PT PAP 101, Heat and Cold Therapy

PT PAP 101, Heat and Cold Therapy

• Course: Physical Therapy
• Topic: Heat and Cold Therapy
• Date: November 25, 2024

Objectives

• Students will understand the physics principles of heat/cold application.
• Students will describe the methods of heat/cold therapy application.

Therapeutic Concept

• Heat and cold are used to change body temperature locally or systemically for therapeutic purposes.
• Heat causes vasodilation.
• Cold causes vasoconstriction.
• Heat, cold, light, and electricity are forms of energy used in therapy.
• Therapies can be used before, during, or after other treatments to enhance their effects.

Measurement

• Thermometry is the indirect measurement of temperature.
• Fahrenheit scale: Normal body temperature (rectal) is approximately 98.6°F.
• Celsius scale: Normal body temperature (rectal) is approximately 37°C.

Transfer of Energy

• Conduction: Energy transfer through direct contact. (Examples: ice packs, hot packs, paraffin, ultrasound).
• Convection: Energy transfer through the movement of a medium. (Examples: fluidotherapy, whirlpools).
• Radiation: Energy transfer through electromagnetic waves. (Examples: shortwave diathermy, microwave diathermy, infrared and laser therapy, ultraviolet therapy).

Therapeutic Application

• Heat Agent: Heat is transferred to the body.
• Cooling agent: Heat is transferred away from the body.
• Superficial and deep heating agents increase skin temperature to 104°F-113°F for therapeutic benefits.

Science-Heat Transfer

• Heat travels from warmer to cooler areas.
• Hot objects in a cool room will cool to room temperature.
• Cold objects in a warm room will warm up to room temperature.

Electrical Heating

• Electrical heating: Electric currents produce heat in resistive tissues.
• Shortwave diathermy: Uses radio frequencies to heat tissues, often for muscle spasms, pain, and joint problems.
• Microwave diathermy: Uses microwaves to heat tissues containing water, for fractures, sprains, bursitis, and tendon injuries.

Heat Modalities

• Variety of methods for applying heat include hot baths, hot packs, paraffin baths, electrical heating pads, etc. The method chosen depends on the required contact area, tissue type, and duration.

Heating Methods

• Heat conduction depends on contact area, tissue type, and duration.
• Thermal conductivity (subcutaneous fat has the lowest, muscle the highest).

Heat Application

• Relieves pain
• Decreases soreness
• Softens exudates and tissues
• Provides warmth
• Promotes healing

Contraindications

• Ischemia: (e.g., arterial insufficiency)
• Hemorrhage: Increased arterial and capillary blood flow.
• Impaired Sensation: (e.g., spinal cord injury, dementia)
• Burns:
• Malignancy: May increase tumor growth.

Classification of Hot Applications

• Local: applied to a specific area (e.g., moist heat packs, paraffin baths, shortwave diathermy).
• General: applied to the whole body (e.g., hot bath, sun bath, blanket).

Cryotherapy (Cold Therapy)

• Mechanism: applied cold reduces tissue temperature, constricts blood vessels, decreasing oxygen use, cell damage, and swelling. Can numb nerve endings reducing pain.
• Methods: Ice towels, ice packs, ice immersion, ice massage, excitatory cold, ice sprays, cold gel.

Use of Cold

• Reduces inflammation and swelling.
• Decreases oxidative stress (free radicals).
• Increases pain threshold and tolerance.

Techniques of Application of Cryotherapy

• Ice towels
• Ice packs
• Immersion
• Ice Cube Massage
• Excitatory cold
• Ice spray
• Cold gel

Contraindications to Ice Treatment

• Cardiac conditions
• Psychological problems
• Peripheral nerve injuries
• Vasospastic disease
• Peripheral vascular disease
• Cold sensitivity