Thermal Agents: Cold and Heat
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Transcript of Thermal Agents: Cold and Heat
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Thermal Agents: Cold and Heat
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Physical Principles of Thermal Transfer Specific Heat
Specific heat is the amount of energy required to raise the temperature of a give weight of a material by a given number of degrees (F or C)
Materials with a high specific heat hold more energy than materials with a low specific heat
Agents with higher specific heat are applied at lower temperatures
Ex – Paraffin bath is applied at lower temperature than hot pack
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Physical Principles of Thermal Transfer Modes of Heat Transfer
Conduction: Heat Transfer by Direct Contact Such as Hot Packs and Cold Packs
Rate of Heat Transfer by Conduction [(contact area) x (thermal conductivity) x
(temp difference)] / tissue thickness Thermal conductivity = rate at which a
material transfers heat
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Physical Principles of Thermal Transfer Modes of Heat Transfer
Guidelines for Heat Transfer by Conduction The greater the temperature difference, the
faster the rate of heat transfer Materials with higher thermal conductivity
transfer heat more rapidly than those with lower thermal conductivity
The larger the area of contact, the greater the total heat transfer
The thicker the tissue, the slower the rate of heat transfer
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Physical Principles of Thermal Transfer Modes of Heat Transfer
Convection: Heat Transfer by Circulation of a Medium of a Different Temperature Such as Fluidotherapy, Whirlpool, Blood Circulation
Convection – heat transfer due to direct contact between a circulating medium and another material of a different temperature
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Physical Principles of Thermal Transfer Modes of Heat Transfer
Conversion: Conversion from One Type of Energy to Another Such as Ultrasound Diathermy, and Metabolism
Conversion of a non-thermal form of energy (physical/mechanical, electrical, or chemical) to a thermal form of energy
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Physical Principles of Thermal Transfer Modes of Heat Transfer
Radiation: Exchange of Energy Directly without an Intervening Medium Such as Infrared Lamp
Radiation – transfer of energy without direct contact
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Physical Principles of Thermal Transfer Modes of Heat Transfer
Evaporation: Absorption of Energy as the Result of Conversion of a Material from a Liquid to a Vapor State Such as Vapocoolant Sprays
During evaporation, energy is absorbed when a solid is converted to a liquid or a liquid is converted to a gas/vapor (sweating)
Vapocoolant sprays result in cooling of an area due to evaporation
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Vapocoolant Spray
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Cold- Cryotherapy Hemodynamic Effects
Initial Decrease in Blood Flow
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Cold- Cryotherapy Hemodynamic Effects
Initial Decrease in Blood Flow
Later Increase in Blood Flow
Ice bath results Cold-induce
vasodilatation Hunting response
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Cold- Cryotherapy Neuromuscular Effects
Decreased Nerve Conduction Velocity As temperature decreases, nerve conduction
velocity decreases
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Cold- Cryotherapy Neuromuscular Effects
Increased Pain Threshold
Gate Control Theory Cold increases
activity of the non-nociceptive fibers causing inhibition of nociceptive fibers
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Cold- Cryotherapy Neuromuscular Effects
Altered Muscle Strength
Short cooling can result in increased strength
Long cooling can result in decreased strength
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Cold- Cryotherapy Neuromuscular Effects
Decreased Spasticity Decrease in motor neuron & muscle spindle
activity Facilitation of Muscle Contraction
Facilitates motor neuron activity by stimulating cutaneous sensory receptors
Lasts for only a short period of times (seconds)
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Cold- Cryotherapy Metabolic Effects
Decreased Metabolic Rate “Slows” or controls inflammation Can slow healing Cryotherapy is used for management of
inflammatory diseases such as OA and RA
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Cold- Cryotherapy Uses of Cryotherapy
Inflammation Control
Slows metabolism Reduces edema Reduces pain
