ultra sound non-heating why
reduce pain
healing is assisted
fluid disperse through mechanical microstreaming
ultrasound contraindication
acute conditions ischemic areas impaired circulation deep vein thrombosis poor sensation eyes, heart, carotid sinus and genitals exposed metal penetrating skin over cancer over active infection over fractures over plastic or cement joint replacements over pace maker over pelvis and lumbar areas during pregnancy
utrasound precaution
over epiphyseal areas in young
nerve plexuses, over spinal cord after laminectomy
ultrasound steps mettler
- turn on machine
- ultrasound set up icon
- 1mhz or 3mhz
- w/cm2
- duty cycle
- time
- gel
- apply sound head
- start
- set intensity
ultrasound acute setting 1mhz
time: 4-6
duty cycle: 10-20%
intensity: 0.5-1.5
ultrasound acute setting 3mhz
time: 4-6
duty cycle: 50%
intensity: 0.5
ultrasound subacute setting 1mh
time: 6-8
duty cycle: 20-50%
inesnity: 0.75-1.25
ultrasound subacute setting 3mhz
time: 6-8
duty cycle: 50%
intensity: 0.75-1
ultrasound chronic setting 1mhz
time: 8-10
duty cycle: 100%
inesnity: 1-2
ultrasound chronic 3mhz
time: 8-10
duty cycle: 100
inesnity: 0.5-1
electrical modalities contraindications
poor cardiac function pacemakers arterial disease uncontrolled hemorrhage over infection over cancer blood clots- DPV pelvis and low back during pregnancy history of seizures exposed metal implants sensory or mental impairment unstable fractures
electrical modalities precautions
abs and back during menstruation
over carotid sinus, pharynx, larynx, eyes, trans-cerebral, transthoracic
epiphyseal plates
ultra low frequency - microcurrent why
tissue healing
increased ATP production
increased membrane transport for waste and nutrients
pain control
tissue stim - monophasic set up
- stim set up
- microcurrent
- polarity - acute (+) or chronic (-)
- frequency to 0.5
- time
- plug electrodes to ch. 2
- prep electrode (groovy over involved area, other 6-8in away
- start
- set intensity to 20uA
pain control - biphasic set up
same as monophasic
- polarity twice
- frequency: 30hz
- intensity: 100uA (25-500uA)
- pads around involved area
microcurrent setting - tissue healing
phasic: monophasic
frequency: 0.5
time: 15-20
intensity: 20
microcurrent setting - pain conrol
phasic: biphasic
frequency: 30
time: 15-20
intensity: 20-500
low frequency TENS why
decrease all pain EXCEPT VICERAL PAIN
low frequency TENS set up
- stim set up
- biphasic
- phase duration: 100us
- phase duration button
- frequency
- prep electrode
- start
- intensity
biphasic TENS settings acute
phase duration: 100us
frequency: 80-120
intensity: perception
mode: continuous
polarity: n/a
time: 10-20
biphasic TENS settings chronic
phase duration: 100us
frequency: 3-5
intensity: tolerance/contract
mode: continuous
polarity: n/a
time: 20-30
HVPC (high volt pulse current) why
pump out edema
exercise muscle tissue
decrease pain
stimulate muscle contraction to break myospasm
HPVC set up
- stim set up
- high volt button
- set polarity - acute (+) chronic (-)
- frequency
- time
HPVC surge for edema or muscle exercise
- stim set up
- high volt button
- set polarity - acute (+) chronic (-)
- frequency
- time
- surge button - edema (10:10) muscle exercise (10:50)
- hold enter button
- prep electrode ch1
- acute + chronic: active electrode over involve area
for myospasm/mm contract : electrodes at both ends of mm - start
- intensity set
HPVC settings acute
freq: 80-120
intensity: perception
mode: continuous
polarity: +
time: 10-20
HPVC settings chronic
freq: 3-5
intensity: tolerance/contraction
mode: continuous
polarity: -
time: 20-30
HPVC settings edema
freq: 10
intensity: tolerance/mild contraction
mode: surge (10:10)
polarity: n/a
time: 10-20
HPVC settings myospasm
freq: 50-55
intensity: tolerance/mild contraction
mode: continuous
polarity: n/a
time: 10-20
HPVC settings muscle ex
freq: 50-55
intensity: tolerance/mild contraction
mode: surge (10:40-10:60)
polarity: n/a
time: 10-20
med freq: true inferential why
pump out edema
decrease pain
true inferential mettler set up
- turn on
- stim set up
- true inferential
- set freq same as lsi
- set time
- prep electrode
- channel 1 and channel 2
- start
- set intensity with both dials
- amplitude med key (not for edema)
true inferential settings acute
freq: 80-150
intensity: perception
mode: continuous
time: 10-20
sweep/vector: on/on
true inferential settings chronic
freq: 3-5
intensity: tolerance/contraction
mode: continuous
time: 20-30
sweep/vector: on/on
true inferential settings edema
freq: 1-15
intensity: tolerance/patient comfort
mode: continuous
time: 10-20
sweep/vector: on/off
pre-modulated inferential why
pump out edema
exercise muscle tissue
decrease pain
stim mm contraction to reduce myospasm
pre-mod inferential mettler set up
- turn on
- stim set up
- press pre-mod button
- set freq
- set time
- *mm ex = press surge (10:40-10:60)
- press enter
- prep electrode
- press start
- set inensity
- for surge press start again
pre-mod inferential settings acute
freq: 80-150
intensity: perception
mode: cont.
