Modalities

Question 1

What are the physiological effects of superficial heat?

increased vs decreased

Answer 1

Increased:
CO, metabolic rate, pulse, RR, vasodilation

Decreased:
BP, muscle activity, blood to internal organs, blood flow to resting muscle, SV

Question 2

What are the indications for superficial heat?

Answer 2

modulate pain
increase connective tissue extesnibility
reduce inflammation and swelling
accelerate rate if tissue healing
reduce joint restriction and muscle spasm

Question 3

What are the contraindications for superficial heat?

Answer 3

acute/subacute trauma and inflammatory conditions
decreased circ or sensation
DVT
impaired cognition
tumour

Question 4

What are the precautions for superficial heat?

Answer 4

cardiac insufficiency
edema
impaired circ or thermal regulation
metal in treatment site
pregnancy
demyelinated nerves
open wounds

Question 5

What are the physiological effects of cryotherapy?

increased vs decreased

Answer 5

Increased:
blood flow to internal organs, CO, SV, arterial blood pressure

Decreased:
metabolic rate, pulse, RR, venous BP

Question 6

What are the indications for cryotherapy?

Answer 6

modulate pain
reduce inflam and swelling
reduce muscle spasm
reduce spasticity
cryokinetics
cryostretch
manage symptoms of MS

Question 7

What are the contraindications to cryotherapy?

Answer 7

cold hypersensitivity
cold intolerance
PVD
impaired sensation
Raynaud's disease
regenerating peripheral nerves

Question 8

What is continuous US used for?

Answer 8

thermal effects
chronic conditions
may cause pain - reduce intensity or increase surface area

Question 9

What is pulsed or low intensity US used for?

Answer 9

acute soft tissue, thin tissue, stasis ulcers

non thermal

Question 10

What is 3MHz and 1MHz US used for?

Answer 10

3MHz - 1cm; greater heat production in superficial layers

1MHz - 5cm; increased heat production in deep layers

Question 11

What do you use low vs high intensity US for? (.5-2.5)

Answer 11

low - acute conditions

high - chronic conditions

Question 12

What are the indications for US?

Answer 12

modulate pain
increase connective tissue extensibility
accelerate rate of healing
wound healing
reduce joint restriction
reduce muscle spasm

Question 13

What is thermal US used for? What type of US is thermal?

Answer 13

continuous US is thermal

pain relief for chronic conditions - bursitis, myositis, tendonitis, arthritis

Question 14

What is phonophoresis? Indications?

Answer 14

US drives meds into deeper tissues
analgesics
anti inflamms

Indications:
pain, decrease inflam to subacute and chronic conditions

Question 15

What are the indications for spinal traction?

Answer 15

herniated disc
DJD
spondylosis
joint dysfunction
hypomobility
muscle spasm

Question 16

What are the parameters for spinal traction?
time
force
duty cycle

Answer 16

time:
disc 3-5 min progressing to 10 min
all else 15-20 min

force:
Cx 7-20% body wt, 20-30 lbs
Lx 25-50% body wt

duty cycle:
disc 60 sec on: 20 off
all else 20-30 on : 10 off

Question 17

What are the indications for tilt table?

Answer 17

stimulate postural reflexes to counter act orthostatic hypotension
postural drainage
active head/trunk control
stretch flexors

Question 18

What are the indications for e-stim?

Answer 18

pain modulation
decrease muscle spasm
impaired ROM
muscle re-edu
disuse atrophy
muscle weakness
soft tissue repair, wound healing
edema reduction
spasticity
denervated muscle

Question 19

What are the contraindications to e-stim?

Answer 19

pacemakers, unstable arrythmias
epilepsy or seizure disorder
low back preggo
transcerebrally
transthoracically
bleeding or infection
metal implants
pharyngeal or laryngeal muscles
healing bone fractures

Question 20

Where are electrodes placed for
superficial e-stim?
deeper e-stim?

Answer 20

superficial:
electrodes close
large electrodes

deep:
electrodes further apart
small electrodes

Question 21

What is iontophoresis?

Parameters?

Answer 21

transports meds through skin via e-stim

continuous pulse
direct current
1-20 min

Question 22

What is high-voltage pulsed / Galvanic stim direct current?

Parameters?

Answer 22

reduce edema
iontophoresis
wound healing / debridement
fracture healing
stim of denervated muscle

parameters for wound healing:
healthy wound - place anode (+) over wound to accelerate infected wound
infected wound - place cathode (-) over wound to retard bacterial growth

Question 23

What is conventional, high rate TENS used for?

Answer 23

acute or chronic

temporary pain relief

Question 24

What is acupuncture, strong low rate TENS used for?

Answer 24

chronic

long lasting pain relief

Question 25

What is brief intense TENS used for?

Answer 25

rapid onset
temp pain relief
wound debridement, deep friciton massage, jt mobs

Question 26

What is burst mode, pulse TENS used for?

Answer 26

chronic
long lasting pain relief
more tolerable than low-rate

Question 27

What is hyperstimulation point TENS?

Answer 27

chronic
long lasting pain relief
pin point with probe

Question 28

What is modulation mode TENS?

Answer 28

chronic and acute
other modes of TENS are modulated to prevent adaptation
parameters altered by >10%

Question 29

What is russian current used for?

Parameters?

Answer 29

muscle strengthening and muscle spasm

strengthening:
rate 50-70
duty cycle 50%

spasm:
duty cycle 1:1

Question 30

What is IFC?

Answer 30

modulate pain
parameters similar to high or low rate TENS

muscle strengthening
similar to low or medium ES

Question 31

What is functional ES / NMES?

Where can you use it?

Answer 31

disuse atrophy
impaired ROM
muscle spasm
muscle reeducation
spasticity

subluxed SH
weak DF during swing
weak PF during push off
HS during late swing
quads/glutes during stance

Question 32

What is electromyographic biofeedback?

Parameters?

Answer 32

increase or decrease muscle activity to achieve functional goal

motor recruitment:
electrodes sidely space, high sensitivity to increase detection

motor relaxation:
electrodes close and sensitivity low to minimise cross talk