Final Study Material Part 2 Flashcards
Physiologically, why are contrast baths effective in treating conditions like CRPS?
- Causes active vasoconstriction and vasodilation of affected blood vessels, which in theory results in a “pumping” effect on tissue edema.
- “Re-educates” chronically vasoconstricted vessels to respond normally to hot (vasodilate) and cold (vasoconstrict
In contrasts baths what are the appropriate temperatures for hot an cold baths?
Hot - 100-111 degrees
Cold - 50-64 degrees
- elapsed time varies, but often a 4:1 (hot: cold) ratio is used for 2 minutes
- always start and end with hot
When is a contrast bath indicated?
- Reflex sympathetic dystrophy, a.k.a “Complex Regional Pain Syndrome.
- Sprains, Strains, Contusions in the sub-acute phase.
Contraindications: Buerger’s Disease (circulatory disorder with glove-like death of the extremities), Diabetes, Arteriosclerosis
What are the temperature ranges for very cold, cold, cool, and tepid water?
Very Cold = 35-55
Cold = 55-65
Cool = 65-80
Tepid = 80-92
What are the temperature ranges for neutral, warm, hot, and very hot water?
Neutral = 92-96
Warm = 96-98
Hot = 98-104
Very Hot = 104-115
Resistance force to movement in water
hydrodynamic force
the pressure exerted by water at increasing depths; more at the bottom of the pool than at the surface of the pool
Hydrostatic pressure
a body immersed in water at rest experiences an upward thrust equal to the water the body displaces
buoyancy
What is the predominant method of heat transfer in a whirlpool?
Convection - movement of water causes water closest to skin to be the same temperature
- without movement (conduction) water closest to the body is slightly cooled bc the heat is transferred into the skin
Where is the center of buoyancy located? how can this be useful for aquatic exercise?
T2-T4 - a flotation device can be used to create a force pushing them in a direction for strengthening
- anterior flotation device pushes posteriorly, cause pt to activate abdominal muscles and, therefore, strengthening them
- COM at L5-S1 level in land
Will a rectangular or triangular wave shape have more accommodation?
Triangular
- has a longer rise time
- spike wave shapes have the least accommodation of all shapes
Does a higher or lower carrier frequency have more accommodation?
higher has more accommodation
- duration that current is flowing is shortened with higher frequency, so less charge is delivered
Does a shorter or longer pulse/cycle duration result in more accommodation
Shorter duration
- less amount of time for charge to be delivered
How long does the off time need to be for a modulation to count as interrupted?
the off time must last for at least 1s
- this can occur with DC, AC, or PC
How does current amplitude, cycle/pulse duration, and charge effect muscle contraction?
- Amplitude - higher amplitude = stronger contraction
- Longer pulse duration (smaller frequency) = stronger contraction
- more charge delivered = stronger muscle contraction
What are the exercise variables for buoyancy?
- Position and directions of movement can be used to produce assisted or resisted motion, or a gravity minimized movement
- Water depth can be used to alter resistance or assistance
- Lever arm length – a longer lever arm gets a greater benefit from a buoyancy assist during AAROM, e.g., AAROM shoulder flexion with the elbow extended greater assist than with the elbow flexed
- Equipment used by the patient can either increase the assistance (buoyancy) or increase the resistance (hydrodynamic effect) to movement through water
What are the effects of hydrostatic pressure on a pts body?
- May help people with peripheral edema
- Alters cardiac function because of centralization of blood flow, in neutral water temperatures, heart rate slows. Before exercise has started hydrostatic pressure changes cardiac dynamics by causing
- Can limit lung expansion- decreased vital capacity
What are the alterations of cardiac functions that are caused by hydrostatic pressure?
- centralization of blood flow
- increased heart volume
- increased stroke volume
- decreased heart rate
What 2 factors can change the resistance of water?
- velocity of movement in the water (slow = less resistance)
- Surface area of structure moving through the water (large = more resistance)
What is the physiological effect of hot and cold water (effect on HR)?
Hot = increase in CO, mostly due to increase in HR
Hold = decrease in HR
- no significant change in CO between 75 and 93 degrees F; this range is suggested to minimize stress to the heart
What is the effect on HR caused by water depth?
Running and jogging in neck deep water = lower HR than running/ jogging in waist deep
- due to hydrostatic pressure assisting in centralization of blood flow increasing SV
What different areas of rehabilitation can be done during aquatic therapy?
- Muscle performance (strength, flexibility, stabilization)
- CV endurance (activity must be sufficient duration, performed 3-5x per week, HR intensity needs to be -17, deeper water for WB limitations)
- Balance
- Functions (transfers, gait training, squatting, etc.)
What is the action of cold application? reaction in the patient?
action = local vasoconstriction, decr. local metabolism/ O2 demand, slowed nerve conduction velocity, endorphin release, decr. m spindle activity (decr. spasticity), stiffened connective tissue reaction = slightly reddened; cold, burning, aching, then numbness
What causes a greater depth of current flow?
greater distance between electrodes
