ch12: therapeutic modalities Flashcards
(52 cards)
1
Q
electromagnetic spectrum: ionizing range
A
- can readily alter components of atoms
- easily penetrate tissue to deposit energy within the cells
- energy lv high = cell loses ability to regenerate leading to cell death
- used diagnostically in radiography and therapeutically to tx cancers
2
Q
electromagnetic spectrum: non-ionizing range
A
used in management of msk injuries
3
Q
transfert of energy: radiation:
A
transfert in the form of infrared waves w/o physical contact, all matter radiates in the form of heat
4
Q
transfert of energy: conduction
A
direct transfert of energy btw two objects in physical contact
difference in temp necessary
5
Q
transfert of energy: convection
A
more rapid process, occurs when a medium such as air or water moves across the body creating temp variations
6
Q
transfert of energy: conversion
A
changing another energy form into heat
7
Q
transfert of energy: evaporation
A
haet loss occurs
8
Q
factors affecting transfert of energy
A
- reflection: energy bounce back
- refraction: dif of intensity as waves pass through barriers
- absorption: wave pass through tissue and energy absorbed
9
Q
physiology of cryotherapy
A
- vaso constriction
- dec vascular permeability
- dec cell metabolism, inflammation, circulation, pain perception, m. spasm, muscle force prod
- inc tissue stiffness
10
Q
depth of cold
A
4-5cm
dependent on duration of tx, the depth and type of tissue
11
Q
effects of cold application
A
- vasoconstriction
-dec tissue metabolism - reduce secondary hypoxia
- dec capillary permeability and pain
- inhibit rel inflammatory mediators and prostaglandin synthesis
- dec temp of peripheral nerves
- dec nerve conduction velocity
- inc threshold for nerve firing
- inhibit nerve and muscle spindle activity
12
Q
cryokinetics parameters
A
cold 10-20 min
mvt
numb wear off - reapply 3-5 min
x3-4/session
13
Q
ice immersion
A
- bucket 4-10 deg
- whirlpool: 10-15.6 deg
- 10-15min
14
Q
indications for cryotherapy
A
- acute/chronic pain
- acute/chronic m. spasm/guarding
- acute inflammation/injury
- postsurgical pain and edema
- neuralgia
- superficial 1st deg burn
- used with exercises to facilitate mob, relieve pain, dec m. spasticity
15
Q
contraindications of cryotherapy
A
- dec cold sens/hypersens
- cold allergy
- circulatory/ sensory impairement
- raynauds
- advanced diabetes
- hypertension
- uncovered wounds
- cardiac or respiratory disorders
- nerve palsy
- arthritis
- lupus
16
Q
paraffin bath
A
- treat subacute or chronic rheumatoid arthritis associated w/ jnt stiffness and dec rom
- paraffin and mineral oil mixture 6:1/&:1 ratio
- 45-54 deg
- 15-20 min
17
Q
fluidotherapy
A
- dry thermal modality that transfers its energy to soft tissue by forced convection
- acute injuries
- 46-51 deg
- 15-20min
18
Q
indication s of thermotherapy
A
- subacute or chronic injuries to: reduce swelling, edema and ecchymosis, reduce m. spasm/guarding
- subacute or chronic m. spasm
- inc bld flow to: inc ROM, resolve hematoma, facilitate tissue healing, relieve jnt contracture
- fight infection
19
Q
contraindication thermotherapy
A
- acute inflammation or injuries
- impaired or poor circulation
- subacute or chronic pain
- advanced arthritis
- impaired or poor sensation
- impaired thermal regulation
- malignancy/neoplasm
- thromboplebitis
20
Q
reverse piezoelectric effect of US
A
converts electrical current to mechanical energy as it passes through a piezoelectricl crystal house in a transducer head
21
Q
thermal effect of US
A
- inc collagen tissue extensibility
- inc bld flow
- inc sensory/motor neuron velocity
- inc enzymatic activity
- dec m. spasm
- dec jnt stiffness
- dec inflammation
- dec pain
22
Q
non-thermal effects
A
- inc skin permeability
- facilitating soft-tissue healing process
23
Q
continuous vs pulsed US waves
A
continuous = thermal/non-thermal effects, used for deep, need inc temp
Pulse= non thermal, facilitates soft-tissue healing, no inc in temop
24
Q
Imhz parameters
A
deep
0.5 = 0.04
1 = 0,2
1.5 = 0.3
2= 0.4
25
3mhz parameters
superficial
0.5 = 0.3
1 = 0.6
1.5 = 0.9
2 = 1.4
26
application of US
- circles of 4cm/s
- area 2-3x transducer head
- underwater: 0.5-3 away from pt, inc intensity 0.5
27
indication for US
- deep tissue healing
- acute inflam cond (pulse)
- chronic inflammation cond
- spastic/m. spasm
- trigger areas
- inc tissue extensibility of collagen
- neuroma
- post-acute myositis ossificans
28
contraindication of US
- acute post acute hemmorrhage
