Cryotherapy

PRATIGYA DEUJA: CRYOTHERAPY- DEFINITION, METHODS OF APPLICATION, PHYSIOLOGICAL & THERAPEUTIC EFFECTS, CONTRADICTION & PRECAUTION

1. CRYOTHERAPY PRATIGYA DEUJA

2. Definition It is the treatment of pathological conditions by the use of low temperature agents such as ice, frozen gels and vapocoolant sprays. It exert it’s therapeutic effect by influencing haemodynamic , neuromuscular and metabolic effects.

3. Methods of application 1) Ice pack : The commercially available pack consists of a gel made from silica or a mixture of saline and gelatin, which is covered by a vinyl covering. The temperature of cold pack is maintained by storing it in freezer at -5°C and allowing it to be cooled for 30 minutes between uses and 2 hours initially. → The pack should be wrapped in a towel and applied to a body parts. Therefore, we use oil in the body parts in order to prevent it from ice burn.

4. Methods of application 2) Ice massage : It is a most common method where ice cubes are gently applied to the body parts and water drawing due to melt of ice is removed by towels. We used this in trigger point, small area of inflammation & pressure sore.

5. Methods of application 3) Cold Compression Units : These are the devices that alternately pump cold water or a temperature of 10°-20° and air into a sleeve that is wrapped around a patient limb. Compression is also applied by intermittent inflation of a sleeve with air. It is mainly used after surgery for controls of post-operative inflammation and edema, it is applied for 15 minutes in every 2 hours.

6. Methods of application 4) Ice Towels : This method is done in large areas. The ice is kept in a towel and applied to the body parts. It is usually given for 20 minutes. 5) Immersion : In this technique, the part mainly distal going to be treated is directly placed in a container for 10 minutes which contains 50% of ice & 50% of water.

7. Methods of application 6) Vapocoolant sprays : Done for sports injury to stretch the tight muscles. A technique where a volatile substance such as ethylchloride or flurorimethane etc. are sprayed directly on to the area to be treated.

8. Physiological Effects 1) Haemodynamic Effects : Cold →Vasoconstriction followed by Vasodilation ( Lewis hunting reaction) 2) Decrease Nerve Conduction : Decrease velocity of conduction in both sensory as well as motor nerves and has a greater effect on myelinated and small diameter fibers i.e. conduction velocity decreases.

9. Physiological Effects 3) Increase in Pain Threshold : Pain decreases due to increase in pain threshold, which occur due to counter irritation via pain gate mechanism and reduction of muscle spasm and sensory nerve conduction velocity. 4) Alteration of Muscle Strength 5) Facilitation of Muscle Contraction : By exciting alpha motor neuron.

10. Physiological Effects 6) Decrease Spasticity 7) Metabolic Effects : Cold leads to abnormal increase in the demand for the metabolic reaction.

11. Therapeutic Effects & Uses of Cold 1) Control of edema 2) Pain control 3) Spasticity reduction 4) Facilitation of muscular contraction 5) Symptom management in multiple sclerosis 6) Acute inflammation

12. Contraindication 1) Peripheral Vascular Disease : Conditions like arteriosclerosis & other peripheral vascular disorders, where there is impairment of circulation over a particular area, the cryotherapy is contraindicated because it may cause vaso -constriction which increase blood viscosity and decrease circulation.

13. Contraindication 2) Vasopastic disorders : E.g : Raynaud’s disease 3) Cold urticaria : Due to release of histamine the patient suffering from urticaria develops itching & erythema .

14. Contraindication 4) Cryoglobulinemia : Precipitation of abnormal blood production which may block blood vessel. 5) Over Regenerating Peripheral Nerve

15. Precautions Open wound Hypersensitive patient Cardiac disease Defective skin sensation Skin hypersensitivity Adverse psychological factors