Intro To Modalities Flashcards
What type of energy do physical agent modalities include?
Thermal, acoustic, electromagnetic, electrical or mechanical energy
What are physical agent modalities?
Transmission of various frequencies into tissues with different energies in pt care
4 types of modalities
Superficial heat and cold, intermittent pneumatic compression, traction, hydrotherapy
What is NMES used for
To promote muscle contraction
What does TENS stand for? Benefit?
Transcutaneous Electrical Nerve Stimulation; modulate pain
What are two benefits of electrotherapies?
Promote edema reduction and wound healing
3 examples of mechanical modalities
Hydrotherapy, intermittent pneumatic compression, mechanical traction
What type of mechanical traction and what body areas is it used for?
Continuous and intermittent; lumbar and cervical
What is intermittent pneumatic compression?
Application of external mechanical pressure to body for therapeutic purpose
Indications for intermittent pneumatic compression
-trauma edema
-stump reduction following limb amputation
-wound healing
-prevention of DVT
-venous stasis ulcers
-lymphedema
Contraindications for pneumatic compression
-acute pulmonary edema
-congestive heart failure
-uncontrolled hypertension
-acute or recent DVTs
-infection
Typical intermittent pneumatic compression protocols and what to avoid
-continuous w/ very low intermittent pressure
-brief: maximal pressure below diastolic, time 15-30 mins
-avoid: swelling in other areas, stiffness, numbness, SOB
Describe the transfer of energy regarding heating and cooling agents
Heating transfers energy TO body
Cooling transfers energy AWAY from body
5 ways for heating and cooling agents to transfer energy
Conduction, convection, conversion, radiation, evaporation
Describe conduction (type of contact)
-Direct contact between two objects that have different temps
-hot molecules collide w/ slow molecules (kinetic motion) and continue until speed equalize
Describe convection (what does it contain, purpose)
-medium present
-heat transferred from circulating medium
Describe conversion (what is it)
-converts non-thermal energy (mechanical, electrical, chemical) into heat (thermal energy)
-doesn’t require direct contact
Describe radiation
-direct transfer of energy from material w/ greater temp
-no medium and no contact
Ex. Of radiation
Infrared lamp, sun
Describe evaporation
Material that absorbs energy and changes it from liquid to a gas or vapor
Indications for therapeutic heat
-general and muscle relaxation
-calming effect, decrease muscle tone and guarding
-pain control
-increase ROM/decrease joint stiffness
-increase tissue extensibility, decrease muscle spasm
-promote healing (increased circulation, O2, metabolic rate)
Effects of vigorous heat
-vasodilation (increase capillary pressure and flow)
-increased O2 hemoglobin dissociation
-neuromuscular effects (increase nerve conduction velocity and firing)
Contraindications for therapeutic heat
-acute injury or inflammation
-recent or potential hemorrhage
-thrombophlebitis
-impaired sensation
-impaired mentation/cognition
-malignancy
-IR irradiation of the eyes
Precautions for therapeutic heat
-pregnancy
-impaired circulation
-poor thermal regulation
-edema
-cardiac insufficiency
-metal in the area
-paraffin over an open wound
-where topical counterirritants have recently been used (cause chemical burns)
Adverse effects of superficial heat
Burns, fainting, bleeding, skin and eye damage from infrared
5 methods of superficial heat application
Moist heat, electric heating pads, whirlpool, paraffin, infrared
What is a hot pack? What temp is water? How to apply?
-Canvas or nylon case filled w/ hydrophilic silicate (sand)
-70 to 75 degrees C
-placed in 6-12 layers of terry cloth and placed in contact w/ pt for 15-20 mins
What is mild heat? Temp and uses?
-counterirritant
-<40 degrees C
-relaxation, decreased muscle tone
What is vigorous heat temp? Causes?
40-45 degrees C
>45 degrees C causes tissue, burning
How is muscle strength affected by heat?
Decreased for 30 mins after heat, increases next 2 hours to greater than pretreatment
How does heat affect tissue extensibility?
-Can lead to permanent elongation when combined w/ stx
4 methods of cold application
Ice pack, massage, bath, flouromethane spray
Indications for therapeautic cold
-acute and sub-acute musculoskeletal trauma and inflammation
-hemodynamic effects (vasoconstriction, control acute inflammatory mechanisms)
-pain control
Cold therapy mechanism and hemodynamic effects
-vasoconstriction due to decreased vasodilator release, direct effect smooth muscle contraction, increased sympathetic activation
-HE = decreased blood flow
Dangerous cold temps and affects
15 degrees C, tissue damage can occur
-4 to -10 degrees C, frost bite and tissue death
How to make home cold pack?
1 part rubbing alcohol, 3 parts water
How much time for ice massage?
8-10 mins
Stages of sensation w/ cold therapy
Stage I: cold (1-3 mins)
Stage II: burning (3-5 mins)
Stage III: aching (5-7 mins)
Stage IV: numbness (7+ mins)
Neuromuscular effects of cold therapy
-temporary decrease in spasticity
-decrease nerve sensitivity
-after 45 mins, decreased hyper-reflex is
Indications for cold therapy
Inflammation control, edema control, pain control, modification of spasticity, facilitation of strength
Contraindications w/ cold therapy
-cold hypersensitivity
-cold intolerance
-Raynaud’s disease or phenomenon
-area w/ circulatory compromise or peripheral vascular disease
Precautions with cold therapy
-superficial main branch of nerve
-open wound
-hypertension
-poor sensation or cognition
-very young or old pts
Negative effects of cold therapy
Tissue death, frostbite, nerve damage, unwanted vasodilation
