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Physical Modalities & Electrotherapy > Electrotherapy 2nd YEAR > Flashcards

Electrotherapy 2nd YEAR Flashcards

1
Q

Deep Thermal Treatment (DDT)

A

It is a way to heat the local area by applying a heating agent from outside

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2
Q

Effects of DDT

A
  • increase in the functions of cells via heating
  • Physiologic effects occur local and systemic
  • reflex vasodilation and relief of muscle spasms via relaxation of skeletal muscles
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3
Q

Appliance of DTT

A
  • High frequency currents (Short wave diathermy)
  • Electromagnetic radiation (Microwave diathermy)
  • High frequency sound waves (Ultrasound)
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4
Q

Diathermy

A

It is the term for applying high-frequency electromagnetic energy to heat body tissues.

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5
Q

Types of diathermy

A
  • Longwave
  • Shortwave
  • Microwave
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6
Q

Short-wave diathermy (SWD)

A
  • It is an electromagnetic high frequency current
  • Frequency: 27.12 MHz, Wavelength: 11 meter
  • It heats large areas.
  • It can be continuous or pulsed (Pulsed application is often preferred).
  • Continuous short wave diathermy effects via kinetic energy
  • Pulsed short-wave diathermy shows the benefits via nonthermal changes
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7
Q

Thermal effects of SWD

A
  • Changes in blood flow due to increased temperature
  • Increased cell metabolism
  • Increased tissue flexibility
  • Muscle relaxation
  • Changes in enzyme reactions (Continuous SWD)
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8
Q

The non-thermal effects of SWD

A
  • Healing of superficial wounds
  • Decrease of edema and lymphedema
  • Decrease of venous stasis ulcers
    (Pulsed SWD)
  • Heals cell dysfunction.
    -It provides the normal balance of the ions of the cells.
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9
Q

Physiological Effects of SWD

A
  • It is sedative.
  • It relaxes the mucles.
  • Reduce spasm and pain transmission.
  • Reduce the excitability of nerves
  • Increase the body temperature
  • Increases of sweating
  • Sweating under the electrodes is more.
  • Generates antibodies (it can be used acne and abscess
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10
Q

Physiological Effects of SWD

A
  • It is sedative.
  • It relaxes the mucles.
  • Reduce spasm and pain transmission.
  • Reduce the excitability of nerves
  • Increase the body temperature
  • Increases of sweating
  • Sweating under the electrodes is more.
  • Generates antibodies (it can be used acne and abscess
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11
Q

Application of SWD

A
  • Application time is 20-30 minutes.
  • The patient should never say “too hot” during application.
  • The patient should not go outside shorthly after SWD.
  • If the patient goes out immediately after applying SWD, he will start to chill.
  • The patient should wait 10-20 minutes after application.
  • SWD can be used comfortably in subacute and chronic periods.
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12
Q

Indications of SWD

A

Contracture
Fibromyalgia
Fibrosis
Bursitis
RA
Capsulitis
Musculoskeletal pain
Inflammation
Pain
Spasm
Sprains
Tendinitis, tenosynovitis

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13
Q

Contraindications of SWD

A

Metal implants
Cardiac pacemaker
Ischemic areas
Peripheral vascular diseases
Pregnancy
Fever
The tendency to bleeding
Sensory loss
Cancer
No application to the abdomen and lumbar region during menstruation
Acute inflammation

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14
Q

Capacitor (capacitor) field method

A
  • Most often used method
  • The patient is in the resonator circuit of the tool (constitutes part of the circuit).
  • Electrical force passes between the two electrodes.
  • The aim of treatment is to increase the temperature equally in deep and superficial tissues.
  • The skin and subcutaneous tissue are overheated.
  • Reciprocal aplication is often preffered.
  • Disc and pad electrodes.
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15
Q

Size of Electrodes

A
  • Electrodes should be slightly larger than the area to be treated. Thus, equal temperature can be applied to the deep and superficial tissues.
  • If it is smaller than the area to be treated, the skin will be overheated.
  • If it is larger than the area to be treated, the energy will be lost.
  • If the one is large and the other is small, the electrical force lines will pass through to the small one.
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16
Q

Application techniques

A

Reciprocal - The part to be treated is between the two electrodes.

