Modalities

Question 1

Contraindications for Moist Heat

Answer 1

Decreased sensation
Poor circulation
Open wound
Acute injury
Malignancy
Hemophiliacs

Question 2

Procedure/Indications for Hot Packs

Answer 2

-Inspect the area for redness/blistering PRIOR to and POST application.
-Treatment time: 15 minutes
-Indications: Muscle pain or spasm

Question 3

Procedure/indications for Whirlpool

Answer 3

Used for increasing tissue temperature on a larger surface area

Question 4

Procedure/Indications for Paraffin

Answer 4

-Paraffin wax should reach 113-122 degrees
-Paraffin provides a more even distribution to areas such as hands and feet
-Indicated for RA

Question 5

Procedures/Indications for Ice Massage

Answer 5

-Treatment time is 5-10 mins.
-Explain progression of sensation to patient: Intense cold, Burn, Ache, Analgesia
-Indications: Small contoured area such as elbow, wrist, knee.

Question 6

Procedure/Indication for Cold Pack

Answer 6

-Should be applied over a towel and may need to be secured with an elastic band to increase surface contact.
-Treatment time not to exceed 20 minutes.
-Indications: Acute injury, inflammation, acute/chronic pain

Question 7

Purpose/Indications for Cold (Ice) Bath

Answer 7

-Body part is immersed in water for 20 minutes maximum.
-Indicated for distal extremity injuries such as wrist or ankle sprain.

Question 8

Purpose/Indications for Controlled Cold Compression Unit (GameReady)

Answer 8

-Compression applied intermittently by inflating sleeve with air, circulates cooled water through the sleeve
-Water temperature is 50-77 degrees
-Indications: RTC repair, post-surgical conditions

Question 9

Purpose/Indications for CryoCuff

Answer 9

-Water circulates through a unit that controls compression
-Water must be re-cooled periodically to maintain temperature
-Indications: Post-op surgical conditions for ankle, shoulder, and knee.

Question 10

Purpose/Indications for Vapocoolant Spray

Answer 10

-Apply the spray in the direction of the muscle fibers–do NOT spray back and forth.
-Produces rapid cooling through evaporation.
-Indications: Trigger points, increase ROM

Question 11

Purpose/Indications for Iontophoresis

Answer 11

Use of a continuous direct current with the purpose of transferring medicinal agents through the skin or mucous membranes.
-Indications for use: Athlete’s foot, Rhinitis, Decubitus ulcers, Post-traumatic edema, Plantar warts, Trigger points, Acute RA, Acute inflammation, Tendonitis

Question 12

Purpose/Application/Indication
TENS (Transcutaneous Electrical Nerve Stimulation)

Answer 12

Purpose: Pain modulation through activation of central inhibition of pain transmission

Application: Electrode placement may be on sites of nerve roots, trigger points, acupuncture sites, or key points of pain/sensitivity

Indications:
-Acute and Chronic pain modulation
-Bone fractures
-Trigeminal neuralgia
-Phantom pain

Question 13

Contraindications for TENS

Answer 13

-Cardiac pacemaker
-Placement over anterior trans-cervical area
-Epilepsy
-Pregnancy

Question 14

Purpose/Application/Indication for IFC (Interferential Current)

Answer 14

Purpose: Combines two high frequency alternating waveforms that are biphasic

Applications: Can be used bipolar or quadripolar (2 or 4 electrodes)

Indications:
-Pain management
-Urinary incontinence
-Edema management
-Osteoarthritic pain
-Migraines

Question 15

Contraindications for IFC

Answer 15

-Malignancy
-Pregnancy
-Placement over anterior trans-cervical area

Question 16

Purpose/Application/Indications for Pre-Modulated Current

Answer 16

Purpose: Bipolar technique in which the two frequencies are “mixed” inside the machine prior to tissue delivery

Application: Used in smaller areas that are unable to accommodate a quadripolar IFC

