1. Polyclinic Therapy Department
Flávia Teixeira da Cunha
Group 7
Kursk - 2012

2. PHYSIOTHERAPY
 Physiotherapy is a healthcare support service, which
assists the medical service in dealing with different
aspects of treatment, rehabilitation and prevention of
disorders utilizing exercise and electrotherapy
procedures. It begins with an assessment of the
patient's condition including medical history and
physical examination.

3. Physiotherapist
 Physiotherapist helps people of all ages who have
physical problems caused by illness, accident or
ageing.
 They relieve pain, rehabilitate muscles alignment and
increase mobility in order to promote health and well-
being. They educate the patients in proper body
alignment as postures and work habits. The patient's
education is a key to success of the physiotherapists.
 The physiotherapist is trained to treat symptoms of
injury and disease by physical means, heat and
pressure.

4. Orthopaedic Physiotherapy
 Orthopaedic Physiotherapy is the oldest branch of
physiotherapy and is oriented towards the treatment
of Musculo – Skeletal ailments. It involves regaining
appropriate health and function of structures
surrounding the Joint regions and normalizing the
Biomechanics following any injury or Orthopaedic
disease. The rehabilitation of Orthopaedically disabled
individuals is also a major area of function.

5. Role
 Impaired posture, Impaired Muscle functions Impaired Joint Mobility, Motor function, Muscle
performance, and range of motion associated with Connective tissue dysfunctions Localized
inflammation as in
 Muscle pain, strain.
 Muscle tear.
 Muscle imbalances.
 Muscle spasm.
 Primary prevention /Risk reduction for skeletal demineralization
 Joint stiffness.
 Fractures.
 Ligament sprain, tear.
 Inflammation of tendons and bursa.
 Joint pain.
 Poor posture.
 Joint inflammation in case of osteoarthritis or rheumatoid arthritis
 Back and neck pain.
 Contractures.
 Joint dislocations.
 Body mechanics assessment.
 Other biomechanical faults.
 Rehabilitation following occupational injury, surgery, sporting injuries, fractures.

6. Physiotherapy & Rehabilitation Center uses a variety of different
treatment methods to help speed up the healing process and
reduce the likelihood of the same thing happening again.
Some of the techniques include:
 Manual techniques (massage, joint mobilization , manipulation, stretches).
 Electrotherapy (ultrasound, interferential currents, TENS, shortwave
diathermy, microwave diathermy, laser).
 Heat therapy (IRR , Hot packs , Wax therapy).
 Cryotherapy.
 Graded Therapeutic exercises.
 Correction of posture, lifting techniques, sporting techniques which contribute
to the problem .
 Taping, Bandaging, Splinting.
 Hydrotherapy.
 Contrast bath.
 Suspension therapy.
 Traction techniques.

7. Cryotherapy is the local or general use of low temperatures in
medical therapy. Cryotherapy is used to treat a variety of benign and
malignant lesions.
The term "cryotherapy" comes from the Greek cryo (κρυο)
meaning cold, and therapy (θεραπεια) meaning cure. Cryotherapy has
been used as early as the seventeenth century.

8. What does Cold Do?
 Pain and muscle spasms are common responses to injury. Tendons and
ligaments are tissues that connect muscles and bones to each other and to
other tissues. The basic building material of muscles, tendons, and ligaments is
a protein called collagen. Under normal conditions, collagen acts like a rubber
band: It stretches when tension is applied (as when we pull a rubber band) and
returns to its normal length when the tension is released. However, when the
collagen is stretched too far, it tears. In this tearing process, blood vessels are
torn and blood cells and fluid escape into the spaces among the muscle fibers.
This is sometimes visible on the surface of the skin as a swollen, bruised area.
 Cold applied to the area decreases the flow of this fluid into the tissues and
slows the release of chemicals that cause pain and inflammation. Cold
decreases feeling in an area by reducing the ability of the nerve endings to
conduct impulses. It may also reduce pain by "countering" the injury. For
example, you might counter the pain of a sore tooth by pinching yourself hard
in the leg.
 Cold also decreases the activity of cells to reduce swelling and internal bleeding
at the site of acute injury. Cooling the deep tissue also reduces muscle spasm by
reducing the muscle's ability to maintain a contraction (contractility).

