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Questions and Answers
What are the three healing phases?
What are the three healing phases?
Initial injury/inflammation, proliferative, maturation
What is the timeline for the initial injury/inflammation phase?
What is the timeline for the initial injury/inflammation phase?
Up to 48 hours
What is the timeline for the proliferative phase?
What is the timeline for the proliferative phase?
1-2 weeks, until damaged tissue is replaced with new tissue
What is the timeline for the maturation phase?
What is the timeline for the maturation phase?
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Which of the following is a physiological event of the initial injury phase?
Which of the following is a physiological event of the initial injury phase?
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Which of the following is a physiological event of the proliferative phase?
Which of the following is a physiological event of the proliferative phase?
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Which of the following is a treatment goal for the proliferative phase?
Which of the following is a treatment goal for the proliferative phase?
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Which of the following is a physiological event of the maturation phase?
Which of the following is a physiological event of the maturation phase?
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Which of the following is a treatment goal for the maturation phase?
Which of the following is a treatment goal for the maturation phase?
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What is conduction?
What is conduction?
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What is evaporation?
What is evaporation?
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Which of the following is an example of conduction in cryotherapy?
Which of the following is an example of conduction in cryotherapy?
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Which of the following is an example of evaporation in cryotherapy?
Which of the following is an example of evaporation in cryotherapy?
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What is the typical time period for which cold therapy is indicated?
What is the typical time period for which cold therapy is indicated?
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Which of the following is a clinical indication for cryotherapy?
Which of the following is a clinical indication for cryotherapy?
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Which of the following is a contraindication for cryotherapy?
Which of the following is a contraindication for cryotherapy?
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Which of the following is a precaution for cryotherapy?
Which of the following is a precaution for cryotherapy?
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What is the typical progression of cryotherapy perception?
What is the typical progression of cryotherapy perception?
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What are some important cryotherapy time parameters?
What are some important cryotherapy time parameters?
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What is the typical time dosage for ice massage?
What is the typical time dosage for ice massage?
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What is the typical time dosage for a cold bath?
What is the typical time dosage for a cold bath?
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Which of the following is an objective measure used to determine the effectiveness of cryotherapy?
Which of the following is an objective measure used to determine the effectiveness of cryotherapy?
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What are some important considerations when documenting the use of biophysical agents?
What are some important considerations when documenting the use of biophysical agents?
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Which of the following is a risk factor for burns?
Which of the following is a risk factor for burns?
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How does heat affect DOMS (Delayed Onset Muscle Soreness)?
How does heat affect DOMS (Delayed Onset Muscle Soreness)?
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How does deep heat affect strength and endurance?
How does deep heat affect strength and endurance?
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Does the greatest degree of temperature elevation occur in the skin/subcutaneous tissue or the muscle?
Does the greatest degree of temperature elevation occur in the skin/subcutaneous tissue or the muscle?
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What is the clinical implication of heat on adipose tissue?
What is the clinical implication of heat on adipose tissue?
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What are some considerations for paraffin therapy?
What are some considerations for paraffin therapy?
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At what temperature does tissue damage begin with heat?
At what temperature does tissue damage begin with heat?
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What does PEACE & LOVE stand for?
What does PEACE & LOVE stand for?
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Study Notes
Healing Phases
- Initial injury/inflammation (up to 48 hours): Characterized by vasoconstriction followed by vasodilation and clot formation, culminating in phagocytosis.
- Proliferative (1-2 weeks): Focuses on fibroblast arrival, epithelialization, collagen production, closure/retraction, and revascularization.
- Maturation (up to 1 year): The final stage involves collagen remodeling, where the balance of production and lysis occurs.
Treatment Goals
- Initial injury phase: Passive care focused on preventing further injury, minimizing inflammation, pain, and functional deficits.
- Proliferative phase: Active care to increase circulation, cellular metabolism, range of motion (ROM), and ease of movement.
- Maturation phase: Active care with increased load and intensity to further enhance circulation, cellular metabolism, ROM, and ease of movement.
Thermal Biophysical Agents
Heat Transfer Methods
- Conduction: Heat transfer through direct contact.
- Convection: Heat transfer through a circulating medium.
- Radiation: Transfer of heat energy without conduction or convection.
- Conversion: Non-thermal energy transformed into heat.
- Evaporation: Heat absorbed through evaporation.
Cryotherapy Examples
- Conduction: Cold packs, ice massage, cold immersion, vapocoolant sprays, controlled cold units.
- Convection: Cold immersion.
- Evaporation: Vapocoolant spray.
Cryotherapy Indications & Timing
- Primarily indicated for the first 24-48 hours post-injury to reduce fluid filtration, inflammation, pain, and local metabolism. Prolonged intense cold might cause edema.
- Pain reduction, decreased edema, muscle relaxation, limited secondary hypoxic tissue injury, suitable for post-operative conditions. Ice massage can reduce pain thresholds around myofascial trigger points.
Cryotherapy Contraindications & Precautions
- Contraindications: Urticaria (cold hypersensitivity), cold intolerance, cryoglobulinemia, paroxysmal cold hemoglobinuria, Raynaud's phenomenon, areas of nerve regeneration or vascular compromise.
- Precautions: Hypertension, thermoregulatory disorders (like MS), open wounds, poor circulation, cognitive impairment, age extremes (65+), cold aversion.
Cryotherapy Perception Progression
- Cold, burning, aching, analgesia (numbness).
Cryotherapy Dosage
- General use: 10-30 minutes.
- Specific use like ice massage: 5-10 minutes.
- Cold bath: 15-20 minutes.
Cryotherapy Assessment
- Edema (girth measurement), pain (Numerical Pain Rating Scale), ROM (goniometry/measuring movement), function (observation), muscle guarding (ROM assessments).
Documentation Considerations
- Use the FITT principle (Frequency, Intensity, Time, Type).
- Record objective parameters and assessment of treatment effect.
Thermotherapy Contraindications & Precautions
- Contraindications: Recent or potential hemorrhage, DVT, impaired sensation, vascular insufficiency, impaired cognition, malignancy, untreated infection.
- Precautions: Acute injury/inflammation, pregnancy, impaired circulation/thermal regulation, edema, open wounds, cardiac conditions/insufficiency, topical counter irritant creams, demyelinated nerves.
Thermotherapy Effects
- Deep heat therapy can decrease isometric strength initially in the first 30 minutes, followed by an increase for 2 hours. Similar findings exist with whirlpool immersion.
- Heat therapy (compared to cold pack and control) reduces eccentric DOMS within 30 minutes after muscle heat therapy.
- A higher adipose tissue presence increases sensitivity to heat.
Paraffin Bath Details
- Low melting point (129°F).
- 8-10 dips.
- Treatment time: 15-20 minutes.
- Safer than moist heat.
Tissue Damage Temperature (Heat)
- Tissue damage begins at 113°F.
PEACE & LOVE Mnemonic
- A helpful acronym to remember considerations for rehabilitation and healing.
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Description
Explore the three phases of healing: initial injury/inflammation, proliferative, and maturation. This quiz covers the treatment goals associated with each healing phase and examines thermal biophysical agents and heat transfer methods. Understand key concepts essential for effective rehabilitation.
