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Modalities > Hydrotherapy & Compression > Flashcards

Hydrotherapy & Compression Flashcards

1
Q

What are the 4 physical properties of water?

A

High Specific Heat
Thermal Conductivity
Hydrostatic Pressure
Buoyancy/Resistance

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2
Q

What are the possible modes of heat transfer associated with hydrotherapy?

A

Conduction & Convection

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3
Q

How is heat transferred in stationary water?

A

By Conduction

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4
Q

How is heat tranferred in moving water?

A

By Convection

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5
Q

What is buoyancy?

A

A force experienced as an upward thrust on the body opposite to the force of gravity.

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6
Q

Per Archimedes’ Principle:
When a body is entirely or partially immersed in a fluid at rest, it experiences an _________________ equal to the weight of the weight of the fluid it displaces

A

Upward Thrust

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7
Q

Which has a higher density: the human body or water?

A

Water

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8
Q

What is Specific Gravity?

A

The ratio of density of a material compared to the density of water.

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9
Q

What does submersion of most of the body do to weight bearing joints , muscles and connective tissues?

A

It decreases stress and compression

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10
Q

What does the viscosity of water do to the motion of a body?

A

It provides resistance to motion.

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11
Q

What direction does resistance occur in relationship to the motion of the body in water?

A

Resistance occurs against the direction of the motion

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12
Q

How is resistance affected relative to the speed of a body’s motion in water?

A

Resistance increases in proportion to the speed.

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13
Q

In addition to the benefits of exercising in water, what other benefit(s) can be derived from the variable resistance and pressure of moving water?

A

It is good for debriding and cleansing wounds.

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14
Q

According to Pascal, does hydrostatic pressure increase or decrease as the depth of immersion increases?

A

Pressure increases as depth increases.

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15
Q

There are no hydrostatic pressure effects when nonimmersion hydrotherapy techniques are used. True or False?

A

True

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16
Q

List 6 psysiological effects of water that result from its physical properties:

A 
Cleansing
Musculoskeletal Effects
Cardiovascular Effects
Respiratory Effects
Renal Effects
Psychological Effects
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17
Q

Can immersion in water assist in alleviating peripheral edema caused by venous or lymphatic insufficiency?

A

Yes

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18
Q

Compare the effects of hydrostatic pressure on a vertical (standing) patient vs a horizontal (swimming) patient?

A

Pressure will be greater on the feet of the vertical patient.

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19
Q

List types of conditions which can progress more rapidly during rehabilitation when buoyancy is used to unload weight-bearing anatomical structures.

A

Arthritis
Ligamentous Instability
Cartilage Breakdown
Degenerative or traumatic conditions of the articular or periarticular structures of the weight-bearing joints

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20
Q

What property(ies) of water can be used to provide force against which muscles can work to gain or maintain strength

A

Velocity dependent resistance

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21
Q

What happens when water flow is adjusted to occur in the same direction of the patient’s motion?

A

Resistance is decreased - the water flow can actually be used to assist the patient’s movement.

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22
Q

The cardiovascular benefits of hydrotherapy are primarily a result of the effects of what?

A

Hydrostatic Pressure

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23
Q

How does hydrostatic pressure benefit cardiovascular therapy?

A

The pressure displaces venous blood proximally
This increases Cardiac Volume
Which increases Stroke Volume and Cardiac Output

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24
Q

What is Starling’s Law?

A

The strength of the heart’s systolic contraction is directly proportional to its diastolic expansion
This means that under normal physiological conditions, the Right Atrium pumps all of the blood returned to it without any blood backing up into the veins.

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25
Q

Is the rate of oxygen consumption lower or higher when exercise is performed in water than when exercise at the same level of perceived exertion is performed on dry land?

A

It is lower

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26
Q

Should Target Heart Rate be used as the gauge for water exercise intensity? Why?

A

No. Heart rate to exercise is “blunted” in water. The LEVEL OF PERCEIVED EXERTION should be the guide for exercise intensity in water.

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27
Q

Why does immersion of the whole body in water increase breathing work?

A

Because the venous blood flow from peripheral to central circulation increases circulation in the chest cavity - the hydrostatic pressure on the chest wall increases the resistance to lung expansion.

