Flashcards in Intro to physical agents Deck (143)
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1
what is a physical agent ?
any of the various means of applying energy and materials to patients
2
What is physical agents also referred as?
physical modality or biophysical agent
3
A physical agent includes what?
heat, cold, water, pressure, sound, electromagnetic radiation, light and electrical currents
4
What is the role of physical agents?
to COMPLEMENT other physical, medical, and surgical interventions with minimal to no side effects
5
What therapeutic effects do physical agents want to achieve?
decrease pain, increase ROM, improve tissue healing, improve muscle activation
6
what are the 3 categories of physical agents
Thermal, Mechanical, & Electromagnetic
7
Can a physical agent fall into more than one category?
yes, depends on system used
8
What do thermal physical agents do?
transfer energy to a patient to produce an increase/decrease in tissue temp
9
An increase in tissue temp causes what?
increase circulation, metabolic rate, and soft tissue extensibility or decrease pain
10
A decrease tissue temp causes what?
decrease circulation, metabolic rate or pain
11
Types of thermal PA
Deep heating agents, superficial heating agents, cooling agents
12
clinical examples of deep heating agents
Ultrasound and diathermy
13
Clinical examples of superficial heating agents
hot packs, paraffin
14
clinical examples of cooling agents
ice pack
15
What do mechanical physical agents do?
apply mechanical force to increase/decrease pressure on the body
16
Types of mechanical physical agents?
Traction, compression, water, sound
17
Clinical examples of traction
mechanical traction
18
clinical examples of compression
Elastic bandages, stockings
19
Clinical examples of water
whirlpool
20
Clinical examples of sound
Ultrasound
21
What does Electromagnetic PA do?
utilize application of electromagnetic energy in the form of electromagnetic radiation and electrical current
22
Electromagnetic PA utilize application of electromagnetic energy in the form of what?
electromagnetic radiation & electrical current
23
Vacation of the frequency and intensity of electromagnetic radiation changes what?
effects and depth of penetration
24
what can Vacation of the frequency and intensity of electromagnetic radiation changes effect and depth of penetration do?
Depolarize nerves
sensory and motor responses to control pain or increase muscle strength and control
25
Types of electromagnetic PA
Electromagnetic field and electrical currents
26
Clinical examples of electromagnetic field
ultraviolet, laser
27
Clinical examples of electrical currents
TENS
28
What are general contraindications for PA
Pregnancy
Malignancy
Pacemaker/ other implanted electronic device
Impaired sensation
Impaired mental status
29
what are 3 reasons why PA fall out of favor?
-Lack of evidence to support effectiveness
-Greater effectiveness with other treatment options
-Laziness on the part of the community using the PA
30
What are the 4 things that need to be considered when choosing a PA
Goals and effects of treatment
Contraindications & precautions
Evidence for PA use
Cost, convenience and availability
31
Top 3 requirements for cost effective use of PA
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
what does physical agents have direct effects on?
LEVEL OF IMPAIRMENT that can prompt improvements over the level of functional limitation and disability
33
Optimally PA are used in conjunction with or in preparation for what ?
-Therapeutic exercise
-Functional training
34
Purpose of PA ?
Increase efficacy of the intervention
35
Treat inflammatory conditions that are results of what?
-Trauma
-Surgical procedures
-Problematic healing
36
Treatments of inflammatory conditions are?
PA
TE
Manual Therapy
37
PA can reduce/eliminate soft tissue what?
inflammation or circulatory dysfunction
38
PA can increase the healing rate of ?
Soft tissue injury
39
PA can modulate?
Pain
40
PA can modify ?
Tone
41
PA can increase connective tissue what?
Extensibility and length
42
PA can remodel
scar tissue
43
PA can treat
Skin conditions
44
When tissue damage occurs due to trauma or disease, the response is what?
generally similar and predictable
45
the 4 primary determinants to the outcome of any injury?
-type and extent of injury
-Regenerative capacity of tissue involved
-Vascular supply to injured site
-Extent of damage to the extracellular framework
46
When selected and applied appropriately, PA can? (5)
-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
When selected and applied INAPPROPRIATELY, PAs may ? (4)
-prolong inflammation
-Increase severity of associated symptoms
-Prevent or delay healing
-Increase probability of adverse consequences and therefore, a poor overall pt outcome
48
what do clinicians need to understand to choice PA appropriately?
