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Flashcards in Modality Basics Deck (59)
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1

Hydrotherapy Indications

Superficial cooling or heating
Wound care (not in the whirl pool)
Water exercise
Pain control
Edema control

2

Hydrotherapy Contraindications

Local:
Maceration around the wound; bleeding
Full body:
Cardiac instability, infectious conditions that may be spread by water, bowel/bladder incontinence, severe epilepsy, suicidal thoughts/tendencies

3

What temperature of hydrotherapy reduces inflammation?

Cold
32-79 deg F

4

What temperature is medium for exercise?
(Hydrotherapy)

Tepid water
79-92 deg F

5

What is neutral warmth (92-96 deg F) used for?
(Hydrotherapy)

Control tone for neurologically based hypertonicity
Circulatory, sensory, cardiac disorders

6

What is the purpose for the application of mild warmth (96-98 deg F) hydrotherapy?

Burns after epithelialization has begun
Promotes mobility, relaxation

7

What is the purpose of hot (99-104 deg F) hydrotherapy?

Pain control
Increase soft tissue extensibility
Large areas of immersion

8

What is the purpose of applying very hot (104-110) hydrotherapy?

Pain control
Increase soft tissue extensibility
Limited body area
OA/RA Nona cute stage

9

Documentation of Hydrotherapy

Type: (thermal, cryotherapy, whirlpool, bath)
Patient position and types of movement
Water temperature
Duration
Patient response
Fluid pressure or additives if applicable

10

What are the different types of superficial heat?

Hot packs
Paraffin- wax bath
Contrast bath
Fluidotherapy
Infrared lamps
Whirlpool

11

What are the indications for using superficial heat?

Promotes soft tissue healing
Promotes general relaxation
Decrease joint stiffness
Pain- decrease/ control
May help to reduce the effects of skin conditions

12

What is the optimum dosage/ therapeutic range of superficial heat?

Tissue should be heated to 104-113 deg F

13

What are the methods of paraffin application?

Continuous immersion/ dip immersion
Dip immersion w/ wrapping
Paining/ brushing with wrapping

14

What are the contraindications of therapy?

Area of recent or potential hemorrhage
Impaired sensation/ mentation
Over malignant area/ tumor
Thrombophlebitis
Over abdominal, pelvic and low back areas of a pregnant woman
Infrared - irradiation of the eyes

15

Thermotherapy Documentation

Area treated
Heating agent type
Treatment parameters (temp, power, insulation, distance)
Patient positioning
Response to intervention

16

Types of cryotherapy

Ice pack, cup
Gel, chemical packs
Cryopressure units
Vapocoolant sprays
Cryohydrotherapy
Cooling suirs

17

What are the indications for cryotherapy?

Abnormal tone
Acute or chronic pain
Acute or subacute inflammation
Bursitis
Muscle spasm
Musculoskeletal trauma
Myofascial trigger points
Tendonitis
Tenosynovitis

18

What are the contraindications of cryotherapy

Cold allergy/hypersensitivity (cold urticaria)
Cold intolerance
Raynaud's disease
Cryoglobulinemia
Paroxysmal cold hemoglobinuria
Over regenerating peripheral nerves
Over areas of circulatory compromise
Inability to discriminate cold

19

Cryotherapy Documentation

Area treated
Cooling agent
Treatment duration
Patient positioning
Response to intervention

20

What are the indications for ultrasound?

Soft tissue shortening
Pain control
Repair of soft tissue injuries
Dermal ulcers/ plantar warts
Tendon injuries
Resorption of calcium deposits
Bone fracture
Carpal runner syndrome
Anti-inflammatory

INCREASE EXTENSIBILITY OF COLLAGEN FIBERS (TENDONS, JOINT CAPSULES)

21

What are the effects of continuous ultrasound?

Thermal effects
Increasing tissue temperature

REDUCTION OF MUSCLE SPASM, PAIN MODULATION, INCREASED BLOOD FLOW, INCREASED METABOLIC RATE, INCREASED NERVE CONDUCTION VELOCITY

22

What are the effects of pulsed ultrasound?

Non-thermal effects
Acoustic streaming
Micro-streaming
Cavitation

INCREASE PROTEIN SYNTHESIS AND TISSUE REPAIR, INCREASE BLOOD FLOW AND BONE HEALING AND REPAIR OF NON UNION FRACTURES

23

Which ultrasound frequency penetrates tissue deeper?

1.0 MHz (2-5cm)

Vs 3.0 MHz (1-2 cm)

24

What are the two different modes of ultrasound delivery?

Continuous (thermal) and pulsed (non-thermal)

25

How do you chose a ultrasound duty cycle?

Thermal = 100%
Non-Thermal = 20 %

26

What is the duration of ultrasound?

5-10 minutes

27

What are the parameters of phonophoresis?

Frequency- 3MHz
Pulse 20% duty cycle
0.5-0.75 W/cm2 intensity
5-10 minutes

28

What are ultrasound contraindications?

Malignancy
Pelvis, abdomens and low back of pregnant woman
CNS issue
Joint cement
Plastic components
Pacemaker
Thrombophlebitis
Eyes and reproductive organs
OPEN EPIPHYSEAL PLATES

29

Ultrasound documentation

Area treated
Ultrasound frequency
Ultrasound intensity
Ultrasound duty cycle
Treatment duration
If underwater
Response to intervention

30

What is the intensity range for therapeutic ultrasound?

