protocoale cryo6
TRANSCRIPT
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Treatment Protocols
Cryo Version 6
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1
Table of Contents
Page
Reflex dystrophy 2CVA sequelae 4Scar 6Subacromial impingement 8
Muscle lesion 10Back pain 12
Ankle sprain 14Epicondylitis 16Haematoma 18
ACL 20Low-back pain 22Cervicobrachial pain 24
Lymphoedema 26Rheumatoid arthritis 28Groin pain 30Sciatica and sciatic pain 32Multiple sclerosis 34Piriformis syndrome 36
Achilles tendonitis 38
Torticollis 40
Cryo6 programme setting 42Treatment duration 42
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2
Reflex dystrophy
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3
Reflex dystrophy
Definition
Autonomic nervous system
disorder characterised by a painsyndrome associated withvasomotor and trophicdisturbances.
Symptomatology
Progressive pain accompanied byloss of mobility and associated
with vasotrophic disturbances(shiny, hot skin).
Positioning Treatment
Depending on the area to betreated.
Target
Vasomotor effectAnalgesiaMobilisation
Hot phase: Thermal shock with cooling duringmobilisation.
Cold phase: Cool before and aftermobilisation.
Prevention: Any post-trauma patient can beconsidered as being in the coldphase.
Methods of t reatment
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Hot phase: P5then P4Cold phase: P3(repeated twice)
Precautions: Stop if the patient does not tolerate the treatment
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4
CVA sequelae
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5
CVA sequelae
Definition
Motor dysfunction associated with
a haemorrhagic or ischaemiccerebrovascular damage.
Symptomatology
Pyramidal rigidity, with or withoutloss of sensitivity.
Positioning Treatment
Patient in a comfortable positionthat allows mobilisation.
Target
Analgesia (painful shoulder)Muscle relaxation (nerveconduction)
Sweep the painful or spastic area and apply gentlemobilisation.
Treatment possible even in the presence of sensorydisturbance.
Methods of t reatment
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
P3or P4 depending on how the patient feelsUse the appropriate nozzle size
Precautions: Ensure that you have the full understanding of the patient beforetreatment.
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6
Scar
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7
Scar
Definition
Mark, whether or not caused by
surgery, affecting different strata ofthe skin.
Symptomatology
Local inflammation due to scarringat different tissue strata.
Positioning Treatment
Depending on the location of thescar, the patient should be as
relaxed as possible.
Target
Reduction of inflammation aroundthe scar.
Thermal shock along the margins of the scar.
Methods:
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Depending on the size of the scar, therefore the treatment duration, select P6
Precautions: The scar should be clean and closed (after 21 days).
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8
Subacromial impingement
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9
Subacromial impingement
Definition
Tendinopathy of the rotator cuff
muscles linked to abnormalmovement patterns in theglenohumeral joint.
Symptomatology
Sharp pain on elevation of the arm,potentially also associated with loss
of function.
Positioning Treatment
Supported-seated position
Target
Analgesia
Cool area while mobilising it.
Sweep the tendon area if the tendon is hyperalgic.
Methods of t reatment
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
P 2 or P3 depending on the severity of the pain
Precautions:
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Muscle lesion
Definition
Damage to a larger or smaller
number of muscle fibres dividedinto several grades (fromelongation to tear).
Symptomatology
Persistent pain, worsening onpalpation, stretching and
contraction. Occurrence of localhaematoma.
Positioning Treatment
Will depend on the muscle affected.The patient should be as relaxed as
possible.
Target
Pain reduction.Limitation of oedema development.
Acute: Thermal shock to affected musclealong its entire length.
Chronic: Drain the haematomaby sweeping.
Methods:
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Acute: P 5 repeat cooling 3 to 4 times at 5 min intervals (P6 large surface)Chronic: P3 or P4 depending on the morphology of the subject
Precautions: Protect untreated areas.
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12
Thoracic spine pain
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Thoracic spine pain
Definition
Thoracic spine pain of sudden or
insidious and progressive onset ,causing dysfunction.
Symptomatology
Dysmobility, dystonia anddysmorphia of the thoracic spine
with more or less pain.
Positioning Treatment
Contralateral lateral supine
Prone
Target
Pain reductionMuscle relaxation
Acute: (posterior costovertebral orarticular joint) thermal shock at the
relevant level.
Chronic: Sweep whole area.
Methods of treatment:
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Acute: P 5Chronic: P 3The use of the articulating arm allows simultaneous combination of mobilisations.
Precautions: Have the patient feel the cold before starting the session
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14
Ankle sprain
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Ankle sprain
Definition
Damage to the various bundles of a
lateral ligament of the ankle (lateralligament complex in 90% ofcases).
