Post on 10-Apr-2015
Cold therapy
Use of local or general cooling for therapeutic purposes
“cryotherapy”
COLD THERAPY
To lower the local tissue temperature and provoke the thermoregulatory responses.
Applying ice to the body surface is a very effective way of withdrawing energy (heat) and hence lowering the surface temperature.
For a constant source of cooling the temperature drop in the tissues will depend on. The temperature difference between the coolant
and the tissues. The thermal conductivity of the tissues. The length of time for which the cold is applied. The size of the area that is being cooled.
Cold therapy
Effects of cooling the skin surface Therapeutic effects of cold Types of application Contra indications and dangers of
cryotherapy
Principles
30 min to lower muscle temperature at 4cm depth by 3.5C
2.5cm-20min to drop by 2.5C
Physiological changes due to cooling the skin
The local effectsGeneral effects of local cooling
Local effects
Immediate vasoconstriction there is increased blood viscosity, due to
cooling, contribute to the slowed blood flow. Followed by vasodilatation Lewis Hunting response
Cold applied to the skin provides a strong sensory stimulus by stimulating the cold receptors.
This may be used therapeutically in the suppression of pain and treatment of hypertonicity.
Local effects
Decrease metabolic rate-oxygen uptake, metabolite production,cellular activity=slowed healing
Decrease nerve conduction velocities Decrease strength, fine
movements,tremors,spasticity,dexterity
General effects of local cooling
Stimulate cold receptors. Extreme cold is experienced as pain, involving pain
receptors. Cutaneous vasoconstriction. Increase metabolism. Heat production, by irregular muscle
contractions.
Therapeutic uses of cold
Recent injuriesPainMuscle SpasmSpasticityMuscle StrengtheningChronic Inflammatory ConditionsChronic edema and joint effusionsOther therapeutic effects
Recent injuries
Limits bleeding by vasoconstriction Limits pain-decreased pain nerve
irritants Reduces metabolic rate and
secondary cell necrosis Reduces joint effusion/edema Reduces edema formation
Alleviation of pain
Reduces conduction of nerves Sensory stimulation acts on pain
gate Strong cold sensation releases
endorphins
Reduction in muscle spasticity
Increased viscosity diminish rapid stretch reflex
Affects muscle spindle Stimulation of cutaneous receptors Decreased nerve velocities
Other therapeutic effects
Pressure sores. Conjunction with stretching. Acute lesions
General contraindications If frostbite has been in area Pt has Raynaud’s disease Circulation to part is compromised Pt very old or young Pt extremely sensitive to cold
Technique of application
preparation of patient Preparation of apparatus Preparation of part Instructions for the patient Application Termination
Before applying cryotherapy Inspect skin Test small area of skin, to determine if hypersensitive Verify good circulatory status Make certain patient never had frostbite in area to be
treated Make certain pt never experienced a lot of spasticity
when used Position & drape pt comfortably
Methods of applying cold therapy
Local immersionCold packs-ice packs\commercial cold
packsIce towels
Ice massageCold-Compression units
Evaporating sprays
Cold or Ice Water Immersion Equipment
Variety of basins or containers can be used, small whirlpool Temperature should be 50-60 degrees F
Indications Circumferential cooling of a body part
Application Athlete immerse body part in water and goes through four stages of cold response Treatment may last 10-15 minutes Once numb body part can be removed from immersion and ROM exercise can be
performed As pain returns re-immersion should take place Cycle can be repeated 3 times
Cold or Ice Water Immersion (continued) Special Considerations
Cold treatment makes collagen brittle -- must be cautious with return to activity following icing
Be aware of allergic reactions and overcooling
Ice Packs (Bags) Equipment
Wet ice (flaked ice in wet towel) Crushed or chipped ice in self sealing bag
Not as efficient, but less messy Useful for approximately 15-20 minutes Towel should be placed between skin and pack
Chemical Cold packs Gel pack Liquid pack
Indications Athlete experiences four stages of cooling and then proceeds with ROM exercises
Special Considerations Avoid excessive cold exposure; w/ any indication of allergy or abnormal pain,
treatment should be stopped
Contrasting cold and of treatment
Could you tell me what the difference is between heat and
cold?
Dangers Contraindications
Excessive local cold on normal tissuesCertain pathological conditions Cold sensitivity Cardiac disease Arterial blood pressure Sensory deficiency Hypersensitive areas
Emotional and psychological featuresPrecautions with particular cooling
methods