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Physical agents > Final > Flashcards

Final Flashcards

1
Q

Adverse effects of heat

A 
- Burns: 
     Erythema ab igne: staining of the skin/ irritation
     Blisters
- Fainting
- Bleeding
- Increased edema
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2
Q

Contraindications of thermotherapy

A
  • Recent or potential hemorrhage
  • Thrombophlebitis
  • Impaired sensation
  • Impaired mentation
  • Malignant tumor
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3
Q

Indications for use of thermotherapy

A
  • Pain control
  • Increase tissue extensibility to increase ROM and flexibility
  • Accelerate healing of injured tissues
  • Reduce muscle guarding or spasms
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4
Q

Capillary refilling should start within ____, so we know there is no frostbite

A

2 secs

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5
Q

Unintended effects of cryotherapy

A
  • Reduced ROM
  • Reduced strength
  • Psychological effects
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6
Q

Clinical indications for cryotherapy: Cryokinetics and cryostretch

A
  • Early intervention following injury
  • Initiating new therpeutic exercise program for patient in chronic pain
  • Increase muscle performance for athletes in training
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7
Q

How long should you apply a cold treatment to facilitate a muscle contraction?

A

5 mins

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8
Q

What is the depth of penetration for cooling agents?

A

1-3cm

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9
Q

What is cold- induced vasodilation?

A

Apply cryotherapy to the region, if it cools to more than 1 deg C and it is maintained for more than 15mins. This can result in edema

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10
Q

How long does it take for the hunting response to happen?

A

15 mins

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11
Q

What is hunting response?

A

A cycling of temp(heating and cooling) in the human body directly underneath the area where a cold agent is applied.

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12
Q

What are the effects of cyrotherapy?

A
  • Hemodynamic effects
    • Vasconstriction
    • Hunting response
    • Cold induced vasodilation
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13
Q

____ results in an increase collagen production which forms thicker tissues and adhesion

A

Chronic inflammation

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14
Q

Chronic inflammation occurs due to ____

A
  1. persistent force producing re-injury

2. immune response from infection or reaction to implant

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15
Q

Chronic inflammation occurs in which phase of healing?

A

Maturation

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16
Q

Cold bath or whirlpool

A

• Immerse part in 13-18 deg C (55-65 deg F) water
• Can use water and crushed ice
• Time – colder water, less time (few seconds to 10 minutes – leave until a little after numbness is achieved)
• Toe cap may make foot more
comfortable

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17
Q

How long should an ice massage be done?

A

5-15 minutes or until beyond numbness

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18
Q

How much area does an ice massage cover?

A

Cover an area about 3-6 inches in diameter

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19
Q

How long should cold packs be used for

A
  • 15-30 minutes (colder the source, the shorter the time)

- Longer time for patients with more subcutaneous fat

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20
Q

What are the normal sensations a person should get during a cold treatment?

A
  • Cold
  • Warm, burning
  • Aching, tingling
  • Numbness
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21
Q

Contraindications of cold treatments

A 
Cold hypersensitivity
• Compromised local circulation
• Cold intolerance
• Cryoglobulinemia
•Raynouds disease
• Paroxysmal cold hemoglobinuria
• On regenerating superficial nerves
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22
Q

Precautions for cold treatments

A
  • Skin sensation which is not normal
  • Previous frostbite to area
  • Anesthesia from ice could mask exercise induced pain
  • Prolonged applications
  • Hypertensive patient
  • Packs or ice stored at 0 deg F or -17 deg C should not be applied directly to the skin
  • Decreased cognitive level
  • Very old/very young individuals
  • Over the superficial main branch of a nerve
  • Directly over an open wound( can be around it)
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23
Q

What is the goal of a cold treatment on an acute injury

A

– Controls inflammation through vasoconstriction and
decreased permeability of vessels
– Decreases pain, numbs the injured area
– Prevents secondary hypoxic ischemia, which is a result of
increased distance for oxygen to diffuse from blood vessel
to tissues.

