You are on page 1of 15

When

ice is applied to the skin, heat is conducted from the tissue to the ice in order to melt it, so consequently, when trying to cool tissues it is important to use ice during treatment as a whole and not just cold water. Therapeutic application of ice drop the temperature down by 5 to 28 C. This reduced temperature showed a particular circulatory response in the body, which was an apparent "hunting" for the mean point of circulation. This "hunting- reaction" was stated by Dr. Lewis in 1930.

It states that , following the application of intense cold to the body there is a vasoconstriction with the liberation of histamine like substance (H) produced by the intense cold and noxious stimuli making the part to become very cold. When there were sufficient 'H' substance, after a short period, vasodilatation occurred for a brief period of time, about 4 to 6 minutes, where all 'H' substances are removed and closes the arteriovenous anastomosis. Thus causing an increased blood flow through the capillaries. This response is once again followed by constriction and dilatation resulting in an apparent hunting for the mean point of circulation.

Varying Effects on Reduced Temperature : a) less than 10 C depressed tissue oxidation, dissociation of oxy hemoglobin, increased erythemal reaction, body heat balance maintenance. b) At -5 C extensive cellular damage, excessive 'H' substance liberation, causes frostbite and ice burns. c) Cooling under 18 C d) Cooling at 20 to 29 C reduces muscle tone isometric muscle endurance is Lewis hunting-reaction,

improved

Special Effects on Nerves : a) At 0 C facilitate reflex contraction in the muscle. b) At 1 C immediate raise in the impulse frequency of non-specific C fibres by 30 impulses per second. c) Below 100 C Selective peripheral nerve inhibition. d) Below 20 C Reduces, the end plate potential, rate of conduction, acetylcholine, selective active potential, causes asynchrony of impulses.

Methods of Cooling Tissues : Convective cooling - An electrical fan Conductive cooling - Crushed ice packs, frozen gel packs, ice baths, wet ice towels, ice cube massage. Evaporative cooling - Ethyl chloride, noninflammable Fluoromethane and chorofluoromethane

Temperature Variations Caused by Cooling Agents : Solid ice 5 C to 28 C Evapocoolent sprays - up to 4 C Ice cube massage and ice immersion- 14 C Ice packs and ice towels - 18 to 20 C in skin, 30 to - 33 C in muscles.

Ice

cube massage Ice packs Ice cold immersions (cold baths) Ice towels Commercial ice packs vasocoolent sprays Contrast baths Cold whirl pools

Properties of cold : When cold is applied to the body, the skin temperature changes. The speed of these changes depends on various factors. Application of particular temperature, & the temperature of the part receiving the treatment Ability of the tissue to recover from the lowest temperature Specific resistance of the tissues to low temperature Duration of the cold application Density of the skin, fat, subcutaneous fascia, muscle The tissues water content Patency of the circulation Region to which it is applied Existing pathophysiology of the underlying lesion

Uses : Reduce/control edema and hemorrhage Reduce pain Reduce muscle spasm Reduce muscle spasticity Improve nerve transmission Facilitate muscle contraction Improve sustained muscle contraction Promote repair Increase visual acuity

Effects :
Local applications :

1) On Circulation

2) On Tissues

Lewis hunting reaction. Reduce the amount of edema and hemorrhage. Responds immediately to acute injury or inflammation. Reduce metabolic rate. Reduce pain by decreased muscle guarding. Increase joint, ligaments & muscle
Produces long contractions & muscles. Brief skin temperature changes at 3-5 seconds, increases. Input to CNS and enhances motor Long periods of cooling at 5-7 minutes diminishes sensation & reduces pain. Tone and nerve conduction velocity. Prolonged period of cooling at 20-30 minutes diminishes muscle.

viscosity relaxations in 3) On Nerves output.

General Application :
There

is generalized vasoconstriction, in response to cooling, of the anterior hypothalamus Respiratory and heart rates are decreased Muscle tone is increased and may be accompanied by shivering The increase in muscle spindle bias will tend to increase spasticity and is directly opposite of the effect of a local application If application is prolonged, metabolism will be increased to produce heat and maintain homeostasis.

Indications : Wherever PRICE is a must (Positioning, Rest. Icing, Compression, Elevation) Pain and muscle spasm (acute and chronic) Any typical soft tissue injury Sprains, strains, muscle contusion (both acute and established) and all postsurgical conditions - all acute injuries or inflammations. Spasticity accompanying CNS disorders Chronic inflammations following trauma

Contra Indications : Hypersensitive or reduced skin sense - with great care Care in arteriosclerotic heart disease Ischaemic tissue Hypertensive individuals with care Geriatric groups No cold to cutaneous area of vagus nerve Psychologically disturbed patients

You might also like