0.1-3 W/cm2

31

When would you use higher intensities and when would you use lower intensities for ultrasound?

Higher intensities= continuous= chronic conditions and thick tissues

Lowe intensities= pulsed= acute conditions and thin tissue

32

What is the pulse duration of most TENS units?

50-400 microseconds

33

What is the pulse frequency of most TENS units?

1-200 Hz
Which is the pulse rate...

34

What are the effects of pulse frequency?

Muscle contraction:
Twitch 1-10 Hz; Tetanic 20-50 Hz
Analgesic:
Enkephalins 40-150 Hz; Serotonin 15-100 Hz; Beta endorphins 2-5 Hz

35

What is the intensity in most TENS units?

0-120 mA
(Higher intensity the greater the penetration depth and greater number of fibers stimulated)

36

What are the 3 levels of responses to TENS?

Sensory- low amplitude
Motor- increased amplitude and duration
Noxious- more intense with long duration

37

What are the electrical pulses of conventional TENS?

Short pulse duration (<150 microseconds)
High frequency (>80 Hz)
Current amplitude is sensory

ACUTE

38

What are the electrical pulses of Acupuncture-like TENS?

Long pulse duration (>150 microseconds)
Low frequency (<10 Hz)
Sensory and motor current amplitudes

CHRONIC

39

What are the electrical pulses of Brief-Intense TENS?

Long duration (>150 microseconds)
High frequency (>80 Hz)
Sensory- motor- noxious current amplitude

40

What are the electrical pulses of burst TENS?

Bursts of pulses instead of individual pulses
Low frequency (<10Hz)
Sensory- motor current amplitudes

41

What are contraindications for TENS?

Over pelvis, abdomen, trunk, and low back area during pregnancy
Over carotid sinus
Demand pacemaker or unstable arrhythmia
Venous/ arterial thrombosis or thrombophlebitis

42

What are some other contraindications of TENS?

Malignant tumor
Epileptic patients
Over metal implants, eyes or testicles
Mucosal membranes
Undiagnosed pain
Implanted defibrillators
Thoracic and cranial areas

43

TENS documentation

Area treated
Patient positioning
Parameters (frequency, duration, amplitude)
Electrode placement
Duration
Response to intervention

44

What are the parameters of laser?

Wavelength (visible light 600-700nm, infrared light >700-1100 nm)
Power
Energy density
Light sources

45

When would an LED laser be used?

Most diffuse light
Widest frequency range
Low power individually
BEST SUITED FOR TREATING LARGE, SUPERFICIAL AREAS
Power- 1-5mW can be 30-40mW

46

When would SLD laser be used?

Less diffuse light
Narrower wavelength
Emit more power than LEDs
BEST SUITED FOR SUPERFICIAL, MODERATELY DEEP AREAS BASED ON WAVELENGTH
Power: 5-35 mW can be >90mW

47

When would Laser Diodes be used?

Provide single wavelength
Very concentrated
Best suited to treat small areas
DELIVERS THE MOST DEEPEST LIGHT TO A SINGLE AREA OF TISSUE
5-500mW (power)

48

What are the clinical indications for lasers?

Soft tissue and bone healing
Arthritis
Lymphedema
Neurological conditions
Pain management

49

What are contraindications of laser?

Malignancy
Direct irradiation of the eyes
Within 4-6 month after radiotherapy
Hemorrhaging regions
Over the enterprise glands
PRECAUTIONS: pregnant women and growth plates

50

Can laser be used for acute conditions?

Yes
It's non-thermal
Can also be used for metal implants and pacemakers

51

Laser Documentation

Type of diode
Wavelength (on machine)
Power (on machine)
Area of body treated
Energy density (on machine)
Position of patient
Response to intervention

52

What are the two types of shortwave diathermy and what are they used for?

Continuous- heating deep tissues
Pulsed- thermal physiological effects: increased microvascular perfusion, altered cell membrane function and cellular activity

53

What are indications for short wave diathermy?

Heating joint capsule before stretching/ mobs
Enhancement of soft tissue healing
Musculoskeletal disorders (pain, muscle guarding, joint stiffness)
Uneven or irregular treatment areas
Bursitis
degenerative joint disease
Decreased collagen extensibility
Peripheral nerve regeneration

54

What are the types of diathermy applicators in the United States?

Inductive coils, drum, garments
Capacitive plates

55

Where is the heat produced during diathermy?

Capacitive plates: produce more heat in the skin and superficial tissue
Inductive applicators: produce more heat in deeper structures

56

What is the duration of diathermy treatment?

Thermal- 15-20 minutes
Non-Therma 30-60 minutes

57

What are the doses for CSWD?

Dose 1- no sensation of heat
Dose 2- mild heating sensation
Dose 3- moderate (comfortable heating sensation)
Dose 4- vigorous heating that iss tolerable below the pain threshold

58

What are contraindications for diathermy?

Recent or potential hemorrhage
Thrombophlebitis
Impaired sensation/ mentation
Malignant tumor
Implanted or transcutaneous stimulators (pacemaker)
Pregnancy (pelvis, abdomen, low back)
CSWD- malignancy, eyes, testes, growth plates
PSWD- directly over deep tissue organs, closed loop plates and screws

59

Diathermy Documentation

Area treated
Frequency range
Average power or power setting
Pulse rate
Treatment duration
Type of applicator
Patient position and distance from applicator
Response to intervention