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24
Q

When is Cold treatment on an acute injury is thought to be most effective?

A

5-10 min after injury, but can still be helpful for up to 72 hours after injury

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25
Q

Contraindications of a paraffin treatment

A
  • Any condition in which heat is contraindicated
  • Open wounds
  • Draining lesions
  • Rashes, infections which might be contagious
  • New skin or recent scar tissue
  • Water on skin – can cause a burn
  • Jewelry – can cause a burn
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26
Q

Precautions of a paraffin treatment

A
  • Any condition for which heat is to be used with caution
  • Small scratches – should be covered with gauze
  • Scar tissue
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27
Q

Indications of a paraffin treatment

A
  • Arthritis
  • Chronic orthopedic conditions
  • Joint stiffness, contractures
  • Scleroderma
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28
Q

Temperature range of paraffin

A

126 -130

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29
Q

How long should a hot pack be used for?

A

About 20 minutes for maximal results

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30
Q

What are the contradictions for heat

A

• Areas of arterial insufficiency or arterial disease
• Areas prone to hemorrhage
(hemophilia, acute trauma, long-term steroid use)
• Acute inflammatory site
• Elevating tissue temperature in area of malignancy
• Impaired cognitive function

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31
Q

Physiological effects of using heat on tissues are

A
  • Vasodilation
    • Brings in more nutrients
    • Picks up more waste
  • Increase in metabolism
    • • For every 10 deg C rise in
      temp., there is a
      2-3 fold increase in the
      rate of metabolism
  • Pain relief
  • Decrease stiffness
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32
Q

Human tissues function best between ___ - ___ deg c

A

35-38

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33
Q

Hypothermia is anything below ____

A

35 deg C

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34
Q

Hyperthermia is anything above ___

A

35 deg C

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35
Q

What is nociceptive pain?

A

Has a clear stimulus-response relationship with the initial injury.

Can be acute and lead to chronic

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36
Q

What is neuropathic pain?

A
  • Burning or lancinating quality
  • Usually accompanied by signs or symptoms of neurological dysfunction, such as paresthesias, itching, anesthesia, weakness
  • Radicular vs. Referred pain

Can be acute and lead to chronic

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37
Q

Types of pain found in visceral tissue

A

Aching quality, frequently referred superficially

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38
Q

Types of pain found in the musculoskeletal tissue

A

Dull/Achy/Heavy and more difficult to localize

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39
Q

Types of pain found in the superficial/skin

A

Sharp/pricking/vibrating and easily located

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40
Q

Characteristics of the A-beta primary afferent neurons

A

• non-painful sensation related to vibration, stretching, and mechanical pressure

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41
Q

Characteristics of the C-afferent primary afferent neurons

A

• longer duration, dull, throbbing, aching, burning, tingling, diffusely localized,
accompanied by sweating, increased heart rate and blood pressure, and nausea
• 0.5-2 m/s
• 80% of pain afferents
• can be blocked by opioid medication

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42
Q

Characteristics of the A-delta primary afferent neurons

A
  • respond to intense mechanical stimulation and heat or cold
  • short duration, sharp, stabbing, or pricking sensation
  • small and myelinated
  • 4-30 m/s
  • 20% of pain afferents
  • not blocked by opioids
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43
Q

What happens in the maturation phase of healing?

A

Modifies the scar tissue into its mature form

  • Day 9 onward
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44
Q

What happens in the proliferation phase of healing?

A

Rebuilds damaged structures and strengthens the wound

  • Days 3-20
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45
Q

What happens in the inflammation phase of healing?

A

Prepares wound for healing.

- Days 1-6

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46
Q

Thought process when choosing a physical agent

A
  • Goal and effects of treatment
  • Contradictions and precautions
  • Evidence for physical agent use
  • Cost, convenience, and availability of the physical agent
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47
Q

Rank of priorities when choosing a physical agent for a patient

A
  • Highest/first: Primary underlying problem/problem most likely to respond to treatment
  • 2nd: treatments that address more than one problem simultaneously
  • Lowest/last: symptomatic treatment only
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48
Q

What is ultrasound?

