Practical exam pro forma for superficial heat and cold therapy

1. Thermotherapy and Cryotherapy: Principles of Application 1
Sreeraj S R
THERMOTHERAPY OR CRYOTHERAPY:
PRINCIPLES OF APPLICATION
Receiving the Patient:
Good morning sir / madam.
Please be seated.
I am your therapist who is going to treat you.
Don’t worry; I will do my best for you.
(Instruction: Sir / Madam, please wait for few minutes until I go through your case sheet.)
Case Sheet Reading:
Do a detailed assessment or go through Assessment and diagnosis done by the physician if
the case is referred. This may be very helpful in finding out the general contraindications for
my treatment. By this I will also be able to know about previous medical or physiotherapy
treatment if any taken by the patient and its effects.
Checking General Contraindications:
By using rapport with patient and by case sheet reading, I will check the general
contraindications (related to the modality to be used, i.e. hot/cold).
(Instruction: Sir / Madam, please wait for few minutes until I prepare things for your
treatment.)
Tray Preparation:
• Pillows
• Towel
• Petroleum jelly or Vaseline
• Test Tubes (hot & cold)
• IR lamp
• Hot & Cold packs
• Goggles
Positioning the Patient:
I will position the patient in most comfortable position.
NOTE:
• The position of the part to be treated should be completely relaxed.
• Patient should be made comfortable by using adequate number of pillows and sand
bags for the support.
• Position of the patient should be such that all the joints of the body are completely
relaxed.
• If possible give the position in which patient can see the treatment.
Checking Local Contraindications:
Check for local contraindications. They are,
• Open wounds
• Scar

2. Thermotherapy and Cryotherapy: Principles of Application 2
Sreeraj S R
• Local skin infections
• Cuts
• Abrasions
• Eczema
• Localized hemorrhagic spots
• Altered skin sensation
Skin sensitivity (testing)
Demonstrate with hot and cold test tubes
Testing Procedure:
Hot and Cold Discrimination:
Tests the individual’s ability to perceive the difference between hot and cold stimuli.
Expected findings:
The individual will be able to discriminate between the hot and cold stimuli with 100%
accuracy.
Equipment:
Two test tubes filled with hot (40 - 45°C) and cold (20°C and 25 °C) water.
Testing procedure:
1. Explain the procedure to the patient with his/her eyes open. For example, “I am going
to touch various parts of your arms (or other body part) with these test tubes filled
with hot and cold water, and when you feel the tube, tell me if it feels hot or cold.”
2. Demonstrate the procedure with the patient’s eyes open until the patient understands
the procedure to be performed.
3. The patient closes his/her eyes, or vision is otherwise occluded.
4. Place the hot or cold test tube against the patient’s skin, making certain not to vary the
surface area of contact between the test tube and skin or the pressure of contact.
5. Have the patient identify each stimulus as hot or cold. Make certain the appropriate
temperatures of the stimulus objects are maintained throughout testing.
6. Vary the time between stimuli to avoid developing a rhythmic pattern.
7. Repeat throughout suspected areas.
8. Document findings.
(Instruction: As I have found no general contraindication and local contraindications, I will
proceed with my treatment. (Mention to the examiner.)
Selection of Technique:
Select the type of application of the treatment wherever possible. (Tell to the examiner.)
Instructions & Warnings:
Instructions:
• Don’t move during the treatment.
• Don’t sleep while the treatment is going on.
Warnings:

3. Thermotherapy and Cryotherapy: Principles of Application 3
Sreeraj S R
• As there are chances of getting a blister due to excessive overheating, so please
inform me if the current is not comfortable or heating is more.
• If there is any burning sensation immediately inform me, as it might lead to burn.
• Inform me if the position is not comfortable.
The warning given should be noted on the patient’s record card.
(Instruction: Sir / Madam, we are going to start the treatment now.)
Treatment:
(I will explain the examiner about my operations.)
Control the heat/cold till it is comfortable for the patient.
Duration of the treatment is decided on the basis of the condition.
The patient must be observed throughout to ensure that treatment is progressing satisfactorily
and without adverse effects.
Termination of Treatment:
• Switch off the machine and the main supply.
• Remove the hot/cold pack and clean the patient.
• At the termination of treatment inspect the treated part for any adverse reactions.
• If the area is erythematic, apply powder.
• If it is too severe, advise him/her to go to the physician.
• An explanation of what to expect is given as well as instructions of when to come
again and what must be done between treatments.
• Do winding up procedure. Replace all items back to their place
Recording:
An accurate record of all parameters of treatment including region treated, technique, dosage,
and the resultant effect must be made.
This is for both assessment purposes and for legal requirements.
(This practical pro forma is combined for superficial heat and cold therapy. Students are
expected to use their creativity and common sense while using this)