BPA Unit 2: Cryotherapy

Question 1

What is Conduction?

Answer 1

The transfer of heat by direct interaction of the molecules in the warmer areas with those in cooler areas

Question 2

Decreasing the skin temp. to what is sufficent to produce local analgesia?

Answer 2

Lowing the skin to 56.5°F is sufficient

Question 3

What is the skin temperature that can produce a 33% reduction in nerve conduction velocity?

Answer 3

50°F

Question 4

What is Convection?

Answer 4

This occurs when there is direct contact between skin and moving fluid particles

Question 5

What is Evaporation?

Answer 5

Vapocollant sprays are used for temporary pain relief before stretching muscles with active trigger points or muscles with local spasms. They transfer energy

Question 6

What ar the biophysical principles of Cryotherapy?

Answer 6

• The resulting arteriolar vasoconstiction reduces bleeding
• The decreased in metabolism and vasoactive agents, which reduces inflammation and outward fluid filtration
• The pain threshold is elevated

Question 7

What are the Hemodynamic Effects of Cryotherapy?

Answer 7

• Decrease in blood flow
• Edema reduction

Question 8

What are the Peripheral Nerve Effects of Cryotheapy?

Answer 8

• Increases threshold for depolarization
• Slows nerve conduction velocity
• Extreme cold can block nerve conduction

Question 9

What are the Neuromuscular effects of Cryotherapy?

Answer 9

• Decrease proprioception
• Spasticity reduction
  –A reflex decrease in gamma-motorneuron activity through stimulation of cutaneous afferents
  –A decrease in afferent spindle discharge by direct cooling of the muscle

Question 10

If a person has pain, what are the physiological and therapeutic benefits/effects?

Answer 10

• Physiological: Decreased peripheral nerve conduction velocity, elevated pain threshold
• Therapeutic: Decreased pain

Question 11

If a person has Injury/surgery, what are the physiological and therapeutic benefits/effects?

Answer 11

• Physiological: Decreased tissue metabolism; Hemodynamic changes (vasoconstriction, increased viscosity)
• Therapeutic: Decreased inflammation and improved healing; decreased swelling

Question 12

If a person has Muscle spasms, what are the physiological and therapeutic benefits/effects?

Answer 12

• Physiological: Decreased muslce-spindle discharge
• Therapeutic: Decreased spasm

Question 13

If a person has Spasticity, what are the physiological and therapeutic benefits/effects?

Answer 13

• Physiological: Decreased gamma-Motoneuron activity
• Therapeutic: Decreased muscle tone

Question 14

What are the Clinical Indications for Cold Therapy?

Answer 14

• Acute injury or surgery
• Pain management
• Muscle spasms
• Myofascial pain syndrome
• Delayed-Onset Muscle Soreness (DOMS)

Question 15

What are the Most approptiate forms of Cryotherapy?

Answer 15

• Cold Compression Device: provides cold and compression at the same time
• Vapocoolant Spray: Limited use, allows spray and stretch at the same time
• Ice Massage: Best for Small or localized areas
• Ice Bag: Convenient, can be given prior to leaving the clinic or patinet can make at home, big areas
• Cold Pack: Clinic use, can be molded to fit area, big areas
• Cold Immersion Bath/Whirlpool: More aggressive cooling, distal extremities, patient can perform exercise while receiving cold therapy

Question 16

What is the typically temperature and total treatment time when using Cold Compression Device?

Answer 16

~50° F
- 10-20 min

This varies in pressure

Question 17

What is the typically temperature and total treatment time when using Cold Packs?

Answer 17

< ~32°F
- 20-30 min

Question 18

What is the typically temperature and total treatment time when using Cold Immersion Bath/Whirlpool?

Answer 18

50-65°F - Extremity
65-80°F - Whole Body
- 10-20 min

Question 19

What is the typically temperature and total treatment time when using Ice Massage?

Answer 19

< ~32°F
- 5-10 min

Question 20

What is the typically temperature and total treatment time when using Ice Bag/Pack?

Answer 20

< ~32°F
- 20-30 min

With this, there can be a weight on top, or this can be wrapped

Question 21

What is the typically the total treatment time when using Vapocoolant Spray?

Answer 21

3 to 5 slow sweeps (10cm/sec)

Hold ~12in away

Question 22

What it the typically patient sensation with Cryotherapy?

Answer 22

Cold -> Burning-> Aching -> Numbness

Question 23

What are the Guildelines for Cryotherapy Application?

Answer 23

• Do a thorough evaluation
• Explain the procedure and expected benefits
• Explain sensory response: cold, burn, ache, numb
• Obtain permission
• Position patient comfortably and elevate the body part
• Apply cryotherapy
• Provide a bell or call system
• Check the treatment area post-treatment

Question 24

For what purpose is indicated positioning the patient’s extremity elevated in the presence of joint swelling?

Answer 24

To decrease the capillary hydrostatic pressure

Question 25

For which of the following methods of cryotherapy transfers via convection? A. Ice Cup Treatment B. Cold Whirlpool treatment C. Cold Compression Treatment D. Vapocoolant Spray Treatment

Answer 25

B. Cold Whirlpool Treatment

Question 26

The patient complaints of significant pain and swelling due to recent right total knee replacement. Which of the following interventions is BEST to provide relief of the patients symptoms? A. Cold Pack surrounding the knee x 20 min B. Cold Pack (gel) surrounding the knee x 15 min C. Cold Pack and compression surrounding the knee x 20 min D. Ice Cup Massage to the area x 10 min

Answer 26

C. Cold Pack and compression surrounding the knee x 20 min

Question 27

When Applying cold on the knee joint to decrease inflammation at the ACL, which of the treatment durations would be more indicated to safely take into consideration? A. 15 min B. 10 min C. 35 min D. 20 min

Answer 27

D. 20 min

Question 28

Which of the following outcomes is MOST appropriate to assess effectiveness of cryotherapy treatment for edema due to an acute ankle sprain? A. Volumentric Measurement B. Modified Ashworth Scale (Spasticity Test) C. MMT D. Blood Pressure

Answer 28

A. Volumentric Measurement

Question 29

Which of the following biophysical principles of Cold MOST appropriately describes why Cold is widely used in the management of acute trauma? A. The resulting Arteriolar vasoconstriction B. The increase of fluid filtration into interstitial tissue C. The increase in tissue metabolism D. The Lowering of the pain threshold

Answer 29

A. The resulting Arteriolar vasoconstriction ## Footnote Cold makes the blood vessels smaller decreasing swelling in the area

Question 30

Which of the following statements has the correct sensory response order that a patient SHOULD exerience during that an Ice Cup Massage Treatment? A. Cold, Burning, Achy, Numbness B. Cold, Burning, Numbness, Achy C. Burning, Numbness, Achy, Cold D. Achy, Cold, Burning, Numbness

Answer 30

A. Cold, Burning, Achy, Numbness