superficial Thermal agents

superficial Thermal agents

1. Cryotherapy

   • conduction
     • ice pack, immersion in bath, controlled cold units
   • convection
     • whirlpool- 25x faster to cool
       • not recommended for  acute phase of healing. dont want to put in dept position (gravity)
   • evaporation
     • vapocoolant spray on TP counterirritant causing decrease motor neuron activity to allow further stretch
   • Indications
     • acute trauma: increase blood viscosity
     • decrease edema
     • decrease ms activity (spasm)
     • ms performance enhancement
       • 5 min, gearing up motor neuron
     • decrease inflammation
   • contraindications
     • cold urticaria
     • cold intolerance (wheels, hives)
     • paroxysmal cold hemoglobinuria (blood in urine
     • cryoglobinemia (blood deficiency)
     • raynaud's disease
     • over regenerative nerve
     • circulatroy compromised area
     • peripheral vascular disease area
   • precautions
     • hypertension
     • aversion to cold
     • superficial nerve area
     • over open wound
     • very young/ old (communication)
     • thermoregulatory disorder
     • poor sensation area (diabetics, spinal cord)
     • poor cognition

2. Thermal Heat

   • conduction
     • • MHP:
         • Advantage: convenient, easy to apply & inexpensieve
           • Disadvan: dont conform to area directly
       • electiric heating pads
         • advantage: readily available, affordable, convenient & dry
           • dis: ppl may sleep w/ it and burn, cant ex w/ it, next to outlet
       • Paraffin
         • Indications
           • increase skin pliability
           • increase ROM
           • deacrease pain
         • Advantages
           • low specific heat
           • low thermal conductivity
             • even though its so hot, it wont burn
           • even distribution of heat
           • minerals for skin
         • disadvantages
           • only use w/ extremeties
           • can't control temp after application
           • last only 20 min
             • may apply heat to keep temp a bit longer
           • passive intervention
   • convection
     • via fluidotherapy w/ corn
       • Advantages
         • convenient & easy to administer
         • temp can be controlled
         • agitation (to desensitize) can be modified for comfort
         • variety of unit sizes
         • allows active ex
         • dry, comfortable heat
         • can wear splint for prolonged stretch
       • Disavantages
         • expensive to purchase
         • can lead to feeling claustrophobic
         • some pts intolenant to the dry materials used
   • radiation
     • laser
   • indications for Heat
     • increase blood flow and viscosity
     • decrease muscle spasm
     • facilitate healing
     • decrease tissue tightness & joint stiffness
     • promote relaxation
     • prepare stiff joints & tight ms for ex
     • decrease pain
   • Contraindications for Heat
     • impaired sensation
     • vascular insufficiency & vascular disease
     • poor cognition/ mentation
     • malignancy
     • recent of potential hemorrhage
     • infection
     • liniments or heat rubs
   • Precautions
     • pregnancy
     • cardiac insufficiency
     • areas of edema
     • areas with metal