Basics of Modalities Flashcards
Therapeutic modalities are tools for bringing about a desired ___________ ___________.
therapeutic response
Define Rehabilitation:
restoring to former capacity by providing treatment or therapy.
Proper _________ of the role of modalities depends on an __________ of the overall orthopedic injury rehabilitation process.
Understanding
understanding
“knob-ology”?
just turning knobs and buttons while not interested in knowing why they are doing it. Modalities is not all evidence based practice.
Application usually precedes theory
Clinical Decision Making: 4 main sources when making a decision
tradition
experience
theory
research
Tradition
how it has always been done
Experience
result of success and failures with similar patients and similar conditions
Theory
best guess at what is going on, based on logical evaluation of the evidence
Research
result of scientific investigation (test theories)
When selecting criteria for rehabilitation keep in mind…
- Correct diagnosis
- Definite concept of pathological &physiological changes associated with injury (create problem list)
- Outline treatment plan (STG, LTG)
- Understand Modality’s effects, indications, contraindications
- Match goals with modality that will help achieve it
Myths about rehab: True or false, treat injuries, then rehabilitate them?
False belief. Rehabilitation is the whole process of returning an individual to pre-injury levels…we treatment with modalities is part of the rehab process. (not something that precedes it)
Myths about rehab: True or false, rehabilitation = reconditioning?
False, rehabilitation includes promotion of healing and pain relief (in addition to conditioning activities)
Example: cannot condition someone with a torn tendon until it is healed. Can condition because pain inhibits strength, flexibility, etc.
Myths about rehab: True or false, rehab is primarily physical?
False, most clinicians & patients will tell you that rehabilitation is 75% mental and 25% physical. Direct connection exists between mind and body. (some pt seem to “give up” after injury, others must be held back)
Types of modalities?
Acoustic Modalities
Electromagnetic Modalities
Acoustic Modalities
Ultrasound
Electromagnetic Modalities
(radiation=radiant energy=EM waves=EM radiation
- Electrical stimulation currents (including iontophoresis
- Biofeedback
- Shortwave diathermy
- Infrared Modalities
- Ultraviolet Therapy
- Laser/light Theryapy
Classifications of modalities
Cryotherapy Thermotherapy Hydrotherapy Electrotherapy Light Therapy Mechanotherapy Exercise
Cryotherapy
Description: Use of cold (~ 32-70F, 0-21C)
Ice massage, ice packs, immersion, cold whirlpool, vapocoolant sprays
Thermotherapy
Description: Use of superficial and deep heat (~98-109F, 37-43C)
Moist heat packs, warm whirlpool, paraffin wax baths, ultrasound, diathermy, ultraviolet
Hydrotherapy
Description: Application of water
Whirlpool, immersion
Electrotherapy
Description: Use of electricity
TENS, NMES, iontophoresis, Diathermy
Light Therapy
Description: Use of electromagnetic radiation.
Laser, light theryapy, infrared
Mechanotherapy
Description: Use of motion, force, pressure.
Massage, mobilization, intermit, compression, CPM, traction, whirlpool, ultrasound
Exercise
Description: Performed by patients
Various (cryokinetics)
Electomagnetic Spectrum: What is the difference between Infrared Radiation and Ultraviolet Radiation?
Infrared region: produces heat, located beyond visible red region.
Ultraviolet region: produces chemical changes, located beyond the visible violet region
Common Theoretical Characterististcs of EM Radiation
- They all travel at an equal velocity
- The basic unit of radiant energy is a PHOTON
- They travel in a straight line until they come in contact with some other surface.
* Reflected, Refracted, Absorbed, or Transmitted
Describe the characteristics of Wavelengths & Frequency
Inverse relationship
Frequency - # of cycles per sec (Hz or MHz)
Wavelength - distance between one wave and the next
Velocity = (wavelength)(frequency)
3x108m/sec (speed of light)
Depths of electromagnetic modalities?
E-stim = Anywhere btw electrodes MW diathermy = 5cm SW diathermy = 3cm Laser = 10-15mm everything else 1cm ultrasound = 1mm
What are Photons
“packets” of energy
The amount of energy in a photon is a function of the frequency of the EM wave.
Greater Frequency = shorter wavelength (has more energy
lower frequencies have no therapeutic values
The four different ways EM radiation is transfered/moved
Reflection
Refraction
Transmission
Absorption
Reflection
As waves hit substance, they bounce back. No penetration into substance.
Refraction
Waves bend as they pass through substance
Transmission
Wave is transmitted through substance. Depth of penetration is dependent on energy waves.
Absorption
Waves are absorbed by tissues and turned to heat
TRUE or FALSE
Radiations that have the shortest wavelengths have greatest depth of penetration.
False
longest
example: US
Name the Laws covering the effects of EM radiation
Arndt-Schultz Principle
Law of Grothhus-Draper
Cosine Law
Inverse Square Law
Arndt-Schultz Principle
No reaction or change can occur in the tissues if the amount of energy absorbed is insufficient to stimulate the absorbing tissue.
Goal: deliver sufficient energy to stimulate tissues to perform normal function. (not to much though)
Law of Grothhus-Draper
The greater the amount of energy absorbed, the less penetration through the tissue.
If therapeutic energy is not absorbed by superficial tissues, it will penetrate deeper
Cosine Law
Radiant energy is more easily transmitted to deeper tissues if source of radiation is at a right angle to area being radiated.
Important for ultrasound
Sun-bathing example, less EM energy will be reflected.
Inverse Square Law
The intensity of the radiation striking a surface varies inversely with the square of the distance from the source. Closer you are to the skin the more energy is passed.
Important for Diarthermies and ultraviolet light
Acoustic waves vs EM waves
Transmit waves transmit BEST through solids and not at all in vacuums. Inverse for EM.
Transmitted by collisions. EM waves slowed by collisions.
Accoustic waves do not travel as fast as EMS waves
