DONE: Physical Medicine Flashcards
modality of choice for pain and edema
short wave diathermy: improves edema drainage and reduces pain after soft tissue injury (ankle, sprains, low back pain, and rotator cuff surgery), also improves wound healing
or sine wave
modality of choice for soft tissue healing
short wave diathermy: incisional wounds, pressure ulcers, burn-related injuries, tendon injuries
after surgical wound sites, SWD showed an increase in collagen formation, WBC infiltration, and phagocytosis, tendons showed increase tensile strength
modality of choice for bone healing
short wave diathermy: can accelerate the healing of bone fractures but NOT nonunion acute fractures
modality of choice for sxs of OA
short wave diathermy
contraindications of diathermy
implanted or transcutaneous neural stimulators (including pacemakers), pregnancy, metal implants and jewelry, malignancy, over the eyes, over the testes, over growing epiphyses
modality of choice for adhesions or trigger points
sine wave
modality of choice for muscle spasms, muscular atrophy, trigger points, restricted joint motion, passive exercise
sine wave
modality of choice for denervation, ischemia
sine wave
contraindications of sine wave
over the eye, brain hematoma, fracture, metallic implant, pregnany, pacemaker, cancerous lesion
modality of choice for pain reduction (muscle spasms, muscle exercise and re-education, circulation enhancement and edema reduction)
high voltage galvanism
contraindications of high voltage galvanism
low back or abdomen in pregnancy, neoplasms, pacemakers, over eyes brain or heart, over hemorrhage
modality of choice for stimulation of denervation of muscles, restricted joint motion
low voltage galvanism
modality of choice for arthritis, neuralgia, sprains, and strains
low voltage galvanism
modality of choice for acute and chronic pain
low voltage galvanism
modality of choice for pressure ulcers
low voltage galvanism
modality of choice for excessive scarring
low voltage galvanism
contraindications to low voltage galvanism
abd and pelvis in pregnancy, cancerous lesions, pacemaker, metallic implants, dont treat on a metal table, dont break the circuit suddenly
modality of choice for calcium deposits
acetate iontophoresis (-)
modality of choice for fungal infection
copper iontophoresis (+)
modality of choice for inflammation
dexmethasone phosphate iontophoresis (-)
modality of choice for local anesthetic
lidocaine iontophoresis (+)
modality of choice for muscle relaxant
magnesium iontophoresis (+)
modality of choice for dermal ulcers or wounds
zinc iontophoresis (+)
contraindications to iontophoresis
pacemaker, defibrillator, unstable arrhythmias, electrodes over carotid sinus, venous or arterial thrombosis or thrombophlebitis, pregnancy, malignant tumors, after application of heat/ice/US
modality of choice for pain relief/anesthetic effect
interferential current (stimulates the release of endorphins and blocks the transmission of pain impulses vis pain gate mechanism
modality of choice for tissue healing, swelling, inflammation
interferential current: increased blood flow
modality of choice for weak muscles due to injury
interferential current: muscle stimulation
contraindications to interferential current
recent surgeries, open wounds, abscesses, circulatory conditions, DVT, metal implants, over pacemakers, pregnant women low back or abdomen, local malignancy, fracture, areas of bone fusion
modality of choice for increasing wound healing or protein synthesis for regeneration of bone tissue
microcurrent
modality of choice for increasing lymphatic flow
microcurrent
modality of choice for sprains, strain, contusions
microcurrent
modality of choice for chronic and acute pain
microcurrent
modality of choice for OA
microcurrent
contraindications for microcurrent
pain syndromes without an etiology, pregnancy, pacemakers, metal implants, infected wounds, malignant or benign tumors, eyes, carotid sinus, laryngeal musculature, over thorax/heart
modality of choice for moderate to severe acute pain
TENS
modality of choice for postoperative pain
TENS: can significantly reduce analgesic intake
modality of choice for chronic pain such as OA
TENS: low back pain use still not established
modality of choice for diabetic neuropathy
TENS
contraindications for TENS
pacemaker, defibrillator, unstable arrhythmias, placement of electrodes over carotid sinus, venous or arterial thrombosis or thrombophlebitis, pregnancy (but OK during L/D), malignant tumors, pain control in (muscle/tendon tears, overuse or acute injury that requires healing)
modality of choice for arthritis, chronic low back pain, fractures, peripheral neuropathy, muscle spasm, strains
IR
modality of choice for skin infections
IR
modality of choice for psoriasis
IR, UV radiation
modality of choice for relaxing tissues before other physical therapies
IR
modality of choice for raynauds disease or thrombophlebitis
IR
contraindications to IR
photosensitivity, poor blood flow, hemorrhage, edema, gangrene, sunburn, fair skin, abdomen in pregnancy, eyes, infants, metal
modality of choice for wound healing
UV radiation
contraindications of UV radiation
