Cold Modalities

MUTHIAH MUNAWWARAH
Definition
 Cryotherapy is the application of cold modalities that have a
temperature range between 0⁰C and 18⁰C
 The physiological effects of cold application depend on decreasing the
temperature of the target tissue to a therapeutic level of 10 C to 15 C
 Cold cannot be transferred because thermal energy always moves
from a high energy concentration (heat) to a lower concentration (cold)
 when a cold modality is placed on the skin, the heat transfer is from the
skin to the cold modality until the temperatures are equal
 Biothermal Changes
•Decreased Skeletal Muscle Temperature
•Decreased Smooth Muscle Temperature
•Decreased Nociceptors Temperature
•Decreased Motor Nerve Temperature
•Decreased Sensory Nerve Temperature
•Decreased Cellular Temperature
 Physiological Effects
•Decreased Skeletal Muscle Temperature
 Decrease In Gamma Motor Neuron Activity
 Decrease in Afferent Spindle and Golgi Tendon
Organ Activity
 Facilitate Alpha Motor Neuron Activity
 Produce A Contraction in a Muscle that is Flaccid
Due to Upper Motor Neuron Dysfunction
 Physiological Effects
•Decreased Smooth Muscle Temperature
 contraction of smooth muscle
 decreased blood volume & pressure
•Decreased Nociceptors Temperature
 decreased in nociceptor excitability
•Decreased Motor Nerve Temperature
 decreased in motor nerve excitability
 Physiological Effects
•Decreased Sensory Nerve Temperature
 decreased in sensory nerve excitability
•Decreased Cellular Temperature
 decreased cellular metabolism
Mekanisme efek Cold Modalities

Chad, 2013
Indications & Contraindications
1. Acute injury or inflammation 1. Circulatory insufficiency
2. Acute, chronic, or postsurgical pain 2. Deep vein trombosis
3. Prevent edema 3. Cold hypersensitivity
4. Spasticity accompaying central nervous 4. Anesthetic skin
system disorder 5. Advanced diabetes
5. Acute or cronic muscle spasm 6. Peripheral vascular disease
7. Raynaud’s phenomenon
8. Lupus
 overcooling the tissues may increase the risk of
frosbite and may delay the healing process.
 skin is rewarmed by the air, absorbing heat from
the underlying tissue, and warm blood flow to
the area.
 Tissue temperatures must reach (10⁰ C to 15⁰C)
to maximize the decrease in cell metabolism.
 Maximum analgesia is obtained when skin
temperature is decreased to approximately
(14,4⁰C)
 if the skin temperatur reaches 0⁰ intracellular
fluid begin to freeze and result in frosbite
Muscle Spasm
 Two mechamisms reduces muscle spasm :
Reducing the threshold of afferent nerve endings
Decreasing the sensitivity of muscle spindles (5⁰C)
 Cold inhibits gamma-motorneurons and facilitates
alpha-motoneurons
Effect of immediated treatment

Rest Ice

Compression Elevation