-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
How do PA's assist in decreasing inflammation and increasing tissue healing by?
Thermal, mechanical, electromagnetic
50
How does thermal PA decrease inflammation and increasing tissue healing?
Change the rate of circulation and rate of chemical reactions
51
How does mechanical PA decrease inflammation and increasing tissue healing?
control motion and alter fluid flow
52
How does electromagnetic PA decrease inflammation and increasing tissue healing?
Alter cell function particularly membrane permeability and transport
53
3 phases of inflammation
inflammation, proliferation, maturation
54
4 things that happen during inflammation phase?
-Vasoconstriction
-Vasodilation
-clot formation
-Phagocytosis
55
4 things that happen during proliferation phase?
-epithelialization
-fibroplasia/ collagen production
-Wound contracture
-Neovascularization
56
3 things that happens during maturation phase
-Collagen synthesis/ lysis balance
-collagen fiber orientation
-Healed injury
57
Inflammation stage prepares wound for what?
healing
58
what days does inflammation phase occur?
days 1-6
59
Proliferation phase rebuilds what and strengthens what?
rebuilds: damaged structures
strengthens: wound
60
What days does proliferation phase occur?
days 3 to 20
61
Maturation phase modifies what?
the scar tissue into its mature form
62
what day does maturation phase occur?
day 9 onward
63
what is necessary for healing ?
inflammation phase
64
When does inflammation phase begin?
when normal physiology of tissue is altered by disease or trauma
65
what happens when inflammation phase becomes inappropriate?
damage and excessive scarring
66
What is the vascular response of inflammation phase
swelling and redness
67
the vascular response is mediated by what?
histamine, kinins, and prostaglandins
68
The immune response of inflammation phase activates what?
neutrophils and other infection fighting cells
69
What does the hemostatic response of the inflammation phase do?
stops bleeding
70
What does the proliferation phase do?
cover wound and strengthens injury site
71
What four simultaneous process does the proliferation phase involve?
-epithelialization
-collagen production (granulation tissue)
-Wound contracture
-Formation of new blood vessels
72
What is the longest phase of inflammation ?
maturation
73
what two things is required for normal remodeling of scar?
balanced synthesis and lysis of collagen
74
what happen when production is greater than lysis
keloid or hypertrophic scar
75
High oxygen exposure favors what?
hypertrophy
76
Type III collagen is replaced by what?
type I
77
How many weeks is acute?
no more than 2 weeks
78
how many weeks is subacute
more than 4 weeks (2-4)
79
How long is chronic
months or years
80
Chronic inflammation
simultaneous progression of active inflammation, tissue destruction and healing
81
chronic inflammation can arise from what two situations
-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
3 factors that affect the healing process?
local, external, and systemic
83
Infection accounts for what percent of the complication of wound healing?
50%
84
Local factors include?
-type, size, location of injury
-infection
-vascular supply
85
what may delay healing?
early movement
86
continuous passive motion used in conjunction with what may be helpful?
short-term immobilization
87
what are systemic factors?
age, disease, medications, nutrition
88
healing is rapid & robust in what age group?
children
89
what diseases can impair healing ?
diabetes and immune or vascular system diseases
90
What is "fuel" for inflammation and repair?
nutrition
91
What can result in accelerated pt progress toward active participation and goal achievement ?
modification of inflammation and tissue healing
92
what are the 4 cardinal signs of inflammation ?
heat, redness, swelling, pain
93
Stages of tissue healing determines what 2 things?
treatment goals
choice of PA
94
what is the firsts stage in tissue healing?
initial injury- control bleeding and inflammation
95
What is the approach of choice for sports med after acute tissue injury
PRICE
96
What are tx goals for initial injury?
prevent further injury or bleeding
clean open wound
97
effective agents for prevention of further injury or bleeding?
static compression
cryotherapy
98
effective agents for clean open wound
hydrotherapy
99
Treatment goals for acute inflammation
control: pain, edema, bleeding, release & activity of inflammatory mediators, and facilitate progression to proliferation phase
100
What PA would you use for pain in acute stage
Cryotherapy
hydrotherapy
ES
PSWD
101
what PA would you use for edema in acute stage
cryotherapy
compression
sensory level ES
PSWD
Contrast Bath
102
What PA would you use for bleeding in acute stage
Cryotherapy
compression
103
what PA would you use for release of inflammatory mediators in acute stage?
cryotherapy
104
What are the treatment goals during chronic inflam during tissue healing?