A

a form of mechanical energy consisting of high frequency vibrations (> 20,000 Hz)

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49
Q

What is clinical US in PT ranges of ultrasound?

A

from 1-3 MHz

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50
Q

The higher the frequency of an ultrasound, the ____ the rate of absorption.

A

Higher (faster heating)

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51
Q

The higher frequency of of an ultrasound, the ____ the depth of penetration

A

lesser

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52
Q

Ultrasound works on ____ piezoelectric effect

A

reverse

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53
Q

What is a piezoelectric effect?

A

Electrical energy (AC current) applied to lead zirconate titanate crystal in sound head which is converted to mechanical energy

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54
Q

What is beam non-uniformity ratio (BNR)?

A

The ratio of the highest intensity in the field (spatial peak) to the average intensity indicated on the machine (spatial average).

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55
Q

Tissues with more attenuation will show a ____

A

greater temperature rise

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56
Q

Attenuation values are higher for tissues with a ____

A

higher collagen content

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57
Q

Attenuation increases as frequency of US ____

A

increases

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58
Q

Attenuation is ____ related to penetration

A

Inversely

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59
Q

Attenuation is best for ____ tissues

A

Collagen rich tissues

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60
Q

Attenuation is worst for ____

A

Fat/Skin/Muscle

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61
Q

What is the duty cycle of a thermal effect?

A

100%

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62
Q

Thermal effects of an ultrasound at a 1 deg temperature rise

A
  • Increases metabolism and healing

* Roughly 13% increase in metabolism for every 1 deg C raise (or up to 2-3 fold increase for 10 deg C rise)

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63
Q

Thermal effects of an ultrasound at a 2-3 deg temperature rise

A

• Decreases pain and muscle spasm

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64
Q

Thermal effects of an ultrasound at a 4 deg C or greater temperature rise

A

Increases extensibility of collagen and scars, and decreases joint
stiffness, a 40-45 degrees C temperature is required for at least 5 minutes

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65
Q

Duty cycle is equal to

A

time on relative to time on + time off

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66
Q

Mechanical effects of a duty cycle occurs at ____

A

20%

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67
Q

1 MHz provides treatment of tissue up to ___ deep

A

5 cm

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68
Q

3 MHz provides treatment of tissue up to ___ deep

A

1-2 cm

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69
Q

With 1 MHz use intensity roughly

A

1.5 to 2.0 W/cm^2

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70
Q

With 3 MHz use intensity roughly

A

0.5 W/cm^2

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71
Q

If non-thermal ultrasound is desired intensities of about _____ have been shown to be beneficial

A

0.5 to 1.0 W/cm2

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72
Q

What is the average duration of an ultrasound?

A

5-10 minutes

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73
Q

For soft tissue shortening what type of effects of ultrasound should be used?

A

Thermal

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74
Q

For soft tissue shortening what type of duty cycle should be used?

A

100%

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75
Q

What level of ultrasound frequency should be used when the depth of a soft tissue shortening is 1-2cm?

A

3 MHz

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76
Q

What level of ultrasound frequency should be used when the depth of a soft tissue shortening is less than or equal to 5 cm?

A

1 MHz

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77
Q

What level of ultrasound intensity should be used when the depth of a soft tissue shortening is 1-2cm?

A

0.5 W/cm^2

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78
Q

What level of ultrasound intensity should be used when the depth of a soft tissue shortening is less than or equal to 5cm?

A

1.5-2.0 W/cm^2

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79
Q

For delayed tissue healing prolonged inflammation what type of effects of ultrasound should be used?

A

Nonthermal

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80
Q

For delayed tissue healing prolonged inflammation what type of duty cycle should be used?

A

20%

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81
Q

What level of ultrasound frequency should be used when the depth of a delayed tissue healing prolonged inflammation is 1-2cm?

A

3 MHz

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82
Q

What level of ultrasound frequency should be used when the depth of a delayed tissue healing prolonged inflammation is less than or equal to 5cm?

