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Flashcards in cryotherapy Deck (80)
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1
Q

what is cryotherapy

A

the therapeutic application of any material or substance that results in WITHDRAWAL of HEAT from the body,

2
Q

Withdrawal of heat from the body causes

A

lowering tissue temp locally and, under some specific applications, the whole-body core temp.

3
Q

modes of heat transfer

A

conduction
convection
evaporation

4
Q

What are considerations with application

A
  • type of agent
  • method of delivery
  • dosimetry
  • precautions/ contraindications
5
Q

What are types of cryotherapy

A

ice packs, ice cups, gel packs, chemical packs, cyropressure units/cryocuff, vapocoolant sprays, cryohydrotherapy, cooling suits

6
Q

indications for cryotherapy

A

abnormal tone, acute or chronic pain, acute or subacute inflammation, bursitis, muscle spasm, musculoskeletal trauma, myofascial trigger points, tendonitis, tenosynovitis

7
Q

local skin temperature is used to what?

A

estimate stage of healing and use of cold

8
Q

If skin temp. elevated equals what

A

use of cold

9
Q

normal skin temp equals

A

cold discontinued to prevent impeding healing process/ impair circulation

10
Q

If the skin temp is elevated greater then 72 hour what should you suspect

A

infection… refer to MD

11
Q

uses of cryotherapy

A
  • inflammtion control
  • edema control
  • pain control
  • modification of spasticity- prolonged icing
  • symptom management in MS- cooling vest
  • facilitation
  • cryokinetics and cryostretch
12
Q

Applying cold immediately after injury or during acute inflammatory phase of healing to control what?

A

bleeding
edema
pain
accelerate recovery

13
Q

Applied after clotting has occurred and therefore has no effect on what ?

A

hemorrhaging

14
Q

can limit and reduce edema formation if applied soon after injury (<5 min) occurs by?

A

slowing of metabolic rate and decrease secondary tissue damage

15
Q

if provided later than 5 mins post trauma the effect on inflammatory process is

A

no effect

16
Q

if provided later than 5 mins post trauma the effect are

A

counterirritant and antispasmotic agent

17
Q

how is cryotherapy a counterirritant ?

A
  • increased cold receptor activity
  • decrease nerve conduction velocity
  • decreased pain
18
Q

how is cryotherapy a antispasmotic agent

A
  • decreased gamma motoneuron activity
  • decreased muscle spindle activity
  • decreased spasm/spasticity
19
Q

what are the causes of warmth and redness

A

inflammation

20
Q

causes of coolness & pallor

A

poor circulation

21
Q

how to control edema with cryotherapy?

A
  • cold for 15 mins (20 on extremities)

- applications at least an hour away

22
Q

edema control with acute inflammation includes

A

RICE

compression with elastic wrap & elevation above heart

23
Q

decrease in tissue temp by cryotherapy can indirectly/directly do what

A

decrease sensation of pain

24
Q

CT directly & rapidly modifies sensation of pain by

A

gating pain transmission through activity of cutaneous thermal receptors producing analgesic effect

25
Q

used in conjunction with joint mobs to

A

reduce possibility of pain and swelling

26
Q

used in conjunction with deep friction massage before and after to

A

reduce pain and irritation

27
Q

used in conjunction with electrical

A

stimulation

28
Q

used in conjunction with exercise to

A

decrease residual swelling

29
Q

used in conjunction with RICE to

A

decrease swelling

30
Q

hemodynamic effects of cold

A

initial decrease in bold flow

31
Q

Neuromuscular effects of cold

A
  • decreased nerve conduction velocity
  • increased pain threshold
  • altered muscle strength
  • decreased spasticity
  • facilitation of muscle contraction
32
Q

metabolic effect of cold

A

decreased metabolism & enzyme activity

33
Q

during hemodynamic, cold causes activation of cutaneous cold receptors by directly stimulating ?

A

smooth muscle of the blood vessel walls to contract

34
Q

hemodynamic triggers reflex activation/depolarization of

A

sympathetic adrenergic nerve fibers

35
Q

hemodynamic leads to the release of neurotransmitter

A

norepinephrine, on the adrenergic receptors of smooth muscles surrounding blood vessels

36
Q

during hemodynamic there is a decrease in production of

A

vasodilator mediators (histamine & prostaglandin)

37
Q

during hemodynamic, cold causes a decrease in

A

cell metabolism

38
Q

Cold induced vasodilation

A

initial decrease in blood flow, later increase in blood flow

39
Q

during hemodynamic there a decreased in what after trauma/injury

A

secondary cell hypoxia

40
Q

during hemodynamic cold causes an increase or decrease in blood viscosity

A

increase

41
Q

how is there an increase in blood viscosity during hemodynamic

A

-reduced flow protects other areas from excessive decreases in temp and stabilizes core body temp

