Intro To Modalities

Question 1

What type of energy do physical agent modalities include?

Answer 1

Thermal, acoustic, electromagnetic, electrical or mechanical energy

Question 2

What are physical agent modalities?

Answer 2

Transmission of various frequencies into tissues with different energies in pt care

Question 3

4 types of modalities

Answer 3

Superficial heat and cold, intermittent pneumatic compression, traction, hydrotherapy

Question 4

What is NMES used for

Answer 4

To promote muscle contraction

Question 5

What does TENS stand for? Benefit?

Answer 5

Transcutaneous Electrical Nerve Stimulation; modulate pain

Question 6

What are two benefits of electrotherapies?

Answer 6

Promote edema reduction and wound healing

Question 7

3 examples of mechanical modalities

Answer 7

Hydrotherapy, intermittent pneumatic compression, mechanical traction

Question 8

What type of mechanical traction and what body areas is it used for?

Answer 8

Continuous and intermittent; lumbar and cervical

Question 9

What is intermittent pneumatic compression?

Answer 9

Application of external mechanical pressure to body for therapeutic purpose

Question 10

Indications for intermittent pneumatic compression

Answer 10

-trauma edema
-stump reduction following limb amputation
-wound healing
-prevention of DVT
-venous stasis ulcers
-lymphedema

Question 11

Contraindications for pneumatic compression

Answer 11

-acute pulmonary edema
-congestive heart failure
-uncontrolled hypertension
-acute or recent DVTs
-infection

Question 12

Typical intermittent pneumatic compression protocols and what to avoid

Answer 12

-continuous w/ very low intermittent pressure
-brief: maximal pressure below diastolic, time 15-30 mins
-avoid: swelling in other areas, stiffness, numbness, SOB

Question 13

Describe the transfer of energy regarding heating and cooling agents

Answer 13

Heating transfers energy TO body
Cooling transfers energy AWAY from body

Question 14

5 ways for heating and cooling agents to transfer energy

Answer 14

Conduction, convection, conversion, radiation, evaporation

Question 15

Describe conduction (type of contact)

Answer 15

-Direct contact between two objects that have different temps
-hot molecules collide w/ slow molecules (kinetic motion) and continue until speed equalize

Question 16

Describe convection (what does it contain, purpose)

Answer 16

-medium present
-heat transferred from circulating medium

Question 17

Describe conversion (what is it)

Answer 17

-converts non-thermal energy (mechanical, electrical, chemical) into heat (thermal energy)
-doesn’t require direct contact

Question 18

Describe radiation

Answer 18

-direct transfer of energy from material w/ greater temp
-no medium and no contact

Question 19

Ex. Of radiation

Answer 19

Infrared lamp, sun

Question 20

Describe evaporation

Answer 20

Material that absorbs energy and changes it from liquid to a gas or vapor

Question 21

Indications for therapeutic heat

Answer 21

-general and muscle relaxation
-calming effect, decrease muscle tone and guarding
-pain control
-increase ROM/decrease joint stiffness
-increase tissue extensibility, decrease muscle spasm
-promote healing (increased circulation, O2, metabolic rate)

Question 22

Effects of vigorous heat

Answer 22

-vasodilation (increase capillary pressure and flow)
-increased O2 hemoglobin dissociation
-neuromuscular effects (increase nerve conduction velocity and firing)

Question 23

Contraindications for therapeutic heat

Answer 23

-acute injury or inflammation
-recent or potential hemorrhage
-thrombophlebitis
-impaired sensation
-impaired mentation/cognition
-malignancy
-IR irradiation of the eyes

Question 24

Precautions for therapeutic heat

Answer 24

-pregnancy
-impaired circulation
-poor thermal regulation
-edema
-cardiac insufficiency
-metal in the area
-paraffin over an open wound
-where topical counterirritants have recently been used (cause chemical burns)

Question 25

Adverse effects of superficial heat

Answer 25

Burns, fainting, bleeding, skin and eye damage from infrared

Question 26

5 methods of superficial heat application

Answer 26

Moist heat, electric heating pads, whirlpool, paraffin, infrared

Question 27

What is a hot pack? What temp is water? How to apply?

Answer 27

-Canvas or nylon case filled w/ hydrophilic silicate (sand)
-70 to 75 degrees C
-placed in 6-12 layers of terry cloth and placed in contact w/ pt for 15-20 mins

Question 28

What is mild heat? Temp and uses?

Answer 28

-counterirritant
-<40 degrees C
-relaxation, decreased muscle tone

Question 29

What is vigorous heat temp? Causes?

Answer 29

40-45 degrees C
>45 degrees C causes tissue, burning

Question 30

How is muscle strength affected by heat?

Answer 30

Decreased for 30 mins after heat, increases next 2 hours to greater than pretreatment

Question 31

How does heat affect tissue extensibility?

Answer 31

-Can lead to permanent elongation when combined w/ stx

Question 32

4 methods of cold application

Answer 32

Ice pack, massage, bath, flouromethane spray

Question 33

Indications for therapeautic cold

Answer 33

-acute and sub-acute musculoskeletal trauma and inflammation
-hemodynamic effects (vasoconstriction, control acute inflammatory mechanisms)
-pain control

Question 34

Cold therapy mechanism and hemodynamic effects

Answer 34

-vasoconstriction due to decreased vasodilator release, direct effect smooth muscle contraction, increased sympathetic activation
-HE = decreased blood flow

Question 35

Dangerous cold temps and affects

Answer 35

15 degrees C, tissue damage can occur
-4 to -10 degrees C, frost bite and tissue death

Question 36

How to make home cold pack?

Answer 36

1 part rubbing alcohol, 3 parts water

Question 37

How much time for ice massage?

Answer 37

8-10 mins

Question 38

Stages of sensation w/ cold therapy

Answer 38

Stage I: cold (1-3 mins)
Stage II: burning (3-5 mins)
Stage III: aching (5-7 mins)
Stage IV: numbness (7+ mins)

Question 39

Neuromuscular effects of cold therapy

Answer 39

-temporary decrease in spasticity
-decrease nerve sensitivity
-after 45 mins, decreased hyper-reflex is

Question 40

Indications for cold therapy

Answer 40

Inflammation control, edema control, pain control, modification of spasticity, facilitation of strength

Question 41

Contraindications w/ cold therapy

Answer 41

-cold hypersensitivity
-cold intolerance
-Raynaud’s disease or phenomenon
-area w/ circulatory compromise or peripheral vascular disease

Question 42

Precautions with cold therapy

Answer 42

-superficial main branch of nerve
-open wound
-hypertension
-poor sensation or cognition
-very young or old pts

Question 43

Negative effects of cold therapy

Answer 43

Tissue death, frostbite, nerve damage, unwanted vasodilation