Coplanar method- Place the electrodes on the same surface of the part to be treated. The temperature is superficial.

Cross application- Electrodes are held in a mediolateral position in the first half of the treatment and in a anteroposterior position in the second half of the treatment.

Monopolar application- One of the electrodes can be placed on the treated side and the other side can be placed or not used.

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17
Q

Induction field method

A
  • The high frequency current passes through the induction coil and creates a magnetic field.
  • Provides more warmth in muscle and connective tissue.
  • Easy to use, penetration of the heat into the tissues is high.
  • Drum or cable electrodes.
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18
Q

Hazards of SWD

A

Burn
Scalding
Electric shock
Gangrene
Hypotension
Dizziness

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19
Q

Microwave Diathermy (MWD)

A

therapeutic heating of the body tissues due to the resistance offered by the tissues to the passage of high-frequency electric currents.

  • The frequency is 433.92 Mhz, and the wavelength is 69 cm. The frequency used for therapy is 2400 Mhz, and the wavelength is 12.24 cm.
  • Penetration depth is between 1-4 cm.
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20
Q

Physiological effects of MWD

A
  • Microwave energy absorbed by body fluids causes an increase in temperature by ion movements.
  • It causes vasodilation with an increase in temperature.
  • The permeability of the cells increases
  • It causes hyperemia.
  • It increases oxygen and nutrient consumption.
  • Provides sedation
  • Reduces pain.
  • Increases drug’s activity.
  • Removes toxic wastes.
  • Increases tendon flexibility.
  • Increases metabolic rate.
  • Reduces muscle spasm.
  • Reduces chronic edema.
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21
Q

Application of MWD

A
  • It should be applied for 10-20 minutes.
  • The duration increases as the area grows and the problem becomes chronic
  • The treatment is applied every day or every other day.
  • The patient should feel warm (like blowing hot air to the hand)
  • The physiotherapist should stay away from the device during the application.
  • If there is redness or excessive sweating on the skin, the treatment should be stopped.
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22
Q

Side effects of MWD

A

Cataract
Cancer
Miscarriage

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23
Q

Advantages of MWD

A
  • Its application is easy.
  • Dosage can be adjusted exactly and correctly.
  • It is used with maximum safety for the patient.
  • Provides local deep temperature.
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24
Q

Disadvantages of MWD

A
  • There are difficulties in practice. For example, joints can only be applied in one direction.
  • Skin burns occur more quickly.
  • Energy can be lost
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25
Q

Indications of MWD

A

Musculo-skeletal system diseases
Fibrocytes
Myocytes
Osteoarthritis
Rheumatoid arthritis
Bursitis
Periarthritis
Tendinitis
Traumatic conditions such as muscle and joint injuries sciatalgia

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26
Q

Hazards of MWD

A

Burn
Scalding
Tissue damage
Organ damage

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27
Q

Contraindications of MWD

A

Acute inflammatory conditions
Acute bleeding or bleeding tendencies
Malign tumors
Pregnancy
Sensory loss
Places covered with cast
Cardiac pacemaker
Intrauterine device
Places with metal
On the epiphyses of the growing bones
On genital organs
On the ischemic fields
Menstruation
Radiotherapy
Joint effusion
Synovitis
Infection
Excessive obesity

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28
Q

Ultrasound

A

very high frequency sound waves that are bounced off structures inside the body in order to obtain images

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29
Q

Theurapeutic ultrasonic device

A

It consists of a high frequency alternating current generator and a transducer (piezoelectric crystal / probe) that converts this high frequency electrical current into acoustic vibrations.

