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Heat-internal vibration of molecules within the body

Heat-internal vibration of molecules within the body. Conduction-heat lost or gained by direct contact Convection-movement through air or H2O tranfers heat to our body Radiation-transfer of heat from warmer source to cooler one Evaporation-transfer from liquid to gas state

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Heat-internal vibration of molecules within the body

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  1. Heat-internal vibration of molecules within the body • Conduction-heat lost or gained by direct contact • Convection-movement through air or H2O tranfers heat to our body • Radiation-transfer of heat from warmer source to cooler one • Evaporation-transfer from liquid to gas state • Superficial heat-HP,W/P paraffin • Deep heat-diathermy, ultra sound

  2. Thermotherapy-heat modalities, used when goal is to increase temperature • Cryotherapy-cold modalities • Hydrotherapy-H2O is used as medium to increase or decrease tissue temp. • Heat: • produces analgesic affect • promotes ms. Relaxation • increases elasticity • decreases viscocity of C.T. • Increases local metabolism of A’s and caps • inc. blood flow to body part treated, inc. edema • inc. Leukocytes and phagocytosis

  3. Examples of superficial heat<1cm. • Hot packs • moist heat-stored in hydrocollator units -165 F • 6-8 layers for insulation • towel for perspiration • consider body part treated, position of pt., weight of HP • Cervical, lumbar, small and large • describe to pt. what to expect • Paraffin • 1 cm. Mineral oil and wax (5# wax/1 part oil) temp. 125 F,retains perspiration and softens skin

  4. Good for distal parts of extremities • Methods • Glove-dip 8-10 times, bag, towel, elevate, treatment time 20 min. return wax to unit • Immersion-dip once to coat, then immerse remainder of time, temp. Increase is greater than glove-edema may result • Advantages • Conforms to body part treated • Disadvantages • can’t use with open wound • Fluidotherapy • dry, warm air is circulated • can use with splints,other things to enhance tx.

  5. Contraindications for heat • acute inflammation,fever, malignancies, acute hemorrhage, PVD, overradiated pt, cardiac insufficiency, unexplained pain, acute infection coma, int bleed; precautions-impaired circulation, pregnancy, older adults and children<4 yo • Precautions: previous existing edema, sensory loss, confused patients

  6. Cryotherapy-use of cold-goal it to decrease tiss temp, it dec metabolism, causes vasocon, dec bl flow, nerve ms excitability, ms spindle activity, edema and promotes analgesia • Ice-silica gel in frig, cold W/P, ice w/p, massage, cold spray, contrast baths, normal cold progression-cold, stinging, burning, numbness Indications-spasticity, acute inf, ms spasm, edema

  7. Contraindications • Raynaud’s disease, cardiac dysfunction open wounds after 48-72 hours, arterial insufficiency, cold urticaria

  8. Contrast Baths -two containers with warm/cool water -warm 80-104 degrees F -cool 55-67 -Immerse in warm 3-4 min, then cool 1 min. -Repeat 5-6 times -Always finish with warm -used for chronic edema, infl. conditions, hypersensitization

  9. Hydrotherapy-Archimedes principle-an immersed object exerts an upward thrust = wt. Of H2O displaced (buoyancy) • viscocity-resistance to flow • W/P source of moist heat • hydrostatic pressure-exerted agst skin • Pascal’s law- fluid exerts = pressure on all surfaces of a body at rest which increases in proportion to depth

  10. Whirlpool • Conduction and convection • Get inc rate of lymph flow, local met inc., perspiration inc, debridement, vasodiation, ms relax, inc cell perm and assist or resis with ROM • Increases hydrostatic pressure which may increase lymph circulation • Graded exercise (with or against turbulence • Debrides necrotic tissue therefore decreasing bacterial load

  11. Indications Stage III and IV wounds Subacute and chronic inflammatory conditions Early PVD Peripheral nerve injuried Muscle weakness

  12. Contraindications • Same as those for heat • Venous ulcers

  13. Very hot-104-110 Hot-99-104 Mild Warm-96-98 Neutral-92-96 Tepid-79-92 Cold-32-79 Soft tissue extens, chronic Pain Burn patients Open wounds, circ, sensory, cardiac disorder, decrease tone Exercise, acute inflam (if not able to tol cold) Acute inflammation Temperatures

