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what effects does a barrier have on cryotherapy?
The barrier does not allow the skin temperature to reach 58 F, where maximum analgesia is achevied.
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when is a barrier for cryotherapy indicated:
- blood flow to the area is compromised
- nerve or cold intolerance
- raynaud's phenomenon
- or if reuseable cold packs are applied
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describe the following of ice bags:
advantages:
disadvantages:
- advantageseasy
- efficient
- safe to use
- require only a plastic bag + ice
- disadvantageice machines are expensive and their cost may be prohibitive in some situations
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describe the following of instant (chemical) cold packs:
advantages:
disadvantages:
- advantages
- disadvantages:short worklife/duration
- only used 1x
- chemcials are extremely caustics to skin if leaked
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describe the following of ice packs AND instant (chemcial) packs:
indications:
- acute injury or inflammation
- acute or chronic pain
- postsurgical pain and edema
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describe the following of ice packs AND instant (chemcial) packs:
contraindications:
- cardiac or respiratory involement
- uncovered open wounds
- circulatory insufficiency
- cold allergy and/or hypersensitivity
- anesthetized skin (absence of sensation)
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describe the following of ice massage:
advantages:
disadvantages:
- advantagespt. able to administer self tx
- clinic or home tx
- convenient, practicle, time efficent
- provide cold tx when ice machine is not available
- disadvantagessmall tx area
- no compression
- temp is not reduced at the same magnited as other cold modalities
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describe the following of ice massage:
indications:
- subacute injury or inflammation
- muscle strains
- contusions
- acute or chronic pain
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describe the following of ice massage:
contraindications:
- cases in which pressure on the injury is contraindicated
- suspected fx
- uncovered open wounds
- circulatory insufficiency
- cold allergy and/or hypersensitivity
- anesthetized skin (absence of sensation)
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describe the following of ice immersion:
advantages:
disadvantages:
- advantages:allows for circumferential cooling and simultaneous ROM exercises (increase venous return)
- injuries with irregular surface
- disadvantages:uncomfortable, increased pain due to larger surface area
- cold penetrates to the bone level in toes, fingers
- limb is in a gravity depedent position
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describe the following of ice immersion:
indications:
- subacute injury or inflammation
- muscle strains
- contusions
- acute or chronic pain
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describe the following of ice immersion:
contraindications:
- cardiac or respiratory involvement
- uncovered open wounds
- circulatory insufficiency
- cold allergy and/or hypersensitivity
- anesthetized skin (absences of sensation)
- absolute inability to tolerate the cold temperatures
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describe the following of vapo coolant spray:
advantages:
disadvantages:
- advantages:rapid decrease of skin temp (decrease pain transmission)
- disadvantagespotential of frostbite (with ethyl chloride)
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describe the following of vapo coolant spray:
indications:
- tirgger points
- muscle spasm
- decreased ROM
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describe the following of vapo coolant spray:
contraindications:
- allergy to the spray
- acute and/or postsurgical injury
- open wounds
- contraindications relating to cold applications
- contraindiciations relating to passive stretching
- use around the eyes. when tx'ing the UE, torso, or neck protect the pts. eyes from the spray
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describe the following of moist heat packs:
advantages:
disadvantages:
- advantage:suitable for localized areas or areas that normally cannot be tx'ed by immersion
- wide variety of size/styles
- disadvantages:
- e
ffectiveness is diminished when used over irregular areas (ankle, fingers)
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list the following of moist heat packs:
indications (7):
- subacute or chronic inflammatory conditions
- reduction of subacute or chronic pain
- subacute or chronic muscle spasm
- decreased ROM
- hematoma resolution
- reduction of joint contractures
- infection
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list the following of moist heat packs:
contraindications:
- acute conditions: this modality will increase the inflammatory response in the area
- peripheral vascular disease: the heat cannot be dissipated, increasing chance of burns
- impaired circulation