A

1 MHz

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83
Q

What level of ultrasound intensity should be used when the depth of a delayed tissue healing prolonged inflammation is 1-2 or less than or equal to 5cm

A

0.5 - 1.00 W/cm^2

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84
Q

The duration of treatment for any type of ultrasound for any impairment should be ____

A

5-10 mins/2 x ERA

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85
Q

What are the indications(things it helps with) for ultrasound?

A
  • Soft tissue shortening
  • Pain control
  • Dermal ulcers
  • Tendon and Ligament injuries
  • Resorption of calcium deposits
  • Bone fractures
  • Carpal tunnel syndrome
  • Phonophoresis (medication added to ultrasound waves to increase medicine penetration)
  • Patient values
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86
Q

What are the contraindications of an ultrasound?

A 
• Malignancy
• Pregnancy
• CNS tissue
• Joint cement
• Plastic
• Pacemaker
• Thrombophlebitis
• Eyes and reproductive
organs
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87
Q

Precautions to be taken when doing an ultrasound?

A
  • Acute inflammation
  • Epiphyseal plates
  • Fractures
  • Breast implants
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88
Q

What is a reverse piezoelectric effect?

A

An electrical current passes through a crystal inside the transducer causing it to expand and contract which generates the acoustic wave

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89
Q

What are the components that will determine the effect of ultrasound on heating tissues?

A

Frequency, intensity, and duty cycle

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90
Q

What determines the safety of the use of US?

A

Depth, duty cycle, frequency and intensity

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91
Q

Nerves conducting information towards the spinal cord and brain are ____ nerves

A

Sensory nerves

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92
Q

Nerves conducting information away from the spinal cord and brain are ____ nerves

A

Motor nerves

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93
Q

The positive side of an electrode is called an ___ and is electron/ion ___

A
  • Anode

- deficient

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94
Q

The negative side of an electrode is called an ___ and is electron/ion ___

A
  • Cathode

- Rich

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95
Q

Indication of TENS

A

Control/relieve pain

96
Q

Secondary benefits of TENS

A
  • Reduce the amount of and dependency on pain medication
  • Provide the patient a more active role in their pain management
  • Increase functional movement and mobility with less discomfort
97
Q

What is parameter for frequency of conventional TENS?

A

100-150 Hz (high frequency)

98
Q

What is parameter for pulse duration of conventional TENS?

A

50-80 microseconds

99
Q

What is parameter for amplitude of conventional TENS?

A

Strong but comfortable

100
Q

What is parameter for treatment duration of conventional TENS?

A

20-30 mins, up to 24 hours

101
Q

What is parameter for mechanism of action of conventional TENS?

A

Gate control

102
Q

What is parameter for analgesia duration of conventional TENS?

A

Immediate relief with little residual effect

103
Q

What is parameter for frequency of acupuncture TENS?

A

2-10 Hz (low frequency)

104
Q

What is parameter for pulse duration of acupuncture TENS?

A

200-300 microseconds

105
Q

What is parameter for amplitude of acupuncture TENS?

A

Strong, visible muscle contraction

106
Q

What is parameter for treatment duration of acupuncture TENS?

A

20-30 mins

107
Q

What is parameter for mechanism of action of acupuncture TENS?

A

Endogenous opiods release

108
Q

What is parameter for analgesia duration of acupuncture TENS?

A

Up to 5 hours

109
Q

How does TENS- acupuncture work?

A

Through brief sharp pain through repetitive muscle twitched and stimulation of A-delta fibers

110
Q

Which fibers are sensory?

A

A-beta

111
Q

Indication for IFC

A

Pain control

112
Q

Secondary indication of IFC

A
  • Edema control (weak evidence)
  • Force production
  • Modulation
  • Treat larger region
113
Q

Electrode placement for IFC is always ____

A

Criss-crossed

114
Q

What are the electrode placements for TENS

A
  • Criss cross
  • Parallel
  • Bracket
  • Unilateral
115
Q

Where should you avoid placing electrode for TENS?