Symptomatology
Oedema, pain on palpation.In the case of a severe sprain,
extensive haematoma, completedysfunction.
Positioning Treatment
Acute: Leg inclined
Target
Pain sedation.Reduction of oedema.
Acute: Have the leg inclined; thermalshock to the developing
haematoma.
Chronic: Sweep the various bundles of theexternal lateral ligament.
Methods of t reatment
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Acute: P 5Chronic:P 3
Precautions: Protect the untreated areas.
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16
Epicondylitis
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Epicondylitis
Definition
Damage to the proximal attachment
of the lateral epicondyle muscles(tennis elbow) or the proximalattachment of the medialepicondyle muscles (golfers elbow)
Symptomatology
Sharp elbow pain that spreadsalong the forearm and increases on
palpation, stretching andcontraction. Head and localoedema.
Positioning TreatmentSitting on a chair, the arm restingon a table and releasing the area tobe treated in order to obtain as
much relaxation as possible.
Target
Reduction of painReduction of oedema.
Acute: Thermal shock to the wholepainful area by sweeping above
and below the painful area (globaloedema treatment).
Chronic: Sweep the painful area.
Methods of treatment:
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Acute: P 5 reducing phase 1 to a power of 7 or 8 depending on thetolerance of the subject.
Chronic: P 3 for 5 to 7 min
Precautions: Protect the untreated areas.
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Haematoma
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Haematoma
Definition
Localised collection of tissue fluid
resulting from a trauma.
Symptomatology
Red/violet coloration of the tissueswith pain on palpation.
Positioning Treatment
Depending on the area to betreated but preferably inclined.
Target
Acute: to prevent haematomaformation.
Chronic: to aid resorption.
Acute: Short-term thermal shock butrepeated several times.
Chronic: Sweep the area, overlapping itwidely.
Methods of treatment
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Acute: P1 for 2 min, repeat 5 times at 5 min intervals.Chronic: P3
Precautions: Protect the untreated areas.
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ACL
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Low-back pain
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Cervicobrachial pain
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Cervicobrachial pain
Definition
Inflammation of a cervical spine
nerve root, causing painfulradiation.
Symptomatology
Pain radiating from the neck to thearm, potentially accompanied by
loss of cervical mobility or jointlocking.
Positioning Treatment
Prone or seated on a stoolsupported on the arms.
Target
AnalgesiaMuscle relaxationAnti-inflammatory
Acute: Circular sweeps at the nerve rootexit points.
Chronic: Sweep along the path of the pain.
Methods of treatment
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Acute: P 6Chronic: P4Use the blow nozzles, as appropriate
Precautions: Return to the cervical spine from the thoracic spine. Avoid in cases ofspasticity.
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Lymphoedema
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Lymphoedema
Definition
Accumulation of lymph linked to
dysfunction of venous return.
Symptomatology
Tissue swelling.
Positioning Treatment
Patient lying down, with the area tobe treated inclined.
Target
Acute: to prevent the developmentof oedemaChronic: to aid resorption.
Acute: Repeated thermal shock.
Chronic: Sweep the whole area,overlapping it widely.
Methods of t reatment
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Acute: P1 only the first phase repeated 4 to 5 timesChronic: P4
Precautions: Take care with delicate skin.
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Rheumatoid arthritis
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Rheumatoid arthritis
Definition
Systemic condition of the
connective tissues that develops inphases and affects the joints.
Symptomatology
Inflammatory episode affecting thejoints, with progressive deformation
of the joints involved
Positioning Treatment
Depending on the area to betreated, being attentive to patient
comfort (particularly during anactive phase).
Target
AnalgesiaDecrease of oedema andinflammationMaintain joint function
Active phase: Thermal shock to the area thenmaintain the cooling.
Chronic phase: Sweep area to be mobilised.
Methods of t reatment
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Active phase: P5Chronic: P4Use the appropriate nozzle for the joints involved.
Precautions: Protect adjacent areas and reduce the power on small joints such as theproximal or distal interphalangeal joints.
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Groin pain
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Groin pain
Definition
Tendonitis of the adductor longus
muscle of the hip at its proximalattachment (quadrilateral surface ofthe pubis).
Symptomatology
Sharp pain at the inguinal fold,exacerbated by stretching and
movement, potentially radiating tothe medial aspect of the thigh.Local heat.
Positioning Treatment
Supine. Flexion, abduction, lateralrotation of the affected hip, resting
against the therapist or on acushion.
Target
Reduction of painReduction of oedema
Acute: Thermal shock along the tendon,following its anatomy.
