TI week 4 summary.pdf

4.5 Cryotherapy Application Indication, Acute MSK trauma considerations > • muscle spasms • myofascial pain syndromes • delayed onset muscle soreness ↑ all based on goals Modes • ice & gel packs • massage • vapocoolant • contrast baths • compression units *4/5 use conduction for en...

4.5 Cryotherapy Application Indication, Acute MSK trauma considerations > • muscle spasms • myofascial pain syndromes • delayed onset muscle soreness ↑ all based on goals Modes • ice & gel packs • massage • vapocoolant • contrast baths • compression units *4/5 use conduction for energy transference* PRICE • know this! Preparation & Expectations Patient Education Assessment • asses pt medical status • acuity of injury • experience intense cold, burning, aching, then analgesia • examine for hypersensitivity • rvw precautions list (hyper/hyposensitivity) • align w/ goals • skin becomes red after use • avoid significant stress at injured tissue for 1-2 hours after ice application Parameters • tx time (10 min intervals 2-3x per tx & stop as soon as analgesic) • cryokinetics (normally precede tx unless trying to reach deep) • session itinerary (how organize session for goals of cryotherapy effects) • barriers • pt position/tolerance (skin exposed and protected) • cooling agent (cost, fxn, time, effect, pt pref, evidence) know these know these too! Summary • cryotherapy for acute msk, manage pain, prevent effusion & secondary tissue death • most common form of energy transfer used conduction • proper assessment & setting appropriate expectations for pt prior to cryotherapy best practice • several parameters for safety • precautions/contraindication (know them!!) 4.6 Thermotherapy Indications & Effects Definition - The use of heat, from any source, to promote therapeutic or physiological response by increase tissue temperature - Can include ultrasound, superficial heat, electromagnetic therapies Physiological Changes in Thermotherapy - Physiological Changes - Metabolic Reactions - Vascular Effects - Neuromuscular Effects - Connective Tissue Effects - ALL dependent on - Extent of temperature increase in tissue - Rate of energy added - Volume of tissue exposed - Composition absorbing tissue - Capacity of tissue to dissipate heat - Thermal therapy best indicated for pain management & anti spasmodic Metabolic Reactions - Heat will increase cell activity & metabolic rate - Increase oxygen uptake by tissues - Increase circulation Vascular Effetcs - Vasodilation - Starts in cutaneous receptors, sends afferent information to SC - Then mediates release of chemicals, causing vasodilation in vasculature - Causes mild Inflammation local to tissues exposed to - Increased Vascular Permeability - Increased Blood Flow - Primarily effecting cutaneous tissue - Minimal change found in muscle tissue Neuromuscular Effects - Elevated Pain Threshold (Increased pain tolerance) - Mediated by Thermal Gate Control - Increased Nerve Conduction Velocity - Decreased Alpha Motor Neuron Activity - Anti-Spasmodic - Heat thought to decrease gamma efferent nerve activity, resets muscle spindles - Allows max sensitivity to stretch - Decreases sensitivity in muscle spindle, relaxes muscle Connective Tissue - Physiological Change - Increased Elasticity - Decreased Blood Viscosity - Blood is a form of connective tissue - Functional Change - Decreased Joint Stiffness - Increased Muscle Flexibility Important Consideration - Degree of penetration modality has - Direct energy will effect superficial cutaneous tissues most Take Aways - Thermotherapy heats tissue to promote therapeutic & physiologic response - Thermotherapy may lead to physiological changes in treated tissue - Thermotherapy has been found to be most indicated for use in patients w/ pain & impaired range associated w/ stiffness & muscle spasms