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AT 552: Modalities > Deep Heat: US and Diathermy > Flashcards

Deep Heat: US and Diathermy Flashcards

1
Q

Therapeutic Ultrasound

A
  • Converts electrical energy to acoustical energy
  • Thermal and non-thermal effects
  • Frequencies between 1MHz-3MHz
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2
Q

Ultrasound Principles: Transducer

A

the head that converts one form of energy to another

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3
Q

Ultrasound Principles: Piezoelectric crystal

A

-A crystal capable of contracting and expanding “piezoelectric effect”

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4
Q

Reverse Piezoelectric effect

A

-as the AC reverses polarity, the crystal expands and contracts, producing ultrasound energy

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5
Q

Effective Radiating Area (ERA)

A
  • Area of the sound head that produces ultrasonic waves
  • Expressed in cm^2
  • Energy output and Temp are greater at center
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6
Q

Beam Profile

A

-Multiple waves emerge uniformly, close to head and then become less consistent farther away (Spatial peak intensity)

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7
Q

Beam Nonuniformity Ratio (BNR)

A
  • The consistency of the US output
  • Ratio between the highest intensity in an US beam and the output reported on the meter
  • 1:1 ideal, 8:1 unsafe
  • Lower BNR reduces hot spots and reduces risk of periosteal pain; must keep the US head moving
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8
Q

FDA Labeling Requirements

A
  1. Output frequency
  2. Effective Radiating Area (ERA)
  3. Beam Nonuniformity Ratio (BNR)
  4. Beam profile
  5. Date of last service/calibration
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9
Q

Sound Energy Absorption in Tissues

A
  • Tissues with higher protein density have higher rate of absorption: Tendons, ligaments, muscle tissues absorb high amount of energy
  • Blood and fat have high water and absorb little US energy
  • Cartilage and bone are at high end of absorption spectrum but is likely to reflect US due to the surface
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10
Q

US Parameters: Frequency

A
  • Mainly use 1-3 Megahertz (1,000,000 cycles per second)
  • 1MHz = low
  • 3MHz = high
  • Determines depth of treatment which is INVERSELY related to frequency
  • 3MHz is more superficial(2cm)
  • 1MHz is deep tissue(4cm>) and heating effects last longer
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11
Q

Dosage (Intensity)

A
  • Watts/surface area (W/cm^2)
  • Higher dose means higher amount of sound energy delivered to the tissues in less time
  • Longer tx time needed for lower intensities
  • Common: 1.5 w/cm^2
  • Greater than 2.5-3 w/cm^2 may cause tissue damage
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12
Q

Tx Time and Thermal effects

A
  • Most effective parameters for increasing muscle temp = increased by 4 degrees celsius or greater
  • RX time 5-10 min (no less than 3min)
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13
Q

Treatment Area

A
  • No greater than 2-3 times the ERA

- Move in slow manner to prevent hot spots

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14
Q

Coupling Methods

A
  1. Direct coupling: Gels made of distilled water and non-reflective material to increase viscosity
    • Move sound head approx 4cm/sec
  2. Pad(bladder) coupling: formed from US gel and packed tightly in order to hold shape
    - Advantages: conforms to irregular shaped areas and limits the size of tx area allowing more energy to be transmitted
  3. Immersion: To treat irregular areas (1 inch away from area at 90 degree angle)
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15
Q

Duty Cycle: Continuous vs. Pulsed

A

Continuous: thermal effects
Pulsed: non thermal effects at cellular level

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16
Q

Thermal Effects: Mild heating

A

-1 degrees C results in increase metabolic activity, initiation of inflammatory process

17
Q

Thermal Effects: Moderate Heating

A

-2-3 degree C results in increase of blood flow, decrease in pain, muscle spasm and chronic inflammation

18
Q

Thermal Effects: Vigorous heating

A

-4 degree C results in improved viscoelastic properties of collagen

19
Q

Non-thermal Effects: Stable Cavitation

A

-rhythmic contraction and expansion of gas bubbles; facilitates fluid movement and membrane transport

