CRYOTHERAPY

1. CRYOTHERAPY Salman Farooqi Lecturer IPM&R, KMU

3. Objectives By the end of this lecture the students will be able to identify & explain • The concept of cryotherapy • Physiological effects • Indications & contraindications

4. What is Cryotherapy

5. By definition • Cryotherapy is the local or general use of low temperatures in medical therapy or the removal of heat from a body part

6. Cryotherapy facts • Cold therapy is one of the most popular methods when it comes to the first aid treatment of some injuries

7. Cryotherapy Facts • Nowadays, local cold application may be applied by the use of various forms of ice or frozen gel packs, • Often skin temperature is reduced to 10 C°.

8. Physical Principles When ice is applied to the skin heat is conducted from the skin to the ice in order to melt it.

9. Physical Principles • The ice requires considerable energy to rise the temperature of 1 g of ice at 0°C to 1 g of water at 37°C requires 491 J. Whereas to rise 1 g of water at 0°C to 37°C requires only 115J

10. Physical Principles • Consequently when trying to cool tissues it is important to use ice during treatment and not just cold water

11. Physiological Effects of Cold Application

12. Question • What is Excitatory Cold Mechanism?

13. Excitatory Cold Mechanism • When cold is applied in an appropriate way on the skin, it increase the excitatory bias around the anterior horn cell

14. Excitatory Cold Mechanism • This can often produce contraction of an inhibited muscle (only with intact peripheral nerve supply).

15. Excitatory Cold Mechanism • This effect can be used when muscle are inhibited postoperatively or in the later stages of regeneration of a mixed peripheral nerve

16. Circulatory Response • The initial skin reaction to cooling is an attempt to preserve heat. It is accomplished by an initial vasoconstriction. This haemostatic response has the effect of cooling of the body part

17. Circulatory Response • After a short period of time vasodilatation follows with alternating periods of constriction and dilatation this is called the “Lewis’s Hunting Reaction”.

18. Circulatory Response • During the vasodilatation, the arteriovenousanastomosis is closed, thus causing an increase blood flow through the capillaries. This is beneficial in the treatment of swelling and tissue damage

19. Circulatory Response • The reduced metabolic rate of cooled tissues allows cooled muscle to contract many more times before fatigue sets in

20. Neural response • The skin contains primary thermal receptors. • Cold receptors are several times more numerous than warm receptors

21. Neural response • The rate of conduction of nerve fibers in a mixed (motor and sensory) peripheral nerve is reduced by cooling.

22. Question • Does ice therapy application cause motor nerve paralysis?

23. Indications

24. Contraindications

25. Immersion

26. Techniques of Application of Cryotherapy Techniques of Application of Cryotherapy • The way which ice is applied will vary according to the required effects. • It may be applied in the following ways: • Ice Packs • Commercial Cold packs • Immersion • Ice cube massage

27. Techniques of Application of Cryotherapy • Excitatory cold ( quick ice) • Ice spray

28. Ice packs • There are many kinds of chemical cold packs available for first aid kits, To make an ice pack with items from home, you'll need: • ice • a sealable plastic bag • a towel or pillow case

29. Ice packs • Never place ice directly on skin. Ice can cause frostbite if left on skin for very long. • Regardless what you put between the ice and the victim's skin, do not leave the ice on the skin longer than 20 minutes

30. Ice packs

31. Commercial Cold packs

32. Commercial Cold packs • These are basically plastic bags filled with a mixture of water and some substance silica gels are the most common • Wet towel should be placed between the skin and the pack to avoid excessive cooling

33. Immersion • immersion involves placing the part to be treated in water ranging in temperature from cool to icy. • Appropriate for treatment of an extremity or large body areas

34. Immersion • Cold water immersion is ideally used following a heavy weights session, between training sessions or after muscle injury resulting in soreness or bruising

35. Immersion

36. Immersion Example • 1 minute plunge- (try to relax as much a possible), • 2 minutes out of water (air temperature) , • Repeat 5 times. • When very brave, 5 minutes straight

37. Ice cube massage • Used for two distinct reasons • counter-irritant action • Muscle stimulation

38. Ice cube massage • For the relive of pain ice block is moved over the part using a slow circular massage • For neurological facilitation the ice should be applied only briefly

39. Evaporating sprays • Spraying a rapidly evaporating liquid on the skin has the effects of cooling the surface. • The liquid is sprayed on to the area to be cooled in a series of short strokes of 5 s each

40. Evaporating sprays • The nozzle of the spray is held about 45 cm from the skin. • Cooling from such sprays not lasts very long