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PCE - Treatment > EPA Pt. 2 > Flashcards

EPA Pt. 2 Flashcards

1
Q

HVPC:

  • ___ Voltage
  • ____ Peak intensity
  • ___ average intensity
A

High
High
Low

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2
Q

HVPC:
Frequency
Pulse width

A

1-200Hz

5-65 pulse width

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3
Q

HVPC uses

A

decreased pain, decreased edema, increased wound healing, muscle stim
- enhances oxygenation, blood flow and tissue formation

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4
Q

What is the benefit of higher voltage

A

more comfortable and larger “punch”

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5
Q

HVPC parameters for pain

A

Same as TENS

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6
Q

HVPC parameters for wound healing

A

50-100Hz (submotor), 30-60 mins, 3-7 days/wk, polarity based on stage of healing
- one electrode in wound, one 10-20cm away

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7
Q

HVPC parameters for subacute edema reduction

A

5-20Hz (want twitch, usually start at negative polarity
- active red on edema (set as negative – pushes away +ve proteins) OR put it on muscle twitch on motor point & nerve trunk (chronic)

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8
Q

HVPC parameters for muscle stim

A

35-65 hz

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9
Q

What is the principle of galvanotaxis

A

can repel molecules or attract desired cells based on polarity

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10
Q

Contraindications to HVPC

A
  • the usual
  • transcranially
  • person with cognitive or communication difficulty
  • impaired circulation
  • Inflammation (don’t want to add energy to injury)
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11
Q

How does iontophoresis work

A

using current flow btw 2 electrodes to push ions through the skin barrier- - Positively charged drug can be made to cross the skin away from positive electrode (anode)

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12
Q

Iontophoresis uses what type of current

A

direct current

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13
Q

in iontophoresis what occurs under the anode

A

possible acidic reaction - skin hardening over time (sclerotic)

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14
Q

in iontophoresis what occurs under the cathode

A

possible alkaline reaction (softening and burning of skin)

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15
Q

Should the cathode or anode be larger in iontophoresis? why?

A

Keep the cathode larger (current density is therefore lower and skin is less likely to burn)

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16
Q

In iontophoresis What is current density limited to under the anode and the cathode?

A
  1. 0mA/cm2 under anode

0. 5mA/cm2 under cathode

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17
Q

What is the use for iontophoresis

A

hyperhidrosis, MSK inflammatory disorders, plantar fasciitis, TMJ disorders, ischemic skin ulcer, fungal infections, bursitis and tendonitis

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18
Q

Iontophoresis contraindications

A
  • over damaged skin or open lesions
  • allergy to therapeutic
  • impaired sensation
  • over electric implants
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19
Q

Short wave diathermy therapeutically ____ body tissues at any depth

A

heats

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20
Q

What are the 2 types of electromagnetic fields producing the heat in short wave diathermy

A

electrostatic and electromagnetic

21
Q

What are the physiological effects of short wave diathermy

A
  • increased tissue healing
  • enhance nerve regeneration
  • pressure ulcers
  • chronic low back pain
  • soft tissue injuries
    some evidence it can be used for pain, muscle spasm, chronic inflammation, delayed wound healing, chronic infection)
22
Q

2 main indications for application of short wave diathermy

A

OA

Ankle sprain

23
Q

Dosage of short wave diathermy based on

A
  • Sensation: want moderate heat (20-30 min)

- Tissue healing phase

24
Q

Contraindications to short wave diathermy

A
  • metallic implants & pacemakers (implanted devices)

- cognitive/communication challenges

25
Q

What is a risk with short wave diathermy

A
  • Can get burns (unequal spacing, perspiration, etc.) – patient should just feel mild, comfortable warmth
26
Q

What are the 3 features of a laser

A
  • Monochromaticity (all photons have a single wavelength)
  • Coherence (all photons travel in same phase and direction)
  • Collimation (minimal divergence over distance)
27
Q

Laser uses

A

To increase tissue healing, decrease pain, decrease inflammation (wound management)

28
Q

What is the choice of laser head based on

A

Depth of lesion

29
Q

A red-near infrared laser head penetrates to what depth

A

1-5mm

30
Q

A near-mid infrared laser head penetrates to what depth

A

5-10mm

31
Q

What is the appropriate laser dose (acute and chronic)

