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Flashcards in Hot and Cold Deck (32)
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Ice Pack/Ice Cups (COLD) Indications

1. Decrease muscle spasm

2. Decrease pain

3. Decrease spasticity (stiff muscles)

4. Relieve swelling and edema

5. Prevent excessive tissue damage following injury



1. Severe coronary artery disease

2. Severe hypertension

3. Some Rheumatoid conditions (Scleroderma, systemic Lupus, Erythamatosa (SLE)

4. Patients with cold hypersensitivity
(Cold uticaria - hives, itching and sweating with cold)
(Cold hemoglobinuria-hemoglobin in urine with cold)

5. Vasospastic disorders (Raynaud's disease)


Ice Pack/Ice (COLD) Cups Precautions

1. Paralyzed patients (lack of central heat control)

2. Coma Patients

3. Any cold on skin > 1 hour

4. Ice over superficial nerves (ex. peroneal nerve)


HEAT Indications (Hot packs, Paraffin bath, Hydrotherapy)

1. Increase Collagen extensibility

2. Decrease joint stiffness

3. relieve muscle spasm

4. Pain relief

5. Increase blood flow

6. As a warm up to assist with exercises

7. Possibly assist in resolving inflammation (especially in hydrotherapy, because it heats quickly)



1. Severe cardiac disease

2. Over malignancy

3. Sepsis


HEAT Precautions

1. With insensitive patient (diabetes)

2. With spinal cord injured patients



Can also be used for open wound debridment. The water pressure, bubble and direction of force can be adjusted to appropriately accommodate the patient.


Contrast Baths Indications

1. Athletic Injuries

2. Leg Ulcers

3. Orthopedic problems (extremity joint stains or sprains)



1. Cardiovascular problems

2. Peripheral vascular diseases (arterial sclerosis)

3. Tendency toward hemorrhage


Contrast Baths Precautions

1. Loss of sensations

2. Pregnancy

3. Hypersensitivity to temperature


Paraffin Bath Controls

Paraffin Bath temperature 125 - 130 F

Treatment time: 20 minutes

Application Techniques:
1. Dip X 6 times and wrap in a bag /w towel
2. Dip X 6 times and re-immerse


Hydrotherapy Controls

From cold to hot (55 -113F) depending on the desired effect.

Treatment Time: 20 minutes

Whirlpool size:
Depending on are toe be treated (low boy or tall boy).

Air Control:
High air decreases mass of fluid.
High air increases sensation of fluid.

Water Pressure :
High pressure moves water faster, improving convection.
High pressure may be painful on wound, so be cautious.

Turbine Height and Direction:
Consider whether treated are needs to be exposed to water force.


Therapeutic Effects of Heat

- Increases the extensibility of collagen tissue. To produce residual elongation, you must stretch during or immediately after application of heat.

- Decrease joint stiffness

- Relieves muscle spas

- Pain relief

- Increase blood flow

- Possibly assist in resolution of inflammation


Therapeutic Effects of Cold

- Decrease muscle spasm

- Decrease pain and spasticity (muscle stiffness)

- Nerve fibers of different diameters and degrees of myelination appear to have different threshold or sensitivities to the effects of cold

- Decrease in Nerve Conduction Velocity

- Relieve swelling and edema (primarily through (vasoconstruction)

- Prevent excessive tissue damage following injury


Body Response to Cold

1. Circulatory
- Vasoconstriction
- Decreased capillary permeability
- Consensual response

2. Respiratory - Minimal effects

3. Shivering

4. Decreased local metabolism


Body Response to Heat

1. Hyperemia (an excess of blood in the vessels)

2. Increased pulse

3. Respiratory - Minimal effects

4. Increases sweating

5. Increase in local metabolism


Local Effects to Heat

Look in packet, way to much shit to type


Standard Temperature Classifications

Cold 55 - 65 F (13-18C)

Cool 65-80 F (18-27C)

Tepid 80-94 F (27-34C)

Warm 94-98 F (34-37C)

Hot 98-104 F (37-40C)

Very Hot 104-113 (40-45C)


Pool Therapy Indications

1. Warm temperature is relaxing.

2. warm temperature can decrease the perception of pain.

3. Buoyancy can be useful
a. To decrease the strength necessary to move in
cases of sever weakness.
b. To decrease weight on diseased or damaged joints
or bones.

4. Water can be used as a resistance during exercise.

5. Standing and walking balance can be improved.

6. Swimming can develop cardiovascular endurance.



1. Open wounds that can't be adequately covered.

2. Incontinence (unable to keep urine from leaking)

3. Patients with isolation precautions.

4. Uncontrolled Seizures (anybody unsafe in water)

5. Severe Cardiac Disease


Pool Therapy Precautions

1. Multiple Sclerosis (totally wipes them out)

2. Possible infection sites such as ostomies, G-Tubes

3. Patients with orthostatic hypotension


Ice Packs, Ice Massage & Cryotherapy Controls

Treatment Time:
3-60 minutes (3-15 minutes for ice massage to numb. 20-30 minutes for typical treatment. Limit to 60 minutes to prevent frostbit).

Cold ice baths is 55-65 F
Ice Pack machines are 10-15 F

Wet towels wrapped around ice cool more quickly. Dry towels are better tolerated by patients who need to have an area cooled for several hours.


Superficial Heating and Cooling Agents

Superficial heating and cooling agents produce temperature changes in the skin and underlying subcutaneous tissue to a depth of approximately 1 cm.

Heating agents include:
- Hot packs
- Paraffin baths
- Hydrotherapy

Cooling agents include:
- Ice packs
- Ice massage
- Cryotherapy


Hydrotherapy Physiological Effects

Used for the same effects and purposes as superficial heat plus:
a. Buoyancy
b. Cooling
c. Debridement


Mechanical Effects of Hydrotherapy

Agitation - serves as mechanical stimulation to skin receptors, which may explain its sedative and analgesic effect.

May act as a counterirritant or stimulus to large sensory afferents thus blocking pain input.


Hydrotherapy and Wound Care

Hydrotherapy is an effective method of debriding a wound to remove necrotic material and of cleansing through the addition of a bactericidal agent.

Mechanical effects stimulate the formation of granulation tissue and in conjunction with appropriate water temperature, assist in softening tissues and stimulates circulation to affected areas.

Increase in local circulation raises the level of )2, antibodies, leukocytes, and nutrition supplied to the tissue and enhances the removal of metabodies.

Increases the availability of antibiotics to the wound area, which assist in diminishing and preventing infection.

Sedative and analgesic effect.



Is the therapeutic application of any substance to the body which results in withdrawal of heat from the body, thereby lowering tissue temperature.



Intermittent cold application and stretching of active exercise.

Principles of exercising:
a. All exercise must be active only
b. All exercise must be pain free
c. All exercise must be performed smoothly without limp
or abnormal motion
d. Exercise must be aggressively progressive but without


Contrast Bath Controls

Hot (105 -110F) water baths are alternated with COLD (55-65F)


Contrast Bath Duty Cycles

H C H C H C H Alterations Time
5 2 5 2 5 5 19
5 2 5 2 5 2 5 7 26
4 1 4 1 4 1 4 7 19