  14. Aquatic therapy • Same principles apply • Water temp-79-97 degrees F • 93-97 for light exercise by elderly deconditoned • 79-83 for more intense exercise and recreational pools • Should not go below 65 F (may impair ms. contract) • % of WB with depth immersion: • C7-8% • Xiphoid-28% • ASIS-47%

  15. Advantages • Ease of movement, weightlessness • Progressive WB • Can facilitate, support or resist mvmt • Ease of pt handling • Total body mvmt • Easy to progress program • Can perform many types of exercise

  16. Laws for dosage of EM radiation • Cosine law-absorption of ray is optimal when it strikes the surface at the perpendicular • Inverse square law-Intensity of radiation at any distance is inversely proportional to the square of the distance b/w the sure face and the source of radiation • Arndt-Schultz law-a certain minimum stimulus is needed to initiate a biological process

  17. Diathermy • To heat through (3-5 cm.) • Converts hi fx electromag E to heat in tissues • Frequency 27.12 MHz • Contraindications • General for heat • Pacemakers • Metal implants • Epiphyses • Eyes, testes, malignancy, pregnancy

  18. Disadvantages • Pool cost/ maintenance and upkeep • Time in commuting/changing • Limited carryover • Additional risk

  19. Precautions • Bowel/bladder incontinence • Open wounds • Infectious disease • Seizures • Tracheotomy tubes • Severe cardiovascular disease • Orthopedic instability

  20. Induction field-places pt in the EM field produced by the equipment ; current is induced in conductive tissues-heats superficial ms., heat is produced in deeper ms. from overlying ms. (drums or induction coil) • Condensor field (capacitance)- pt. is placed b/w 2 e’s in the electrical circuit (air spaced plates)

  21. Radiant Heat • Infrared and ultraviolet • Infrared-form of radiant heat which emits infrared waves (outside visible spectrum) • 2 types- • Luminous-emits short infrared waves • Non-luminous-emits long infrared waves • Indications-seeping wounds,chronic conditions • Contra-same for heat

  22. Ultraviolet • Causes a chemical change in tissues • Both UV and infrared possess these characteristics • Direction of travel is in straight line that can be reflected, refracted, absorbed or passed through depending on the medium they strike

  23. Light is characterized by: • Wavelength-measured in nanometers • Visible-b/w 400-800 nm • UV light-180-400 • Infrared-800-1500 • Frequency-# of oscillations or vibrations in 1 second-expressed in hertz • The higher the frequency, the shorter the wavelength

  24. UVA-320-400 nm.-penetrates furthest (into dermis) • UVB-290-320-psoriasis • UVC-<290, cold quartz-operates at low temps. Used to promote bacteriocidal effects, wound debridement, tissue regeneration • UV is used to promote erythemal response w/in 12 hours of exposure-causes chemical reaction that impacts on the immune system

  25. Indications • -pressure sores, acne, wound care, psoriasis, to decrease bacteria in pressure sores (especially after pulsed lavage) • Contraindications • -photosensitivity, cancer, systemic lupus errythmatosis, cardiac, kidney or liver disease active TB, fever, acute diabetes, drugs, direct eye contact

  26. Precautions • Photosensitivity as a result of drugs • Drugs such as gold salts, psoralens, tetracyclines • Syphilis • Alcohol • Elevated levels of estrogen • Foods such as shellfish, strawberries

  27. Must establish MED-exposure time necessary to produce mild erythemal dose-lasts to 48 hours • SED-no erythema • MED-smallest dose producing erythema • Appears 1-6 hrs, fades in 24

  28. Technique • Goggles • Place body part perpedicular • Protect skin not treated • Use same lamp • Cover genitals, nipples • Place lamp 24-36 inches away • Use test strip to test-uncover each hole so 1st hole will have greatest exposure

  29. Procedure • Cut six holes with different shapes • Use skin not exposed to uv light • Remove clothing, jewelry, wash area • Attach MED strip and cover with towel • Position lamp perpend to treated surface • 30 sec hole 1,2. 15 sec. 3-6

  30. Instruct pt. to check arm in bright area every 2 hrs. and document which symbols appear and fade • Dosage time should be increased by 25% next treatment as long as effects of previous dose have disappeared

  31. Lasers • EM E within visible spectrum • Low level laser therapy • Used for tissue healing and pain management • Contraindicated for pregnant women, unclosed fontanelles of children, cancerous lesions, cornea, endocrine glands and hemorrhaging lesions

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