Immersion Therapy Hydrotherapy

Contrast bath

• Contrast baths is a form of hydrotherapy, it is alternate

immersions of the part in hot (100-105°F/40-45°C) and
cold (59 -68°F/15-20°C) water to produce marked
hyperemia of the skin.

• The duration of the components of contrast applications can

vary, but an average guideline is a 3:1 ratio of heat: cold.

• Begin with warm submersion for 4-6 minutes and follow

with cold submersion for 1- to 4-minute. The cycle is
repeated 4 times, with total treatment time 15-30 minutes.

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Figure 45: Contrast bath

Physiological Effects of Contrast Baths:

• Contrast applications enhance peripheral blood flow

because they take advantage of the primary effects of both
heat and cold, (alternating local vasodilatation and
vasoconstriction).

• The result is known as a vascular flush or circulatory whip

and can increase local blood flow by up to 100%.

• So, contrast (alternating) applications are much more

effective at increasing local circulation in a tissue area than
heat or cold alone.

All these lead to the following physiological changes:

• Marked vasodilatation occurs immediately.

• Increase local circulation more than hot baths.

• An increase of deeper circulation occurs reflexively.

• The skin temperature increases rapidly.

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• Considerable sensory stimulation as cutaneous hot and cold

receptors is alternately activated.

• Marked sedative effect.

Indications of Contrast Baths:

• Post-traumatic swelling and edema

• Neuropathic pain.

• Chronic inflammation

• Excessive sweating

• Chronic sprains and contusions.

• Rheumatologic disease

• Reflex sympathetic dystrophy.

Contra-indications of Contrast Baths:-

• Advanced peripheral vascular disease.

• Arterial insufficiency

• Diabetes.

• Caution with Contrast

• Any of the conditions that require caution using either cold

or heat must also be carefully monitored when applying
contrast treatments.

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Practical Application of Contrast Baths

•Two suitable sized baths are filled, one with hot water at 40°
to 45° C, and the other with cold water at 15-20 °C.

•It is usual to start and end with immersion in hot water.

•Some therapists prefer to end with cold water.

•One or more extremities (not the entire body) are immersed

first in the hot water for 4-6 minutes. Immediately afterwards
place the limb in cold water for 1-4 minute. This cycle is
repeated three or four times so that the whole treatment lasts
15 -30 minutes.

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