9. Types of cryotherapy
Ice bags Ice massage
 This technique uses simple bags  Ice massage is another
such as a plastic bag, a hot water cyrotherapy technique. Place
bottle, chemical cold packs or clean tap water into a foam cup
frozen vegetables. Technique- Dry and place in your freezer until it
the area first. Apply a dry terry is completely frozen. Peel back a
cloth towel over the area to small amount of the top of the
prevent direct contact of the ice to cup and massage this onto area
the skin. Apply your choice of of pain using constant circular
cold to the area for no more than motion. DO NOT hold the ice in
20 minutes. The skin will pass one area for more than 3
through four stages of sensation minutes since this may cause
in 10-15 minutes. These sensations frostbite. ** Cold therapy
in order are: 1.) Cold 2.) Burning should be stopped once the
3.) Aching 4.) Numbness ** Cold skin feels numb.
therapy should be stopped
once the skin feels numb.

10. Advantages Disadvantages
 Easily available materials  The ice easily falls off the joint.
found in most homes. It is difficult to keep the ice in
place
 Usually inexpensive.
 The ice quickly melts and can
 Quick application with little create a mess especially if in
preparation. bed.
 Good for minor injuries that  Ice is applied to limited surfaces
only require cold therapy for a of the joint.
day or two.  No compression is applied.
 Can only be applied for short
periods of time (10-20 minutes).
 Very frustrating to use for more
major injuries or after surgery for
the above reasons.

11.  These benefits start with the
Benefits reduction of inflammation, pain
relief, and improved mobility.
 Faster muscle recovery  decreases cellular metabolism,
increases cellular survival, decreases
 Promotes healthier skin inflammation, decreases pain and
complexion spasm, and promotes
 Invigorates the mind vasoconstriction and vasodilatation
which leads to increased levels of
 Improves sleep pattern oxygenated blood delivered to
 Assists with cellulite damaged tissue.
reduction  In the cold temperatures, the blood
vessels quickly constrict forming a
 Effective with chronic pain protective layer while the core body
management temperature is maintained.
 Faster surgical recovery  The process naturally stimulates
blood circulation as the body's
 Reduces stress & anxiety hormone, immune, and nervous
systems are activated.

12. Indications Contraindications
 Reduce of general resistance all  General grave condition of
organisms; patient;
 Decompensation chronically
 Prevention for acute respiratory cardiovascular disease;
disease;  Acute myocardial infarction and
 Prevention for cardiovascular subsequent discharge ;
and bronchopulmonary  Cerebral impulse;
diseases;  Essential hypertension at 2 extant;
 Prevention for peripheral vessels  Cardiac decompensation at 2
disease; extant;
 Polyarticular rheumatoid  Prognostic negative disturbances
of cardiac rate and conductivity;
arthritis with prior join affection
in active (3 extent ) and not  Fever;
active phase;  Active pulmonary tuberculosis;
 Cancerous growth;
 Ankylosing [rheumatoid]
 Hysteric neuroses;
spondylitis;
 Individual intolerance of coldness;
 Skin diseases (eczema, psoriasis,  Hemorrhagic diathesis.
neurodermatitis).

13. Donjoy ArcticFlow Knee Wrap
with Cooler
 What is the Donjoy ArcticFlow Knee Wrap with Cooler?
 The Donjoy ArcticFlow Knee Wrap with Cooler is a fantastic
value for money continuous ice therapy and compression device.
 When can I use it?
 Ice therapy and compression are the treatment of choice for
knee swelling and pain that is common with all knee ligament
injuries, torn cartilage, knee arthritis and following all types of
knee surgery.
 Size
 One size fits all.
 How does it work?
 It's incredibly simple to use at home. Just fill the Donjoy
ArcticFlow Cooler with ice and water. It holds 3.5 litres of water
and ice - enough for three hours of ice therapy - a much longer
therapeutic period than an ice pack. The Cooler is attached to
the latex free elastic Donjoy ArcticFlow Knee Wrap which snugly
fits the knee joint. Simply elevate the Cooler above knee height
to fill the Wrap with ice cold water to provide ice therapy and
compression.

14. Donjoy ArcticFlow Shoulder Wrap
with Cooler
 What is the Donjoy ArcticFlow Shoulder Wrap with Cooler?
 The Donjoy ArcticFlow Shoulder Wrap with Cooler is a fantastic
value for money continuous ice therapy and compression device.
 When can I use it?
 Ice therapy and compression are the treatment of choice for
Shoulder swelling and pain that is common with a shoulder sprain,
shoulder bursitis, rotator cuff injury, dislocated shoulder, shoulder
separation, broken Collar bone, shoulder tendonitis and following
Shoulder surgery.
 Size
 One size fits all.
 How does it work?
 It's incredibly simple to use at home. Just fill the Donjoy ArcticFlow
Cooler with ice and water. It holds 3.5 litres of water and ice -
enough for three hours of ice therapy - a much longer therapeutic
period than an ice pack. The Cooler is attached to the latex free
elastic Donjoy ArcticFlow Shoulder Wrap which snugly fits the
shoulder joint. Simply elevate the Cooler above shoulder height to
fill the Wrap with ice cold water to provide ice therapy and
compression.

