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modalities Flashcards

1
Q

lumbar traction to increase intervertebral space L5-S1 position

A

hip flexion 45-60deg

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2
Q

what is ultrasound hot spot
ways to fix it

A

patient feels deep heat and burning during US
caused by periosteum burn: bone is feeling heat
need to add more coupling gel, decrease intensity, increase freq to 3Hz, move soundhead, decrease duty cycle, change to pulsed

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3
Q

NMES for m strengthening: treatment time

A

10-20 mins to produce10-20 reps

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4
Q

US intensity

A

amount of energy delivered per unit area
W/cm^2
depends on treatment goal
Deeper and larger mm use higher intensity

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5
Q

would greater trochanteric bursa be deep or superficial for US?

A

deep because under mm and adipose

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6
Q

acupuncture like (low rate)
TENS:
Type:
Waveform:
Pulse Freq:
Pulse duration:
Amplitude:
Tx duration:

A

Type: motor stim
Waveform: mono or biphasic pulsed
Pulse Freq: <10pps
Pulse duration: >150us
Amplitude: visible twitch
Tx duration: 20-45 mins

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7
Q

hot pack temp settings

A

160-170 F
20-30mins
6-8 towel layers (terry cloth can be 4-6 towel layers)
peak heat in 5 mins! want to skin check at 5 mins

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8
Q

ramp time

A

how long it takes to get to maximal delivery

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9
Q

US duty cycle

A

on time/(on + off time)
pulsed or continuous

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10
Q

What US intensity to use for thermal and deep mm?

A

1.5-2 W/cm^2

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11
Q

decreases with cryotherapy

A

local metabolic, capillary permeability, spasticity (with prolonged ice over 20 mins), collagen extensibility, blood flow, N conduction velocity

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12
Q

superficial cryotherapy contraindications

A

-Cryoglobulinemia (protiens glob together and block blood flow when cold)
-Reynaud’s
-Paroxismal cold hemoglobinuria (immune system produce antibodies that destroys RBCs when with cold)
-Over-regenerating peripheral Ns (need to keep all blood flow it can get)
- Cold hypersensitivity
- Cold intolerance
- Circulatory compromise

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13
Q

when to use supine for lumbar traction

A

put pillows under knees for more spinal flexion
intervertebral joints, facet joints, muscle elongation

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14
Q

HVPC: goal with polarity

A

negative for healing of inflamed/infected wounds
positive for healing of wounds without inflammation

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15
Q

pulse duration

A

how long each pulse is held for
smaller mm need shorter time than longer mm

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16
Q

EMG biofeedback for muscle relaxation

A
  • to inhibit/relax m
  • use low sensitivity
  • place electrodes close together
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17
Q

What US intensity to use for thermal and shallow mm?

A

.5 W/cm^2

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18
Q

weight for cervical traction for disc protrusion, spasm, elongation

A

11-15lbs

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19
Q

lumbar traction to increase intervertebral space L3-L4 position

A

75-90deg hip flexion

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20
Q

acute pain (high rate)
TENS:
Type:
Waveform:
Pulse Freq:
Pulse duration:
Amplitude:
Tx duration:

A

Type: sensory stim
Waveform: monophasic or biphasic pulsed
Pulse Freq: 100 pps
Pulse duration: 50-100us
Amplitude: comfortable tingling
Tx duration: 20-30mins or during activity

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21
Q

EMG biofeedback for muscle re-education

A
  • to facilitate/recruit m
  • use high sensitivity
  • place electrodes far apart
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22
Q

Calcium deposits
Iontophoresis:
Ions from medicine
Polarity of ions
Commonly used medical sources

A

Acetate (-), acetic acid

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23
Q

NMES for m strengthening: amplitude

A

> 10% MVIC for acute/injured
50% for non-acute/non-injured

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24
Q

Sclerotic scars
Iontophoresis:
Ions from medicine
Polarity of ions
Commonly used medical sources

A

Iodine (-)