42
Q

effects of neuromuscular causes a decrease in

A

NCV in proportion to degree and duration of temp changes

43
Q

Therapeutic effect of neuromuscular

A
  • decrease in NCV
  • Elevation of pain threshold
  • decrease in apsticity
  • change in muscle force generation
44
Q

neuromuscular causes elevation of pain threshold by

A
  • decrease sensation of pain

- stim of cold receptors: increased sensory input blood stimuli to brain cortex

45
Q

neuromuscular can cause counter irritation via the gating control mechanism and interrupts what

A

pain-spasm- pain cycle and decreases muscle spasm, sensory NCV, edema

46
Q

neuromuscular decreases spasticity by

A

a reflex reaction to stimulation of cutaneous cold receptors

47
Q

neuromuscular decreases spasticity initially by

A

decrease in gamma motor neuron activity

48
Q

neuromuscular decreases spasticity later by

A

decrease in afferent spindle and golgi tendon organ activity

49
Q

neuromuscular change in muscle force generation with ice massage <5 min increases in

A

isometric strength

50
Q

neuromuscular change in muscle force generation with cooling 30+ mins by initial decrease in

A

isometric force for 1 hour and then increase for > 3 hours to greater than pre-cooling strength

51
Q

strength testing should be performed when to cryotherapy ?

A

before application

52
Q

Brief application of cold (few seconds) causes

A

facilitation of muscle contraction

53
Q

Cold facilitates Alpha motor neuron activity to produce

A

contraction in flaccid muscle which is a result of an upper motor neuron dysfunction

54
Q

Metabolic effects of cold decrease

A

in rate of all metabolic activities, including those involved in inflammation and healing

55
Q

Should CT be considered for OA and RA

A

yes

56
Q

During RA, cold decreased what

A

histamine in blood

57
Q

at joint temp <86, there is a decrease in

A

activity in cartilage degrading enzymes

58
Q

Cartilage degrading enzymes include

A
  • collagenase
  • Elastase
  • Hyaluronidase
  • protease
59
Q

causes of the primary effects of cooling effects

A
  • vasocontriction
  • Increase cold receptor activity
  • Decreased gamma motor neuron activity
60
Q

causes of vasoconstriction

A
  • decreases swelling

- decreases nerve compression via reduction in edema formation

61
Q

causes of increased cold receptor activity

A
  • decrease pain

- aids in decreasing spasticity

62
Q

causes decreased gamma motor neuron activity

A

decreases spasm/ spasticity

63
Q

Contraindication of cryotherapy

A
  • cold allergy/ hypersensitivity aka cold urticaria
  • cold intolerance
  • raynaud’s disease/ phenomenon
  • cryoglobulinemia
  • paroxysmal cold hemoglobinuria
  • over regenerating peripheral nerves
  • over areas of circulatory compromise or PVD
  • Inability ot discriminate cold
64
Q

Raynaud’s disease/ phenomenon

A

vessels already in chronic state of vasoconstriction/ vasospasm; further application can lead to ischemic necrosis

65
Q

Cryoglobulinemia

A

aggregation of serum proteins in small distal vessels after cold applications that can impair circulation and cause gangrene

66
Q

Paroxysmal cold hemoglobinuria can be signaled by

A

blood in urine

67
Q

multiple sclerosis is aggravated by

A

generalized heating (warm environments/ activities)

68
Q

peripheral cooling for MS

A

decreases tremor

69
Q

cooling vests for MS improve what and reduce what

A

improve: strength, visual function, postural stability
reduce: fatigue

70
Q

what demonstrated as much importance as use of cryotherapy in IMMEDIATE post ACL reconstruction edema control

A

compression

71
Q

what demonstrated a significantly lower tissue temperature than ice pack

A

ice massage

72
Q

lower temperature was seen in a shorter period of time with what over an ice pack

A

ice massage

73
Q

What are expected physiological response to cryotherapy

A
  • short term skin redness
  • anesthesia
  • analgesia
74
Q

Typical sequence of sensation to CT

A
  • intense cold
  • burning
  • aching
  • analgesia
  • numbness
75
Q

Precautions

A
  • over superficial main branch of nerves
  • hypertension
  • very young/old pt
  • poor sensation or mentation
  • over open wound
  • use of vapocoolant sprays- may be inflammable or harmful to ozone layer
76
Q

Adverse effects of cryotherapy

A

tissue death or dame

77
Q

temp of tissue damage

A

<15C (59 F)

78
Q

temp of freezing/frostbite

A

4 to 10 C (39 to 50 F)

79
Q

optimum mins of cryotherapy to achieve vasoconstriction

A

10-20

80
Q

documentation of cryotherapy include

A
  • area treated
  • cooling agent
  • treatment duration
  • Patient positioning
  • response to intervention