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30
Q

therapeutic ultrasound

A
  • The frequencies of ultrasound for therapeutic purposes is between 85 KHz and 3 MHz
  • The density of ultrasound is between 0 to 3 w / cm2.
  • The average density is obtained by dividing the head total power (watt) to the head surface area (cm 2).
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31
Q

Properties of ultrasonic waves

A
  • spreads as longitudinal compression waves.
  • Speed ​​= Wavelength X Frequency
  • Sound waves travel faster where the molecules are dense. Therefore, they pass faster at solid and liquid than gases
  • Sound waves have physical properties such as penetration, reflection, refraction, damping and absorption
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32
Q

Absorption of ultrasound

A
  • Ultrasound is absorbed gradually as it spreads through tissues.
  • According to the Grotthus-Draper law, waves can not show their effect unless absorbed.
  • The ultrasound energy is absorbed at a fixed rate per unit distance (absorption coefficient)
  • Absorption is high in the blood and low in the fat tissue
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33
Q

Penetration of ultrasound

A
  • Ultrasonic waves are transmitted at high speed in a homogeneous and dense environment.
  • Penetration is more pronounced in a more conducive environment and at a suitable force.
  • Penetration depth is 3-5 cm.
  • It is inversely proportional to frequency.
  • Lower frequency penetrates deeper.
  • As the frequency increases, the damping increases.
  • The energy that transforms into heat under the subcutaneous fat and muscles is not much.
  • Ultrasonic penetration depth is higher than SWD & MWD
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34
Q

Reflection of ultrasound

A
  • A reflection occurs when the ultrasound wave travels from a high permeable environment to a low permeable enviroment.
  • There must be no air between the treatment head and the treatment area to prevent reflection.
  • The proportion of reflected and absorbed ultrasonic waves called acoustical impedance
  • The transition is high when the acoustic impedance is low, and low when the acoustic impedance is high.
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35
Q

Reflection of ultrasound

A
  • A reflection occurs when the ultrasound wave travels from a high permeable environment to a low permeable enviroment.
  • There must be no air between the treatment head and the treatment area to prevent reflection.
  • The proportion of reflected and absorbed ultrasonic waves called acoustical impedance
  • The transition is high when the acoustic impedance is low, and low when the acoustic impedance is high.
  • Excessive energy concentration can damage tissue.
  • The diffusion of the ultrasound in tissues depends on the absorption properties of tissue.
  • Minimal reflection occurs between soft tissues.
  • At frequencies below 1 MHz, ultrasonic waves easily pass through the tissues without being absorbed
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36
Q

refraction of ultrasound

A
  • Ultrasonic wave refract from one enviroment to another.
  • It refracts through the common point of the environment.
  • Ultrasonic waves deviates when it travels from low permeable enviroment to high permeable enviroment.
  • Damping: Ultrasonic energy passing through the enviroment is reduced by absorption and diffusion.
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37
Q

Non thermal effects of ultrasounds

A
  • The primer effect of ultrasound is the oscillation movements of pressure waves in tissues.
  • These movements are mass movements.
  • These movements have little effect on the ligament formation and the diffusion rate.
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38
Q

Acoustic flow of ultrasound

A
  • There is a regional fluid flow.
  • Small fluid movements occur around the cells, in the tissue fibers.
  • This is called acoustical current.
  • It increases the diffusion rate and permeability of the membranes and accelerates chemical reactions and tissue repair.
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39
Q

Cavitation of ultrasound

A
  • It is the accumulation of small gas bubbles in the tissues due to ultrasonic vibration
  • There are 2 types of cavitation.
  • Stabil cavitation: The cavities are fixed.
  • Temporary cavitation: Gaseous cavities suddenly appear and collide with the pressure of the ultrasonic field.
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40
Q

Physiological effects of therapeutic ultrasound: Heat Effect

A
  • As ultrasonic waves spreads in tissues, they are gradually absorbed and converted to heat at that point.
  • In tissues with high protein content and high absorption coefficient, a selective heat increase occurs.
  • As a result, the nerves, tendons and bone tissues become warmer than other tissues.
  • The absorption of ultrasound energy is at least in the fat, most in the bone.
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41
Q