Indications:
-Pain control
-Edema reduction via the “muscle milking” technique

Question 17

Contraindications for Pre-Mod

Answer 17

-Malignancy
-Pregnancy
-Placement over the anterior trans-cervical area

Question 18

Purpose/Application/Indications for NMES or Functional Electrical Stimulation (FES)

Answer 18

Purpose: Technique used to facilitate skeletal muscle activity

Application: Bipolar electrode placement over the target muscle, treatment ranges from 15-20 minutes and can be used multiple times/day

Indications: Facilitates the return of controlled functional muscular activity or maintenance of postural alignment until recover returns

Question 19

Contraindications for NMES/FES

Answer 19

-Cardiac pacemaker
-Placement over anterior trans-cervical area
-Epilepsy
-Pregnancy

Question 20

Application of Continuous Mode Ultrasound

Answer 20

-Thermal Effects
-1 mhz used for heating DEEP tissues
-3 mhz produces higher temps and used on SUPERFICIAL tissue
-Intensity set between 0.5 and 2 W/cm2

Question 21

Indications for Ultrasound

Answer 21

-Soft tissue repair
-Contracture
-Bone fracture
-Trigger point
-Dermal ulcer
-Scar tissue
-Pain

Question 22

Contraindications for Ultrasound

Answer 22

-Over eyes or pregnant uterus
-Over cemented prosthetic joint
-Over heart
-Over male reproductive organs
-Over malignancy

Question 23

Application for Pulsed Mode Ultrasound (Non-thermal)

Answer 23

-1 mhz used for deep tissues
-3 mhz used for superficial tissues
-Intensity set between 0.5 to 0.75 W/cm2
-NON-THERMAL

Question 24

Purpose of Traction

Answer 24

Decreased disc protrusion
Decreased pain
Increased joint mobility
Increased muscle relaxation
Increased soft tissue elasticity
Promotes arterial, venous, and lymphatic flow

Question 25

Indications for Traction

Answer 25

Disc herniation Joint hypomobility Narrowing of the IV foramen Nerve root impingement Osteophyte formation Subacute pain

Question 26

Contraindications for Traction

Answer 26

Acute inflammation Acute sprains/strains Bone disease Cardiopulmonary problems Movement increases symptoms Dislocation Fracture Hiatal hernia Meningitis Osteoporosis Positive vertebral artery test Pregnancy Advanced RA TMJ dysfunction Tumors Vascular conditions

Question 27

Application of Cervical Traction

Answer 27

-Use 10 lbs to assess tolerance initially -7-10% of body weight for soft tissue stretch, muscle spasm, and disc protrusion -13-20% of body weight for joint distraction. **Rule of thumb is not to exceed 30 lbs. of force.

Question 28

Application of Lumbar Traction

Answer 28

25% of patient's body weight is needed to overcome the force of friction.

Question 29

Purpose/Application/Indications for Pneumatic Compression

Answer 29

Purpose: Pneumatic device applies external pressure to an extremity through an inflatable sleeve. Application: Check patient's BP, elevate limb 45 degrees and abduct up to 70 degrees. Inflation/deflation rate is 3:1 for edema, 4:1 to reshape limb Indications: -Lymphedema -New residual limb -Risk for DVT -Edema -Stasis ulcer -Hypertrophic scarring

Question 30

Contraindications for Pneumatic Compression

Answer 30

-Malignancy of treated areas -DVT -Unstable or acute fracture -Heart failure -Infection of treated area -Pulmonary edema -Circulatory obstruction

Question 31

Purpose of Biofeedback

Answer 31

Uses electromechanical device to provide visual and/or auditory feedback related to the amount of electrical activity detected. Can be utilized to receive information related to motor performance, kinesthetic performance, or physiologic response.

Question 32

Therapeutic Effects of Biofeedback

Answer 32

Decreased accessory muscle use Decreased muscle spasm Decreased pain Improved muscle strength Muscle relaxation Neuromuscular control Does not measure muscle contraction, but electrical activity.

Question 33

Application of NMES

Answer 33

The two active electrodes should be placed parallel to the muscle fibers and close to each other.