Intro to PT Modalities

Question 1

Energy is defined as…

Answer 1

the capacity of the system to do work

Question 2

Law of Thermodynamics

Answer 2

Energy cannot be created or destroyed, it can be transformed from one form to another

Question 3

Types of electromagentic energy

Answer 3

SW Diathermy, infrared, UV, low power lasers

Question 4

Types of thermal enegery

Answer 4

Thermotherapy, cryotherapy

Question 5

E-stim, iontophoresis, biofeedback are all types of what energy

Answer 5

Electrical

Question 6

Ultrasound and Phono are what type of energy

Answer 6

Acoustic

Question 7

Arndth-Schultz Principle

Answer 7

Energy must be absorbed by the tissues and must be sufficient to stimulate a physiological response (too little stimulus=no effect and too much stimulus=injury)

Question 8

Inverse relationship btw absorption and penetration of energy. Energy absorbed by one tissue layer is not passed along to deeper layers. The more energy absorbed in superficial layers, the less available for deeper layers. This is an example of what principal???

Answer 8

Grotths-Draper

Question 9

Cosine Law: Angle of Incidence

Answer 9

The angle at which energy strikes the body

As the angle of incidence changes from 90, the less effective the transmission (Want a 90 degree angle, if at 45 degree angle you only get 50% transmission)

Question 10

Inverse Square Law

Answer 10

Intensity of radiant energy depends on the distance between the source and target. Changing the distance changes the intensity.

Question 11

Formula for inverse square law

Answer 11

E=Es/D^2
E-energy received by the tissue
Es-energy produced by the source
D^2-square of the distance btw the target and the source (doubling the distance btw tissue and target decreases intensity by a factor of 4)

Question 12

Transfer of energy is based on…

Answer 12

a gradient btw 2 points. Energy always moves from a high concentration to low.

EX: Moist heat pack to the skin, skin to an ice pack

Question 13

If I increase the gradient size, what happens to the amount of energy that is transferred?

Answer 13

An increase in energy will be transferred

Question 14

One object loses heat while the other gains heat. The objects are touching each other.

Answer 14

Conduction

Question 15

Examples of conductors

Answer 15

Skin and muscle

Question 16

Examples of insulators

Answer 16

Adipose and terrycloth towels

*Thermotherapy (heat packs) are not able to heat deep tissues b/c subcutaneous fat acts as an insulator

Question 17

Convection

Answer 17

Involves the circulation of air or water, one object is cooled and another object is heated
*Factors that influence this include temp, speed of movement, and conductivity of the part

Question 18

Whirlpool is an example of what transfer of energy?

Answer 18

Convection

Involves circulation of water

Question 19

Radiation

Answer 19

No medium required. Thermal modalities provide radiant energy but is not the primary from of heat exchange.
EX: Lasers, infrared ligh, UV light (types of electromagnetic energy)

Question 20

Change of one form of energy to another

Answer 20

Conversion

Question 21

Electromagnetic energy to heat is what transfer of energy? EX: SW Diathermy and US

Answer 21

Conversion

Question 22

Administration of thermal, acoustic, mechanical, electromagnetic and electrical energies for specific therapeutic effects do what….

Answer 22

• Dec pain
• Inc ROM
• Inc tissue healing
• Inc mm recruitment

Question 23

Modalities must be used as a…..

Answer 23

complement to a more comprehensive therapy POC

Question 24

Selecting the appropriate modality depends on what factors?

Answer 24

1. ) Injury (type, area, severity, stage of healing)
2. ) Indicated or Contraindicated
3. ) Do you need a physician prescription (iono)

Question 25

Name the phases of tissue regeneration/repair

Answer 25

1. ) Inflammatory
2. ) Proliferative/fibroplasia
3. ) Maturation/remodeling

Question 26

Inflammatory Process 5 Signs

Answer 26

1. ) Heat
2. ) Pain
3. ) Redness
4. ) Swelling
5. ) Loss of Function

• Activation of monocytes into macrophages marks end of early phase of inflammation, late inflammation marks macrophage accumulation
• Lasts about 2-5 days

Question 27

Chronic Inflammation (After 5-6 days)

Answer 27

• Persistence of inflammatory phase can result in significant tissue damage beyond what was caused by initial injury
• Persistence of macro-phages due to replication rather than chemotaxis; resulting blockade of repair

Question 28

Proliferative/Fibroplasia Phase

Answer 28

Lasts 4-6 weeks
Repair=Replacement of scar tissue
Regeneration=Replacement of damaged tissue w/same type of tissue
Characteristics of this stage include angiogensis and re-epithelization
Fibroblasts accumulation and production of extra-cellular matrix occurs

Question 29

Angiogensis

Answer 29

Growth of endothelial capillary buds into wound site (neovasculaization), occurs in prolifertaive/fibroplasia phase

Question 30

Re-Epithelization

Answer 30

Beginning from edges and providing a barrier over the wound site, occurs in prolifertaive/fibroplasia phase

Question 31

Maturation/Remodeling Phase

Answer 31

Long term, lasts for 1yr or more

• Amt of vascurlaization dec so the mature scar gets less blood
• Prior to remodeling collagen fibers are random, after remodeling collagen fibers oriented along lines of applied tension (Wolff’s Law!)

Question 32

You are applying a heating pack to your patient. The rate of temperature increases too slowly; the increase in BF will dissipate the heat from the hot pack and you do not get a therapeutic benefit. What principal is this?

Answer 32

Arndth-Schultz Principle

Question 33

You apply a heating pad to your pt’s neck. What type of energy transfer is this and what type of energy is it?

Answer 33

1. ) Conductive energy transfer – Occurs when heat is transferred from a warmer object to a cooler one
2. ) Thermal energy

Question 34

You have heat pack on that only affects superficial tissues….what law is this stating?

Answer 34

Grotths-Draper

Question 35

You decide to use fluidotherapy as a modalility. What type of energy transfer is this?

Answer 35

Convective energy transfer (dry heat modality)

Question 36

You are doing US on a patient and accidentally make the treatment area more than 2-3x the ERA and now you do not get the full thermal effect. What law is this?

Answer 36

Arndth-Schultz Principle

Energy must be absorbed by the tissues and must be sufficient to stimulate a physiological response (too little stimulus=no effect and too much stimulus=injury)

Question 37

What type of energy and what type of transfer of thermal energy is SWD?

Answer 37

Electromagnetic Energy and Conversion transer

Question 38

What type of energy is biofeedback?

Answer 38

Electrical

Others include e-stim and iontophoresis

Question 39

You forget about the angle of incidence concept and you move your transducer head for your US tx at an angle of 45 degrees. How much transmission is your pt receiving?

Answer 39

50%

Question 40

There are all characteristics of what healing phase?
-Vascular and cellular response
-Defend body against alien substances
Stop the bleeding and dispose of dead tissue
-Increased BF
-Diapedesis (leakage btw endothelial cells)
-Influx of plasma proteins that facilitate edema

Answer 40

Inflammatory Process (2-5 days)

Question 41

Collagen (T III) and elastin fibers deposited in random fashion and ground substance (PG) deposited btw the fibers–forming the production of extracellular matrix. What phase of healing is this?

Answer 41

Proliferative/Fibroplasia