- poor thermal regulation
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list the following of paraffin baths:
advantages:
disadvantages:
- advantage:delivers heat to small, irregular shaped areas
- 6x the amount of heat as H20
- disadvantages:risk of burns (touching the sides and bottom of the unit)
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describe the following of paraffin baths:
indications:
- subacute and chronic inflammatory condititons
- limitations of motion after immobilization
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describe the following of paraffin baths:
contraindications:
- open wounds: wax and oil would irritate the tissues
- skin infections: the warm, dark environment is an excellent breeding ground for bacteria
- sensory loss
- peripheral vascular disease
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describe the following of warm whirlpool baths:
advantages:
disadvantages:
- advantagesable to perform ROM activities while rec'ving thermal tx
- extremities or entire body
- promote muscular relaxation
- disadvantages:hyper or hypothermia may occur (full body immersion)
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list 5 clinical indications of compression:
- acute injury: with swelling/edema
- edema: medical origin, venous insufficiency, lymphedema (to promote swelling)
- deep vein thrombosis (prevention of)
- venous statis ulcers
- control hypertrophic scarring (a rasied scar)
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list 7 contraindications of compression:
- CHF or pulmonary edema
- recent or acute DVT
- obstructed lymphatic or venous return
- arterial insufficiency: not enought artial blood flow
- acute local infection: spread to systemic infection
- severe hypoproteinemia: low protein to kidney (which filters)
- acute fx
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list the indications for a new lateral ankle sprain that would warrent the use of an ice pack:
- acute injury/inflammation
- acute pain
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use the following case studies to discuss and note the clinical use of heat and cold. state and justify which cold or heat modalitiy you would use:
an athlete has subacromial bursitis in the L shoulder. there is decreased GH motion due to pain
- vapo coolant: decreased ROM
- moist heat pack: decreased ROM
- Whirlpool: decreased ROM
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use the following case studies to discuss and note the clinical use of heat and cold. state and justify which cold or heat modalitiy you would use:
athlete is 2 days post decompression surgery:
- ice pack: postsurgical pain/edema
- compression: TEDS, prevention of DVT
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use the following case studies to discuss and note the clinical use of heat and cold. state and justify which cold or heat modalitiy you would use:
an athlete sustaned a quad strain 4 days ago and now has weakness and stiffness in this muscle. the area is not warm to the touch or red:
- ice massage: muscle strains; subacute injury
- ice immersion: muscle strains; subacute injury
- moist heat pack: subacute inflammatory, reduce subacute pain
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use the following case studies to discuss and note the clinical use of heat and cold. state and justify which cold or heat modalitiy you would use:
a soccer player sprained his ankle 24 hrs ago. There is minimal effusion or edema, but the ankle is painful, especially with motion:
- ice pack: acute injury/inflammation/pain
- compression: acute injury
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use the following case studies to discuss and note the clinical use of heat and cold. state and justify which cold or heat modalitiy you would use:
a wrestler complains of pain and spasm of the upper trapezius. you can palpate localized areas of painful trigger points:
- vapo coolant spray: trigger points, muscle spasm
- moist heat pack: subacute/chronic muscle spasm
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use the following case studies to discuss and note the clinical use of heat and cold. state and justify which cold or heat modalitiy you would use:
a football player has been rehabbing after a flexor tendon rupture. you notice decreases in ROM extension.
- paraffin bath: limitations of motion, subacute inflammatory
- vapo coolant spray: decreased ROM
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list the 7 contraindications for the game ready:
- acute inflammatory phlebitis (superficial veins)
- hx/recent DVT or pulmonary embolus
- arteriosclerosis or vascular ischemic disease
- condition in which increased venous or lymphatic return is not desired
- decompensated hypertonia (spasticity)
- significant vascular impairment (prior frostbite, diabetes)
- hemtaological dyscrasias
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list the 4 pressure settings on the game ready:
none:
low:
med:
high:
- none:
- low: 5-15 mmHg
- med: 5-50mmHg
- high: 5-75 mmHg
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