TH521: Machines PT 2
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110 Terms
What is thermotherapy?
The therapeutic application of heat to superficial or deep tissues.
What is cryotherapy?
The therapeutic application of cold to lower tissue temperature.
Traditional rule for heat vs. cold?
Ice for acute injuries; heat for chronic conditions.
What should determine whether heat or cold is used?
The treatment goal and desired physiological effects.
Name the five mechanisms of heat exchange.
Conduction, convection, conversion, radiation, evaporation.
What is conduction?
Direct heat transfer through molecular contact.
Example of conduction
Hot packs or cold packs.
What is convection?
Heat transfer by circulating liquids or gases.
Examples of convection
Hot tubs, whirlpools, saunas.
What is conversion?
Non-thermal energy converted into heat.
Examples of conversion
Ultrasound and diathermy.
What is radiation?
Heat transfer through photons without a medium.
Example of radiation
Infrared lamps or light therapy.
What is evaporation?
Heat loss when liquid changes into gas.
Example of evaporation
Cooling sprays.
What is the therapeutic temperature range for heat?
104-113°F (40-45°C).
What happens below 104°F (40°C)?
Little or no therapeutic heating occurs.
What happens above 113°F (45°C)?
Increased risk of tissue damage.
What is superficial heat?
Heating tissues less than 1 cm deep.
What is deep heat?
Heating tissues deeper than 1 cm.
Examples of deep heating modalities
Ultrasound and diathermy.
How does deep heat differ from superficial heat?
It is usually not directly perceived by the patient.
Primary physiological effect of heat
Increased circulation.
How does heat affect blood vessels?
Causes vasodilation.
How does heat affect blood viscosity?
Decreases viscosity.
How does heat affect tissue metabolism?
Increases metabolism.
Optimal enzyme activity occurs at what temperatures?
102-109°F (39-43°C).
What happens to enzyme activity above 113°F (45°C)?
It decreases.
How does heat affect oxygen consumption?
It increases.
How does heat affect phagocytosis?
It increases.
How does heat affect waste removal?
Accelerates removal of lactic acid and CO₂.
How does heat affect collagen?
Increases collagen extensibility.
Why apply heat before stretching?
It improves tissue extensibility.
How does heat affect joint stiffness?
It decreases stiffness.
How does heat affect muscle spasm?
It promotes relaxation.
How does heat decrease pain?
Raises pain threshold and stimulates pain gate mechanisms.
How does heat affect heart rate?
Increases approximately 10 beats/min for every 1°F rise in body temperature.
How does heat affect respiration?
Increases respiratory rate while decreasing depth.
How does heat affect blood pressure?
May decrease it.
General systemic effect of heat
Sedation and relaxation.
Common indications for thermotherapy
Pain, joint stiffness, muscle spasm, swelling, tissue healing.
Why is heat useful before stretching?
It softens connective tissue.
Contraindication to heat over impaired sensation
Increased burn risk.
Contraindication to heat over malignancy
May increase tumor growth/metastasis.
Contraindication to heat over hemorrhage
May increase bleeding.
Contraindication to heat over thrombophlebitis
Risk of embolism.
Why avoid heat over non-draining infections?
May worsen infection.
Why avoid heat over the pregnant abdomen?
Increased fetal risk.
Precaution for superficial metal implants
Metal may conduct heat and burn tissue.
Why monitor elderly and young children closely with heat?
Poor thermoregulation.
General treatment time for thermotherapy
10-20 minutes.
When should heat treatment be stopped?
If uncomfortable or painful.
Factors affecting heat transfer
Temperature difference, treatment time, tissue conductivity, heat source.
Signs of excessive heat exposure
Erythema ab igne, swelling, wheals, burns, blisters.
What is erythema ab igne?
Mottled skin discoloration from prolonged heat exposure.
Modes of heat delivery
Hot packs, immersion, paraffin, sauna, steam room, hot tubs, ultrasound, diathermy, lamps.
What is a hydrocollator?
A clay-filled hot pack stored in heated water.
Hydrocollator storage temperature
165-170°F (74-77°C).
Recommended towel layers for hydrocollator packs
6-8 layers.
Treatment time for hydrocollator packs
20-30 minutes.
Inspection interval for hydrocollator packs
Every 4-5 minutes.
How do electrical heating pads generate heat?
Electrical resistance.
How do chemical heating pads generate heat?
Exothermic chemical reactions.
Primary goal of cryotherapy
Lower tissue temperature.
What skin temperature produces analgesia?
Less than 56°F (13°C).
At what tissue temperature is metabolism maximally reduced?
41-59°F (5-15°C).
At what temperature does metabolism begin slowing?
About 86°F (30°C).
Mechanisms used in cryotherapy
Conduction, convection, evaporation.
How does cold affect blood vessels?
Causes vasoconstriction.
How does cold affect blood viscosity?
Increases viscosity.
How does cold affect blood flow?
Decreases blood flow.
How does cold affect hemorrhage?
Reduces bleeding.
How does cold affect edema?
Reduces edema.
How does cold affect histamine release?
Decreases histamine release.
How does cold affect metabolism?
Slows metabolism.
How does cold reduce secondary tissue injury?
Reduces oxygen demand and secondary hypoxia.
Most important physiological benefit of cryotherapy
Reduction of secondary cell hypoxia.
How does cold affect muscle spasm?
Reduces muscle spindle activity and spasm.
How does cold affect nerve conduction?
Slows nerve conduction.
How does cold reduce pain?
Slows nerve conduction and activates pain gate mechanisms.
Indications for cryotherapy
Acute injury, inflammation, edema, hemorrhage, pain, muscle spasm.
Contraindication: cold urticaria
Cold-induced allergic reaction.
Contraindication: Raynaud phenomenon
Cold-induced vasospasm.
Contraindication: cryoglobulinemia
Abnormal blood proteins gel in the cold.
Contraindication: paroxysmal cold hemoglobinuria
Cold-induced hemolysis.
Contraindication: impaired sensation
Increased frostbite risk.
Contraindication: regenerating nerve
May delay healing.
Signs of frostnip
Blanching, tingling, burning.
Signs of frostbite
White, hard, anesthetic tissue.
Typical cryotherapy treatment time
About 20 minutes.
Recommended on:off ratio for cryotherapy
1:6 (minimum 1:2).
What is the hunting response?
Cold-induced vasodilation after prolonged cooling.
When does the hunting response typically begin?
After about 10-30 minutes.
According to some research, when should cryotherapy ideally begin after injury?
Within 5 minutes.
Main benefit of delayed cryotherapy
Reduces pain and muscle spasm more than inflammation.
How is cold urticaria tested?
Apply ice for 3 minutes and observe for wheal formation.
Normal response to cold urticaria test
Redness (erythema).
Positive cold urticaria test
Wheal formation.
Why is cryotherapy dangerous in Raynaud disease?
It may produce severe ischemia.
Examples of conditions associated with cryoglobulinemia
Rheumatoid arthritis, lupus, leukemia, multiple myeloma.