CYCLOTHERM

PO O J A N
M PT 2 N D Y E A R ( N EU RO S C I EN C E )
TO CP T
Contents
Introduction
Definition
Construction
Physiological effect
Therapeutic effect
Indications and contraindications
Benefits
Complications
Introduction
A flexible applicator, in which fluid circulates, is held in contact with the tissue
surface.
The device can be programmed to apply predetermined temperatures for pre-
set times for thermotherapy, cryotherapy and, perhaps most usefully, thermal
contrast therapy
This system is able to apply a temperature up to 40°C and down to 1°C and
vary it between these limits at a rate of approximately 13°C per minute.
Definition

Cyclotherm is a device which can heat or cool the skin surface by means of
varying the temperature of a circulating fluid
Instrumentation / Construction
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
The water circulates through the bag which covers the area being treated.
Depending on the unit, the water is kept at a thermostatically pre-set temperature (pre-
set temperature)
Flaked ice is added to the water in the reservoir so water at or close to 0°C is
circulated.
 Cont.…
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)
 TEMPERATURE
SETTER

WATER
RESERVIOR
SEALED
BAG UNIT

INSULATED FLAKE
TUBE D
ICE
 Physiological Effect
HEAT:
Increase circulation
Increase metabolism
Increase inflammation ( phagocytosis and ↑ wound healing)
Decreased pain (analgesic effect)
Decrease muscle spasm
Decrease tissue stiffness
CONT….
COLD
On cutaneous blood vessels: 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:
Reduced O2 uptake
Reduced production of metabolites
Reduced cellular activity Slowed healing
 CONT….
On PNS
Cold applied to the skin provides a strong sensory stimulus by stimulating cold
receptors
Effects seen on PNS due to reduced nerve conduction: reduction of Pain
 Indications
Acute musculoskeletal injuries: sprains, strains, and contusions.
Chronic musculoskeletal conditions: Conditions like arthritis, tendonitis, and bursitis.
Postoperative rehabilitation: Following certain surgeries, such as joint replacements or ligament
repairs
Connective tissue contracture (2 weeks or longer) resulting from immobilisation
Sub-acute 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
 Contraindication
Vasospasm or any kind of vascular disorders such as arteriosclerosis
Cryoglobinaemia – abnormal protein present in blood, which precipitates at low
temperatures, blocking blood vessels and causing local ischaemia
Cold urticaria – cold causes release of histamine from mast cells leading to local
erythema and sometimes symptoms like lowered BP and raised pulse rate
Malignancies
Loss of sensation
Infection
 Cont….
Circulatory disorders: Individuals with circulatory disorders like peripheral artery disease or
Raynaud's disease
(The extreme temperature changes can affect blood flow and potentially worsen these
conditions)
Impaired thermal sensation: Patients with impaired thermal sensation, such as neuropathy or
nerve damage, may not be able to accurately perceive the temperature changes
Hypersensitivity to temperature
Pregnancy
 Therapeutic uses
Relieves stiffness and pain
Reduces necrotic cells and aids healing
Reduces inflammation and pitting edema
Decreases stasis and scar tissue
Improves range of motion
Provides a transition for tissue accommodation between immediate cryotherapy and later
thermotherapy treatment
 Benefits
Continuous-flow has been proved to decrease pain, inflammation, swelling, blood loss, and
narcotic usage in the postoperative setting.
 Complication
Complications include frostbite
Continuous-flow cold therapy should be discontinued when capillary refill time is greater than 5
seconds
There is some evidence that the additional compression of a brace or strap over a flow bag can
increase the risk of skin damage.
 References
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
Thank You!