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25
NMES for m strengthening: pulse duration
150-200us for smaller mm 200-350 for larger mm
26
NMES for m strengthening: on : off times and ratio
1:5 start with - can decrease off time if pt progresses 6-10s on : 50-120s off
27
when to use prone for lumbar traction
disc herniation
28
increases with thermal
HR, RR, CO, metabolic rate, vasodilation
29
hyperhyidrosis iontophoresis: ions from medicine polarity of ions commonly used medical sources
Water -/+ tap water
30
when to use thermal US? what duty cycle for thermal?
soft tissue shortening, pain 100% duty cycle (continuous)
31
Fungal infections Iontophoresis: Ions from medicine Polarity of ions Commonly used medical sources
Copper + Copper sulfate
32
noxious TENS indication
trigger points
33
US frequency
amount of cycles per second 1 MHz - for deep mm 3 MHz for superficial mm
34
HVPC: pulse duration
40-100us
35
HVPC: treatment time
45-60 mins at least 5 days a week
36
Noxious TENS: Type: Waveform: Pulse Freq: Pulse duration: Amplitude: Tx duration:
Type: Hyperstim Waveform: Direct Current DC or Monophasic Pulse Freq: high 100pps low 1-5pps Pulse duration: >250us up to 1 sec Amplitude: highest tolerance/painful stim Tx duration: 30-60s/area
37
weight for initial cervical traction
7-9lbs
38
increases with cryotherapy
jt stiffness, m activity (quick ice), pain threshold
39
when to use 1MHz US frequency
up to 5cm depth
40
NMES for m strengthening: ramp time
at least 2s
41
when to use non-thermal US? what duty cycle for non-thermal?
delayed tissue healing, inflammation, acute condition less than 100% - 20% duty cycle
42
NMES for m strengthening: times per day
every 2-3 hours when awakw
43
amplitude
what we want to be produced
44
Dermal Ulcers Iontophoresis: Ions from medicine Polarity of ions Commonly used medical sources
Zinc + Zinc oxide
45
What US intensity to use for nonthermal US?
.5-1 W/cm^2
46
weight for cervical traction for joint distraction
20-29lbs max or 7% BW
47
Brief intense TENS: Type: Waveform: Pulse Freq: Pulse duration: Amplitude: Tx duration:
Type: motor stim Waveform: mono or biphasic pulsed Pulse Freq: 100pps Pulse duration: >150us Amplitude: strong m twitch Tx duration: <15 min
48
Edema reduction Iontophoresis: Ions from medicine Polarity of ions Commonly used medical sources
Hyaluronidase + Wydase
49
Muscle spasm Iontophoresis: Ions from medicine Polarity of ions Commonly used medical sources
calcium, magnesium + calcium chloride magnesium sulfate
50
HVPC: pulse frequency
60-125pps
51
pulse frequency
how many pulses delivered per second
52
MSK inflammation Iontophoresis: Ions from medicine Polarity of ions Commonly used medical sources
Dexamethasone - Dexamethasone phosphate
53
where to put ions on for iontophoresis
put negative on anode put positive on cathode opposites repel - so want to put like charges together so it meds pushed further into tissue
54
decreases with thermal
BP, blood to internal organs, circulation to resting mm, muscle activity, SV
55
cold pack temp settings
25 F 10-20 mins check at 10 mins - want skin to blanch can be applied every 1-2 hours
56
mechanical traction contraindications
Immobilization Acute injury or inflammation Joint hypermobility or instability Peripheralization of symptoms with traction (radiating/radicular pain) Uncontrolled hypertension
57
Bodyweight for lumbar traction
disc protrusion, spasm, elongation: 25% BW joint distraction: 50 lbs or 50% BW
58
stages of cold
CBA(A)N cold, burning, aching, (analgesia), numbness
59
HVPC: amplitude
comfortable tingling
60
NMES for m strengthening: pulse frequency
35-80 pps
61
where to place electrode for HVPC
in wound with saline soaked gauze - will conduct electricity around wound
62
Analgesic Iontophoresis: Ions from medicine Polarity of ions Commonly used medical sources
Salicylate (-), lidocaine (+), xylocaine (+)
63
when to use 3MHz US frequency
1-2cm depth
64
superficial thermotherapy contraindications
thrombophlebitis (blood clot in veins - causing inflammation and pain of vessels) impaired sensation or mentation over area of decreased circulation over area of malignancy infrared irridation of eyes arterial disease bleeding or hemorrhage

NPTE (60 decks)

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