Cold Modalities

Question 0

Convection

Answer 0

Heat loss or gain through movement of fluid or air between regions of unequal temperature

Question 1

Conduction

Answer 1

Heat loss or gain through direct contact

Question 2

Radiation

Answer 2

The emission of energy

Question 3

Conversion

Answer 3

Changing from one energy form to another

Question 4

Evaporation

Answer 4

Thermal energy must be removed to undergo a phase change from liquid to gas

Question 5

Most effective when talking about rapid cooling is an object….

Answer 5

Going through a phase change

Question 6

Cryotherapy

Answer 6

The application of cold modals that have a temperature range between 32-65 deg F

Heat is removed from body and absorbed by the cold modal

May cause local or systemic effects

Question 7

Thermal agents

Answer 7

Represent a transfer of heat energy toward or away from tissue in a unidirectional manner

Question 8

Fundamental principle

Answer 8

One object must have a higher temperature than the other

The warm tissue loses heat to the cold modal

Question 9

The amount of _______ is the primary limiting factor affecting the depth of penetration

Answer 9

Adipose tissue

Question 10

Ice with ______ produces more change in tissue temp than ice alone

Answer 10

Compression

Question 11

The primary rationale for using cryotherapy is….

Answer 11

To decrease the metabolic rate of tissues

This reduces the demand for oxygen and limits secondary hypoxic injury

Question 12

Maximum temperature for reduction of ____________ __________ is 50-59 deg F

Answer 12

Cell metabolism

Question 13

Local effects: Cellular response

Answer 13

Decrease cell metabolism

Question 14

Local response: blood and fluid dynamics

Answer 14

Vasoconstriction

Question 15

Local response: nerve conduction

Answer 15

Decreased afferent nerve conduction

Question 16

Inflammation

Answer 16

Decreases inflammation

Decrease release of inflammatory mediators

Question 17

Local response: muscle spasm

Answer 17

Decreases sensitivity of muscle spindle

Breaks the pain-spasm cycle

Question 18

Cold therapy alters pain perception and transmission by….

Answer 18

Stimulating a beta fibers
Reducing nerve conduction velocity
Reducing muscle spasm
Controlling edema

Question 19

Indications for cryotherapy

Answer 19

Acute injury or inflammation
Acute or chronic pain
Post surgical pain
Small superficial burns
Acute or chronic muscle spasm 
Neuralgia

Question 20

Contraindications to cryotherapy

Answer 20

Cold allergy
Cardiac and respiratory involvement
Uncovered open wounds
Anesthetic skin
Known Raynaud's phenomenon 
Prolonged application over superficial nerves

Question 21

What will you feel during cold application?

Answer 21

Cold burning, tingling, aching, numbness

Question 22

Reuse able cold packs

Answer 22

Silica, water, and antifreeze
Advantage: cost effective
Disadvantage: risk of frostbite

Question 23

Instant cold packs

Answer 23

Two chemicals separated by a barrier
Advantages; portable, small, quick
Disadvantages: one time use, looses cold quickly

Question 24

Ice bags

Answer 24

Most commonly used 20 min application Advantages: quick, easy Disadvantage: machine and bags are investment

Question 25

Cold compression therapy units

Answer 25

Combine static external compression with cold application Less effective cooling

Question 26

Game ready

Answer 26

Intermittent cold compression unit Applies pumping principle Advantages: price, reusable Disadvantages: initial investment, setup/ clean up

Question 27

Ice massage

Answer 27

Delivered to small unevenly shaped areas 5-10 min application Advantages: convent self treatment, cost and time effective Disadvantages: cannot cover large areas, messy, no compression

Question 28

Cold whirlpool

Answer 28

Effective in applying cold therapy to irregularly shaped areas/ large surface areas Indications: decreased ROM, subacute or chronic conditions Contraindications: acute conditions, postural support Between 50 and 65 deg F

Question 29

Whirlpool safety

Answer 29

Need to fill above turbine As surface area increases so should temp Disinfect Patient should never touch on off switch

Question 30

Whirlpool cleaning

Answer 30

``` Drain water enough to run turbine Add disinfectant Run for five on off Sykes Drain and scrub Rinse ```

Question 31

Cold water immersion

Answer 31

Temp 40-50 deg 10-15 min Indications: acute injury or inflammation Precautions: dependent position, nerve palsy Contraindications: same as other cold modals

Question 32

Vasocoolant sprays

Answer 32

Combine cold and stretching Decreases skin temp and decrease pain transmission Flouromethane spray Indications: trigger point, muscle spasm, decreased ROM, acute pain Contraindications: allergy, acute/ post surgical injury, open wound use on face and eyes