time: 10-20
sweep/vector (lsi): on/off
pre-mod inferential settings chronic
freq: 3-5
intensity: tolerance/contraction
mode: cont.
time: 20-30
sweep/vector (lsi): on/off
pre-mod inferential settings edema
freq: 1-15
intensity: pain comfort/sub-contraction
mode: cont.
time: 10-20
sweep/vector (lsi): on/off
pre-mod inferential settings myospasm
freq: 50-55
intensity: tolerance/strong-contraction
mode: cont.
time: 10-20
sweep/vector (lsi): on/off
pre-mod inferential settings mm ex
freq: 50-55
intensity: tolerance/strong-contraction
mode: surge 10:40-10:60
time: 10-20
sweep/vector (lsi): on/off
russian stim why
pump out edema
mm exercise
stim mm contraction to stop myospasm
russian stim lsi set up
- turn on machine
- set freq (press 25000hz)
- set time
- prep electrode over origin/insertion
- set intensity
- start
- surge with 10:10/10:50
russian stim mettler set up
- turn on
- stim set up
- med freq button
- time
- surge (10:10 for myospasm/edema) (10:50 for mm strength)
- press enter to set surge
- prep electrode
- start
- set intensity with left dial
- start button to start on/off cycle
russian stim settings edema
freq: 50
intensity: patient comfort/sub contract
mode: surge 10:10
time: 10-20
sweep/vector (lsi): off/off
russian stim settings myospasm
freq: 50
intensity: tolerance/strong contraction
mode: surge 10:10
time: 10-20
sweep/vector (lsi): off/off
russian stim settings mm ex
freq: 50
intensity: tolerance/strong contraction
mode: surge 10:50
time: 10-20
sweep/vector (lsi): off/off
cold laser why
pain control
wound healing
inflammation control
cold laser erchonia set up
- turn on
- pw 1234
- mode select
- preset protocol
- extremities: shoulder, axial: neck, radiculopathy: nerve root
- hold laser 2-6 inch area of complaint then press start
- move circular motion over area
- complete by pressing back to mode select then power down
cold laser erchonia contraindications
- taking photo-sensitizing drugs, anti-coagulants or aspirin
- history of cancer
- history of herpes simplex
- history of keloid or hypertrophic scar formation
- eyes
- family history of cancer
- active inf or compromised immune system
- pregnancy
cold laser MR4 set up
- turn on
- test head on unit (press arrow button)
- press program button to enter sweep
- press arrow to cycle through 1-3: chronic, 4-6: acute/subacute
- start by placing laser head over lymphatic drainage point
(lymphatic drainage point: left axillary for all except right side of upper ext. - set machine to target mode on laser head
- sweep until beep, then lift and place back on
- beep again then lift then place on skin cont. sweeping
cold laser MR4 contraindications
- dont treat for more than 45 min per day - 10 min max in head area
- avoid direct treatment of thyroid
- dont treat over heart or pacemaker
- children 14 and under = 50% freq
- history of organ transplant
- over hemorrhage
- malignancy
- pyrexia
- within a frew weeks after steroid shot
- throughout pregnancy