dr. rashi thermotherapy(1)

12/19/14Dr. Rashi Goel

1

Human perception Absence of heat Heat energy is being transferred away from the

body


2


3

METHODS OF APPLICATION

Local immersion

Cold Packs

Ice towels

Ice massage

Cold compression units

Evaporating sprays

Contrast bath

Cryokinetics

Local changes at the cooled site General systemic changes- when heat

regulating mechanism is activated


4

Immediate vasoconstriction of the blood vessels- become pale

Increased blood viscosity


5

Immediate vasoconstriction Reduces blood flow Minimizes heat loss


6

Vasoconstriction Vasodilatation Vessel hunts about its mean position


7

COLD INDUCED VASODILATATION The immediate vasoconstriction response to

cold is a consistent phenomenon however, when cold is applied for longer periods of time or when the tissue temperature reaches less than 10 deg. C (50 deg. F), vasodilation may occur


8

Hunting response cold-induced vasodilatation of finger immersed

in ice water, measured by skin temperature change


9

Hunting response is mediated by an axon reflex in response to the pain of prolonged cold or very low temperatures- release of Histamine like substance

OR Caused by inhibition of contraction of the

smooth muscles of the blood vessel walls by extreme cold


10


11

Protect tissues from damage Due to prolonged cooling and relative ischemia


12

Vasoconstriction Viscosity increases Blood flow decreases


13

Contra lateral ef fect - local icing in a hemiplegic of unaffected side


14

Reduced Metabolic Rate Reduces oxygen uptake Reduced production of metabolites Reduced cellular activity Slowed healing


15

Pain reduction Spasticity treatment

Cold reduces conduction velocity of peripheral nerves

Delayes synaptic transmission


16

Initial decreased muscle strength (viscosity n metabolic rate)

Increase in strength after 1 hour of ceasation

5 min of ice- increases isometric strength


17

Diminished dexterity Decrease in velocity of movement Decrease in tapping speed

Cause- NCV


18

General shivering Teeth chattering


19

Hemodynamic effects Neuromuscular effects Metabolic effects


20

Recent injuries Pain Spasticity Muscle spasm Muscle strengthening Chronic edema


21

Limits bleeding by vasoconstriction, blood viscosity

Dec pain nerve irritants Red metabolic rate and secondary cell necrosis Red joint effusion

PRICE


22

Increased pain threshold Pain spasm pain cycle Reducing blood flow Decreasing rate of reaction due to acute

inflammation Controlling post injury edema formation Release of endorphins and enkephalins Reduces pain from compression of nerves


23

SKIN- CNS stimulation- facilitate muscle contraction

MUSCLE-dec gamma motor neuron activity-dec muscle spindle discharge

More viscid- allows less rapid stretching


24

Shorter application-

Initial inc- facilitation of alpha motor neuron pool

Sympathetic system stimulation


25

Prolonged intensive cooling-

More viscid More energy on contraction Weakness


26

Immediate ice and compression bandage


27

Decreased NCV Increased pain threshold Altered muscle strength Decreased spasticity


28

Cold can decrease the conduction velocity of both sensory and motor nerves

A -delta fibers, are small diameter, myelinated, pain-transmitting fibers, demonstrate the greatest decrease in conduction velocity in response to cooling


29

Vasospasm- Reynaud's disease Vasospasm + obstruction- Buerger’s disease Cryoglobinaemia- with SLE and RA Coronary artery disease Close to superficial nerves older patients- psychological features

12/19/14

30

Dr. Rashi Goel

dr. rashi thermotherapy(1)

Healthcare