Chronic: ditto.
Methods of t reatment
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Acute: P 6Chronic: P 3 or P 4 depending on the tolerance of the patient
Precautions: Dry the inguinal fold (risk of frostbite).Protect the untreated areas, particularly the genitalia.
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Sciatica and sciatic pain
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Sciatica and sciatic pain
Definition
Low-back pain radiating to the legs.
Symptomatology
Mechanical pain, painful low-backcontractures, unilateral radiation
with paraesthesia and more or lessfrank motor signs.
Positioning Treatment
Contralateral lateral supineProne
Target
Pain sedation.Muscle relaxation
Acute: Thermal shock to the painful area.
Chronic: Sweep the entire area of painradiation.
Methods of treatment
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Acute: P6Chronic: P4
Precautions: Protect the untreated areas.Do not exceed the treatment time (risk of cold-induced paralysis)
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Multiple sclerosis
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Multiple sclerosis
Definition
Degenerative disease of the central
nervous system.
Symptomatology
Pyramidal rigidity, with or withoutsensory disturbances.
Positioning Treatment
Patient in comfortable position thatallows mobilisation.
Target
Analgesia (painful shoulder)Muscle relaxation (nerveconduction)
Sweep the spastic area accompanied by gentlemobilisation to reduce hypertonicity.
Methods of t reatment
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
P3 or P4 depending on how the patient feels.Use of the articulating arm and gentle mobilisation in the cold air flow.
Precautions: Check if the sensory function of the patient is intact.
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Piriformis syndrome
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Piriformis syndrome
Definition
Contracture of the piriformis,
leading to compression of thesciatic nerve.
Symptomatology
Pain on contraction and stretchingof the piriformis, radiating into the
leg and even a loss of motorfunction.
Positioning Treatment
Contralateral lateral supine.Flexion of hip and knee. Leg resting
on a cushion.
Target
Reduction of piriformisinflammation
Acute: Thermal shock to piriformismuscle belly, overlapping the area
affected.
Chronic: Sweep along the muscle belly.
Methods of treatment
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Acute: P1Chronic: P2
Precautions: Protect the untreated areas.Do not exceed the treatment time (risk of damage to sciatic nerve).
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Achilles tendonitis
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Achilles tendonitis
Definition
Inflammation of the Achilles tendon.
Symptomatology
Pain on contraction, stretching andpalpation of the triceps surae. Local
inflammation and oedema.
Positioning Treatment
Prone, the foot off the table.
Target
Sedation of pain.Reduction of inflammation
Acute: Thermal shock to allaspects of the tendon.
Chronic: Sweep along the tendon.
Methods of treatment
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Acute: P5Chronic: P 3
Precautions: Protect the untreated areas.
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Torticollis
Definition
Abnormal cervical posture linked to
spasms of the cervical muscles (theSCM, etc).
Symptomatology
Scoliotic posture of sudden onsetaffecting the cervical spine and
associated with severe musclespasms as well as severe pain onmobilisation.
Positioning Treatment
Patient supine with a small cushionunderneath the head (chronic) or
prone in order to reach the occipitalridge.
Target
AnalgesiaMuscle relaxation
Acute: Sweep along the occipital lineand the nuchal ligament,
then sweep precisely along thepath of the pain.
Chronic: Static, adding massageto the painful area.
Methods of treatment
Cryo 6 programme P1 P2 P3 P4 P5 P6
Cryo 5 air flow 1 2 3 4 5 6
Acute: P6Chronic: P4 for 5 to 6 minUse the nozzles, as appropriate
Precautions: Return to the cervical spine from the thoracic spine to avoid taking thepatient by surprise. Avoid subjects with spasmophilia and cold-induced conditions.
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Programmes of the Cryo 6
9 air-flow levels from 100 l/min to 1000 l/min.
Sequence 1 Sequence 2
Programme Air flow Time Air flow Time1 9 3 min - -
2 6 5 min - -
3 4 5 min - -4 3 10 min - -
5 9 30 sec. 6 2:30 min6 7 1 min 5 4 min
Cryo 56 air-flow levels from 300 l/min to 1000 l/min.
Treatment duration
This depends mainly on the quantity and surface area of the partsto be treated. Of course, the response of the patient and his/hersensitivity to the cold must also be taken into account.
For small joints (wrist, elbow, ankle) up to 2 minutes.For large joints (shoulder, knee, hip) up to 4 minutes.
On programmes 1 and 2, with high air flows with the Cryo 6, at aan application distance of between 2 and 5 centimetres, thermalshock is obtained in less than 15 seconds.
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