Physiological effects of therapeutic ultrasound: Micromassage effect

A
  • It causes pressure changes in the tissues
  • The mechanical reactions on the tissue are micro massage effect.
  • Membrane permability increases.
  • The adhesion of collagenous fibers can be solved.
42
Q

Application techniques of ultrasound: Direct contact

A
  • If the surface to be treated is smooth, apply a substance that prevents air from entering between the skin and the treatment head.
  • There are circular lines, eight figures and transverse lines tecniques.
43
Q

Application techniques of ultrasound: In-water application

A
  • It can be done uneven areas such as hands, feet, elbows or oversensitive areas
  • It must be used with demineralized water
  • if tap water is used, air bubbles collected on the head and patient’s skin during application should be cleaned frequently to avoid reflection.
  • During the treatment, the head must be kept at a distance of 1 cm, longitudinal to the skin surface and moved in circles
44
Q

Application techniques of ultrasound: Water bag application

A
  • A rubber bag filled with degassed water can be used to apply on irregular bone surfaces.
  • A substance must be applied between the patient’s skin and bag and between bag and the treatment head
  • There are disadvantages such as
  • The presence of too many common surfaces
  • The most of the energy is absorbed by the rubber.
45
Q

Application techniques of ultrasound: Phonophoresis /Sonophoresis

A
  • Application of therapeutic substance via ultrasound
  • It is used for improving efficacy of drugs which applied locally.
  • The drug has to be included to gel to apply affected area
46
Q

Treatment dose of ultrasound

A
  • Ultrasound therapy can be applied continuously or pulsed
  • By applying pulsed ultrasound, the heat effect can decrease and the mechanical effect can increase.
  • Treatment can be done 3 days a week.
  • Duration is usually 5-10 minutes.
  • Low-dose, short-term and pulsed administration is recommended in acute conditions.
  • Chronic conditions can be treated with both continuous and pulsed ultrasound
  • The application time can be maximum 8 minutes and 2W / cm2.
  • In water applications, the dose is kept slightly higher and an average of 3 W / cm2 can be applied for 5 minutes.
47
Q

Treatment dose of ultrasound

A
  • Ultrasound therapy can be applied continuously or pulsed
  • By applying pulsed ultrasound, the heat effect can decrease and the mechanical effect can increase.
  • Treatment can be done 3 days a week.
  • Duration is usually 5-10 minutes.
  • Low-dose, short-term and pulsed administration is recommended in acute conditions.
  • Chronic conditions can be treated with both continuous and pulsed ultrasound
  • The application time can be maximum 8 minutes and 2W / cm2.
  • In water applications, the dose is kept slightly higher and an average of 3 W / cm2 can be applied for 5 minutes.
48
Q

Indications of ultrasound

A
  • Tissue regeneration-wound healing
  • Scar tissue
  • Soft tissue lesions
  • Rheumatic diseases
  • Myofascial pain syndrome
  • Contractures
  • Fractures
  • Vascular diseases (Functional circulatory disturbances resulting from disorder of the sympathetic nervous system)
49
Q

Contradiction of ultrasound

A
  • The water-filled organs: Such as the eye, heart, testis, brain, pregnant uterus, liver, spleen
  • Ischemic areas in peripheral vascular insufficient
  • Areas that have decreased sensitivity
  • In uncompensated heart failure
  • Cancer and precancerous lesions
  • Tuberculosis
  • On medulla spinalis or cauda equina after laminectomy
  • Epiphyses in the era of growth and development
  • Acute infections
  • Hemorrhagic diathesis
  • Parts with metal implants or prostheses (pulsed ultrasound should be preferred in order to avoid burns by heating the metal).
  • Cardiac pacemakers
50
Q

Laser

A

light amplification by stimulated emission of radiation

51
Q

Monochrome

A
  • Laser beams are monochromatic because they consist of rays of a single wavelength.
  • It allows certain wavelengths to be selected for some tissues and specific applications.
  • Helium-neon: Red laser beam with wavelength 632.8 nm,
  • Ga-As: Infrared laser beam with wavelength 904 nm
52
Q

Cohesion

A
  • Light emitted from sources such as sunlight or electric bulb diffuses scattered around.
  • Unlike normal light, the laser beam does not dissipate, it consists of parallel waves that center the same direction and the same phase.
  • Since the laser is a concentrated light, it does not dissipate and energy is collected at one point (collimation).
53
Q

High intensity lasers

A

hard hot lasers mostly used in surgery.

