effects of heat

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Thermotherapy : 

Pta 200 Modalities and procedures in physical therapy Thermotherapy

Definition of Thermotherapy : 

Definition of Thermotherapy Therapeutic application of heat Uses: Pain control Increased soft tissue extensibility Increased circulation Accelerated healing

Effects of Heat : 

Effects of Heat Hemodynamic Effects Vasodilation (locally and systemically) Superficial heat has more local effects

Vasodilation : 

Vasodilation Directly By activation of smooth muscles of blood vessels (via cutaneous thermoreceptors) Locally dilates Indirectly By thermoreceptors

Indirect Vasodilatation by Thermoreceptors : 

Indirect Vasodilatation by Thermoreceptors Causes spinal cord stimulation produces inhibitory stimulus to sympathetic nervous system results in relaxation of smooth muscles in vessels of distal extremities Theoretically, heat to low back can increase blood flow to foot

Effects of Heat : 

Effects of Heat Increases local release of histamine, prostaglandins Control, mediate inflammation Superficial heat DOES NOT increase blood flow to muscles

Neuromuscular Effects of Heat : 

Neuromuscular Effects of Heat Increases nerve conduction velocity Decreases firing rate of motor neurons, resulting in muscle relaxation Increases pain threshold

Increasing Pain Threshold : 

Increasing Pain Threshold Counter-stimulus Decreases spasm decreases ischemic pain Speeds healing

Changes in Muscle Strength : 

Changes in Muscle Strength Decreases strength initial 30 minutes after heat Recovers, then increases to > pre-treatment strength over next 2 hours Always assess muscle strength before applying heat

Metabolic Effects of Heat : 

Metabolic Effects of Heat Increases metabolic rate (up to 1130 F) Above 1130 decreases Ceases completely at 1220 F Increased MR, increases oxygen uptake, accelerates healing May also accelerate destruction Heat must be used with caution in patients with acute inflammatory disease such as RA

Increases Soft Tissue (Collagen) Extensibility : 

Increases Soft Tissue (Collagen) Extensibility Maintains a greater increase in length after stretching Decreased elasticity Less force required to increase length Risk of tissue tearing decreased Tissue must be maintained at 104-1130 for 5-10 minutes Remember, superficial heat does not penetrate to deeper structures.

Uses of Superficial Heat : 

Uses of Superficial Heat Pain Control Gate theory/ counter-stimulus By improved healing Secondary to decreased muscle spasm Secondary to decreased ischemia, increased blood flow Comfort/relaxation Do not use in acute pain secondary to… Edema Inflammation Infection

Uses of Superficial Heat : 

Uses of Superficial Heat Increased ROM/ Decreased joint stiffness Maintain at 104-1130 F for 5-10 minutes Slow, maintained stretch will result in an increase in restored ROM Accelerates Healing Increased blood flow Increased metabolic rate Increased oxygen to tissues

Uses of Superficial Heat : 

Uses of Superficial Heat Infrared Radiation for Psoriasis UV most commonly used, but also IR Increased temperature of upper epidermis, dermis decreases psoriatic plaques Infrared for Dermal Ulcers Improves healing by increasing circulation, decreasing bacterial growth, dehydrating wound Rarely used secondary to theory of maintaining moist wound environment

Contraindications for Heat : 

Contraindications for Heat Acute injury or inflammation Recent or potential hemorrhage Thrombophlebitis Impaired sensation Malignant tissue Infrared to eyes may cause optical damage

Precautions for Heat : 

Precautions for Heat Pregnancy Full body heating avoided immersion therapy / WP Hot Packs on distal extremities, OK Poor circulation or thermal regulation. Edema Cardiac insufficiency Metal Use with milder temp. or more insulation

Precautions for Heat : 

Precautions for Heat Areas where topical counterirritants have recently been applied Ointments that produce heat “Hot Ice”, “Icy Hot”, “Biofreeze”

Application of Superficial Heat : 

Application of Superficial Heat Commercial Hot Packs Made of Bentonite (silica gel) covered with canvas. Various shapes, sizes Water 158-167 degrees Takes 2 hrs. to heat initially, and 30 minutes to reheat .

Electric Heat : 

Electric Heat Do NOT cool during application, easily burn patient. At home, use medium or low settings; D/C after 20 minutes or if pain or burning occurs. Inspect skin after use.

Adverse Effects of Heat : 

Adverse Effects of Heat Burns Applied too long, too hot, or to patient without appropriate protective vasodilation response. Always use adequate insulation, inspect skin prior to and after treatment. Do NOT use on sunburn!! Fainting Caused by peripheral vasodilation, decreased BP, decreased HR. Bleeding Skin and eye damage (IR)

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