Sample Outline: Cryotherapy

Cryotherapy- therapeutic application of cold

Cryokinetics- used of cold in therapeutic exercise

Modes of Transmission of Cold Therapy

1.Conduction – commonly used

Factors affecting magnitude change:

*temperature gradient differences between the cold and the tissue

*time and pressure

*thermal conductivity of the area being cooled

*type of cooling agent

2. Convection – least common, not practical to use

3. Evaporation – consist of highly volatile liquids that evaporate rapidly in contact with warm objects

Physiologic Effects of Cold

1. Increase blood viscosity

2. Vasoconstriction

3. Decrease metabolism thus decrease metabolic by products and decrease leukocytic phagocytic action which lead to retardation of healing

4. Decrease blood flow thus decrease bleeding and decrease removal of metabolites

Biophysical Effects

1. Hemodynamic Effects

-Quick icing can lead to cutaneous vasoconstriction

-Prolonged icing can lead to shivering and the Hunting Response of Lewis (5-10 deg C)

Causes:

a. Direct action of cold on smooth muscle of blood vessels

b. Reflex cutaneous of anterior hypothalamus as cooled blood returns, more vasoconstriction; in general, shivering and increased metabolic occurs

2. Decreased in Blood Flow

Causes:

a. Vasoconstriction

b. Increase in blood viscosity

c. Decrease production of metabolites

d. Effects of on post traumatic edema and inflammation

*less fluid filtration into the interstitium

*less inflammation and less pain

*decrease in metabolic rate

e. effects on peripheral nerve- decrease in motor and sensory nerve conduction velocity

* sensory- type A> type C

* motor- A gamma blocked before A alpha

f. effects on muscle strength

* increase in mm strength in quick icing

*decrease in mm strength in prolonged icing

g. neuromuscular effects

*transient reduction in spasticity

(note: some books say it can decrease but some researches imply that it can also increase)

General Indications of Cryotherapy

1. Musculoskeletal conditions (sprain, strain, bursitis, tendinitis)

2. Acute conditions

3. Chronic Inflammation

4. Myofascial Pain Syndrome

5. After orthoperic procedures

6. Pain and muscle spasm

7. Emergency treatment for minor burns

8. Edema

9. Spasticity

General Contraindications of Cryotherapy

1. Cold Conditions

· Raynaud’s Phenomenon

· Cryoglobilinemia

· Paroxysmal Cold Hemoglobulinuria

· Cold Urticaria or Cold Hypersensitivity

2. Cold Intolerance

3. Impaired Sensation

4. PVD

5. Impaired Circulation

6. Prolonged application over superficial nerve

7. Cardiac Disease or Cerebrovascular Insufficiency

8. Over the posterior rami of trunk

9. Throat ear and side of neck

10. Cancer and sickle cell anemia

11. Unrealiable patients

12. Severe abnormal BP