Cyclotherm

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.
 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.
 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
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.
 The water circulates through the bag which
covers the area being treated.
 Depending 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 0°C is circulated.
 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)
Physiological effects
Heat :
 Increase circulation
 Increase metabolism
 Increase inflammation (↑ phagocytosis and
wound healing)
 Decreased 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
 Decrease muscle spasm
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
 Reduced O2 uptake

 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
 Hypertonicity

 Muscle strength – variable effect

Therapeutic uses
Heat :
 Therapeutic heat is most effective in
decreasing general soreness and in preparing
soft tissues for stretching and joint
mobilisation
 To 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
Cold :
 Applied to recent injuries
 Limits bleeding by vasoconstriction and increased
blood viscosity
 Pain relief
 Reduces the conduction of cutaneous nociceptive
fibres
 Reduces muscle spasm
 Reduces muscle spasticity
 Facilitates muscle contraction

Therapeutic effects of thermal
contrast therapy 3
 Facilitates a mild tissue temperature increase
 Stimulates circulation
 Increases circulation in the contralateral
extremity due to the crossover phenomenon
 Produces increased blood flow to the involved
area
 Produces hyperemia by alternating
vasodilatation and vasoconstriction of the
superficial blood vessels
 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
Indications
Heat
 Connective tissue contracture (2 weeks or
longer) resulting from immobilisation must
be treated with heat followed by stretching
and mobilisation
 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
Cold
 Immediate care of acute injuries
 Facilitating exercise during rehabilitation of
orthopaedic injuries
 Muscle spasm with cold and stretching is
relieved faster than with heat and stretching
Contraindications
 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
 Special care with:
 Cardiac disease
 Hypertension
 Malignancies
 Loss of sensation
 Infection
Benefits 2

 Continuous-flow cryotherapy has been proved

to decrease pain, inflammation, swelling, blood
loss, and narcotic usage in the postoperative
setting.
Complications 2

 Complications include frostbite, chronic pain,

and loss of digits.
 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

1. Low and Reed – 3rd edition

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