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Flashcards in Intro to physical agents Deck (143)
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1
Q

what is a physical agent ?

A

any of the various means of applying energy and materials to patients

2
Q

What is physical agents also referred as?

A

physical modality or biophysical agent

3
Q

A physical agent includes what?

A

heat, cold, water, pressure, sound, electromagnetic radiation, light and electrical currents

4
Q

What is the role of physical agents?

A

to COMPLEMENT other physical, medical, and surgical interventions with minimal to no side effects

5
Q

What therapeutic effects do physical agents want to achieve?

A

decrease pain, increase ROM, improve tissue healing, improve muscle activation

6
Q

what are the 3 categories of physical agents

A

Thermal, Mechanical, & Electromagnetic

7
Q

Can a physical agent fall into more than one category?

A

yes, depends on system used

8
Q

What do thermal physical agents do?

A

transfer energy to a patient to produce an increase/decrease in tissue temp

9
Q

An increase in tissue temp causes what?

A

increase circulation, metabolic rate, and soft tissue extensibility or decrease pain

10
Q

A decrease tissue temp causes what?

A

decrease circulation, metabolic rate or pain

11
Q

Types of thermal PA

A

Deep heating agents, superficial heating agents, cooling agents

12
Q

clinical examples of deep heating agents

A

Ultrasound and diathermy

13
Q

Clinical examples of superficial heating agents

A

hot packs, paraffin

14
Q

clinical examples of cooling agents

A

ice pack

15
Q

What do mechanical physical agents do?

A

apply mechanical force to increase/decrease pressure on the body

16
Q

Types of mechanical physical agents?

A

Traction, compression, water, sound

17
Q

Clinical examples of traction

A

mechanical traction

18
Q

clinical examples of compression

A

Elastic bandages, stockings

19
Q

Clinical examples of water

A

whirlpool

20
Q

Clinical examples of sound

A

Ultrasound

21
Q

What does Electromagnetic PA do?

A

utilize application of electromagnetic energy in the form of electromagnetic radiation and electrical current

22
Q

Electromagnetic PA utilize application of electromagnetic energy in the form of what?

A

electromagnetic radiation & electrical current

23
Q

Vacation of the frequency and intensity of electromagnetic radiation changes what?

A

effects and depth of penetration

24
Q

what can Vacation of the frequency and intensity of electromagnetic radiation changes effect and depth of penetration do?

A

Depolarize nerves

sensory and motor responses to control pain or increase muscle strength and control

25
Q

Types of electromagnetic PA

A

Electromagnetic field and electrical currents

26
Q

Clinical examples of electromagnetic field

A

ultraviolet, laser

27
Q

Clinical examples of electrical currents

A

TENS

28
Q

What are general contraindications for PA

A
Pregnancy
Malignancy
Pacemaker/ other implanted electronic device 
Impaired sensation
Impaired mental status
29
Q

what are 3 reasons why PA fall out of favor?

A
  • Lack of evidence to support effectiveness
  • Greater effectiveness with other treatment options
  • Laziness on the part of the community using the PA
30
Q

What are the 4 things that need to be considered when choosing a PA

A

Goals and effects of treatment
Contraindications & precautions
Evidence for PA use
Cost, convenience and availability

31
Q

Top 3 requirements for cost effective use of PA

A
  1. Assess and analyze the presenting problem
  2. Know when physical agents can be an effective form of tx
  3. Know when and how to use PA most effectively
    - Reassess tx often & adjust POC accordingly
32
Q

what does physical agents have direct effects on?

A

LEVEL OF IMPAIRMENT that can prompt improvements over the level of functional limitation and disability

33
Q

Optimally PA are used in conjunction with or in preparation for what ?

A
  • Therapeutic exercise

- Functional training

34
Q

Purpose of PA ?

A

Increase efficacy of the intervention

35
Q

Treat inflammatory conditions that are results of what?

