2. Where & when to use the contrast bath? Indications. Equipment required Advantages Disadvantages Procedure

3. Indications Equipment required Advantages Disadvantages Procedure

4. It is applied by alternately immersing an area, usually distal extremity. 1 st – in warm or hot water 2 nd – in cool or cold water It cause fluctuations in blood flow over a 20 minute treatment.

5. It is mainly & frequently used in clinical setup – where the goal of treatment is to achieve the benefits of HEAT – including decreased pain & increased flexibility, while avoiding the risk of increased edema. The varying sensory stimulus is also thought to promote PAIN RELIEF & DESENSITIZATION.

6. Chronic edema Sub-acute trauma Inflammatory conditions like – sprains, strains or tendonitis or hyperalgesia or hypersensitivity caused by RSD.

7. 2 water containers Thermometer Towels

8. More vigorous circulatory effect than heat or cold alone Good contact with contoured distal extremities compared with other thermal agents Help to provide pain control without aggravating edema. Allow movement in water for increased circulatory effects

9. Limb is in dependent position – may aggravate edema Some patients do no tolerate cold immersion Lack of research evidence evaluating the effects of contrast baths.

10. 1. Fill 2 adjacent containers with water. ( Buckets or tubs) 2. Fill 1 container with warm water at 38 – 44 degree Celsius 3. Fill 2 nd container with cool water at 10 – 18 degree Celsius When using for pain control or edema, it is recommended that the temperature difference between the warm & cold water be large.

11. When using for desensitization, it is recommended that the temperature difference between 2 baths initially be small & then gradually increased for later treatments as the patient’s sensitivity decreases. First immerse in warm water for 3-4 minutes, the immerse in cold water for 1 minute. Repeat this sequence 5 – 6 times to provide a total treatment time of 25 – 30 minutes & end with immersion in the warm water.

12. When the treatment is completed, dry the area quickly & thoroughly.