Modalities Flashcards
(57 cards)
Systemic and physiological effects of heat application:
increased
cardiac output
vasodilation
heart rate
respiratory rate
metabolic rate
“dog in hot car”
Systemic and physiological effects of heat application:
decreased
muscle activity
blood pressure
blood to internal organs
blood flow to resting muscle
stroke volume
“relaxation”
Systemic and physiological effects of cold application:
increased
joint stiffness
pain threshold (improve pain tolerance)
muscle activation
Systemic and physiological effects of cold application:
decreased
collagen extensibility
blood flow
capillary permeability
local metabolism
spasticity
nerve conduction velocity
cold application
spasticity vs flaccidity
spasticity: increase muscle activity = prolonged 15-20+ min
flaccidity: quick stroking, facilitate + activate = rapid and short duration
Temperature Settings
hot pack:
Treatment temp: Stored at 158-167°F
Treatment time: 20-30 minutes
- 6-8 layers of toweling
- Hot pack peaks heat in first 5 minutes
Temperature Settings
cold pack:
Treatment temp: Stored at 25°F
Treatment time: 10-20 minutes
Can be applied every 1-2 hours
Stages of cold:
C.B.A.A.N:
(1) intense Cold
(2) Burning
(3) Aching
(4) Analgesic
(5) Numb
Superficial Thermotherapy: Contraindications
MC TIBIA
Malignancy
Compromised circulation
Thrombophlebitis
Infrared irradiation of eyes
Bleeding or hemorrhage
Impaired sensationmentation
Arterial disease
Superficial Cryotherapy: Contraindications
Cold intolerance
* Cold hypersensitivity
* Cryoglobulinemia
* Paroxysmal cold hemoglobinuria
* Raynaud’s phenomenon
Over-regenerating peripheral nerves
Circulatory compromise
Electrical Stimulation Parameters:
Muscle Contractions:
muscle strengthening
muscle reeducation
muscle spasm reduction
edema reduction
E-stim
pulse frequency:
pulse duration:
pulse frequency: 35-80 pps
pulse duration:
125-200 us for small muscles
200-350 us for large muscles
E-stim: muscle strengthening
amplitude:
To >10% of MVIC in injured
>50% MVIC in uninjured
on:off times: 6-10 sec on, 50-120 sec off, ratio of 1:5 initially. May reduce the off time with repeated treatments
ramp time: At least 2 sec
treatment time: 10-20 min to produce 10-20 repetitions
times per day: Every 2-3 hours when awake
E-stim: muscle reeducation
amplitude: Sufficient for functional activity
on:off times: Depends on functional activity
ramp time: At least 2 sec
treatment time: Depends on functional activity
times per day: N/A
E-stim: muscle spasm reduction
amplitude: To visible contraction
on:off times: 2-5 sec on, 2-5 sec off; equal on:off times
ramp time: At least 1 sec
treatment time: 10-30 min
times per day: Every 2-3 hours until spasm relieved
E-stim: edema reduction using muscle pump
amplitude: To visible contraction
on:off times: 2-5 sec on, 2-5 sec off; equal on:off times
ramp time: At least 1 sec
treatment time: 30 min
times per day: 2x a day
How to Increase Patient Comfort?
E-stim parameters
Ramp time - increase up to 4 sec
Pulse duration - DDDD
(decrease duration to decrease discomfort)
Electrode size and quality - larger and sticky
Pulse frequency - high (35-50) feels better than a slow poke
On:Off time: increase off time
A clinician is treating a patient with a radial nerve injury and drop wrist
deformity. Which of the following neuromuscular electrical stimulation
parameters is the MOST APPROPRIATE?
A. Pulse duration - 250-300 microsec; 10 seconds on, 50 seconds off
B. Pulse duration - 150-170 microsec; 10 seconds on, 20 seconds off
C. Pulse duration - 250-300 microsec; 10 seconds on, 20 seconds off
D. Pulse duration - 125-200 microsec; 10 seconds on, 50 seconds off
D. Pulse duration - 125-200 microsec; 10 seconds on, 50 seconds off
radial nerve injury = muscle re-ed or strength
small m.
High-Voltage Pulsed Galvanic Current
Negative electrode used to promote healing of the inflamed or infected wounds.
Positive electrode used to promote healing of the wounds without inflammation.
Electrode is placed in or around the wound area.
Treatment time: At least 3-7 days/week with treatment sessions lasting 45 to 60 minutes.
Tissue healing: inflammatory
phase/ infected
parameters:
polarity: Negative
pulse frequency: 100-105 pps
pulse duration: Usually preset for HVPC at ~100us
amplitude: To produce comfortable tingling
treatment time: 45-60 min
Tissue healing: proliferation
phase/ clean
parameters:
polarity: Positive
pulse frequency: 100-105 pps
pulse duration: Usually preset for HVPC at ~100us
amplitude: To produce comfortable tingling
treatment time: 45-60 min
Iontophoresis Indications:
Hyperhidrosis
Scars
Analgesic
Calcium deposits
Musculoskeletal inflammation
Dermal ulcers
Fungal infections
Edema reduction
Muscle spasm
ISAD
negative ions
Iodine
Salicylate
Acetate
Dexamethasone
Hyperhidrosis:
ions: water
polarity: +/-
common medicinal sources: tap water
