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Cyclotherm
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What is cyclotherm? 1

Cyclotherm is a device which can heat or cool the skin surface by means of varying the temperature of a circulating fluid. system is able to apply a temperature up to 40C and down to 1C and vary it between these limits at a rate of approximately 13C per minute.

This

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flexible applicator, in which fluid circulates, is held in contact with the tissue surface. device can be programmed to apply predetermined temperatures for pre-set times for thermotherapy, cryotherapy and, perhaps most usefully, thermal contrast therapy

The

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Construction 2
It

comprises a water reservoir to which water is added and that is then connected, via an insulated tube, to a sleeve or sealed bag-like unit. water circulates through the bag which covers the area being treated. on the unit, the water is kept at a thermostatically preset temperature (controlled temperature flow) or flaked ice is added to the water in the reservoir so water at or close to 0C is circulated.

The

Depending

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The

water is either pumped through continuously by an electric pump (continuous flow) or is circulated by flushing it back through the reservoir every 15 minutes or so (intermittent flow)

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Physiological effects

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Heat :
Increase Increase Increase

circulation metabolism

inflammation ( phagocytosis and wound healing) pain (analgesic effect)

general sedative effect that promotes relaxation, effective for general soreness, aches, pain, but not as effective as cold application in removing acute injury pain

Decreased

Decrease

muscle spasm

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Cold :
On

cutaneous blood vessels

There

is immediate vasoconstriction of cutaneous blood vessels, this restricts the blood flow in the skin so that heat loss is minimised

On

muscle blood flow

Cooling

provokes vasoconstriction in all vascular smooth muscles and the increased viscosity leads to reduced flow of blood

Lowered

metabolic rate
O2 uptake production of metabolites

Reduced Reduced

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On

PNS

Cold

applied to the skin provides a strong sensory stimulus by stimulating cold receptors seen on PNS due to reduced nerve conduction: reduction of

Effects

Pain Hypertonicity

Muscle

strength variable effect

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Therapeutic uses

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Heat :
Therapeutic

heat is most effective in decreasing general soreness and in preparing soft tissues for stretching and joint mobilisation increase blood flow to the injured body part; during this process blood also delivers nutrients to that area and carries metabolites and other waste products, thereby increasing the rate of healing of the injury

To

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Cold :
Applied Limits Pain

to recent injuries

bleeding by vasoconstriction and increased blood viscosity

relief
the conduction of cutaneous nociceptive

Reduces

fibres

Reduces Reduces

muscle spasm muscle spasticity muscle contraction of chronic inflammation and joint

Facilitates Reduction

Therapeutic effects of thermal contrast therapy 3

Facilitates

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a mild tissue temperature increase circulation

Stimulates Increases

circulation in the contralateral extremity due to the crossover phenomenon area increased blood flow to the involved

Produces

Produces

hyperemia by alternating vasodilatation and vasoconstriction of the superficial blood vessels

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Relieves Reduces Reduces

stiffness and pain necrotic cells and aids healing inflammation and pitting edema stasis and scar tissue range of motion

Decreases Improves Provides

a transition for tissue accommodation between immediate cryotherapy and later thermotherapy treatment

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Indications

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Heat
Connective

tissue contracture (2 weeks or longer) resulting from immobilisation must be treated with heat followed by stretching and mobilisation joint sprains (4-14 days post injury) that remain sore but allow the patient to exercise should be treated with heat before exercise and with cold afterward

Sub-acute

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Cold
Immediate Facilitating

care of acute injuries

exercise during rehabilitation of orthopaedic injuries spasm with cold and stretching is relieved faster than with heat and stretching

Muscle

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Contraindications

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Vasospasm

or any kind of vascular disorders such as arteriosclerosis

blood, which precipitates at low temperatures, blocking blood vessels and causing local ischaemia from mast cells leading to local erythema and sometimes symptoms like lowered BP and raised pulse rate

Cryoglobinaemia

abnormal protein present in

Cold

urticaria cold causes release of histamine

Special

care with:
disease

Cardiac

Hypertension

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Malignancies Loss

of sensation

Infection

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Benefits 2
Continuous-flow

cryotherapy has been proved to decrease pain, inflammation, swelling, blood loss, and narcotic usage in the postoperative setting.

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Complications 2
Complications

include frostbite, chronic pain, and loss of digits. cold therapy should be discontinued when capillary refill time is greater than 5 seconds. is some evidence that the additional compression of a brace or strap over a flow bag can increase the risk of skin damage.

Continuous-flow

There

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References
1. 2.

Low and Reed 3rd edition Low and Reed 4th edition: Continuous flow cryotherapy units J. William Myrer , 1994 Contrast Therapy and Intramuscular Temperature in the Human Leg

3.

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Thank You