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Physiological Properties of Thermal Modalities (2)

Physiological Properties of Thermal Modalities (2). Physiological Effects of Heat. 1. Haemodynamic Effects: Vasodilation Increases the rate of blood flow (locally and systemically) It is increases more locally. 1. Haemodynamic Effects:. It occurs due to:

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Physiological Properties of Thermal Modalities (2)

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  1. Physiological Properties of Thermal Modalities (2)

  2. Physiological Effects of Heat 1. Haemodynamic Effects: • Vasodilation • Increases the rate of blood flow (locally and systemically) • It is increases more locally

  3. 1. Haemodynamic Effects: • It occurs due to: • Direct activation on the smooth muscles of blood vessels • Indirect activation • Effect on spinal cord on the grey matter  smooth muscle • Sympathetic nervous system  vasodilation

  4. 1. Haemodynamic Effects: • No increase in the temperature of most muscles • Protect body from excessive damage • Convection reduce the risk of burning

  5. 2. Neuromuscular Effects: • Change in nerve conduction velocity and firing rate: • Change in nerve conduction velocity (N.V.C) • Decrease conduction latency (in sensory & motor nerves) • Increase pain threshold • Direct  gating • Indirect   ischemia +  muscle spasm

  6. 3. Metabolic Effects: • Increase metabolic rate • Increase the rate of chemical reactions including enzymatic activity • Up to 45°C • Increase rate of cellular biochemical reactions • Increase O2 uptake • Increase healing

  7. 4. Alter Tissue Extensibility : • Increase collagen extensibility • Stretching the soft tissue without heating  elastic deformation • Stretching the soft tissue with heating  plastic deformation • Plastic deformation is due to the change in the viscoelasticity of collagen fibers + the organization of collagen fibers • 40 - 45°C from 5 – 10 minutes (when applying the agent apply for 15 minutes)

  8. Physiological Effects of Heat Factors affecting these physiological effects: • Size of the heated area • Depth of absorption of specific radiation • Duration of heating • Frequency of treatment • Intensity of radiation • Method of application

  9. Therapeutic Effects of Heat • Pain control: • Direct due to gating • Indirect through healing,  muscle spasm,  ischemia •  Skin temperature • Not recommended for acute inflammation. Remember! Applying hot agents to acute inflammation might cause destruction of the tissue

  10. Therapeutic Effects of Heat • Increase range of motion and decrease joint stiffness •  Soft tissue extensibility • Passive stretch (45°C for 5-10 minutes) •  Extensibility and viscoelasticity of particular structures (joint capsule, ligaments ..etc) • Superficial stretching (hot pack, infrared, paraffin) • Deep stretching (ultrasound, shortwave diathermy)

  11. Therapeutic Effects of Heat • Accelerate healing •  Circulation •  Enzymatic activity • O2, nutrients, remove waste products • In chronic inflammation (third & forth stages of inflammation) • Inflammation & healing rapidly

  12. Therapeutic Effects of Heat • Reduction of muscle spasm • Golgi tendon • Muscle spindle

  13. Sedative effect Sleeping • Prophylaxis of pressure sores  Blood flow Risk of skin breakdown • Skin disease Like I.R. Precursor for other treatment (Before stretching, exercises ,massage)

  14. Contraindications of Superficial Heating • Acute injury or inflammation • Recent or potential hemorrhage • Thrombophlibitis • Impaired sensation • Impaired mentatiion • Malignancy • I.R irradiation to eyes damage of retina (use a goggle)

  15. Precautions • Pregnancy • Impaired circulation • Poor thermal regulation • Edema chronic  hot agent + elevation • Cardiac insufficiency • Metal in the area • Over an open wound • Over area where topical counterirritant hae recently been applied

  16. Adverse Effects of Thermo-therapy • Burns •  Intensity • Too long time of application • Patient fall asleep • Contraindicating • Fainting • Vasodilation   blood flow in the area treated   blood pressure

  17. Adverse Effects of Thermo-therapy • Bleeding • Skin and eye damage from I.R irradiation

  18. Conductive Agents Heat Methods of Application Two types of heat: • Dry heat: increase surface temperature • Wet heat: increase temperature slightly deeper Conduct techniques: • Superficial • Deep

  19. Conductive Agents Heat Methods of Application Superficial contact heat depends on: • Intensity of heat • Length of exposure to heat • Thermal medium for surface heat

  20. Conductive Agents Heat Methods of Application Heating tempreture 40 – 45°C Above this level  burning Below this level  mild effect Maximum elevation of skin temperature within 6-8 minutes Deep contact  deep heat modalities

  21.  Good Luck 

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