  • Nd-Yag (Neodymium ytrium aluminium oxidized garnet) is used in physical therapy
54
Q

Low intensity lasers

A

Their power is about 1mW. They are also used in physical therapy.

55
Q

Effects of Laser: Reversible effects

A

Heating
Dehydration

56
Q

Effects of Laser: Irreversible effects

A

Protein coagulation
Termolisis
Evaporation
Absorbation
Penetration (2mm-4cm)

57
Q

Mechanism of Laser Influence

A

Chemicals effects at cells
↓
Absorbed by chromophores
↓
ATP production increases
↓
Normalization of cell functions
↙ ↘
Pain reduction and healing

58
Q

Therapeutic Effects of Laser

A
  • ATP production and O2 consumption
  • muscle relaxation
  • Serotonin and endorphin
  • Prostaglandin synthesis
  • anti-inflammatory effect
  • Blood circulation
  • The membrane permeability of nerve cells
  • Lymphatic flow, edema
59
Q

Indications of laser

A
  • Acute (traumatic) and chronic pain
  • RA, OA, Fibromyalgia, trigger points, neck and back pain
  • Sports injuries, tendinitis, tennis player / golfer elbow,
  • Carpal tunnel syndrome, postherpathic neuralgia
  • Skin inflammation, burns, non-healing ulcers
  • Treatment of lymphedema, scarring and keloid tissue
60
Q

Contradiction of laser

A

Pregnancy
Cancer
Epilepsy
Infected skin
Cardiac pacemaker
Tuberculosis

61
Q

Application of laser

A
  • Treatment frequency: 2-3 / week
  • The duration of treatment is variable according to the indication.
  • For the deep tissues, the long wavelength is chosen.
  • High wavelength is chosen for heat effect.
    -When the problem is acute, pulsed can be used.
  • Frequency: 2Hz - 300 KHz (Pulsed version can be used to decrease the energy. Low frequency low intensity, High frequency high intensity)
62
Q

Microcurrent Electrical Nerve Stimulation (MENS)

A

used primarily in tissue healing, the current intensities too small to excite peripheral nerves

63
Q

Microcurrent

A
  • Max current intensity is less than 1 mA.
  • Continuous or discrete/pulsed/interrupted
  • Monophasic
  • Rectangular wave
  • Pulse duration 500 ms (0.5 s)
  • Patient does not feel the current
64
Q

Physiology of microcurrents

A
  • In healthy people, there is an electrical balance between the corneum and the dermis.
  • This electrical balance is provided by Na, K and CL.
  • This electrical balance is disturbed by injury.
  • An electrical current forms around the wound.
  • The center of the wound is negative polarity. Wound edges are positive polarity.
  • High electrical resistance occurs in the scar tissue.
  • The wound first has positive polarity, 3-4 days later, negative polarity.
  • Impaired electrical activity reduces recovery.
  • The microcurrent regulates this impaired electrical activity.
  • Increases the orientation of cells such as microcurrent neutrophils, macrophages and fibroblast.
65
Q

Wound mechanism and Microcurrent

A
  • Muscle spasm
  • Decreased circulation
  • Local hypoxia
  • Harmful metabolite accumulation causes pain.
  • ATP synthesis is reduced.
  • 100-500 microamper increases amino acid transport and protein synthesis.
  • Weak stimuli increase physiological activity
66
Q