A
  • Trauma
  • Surgical procedures
  • Problematic healing
36
Q

Treatments of inflammatory conditions are?

A

PA
TE
Manual Therapy

37
Q

PA can reduce/eliminate soft tissue what?

A

inflammation or circulatory dysfunction

38
Q

PA can increase the healing rate of ?

A

Soft tissue injury

39
Q

PA can modulate?

A

Pain

40
Q

PA can modify ?

A

Tone

41
Q

PA can increase connective tissue what?

A

Extensibility and length

42
Q

PA can remodel

A

scar tissue

43
Q

PA can treat

A

Skin conditions

44
Q

When tissue damage occurs due to trauma or disease, the response is what?

A

generally similar and predictable

45
Q

the 4 primary determinants to the outcome of any injury?

A
  • type and extent of injury
  • Regenerative capacity of tissue involved
  • Vascular supply to injured site
  • Extent of damage to the extracellular framework
46
Q

When selected and applied appropriately, PA can? (5)

A
  • Accelerate the completion and resolution of the phases of tissue healing
  • Stimulate necessary processes to resume if they are stopped
  • Accelerate overall recovery
  • Improve final patient outcome
  • Minimize risk of adverse effects from delayed or incomplete healing
47
Q

When selected and applied INAPPROPRIATELY, PAs may ? (4)

A
  • prolong inflammation
  • Increase severity of associated symptoms
  • Prevent or delay healing
  • Increase probability of adverse consequences and therefore, a poor overall pt outcome
48
Q

what do clinicians need to understand to choice PA appropriately?

A
  • physiology of inflammation and healing: stages of healing
  • Patho behind impairments
  • Biomechanics of affected area
  • Effects of immobilization and therapeutic interventions on healing process
  • how PA will modify the present level of healing
49
Q

How do PA’s assist in decreasing inflammation and increasing tissue healing by?

A

Thermal, mechanical, electromagnetic

50
Q

How does thermal PA decrease inflammation and increasing tissue healing?

A

Change the rate of circulation and rate of chemical reactions

51
Q

How does mechanical PA decrease inflammation and increasing tissue healing?

A

control motion and alter fluid flow

52
Q

How does electromagnetic PA decrease inflammation and increasing tissue healing?

A

Alter cell function particularly membrane permeability and transport

53
Q

3 phases of inflammation

A

inflammation, proliferation, maturation

54
Q

4 things that happen during inflammation phase?

A
  • Vasoconstriction
  • Vasodilation
  • clot formation
  • Phagocytosis
55
Q

4 things that happen during proliferation phase?

A
  • epithelialization
  • fibroplasia/ collagen production
  • Wound contracture
  • Neovascularization
56
Q

3 things that happens during maturation phase

A
  • Collagen synthesis/ lysis balance
  • collagen fiber orientation
  • Healed injury
57
Q

Inflammation stage prepares wound for what?

A

healing

58
Q

what days does inflammation phase occur?

A

days 1-6

59
Q

Proliferation phase rebuilds what and strengthens what?

A

rebuilds: damaged structures
strengthens: wound

60
Q

What days does proliferation phase occur?

A

days 3 to 20

61
Q

Maturation phase modifies what?

A

the scar tissue into its mature form

62
Q

what day does maturation phase occur?

A

day 9 onward

63
Q

what is necessary for healing ?

A

inflammation phase

64
Q

When does inflammation phase begin?

A

when normal physiology of tissue is altered by disease or trauma

65
Q

what happens when inflammation phase becomes inappropriate?

A

damage and excessive scarring

66
Q

What is the vascular response of inflammation phase

A

swelling and redness

67
Q

the vascular response is mediated by what?

A

histamine, kinins, and prostaglandins

68
Q

The immune response of inflammation phase activates what?

A

neutrophils and other infection fighting cells

69
Q

What does the hemostatic response of the inflammation phase do?

A

stops bleeding

70
Q

What does the proliferation phase do?

