Week 13 Laser/Diathermy/ and Alternative Approaches

Question 1

Biofeedback Definition

Answer 1

The technique of using equipment to reveal to human beings some of their internal physiological events, normal and abnormal, in the form of visual and auditory signals in order to teach them to manipulate these otherwise involuntary or unfelt events by manipulating the displayed signals

Question 2

EMG Definition

Answer 2

Electromyography: the summation of all motor unit action potentials that a sensor can record from the muscle(s) underneath the sensor
–> A higher EMG amplitude indicates there are more motor unit recruitment or motor units are firing at a higher rate or both: either one will result in a higher force output
–> Affected by the skin impedance and subcutaneous structures

Question 3

When do you use EMG Biofeedback

Answer 3

1. To increase muscle activity
   - motor learning
   - muscle re-education
   - postural training
   - ect
2. To decrease muscle activity
   - decrease muscle guarding
   - relaxation
   - muscle reeducation

Question 4

What are the different Modes of EMG

Answer 4

1. ABOVE threshold (Tone): machine will give auditory/visual feedback when the muscle activity is ABOVE the threshold
2. BELOW threshold (tone): Machine will give auditory/visual feedback when the muscle activity is below the threshold

Question 5

EMG Contraindications/Precautions

Answer 5

Contraindications/NA

Precautions:
1. Open wound
2. fragile skin
3. Allergy to adhesive materials or gel

Question 6

Laser Means

Answer 6

L ight
A mplification
S timulated
E mission
R adiation

Question 7

Characteristics of Laser

Answer 7

1. Monochromatic= all photons have a single wavelength and thus a single color
2. Coherent= all photons travel in the same phase and direction
3. Collimated(parallel)= minimal divergence over distance

Question 8

What is the wavelength for lower penetration helium neon?

Answer 8

400-700nm

Question 9

What is the wavelength for higher penetration Gallium arsenide?

Answer 9

600-1200nm

Question 10

What are the frequencies used for laser

Answer 10

1. 630-640 visible red : 8-10mm
2. 830 nm infrared: 50-60mm
3. 904nm infrared: 30-40mm

Question 11

What are some cellular changes that can be caused by laser

Answer 11

1. can trigger the production of enzymes
2. production of protein substance vital for innumerable biochemical actions
3. Stimulates Mitochondria

Question 12

What are the effects of Laser?

Answer 12

1. reduce excitability of nervous tissue
2. increased vascularity
3. reactivate enzymes
4. increase ATP release
5. stimulate collagen production
6. increased RNA and DNA synthesis
7. increased lymphatic drainage
8. Stimulate Fibroblastic activity
9. Increased phagocytosis

Question 13

What are the potential Mechanisms of Laser in pain control?

Answer 13

1. Direct action on nerve= inhibit activity of the enzyme sodium potassium ATPase responsible for nerve depolarization in action potential
2. Energization of inactivated enzymes which were inactivated by hypoxia and acidosis, in painful muscle
3. Production of energy molecules (ATP) in dysfunctional muscles

Question 14

Laser Contraindications/Precautions

Answer 14

1. Over the eye
2. Epilepsy
3. Fever
4. Near cancerous lesions
5. Pregnant women
6. Active hemorrhage area
7. Over endocrine glands
8. photosensitive

Question 15

When should laser be used?

Answer 15

1. Pain
2. inflammation
3. Wound
4. Trigger point
5. Arthritis
6. fracture

Question 16

Diathermy is

Answer 16

1. electrical magnetic energy
   - High freq. electromagnetic waves penetrate into body
   - increases energy of tissues and cells
   - Much like ultrasound

Question 17

Microwave Diathermy

Answer 17

• More focal: hot spots
• More superficial (skin burn)
  -300MHZ-300GHz

Question 18

Short-wave Diathermy

Answer 18

• High freq., short wave length
• Deeper
• Continuous or pulsed

Question 19

Inductive Diathermy

Answer 19

• Drum or sleeve
• Increases heating of muscle
• Less heating of connective tissue

Question 20

Capacitive Diathermy

Answer 20

1. series
   - treated area between plates
   - High impendence tissue (fat)
2. Parallel
   - both plates over treated area
   - lower impedance tissue (muscle)

Question 21

What 2 things happen when SWD works?

Answer 21

1. there is an increase in the random motion and kinetic energy among atoms, ions, and molecules
2. eddy current

These result in thermal and mechanical effects

Question 22

SWD Continuous

Answer 22

• Energy Absorption
• Increased molecular average kinetic energy
• Thermal heat effect
• increased cell metabolism and function
• Enhancement of soft tissue healing

Question 23

SWD Pulsed

Answer 23

• energy absorption
• Alteration of cell ion-binding properties, protein synthesis, and ATP production
• Athermal effect
  -Increased cell metabolism and function
• enhancement of soft tissue healing

Question 24

Indications for Diathermy

Answer 24

1. Pain relief, especially over large areas of the body such as the low back
2. Relaxation of muscle spasm
3. nonacute inflammation
4. soft tissue tightness, contractures, and joint stiffness
5. To increase blood flow to extremities by heating the low back
6. Pelvic inflammatory disease
7. To promote healing of herpes zoster vesicles

Question 25

Diathermy Contraindications

Answer 25

1. metal on, in or near the patient 2. Chest/trunk with pacemaker or ICD 3. Pregnant or who may be pregnant 4. use of thermal over acute inflammation 5. active bleeding 6. eyes or testes 7. over cancerous tissues 8. hemophillia 9. mentally confused or unconscious

Question 26

Diathermy Precautions

Answer 26

1. thin soft tissue, bony prominences 2. growing epiphyses 3. uncooperative patients 4. Over moist clothes, dressings, or accumulations of perspiration 5. Medical electrical devices 6. Obese 7. Over the low back or pelvis in woman who are menstruating

Question 27

PSWD Parameter's at Nonthermal

Answer 27

1. Indications= acute trauma, nonoticeable inflammation, edema reduction, cell repolarization and repair 2. pulse width= 65 microseconds 3. pulse rate= 100-200 pps 4. Average watts= N/A

Question 28

PSWD Parameters at 1°C Mild warmth

Answer 28

1. Indications= Subacute inflammation 2. Pulse width= 100microseconds or 200 3. Pulse Rate = 800pps or 400 pps 4. Average Watts=12

Question 29

PSWD Parameters at 2°C Moderate warmth

Answer 29

1. Indications= Pain reduction, muscle spasm, chronic inflammation 2. Pulse width= 200 microseconds or 400 microseconds 3. Pulse Rate =800pps or 400 pps 4. Average Watts=24

Question 30

PSWD Parameters at 4°C Vigorous Heating

Answer 30

1. Indications= Stretching collagen rich tissues 2. Pulse width=400 microseconds 3. Pulse Rate = 800pps 4. Average Watts=48

Question 31

Indications for hydrotherapy

Answer 31

-Pain - Arthritis - Wounds - Cardiovascular training - Strength/endurance training

Question 32

Contraindications for Hydrotherapy

Answer 32

1. Impaired sensation 2. severe cardiopulmonary disorders 3. Over bleeding area 4. Urinary incontinence 5. Mental disability

Question 33

What is the evidence of static magnetic field

Answer 33

- 200-500 G has been shown effect of decreasing pain associated with postpolio syndrome and diabetic neuropathy - knee arthritic pain when using high strength 720-1900Gs - Most manufactures cite references from electromagnetic studies and claim the effect of static magnets