Modalities Flashcards
Systemic and physiological effects of heat application
Increased
- cardiac output
- vasodilation
- heart rate
- respiratory rate
- metabolic rate
Decreased
- muscle activity
- blood pressure
- blood to internal organs (blood moves to skin)
- blood flow to resting muscles
- stroke volume (compensates for increase HR and CO)
Systemic and physiological effects of cold application
Increased
- joint stiffness
- pain sensitivity
- muscle activation
Decreased
- collagen extensibility
- blood flow
- capillary permeability
- local metabolism
- spasticity
- nerve conduction velocity
Hot pack use guidelines
Treatment temp: stored at 158-167 deg F
Treatment time: 20-30 minutes
6-8 layers of toweling
Hot pack peaks heat in first 5 min
Do not lie on top of > accelerates heat and burns
Cold pack use guidelines
Treatment temp: stored at 25 deg F
Treatment time: 10-20 min
Can be applied every 1-2 hours
4 stages of cold (each last 3-5 min)
“CBAN”
- Cold
- Burn
- Aching
- Numbness
Contraindications to thermotherapy
Arterial disease
Bleeding or hemorrhage
Over an area of compromised circulation
Over an area of malignancy
Thrombophlebitis
Impaired sensation or mentation
Infrared irradiation of the eyes
Contraindications to cryotherapy
Cold hypersensitivity
Cold intolerance
Cryoglobulinemia
Paroxysmal cold hemoglobinuria
Raynaud’s phenomenon
Over-regenerating peripheral nerves
Circulatory compromise
Cryoglobulinemia
Characterized by raynaud’s, cyanosis, purpura
Also known as cryoglobulinemic vasculitis
Rare condition that occurs when abnormal proteins in the blood clump together at cold temps
Hemoglobinuria
O2 transport protein hemoglobin is found in abnormally high concentrations in urine
Raynaud’s phenomenon
Narrowing of blood vessels in hands/feet
Decreased BF causes fingers/toes to become cold, numb, and discolored white or blue
Electrical stimulation (NMES/FES) parameters for muscle contraction
High voltage pulsed galvanic current parameters
Negative electrode: promote healing of inflamed or infected wound
Positive electrode: promote healing of wounds without inflammation
Electrode is placed in or around wound area
Treatment time: At least 3-7 days/week, 45-60 min sessions
Polarity is only difference between parameters
Iontophoresis parameters
“I SAD” - only negative ions
TENS parameters and types
*brief intense TENS for painful procedures like wound debridement
Ultrasound parameters
Intensity
- amount of energy delivered per unit area (W/cm2)
- dependent on treatment goal
Frequency:
- cycles per second
- 1MHz for deep structures
- 3MHz for superficial structures
Duty cycle:
- Acute = pulsed, low intensity
- chronic = continuous, high iintensity
EMG biofeedback parameters
Muscle relaxation
- for tight/spastic muscles
- low sensitivity, close electrode placement
Muscle re-education
- for weak/flaccid muscles
- high sensitivity, far electrode placement
“Work from home = WFH”
- for Weakness, use Far spaced electrodes and High sensitivity