A

cover wound and strengthens injury site

71
Q

What four simultaneous process does the proliferation phase involve?

A
  • epithelialization
  • collagen production (granulation tissue)
  • Wound contracture
  • Formation of new blood vessels
72
Q

What is the longest phase of inflammation ?

A

maturation

73
Q

what two things is required for normal remodeling of scar?

A

balanced synthesis and lysis of collagen

74
Q

what happen when production is greater than lysis

A

keloid or hypertrophic scar

75
Q

High oxygen exposure favors what?

A

hypertrophy

76
Q

Type III collagen is replaced by what?

A

type I

77
Q

How many weeks is acute?

A

no more than 2 weeks

78
Q

how many weeks is subacute

A

more than 4 weeks (2-4)

79
Q

How long is chronic

A

months or years

80
Q

Chronic inflammation

A

simultaneous progression of active inflammation, tissue destruction and healing

81
Q

chronic inflammation can arise from what two situations

A
  • persistance of injuries or other interference with normal tissue healing
  • Immune response to either an altered host tissue or a foreign material or autoimmune disease
82
Q

3 factors that affect the healing process?

A

local, external, and systemic

83
Q

Infection accounts for what percent of the complication of wound healing?

A

50%

84
Q

Local factors include?

A
  • type, size, location of injury
  • infection
  • vascular supply
85
Q

what may delay healing?

A

early movement

86
Q

continuous passive motion used in conjunction with what may be helpful?

A

short-term immobilization

87
Q

what are systemic factors?

A

age, disease, medications, nutrition

88
Q

healing is rapid & robust in what age group?

A

children

89
Q

what diseases can impair healing ?

A

diabetes and immune or vascular system diseases

90
Q

What is “fuel” for inflammation and repair?

A

nutrition

91
Q

What can result in accelerated pt progress toward active participation and goal achievement ?

A

modification of inflammation and tissue healing

92
Q

what are the 4 cardinal signs of inflammation ?

A

heat, redness, swelling, pain

93
Q

Stages of tissue healing determines what 2 things?

A

treatment goals

choice of PA

94
Q

what is the firsts stage in tissue healing?

A

initial injury- control bleeding and inflammation

95
Q

What is the approach of choice for sports med after acute tissue injury

A

PRICE

96
Q

What are tx goals for initial injury?

A

prevent further injury or bleeding

clean open wound

97
Q

effective agents for prevention of further injury or bleeding?

A

static compression

cryotherapy

98
Q

effective agents for clean open wound

A

hydrotherapy

99
Q

Treatment goals for acute inflammation

A

control: pain, edema, bleeding, release & activity of inflammatory mediators, and facilitate progression to proliferation phase

100
Q

What PA would you use for pain in acute stage

A

Cryotherapy
hydrotherapy
ES
PSWD

101
Q

what PA would you use for edema in acute stage

A
cryotherapy 
compression 
sensory level ES
PSWD
Contrast Bath
102
Q

What PA would you use for bleeding in acute stage

A

Cryotherapy

compression

103
Q

what PA would you use for release of inflammatory mediators in acute stage?

A

cryotherapy

104
Q

What are the treatment goals during chronic inflam during tissue healing?

A
  • prevent or decrease joint stiffness
  • Control pain
  • Increase circulation
  • progress to proliferation phase
105
Q

what PA would you use to prevent/ DC joint stiffness is chronic

A

Thermotherapy
Motor ES
Whirlpool
Fluidotherapy

106
Q

What PA would you use to control pain in chronic

A

thermotherapy
ES
Laser

107
Q

What PA would you use to increase circulation in chronic

A

Thermotherapy
ES
Compression
Hydrotherapy

108
Q

What PA would you use to progress to proliferation phase in chronic

A

pulsed US
ES
PSWD

109
Q

What are the treatment goals for remodeling/ maturation stage of healing ?