20
Q

Non-thermal Effects: Unstable cavitation

A

-The formation of bubbles at the low pressure part of the US cycle; results in bubble collapse and tissue damage

21
Q

Non-thermal Effects: Acoustical Microstreaming

A
  • Unidirectional movement of fluids along the boundaries of cell membranes
  • Increases Sodium and calcium permeability at cell membrane
22
Q

US/E-Stim

A
  • Treats: trigger points and muscle spasms
  • Parameters: Thermal US and motor level E-stim
  • Transducer head and dispersive pad
23
Q

Phonophoresis

A

-US is used to deliver a medication via a safe, painless, noninvasive technique

24
Q

Short Wave Diathermy

A

-Therapeutic generation of local heating by high frequency electromagnetic waves

25
Q

SWDiathermy: Advantages

A
  1. thermal effects similar to US but effect deeper tissue
  2. Heats larger area of tissue
  3. Doesn’t reflect from bone so less likely to create hot spots
  4. Pulsed current can create thermal effects as well, heat retained 3 times longer
26
Q

SWDiathermy: Disadvantages

A
  1. Expensive
  2. Only treats one patient at a time
  3. Potential for burns
27
Q

Pulsed SWD

A
  • Heats deep tissue

- Depths of 3-5 cm via high frequency current

28
Q

SWD: Induction field generators

A
  • Places patient in electromagnetic field
  • Produce greatest heat within the muscle directly beneath the coil
  • Induction cable or Induction drum
29
Q

SWD: Capacitive Field Generators

A
  • Body is actually placed in the electric field; part of circuit between 2 electrodes of opposite charge
  • Tissues with greatest resistance create most heat as current flows through path of least resistance
  • Not recommended for pts with thick adipose tissue
30
Q

Indications for Traction

A
  1. HNP (prolapse, protrusion, extrusion)
  2. Facet impingement/malalignment
  3. Facet joint hypo mobility
  4. DDD/DJD
  5. Stenosis (central or lateral)
  6. Muscle spasm
31
Q

Types of Traction

A
  1. Manual - more specific to segment (cervical)
  2. Positional - Ideal for localizing segment
  3. Mechanical
  4. Bed Traction-pulleys on bed
  5. Cottrell 90/90 - Posterior tilt; pt pulls on rope to increase post P tilt = good for lateral stenosis, not HNP
  6. Inversion boots
  7. Home doorway
32
Q

Lumbar Traction Technique

A

-Measurabel separation of lumbar segments from 80-200 lbs
-Traction force of 1/2(never more) body weight is needed on slip table
-Begin at 25-50 lbs then increase by 5-15 lbs per session
Duration: 5-10mins first session; then 20-30 minutes

33
Q

Cervical Traciton: Position

A
  • Mid cervical(C2-5): 10-20 deg
  • Lower(C5-7): 25-30 degrees
  • 0-5 degrees for upper c spine
  • Max separation at approx 24 degrees of flexion
34
Q

Cervical Traction Technique

A
  • 25-40 lbs of force is necessary to demonstrate a measurable change in Cervical spine
  • Seperation of atlanto-occipital joint with 10 lbs of traction
35
Q

Cervical Traction: Force

A

-Start at 8-10 lbs
-Nerve root or facet 20-30 lbs
-Disc, soft tissue stretch: 12-15 lbs
-Increase at 3-5 lbs per session
-Do not exceed 2x weight of pts head (~30lbs)
Duration:
-HNP = 60/10, 5-10 mins
-Joint/muscle = 30/10, 10-15 mins

36
Q

Contraindications of Traction

A
  • Acute Injuries
  • Unstable spine
  • Vertebral fxs or dislocations
  • Rheumatoid arthritis
  • Vertebral artery problems or vertigo
  • Ankylosed (natural fused) segments
  • Pregnancy for lumbar
  • Recent surgery to ab or Tspine
  • Fused spine
  • Osteoporosis
  • Cancer
  • Local infection

AT 552: Modalities (6 decks)

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