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Fall 2023- Physical Agents > WK9-Hydrotherapy and Compression > Flashcards

WK9-Hydrotherapy and Compression Flashcards

1
Q

List some of the physical properties of water.

A

High specific heat and thermal conductivity.
Buoyancy: upward thrust against gravity.
Resistance: when motion applied downward
Hydrostatic Pressure: equal pressure exerted on your body from all directions under water.

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2
Q

List the physiological effects of hydrotherapy.

A

Cleansing, MSK, CV, Respiratory, Renal, Psychological

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3
Q

What are the cleansing effects of hydrotherapy.

A

Mostly referring to whirlpool

softens materials, such as scars or wounds allowing for debridement of wounds, antimicrobials may be additive

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4
Q

What are the MSK effects of hydrotherapy ?

A
  • Buoyancy decreases weight bearing
  • Resistance provides force for strengthening
  • Hydrostatic pressure increases resting muscle blood flow by 100-225% during immersion of the body up to the neck.
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5
Q

What are the cardiovascular effects of hydrotherapy ?

A

Enhanced venous return as blood is displaced proximally from extremities by hydrostatic pressure

central blood volume increases 60%, cardiac volume by 30% leading to a 30% increase in cardiac output

This results in a slower HR, therefore, RPE should be used to assess effort level.

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6
Q

What are the respiratory effects of hydrotherapy ?

A

Increased work of breathing due to chest wall compression, increased circulation in chest cavity, it becomes harder to get air in

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7
Q

What are the renal effects of hydrotherapy ?

A

increased urine production from increased renal blood flow, increased central blood volume, decreased ADH and aldosterone

increased Na and K excretion in cold water.

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8
Q

What should you inform patients of doing before getting into a pool ?

A

Empty their bladder

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9
Q

Describe the advantages and disadvantages of hydrotherapy for: heating and cooling

A

advantages: perfect contact with skin, allows movement
disadvantages: dependent position ( upright immersion) may aggravate edema.

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10
Q

What are the common uses of water exercise ?

A

increase circulation, muscle strength, joint viscoelasticity, flexibility, ROM, ambulation, coordination, CV conditioning, psychological well being. Leads to decreased pain, muscle spasm, and stiffness.

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11
Q

How does hydrotherapy aid edema control ?

A

Hydrostatic pressure results in increased circulation and renal control, cold water may also vasoconstrict vessels leading to decreased vascular permeability

AVOID HOT WATER IMMERSION WITH EDEMA.

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12
Q

What are the benefits of hydrotherapy for wound care ?

A

accelerates wound healing, facilitates rehydration, softening, and debridement, may improve circulation

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13
Q

What is the general range of temperatures that is appropriate for multiple common disorders?

A

79-90 F

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14
Q

What temperature of water is recommended for patients that would benefit from analgesia, vasodilation, relaxation, and improved connective tissue mobility ?

A

96.2-98.2 F

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15
Q

What temperature of water is recommended for patients with spasticity, MS, or longer immersion times to avoid fatigue and overheating ?

A

86-94 F

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16
Q

What are the contraindications for local and full body immersion for hydrotherapy ?

A

local: maceration around a wound, bleeding

full body: cardiac instability, infectious conditions that may spread through the water, bowel and incontinence, severe epilepsy, suicidality

17
Q

What are the contraindications and precautions for negative pressure wound therapy ?

A

contraindications: necrotic tissue, untreated osteomyelitis, malignancy in the wound, untreated malnutrition, exposed vessels, nerves, or organs, non-enteric and unexplored fistulas, exposed anastomotic sites

precautions: anticoagulant therapy, difficult hemostasis, confusion/disorientation

18
Q

What are some precautions for local immersion and full body immersion in hot water ?

A

local: impaired thermal sensation locally, infection, impaired mentation, recent skin grafts

full body: pregnancy, MS, poor thermal regulation

19
Q

What are some precautions for full body immersion of any temperature ?

A

confusion, disorientation, alcohol ingestion, limited strength, ROM, balance, endurance, urinary incontinence, medications, fear of water, respiratory issues.

20
Q

What are the effects of compression?

A

improves venous and lymphatic circulation
limits the shape and size of tissue
increases tissue temperature
Reduces edema
Prevents DVTs through increased blood flow

21
Q

Which is better for the control of venous and lymphatic circulation, static or intermittent compression ? Why ?

A

Intermittent, because it ‘milks’ fluids from proximal to distal vessels, it is more like a pump which mimics the bodies natural pump

22
Q

How does an increase in tissue temperature aid scar formation ?

A

May increase activity of temperature sensitive collagenases

23
Q

What are the clinical indications for external compression ?

A

Edema control, DVT prevention, VI ulcers, residual limb shaping post amp, control of hypertrophic scarring

24
Q

What are some different causes of edema ?

A

Imbalance between hydrostatic and osmotic pressure inside and outside of vessels, venous or lymphatic obstruction, increased capillary permeability, immobility, pregnancy

25
Q

When should you not treat with compression ?

A

When patients edema is due to systemic causes, typically indicates CHF, and compression may worsen situation.

26
Q

What are some contraindications to compression therapy ?

A

ABI <.8
heart failure or pulmonary edema
Recent or acute DVT
obstructed lympathic or venous return
Severe PAD
acute local skin infection
hypoproteinemia
acute trauma/fracture
arterial revascularization

27
Q

What are some common precautions to compression?

A

impaired sensation/mentation
uncontrolled HTN
Cancer
Stroke/ Cerebrovascular Insufficiency
Over superficial peripheral nerves that may be easily compressed.

28
Q

What is the range of compression for DVT prevention ?

A

16-18 mmHg worn for 24h/day

29
Q

What is the range of compression for scar tissue control ?

A

20-30 mmHg

30
Q

What is the range of compression for edema control ?

A

30-40 mmHg

Fall 2023- Physical Agents (9 decks)

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