Lecture #1 (Basic Science of Modalities)

Question 1

Therapeutic modalities are an effective what to therapeutic exercise and should be treated as such.

Answer 1

Adjunct-they should only be used in addition to therapeutic exercise. “They can help to control pain while the body heals”

Question 2

What types of modalities can be utilized by the AT? (x6)

Answer 2

Ice, heat, electrical stim, ultrasound, massage, and traction.

Question 3

What should the AT be able to educate the patient about in regards to modalities?

Answer 3

The effects of the treatment and why they’re using it for that problem.

Question 4

What are the three most important things for an AT to know concerning a modality?

Answer 4

Function, indications, and contraindications.

Question 5

What should the selection of a modality be based on?

Answer 5

An accurate evaluation of the problem affecting the patient. They need to use the modality to affect the desired target tissue to get specific results.

Question 6

Typically ATs deal with modality use for these types of injuries:
while PTs deal with them for these types of injuries:

Answer 6

Acute (AT)

Subacute/Chronic (PT)

Question 7

In regards to patient positioning, what should be considered: (x7)

Answer 7

Make them comfortable (prop or bolster)
Should allow access to injured area
Should allow for accurate placement & direction of modality
Drape sensitive areas
Attach modality securely so they don’t have to hold it (i.e. wraping)
Use toweling to clean area after application

Question 8

Energy is defined as:

Answer 8

The capacity of a system for doing work.

Question 9

Radiation is what?

Answer 9

The process through which energy travels through space.

Question 10

What modality absorbs energy from patients instead of transfering energy into them.

Answer 10

Biofeedback

Question 11

What is the acoustic spectrum and what modality uses it?

Answer 11

The range of frequencies and wavelengths of sound waves; ultrasound.

Question 12

What is the electromagnetic spectrum?

Answer 12

The range of frequencies and wavelengths associated with radiant energy.

Question 13

What portion of the electormagnetic spectrum is associated with thermal changes? What modalities work within this spectrum?

Answer 13

Infrared; heat & ice.

Question 14

What portion of the electromagnetic spectrum is associated with chemical changes?

Answer 14

Ultraviolet

Question 15

What type of energy does traction utilize?

Answer 15

Mechanical energy.

Question 16

Diathermy, infrared lamps, ultraviolet light, and low power lasers all produce what kind of energy?

Answer 16

Electromagnetic energy.

Question 17

Thermotherapy and cryotherapy produce what kind of energy in addition to electromagnetic energy?

Answer 17

Thermal energy.

Question 18

Electrical stimulating current, biofeedback, and ionto produce what kind of energy in addition to electromagnetic energy?

Answer 18

Electrical energy.

Question 19

Ultrasound and extrracorporeal shockwave therapy produce what kind of energy?

Answer 19

Sound (acoustic) energy.

Question 20

Intermittent compression, traction, and massage all produce what kind of energy?

Answer 20

Mechanical energy.

Question 21

What region of the spectrum produces heat?

Answer 21

Infrared.

Question 22

What region of the spectrum produces chemical changes?

Answer 22

Ultraviolet.

Question 23

What are ultraviolet, infrared, and visible light rays produced by? Why is this?

Answer 23

Heat; as the temperature increases, the molecules vibrate and increase electron activity. The movement of electrons creates the electromagnetic waves.

Question 24

Electromagnetic radiations (waves) travel through space at a constant velocity of?

Answer 24

300 million meters/sec.

Question 25

Depending on what a wave strikes, what are the four things that can happen to it?

Answer 25

It is reflected, refracted, absorbed, or transmitted.

Question 26

What is a wavelength?

Answer 26

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

Question 27

What is the frequency of a wave? What is it measured in?

Answer 27

The number of wave vibrations occurring in one second; hertz (Hz)

Question 28

Waves travel at the same velocity (velocity=wavelength x frequency). What does this mean in terms of wavelengths and frequencies?

Answer 28

Longer wavelengths have smaller frequencies and shorter wavelengths have larger frequencies.

Question 29

Does a shorter or longer wavelength have the ability to penetrate deeper into the body?

Answer 29

Longer.

Question 30

What is the Arndt-Schultz Principle?

Answer 30

No reactions or changes can occur in the body tissues if the amount of energy absorbed is insufficient to stimulate the absorbing tissues.

Question 31

What can too much energy absorbed into a tissue do?

Answer 31

Damage it.

Question 32

What is the Law of Grotthus-Draper?

Answer 32

There is an inverse relationship between energy absorption by a tissue and energy penetration to deeper tissues. This means that the portion of a wave that is not reflected (by the skin) will penetrate into the tissue.

Question 33

What property of a tissue determines how much energy is refracted and absorbed?

Answer 33

Its density.

Question 34

According to the Law of Grotthus-Draper, if there is more energy absorbed by the superficial tissue, then:

Answer 34

There is less energy available to travel to deeper tissue.

Question 35

What is the Cosine Law?

Answer 35

The smaller the angle between the propagating ray and a right angle, the less radiation is reflected and the greater absorption of the wave into the tissues. (so you want the angle to be closer to 90 degrees).

Question 36

When using the ultrasound modality, how should the cosine law be applied?

Answer 36

Keeping the head flat–this will allow more energy to travel down into the tissue instead of being reflected because the angle will be closer to 90 degrees.

Question 37

List the wavelengths of the four electromagnetic modalities in order from longest to shortest:

Answer 37

E-stim (longest)
Diathermy
Infrared
Ultraviolet

Question 38

What are e-stim currents able to do clinically?

Answer 38

• Control pain at high frequencies through nerve stimulation and at low frequencies through the release of endorphins.
• Stimulate muscular contractions, tetany, or relaxation.
• Facilitate healing with microcurrents.
• Cause chemical changes through movement of ions.

Question 39

What is the wavelength of e-stim currents? What is typically the frequencies used clinically?

Answer 39

Wavelength= 15,000km
Frequency= 1-4,000Hz

Question 40

Which modality is able to accurately measure the electrical activity of the body and muscles?

Answer 40

Biofeedback

Question 41

What modality causes heat as it contacts tissue because it has such a high frequency? (1 million cycles a sec)

Answer 41

Diathermy (it can also through off radar!)

Question 42

What is the most commonly used agent?

Answer 42

Infrared (ice)

Question 43

How do infrared modalities work?

Answer 43

Its energy is transferred to the objects that are in contact with it through radiation.

Question 44

All agents at the infrared end of the spectrum have very short wavelengths (so they can’t penetrate extremely deep). Lower temps have (blank) wavelengths and higher temps have (blank) wavelengths–meaning which penetrates deeper, heat or ice?

Answer 44

Lower temps = longer wavelengths
Higher temps = shorter wavelengths

Ice penetrates deeper than heat

Question 45

Ultraviolet light is not commonly used clinically because it doesn’t heat tissue effectively. It only penetrates the tissue this much:

Answer 45

1 mm 
(also mainly causes chemical changes in tissue)

Question 46

What modality is capable of deep heat? Why?

Answer 46

Ultrasound: the acoustic vibrations travel much slower than electromagnetic waves. Also the vibration creates friction which creates heat.

Question 47

What is a part of the acoustic spectrum that includes high pressure, short duration, and sound waves that seems to have a stimulating effect on bone tissue?

Answer 47

ESWT (extracorporeal shock wave therapy)