Cryotherapy

Question 1

What kind of mechanism of heat transfer it utilized with ice massage, cold packs, ice bath, and cold water circulation cuffs?

Answer 1

Conduction

Question 2

What kind of mechanism of heat transfer it utilized with a cold whirlpool?

Answer 2

Convection

Question 3

What is convection?

Answer 3

Air or water particles moving across the body part causing cooling

Question 4

How does conduction transfer heat?

Answer 4

Direct contact

Question 5

What kind of mechanism of heat transfer it utilized with a vapocoolant spray?

Answer 5

Evaporation

Question 6

What is cryotherapy?

Answer 6

Application of cold for therapeutic purposes

Question 7

What is cryokinetics?

Answer 7

A combination of cold and exercise in the form of treatment

Question 8

What is another name for Cold Induced VasoDilation (CIVD)?

Answer 8

Hunting response (Hunting-Lewis response)

Question 9

What is CIVD?

Answer 9

Increase in tissue temperature during cold therapy (approximately 15 minutes into treatment)

Question 10

What are the goals of cryotherapy?

Answer 10

1 relieve/decrease pain
2 decrease blood flow/metabolism
3 protect injured tissue
4 decrease muscle spasm

Question 11

How does cryotherapy decrease muscle spasms?

Answer 11

By decreasing gamma motor neuron, GTO, and muscle spindle activity

Question 12

How does cryotherapy decrease pain?

Answer 12

Activating thermoreceptors to decrease nociceptor conduction velocity (counterirritation)

Question 13

How does cryotherapy decrease edema?

Answer 13

By reducing free proteins

Question 14

How does cryotherapy minimize secondary tissue damage?

Answer 14

By decreasing blood flow and cell metabolism (longer survival of hypoxic tissue)

Question 15

What are the contraindications for cryotherapy?

Answer 15

1 impaired cold sensation
2 cold-induced urticaria (cold allergy)
3 Raynaud's disease
4 cryoglobulinemia
5 paroxysmal cold hemoglobinuria
6 open wounds
7 peripheral vascular disease
8 confused/unreliable patients

Question 16

What is the condition involving an allergic reaction to cold exposure?

Answer 16

Cold urticaria

Question 17

Raynaud’s is more common in what gender?

Answer 17

Females

Question 18

What is cryoglobinemia?

Answer 18

Abnormal clumping of plasma proteins stimulated by cold application

Question 19

Cryoglobinemia is associated with what other conditions and pathologies?

Answer 19

1 multiple myeloma
2 Waldenstrom macroglobulinemia
3 chronic liver disease
4 infections (hepatitis)
5 connective tissue diseases like SLE or Sjogren's

Question 20

What is cold induced hemoglobinuria (AKA paroxysmal cold hemoglobinuria)?

Answer 20

When cold temperature activates antibodies to RBCs causing lysis

Question 21

What are the symptoms of cold induced hemoglobinuria?

Answer 21

Darkened urine (excess hemoglobin from lysis) and back pain

Question 22

Acute cold induced hemoglobinuria usually affects what age population and when?

Answer 22

Young children following acute viral or upper respiratory illness

Question 23

Chronic cold induced hemoglobinuria usually affects what age population?

Answer 23

Elderly

Question 24

What are the risk factors associated with cryotherapy?

Answer 24

1 impaired circulation
2 thoracic area in patients with coronary artery disease
3 hypertensive patients
4 cardiovascular and cardiorespiratory disorders
5 superficial peripheral nerves
6 hemiplegic
7 very young/very old
8 obesity

Question 25

What are the four sensations of cryotherapy in order as they appear?

Answer 25

``` Cold Burning Aching Numbness (CBAN) ```

Question 26

What type of ice is best used for cryotherapy?

Answer 26

Crushed ice

Question 27

How fill must a bag be filled with ice when being used for treatment?

Answer 27

Half full or less

Question 28

How long should ice bags and gel packs be applied?

Answer 28

10-20 minutes

Question 29

Which is considered more effective: ice bags or gel packs?

Answer 29

Ice bags

Question 30

What are the usual temperature levels for a cold whirlpool?

Answer 30

50-60 degrees F | 10-15 degrees C

Question 31

What is the treatment time for a cold whirlpool?

Answer 31

15-20 minutes

Question 32

What are the advantages of using a cold whirlpool?

Answer 32

1 surrounds entire joint | 2 can do active exercises while cooling tissue (cryokinetics)

Question 33

What are the disadvantages of using a cold whirlpool?

Answer 33

1 part can't be elevated | 2 not ideal for acute situation

Question 34

At what temperature could a bucket of cold water be used to cool tissue in the same manner as an ice pack?

Answer 34

40-50 degrees F | 4-10 degrees C

Question 35

What is term for the warmer layer of water that forms around the body part in a cold whirlpool due to constant circulation?

Answer 35

Thermopane

Question 36

What is the ratio of ice to water for a good ice bath?

Answer 36

50:50

Question 37

What is the approximate treatment time for an ice bath?

Answer 37

8-20 minutes

Question 38

What is the treatment time for an ice massage (CryoCup/styrofoam cups)?

Answer 38

5-10 minutes or until numbness (10 minutes max)

Question 39

Is the ice massage technique used for small or large treatment areas?

Answer 39

Small (superficial areas and bony prominences)

Question 40

Is ice massage used more for acute or chronic situations?

Answer 40

Chronic (compression is needed for acute situations)

Question 41

How can ice massage be used for trigger points?

Answer 41

Desensitization

Question 42

What is the benefit with using a controlled continuous cold unit post surgery?

Answer 42

Provides compression, as well

Question 43

Where in the skin does temperature change take place with the use of vapocoolant sprays?

Answer 43

Above the epidermis (NOT BELOW)

Question 44

How can vapocoolant sprays be effective in trigger point therapy?

Answer 44

Numbs the area temporarily

Question 45

What are the indications for vapocoolant sprays?

Answer 45

1 trigger points 2 muscle spasms 3 decreased ROM

Question 46

What are the chemical types of vapocoolant sprays?

Answer 46

Fluoromethane or ethylchloride

Question 47

What are the precautions associated with vapocoolant sprays?

Answer 47

1 can cause frostbite 2 ethyl chloride is extremely flammable 3 ethyl chloride becomes a general anesthetic when inhaled 4 based on tradition instead of fact

Question 48

What are the contraindications for vapocoolant sprays?

Answer 48

1 allergy 2 open wounds 3 post surgical 4 eyes

Question 49

Why is it dangerous to ice the skin too much?

Answer 49

Skin takes energy as heat from deeper tissues

Question 50

What is the usual ratio for treatment time to re-warming time for cryotherapy?

Answer 50

1:2 (more re-warming time)

Question 51

Why does an ice bath produce a greater reduction in interarticular temperature?

Answer 51

More surface area exposed to the cold

Question 52

What layer of tissue has a big impact on the depth that is able to be reached through cryotherapy?

Answer 52

Subcutaneous adipose

Question 53

What can make the re-warming process quicker?

Answer 53

Engagement in activity

Question 54

What are the indications for cryotherapy?

Answer 54

1 pain 2 spasm 3 acute injury 4 chronic and inflammatory arthritis

Question 55

How does cryotherapy affect vertical jump and muscle contraction strength?

Answer 55

Decreased

Question 56

How does cryotherapy affect proprioception, balance, and agility?

Answer 56

Mixed evidence

Question 57

When icing before sports participation, what step is important to remember?

Answer 57

Rewarming of tissues

Question 58

How many times can cryokinetics be repeated?

Answer 58

Up to 5