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Cold- Cryotherapy Uses of Cryotherapy
Edema Control Due to
vasoconstriction
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Cold- Cryotherapy Uses of Cryotherapy
Pain Control Gate Control
Theory - Cold increases activity of the cutaneous thermal receptors (non-nociceptive fibers) causing inhibition of nociceptive fibers
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Cold- Cryotherapy Uses of Cryotherapy
Modification of Spasticity
Decrease in reflexes
Duration - 5 – 30 mins
30 mins for severe spasticity
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Cold- Cryotherapy Uses of Cryotherapy
Facilitation Quick icing may be
used to elicit desired motor patterns
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Cold- Cryotherapy Uses of Cryotherapy
Cryokinetics and Cryostretch Cryotherapy is used to minimize sensation
(numbness) prior to exercise/stretching to decrease pain perception
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Cold-Cryotherapy Contraindications for Cryotherapy
Cold Hypersensitivity Elevated patches which are red or pale
Cold Intolerance Cryoglobulinemia – aggregation of serum
proteins limiting circulation Associated w/ lupus & RA
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Cold Hypersensitivity
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Cold-Cryotherapy Contraindications for Cryotherapy
Raynaud’s Disease/Phenomenon Sudden pallor & cyanosis followed by redness
(mainly seen in the distal extremities) Over Regenerating Peripheral Nerves Over an Area With Circulatory Compromise
or Peripheral Vascular Disease
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Raynaud’s Disease/Phenomenon
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Cold-Cryotherapy Precautions for Cryotherapy
Apply Cryotherapy with Caution: Over a Superficial Main Branch of a Nerve Over an Open Wound When Treating Patients with Hypertension When Treating Patients with Poor Sensation or
Mentation When Treating Very Young and Very Old Patients
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Cold-Cryotherapy Adverse Effects of Cryotherapy
Tissue Death Frostbite Nerve Damage Unwanted Vasodilatation
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Cold-Cryotherapy Application Techniques
Sequence of Sensations in Response To Cryotherapy
Intense Cold Burning Aching Analgesia and numbness
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Heat-Thermotherapy Effects of Heat
Hemodynamic Effects
Vasodilatation
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Heat-Thermotherapy Effects of Heat
Neuromuscular Effects Changes in Nerve Conduction Velocity and
Firing Rate
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Heat-Thermotherapy Effects of Heat
Neuromuscular Effects Increased Pain Threshold
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Heat-Thermotherapy Effects of Heat
Neuromuscular Effects Changes in Muscle Strength
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Heat-Thermotherapy Effects of Heat
Metabolic Effects Increased Metabolic Rate
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Heat-Thermotherapy Effects of Heat
Altered Tissue Extensibility
Increased Collagen Extensibility
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Heat-Thermotherapy Uses of Superficial Heat
Pain Control
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Heat-Thermotherapy Uses of Superficial Heat
Increased ROM and Decreased Joint Stiffness
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Heat-Thermotherapy Uses of Superficial Heat
Accelerated Healing
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Heat-Thermotherapy Uses of Superficial Heat
Infrared Radiation for Psoriasis and Dermal Ulcers
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Heat-Thermotherapy Contraindications for the Use of
Thermotherapy Acute Injury or inflammation Recent or Potential Hemorrhage Thrombophlebitis
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Heat-Thermotherapy Contraindications for the Use of
Thermotherapy Impaired Sensation Impaired Mentation Malignancy Infrared Irradiation of the Eyes
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Heat-Thermotherapy Precautions for the Use of
Thermotherapy Pregnancy Impaired Circulation Poor Thermal Regulation Edema
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Heat-Thermotherapy Precautions for the Use of
Thermotherapy Cardiac Insufficiency Metal in the Area Over an Open Wound Over Areas Where Topical Counterirritants
Have Recently Been Applied
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Heat-Thermotherapy Adverse Effects Of Thermotherapy
Burns Fainting Bleeding Skin and Eye Damage from IR Radiation