Application of microcurrents

A
  • Current intensity: 1-1000 microamper
  • Positive pole for pain; negative pole for stimulation or sclerotic effect: should be changed every 3 days
  • Pulsed (0.1 -200 beats) or continuous, low frequency <1pps
  • High frequencies are used in pain.
  • 20 min-120 min
  • 1-4 sessions per day
  • 5-7 days per week
  • Voltage: 60V
  • Sponges, hydrogel pad and gauze dipped in warm water are used.
  • Negative electrode in acute period, positive electrode in recovery period
  • The electrode is placed on the wound.
  • The other electrode is placed 5-10 cm away.
67
Q

Indications of microcurrents

A

Wound healing
Trigger points
Tendinitis
Epicondylitis
TMJ pathologies
Fractures
Ulcers
Peritendinitis

68
Q

Contraindication of microcurrents

A

Cancer
Osteomyelitis
Implant

69
Q

Magnetic Field

A

is defined as the force created by the force lines coming out of the poles of the metal parts with magnetic properties in the environment.

  • When an electric current is passed through a solenoid, the magnetic field is arranged perpendicular to the surface of the last rings on either side of the solenoid
  • Inside the coil, there is a strong magnetic field than outside
70
Q

Measurement of Magnetic Field

A
  • The measurement of the magnetic field: “Gauss” or “Tesla unit”
  • 1 Tesla equals 10000 Gauss
71
Q

Mechanism of Magnetic Field

A
  • The ions move between the inside and outside of the cells.
  • Ions are positively or negatively charged.
  • The magnetic field changes the permeability of the K+, Ca²⁺, Mg2⁺ and H⁺ in the cell membrane.
  • The pulsatile magnetic field improves the permeability of cell membranes by appropriately affecting body tissues.
  • In the case of damaged or diseased cells, cellular ion exchange disruption results in changes at resting cell potential and the usage of oxygen.
  • Magnetic field therapy affects intracellular and extracellular ionic balance by affecting cell potential
72
Q

Effects of Mechanic Field

A
  • Regulates cell functions.
  • Removes waste and toxins.
  • It facilitates the intake of water, nutrients, oxygen and essential minerals.
  • It increases blood flow.
  • It increases hormone secretion.
  • It regulates enzymatic reactions.
  • Increases collagen synthesis.
  • It reduces edema.
  • It reduces spasm.
  • Stimulates bone construction.
  • The drug increases its effectiveness.
  • It regulates the rhythm of the heart
73
Q

Static magnetic field treatment

A
  • Magnets with a diameter of 1,5 mm-1.5 cm are placed on trigger points with adhesive tapes.
  • Up to 1 week available.
  • Power of magnets from 1100-1200 G
  • Improving circulation, analgesia, and wound healing
  • When applied to an inflamed region, the magnetic field penetrates the skin, deep tissue, and blood flow.
  • Damaged cells interact with the magnetic field and the impaired ion balance is regained.
  • Magnetic fields affect the membrane potential and provide depolarization in the nociceptive C fibers already possessing a low threshold potential.
  • It also reduces pain by increasing blood flow in subcutaneous and muscle tissues.
  • Static magnetic fields; occur through a direct current passage through a coil.
74
Q

Low-frequency sinus wave electromagnetic fields

A
  • It is between 60 Hz (USA and Canada) and 50 Hz (Europe and Asia).
  • The magnetic force line changes direction and intensity at certain intervals.
  • It can be directed to a certain part of the body.
75
Q

Pulse electromagnetic fields (PEMF

A

usually with specific shape, amplitude and low frequency.

  • A wide variety of PEMF devices have been produced.
  • Pulse radiofrequency fields are used in the range of; 13.56 MHz, 27,12 MHz and 40,68 MHz radiofrequency.
76
Q

Transcranial magnetic stimulation

A
  • is a treatment method that provides short but intense magnetic pulses to the brain’s selective regions.
  • Milimetric waves; It has a very high frequency in the range of 30-100 GHz. Their magnetic fields are weaker. It is placed with full contact
  • Ultra short vibration has been developed in the last year and researches continue.
77
Q

Pulse magnetic field therapy

A
  • Anti-inflammatory and analgesic effect
  • Reduces pain and chronic headaches at a frequency of 9-16 Hz.
  • Endorphin, encephalon, seratonin, and neurodrenaline release inhibit the pain.

