class five: modalities Flashcards
what increases with moist heat application
CO
vasodilation
HR
RR
metabolic rate
think of a dog in a hot care
what does metabolic rate mean
the rate in which your body burns calories
what decrease with application of moist heat
muscle activity
BP
blood to the internal internal organs
blood flow to resting muscle
SV
what increase with application of cold pack
joint stiffness
pain threshold
muscle activation
what decrease with application of clod pack
collagen extensibility
blood flow
capillary permability
local metabolism
spaticity
nerve conduction velocity
what is the time for prolonged ice in order to treat spatiscity
25 - 30 min
how can ice treatment create both muscle activation and decreased spaticity
short icing vs prolonged iceing
prolonged ice is use to treat spas
what temp should ice pack be stored
25 F
do we want our skin to be blanchable
yes - if not there is an injury like pressure sore or burn
with prolonged icing do we experience vasodilation or constriction
vasodilation
what should be the temp hot pack are kept
158 -167 F
160 - 170
how many layers of toweling should we have for hot packs
6-8
when does hot pack heat peak
5 min
how long should hot pack treatment time be
20-30 mins
what temp should cold pack be kept at
25 F
how long should cold pack treatment take
10-20 min
how often can cold pack treatment be places
every 2-3 hours
how many layers is the the terry cloth cover when new
4-6
what are the stages of cold
CBAN
cold
burn
aching
numbness
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
what is Thrombophlebitis
inflammation of the wall of a vein with associated thrombosis, often occurring in the legs during pregnancy.
Superficial Cryotherapy: Contraindications
- Cold hypersensitivity
- Cold intolerance
- Cryoglobulinemia
- Paroxysmal cold hemoglobinuria
- Raynaud’s phenomenon
- Over-regenerating peripheral nerves
- Circulatory compromise
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.
what does pulse freq mean
in 1sec (period of time) how many pulse are there
35
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