A
  • Transcranial

- Over genitalia

116
Q

What do you use a vector scan for in IFC?

A

For change in position of interference pattern (scan entire field)

117
Q

What is the purpose of the sweep mode in IFC?

A

To decrease sensory habituation for longer treatment times

118
Q

IFC provides pain relief over a _____ region with ____ body tissue involvement

A

IFC provides pain relief over a larger region with multiple body tissue involvement

119
Q

When should pre-modulated current be used?

A

In small/narrow regions where the 4 electrode placement used in IFC is not possible

120
Q

How many channels and electrode pads should be used in pre-mod?

A
  • 1 channel

- 2 large pads

121
Q

How many channels and electrode pads should be used in IFC?

A
  • 2 channels

- 4 small pads

122
Q

HVPC is a ___ current

A

Direct current

123
Q

What are the indications of HVPC?

A
  • Wound healing (supportive evidence)

- Inflammation/edema (weak evidence)

124
Q

Theoretical clinical use of HVPC

A
  • Softening scar tissue

- Increased tissue density

125
Q

What is a side effect from HVPC?

A

Increased aching in the area of the dispersive pad (larger electrode)

126
Q

What kind of polarity should be used when using HVPC to treat edema?

A

Negative polarity

127
Q

What kind of polarity should be used when using HVPC to treat tissue healing?

A

Positive polarity

128
Q

What color channel should be used at the treating/active pad?

A

Red channel

129
Q

What color channel should be used at the dispersive pad?

A

Black channel

130
Q

What is/are the indication(s) for russian?

A

Strengthening of muscle

131
Q

What is/are the indication(s) for NMES?

A
  • Stimulation of denervated muscles
  • Improve/retrain motor control
  • Strengthening
  • Muscle pump for edema control
  • Reduce spasticity by applying over the antagonist muscle (NMES)
132
Q

Characteristic of a russian current

A

Burst modulation

133
Q

Recommended parameter of a russian treatment?

A
  • 50 bursts/ second
  • Burst duration is 10 microsecs
  • 10 secs contraction time
  • 50 secs off time
  • 10 repetitions
134
Q

What are the precautions of HVPC?

A
  • Cardiac disease
  • Impaired sensation
  • Malignant tumors
  • Skin irritation or open wounds
135
Q

What are the contraindications of HVPC?

A
  • Pacemakers, heart conditions (unstable arrythmias)
  • Over the carotid sinus
  • Venous or arterial thrombosis or thrombophlebitis
  • Pelvis, abdomen, trunk, and low back during pregnancy(1st trimester), can be used for pain control during delivery
136
Q

What are the contraindications of HVPC, TENS, IFC?

A
  • Pacemakers, heart conditions (unstable arrythmias)
  • Over the carotid sinus
  • Venous or arterial thrombosis or thrombophlebitis
  • Pelvis, abdomen, trunk, and low back during pregnancy(1st trimester), can be used for pain control during delivery
137
Q

What are the risk of TENS, HVPC, NMES, russian, and IFC

A

discomfort

138
Q

For immediate increased ROM, which frequency of IFC should be used?

A

High frequency (80-150)

139
Q

If patient has a fear of movement, and will be performing movement for a short period of time post treatment, which frequency of IFC should be used?

A

High frequency (80-150)

140
Q

If patient has a fear of movement, and will be performing movement for a long/extended period of time post treatment, which frequency of IFC should be used?

A

Low frequency (2-10)

141
Q

What frequency should for a patient getting E-stim for the first time?

A

80-150

142
Q

What is difference the feeling from IFC/TENS under high and low frequency?

A

They both feel pins needles, but a high frequency is a strong but comfortable feeling, while a low frequency is at a higher intensity, and a deeper level. It is a strong but comfortable feeling with a muscle twitch

143
Q

When should you come back to check on a patient?

A

In 5 mins

144
Q

What is frequency called on a TENS unit?

