class five: modalities Flashcards by VB VB

what increases with moist heat application

vasodilation

metabolic rate

think of a dog in a hot care

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what does metabolic rate mean

the rate in which your body burns calories

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what decrease with application of moist heat

muscle activity

blood to the internal internal organs

blood flow to resting muscle

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what increase with application of cold pack

joint stiffness

pain threshold

muscle activation

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what decrease with application of clod pack

collagen extensibility

blood flow

capillary permability

local metabolism

spaticity

nerve conduction velocity

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what is the time for prolonged ice in order to treat spatiscity

25 - 30 min

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how can ice treatment create both muscle activation and decreased spaticity

short icing vs prolonged iceing

prolonged ice is use to treat spas

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what temp should ice pack be stored

25 F

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do we want our skin to be blanchable

yes - if not there is an injury like pressure sore or burn

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with prolonged icing do we experience vasodilation or constriction

vasodilation

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what should be the temp hot pack are kept

158 -167 F

160 - 170

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how many layers of toweling should we have for hot packs

6-8

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when does hot pack heat peak

5 min

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how long should hot pack treatment time be

20-30 mins

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what temp should cold pack be kept at

25 F

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how long should cold pack treatment take

10-20 min

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how often can cold pack treatment be places

every 2-3 hours

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how many layers is the the terry cloth cover when new

4-6

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what are the stages of cold

CBAN

cold
burn
aching
numbness

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what are contraindication for superficial thermo modalities

Arterial disease
Bleeding or hemorrhage
Over an area of compromised circulation
Over an area of malignancy
Thrombophlebitis
Impaired sensation or mentation
Infrared irradiation of the eyes

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what is Thrombophlebitis

inflammation of the wall of a vein with associated thrombosis, often occurring in the legs during pregnancy.

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Superficial Cryotherapy: Contraindications

Cold hypersensitivity
Cold intolerance
Cryoglobulinemia
Paroxysmal cold hemoglobinuria
Raynaud’s phenomenon
Over-regenerating peripheral nerves
Circulatory compromise

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what is Cryoglobulinemia

medical condition in which the blood contains large amounts of pathological cold sensitive antibodies called cryoglobulins – proteins that become insoluble at reduced temperatures.

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what does pulse freq mean

in 1sec (period of time) how many pulse are there

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what is more comfotable higher or lower pulse freq

higher is more comfortable - more vibration feeling

what is pulse duration

how long is how long the pulse are lasting

what is more comfortable longer or shorter pulse duration

shorter pulse duration is more comfotable

what is amp in estim

this is the insensity - this is what we turn up

what is ramp time

the time it take to get to the highest amp longer ramp time slower to the top - feels better

for muscle strengthening - pulse freq

35-80 pps

for muscle strengthening -pulse duration

150-200 small muscle 200-350 large muscle

for muscle strengthening - amp

to 10%of MVIC in injured 50% or more if not injury

for muscle strengthening - on and off

(on) 1:5 (off)

for muscle strengthening - ramp time

2 secs

for muscle strengthening - treatment time

10-20 mins

what kind of eletrical stimulation do we use for wound care

High-Voltage Pulsed Galvanic Current

what is the Negative electrode used for in High-Voltage Pulsed Galvanic Current

used to promote healing of the inflamed or infected wounds. - = bad

what is the positive electrode used for in High-Voltage Pulsed Galvanic Current

used to promote healing of the wounds without inflammation.

for High-Voltage Pulsed Galvanic Current - where can the electrodes be placed

placed in or around the wound area.

what is the treatment time for High-Voltage Pulsed Galvanic Current -

At least 5 days/week with treatment sessions lasting 45 to 60 minutes.

positive - High-Voltage Pulsed Galvanic Current

pluse freq: 100-105 pulse duration: 100 amp: enough to promote comfortable tingling treatment time : 45-60 min

negative - High-Voltage Pulsed Galvanic Current

pluse freq: 100-105 pulse duration: 100 amp: enough to promote comfortable tingling treatment time : 45-60 min

what is iontophoresis

the is a type of estim that delivers a type of medication into the skin paired with different ions

what are the negative ions for ionphoresis

ISAD idoine salicylate acetate dexamethasone

do big electrodes or small electrodes feel better

big electrodes feel better

US - intensity

̶Amount of energy delivered per unit area (W/cm2) ̶Dependent on treatment goal like amp

US - freq.

̶Cycles per second (Hz, 1 or 3MHz)

US - Duty Cycle

̶On Time / (On Time + Off Time) ̶Pulsed or continuous

US - freq 1 HZ

this is for a deep tissue 1 > D

US freq 3 HZ

this is for a superficial tissue 3 > S

what is a periosteal burn

occurs when the thin membrane around the bone becomes overheated seen with ultra sound

100% duty cycle is for what

soft tissue shortenting and pain

what is a 20% duty cycle for

delayed issue healing and prolonged inflammation

acute injury - thermal or non thermal US

nonthermal - this issue is already warm do not add heat to it

what are conractindication of estim

implanted devices - pacemaker pregnacy - abd or LB broken bones corotid sinus thrombosis

what are thrombosis

local coagulation or clotting of the blood in a part of the circulatory system.

is cancer a precaution to estim

yes not a contrindication

what is EMG biofeedback

a technique that uses electrodes to monitor muscle activity and provide feedback to help patients learn to control their muscles

EMG biofeedback - close electrodes

muscle relaxation low sensitivity

EMG biofeedback - far apart electrodes

for muscle reed high sensitivity

when do we do prone lumbar traction

when there is a posterior disc herniation

how much hip flexion for L5-S1 increased space

45-60-deg

how much hip flexion for L3-L4 increased space

75-90 deg

how much weight do we need for joint distraction

50lbs or 50% of body weight

how long is the first lumbar traction session

5-10 min - see how it feel progress up to - 20-30 min sessions

cervical traction - initial weight

7-9 lbs

cervical traction - Disc protrusion, spasm, elongation

11-15 lbs

cervical traction - Joint distraction

20-29 lbs (max), or 7% body weight

Mechanical Traction- Contraindications

* Immobilization * Acute injury or inflammation * Joint hypermobility or instability * Peripheralization of symptoms with traction * Uncontrolled hypertension

how do we do estim in a wound

we use saline soaked gauze to put it in the wound

ISAD reason why they are used

SCAM I - scar S - anagelsia A - calcium deposits D - MSK inflammation

what is acuputure tens used for

management of soft tissue pain

what is brief intense tens used for

counter irraidant - distract the paitient for the stimulant

what is noxious tens used for

very uncomfortable this is the must uncomfort the patient can take trigger point - think of head ache

what is accuputure tens used for

when patient has gotten used to the convential tens feeling

what percentage is considered continous US

100%

what percentage is considered pulsed US in terms of duty cycle

99% and lower

when do we use pulse vs continous

pulse: up to 3 weeks continuous: greater the 3 weeks

pulse freq - refers to what in terms of US

depth

what is the depth in cms for 1Hz

up to 5 cm

what is the depth in cm's for 3 HZ

1-2 cm

what can we do to avoid hot spot with US

keep it moving add more medium decrease intensity larger treatment area continuous > pulsed 1 Hz > 3 Hz