Low frequency (3-300 Hz) pulse magnetic field therapy is the most commonly used in the therapy.

78
Q

Application of magnetotherapy

A
  • Frequency: 1-100 hz
  • Magnetic field intensity: 600-3600 gaus
  • Wave shape: Sine, half and full rectified square and triangular wave
  • Duty cycle: 20% -50% -100%
  • Bed sheets should be covered on the patient.
79
Q

Mechanism of PEMF

A
  • It stimulates the lysosome, ribosome and mitochondria.
  • It increases enzymatic activity and synthesis activities.
  • Increases DNA and protein synthesis.
  • It also increases the formation of bone and cartilage as an effect on growth factors.
  • It causes vasodilatation.
  • Increases tissue perfusion and removal of metabolic debris from tissues.
  • It produces analgesic and antiinflammatory effect.
80
Q

Devices and Equipment of PEMF

A

Wide circular pipe device: Arm, leg and body are placed inside. 20-50 gauss, frequency can be adjusted as 2/15/30 hz. 30 minutes

Flat plate tool: Applied to extremities.

Small natural magnets: Recommended for patients complaining of pain. Magnets are attached with adhesives.

81
Q

Magnetotherapy Hz

A

1-4 Hz: Reduces inflammation.
5-8 Hz: Reduces muscle spasm.
9-16 Hz: Reduces chronic pain.
12-15 Hz: It increases blood flow.
17-32 Hz: Stimulator.

82
Q

Indications of magnetotherapy

A

-Degenerative and inflammatory arthritis
- Osteoporosis
- Carpal tunnel syndrome
-Unfussed or late-fused fractures
- Plantar fasciitis
- Lateral and medial epicondylitis
- Aseptic necrosis
- Other injuries
- Neuropathic pain
- Reflex sympathetic dystrophy
- Calcific tendonitis
- Post-polio pain
- Fibromyalgia
- Post traumatic edema
- Diabetic neuropathy
- Urine rincontinence

83
Q

Contraindications of magnetotherapy

A
  • Pregnancy
  • Pacemaker
  • Implanted medical devices such as an insulin pump or a liver infusion pump
  • Intrauterine device
  • Epilepsy
  • Acute hemorrhage
  • Neoplasms
84
Q

Hazards of magnetotherapy

A

neoplasms
Cerebrovascular changes
Cardiovascular system problems
Kidney diseases
Osteoporosis

85
Q

Physical properties and Extracorporeal Shock Wave Therapy (ESWT) types

A

Focused ESWT and radial pressure waves

86
Q

Focused ESWT

A
  • It allows to focus on the desired tissue depth.
  • It consists of wide frequency range (150 Khz-100MHz), high pressure amplitude (150 MegaPascal: Mpa) and low tensile wave (-25Mpa).
  • The pulse width is small.
  • Energy density increases in a short time like a hundred nanoseconds.
  • It is produced with three different types of generators.
87
Q

Electro hydraulic generator

A
  • An electrode is placed in the focal center of the water-filled half ellipsoid shaped reflector.
  • The electrode is applied high voltage
  • Electric sparks are produced.
  • Rapid evaporation of water produces a shock wave.
  • The shock wave spreads through the applicator to form the radial primary wave.
  • Waves reflected back to the applicator create focused shock waves.
  • Reflections occur in the metalic membrane.
  • Electromagnetic waves from the coil form acoustic waves in water. Curved reflective surface focuses shock wave
  • The coil creates a magnetic field.
88
Q

Piezoelectric generator

A

Acoustic energy is created with the crystal.
Waves form in the water around it.
The resulting wave is applied.