A

Pulse rate

145
Q

What is pulse duration called on a TENS unit?

A

Pulse width

146
Q

Indications of an ultrasound

A
  • Pain control
  • Dermal ulcers
  • Tendon and ligament injuries
  • Bone fractures
  • Carpal tunnel syndrome
  • Soft tissue inflammation
  • Tissue extensibility
  • Scar tissue remodeling
  • Tissue healing
147
Q

The higher the frequency, the ____ the absorption, hence ____ depth of penetration

A

The higher the frequency, the higher the absorption, hence less depth of penetration

148
Q

When looking to get a mechanical effect of US, ___ duty cycle should be used

A

Lower duty cycle (20%)

149
Q

When looking to get a thermal effect of US ___ duty cycle should be used

A

Higher duty cycle (100%)

150
Q

At what temperature does US start to increase metabolism and healing?

A

1 deg C

151
Q

What temperature does US start to decrease pain and muscle spasms?

A

2-3

152
Q

What temperature does US increase extensibility, and decrease joint stiffness

A

4 deg C or higher

153
Q

What frequency will you use for a tissue depth of up to 5cm?

A

1 MHz

154
Q

What frequency will you use for a tissue depth of 1-2 cm deep?

A

3 MHz

155
Q

What intensity should be used at 1 MHz?

A

1.5-2 W/cm^2

156
Q

What intensity should be used at 3 MHz?

A

0.5 W/cm^2

157
Q

What intensities should be used if a non-thermal effect is desired?

A

0.5-1.0

158
Q

How long should all US be done?

A

5-10 min/2 x ERA

159
Q

What waveform should be used in the tissue healing: inflammatory/infected parameter setting/goal

A

HVPC

160
Q

What frequency(Hz) should be used in the tissue healing: inflammatory/infected parameter setting/goal?

A

60-125

161
Q

What pulse duration should be used in the tissue healing: inflammatory/infected parameter setting/goal?

A

40-100 microseconds

162
Q

What (I) should be used in the tissue healing: inflammatory/infected parameter setting/goal?

A

Tingling

163
Q

What polarity should be used in the tissue healing: inflammatory/infected parameter setting/goal?

A

Negative

164
Q

What treatment time should be used in the tissue healing: inflammatory/infected parameter setting/goal?

A

45-60 mins few times/day

165
Q

What waveform should be used in the tissue healing/proliferation clean parameter setting/goal?

A

HVPC

166
Q

What Hz should be used in the tissue healing/proliferation clean parameter setting/goal?

A

60-125

167
Q

What pulse duration should be used in the tissue healing/proliferation clean parameter setting/goal?

A

40-100 microseconds

168
Q

What (I) should be used in the tissue healing/proliferation clean parameter setting/goal?

A

Tingling

169
Q

What polarity should be used in the tissue healing/proliferation clean parameter setting/goal?

A

Positive

170
Q

What treatment time should be used in the tissue healing/proliferation clean parameter setting/goal?

A

45-60 mins few times/day

171
Q

What waveform should be used in the edema control: acute parameter setting/goal?

A

HVPC

172
Q

What Hz should be used in the edema control: acute parameter setting/goal?

A

100-120

173
Q

What pulse duration should be used in the edema control: acute parameter setting/goal?

A

40-100 microseconds

174
Q

What (I) should be used in the edema control: acute parameter setting/goal?

A

Tingling

175
Q

What polarity should be used in the edema control: acute parameter setting/goal?

A

Negative

176
Q

What treatment time should be used in the edema control: acute parameter setting/goal?