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28
Q

What kind of conditions/impairments should be carefully monitored during water based exercise?

A

Respiratory and/or cardiovascular impairments.

The additional respiratory challenge of exercising in water may overload patients with these conditions.

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29
Q

Is water based exercise more or less likely than land based exercise to aggravate asthma?

A

Less likely

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30
Q

What renal effects can be seen in individuals immersed up to the neck in water?

A

Increased urine production

Urinary Sodium & Potassium excretion

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31
Q

What type of patients may benefit from immersion in warm water?

A

Individuals with CHF
Patients who need a calming environment
Overstimulated or agitated patients

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32
Q

What type of patients may benefit from immersion in cold water?

A

Patients who can benefit from the stimulation of the cold water -
Patients who are generally less active or less responsive

33
Q

What type of symptoms/conditions would suggest using a contrast bath?

A

Chronic Edema

Subacute Trauma

Inflammatory conditions such as sprains, strains, or tendonitis

Hyperalgesia

Hypersensitivity caused by reflex sympathetic dystrophy or other conditions

34
Q

What are the benefits of a contrast bath?

A

It is used to achieve the benefits of heat, including decreasing pain, increasing flexibility, while avoiding the risk of increased edema

35
Q

What direction should the turbine be directed to control pain or to remove tightly adhered wound debris?

A

It should be turned toward the affected area

36
Q

When should the turbine in a WP be directed away from the involved area?

A

If the area is hypersensitive
If granulation tissue is present
Recent skin grafts

37
Q

Clinically, what is the general use of Whirlpools?

A

Exercise or pain control in limited areas of the body.

They are sometimes used for wound care as well.

38
Q

What are the 7 things that should be included in hydrotherapy documentation?

A
  1. Type of hydrotherapy used
  2. Patient position / activity
  3. Water Temp
  4. Treatment time
  5. Outcome/response to treatment
  6. Fluid pressure, if applicable
  7. Any water additives used
39
Q

What are the contraindications for local immersion hydrotherapy?

A

Maceration around a wound

Bleeding

40
Q

What are the precautions for local immersion hydrotherapy?

A
  1. Impaired thermal sensation in the area to be immersed
  2. Infection in the area to be immersed
  3. Confusion or impaired cognition
  4. Recent skin grafts
41
Q

What are the adverse effects of hydrotherapy?

A
  1. Burns
  2. Fainting
  3. Hyponatremia (salt loss) - pt w/extensive burns
  4. Infection
  5. Aggravation of edema
  6. Bleeding
  7. Drowning
42
Q

What are the precautions for full body immersion in Hot or Very Warm water?

A
  1. Pregnancy
  2. Multiple Sclerosis
  3. Poor Thermal Regulation
43
Q

What are the contraindications for full body immersion hydrotherapy?

A
  1. Cardiac instability
  2. Infectious conditions that may be spread by water
  3. Bowel incontinence
  4. Severe epilepsy
  5. Suicidal patients
44
Q

What are the precuations for the use of full body immersion hydrotherapy?

A
  1. Confusion or disorientation
  2. Alcohol ingestion by the patient
  3. Limited strength, endurance, balance or ROM
  4. Medications
  5. Urinary Incontinence
  6. Fear of Water
  7. Respiratory Problems
45
Q

What WP temperature setting is most appropriate for treating acute inflammation?

A

Cold: 32-79 F

OR if not tolerated, 79-92 (Tepid)

46
Q

What WP temperature setting is most appropriate for therapeutic exercise?

A

Tepid: 79-92 F

47
Q

What WP temperature setting is most appropriate for treating open wounds?

A

Neutral: 92-96 F

48
Q

What WP temperature setting is most appropriate for medically compromised patients?

A

Neutral: 92-96 F

49
Q

What WP temperature setting is most appropriate for treating decreased tone?

A

Neutral: 92-96 F

50
Q

What WP temperature setting is most appropriate for increasing mobility in burn patients?

A

Mild Warmth: 96-98 F

51
Q

What WP temperature setting is most appropriate for pain control?

A

Hot: 99-104 F

52
Q

What WP temperature setting is most appropriate for increasing soft tissue extensibility?

