Thermal Biophysical Agents Overview
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Questions and Answers

What are the three phases of tissue healing? (Select all that apply)

  • Regeneration
  • Initial Injury/Inflammation (correct)
  • Proliferative (correct)
  • Maturation (correct)

    • Which of the following is NOT a physiological event that occurs during the initial injury phase?

  • Vasodilation
  • Vasoconstriction
  • Phagocytosis
  • Hemostasis
  • Fibroblast arrival (correct)

    • What are the treatment goals for the initial injury phase of healing?

  • Increase ease of movement
  • Minimize functional deficits (correct)
  • Increase circulation
  • Increase range of motion
  • Prevent further injury (correct)
  • Minimize pain (correct)
  • Minimize inflammatory effects (correct)
  • Increase cellular metabolism

    • Which of the following is NOT a physiological event that occurs during the proliferative phase of healing?

    <p>Hemostasis (C)</p> Signup and view all the answers

    What are the general treatment goals for the proliferative phase of healing? (Select all that apply)

    <p>Increase ease of movement (B), Increase circulation (C), Increase range of motion (D), Increase cellular metabolism (E)</p> Signup and view all the answers

    Which of the following is a characteristic of the maturation phase of healing?

    <p>Collagen balance: synthesis/lysis (C)</p> Signup and view all the answers

    What are the primary treatment goals for the maturation phase of healing?

    <p>Increase circulation (A), Increase ease of movement (B), Increase cellular metabolism (E), Increase range of motion (F)</p> Signup and view all the answers

    Which of the following is an example of heat transfer through conduction?

    <p>Applying a heating pad to the back (A)</p> Signup and view all the answers

    Which method of heat transfer involves a circulating medium?

    <p>Convection (B)</p> Signup and view all the answers

    Which of these is NOT a method of heat transfer?

    <p>Evaporation (A)</p> Signup and view all the answers

    What type of heat transfer does a microwave use?

    <p>Conversion</p> Signup and view all the answers

    Which of the following is an example of cryotherapy using conduction?

    <p>Ice massage (A), Controlled cold unit (B)</p> Signup and view all the answers

    Which of the following is an example of cryotherapy using evaporation?

    <p>Vapocoolant spray (A)</p> Signup and view all the answers

    When is cold therapy typically indicated for injury treatment?

    <p>The first 24-48 hours after injury</p> Signup and view all the answers

    Which of the following is a clinical indication for cryotherapy?

    <p>Decrease edema formation (C)</p> Signup and view all the answers

    Which of the following is a contraindication for cryotherapy?

    <p>Cryoglobulinemia (E)</p> Signup and view all the answers

    Which of the following is a precaution for cryotherapy?

    <p>All of the above (E)</p> Signup and view all the answers

    What is the typical progression of sensation experienced during cryotherapy?

    <p>Cold, Burning, Aching, Analgesia (C)</p> Signup and view all the answers

    Flashcards

    3 Healing Phases

    Initial injury/inflammation (up to 48hrs), Proliferative (1-2wks), Maturation (up to 1yr post injury)

    Initial Injury Phase Events

    Immediate vasoconstriction followed by vasodilation, hemostasis/clot formation, cell phagocytosis.

    Treatment Goals: Initial Phase

    Prevent further injury, minimize inflammation, pain, and functional deficits.

    Proliferative Phase Events

    Fibroblast arrival, epithelialization, collagen production, closure, revascularization.

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    Treatment Goals: Proliferative Phase

    Increase circulation, cellular metabolism, range of motion (ROM), and ease of movement.

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    Maturation Phase Events

    Collagen balance: synthesis and lysis, collagen remodeling.

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    Treatment Goals: Maturation Phase

    Increase circulation, cellular metabolism, ROM, and ease of movement with higher loads.

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    Conduction

    Heat transfer through direct contact.

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    Convection

    Heat transfer through circulating medium.

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    Radiation

    Heat generated without conduction or convection.

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    Conversion

    Non-thermal energy converted to heat.

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    Evaporation

    Heat drawn away through evaporation.

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    Cryotherapy: Conduction Examples

    Cold packs, ice massage, cold immersion, vapocoolant spray.

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    Cryotherapy: Convection Examples

    Cold immersion.

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    Cryotherapy: Evaporation Examples

    Vapocoolant spray.

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    Cold Indication Period

    Indicated for 24-48hrs post-injury to decrease pain and inflammation.

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    Clinical Indications for Cryotherapy

    Pain reduction, edema control, muscle relaxation, limits secondary injury.

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    Cryotherapy Contraindications

    Conditions like urticaria, cryoglobulinemia, and Raynaud's phenomenon that prevent use.

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    Cryotherapy Precautions

    Conditions like hypertension, thermoregulatory disorders, and young/old age require caution.

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    Cryotherapy Sensation Progression

    Cold, burning, aching, analgesia (numbness).

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    Important Cryotherapy Duration

    10-30 min for effective depth of heat penetration.

