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Principles Of Athletic Training > Chp 15. Using Therapeutic Modalities > Flashcards

Chp 15. Using Therapeutic Modalities Flashcards

1
Q

Examples of thermal energy modalities

A

Cryotherapy and thermotherapy

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2
Q

Examples of electrical energy modalities

A

Electrical stimulating currents, iontophoresis

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3
Q

Examples of electromagnetic energy modalities

A

Shortwave and microwave diathermy, infrared lamps, ultraviolet light therapy, low power lasers

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4
Q

Examples of sound energy modalities

A

Ultrasound, extracorporal shockwave therapy

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5
Q

Examples of mechanical energy modalities

A

Intermittent compression, traction, massage

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6
Q

List the desirable therapeutic effects of heat

A

-increased extensibility of collagen tissues
-decrease joint stiffness
-reduce pain
-relieving muscle spasm
-reducing inflammation, edema and exudates in postacute phase of healing
-increased blood flow

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7
Q

Heat and cold relieving pain through what pain theory?

A

Gate control theory

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8
Q

Ischemia

A

Reduced blood flow

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9
Q

List the mechanisms through which heat assists w/the healing process

A

-raising temp
-increased metabolism
-reduce oxygen tension
-lowering pH level
-increased capillary permeability
-releasing bradykinin and histamine which cause vasodilation

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10
Q

Conduction

A

Occurs when heats transferred from a warmer object to a cooler one

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11
Q

When using heat, to avoid tissue damage what should the temperature not exceed? And when in close contact?

A

-shouldnt exceed 116.6 F
-close contact w/medium shouldnt exceed 113 F for 30 mins

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12
Q

Convection

A

Refers to transference of heat through the movements of liquid and gases

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13
Q

Give an example of a modality that uses both convection and conduction

A

Whirlpool
-conduction-skin contact w/higher water temp
-convection- water swirling around skin surface

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14
Q

Radiation, example

A

Process where heat energy is transferred from one object through space to another; shortwave diathermy

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15
Q

Does moist or dry heat cause a greater indirect increase in deep tissue temperature? Which can be tolerated at higher temps moist or dry?

A

-moist heat causes great indirect increase in deep tissue temp
-dry heat can be tolerated at higher temps

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16
Q

Hydrocollator water kept at?

A

Kept at 160-170F, retains heat for 20-30 mins

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17
Q

Hydrocollator indications

A

Relaxes and reduces the pain-guarding-ischemia-hypoxia-pain cycle

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18
Q

Hydrocollator limitations

A

-deeper tissues like muscle arent heated bc of subcutaneous fat
-increased blood flow to skin, cools and carries away heat externally applied

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19
Q

Hydrocollator application

A

-place cover and towels over pack, create space between skin and hot pack
-15-20 mins
-patient shouldnt lie on the pack

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20
Q

Whirlpool indications

A

Reduces swelling, pain, and muscle spasm

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21
Q

Whirlpool application

A

-as volume of body part increases, temperature should decrease, not exceed 104F for full body
-water jet placed on side of tank not directly over injury (acute phase mainly)
-ranges >55F-110F
-when streams directed at injury, should be 8-10 in away
-20-30 min

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22
Q

Whirlpool special considerations

A

-whirlpool emptied and disinfected (inside and out) after every patient
-all outlets have ground fault interrupters (GFIs)
-on/off switch should be far from whirlpool

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23
Q

Paraffin bath equipment parameters

A

-maintain temp of 126-130F
-mixture of 25kgs of paraffin wax to 1 liter of mineral soil

24
Q

Paraffin bath indications

A

-chronic injuries in angular areas such as wrist, hands, ankle, feet,elbows

25
Q

Paraffin bath application

A

-dipped and wrapped in plastic bag or dipped and reimmersed 8-10 times
-clean body parts before use
-remove wax and add back into mixture

26
Q

Paraffin bath special considerations

A

-avoid open wounds/areas of poor circulation
-mixture replaced every 6 months

27
Q

POLICE stands for

A

Protection, optimal loading, ice, compression, elevation
(use ice day of injury up until 2 weeks after)

28
Q

What factors affect the extent to which the tissue is cooled?

A

-cold medium applied
-duration of cold exposure
-conductivity of area being cooled

29
Q

Is fat or muscle tissue a better cold conductor?

A

Muscle tissue, muscle has a higher water content

30
Q

Hunting response

A

When tissue has been cooled for 30 minutes, intermittent periods of vasodilation occur lasting 4-6 mins

31
Q

Phsyiological effects of cold

A

-lower metabolic rate, as a result decreases muscle guarding
-reduces swelling in acute phase
-produces vasoconstriction
-decreases free nerve ending excitability, peripheral nerve exictability

32
Q

What factors affect nerve fiber response to cold? What nerve fibers are most and least sensitive to cold?