A 
acute = 2J/per point
chronic = 4 J/per point (according to WALT guidelines)
32
Q

What is the appropriate laser frequency (acute and chronic)

A

acute <1000 kHz (wavelength 600-1000 nm)

chronic >1000 kHz (wavelength 1000-1350 nm)

33
Q

Laser contraindications

A
  • Treatment of the eyes
  • Known or suspected malignancy
  • Low back or abdomen of pregnant women
  • Hemorrhage or severe vascular disease
  • Tissue infected by TB or virulent bacteria
  • Actively bleeding tissues or untreated hemorrhagic disorders
  • Active DVT or thrombophlebitis
  • Reproductive tissues (testes)
34
Q

Laser precautions

A
  • Recently radiated tissue
  • infected regions (compromised immune function)
  • anterior neck
  • photosensitive areas
  • cognitive impairments
  • epiphyseal plates in children
35
Q

BCCDC Laser safety guidelines

A
  • Use in a controlled area
  • Laser eye protection is required
  • Only authorized personnel must occupy the area
  • The area must have an appropriate warning sign
  • Any windows, doorways, openings, etc. must be either covered or restricted
36
Q

UV is used to treat what?

A
  • psoriasis
  • eczema
  • vitiligo
  • pruritus (secondary to liver/kidney disease)
  • acne
  • photodermatoses
  • wound healing
  • atopic dermatitis
37
Q

UV dosage is based on….

A

on MED: then start at 70% then work up by 5-10 % as tolerated (combo of UVB and UVA)

38
Q

UV Contraindications

A
  • photosensitivity
  • skin cancer
  • CT disorder (be aware of drugs causing photosensitivity)
  • On eyes: can cause conjunctivitis or photokeratitis (inflammation of cornea) – cataracts are caused by chronic exposure to UV
39
Q

What is the effect of ultrasound on tissue healing

A

• Accelerates inflammatory phase to make it as efficient as possible - Alters membrane permeability, releases “wound-healing” factors (ie. histamine, serotonin)

40
Q

What are important things to remember when treating with ultrasound

A

Maintain contact and keep head moving and perpendicular to tissue

41
Q

What are the thermal effects of ultrasound

A
  • decreased pain
  • decreased joint stiffness
  • improved blood flow
  • promote healing (decreases inflammation)
42
Q

What are the non-thermal effects of ultrasound

A
  • wound healing
  • inflammation and soft tissue healing
  • altered scar tissue formation
  • stim of collagen synthesis
  • angiogenesis
  • repair of articular cartilage
43
Q

Ultrasound parameters

A
  • Frequency 1MHz (deep) and 3MHz (superficial)
  • intensity: inflammatory phase 0.1-0.5 W/cm2. proliferation phase 0.5-0.8 W/cm2. remodeling phase up to 2.5 W/cm2
  • pulsed (acute) and continuous (chronic)
  • acute = 5-20mins, less time for acute and more time for chronic
  • pulse ratio: 1:8 to 1:1 to continuous
44
Q

Ultrasounds should not be applied to an area larger than…

A

2-2.5xERA (ERA = area producing 5% or more of max. power output – higher = better)

45
Q

Ultrasound contraindications

A
  • implantable devices (ie. pacemaker, Medtronic stimulation system)
  • abdomen and pelvis if pregnant
  • malignancy
  • bleeding disorder
  • acute sepsis or infection
  • TB of lungs or bone
  • active DVT or thrombophlebitis
  • myositis ossificans
  • Fracture
  • impaired circulation or sensation
  • pelvis and lumbar spine if menstruating
  • radiotherapy (not for 6 months)
  • gonads
  • abscess
  • areas of acute inflammation (if using continuous as it generates heat)
46
Q

Ultrasound precautions

A
  • spinal cord or superficial nerves
  • regenerating nerves
  • epiphyseal plate unfused
  • implants (metal OK if using pulsed US
47
Q

What is tape used for

A
  • used for proprioceptive feedback
  • warning to stay out of posture
  • to maintain biomechanical gains of treatment
  • provide external stability
48
Q

What a splints used for

A

Same as tape but used in more acute phase or prophylactically for return to play

49
Q

What are orthotics used for

A

used as support for structure or off loading

PCE - Treatment (6 decks)

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