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    Ice Massage Duration

    5-10 minutes for effective cooling.

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    Cold Bath Duration

    15-20 minutes for effective cooling.

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    Objective Measures for Cryotherapy

    Girth measurement for edema, NPRS for pain, goniometer for ROM, task demonstration for function.

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    BPA Documentation Consideration

    Consider FITT: frequency, intensity, time, type; specific parameters and effect assessment.

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    Burn Risk Factors

    Increased risk for those aged 60+, diabetes, or with poor sensation.

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    Thermotherapy Precautions

    Acute injury, pregnancy, impaired circulation, or over open wounds require caution.

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    Thermotherapy Contraindications

    Recent hemorrhage, DVT, malignant conditions, untreated infections prevents use of heat.

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    DOMS and Heat Effect

    Eccentric induced DOMS reduced 30 min post heat compared to other methods.

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    Deep Heat and Strength Effect

    First 30 min after diathermy showed decreased isometric strength followed by increase.

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    Temperature Elevation in Tissues

    Greatest temp elevation occurs in skin/subcutaneous tissue, less in muscle.

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    Heat Sensitivity and Adipose

    Greater adipose increases sensitivity to heat exposure.

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    Paraffin Treatment Considerations

    Low melting point, multiple dips, safer than moist heat applications.

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    Temperature for Tissue Damage

    Tissue damage begins at 113°F.

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    PEACE & LOVE Acronym

    Protection, Elevation, Avoid anti-inflammatories, Compression, Education; Load, Optimism, Vasculaturisation, Exercise.

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    Study Notes

    Thermal Biophysical Agents Study Notes

    • Healing Phases: Three phases of healing follow injury:
      • Initial Injury/Inflammation (up to 48 hours): Characterized by vasoconstriction followed by vasodilation, hemostasis, and phagocytosis. Focus on preventing further injury, minimizing inflammation, pain, and functional deficits through passive care.
      • Proliferative Phase (1-2 weeks): Fibroblast arrival, epithelialization, collagen production, closure, and revascularization are key processes. Active care focusing on increasing circulation, cellular metabolism, range of motion, and movement ease is critical.
      • Maturation Phase (up to 1 year): Focus shifts to collagen balance (synthesis and lysis), and collagen remodeling. Active care with increasing load and intensity are used for increasing circulation, cellular metabolism, range of motion, and movement ease.

    Cryotherapy

    • Mechanism of Action: Transfer of heat through conduction, convection, and evaporation.
    • Types:
      • Conduction: Ice massage, cold packs, ice immersion.
      • Convection: Cold immersion baths.
      • Evaporation: Cooling spray.
    • Indications (First 24-48 hrs): Pain reduction; decrease edema; muscle relaxation; secondary hypoxic tissue injury prevention, post-operative situations. Ice massage targets myofascial trigger points..
    • Contraindications: Cold hypersensitivity (urticaria), cold intolerance, cryoglobulinemia (vascular blockage).
    • Precautions: History of Hypertension (HTN), thermoregulatory conditions (MS), open wounds requiring caution around infection. Poor circulation, impaired cognition, young/old, cold aversion. Consider tissue regeneration & vascular compromise.
    • Progression of Sensation: Cold, burning, aching, analgesia (numbness).
    • Duration: 10-30 minutes, with 20 minutes on, cooling 2cm deep. Ice massage: 5-10 minutes. Cold bath: 15-20 minutes.
    • Objective Measures: Edema; Pain (NPRS); ROM; Function ("show me the task"); muscle guarding assessments.
    • Risk Factors: Age (65+), Diabetes Mellitus, and poor sensation are high risk factors for burns. Precaution- cognitive impairment.

    Thermotherapy

    • Mechanism of Action: Conduction, convection, radiation, conversion, and evaporation transfer of energy.
    • Contraindications: Recent/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, topical counter irritants, demyelinated nerves.
    • Effect on Delayed-Onset Muscle Soreness (DOMS): Reduced eccentrically induced DOMS by 30 minutes post-heat application compared to cold and control groups.
    • Effects on Strength & Endurance: Short burst heat (diathermy, whirlpool) may transiently reduce isometric strength followed by improvement over time.
    • Temperature Elevation: Greater for skin/subcutaneous tissue (0.5-2cm) than muscle (1-2cm). Adipose influences sensitivity.
    • Tissue Damage Threshold: Tissue damage begins at 113°F.
    • Paraffin Baths: Low melting point (129°F), 8-10 dips, 15-20 min; safer than moist heat.
    • PEACE & LOVE: Framework for managing musculoskeletal injuries: P-protection, E-elevation, A-avoid anti-inflammatories/ice, C-compression, E-education; and L-load, O-optimism, V-vasculature, E-exercise

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    Description

    This quiz provides an overview of thermal biophysical agents, focusing on the healing phases following an injury. Key aspects include the initial injury phase, the proliferative phase, and the maturation phase, along with the mechanism of cryotherapy. Enhance your understanding of these important concepts in rehabilitation and therapy.

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