A

-depends on myelination and diameter of the fiber
-most sensitive to cold: gamma efferent myelinated fibers to muscle spindles
-next most sensitive: alpha motor nerves
-least sensitive: unmyelinated pain fibers and sympathetic nerves

33
Q

Describe the sensation a patient will feel during cold application

A

CBAN
Cold, burning, aching, numbness

34
Q

Why do the effects of cold last longer than heat?

A

Fat acts as an insulator against rewarming

35
Q

In which temperatures does frostbite occur?

A

26.6-24.8 F

36
Q

Raynauds phenomenon

A

Medical condition in which the spasm of small arteries causes reduced blood flow to end arterioles. Usually in the fingers and less commonly in toes

37
Q

Nerve palsy

A

Occurs when cold is applied to a part that has motor nerves close to it like the peroneal nerve at the fibular head. Condition usually resolves on its own

38
Q

Cryokinetics

A

Combination of cryotherapy and exercise. Goal is to numb the injured part and then work toward achieving normal ROM through progressive active exercise

39
Q

Cryokinetics application

A

-Apply for 12-20 mins so that area is numb
-proceed with exercise
-reapply ice for 3-5 mins so area becomes numb again, and perform exercise
-exercises should be performed when area is numb and progress in intensity and be pain free

40
Q

Depolarization of nerves

A

When an electrical current is applied to nerve tissue as a sufficient intensity and duration and reaches that tissues excitability threshold it results in membrane depolarization or firing.

41
Q

As intensity and duration of electrical stimulation increase what nerve fibers will depolarize first?

A

First-sensory fibers, then-motor fibers, last-pain fibers

42
Q

Direct current; used for

A

-AKA monophasic, only a single phase of current that flows in one direction only from the positive pole to the negative pole
-used for pain modulation, muscle contraction, or to produce ion movement

43
Q

Alternating current; used for

A

-aka biphasic, one phase the current flows towards positive pole and in the second phase the current flows towards the negative pole, current reverses the direction of flow each cycle
-used for pain modulation, muscle contraction

44
Q

Pulsatile current; used for

A

-aka polyphasic current, groups of phases are interrupted for short periods of time and repeat themselves at regular intervals
-interferential pre-modulated and russian currents

45
Q

Modulation; name the diffrent types of modulation

A

Changing the magnitude or duration of a waveform. Can be continuous, bursts, surging/alternating, direct, pulsatile currents.

46
Q

Continuous modulation

A

Long-duration uninterrupted current, applied often w/a direct current

47
Q

Burst modulation

A

Interpulse interval that briefly interrupts current output, used w/pulsatile currents

48
Q

Surging modulation

A

Current intensity gradually ramps-up to some max amplitude and then gradually ramps down

49
Q

Current intensity; whats low and high and what is each used for?

A

Current intensity is the voltage output
-low: 150V used for causing ion movement
-high: 500v used to stimulate muscle contraction

50
Q

Pulse duration/pulse width

A

The length of time that current is flowing

51
Q

Frequency; units

A

The number of waveforms being emitted by the electrical stimulating unit in 1 second; pulses per second (pps), cycles per ssecond (cps), or hertz (Hz)

52
Q

Polarity

A

Direction of current flow toward either a positive or negative pole

53
Q

When using a large electrode and a small electrode where will most of the current be concentrated?

A

The large pad disperses the current while the small pad concentrates the current (usually small pad is placed close to the nerve/motor point)

54
Q

Indications for electrical stimulation

A

-depolarization of sensory nerves to modulate pain
-depolarization of motor nerve fibers to elicit muscle contraction
-create electrical field in biological tissues to stimulate/alter healing process at the cellular level
-create electrical field on the skins surface to transport ions beneficial to healing process into deeper target tissues (iontophoresis)

55
Q

Electrical stimulation, gate control application; parameters

A

-stimulation of sensory nerves causes the gate to pain to be closed
-if stimulation stops, gate is open and pain returns
-intensity should cause tingling sensation but no muscle contraction frequency set as high as can be to create as much sensory cutaneous stimulation as possible

56
Q

Electrical stimulation, Descending pathway pain control parameters

A

-current intensity should be high approaching a noxious level, pulse duration should be 10 microseconds, frequency
Should be 80 pulses per second

57
Q

Electrical stimulation, opiate pain control, parameters

A

Electrical current placed close to site of pain or acupuncture/trigger points both local and distant from pain area.
-current intensity as high as tolerable, pulse duration as max possible on machine, frequency 1-5 pps

Principles Of Athletic Training (4 decks)

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