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Hot, Cold, and Ultrasound
Terms in this set (62)
What are the therapeutic methods of heat exchange?
conduction, convection, conversion, radiation, and evaporation
Involves direct contact of two objects or substances which are of different temperatures
Transfer of heat that occurs when fluid or air circulates around/over an object of a different temperature
Non thermal energy (mechanical, electrical, chemical) changes/is converted into heat
Direct transfer of energy, there is no need for contact or a transmitting substance
Change from a liquid to a gas or vapor
What are the uses of cryotherapy?
Inflammation control, edema control, and pain control
What are the contraindications for cryotherapy?
Cold hypersensitivity, cold intolerance, Raynaud's disease, regenerating peripheral nerves, and areas with circulatory compromise
skin reaction marked by the transient appearance of smooth, slightly elevated patches, which are redder and paler than the surrounding skin and often severely itchy
severe pain, numbness, and color changes in response to cold
characterized by sudden pallor and cyanosis followed by redness of the skin of the digits precipitated by cold or emotional upset and relieved by warmth
regenerating peripheral nerves
local vasoconstriction or altered nerve conduction may delay nerve regeneration
a protein disorder which impairs circulation
paroxysmal cold hemoglobinuria
a condition in which hemoglobin from red blood cells are released into the urine
Why should a wet towel be used between the patient and the cryotherapy agent?
moisture is necessary to enhance the heat exchange between the pack and the patient
What sensations will the patient feel during cryotherapy?
cold, burning, stinging, aching, and numbness
To control pain, inflammation, or edema, how long should a cold/ice pack be left in place?
10 to 15 minutes
How is numbness checked?
By lightly tapping the finger tips on the area treated or by placing finger tips on the area and asking the patient how many fingers are on the site
How should you not check for numbness?
rubbing the skin
How long should an ice massage be?
until anesthesia is reached, usually 5 to 10 minutes
To provide cooling, what should the temperature of the water be?
50 to 77 degrees Fahrenheit
What are the contraindications for the use of thermotherapy?
recent injury with a high risk of potential hemorrhage, thrombophlebitis, impaired sensation or impaired mentation, malignant tissue
How many layers of toweling should be placed between a heat pack and the patient?
6 to 8 layers
What is the temperature of a paraffin bath?
125 to 127 degrees Fahrenheit
What is fluidotherapy?
A dry heating agent that transfers superficial heat by convection using fine particles that when suspended by the heat has the properties of a liquid
What is the therapeutic temperature range for fluidotherapy?
105 to 125 degrees Fahrenheit
What is hydrotherapy?
The use of water for the treatment of physical dysfunction
If a patient cannot tolerate a cold sensation, what sensation could be applied next?
Tepid: 80 to 92 degrees Fahrenheit, acute inflammation if cold not tolerated
What are the contraindications for hydrotherapy?
all contraindications for thermotherapy, maceration around a wound, and bleeding
After the application of a contrast bath, what must the final dip occur in for edema control?
a cold bath
What are the precautions for cryotherapy?
over a superficial main branch of a nerve, over an open wound, hypertension, poor sensation, very young and very old patients
What are ice packs?
made of crushed ice and placed into a plastic bag
What are cold packs?
commercially filled with a hydrated gel and are usually covered with vinyl or plastic
What are the uses of heating modalities?
pain control, increased ROM and decreased joint stiffness, accelerated healing
What is done if there is metal in the area?
If it cannot be removed, apply heat with caution and frequently check skin for signs of burning
What is the treatment time for a hot pack?
15 to 20 minutes
Prior to the first dip in a paraffin bath, what should be done?
1. ensure all jewelry has been removed
2. patient has washed and dried hands
3. temp of bath is 125 to 127 degrees Fahrenheit
4. plastic wrap is ready to use
What is an advantage of fluidotherapy?
patient can move during the intervention to work on gaining AROM
After the application of a contrast bath, what must the final dip occur in for comfort?
a warm bath
What is ultrasound?
the therapeutic application of a form of acoustic vibration at frequencies too high to be heard by the human ear
What is the therapeutic ultrasound range?
0.8 to 3 MHz
What can occur if the transducer is dropped or overheated?
The crystal may be permanently damaged
Spatial average intensity (SAI)
the average intensity of the ultrasound output over the area of the transducer
Spatial peak intensity (SPI)
the peak intensity of the ultrasound output over the area of the transducer
How deep does 1 MHz penetrate?
How deep does 3 MHz penetrate?
What are the thermal effects of ultrasound?
1. decrease joint stiffness
2. reduce muscle spasm
3. increase blood flow
4. increase nerve conduction
5. increase collagen fiber extensibility
6. pain modulation
What are the non-thermal effects of ultrasound?
3. stimulation of fibroblast activity
4. increased blood flow in chronically ischemic tissues
5. bone healing and repair of non-union fractures
What should the ideal coupling medium do?
must transmit waves and not absorb them
What are some methods of application for ultrasound?
1. direct contact coupling
2. indirect contact coupling (underwater)
3. continuous ultrasound
4. pulsed ultrasound
What is combination ultrasound used for?
trigger points, superficial pain areas, decrease adhesions, and muscle tightness
What is the information needed from a therapist prior to initiating an ultrasound treatment?
What are the indications for the use of ultrasound?
Non-acute inflammatory conditions
Muscle guarding or spasm
Scar tissue softening
Transdermal drug delivery
What are the contraindications for the use of ultrasound?
Central nervous system tissues
Areas of decreased sensation
Over reproductive organs or eyes
Joint cement or plastic products
What are the precautions for ultrasound?
1 MHz should be used for tissue ____
5 cm deep
3 MHz should be used for tissue ____
1-2 cm deep
How should the intensity be kept when the goal is to attain non-thermal effects?
0.5 W/cm^2 and 1.0 W/cm^2
What should the duration of ultrasound treatment be for an area that is twice the size of the ERA of the sound-head?
5 to 10 minutes
What is the area to be treated for ultrasound?
size of treatment area depends upon the ERA of the sound-head and duration of the treatment being applied
What should the sound head movement be like?
4 cm/second, quickly enough to maintain motion yet slowly enough to maintain good contact with the skin
What are the actions to be taken upon each complaint during the treatment of ultrasound?
1. increase speed of sound-head
2. decrease intensity by 0.5, return to normal speed
3. change for continuous to pulsed at 50%, return to normal speed
4. stop treatment and notify PT
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