Modalities

Question 1

What are therapeutic modalities?

Answer 1

They are the application of any physical agent applied to produce therapeutic effects changes to biologic tissues.

Question 2

What are the different types of therapeutic modalities? (7)

Answer 2

1. Superficial heat and cold
2. Intermittent pneumatic compression
3. Traction
4. Hydrotherapy
5. Deep heating agents
6. Electro-therapies
7. Cold light laser

Question 3

Intermittent Pneumatic Compression

Answer 3

• Application of external mechanical pressure to the body for therapeutic purposes (sleeve for entire LE or UE)
• Continuous w/ very low intermittent pressure
• Maximal pressure: below diastolic
• Time: 15-30 minutes
• Avoid: swelling in other areas, stiffness, numbness, SOB

Question 3

Indications for Intermittent Pneumatic Compression

Answer 3

• Traumatic edema
• Stump reduction following limb amputation
• Wound healing
• Prevention of DVT
• Venous stasis ulcers
• Lymphedema

Question 3

Contraindications for Intermittent Pneumatic Compression

Answer 3

• Acute pulmonary edea
• Congestive heart failure
• Uncontrolled hypertension
• Acute or recent DVT’s
• Infection

Question 4

Traction

Answer 4

• A mechanical intervention
• Lumbar traction performed to: disc herniations, sciatica, DDD, DJD
• Cervical traction performed: continuous, intermittent

Question 5

Electro-Therapies

Answer 5

• To promote muscle contractions: neuromuscular electrical stimulation (NMES)
• To modulate pain- Transcutaneous Electrical Nerve Stimulation (TENS)
• To promote edema reduction and wound healing

Question 6

Heating agents transfer energy ____ the body, cooling agents transfer energy ______ from the body.

Answer 6

• To
• Away

Question 7

What are the 5 thermal agents of heat?

Answer 7

1. Conduction
2. Convection
3. Conversion
4. Radiation
5. Evaporation

Question 8

What is conduction and name some examples?

Answer 8

Direct contact b/w two objects with different temperatures. Hot and cold molecules collide and continue until molecules equalize (kinetic motion). EX: paraffin, moist heat, stove

Question 9

What is convection and name some examples?

Answer 9

A medium is present, hot air is circulating. Heat is transferred from circulating medium to tissue (not direct contact). EX: whirlpool, fluidotherapy, air frier, convection oven

Question 10

What is conversion and name some examples?

Answer 10

Converts non-thermal form of energy (mechanical, electrical, chemical) into heat/thermal energy. Doesn’t require direct contact amt. of energy depends on how much power the energy source provides
EX: ultrasound, diathermy

Question 11

What is radiation and name some examples?

Answer 11

Direct Transfer of energy from a material with greater temperature.
Difference is there is no medium and no contact EX: infrared lamp, sun

Question 12

What is evaporation and name some examples?

Answer 12

Material that absorbs energy and changes it from liquid to gas or vapor. Removes energy from body to make it cooler. EX: vapocoolant sprays, sweating, fluromethane sprays

Question 13

What are some indication for heat?

Answer 13

• General muscle relaxation (calming effect diminished muscle tone and guarding)
• Increase range of motion
• Decrease joint stiffness
• Increased tissue extensibility, decrease muscle spasm
• Promote healing (increased circulation & O2, increased metabolic rate)
• Pain control

Question 14

What are the effects of vigorous heat?

Answer 14

• Vasodilation: increase capillary pressure and flow clearance locally and systemically
• Increases oxygen to tissue via hemoglobin dissociation
• Neuromuscular effects: increased nerve conduction velocity, and increase pain threshold, decrease muscle spasm

Question 15

Contraindications of Heat

Answer 15

• Acute injury or inflammation
• Recent or potential hemorrhage
• Thrombophlebitis (clots)
• Impaired sensation
• Impaired mental/cognition
• Malignancy
• IR irradiation of the eyes

Question 16

Precautions of Heat

Answer 16

• Pregnancy (esp. 1st trimester)
• Impaired circulation
• Poor Thermal regulation
• Edema
• Cardiac insufficiency (stresses CV system)
  Metal in the area (can cause internal burns)
• where topical counterirritants have been recently been used (icy hot, bengay)
• Individuals with MS