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Treatment Protocols

Cryo Version 6


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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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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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CVA sequelae


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CVA sequelae

Definition

Motor dysfunction associated with

a haemorrhagic or ischaemiccerebrovascular damage.

Symptomatology

Pyramidal rigidity, with or withoutloss of sensitivity.


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.




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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Scar


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Scar

Definition

Mark, whether or not caused by

surgery, affecting different strata ofthe skin.

Symptomatology

Local inflammation due to scarringat different tissue strata.


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:



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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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.


Supported-seated position

Target

Analgesia

Cool area while mobilising it.

Sweep the tendon area if the tendon is hyperalgic.




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.


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:



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.


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:



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.


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.




Acute: P 5Chronic:P 3

Precautions: Protect the untreated areas.


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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:



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



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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.


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



Acute: P1 for 2 min, repeat 5 times at 5 min intervals.Chronic: P3



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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.


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.




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.


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.




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


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.




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.


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.




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.


Contralateral lateral supineProne

Target

Pain sedation.Muscle relaxation

Acute: Thermal shock to the painful area.

Chronic: Sweep the entire area of painradiation.




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.


Patient in comfortable position thatallows mobilisation.

Target

Analgesia (painful shoulder)Muscle relaxation (nerveconduction)

Sweep the spastic area accompanied by gentlemobilisation to reduce hypertonicity.




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.


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.




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.


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.




Acute: P5Chronic: P 3



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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.


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.




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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