thromboses in smaller vessels
(b) Temporary or permanent nerve damage
- Results in pain, numbness, tingling, hyperhidrosis, or nerve conduction abnormalities
- Limit cold application to under 15-20 minutes
Systematic Review of Cryotherapy = ?
Cryotherapy
Systematic Review of Cryotherapy
(a) Recovery Characteristics
- DOMS, RPE, Objective markers (blood splama markers and cyotkines)
Pooled data from 27 articles revealed:
DOMS:
- Cooling and especially cold water immersions, reduced the symptoms of DOMS significantly, compared to the control conditions after 24 hrs recovery.
- This effect remained significant after 48 hrs and 96 hrs
RPE
- Studies favored cooling agents to control conditions after 24 hours of recovery
- No significant difference after 48 hours
There was no evidence, that cooling affects any objective recovery variable
- Cooling did not affect objective recovery variables such as lactate-levels, CK-levels or IL6-levels.
Cryotherapy Types - Cold Packs
- Temp = ?
Cryotherapy
Cold Packs
(-) Temp
- Cold packs should be between 0-5 deg. C / 32-41 deg. F
Cryotherapy Types - Cold Pack
- ? min. = normally
- ? min. = spasticity
Cryotherapy
Cold Pack - Duration:
- 20 minutes normally
- 30 minutes for spasticity
- Applied every 1-2 hours for inflammation and pain control
- Inspect skin after
- Red or dark pin
- Presence of wheals (welts) or a rash
Cryotherapy Types
Ice pack provides = ?, compared to cold pack
Cryotherapy
Ice Pack:
(-) Provides more aggressive cooling than cold packs at the same temperature.
- Ice has a higher specific heat than most gels
- Ice absorbs a large amount of energy when it melts