A

20-30 mins

177
Q

What waveform should be used in the edema control: chronic lack of motion parameter setting/goal

A

NMES/HVPC

178
Q

What Hz should be used in the edema control: chronic lack of motion parameter setting/goal

A

35-50

179
Q

What pulse duration should be used in the edema control: chronic lack of motion parameter setting/goal

A

150-350 microseconds

180
Q

What (I) should be used in the edema control: chronic lack of motion parameter setting/goal

A

Visible motor response

181
Q

What polarity should be used in the edema control: chronic lack of motion parameter setting/goal

A

N/A

182
Q

What treatment time should be used in the edema control: chronic lack of motion parameter setting/goal

A

20-30 mins

183
Q

Inflammatory phase use ____ electrode on affected area

A

Inflammatory phase use negative electrode on affected area

184
Q

Proliferation phase use positive electrode to attract more _____ to the affected area

A

Proliferation phase use positive electrode to attract more proteins to the affected area

185
Q

What should you do to an area during edema control?

A

Elevate the area

186
Q

What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in the muscle fiber type?

A

PIC: Slow twitch type 1 first
ESC: fast twitch type 2 first

187
Q

What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in the contraction force?

A

PIC: low
ESC: high

188
Q

What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in the speed of contraction?

A

PIC: slow
ESC: fast

189
Q

What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in fatigue?

A

PIC: fatigue resistance
ESC: fatigues quickly

190
Q

What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in atrophy?

A

PIC: atrophy resistant
ESC: atrophies quickly

191
Q

What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in recruitment?

A

PIC: asynchronous
ESC: synchronous

192
Q

What are the 2 ways that electrical stimulation strengthens muscles?

A
  • Overload principle

- Specificity

193
Q

What is the overload principle?

A

Increased pulse duration, amplitude, electrode size, external resistance leads to higher load leads to higher force contraction leads to greater strengthening

194
Q

What is specificity?

A
  • Contractions specifically strengthen fibers that contract
  • ES has more effect on type II muscle fibers than on type I
  • Disuse atrophy is primarily present with type II fibers
195
Q

What are the clinical application of electrically stimulated muscle contractions?

A
  • Orthopedic conditions: increased strength after surgery, nonsurgical management of knee conditions
  • Neurological disorders: stimulates intact peripheral nerves in patients with CNS damage, can integrate with performance of functional activities= functional electrical stimulation
  • Functional electric stimulation (FES)
196
Q

What does electric stimulation do for spinal cord injury?

A
  • Counteract disuse muscle atrophy
  • improve circulation
  • contract muscle to assist with locomotion
  • contract muscle to assist with hand grasp, respiration, conditioning, bowel and bladder voiding
197
Q

What are requirements for ES for spinal cord injury?

A
  • Sufficient force to carry out activity
  • Not painful
  • Can be controlled and repeated
  • Acceptable to the user
198
Q

What is the lower extremity stimulation of ES for stroke?

A
  • Improved gait
  • Increased ankle dorsiflexion torque
  • Reduced agonist-antagonist co-contraction
  • Increased probability of returning home
199
Q

What are the advantages of adding NMES to strength training?

A
  • Can enhance strength gains
  • May or may not enhance functional performance
  • Is not a substitute for sports-specific training
200
Q

What frequency should generally be used on smaller muscles during russian ES?

A

20-30 pps

201
Q

What frequency should generally be used on larger muscles during russian ES?

A

35-50pps

202
Q

What are the contraindications of iontophoresis?

A
  • Patient being allergic to drug or chemical being used
  • Active bleeding in area to be treated
  • Metallic implants in immediate vicinity of area to be treated
  • Any condition where electric stimulation is contraindicated
203
Q

What are the precautions of iontophoresis?

A
  • Cardiac disease
  • Malignant tumors
  • Skin irritation or open wounds
  • Lack of sensation in area to be treated
204
Q

What are the factors affecting the efficacy of treatment for iontophoresis?

A
  • Skin integrity
  • Polarity of treatment electrode and drug ion. need to use lower currents with (-) ions
  • pH of drug solution
  • Concentration of drug in solution – Relatively low concentrations seem to be most successful
  • Presence of competing ions in the solution - Application of other treatments prior to or after – ie. heat or ultrasound
  • Parameter settings
205
Q

The ____ electrode is placed over a remote location

A

The dispersive (larger) electrode is placed over a remote location

206
Q

The ____electrode is the one that has the medication and is placed over the treatment area

A

The delivery electrode is the one that has the medication and is placed over the treatment area

207
Q

The ____ electrode depends on the polarity of ion to be delivered

A

The active electrode depends on the polarity of ion to be delivered

208
Q

An anode (+) will repel ___ ions

A

Positive ions

209
Q

A cathode (-) will repel ___ ions

A

Negative ions

210
Q

What is the treatment time range to keep a dupel (blue) machine and why?