- infection
- areas of impaired circulation/sensation
- stress fx
- osteoporosis
- cancer/malignancy
- over pelvic/lumbar areas during menstruation/pregnant
- over epiphyseal plates
- over eyes, heart, skull, spine, genitals
- over active sites of infection or sepsis
- over pacemaker
- over exposed metal
29
phonophoresis
mechanical effects of US are used to enhance percutaneous absorption of anti-inflame drugs and local analgesic through the skin
- 5-6 cm depth
30
electrotherapy modifications
- amplitude: force, intensity that drive current
- frequency: amplitude of waveform cycles per second
- pulse duration
- pulse charge
- polarity: direction of current flow
- mode
- duty cycle
- duration: 15-30min
31
frequency of electrical stim use
- low: < 15 pps = muscle twitch
- inc: 15-40pps = minimizes the relaxation phase of the muscle contraction
- high : 40pps = maximal contraction
32
direct current
continuous
one- directional flow of ions
modulate pain
elicit m. contraction
produce ion mvt
33
alternating current
continuous
- two directional
- modulate pain
- elicit m. contraction
34
types of TENS
- conventional: short duration pulse, high frequency, low to comfy amplitude
- acupuncture: long duration pulse, low frequency, comfy amplitude, low pulse frequency
- brief-intense: long duration pulse, high frequency,
35
high-voltage pulsed stimulation
- MONOPHASIC CURRENT
- twin-peak waveform
- short pulse duration
- long interpose interval
- amplitude above 150mV
- activates sensory and type II motor nerves w/o stim pain fibers
- re-educate m.
- inc jnt mob
- promote dermal wound helaing
- dec pain/edema/muscl spasm/atrophy
36
NMES
- elicit m. contraction
- biphasic current w/ duty cycle
- reduce edema, pain and muscle spasm
37
iontophoresis
- DC monophonic waveform w/ peak current amplitude of up to 5 mA
- drives molecules from certain meds
- treat inflammation cond
- non-invasive painless
38
possible effects of low-level laser therapy
- inc mast cell membrane
- promote interleukin-6 formation
- dec dermal necrosis
- inc collagen formation
- degranulation
- myofibroblast conversion
39
indication s for tens
- postraumatic pain, acute and chronic
- post surgical pain
- inc analgesia
40
contraindication of tens
- pacemaker
- pregnancy
- unknown source of pain
41
indication for high-voltage pulsed
- inc circulation and jnt mob
- inc muscle reeducation and strength
- inc wound and fx healing
- dec muscle spasm
- dec pain and edema
-
42
contraindication of high voltage pulsed
- pacemaker
- pregnancy
- unknown pain
- thrombophlebitis
- cancerous lesion or suspected fx site
- skin lesion
43
IFC indication
- inc circulation and wound healing
- dec pain acute and chronic
- dec muscle spasm/guarding
- dec edema
44
indication low-intensity stim
- inc nonunion wound healing
- in cox healing
-
45
techniques of massage
- effleurage: relax pt
- pétrissage: inc circulation, promot venous/lymph return, break up adhesion, inc elasticity
- tapotement: inc circulation, stim subcutaneous structures
- vibration: relax/stim
- friction: loosen fibrous scar tissue, aids in absorption of edema, reduces inflammation, reduce muscular spasm
46
indication for massage
- inc local circulation
- inc venous/lymph return
- reduce pain
- reduce m. spasm
- stretch superficial scar tissue
- improve systemic relax
- chronic myositis, bursitis, tendinitis, tenosynovitis, fibrositis
47
contraindication of massage
- acute contusion, sprain, strain
- over fx
- over open lesion
- cond: acute phlebitis, thrombosis, severe varicose veins, cellulitis, synovitis, arteriosclerosis, cancerous regions
48
indication of traction
- herniated disk protrusion
- spinal nerve impingement
- spinal nerve inflam
- jnt hypo mobility
- narrowing of intervertebral foramen
- DDD
- spondylolisthesis
- m. spasm/guarding
- jnt pain
49
contraindication traction
- unstable vertebrae
- acute lumbago
- gross emphysema
- s4 nerve root signs
- temporomandibular dysfunction
- pt discomfort
50
continuous passive motion
- external force move jnt through a pre-set arc of motion
- post-surgical
- improve wound healing, accelerate clearance of hermathrosis, prevent cartilage degeneration in septic arthritis
- pain free
51
indication of continuous passive motion
- postoperative rehab,
- reduce pain, improve circulation,
- enhance jnt nutrition,
- prevent jnt contracture
- benefit collagen remodeling
52
contraindication of continuous passive motion
- noncompliant pt
- disrupt surgical repair, fx fixation
- malfunction of device
