Practical Exam

Question 1

NMES Indications

Answer 1

incontinence, neurologic conditions, orthopedic surgery

Question 2

NMES expectations for pts

Answer 2

should be strong but comfortable. will help to gain muscle strength and ROM as we do an exercise with stimulation

Question 3

Goals for NMES

Answer 3

restoring muscle function, inhibit spasms, increase ROM

Question 4

Application of NMES

Answer 4

Frequency = 50-80 hz.

Pulse duration = 300 ms.

5-20 min for 2-5x/week.

Higher frequency & longer duration = larger muscles.

Longer off time = stronger contraction, Shorter off time = more reps.

Low frequency = small muscles.

Start with 1:5 ratio and then go to 1:1 ratio

Question 5

Post-intervention NMES

Answer 5

MMT, pain

Question 6

Precautions of NMES

Answer 6

impaired sensation, decreased circulation

Question 7

Contraindications of NMES

Answer 7

malignancy, active bleeding, 3rd trimester pregnancy

Question 8

Indications of TENS

Answer 8

RA, OA, DOMS, pain

Question 9

TENS expectations for pt

Answer 9

Strong but comfortable. Tingling sensation. Will help muscles to relax

Question 10

TENS goals

Answer 10

Decreases pain, stops muscle spasms, increase blood flow to muscles

Question 11

TENS application

Answer 11

Wider spacing allows for deeper penetration.

Acute pain = lower pulse (50-80 uSec) and higher frequency (100-150 hz), continuous duration (can be on for hours) .

Chronic = higher pulse (150-300 uSec) and lower frequency (2-10 Hz), phasic duration (30-60 min on and off)

Question 12

TENS post intervention

Answer 12

Rate pain, ROM?

Question 13

Precautions of TENS

Answer 13

impaired circulation, infection

Question 14

Contraindications of TENS

Answer 14

malignancy, impaired communication, damaged skin

Question 15

Ultrasound indications

Answer 15

Acute pain, wound healing, carpal tunnel syndrome

Question 16

Ultrasound expectations of treatment

Answer 16

increases blood flow, thermal effects that would help to decrease pain. Increases cellular activity for wound healing. 3-5 min window after done for thermal effects drop

Question 17

Goals of ultrasound

Answer 17

helps increase quality of inflammation phase, stimulates cellular growth w/protein synthesis in proliferative phase, enhances collagen maturation in remodeling phase. INCREASES blood flow and tissue extensibility

Question 18

Application of ultrasound

Answer 18

superficial tissue = 3 MHz, continuous duty, 5-10 min @ .5 intensity.

Deep = 1 MHz, continuous duty, 5-10 min, 1.5-2.0 intensity.

Max of 15 min, movement should be small slow circles

Question 19

Post intervention of ultrasound

Answer 19

Exercise! Rate pain, ROM

Question 20

precautions of ultrasound

Answer 20

breast implants, acute inflammation

Question 21

contraindications of ultrasound

Answer 21

active bleeding, lack of sensation, malignancy

Question 22

indications of cyrotherapy

Answer 22

pain, inflammation, swelling, DOMS

Question 23

expectations for pt for cyrotherapy

Answer 23

Stages: Cold, Burning, Aching, Numbness

Question 24

goals of cyrotherapy

Answer 24

improving pain, increases pain threshold, reduction in DOMS

Question 25

Application of cyrotherapy

Answer 25

barrier to the skin small area = 3-5 min large area= 15 min inflammation = 10 min on/off

Question 26

post intervention for cyrotherapy

Answer 26

have patient rate pain, rate edema

Question 27

precautions of cyrotherapy

Answer 27

damaged skin, very young/old patient

Question 28

contraindications of cyrotherapy

Answer 28

impaired circulation, impaired sensation, malignancy

Question 29

indications for thermotherapy

Answer 29

muscle guarding, pain, muscle spasms

Question 30

pt expectations for thermotherapy

Answer 30

comfortable and warm, not hot or burning

Question 31

goals of thermotherapy

Answer 31

relax muscle spasms, increased pain threshold, increase extensibility

Question 32

application of thermotherapy

Answer 32

No set time, 10-20 min is the best. Protect from burns with barrier to skin

Question 33

post intervention for thermotherapy

Answer 33

have patient rate pain, ask about muscle spasms, ROM. MMT

Question 34

precautions of thermotherapy

Answer 34

chronic wound, damaged skin

Question 35

contraindications of thermotherapy

Answer 35

impaired circulation, impaired sensation, malignancy

Question 36

Cervical traction indications

Answer 36

pain, tight joint capsule

Question 37

cervical traction expectations for pt

Answer 37

pulling sensation, should be comfortable stretch

Question 38

goals of cervical traction

Answer 38

distracting joints, soft tissue stretch, reducing disc herniation, reduce pain, muscle relaxation

Question 39

Application of cervical traction

Answer 39

Supine, 15-20 degrees. Joint = 20 to 30 lbs, Disc = 10-15 lbs. Acute = 5-10 min, chronic = 15-30 min. Can do static (disc/motion aggravated pain) or intermittent (disc/joint distraction)

Question 40

Post intervention cervical traction

Answer 40

ROM, rate pain

Question 41

Precautions of cervical traction

Answer 41

claustrophobia, pregnancy

Question 42

contraindications of cervical traction

Answer 42

fractures, worsening neural signs, acute inflammation

Question 43

iontophoresis indications

Answer 43

inflammation, tendonitis/bursitis

Question 44

ionto expectations for pt

Answer 44

little sting, should not be painful. helping to deliver drugs deeper into the skin.

Question 45

goals of ionto

Answer 45

reduce inflammation, break up scar tissue, decrease pain/muscle spasms. All dependent on medication

Question 46

Application of ionto

Answer 46

applied with a medication, like dexamethasone. Clean skin, trim hair. Longer treatment = more comfortable and more meds. Usually worn on avg for an hour

Question 47

Post intervention for ionto

Answer 47

reduction of pain w/ADLs?

Question 48

ionto precautions

Answer 48

obesity, metal implants

Question 49

ionto contraindications

Answer 49

impaired sensation, impaired cognition, malignancy