15. Aircast Ankle Cryo/Cuff with
Cooler
 What is the Aircast Ankle Cryo/Cuff with Cooler?
 The ultimate ankle ice therapy/cryotherapy device. Provides compression to
minimise bleeding and swelling, and cold to minimise pain following ankle injury.
 When can I use it?
 Many elite athletes use this product following ankle injuries and ankle surgery.
Anyone with an ankle injury can also benefit from using this product. It can be used
at home for the treatment of all ankle injuries, such as sprained ankle; dislocated
ankle; ankle arthritis; Talar dome lesions; Osteochondral lesions; Avulsion fractures;
and following ankle arthroscopy and ankle surgery.
 Size
 The Ankle Cryo/Cuff™ with Cooler is one-size for adults.
 How does it work?
 The Aircast Ankle Cryo/Cuff™ with Cooler is an easy to use device that circulates ice
cold water to provide cold therapy in the treatment of injuries. This version is specific
for the ankle and offers the very best option in ice and compression therapy.
 The Aircast Ankle Cryo/Cuff™ with Cooler combines the therapeutic benefits of
controlled compression to minimise bleeding and swelling in the ankle, and cold to
minimise pain. The cuff is anatomically designed to completely fit the ankle
providing maximum benefit.
 The Cooler element is Universal to all Cryo/Cuff™ models. The Cryo/Cuff™ Cooler
holds water and ice needed for six to eight hours of cryotherapy - much longer than
an ice pack. The durable cooler comes with a tube assembly and insulation disk and
is labelled with simple-to-follow directions for use.

16. Aircast Elbow Cryo/Cuff with
Cooler
 What is the Aircast Elbow Cryo/Cuff with Cooler?
 The ultimate elbow ice therapy/cryotherapy device. Provides compression to minimise
bleeding and swelling, and cold to minimise pain following elbow injury.
 When can I use it?
 Many elite athletes use this product following elbow injuries and elbow surgery.
Anyone with a elbow injury can also benefit from using this product. It can be used at
home for the treatment of all elbow injuries, such as sprained elbow; dislocated elbow;
elbow arthritis; Golfers Elbow; Tennis Elbow; elbow fractures; and following elbow
arthroscopy and elbow surgery.
 Size
 The Elbow Cryo/Cuff™ with Cooler is one-size for adults.
 How does it work?
 The Aircast Elbow Cryo/Cuff™ with Cooler is an easy to use device that circulates ice
cold water to provide cold therapy in the treatment of injuries. This version is specific
for the elbow and offers the very best option in ice and compression therapy.
 The Aircast Elbow Cryo/Cuff™ with Cooler combines the therapeutic benefits of
controlled compression to minimise bleeding and swelling in the elbow, and cold to
minimise pain. The cuff is anatomically designed to completely fit the elbow providing
maximum benefit.
 The Cooler element is Universal to all Cryo/Cuff™ models. The Cryo/Cuff™ Cooler
holds water and ice needed for six to eight hours of cryotherapy - much longer than an
ice pack. The durable cooler comes with a tube assembly and insulation disk and is
labelled with simple-to-follow directions for use.
 The Elbow Cryo/Cuff™ with Cooler is one-size for adults.

17. Aircast Hand & Wrist Cryo/Cuff
with Cooler
 What is the Aircast Hand & wrist Cryo/Cuff with Cooler?
 The ultimate hand & wrist ice therapy/cryotherapy device. Provides compression to
minimise bleeding and swelling, and cold to minimise pain following hand & wrist
injury.
 When can I use it?
 Many elite athletes use this product following hand or wrist injuries and hand surgery.
Anyone with a hand or wrist injury can also benefit from using this product. It can be
used at home for the treatment of all hand & wrist injuries, such as sprained wrist;
dislocated wrist; hand & wrist arthritis; broken hand; broken wrist; Carpal Tunnel
Syndrome; and following wrist arthroscopy and hand & wrist surgery.
 Size
 The Hand & wrist Cryo/Cuff™ with Cooler is one-size for adults.
 How does it work?
 The Aircast Hand & wrist Cryo/Cuff™ with Cooler is an easy to use device that circulates
ice cold water to provide cold therapy in the treatment of injuries. This version is specific
for the hand & wrist and offers the very best option in ice and compression therapy.
 The Aircast Hand & wrist Cryo/Cuff™ with Cooler combines the therapeutic benefits of
controlled compression to minimise bleeding and swelling in the hand & wrist, and cold
to minimise pain. The cuff is anatomically designed to completely fit the hand & wrist
providing maximum benefit.
 The Cooler element is Universal to all Cryo/Cuff™ models. The Cryo/Cuff™ Cooler holds
water and ice needed for six to eight hours of cryotherapy - much longer than an ice
pack. The durable cooler comes with a tube assembly and insulation disk and is labelled
with simple-to-follow directions for use.