A
  • regain or maintain strength
  • regain or maintain flexibility
  • control scar tissue formation
110
Q

what PA would you use to regain. maintain strength in maturation

A

motor ES

water exercise

111
Q

What PA would you use to regain/maintain flexibility in maturation

A

Thermotherapy

112
Q

what PA would you use to control scar tissue formation in maturation

A

Brief ice massage

compression

113
Q

Cutaneous noxious stimulation pain is?

A

well localized

sharp, pricking, tingling

114
Q

Musculoskeletal structure pain is?

A

poorly localized

dull, heavy, aching

115
Q

Visceral pain is?

A

refers superficially

aching quality

116
Q

Goals of care for pain management ? (3)

A
  • resolving underlying patho when possible
  • modifying discomfort and suffering
  • max function within the limitations imposed by pt’s condition
117
Q

Persistent pain may need to be integrated by what?

A

multidisciplinary treatment (psycho, psychosocial, PA and exercise)

118
Q

Benefits for using PA for pain management?(4)

A
  • directly moderates inflammation, modulates pain at the spinal cord, alters nerve conduction, or increases endorphins
  • reslove underlying cause
  • allow pt to interact with their injured body parts and practice indep pain management skills
  • avoids medication related side effects
119
Q

PA commonly used for pain reduction ?

A

cryotherapy
thermotherapy
electrical stimulation
traction

120
Q

what can you use to measure pain for documentation

A
  • visual analog
  • numeric scales
  • comparison with predefined stimulus
  • face scale
121
Q

what is Muscle tone

A

underlying tension in the muscle that serves as a background for contraction

122
Q

what is hyptonicity

A

abnormally low tone

123
Q

flaccidity

A

total absence of tone

124
Q

examples of hypotonicity

A

Down syndrome, poliomyelitis

125
Q

hypertonicity

A

abnormally high tone

126
Q

rigidity

A

velocity independent resistance to stretch

127
Q

Spasticity

A

velocity dependent resistance to stretch

128
Q

Clonus

A

rhythmic oscillations or beats of involuntary contraction in response to quick stretch

129
Q

PA are used to alter muscle tone directly or indirectly

A

both

130
Q

PA are used to alter muscle tone directly by

A

altering nerve conduction or sensitivity

131
Q

PA are used to alter muscle tone indirectly by

A

reducing pain or underlying cause of pain

132
Q

quantitative measure for measuring muscle tone are?

A
  • Dynamomter or myometer
  • Isokinetic testing systems
  • Electromypgraphy
133
Q

what does an EMG record?

A

electrical activity sampled from muscles at rest and during contraction, using surface, fine wire or needle electrodes

134
Q

What are pathologies that can cause motion restrictions?

A

contracture, edema, adhesion, mechanical block, spinal disc herniation, adverse neural tension, weakness

135
Q

PA are generally not sufficient to do what?

A

reverse or prevent motion restrictions

136
Q

PA are used as what?

A

adjuncts

137
Q

PA are used as adjusts to treatment to help do what?

A
  • increase soft tissue extensibility
  • control inflammation and adhesion formation
  • control pain during stretching
  • facilitate motion
138
Q

Role of PA in motion restriction ?

A
  • Increase soft tissue extensibility
  • Control inflammation and adhesion formation
  • control pain during stretching/PROM
  • Faciliate Motion
139
Q

How does PA play a role to increase soft tissue extensibility ?

A

increase temp can alter viscoelasticity of soft tissue fibers, allowing plastic deformation to occur

140
Q

How does PA play a role in control inflammation and adhesion formation ?

A

limit edema during acute inflammatory stage. limits degree of immobilization

141
Q

How does PA play a role in controlling pain during stretching/PROM

A

to allow for increased stretching and sooner imitation of motion

142
Q

How does PA play a role in facilitate motion ?

A

principles of buoyancy, muscle contraction (russian ES) to initiate motion

143
Q

what are two stage of tissue healing determines?

A
  • goals

- types of PA