Cryotherapy Flashcards by Jordan Harding

C. - F.

C=5/9 F-32

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F. - C.

F=9/5 C +32

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Cryotherapy is the most versatile modality. It elicits a wide range of cellular, vascular, and nervous system responses. Which are??

Regulates inflammatory response
Limits scope of original injury
decreases pain
decreases acute muscle spasm

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T or F

Cyrotherapy can be used throughout the healing process.

True

different uses during different stages

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Stage of Acute care or recurring acute care and the 3 phases within

Acute care: 0-4 days
Emergency care: CPR, transport to ER
Immediate care: 0-12 hr
Transition care: 12hr-4days

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Stage of Subacute care

Subacute care: 4-14 days

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Stage of Post-acute care

Post-acute care: after 14 days

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ICE

I: ice
C: compression
E: elevation

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RICE

R: rest
I: ice
C: compression
E: elevation

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PRICE

P: protect
R: rest
I: ice
C: compression
E: elevation

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RICES

R: rest
I: ice
C: compression
E: elevation
S: stabilization

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When RICES is begun within first 10-20 min, it helps to minimize…

swelling
pain
muscle spasm
neural inhibition
secondary injury

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ALL acute musculoskeletal injuries should be treated with _________.

RICES

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Theoretical basis for RICES: What is the purpose of rest?

Rest helps to limit injury aggravation. Injured limb should move as little as possible (don’t cause further injury).

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Theoretical basis for RICES: Why is rest important?
Pain = ??
Pain = ??

spasming
neural inhibition (decrease strength & ROM)
Rest will help decrease these 2 because we are not causing further damage.

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Theoretical basis for RICES: (rest) During IMMEDIATE care phase (0-12hr) what should the athlete always use?

Always use crutches until they can walk with normal, pain-free gait.

Theoretical basis for RICES: (rest)

During transition care, why is it important to use “relative rest”?

Because to-little activity results in delayed healing, adhesions, atrophy, loss of conditioning.

T or F

“no pain, no gain” is a slogan used frequently during rehab.

False
avoid pain
not about how tough the patient is but how smart

Theoretical basis for RICES: What is the purpose for ICE?

Limits secondary injury (2nd metabolic injury)
Controls swelling
Limits neural inhibition

Theoretical basis for RICES: (ICE) Describe the decreased blood flow theory (aka circulatory theory)

Cold causes vasoconstriction -> decreases blood flow -> decreases hemorrhage -> reduces swelling

BUT…ice would have to be applied within 5-10 min to constrict hemorrhaging vessels

Metabolism and cooling: There is a direct relationship between tissue _________ and ________ consumption. The cooler the ______, the lower its ________.

temperature
oxygen
tissue
metabolism

Theoretical basis for RICES: (compression) What is the purpose for compression?

Controls edema formation. It increases pressure outside of the capillaries, which decreases capillary filtration pressure.

When is compression most beneficial?

Once edema begins but also is effective for as long as edema is present. (unknown when edema will start so apply compression within minutes & continue until edema is resolved)

Constant Compression VS. Intermittent Compression - When and why?

Constant: when goal is to prevent edema
Intermittent: when goal is to remove edema, It stimulates lymphatic system (removes tissue debris).

T or F Compression exerted by an elastic wrap over a crushed ice pack causes a greater tissue temperature reduction than application of the ice pack alone. Compression enhances cooling.

true

Theoretical basis for RICES: (elevation) What is the purpose of elevation?

Helps control edema. Decreases capillary hydrostatic pressure, which decreases fluid forced out of capillaries. Positively impacts limb hydrostatic pressure.

Theoretical basis for RICES: (stabilization) What is the purpose of stabilization?

It limits neural inhibition. Goal: support injured limb so surrounding muscles can relax. This will: 1. reduce pain 2. prevents neural inhibition 3. prevents spasm/guarding (pain-spasm cycle)

Which other RICES factors can stabilization be confused with and why?

Compression or Rest | Purpose is different: stabilization may provide compression and force the body to rest, but these are secondary effects.

Definition of cold

a relative temperature state characterized by a decrease in molecular motion. Cold = absence of heat

T or F | The state of "being cold" is relative

true after a hot summer, 50 degrees F feels cold after a cold winter, 50 degrees F feels warm

Cold cannot be transferred, what does that mean?

Cold cannot be transferred to another object or space. Heat is the only thing that is transferred because heat goes from a high intensity to low which is cold so heat is transferred to cold. (Cold (er,heat) transfer - during cooling heat is transferred from body tissues to cold modality through conduction)

Cold (er, heat) transfer: During cooling, heat is transferred from body tissues to cold modality through conduction. Rate of conduction (rate of tissue temperature decrease) depends on??

1. temp difference between body & modality - larger difference=faster heat conduction=deeper effects of Rx 2. removal of heat from the body will continue until the temperature of the area is equal to the temperature of the modality.

Other factors that the rate of conduction ALSO depends on:

1. Regeneration of body heat &/or modality cooling - heat is replaced by circulation blood heat - Heat transferred from body to modality 2. Heat storage capacity of modality, a modality that can accept a greater amount of heat before it begins to warming will maintain a greater temperature differential between modality and body

What is specific heat?

Crushed ice packs are more effective than gel packs because they undergo a phase change (solid to liquid), which results in more heat being withdrawn from the body.

Other factors that the rate of conduction for the 3rd time ALSO depends on:

1. size of cold modality (larger=more heat accepted) 2. amount of tissue in contact with cold modality, Example: immersing forearm in 50 degree F water will cool it to the same degree as a 32 degree F cold pack. 3. Length of application 4. Individual variability (people react differently)

The depth of penetration in tissue cooling is based on:

Temp of cryotherapy intensity (including contact) circulatory responses treatment time (longer=greater depth of cooling & greater temp decrease)

What is the order of tissues to loose heat

1. skin 2. adipose 3. fascia 4. muscle

Temperature changes:

see podcast