Ch 8 - Physical Modalities Flashcards

1
Q

What are examples of physical modalities?

A
  • Thermotherapy (heat and cold modalities)
  • Hydrotherapy
  • Light therapy (ultraviolet [UV] radiation, laser)
  • Electrotherapy
  • Manual therapy (traction, therapeutic massage, manipulation, mobilization)
  • Pressure
  • Acupuncture
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2
Q

What is an outcome of thermotherapy?

A

Combined use of heat and stretching has been shown to significantly increase tendon extensibility

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3
Q

What are contraindications of heat therapy?

A
Ischemia
Bleeding disorders
Impaired sensation
Inability to communicate
Malignancy
Acute trauma or inflam
Scar tissue
Edema
Atrophic skin
Poor thermal regulation
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4
Q

What does heat do to scar tissue?

A

Inadequate vascular supply can lead to ischemic necrosis

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5
Q

What is conduction?

A

Transfer of heat between two bodies at different temperatures through direct contact

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6
Q

What is convection?

A

Transfer of heat occurs by fluid circulation (typically liquid or gas) over the surface of a body

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7
Q

What is conversion?

A

Heat transfer occurs through conversion of electromagnetic radiation (nonthermal energy) into heat energy

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8
Q

What is Superficial heat?

A

Radiant heat (infrared lamps)

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9
Q

Where is US absorption greatest?

A

Absorption (heating) is greatest at the bone–muscle soft-tissue interface

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10
Q

What are indications of US?

A
  • Bursitis
  • Tendinitis (calcific tendinitis)
  • MSK pain
  • Degenerative arthritis and contracture
  • Small joints used underwater but only if water is degassed
  • Subacute trauma
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11
Q

What are contraindications of US?

A
  • General heat CI
  • Near brain, cervical ganglia, spine, laminectomy sites
  • Near the heart, reproductive organs
  • Near pacemakers
  • Near tumors
  • Gravid or menstruating uterus
  • At infection sites
  • On contact lenses, eyes
  • Skeletal immaturity
  • TKA or TKA prostheses with methyl methacrylate or high density polyethylene
  • Arthroplasties
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12
Q

What is the frequency of US for treatment?

A

0.8 to 1.1 MHz

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13
Q

What is the frequency of US for treatment of tendinits/bursitis?

A

1.2 to 1.8 W/cm2 (0.5 to 2.0 W/cm2 range)

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14
Q

What is the duration of US treatment?

A

5 to 10 minutes per site

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15
Q

What is Phonophoresis?

A

US to drive medications through the skin by increasing cell permeability

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16
Q

What is Shortwave diathermy?

A

Produces deep heating through the conversion of radio wave electromagnetic energy to thermal energy

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17
Q

What is MC frequency of Shortwave diathermy?

A

27.12 MHz

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18
Q

What does Shortwave diathermy provide?

A

Heat over a larger area as well as deep heat to 4 to 5 cm depth

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19
Q

When is the Inductive coil method indicated?

A

Heat to more superficial muscles or joints with minimal superficial tissue is desired

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20
Q

What are indications for Shortwave diathermy?

A
  • Muscle spasms (especially low back)
  • Myalgia
  • Refractory pelvic inflammatory disease
  • Chronic prostatitis
21
Q

How does cold decrease spasticity?

A

– Dec muscle spindle activity—dec firing rates of Ia and II afferent fibers
– Dec Golgi tendon organ activity—dec firing rates of Ib afferent fibers

22
Q

What is cold evaporation used for?

A

Spray-and-stretch techniques to treat myofascial and musculoskeletal pain

23
Q

What are effects of UV radiation on wounds?

A

Increased vascularization of wound margin

24
Q

What are indications of UV radiation treatment?

A

Psoriasis treatment—utilizes Goeckerman’s technique, where a coal–tar ointment is applied to the skin prior to UV treatment

25
Q

What are precautions of UV radiation treatment?

A

Scars

Atrophic skin

26
Q

What are the doses of UV radiation treatment?

A

minimal exposure time required to cause erythema on the volar surface of the forearm—measured in minimal erythema dosage (MED)

27
Q

What % of TENS unit pain control is from placebo effect?

A

30-35%

28
Q

What is the proposed mech of pain control with TENS unit?

A

Gate control theory

29
Q

What is the most effective type of TENS?

A

High-frequency, low-intensity stimulation

30
Q

What are clinical uses of NMES?

A

Strengthens muscles and maintains muscle mass after immobilization

31
Q

What are benefits of NMES?

A

Inc muscle mass, stroke volume (SV), and cardiac output (CO), as well as reduce venous pooling

32
Q

What is iontophoresis?

A

Transdermal delivery system in which a substance bearing a charge is propelled through the skin by a low electrical current

33
Q

What are reflexive effects of massage?

A
  • Reflex vasodilation with improvement in circulation

* Dec in pain by means of the gate control or release of endogenous opiates

34
Q

What are mechanical effects of massage?

A

Assist in venous blood return from the periphery to the central nervous system

35
Q

What is effleurage?

A

Gliding, rhythmic strokes of the hand over the skin in a distal to proximal direction

36
Q

What is Pétrissage?

A

“Kneading” technique in which the muscle tissue is “pinched” with the fingers and lifted from its underlying origin

37
Q

What is Tapotement?

A

Percussion

38
Q

What is Friction massage?

A

Prevents adhesions in acute muscle injuries and breaks adhesions in subacute and chronic injuries

39
Q

What is Soft-tissue mobilization?

A

Forceful massage of the fascia-muscle system

40
Q

What is Myofascial release?

A

Prolonged light pressure is applied in specific directions of the fascia system to stretch focal areas of muscle or fascial tightness

41
Q

What is Acupressure?

A

Finger pressure is applied over trigger points or acupuncture points to decrease pain

42
Q

What is Thrust?

A

Impulse, high velocity, low amplitude, final activating force is from the operator

43
Q

What is Articulation?

A

Low velocity, high amplitude

44
Q

What is Muscle energy?

A

(direct isometric type): Patient contraction is the final activating force.

45
Q

What is Direct myofascial release?

A

Tissue is held in a loaded, stretched position until muscle is released

46
Q

What is Vertebral joint distraction?

A

Elongation of the cervical spine of 2 to 20 mm; can be achieved with 25 pounds or more of tractive force

47
Q

What are contraindications of cervical spine traction?

A
  • Cervical ligamentous instability
  • Infectious process of the spine
  • Cervical spinal stenosis with significant cord compromise
  • Atlantoaxial subluxation with spinal cord compromise
  • Vertebrobasilar insufficiency
48
Q

What amount of traction is needed for the cervical spine?

A

> 25 lbs

49
Q

What amount of traction is needed for the lumbar spine?

A

> 50 lbs