89
Q

RPW (Radial pressure waves)

A
  • The waves propagate radially.
  • It has 30 MPa pressure and 3 microsecond rise time.
  • In the generator, compressed air accelerates a projectile inside the cylindrical tube.
  • When the bullet hits the applicator inside the tube, it produces a pressure wave. This wave expands in the target tissue.
  • It is also called radial shock wave.
90
Q

Effect mechanism

A
  • Acoustic energy in the shock wave at the boundary that separating two area, creates limited mechanical strength, pressure and cavitation.
  • Air bubbles are formed with the shock wave at the boundary surface and colapsed again.
  • A pressure of up to 500-1000 bar is produced during this period.
  • Shock minute creates cavitations in the tissue.
  • The destruction of cavitation causes the calcified tendons to dissolve.
  • It forms a hematoma again in the fracture area. High energy must be applied.
  • It creates excessive stimulation analgesia. It reduces pain with door control.
  • It changes the permeability of the cell membrane.
  • Growth factor release
  • The formation of new vascular structures
91
Q

Applications of ESWT

A
  • Gel is used during application.
  • 2 sessions of 2000 beats 1 week apart for optimum treatment
  • Energy use is recommended at the level of pain the patient can tolerate.
  • All generators are known to have a similar effect
  • It is applied to the painful area.
92
Q

Indications of EWST

A

Unfused fractures
Fixation of loose uncemented prosthesis
Stress fractures
Calcific tendonitis
Plantar fasciitis
Impingement syndrome
Tenosynovitis and tendinitis
Muscular injuries
Morton’s neuroma
Joint injuries
Avascular necrosis of the femoral head
Osteochondritis dissecans

93
Q

Contraindications of EWST

A

Osteomyelitis
Immature bones
Pregnant women
Cardiac pacemaker
Bone tumors
Epiphyseal region

94
Q

Side effects

A

Tingling
Hematoma
Pain
Erythema
Swelling
Hypervascularisation

95
Q

Biofeedback

A

It is all kinds of information and notifications that are returned to the person by the system regarding the situation and the action he / she has done.

  • During biofeedback, special sensors are located into the body.
  • Muscle tone (EMG or electromyographic feedback)
  • Brain waves (EEC or electroencephalographic feedback)
  • It measures body functions such as respiration and body temperature (thermal feedback).
  • Kinesthetic, visual, cutaneous, vestibular and auditory signals
96
Q

Mechanism of Biofeedback

A
  • Peripheral body heat
  • Finger phototransmission (Vasocons, Vasodilat)
    EMG (Diagnostic)
  • Measurement of membrane potential
  • It does not measure muscle contraction directly.
  • It measures electrical activity.
  • Silver or stainless steel electrode
  • 4mm-12.5mm
  • The area must be cleaned with alcohol before application.
  • The electrodes are parallel to the muscle fibers.
97
Q

Acetylcholine

A

released from the neuromuscular junction, binds to the receptor on sarcolemma and initiates depolarization in the muscle.

98
Q

Muscle contraction

A

caused by the electrical potentials known as Motor Unit Action Potentials

99
Q

EMG signals

A

measured through two types of electrodes, surface electrodes and needle electrodes
- EMG signals can be taken as monopolar (monopolar) or bipolar (bipolar).

100
Q

Objectives of EMG

A
  • Determining the duration of muscle activation
  • Determining the length of time the muscles have been awakened (stimulated)
  • Determination of muscle strength
  • Detection of frequency band gap against muscle fatigue
101
Q

Application of Biofeedback

A
  • Duration: 15-20 minutes
  • Electrodes: 4mm-12.5 mm for EMG
  • Activity is must be done from easy to difficult
  • Three electrodes can be used
  • Two active one reference electrodes
  • The information from two electrodes can be compared from reference electrode. And the noise can be eleminated.
  • Parallel to muscle fibers and origin to insertion
102
Q

Indications of Biofeedback

A

Psychological problems
Pain
Spasm
Spasticity
Incontinence
Constipation
Muscle weakness

Physical Modalities & Electrotherapy (1 decks)

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