18. Aircast Thigh Cryo/Cuff with
Cooler
 What is the Aircast Thigh Cryo/Cuff with Cooler?
 The ultimate thigh ice therapy/cryotherapy device. Provides compression to
minimise bleeding and swelling, and cold to minimise pain following thigh injury.
 When can I use it?
 Many elite athletes use this product following thigh injuries and thigh surgery.
Anyone with a thigh injury can also benefit from using this product. It can be used
at home for the treatment of all thigh injuries, such as thigh strain; bruised thigh;
dead leg; quads strain; hamstring strain; and following thigh surgery.
 Which size do I need?
 Measure around the thigh:
 Regular 43-58cm (17"-23")
 X-Large 51-69cm (20"-27“)
 How does it work?
 The Aircast Thigh Cryo/Cuff™ with Cooler is an easy to use device that circulates ice cold water to
provide cold therapy in the treatment of injuries. This version is specific for the thigh and offers the
very best option in ice and compression therapy.
 The Aircast Thigh Cryo/Cuff™ with Cooler combines the therapeutic benefits of controlled
compression to minimise bleeding and swelling in the thigh, and cold to minimise pain. The cuff is
anatomically designed to completely fit the thigh providing maximum benefit.
 The Cooler element is Universal to all Cryo/Cuff™ models - you fill this up with ice and cold water. The
Cryo/Cuff™ Cooler holds water and ice needed for six to eight hours of cryotherapy - much longer
than an ice pack. The durable cooler comes with a tube assembly and insulation disk and is labelled
with simple-to-follow directions for use.

19. Precautions
a. Hypertension
i. Careful monitoring is needed because of transient increases
that can occur in systolic and diastolic blood pressure.
ii. Treatment should be discontinued if increase in blood
pressure is seen.
b. Elderly patients
i. Decreased efficiency with vasoconstriction.
ii. Therefore, they have decreased ability to conserve heat.
c. Length of treatment
i. Do not use cold gel packs longer than 15-20 minutes directly on
skin, and do not apply any cryotherapy directly to skin for > 1
hour continuously.
ii. Extended treatment may lead to neurapraxia or axonotmesis
of superficial peripheral nerves.

20. Testemonial
 I've used icing as a way to reduce swelling and
speed up recovery since I started running
marathons ten years ago. Ice is a great recovery
tool, US Cryotherapy’s technology is amazing!
The localized machine gets the skin temperature
lower than just using ice packs and saves valuable
time. Having US Cryotherapy on Run It Forward,
running from Chicago to Santa Monica, aided me
in being able to get back out and hammer out the
miles day after day and still have enough energy
to run with the kids as well!
 -Kate Martini Freeman
Ultra Runner, Run It Forward Runner, 3:04
marathoner

21. Testemonial
 Coming into the Run It Forward program I had a
left Achilles issue and a right calf issue. By the
fourth day of running full marathons in a row my
body was broken. I was hurting so bad, and my
sore Achilles was now making it so it even hurt to
walk. I was very concerned as I somehow still
needed to be able to run another 15 days straight.
Dr. Mike started the US Cryotherapy machine on
it, and within a few times it was much better. I was
able to run faster and it made my pain almost
subside. This machine is miraculous in healing
sports injuries. I came home from Run It forward
totally injury free, and have been training about
100 miles a week getting ready for my next big 100
mile race. Such a great piece of equipment!!
 Keira Henniger, Ultrarunner and Race Director

22. Conclusion
 Cryotherapy is a safe and easy to use treatment to
destroy many benign and malignant lesions.
 The cryotherapy operator must be aware of the
complications associated with this modality; for
example, a complication is hypopigmentation (dark-
skinned individuals are prone to hypopigmentation).
 One needs to be aware of the fact that lesions may
need to be treated multiple times before resolution.

23. Perspectives
 Thus, this cryotherapy treatment suits for the treatment of
almost all known diseases. Exceptionally wide range of
positive cryotherapy effects is confirmed by many recent
published announcements on this topic.
 For example, Chernyshev in his
manual points out the following
promising fields of applied
medicine: pulmonology,
gynaecology, combustiology
(burns treatment), general
surgery (proctology and
traumatology), gastroenterology,
neuropathology and
vertebrology, cosmetology and
sports medicine.