Intro to physiotherapy

Question 1

What wavelength is used in acute pain?

Answer 1

Short wave lengths

Question 1

What is the difference between tightness and contracture?

Answer 1

• Tightness: adaptive shortening of the soft tissue, which is reversible because it is caused by the adaptive situation that the person is currently in.
• Contracture: is irreversible shortening ( if a patient has a burn the soft tissues because of the severe heat will melt and start fusing on each other and the muscle itself goes into shortening which is irreversible if we are talking about second and third-degree burns which will lead to the formation of an eschar which requires surgical release.
• Pseudo contracture: ( neurological defects) meaning false contraction such as a stroke the patient will have hypotonia

Question 2

What is a proprioceptors?

Answer 2

Proprioceptors are the receptors that provide the brain with information regarding the position and direction of movement; they are also present in the ligaments and joints surfaces

Question 3

What are the goals of physiotherapy?

Answer 3

1) Relieve of Pain

2) Restoring ROM & strength

3) Restoring Functional abilities

Question 4

What are the modalities of physiotherapy?

Answer 4

1) Electromagnetic: wavelength, amplitude, frequency and intensity

2) Thermal

3) Mechanical

Question 5

What is a wavelength?

Answer 5

The distance between the peak of one wave and the peak of the next one

Question 6

What is meant by frequency?

Answer 6

Number Of Wave Oscillations Or Vibrations Per Second (Hz, CPS, PPS)

Question 7

List an example of a situation where we use the electromagnetic spectrum

Answer 7

When stimulating muscles that are not responding like in the case of a stroke

Question 8

What type of wavelength and frequency are used in electrical stimulating currents?

Answer 8

Longest wavelength and lowest frequency

Question 9

What type of wavelength and frequency are used in ionizing radiation?

Answer 9

Shortest wavelength and highest frequency

Question 10

What is the function of an electrical simulator?

Answer 10

1) It stimulates the muscles for contraction which will reduce the pain (using Transcutaneous electrical nerve stimulators), - we have two types of pain fast acting and chronic, TENS will reduce the feeling of chronic pain by stimulating the substantia negra AKA substantia gelatinosa to produce fast acting pain impulses overriding the chronic pain feeling. This technique can only be used for up to 24 hours

2) Prevents atrophy due to lower extremity swelling as it can stimulate the pumping action in comatose patients

Question 11

What are the different types of electrical stimulating currents?

Answer 11

1) Electrical muscle stimulators (EMS)

2) Transcutaneous electrical nerve stimulators (TENS)

3) Low-intensity stimulators (LIS / MENS)

Question 12

Where do we place the electrodes to stimulate muscle contraction?

Answer 12

The motor probe of the muscle

Question 13

What are the uses of electrically inducing muscles?

Answer 13

1) Muscle re-education
2) Muscle pumping contractions (reducing edema)
3) Retardation of atrophy
4) Muscle strengthening
5) Increasing the range of motion
6) Producing a net movement of ions via the use of continuous low-voltage currents which elicits a chemical change in the tissue (iontophoresis)

Question 14

What is the meaning of iontophoresis?

Answer 14

Chemical changes that occur in the tissues, like when placing ointments/medications on the electrodes

Question 15

What is the anatomy of the nerves connected to the substantial negra?

Answer 15

1) AB fiber (myelinated, fast fibers, responsible for the initial sharp pain at the time of the injury, activated to stop the transmission of pain signals)

2) C fiber (Slow, for dull long-lasting pain)

3) Inhibitory interneuron (activated by the AB fiber, stops the feeling of the chronic pain)

Question 16

How are muscles re-educated?

Answer 16

• Used for patients who can’t control their muscles due to chronic paralysis or immobilization in which the patient has forgotten how to stimulate muscle movement

1) Uses surface EMG “electromyogram” that is inserted into the insertion and origin of a muscle which measures the stimulation in the muscles collecting impulses and displaying them visually (like a green light) where the patient would learn the best way to control the muscle

• It is also used to treat urinary incompetence, and females with prolapses during delivery.

Question 17

What is a diathermy?

Answer 17

A medical technique that uses high-frequency electromagnetic currents to generate heat in body tissues

Question 18

Why do we not use heat in acute stages?

Answer 18

If we apply heat at that time, circulation will improve so more substances will enter the inflamed area, but nothing will leave because of the decreased lymphatic drainage which causes the swelling and congestion to worsen leading to cell death.

• Cell death will lead to the release of lysosomal enzymes which would increase inflammation and pain and become a source of inflammation which is called congestion.

Question 19

Why do we use ice in acute injuries?

Answer 19

Ice causes vasoconstriction which would prevent further congestion and It also reduces nerve conduction in the area 🡪 less pain, you can use it for 5-12 minutes maximum to avoid frostbite which leads to burns (because of the lysosomes released upon cell death due to freezing)

Question 20

What are the contraindications in the use of SWD?

Answer 20

Metal implants

Question 21

When is a SWD used?

Answer 21

1) If The Skin or Some Underlying Soft Tissue Is Tender And Will Not Tolerate Pressure

2) In Areas Where Subcutaneous Fat Is Thick And Deep Heating Is Required

Question 22

What are the advantages of cryotherapy?

Answer 22

1) Decrease Local Temperature

2) Decrease Local Metabolism

3) Decrease Blood Flow (Vasoconstriction)

4) Decrease Venous And Lymphatic Flow
5) Decrease Nerve Conduction Velocity

6) Decrease Muscle Excitability

7) Analgesia

Question 23

What is the use of warm water?

Answer 23

1) warm water relaxes, and dipping in Paraffin maintains a constant temperature gradient, it decreases slowly and soothes the area

2) If a patient has a stroke or amputation and he is heavy we can use the characteristics of water to carry the patient

3) You can cover a whole area by dipping in fluids so you can use this area as a medium for the ultrasound

Question 24

What type of energy is provided by ultrasounds?

Answer 24

Acoustic energy, which makes molecules vibrate producing heat or breaking down tissues breaking adhesions

• It has two modes (pulsatile “makes the molecules move for a while and pause allowing the heat to disseminate, then there will be no chance of heat accumulation” & continuous)

Question 25

What are the benefits of ultrasounds?

Answer 25

1) Thermal effects in deeper tissues

2) Enhances healing at the cellular level

3) Non-thermal effects

Question 26

What is meant by traction?

Answer 26

Chinese invented, where you would add weight, pulling the neck in a specific position and that would relieve the compression, but it doesn’t act on decreasing the load only it also stretches the muscles of the neck which is considered a sustained stretching technique.