PA: Cold Modalities
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| What are the physiologic responses of cryotherapy? | 1. Vasoconstriction
2. Decreased inflammation
3. Decreased spasm therefore increased ROM
4. Increased pain threshold
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| How is cooling accomplished? | By removing heat from an object
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| What ways does cooling occur? | Conduction
Convection
Evaporation
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| What is conduction? | Transfer of heat by direct interaction
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| What are some examples of conduction? | Ice packs
Cold water immersion
Ice water filled cuffs
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| What are the four sensations you will feel with cryotherapy? | Cold
Burning
Aching
Numb
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| Why is convection rarely used? | Because you have to put them in a gravity dependent position which doesn't help with edema
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| What is convection? | Direct connection between skin and MOVING fluid
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| What is an example of convection? | Cold whirlpool
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| What are evaporative cold therapies used for? | Trigger points before stretch
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| What is an example of an evaporative cold therapy? | Vapocoolant spray
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| What are some hemodynamic effects of cold agents? | Immediate vasoconstriction
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| What are some peripheral nerve effects of cold agents? | Alteration of conduction velocity
Failure to conduct impulses
Cooling to 56 degrees blocks A fibers
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| What are some effects on the muscle due to cold agents? | Increase in strength after 5 mins of ice massage (due to smpathetic response which would bring blood to area)
Decrease in strength after 30 mins of immersion in 10-12 decree water
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| What are some neromuscular effects of cold agents? | Help reduce spasticity
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| What are the primary goals of cryotherapy? | Limit edema
Reduce pain
Muscle relaxation/contraction
Limit secondary hypoxic tissue injury
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| What is the goal for helping spasticity? | Decrease tone to allow for increased movement
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| Where are ice massages typically done? | Muscle belly
Tendon
Bursa
Trigger points
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| What are the water temperature ranges for cold baths? | 13-18 degrees C
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| What temperature range are controlled cold compression units set at? | 10-25 degrees C
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| What are some contraindications of cold? | Uticaria
Cold intolerance
Cryoglobulinemia
Raynauds disease
Over a regenerating peripheral nerve
Over an area of circulatory compromise
Over an area of PVD
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| What are some precautions of cold? | Hypertension
Over a superficial nerve
Over an open wound
Poor sensation
Poor cognition
Very young or very old
Aversion to cold
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