A

Treatment times should be less than 30 minutes.

This is because as the duration of the treatment increases, skin resistance decreases and therefore risk of burns increases

211
Q

The duration of treatment of iontophoresis depends on…?

A

The current amplitude and dosage

212
Q

What is the max current amplitude of most machines?

A

4.0 mA

213
Q

When should the 40 mA min and 80 mA min be used?

A

Begin with 40 mA min on first treatment, increase towards 80 mA min as quickly as tolerated over future sessions for increased therapeutic affect

214
Q

What is the typical range of dosage of iontophoresis?

A

40-80 mA min

215
Q

How is the dose calculated for iontophoresis?

A

Intensity x time

216
Q

What is the maximum current density when the delivery electrode is positive?

A

Less than or equal to 1

217
Q

What is the maximum current density when the delivery electrode is negative?

A

Less than or equal to 0.5

218
Q

How is the current density of iontophoresis calculated?

A

Current amplitude/ surface area of delivery electrode

219
Q

What is the purpose of iontophoresis?

A

Alternative to phonophoresis, oral, and injection methods of drug delivery

220
Q

The tissue treated by iontophoresis should be ___

A

Should be relatively small, superficial and localized

221
Q

How are ions created in iontophoresis?

A

Ions are created by dissolving an intended drug or chemical compound that must be ionized, stable in condition, not altered by electrical current and small or moderate in size

222
Q

What is iontophoresis?

A

The transcutaneous delivery of ions into the body using low amplitude direct current to insure unidirectional flow of the ions

223
Q

____ provides sensory stimulation in addition for the benefits of heat

A

Fluidotherapy

224
Q

What is the temperature range for fluidotherapy?

A

110-120

225
Q

___ is a dry heating agent that transfers heat via convection, and allows patients to perform AROM while being heated at the same time

A

Fluidotherapy

226
Q

In an IR lamp, the intensity of radiation reaching target changes in proportion to ____

A

The inverse square of the distance

227
Q

IR lamp needs to be imparted as close to ____ to skin surface as possible

A

IR lamp needs to be imparted as close to perpendicular to skin surface as possible

228
Q

____ is an electromagnetic radiation within range that gives rise to heat when absorbed

A

IR lamp

229
Q

What are some other options for superficial heat?

A
  • IR lamp

- Fluidotherapy

230
Q

What are the adverse effects of laser and light?

A
  • Exposure of eyes to laser can cause retinal damage
  • Transient tingling
  • Mild erythema
  • Rash
  • Burning sensation
  • Increased pain/numbness
  • Burns from war diode
231
Q

What are the precautions of laser and light?

A
  • Low back or abdomen during pregnancy
  • Epiphyseal plates in children
  • Impaired sensation
  • Impaired mentation
  • Photophobia/light sensitivity
  • Pretreatment with photosensitizer
232
Q

What are the contraindications of laser and light?

A
  • Direct radiation of eyes; patients and clinicians should wear provided goggles
  • Malignancy
  • Within 4-6 months after radiotherapy
  • Hemorrhage
  • Thyroid or other endocrine glands
233
Q

What are the clinical indications for laser and light?

A
  • Soft tissue and bone healing
  • Arthritis
  • Lymphedema
  • Neurological conditions
  • Pain management
234
Q

What are the effects of lasers and light?

A
  • Promote ATP production by mitochondria
  • Promote collagen production by fibroblasts
  • Modulate inflammation
  • Inhibit bacterial growth
235
Q

What is power?

A

The rate of energy flow, mW

Physical agents (7 decks)

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