eyes, skin cancer, pulmonary TB, kidney or liver disease, SLE, fever, photosensitizing meds and supplements, recent XR therapy
modality of choice for healing chronic and acute woulds, pressure ulcers, tendons, and ligaments
lasers and lights
modality of choice for RA
lasers and lights: short term relief of pain and morning stiffness due to reduced inflammayion or changes in nerve conduction/activation. evidence for OA is conflicting
modality of choice for pain associated with diabetic peripheral neuropathy
lasers and lights: more research needed to confirm effectiveness on TBI and AD, but there is strong indication of mitigatin the neurodegeneration cascade
modality of choice for fungal infection/onychomycosis
lasers and lights at 635 nm and 405 nm
contraindications to lasers and lights
direct irradiation of eyes, malignancy, 4-6 mo after radiotherapy, over hemorrhaging regions, over thyroid or endocrine glands, abd area of women or pregnant women
modality of choice before stretching of shortened soft tissue and to reduce pain
US (thermal effects): stretching should be applied during heating by US and maintained for 5-10 minutes after US is removed while tissue is cooling
modality of choice for accelerating healing for dermal ulcers, surgical skin incisions, tendon injuries, bone fractures
US (nonthermal): alters membrane permeability, use very low dose US for bone healing
modality of choice for carpal tunnel syndrome
US: pulsed
contraindications to therapeutic US and phonophoresis
malignant tumor, pregnancy, near joint cement, pacemaker, defibrillator, thrombophlebitis, eyes, reproductive organs
cautions: breast implants, acute inflammation, epiphyseal plates, (high dose) fractures (high dose)
which frequencies of US should be used for 1-2 cm depth and up to 5 cm depth and which intensity should be used with each to produce heat
1-2 cm: 3MHz: 0.5 W/cm2 intensity should produce heat in 2-3 minutes without discomfort
up to 5 cm: 1MHz: 1.5-2.0 W/cm2 intensity should produce heat in 2-3 minutes without discomfort
which form of US duty cycle should be used to increase tissue temperature vs nonthermal effects?
thermal: 100% continuous
nonthermal: < 20% pulsed
how many minutes should therapeutic US be used for, and after how many session should they see progress?
5-10 minutes for thermal or nonthermal
progress seen within 1-3 sessions (but chronic wounds and fractures take longer)
modality of choice for localized inflammation of a tendon, bursa, or joint
phonophoresis
medications used in phonophoresis
corticosteroids (hydrocortisone, dexamethasone), salicylates, anesthetics (lidocaine)
modality of choice to decrease blood vessel distention, lymph drainage, decrease venous stasis, or edema
compression stockings or bandages
modality of choice for sprains, strains, muscle spasms, edema, disc herniation, hypo-mobility, nerve root impingement, compression fractures
traction devices
contraindications to traction devices
acute trauma, cancer, healing fracturs, osteoporosis, acute inflammation, joint instability, spinal cord compression
hydrotherapy of choice for *chronic inflammation and muscle tension
hot applications
hydrotherapy of choice for *acute inflammation, acute traumatic conditions, MSK conditions (arthritis, bursitis), trigger points, immediate treatment of minor burns
cold applications: reduction of inflammation and edema in first 24-48 hours
hydrotherapy of choice for chronic inflammations, *infections, arthritis, pain, sore muscles
contrast applications
contraindications to heat applications hydrotherapy
ischemia, bleeding disorders or hemorrhage, impaired sensation, inability to communicate or respond to pain, malignancy, acute trauma or inflammation, scare tissue, edema, atrophic skin, poor thermal regulation
contraindications to cold applications hydrotherapy
cold intolerance or hypersensitivity (raynauds, etc), arterial insufficiency, cardiac or respiratory involvement, open wounds after 48 hours, cutaneous infection
contraindications to contrast applications hydrotherapy
raynauds, cardiac disease, hypoesthesia
modality of choice for stimulation of liver detox
castor oil
modality of choice for constipation
castor oil
modality of choice for uterine fibroids, PMS cramps
castor oil
modality of choice for non-malignants ovarian cysts
castor oil
contraindications to castor oil
malignant abdominal tumors, bleeding, pregnancy
modality of choice for mobilization of intertissue fluids, reduction/modification of edema, increase blood flow, decrease muscle sore/stiffness, pain, relaxation, adhesions
massage
absolute contraindications to massage/muscle energy technique
DVT, acute infection, bleeding, new or open wound
relative contraindications to massage/muscle energy technique
incompletely healed scar tissue, fragile skin, calcified soft tissue, skin grafts, atrophic skin, inflamed tissue, malignancy, inflammatory muscle disease, pregnancy
modality of choice for proprioceptive neuromuscular facilitation
muscle energy technique
ZZ. which home exercise program would most safely and effectively improve ROM in shoulder with bicipital tendonitis?
wall climbing shoulder exercises