Cold

Question 1

what are the three cryotherapy physiologic responses

Answer 1

1. dec blood flow
2. dec tissue metabolism
3. inc pain threshold

Question 2

what is a conduction cold modality?

Answer 2

cold pack

Question 3

how does temp difference influence response to cold?

Answer 3

higher the difference, greater the effect of cold

Question 4

how does exposure tiem influence response to cold

Answer 4

longer the exposure, the greater the effect

Question 5

how does thermal conductivity/sub cue fat influence response to cold

Answer 5

fat insulates and decreases the effect of cold

Question 6

how does the type/size of cooling agent influence response to cold

Answer 6

ice slurry works best

Question 7

how does surface area to be cooled influence response to cold?

Answer 7

larger surface area to be cooled = decreases effect of cold

Question 8

how does activity level influence response to cold?

Answer 8

higher activity level requires more cooling

Question 9

how deep does cold go?

Answer 9

3cm

Question 10

wetted ice/cubed ice/crushed ice… which is most/middle/least effective at cooling?

Answer 10

1. wetted
2. cubed
3. crushed

Question 11

ice massage v ice bag, which has the greatest decrease in temp and which decrease temp faster?

Answer 11

equal dec in temp, ice massage faster

Question 12

what is a cold convection modality?

Answer 12

cold WHIRLPOOL

Question 13

what cools better and why, conduction or convection?

Answer 13

convection such as whirlpool because it continuously cycles cold water to pull heat from the body

Question 14

what is an example of an evap cooling modality?

Answer 14

vapocoolant

Question 15

how does vapocoolant work (4 steps)

Answer 15

1. heat tx to liquid to vapor
2. spray stimulates thermal afferents
3. reduced motor neuron activity
4. increased ROM

Question 16

what is the hemodynamic effect of cold?

Answer 16

1. cold applied
2. vasoconstriction and increased blood viscosity
3. decreased in bloodflow

Question 17

how does vasoconstriction occur?

Answer 17

cold stimulates thermal sensors which leads to INCREASED SYMPATHETIC ADRENERGIC fiber response

Question 18

how does vasodilation occur?

Answer 18

cold stimulates thermal sensors which leads to DECREASED SYMPATHETIC ADRENERGIC fiber response

Question 19

describe ice’s use post-trauma

Answer 19

reduces inflammation in the first 48, compression and elevation help with edema, overwhelmingly safe to use

Question 20

how does cold influence muscle contraction?

Answer 20

brief periods of cold (less than 10 min) may increase isometric contraction

Question 21

how does cold influence performance?

Answer 21

10+ min of cooling diminishes performance (40 yd dash, vert, agility)

Question 22

how does cold impact joint position sense?

Answer 22

decreases balance but doesn’t effect proprioception

Question 23

how do cold modalities have neuromuscular effects?

Answer 23

decrease spasticity, deep tendon reflexes, and muscle spindle activity

Question 24

how does cold affect MS patients?

Answer 24

improves balance and TUG while wearing a cooling vest

Question 25

what is megan's sports team

Answer 25

steelers

Question 26

when do you choose ice? (5)

Answer 26

``` acute msk trauma pain spasm myofascial pain guarding ```

Question 27

is ice good for DOMS

Answer 27

no, no evidence

Question 28

what are the six contraindications for cold

Answer 28

1. cold urticaria 2. cryoglobulinemia 3. raynauds 4. paroxysmal cold hemoglobinuria 5. area of nerve regen 6. area of compromised circulation

Question 29

what are seven precautions for cold

Answer 29

1. HTN 2. hypersensitivity 3. circulation 4. wound 5. superficial peripheral nerve 6. cold aversion 7. poor cognition/comm

Question 30

why is ice more effective than gel?

Answer 30

takes more energy to melt ice

Question 31

how long to ice massage?

Answer 31

5-8 min

Question 32

how do you use vapocoolant? does it work?

Answer 32

1. hold 12-18 inches 2. spray proximal to distal 3. stretch no proof it works

Question 33

how cold is the water in a cold bath?

Answer 33

50-60 F

Question 34

what MUST you do after applying a modality

Answer 34

reassess pain/ROM and document

Question 35

what are the stages of cold

Answer 35

``` cold stinging burning aching numbness ```