-prevent or decrease joint stiffness
-Control pain
-Increase circulation
-progress to proliferation phase
105
what PA would you use to prevent/ DC joint stiffness is chronic
Thermotherapy
Motor ES
Whirlpool
Fluidotherapy
106
What PA would you use to control pain in chronic
thermotherapy
ES
Laser
107
What PA would you use to increase circulation in chronic
Thermotherapy
ES
Compression
Hydrotherapy
108
What PA would you use to progress to proliferation phase in chronic
pulsed US
ES
PSWD
109
What are the treatment goals for remodeling/ maturation stage of healing ?
-regain or maintain strength
-regain or maintain flexibility
-control scar tissue formation
110
what PA would you use to regain. maintain strength in maturation
motor ES
water exercise
111
What PA would you use to regain/maintain flexibility in maturation
Thermotherapy
112
what PA would you use to control scar tissue formation in maturation
Brief ice massage
compression
113
Cutaneous noxious stimulation pain is?
well localized
sharp, pricking, tingling
114
Musculoskeletal structure pain is?
poorly localized
dull, heavy, aching
115
Visceral pain is?
refers superficially
aching quality
116
Goals of care for pain management ? (3)
-resolving underlying patho when possible
-modifying discomfort and suffering
-max function within the limitations imposed by pt's condition
117
Persistent pain may need to be integrated by what?
multidisciplinary treatment (psycho, psychosocial, PA and exercise)
118
Benefits for using PA for pain management?(4)
-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
PA commonly used for pain reduction ?
cryotherapy
thermotherapy
electrical stimulation
traction
120
what can you use to measure pain for documentation
-visual analog
-numeric scales
-comparison with predefined stimulus
-face scale
121
what is Muscle tone
underlying tension in the muscle that serves as a background for contraction
122
what is hyptonicity
abnormally low tone
123
flaccidity
total absence of tone
124
examples of hypotonicity
Down syndrome, poliomyelitis
125
hypertonicity
abnormally high tone
126
rigidity
velocity independent resistance to stretch
127
Spasticity
velocity dependent resistance to stretch
128
Clonus
rhythmic oscillations or beats of involuntary contraction in response to quick stretch
129
PA are used to alter muscle tone directly or indirectly
both
130
PA are used to alter muscle tone directly by
altering nerve conduction or sensitivity
131
PA are used to alter muscle tone indirectly by
reducing pain or underlying cause of pain
132
quantitative measure for measuring muscle tone are?
-Dynamomter or myometer
-Isokinetic testing systems
-Electromypgraphy
133
what does an EMG record?
electrical activity sampled from muscles at rest and during contraction, using surface, fine wire or needle electrodes
134
What are pathologies that can cause motion restrictions?
contracture, edema, adhesion, mechanical block, spinal disc herniation, adverse neural tension, weakness
135
PA are generally not sufficient to do what?
reverse or prevent motion restrictions
136
PA are used as what?
adjuncts
137
PA are used as adjusts to treatment to help do what?
-increase soft tissue extensibility
-control inflammation and adhesion formation
-control pain during stretching
-facilitate motion
138
Role of PA in motion restriction ?
-Increase soft tissue extensibility
-Control inflammation and adhesion formation
-control pain during stretching/PROM
-Faciliate Motion
139
How does PA play a role to increase soft tissue extensibility ?
increase temp can alter viscoelasticity of soft tissue fibers, allowing plastic deformation to occur
140
How does PA play a role in control inflammation and adhesion formation ?
limit edema during acute inflammatory stage. limits degree of immobilization
141
How does PA play a role in controlling pain during stretching/PROM
to allow for increased stretching and sooner imitation of motion
142
How does PA play a role in facilitate motion ?
principles of buoyancy, muscle contraction (russian ES) to initiate motion
143