A

Very Hot: 104-110 F

53
Q

What WP temperature setting is most appropriate for treating chronic conditions?

A

Very Hot: 104-110 F

54
Q

Can Very Hot temperatures (104-110 F) be used for whole body immersion hydrotherapy?

A

No. It should be used only when treating a limited body area.

55
Q

What is an Autograft?

A

A skin graft using the patient’s own skin.

56
Q

What is an Allograft?

A

A skin graft using another person’s skin.

57
Q

What is a Xenograft?

A

A graft of tissue transplanted between animals of different species

58
Q

What is a Cultured Graft?

A

Made from the patient’s own skin cells, in combination with a medical fabric that dissolves after grafting to the wound.

59
Q

What is a Biosynthetic Dressing?

A

Gels, solutions or semi-permeable sheets derived from a natural source

60
Q

What is compression?

A

A mechanical force that increases external pressure on the body or a body part.

61
Q

What are the therapeutic effects of external compression?

A
  1. Improves venous and lymphatic circulation
  2. Limits the shape and size of tissue
  3. Increases tissue temperature
62
Q

What are the clinical indications for the use of external compression?

A
  1. Edema
  2. Lymphedema
  3. Prevention of DVT
  4. Venous Stasis Ulcers
  5. Residual Limb Shaping after Amputation
  6. Control of Hypertrophic Scarring
63
Q

What are the contraindications for compression?

A
  1. Acute trauma or fracture
  2. Heart Failure or Pulmonary Edema
  3. Acute Infection
  4. Recent or acute DVT, Thrombophlebitis or pulmonary emobolism
  5. Arterial Revascularization
  6. Lymphatic or Venous Obstruction
  7. Peripheral arterial disease or ulcers due to sever arterial insufficiency
  8. Hypoproteinemia
64
Q

What are the precautions for compression?

A
  1. Impaired sensation
  2. Uncontrolled Hypertension
  3. Impaired Mentation
  4. Cancer
  5. Stroke or cerebrovascular insufficiency
  6. Superficial peripheral nerves
65
Q

What is the appropriate pressure for upper extremity compression?

A

30-60 mm Hg

66
Q

What is the appropriate pressure for lower extremity compression?

A

40-80 mm Hg

67
Q

What is the standard compression treatment time?

A

2 to 3 hours

68
Q

What inflation/deflation ratio is most appropriate for treating edema?

A

3:1

Specifically:
80-100 sec Inflation : 25-35 sec Deflation

69
Q

What inflation/deflation ratio is most appropriate for DVT prevention?

A

3:1

Specifically:
80-100 sec Inflation : 25-35 sec Deflation

70
Q

What inflation/deflation ratio is most appropriate for treating a venous stasis ulcer?

A

3:1

Specifically:
80-100 sec Inflation : 25-35 sec Deflation

71
Q

What inflation/deflation ratio is most appropriate for residual limb reduction?

A

4:1

Specifically:
40-60 sec Inflation : 10-15 sec Deflation

72
Q

What are the possible adverse reactions to compression?

A
  1. Aggravating a condition that is causing edema

2. Impairing circulation with too much pressure

73
Q

What can be done to minimize the probability of adverse reactions to compression?

A

When edema in an extremity has fluid accumulation at the proximal end of the extremity, it should be mobilized using massage.

To avoid adverse circulatory effects, the patient should be monitored for changes in BP or edema - especially during the first application. Treatment parameters can also be adjusted.

74
Q

How much pressure is recommended to control scar tissue formation using compression?

A

20-30 mm Hg

Usually compression garments or elastic bandages.

75
Q

How long should compression garments be worn?

A

24/7 except when bathing.

76
Q

What 6 things should be included in documentation of compression treatment?

A
  1. Type of compression device
  2. Area of body being treated
  3. Inflation and deflation times
  4. Compression or inflation pressure
  5. Total treatment time
  6. Patient’s response to treatment
77
Q

What type of sensation testing is most appropriate prior to applying intermittent pneumatic compression?

A

Pressure test

78
Q

What patient assessments should be completed AFTER compression treatment?

A

Blood Pressure
Girth Measurement
Skin Integrity

Modalities (7 decks)

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