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Modalities Flashcards

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1
Q

What are the 4 indications for therapeutic modality use?

A

PAIR

  • pain
  • abnormal tone
  • inflammation and repair
  • restriction in motion
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2
Q

What are the 5 ways heat can be transferred?

A 
Conduction
Convection
Conversion
Evaporation
Radiation
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3
Q

Cold whirlpool, fluidotherapy, and hot whirlpool are all examples of what type of heat transfer?

A

CONVECTION

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4
Q

Vapocoolant spray transfers heat how?

A

VIA EVAPORATION

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5
Q

What type of heat transfer occurs with use of infrared lamp, laser or UV light?

A

RADIATION

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6
Q

What type of heat transfers is involved with use of a cold pack, cryo cuff, ice massage, hot pack and paraffin wax?

A

CONDUCTION

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7
Q

What type of heat transfer is involved with use of diathermy or ultrasound?

A

CONVERSION

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8
Q

Ice massage should be applied using small overlapping _ or _. An area of 10 cm by 15 cm can be covered in _ to _ _. Ice is applied with direct pressure over the _ _ for - seconds or _ _ over targeted are to enhance _.

A

Should be applied using small, overlapping CIRCLES OR STROKES

An area of 10 cm by 15 cm can be covered in 5 TO 10 MINUTES

Ice is applied with direct pressure over the MUSCLE BELLY for 3-5 seconds or QUICKLY STROKED over the targeted area to enhance CONTRACTION

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9
Q

What 4 sensations occur during ice massage (in order)?

A

Intense cold
Burning
Aching
Analgesia

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10
Q

Cold packs should be cooled for at least _ _ in between uses or for more than _ _ prior to initial use. Should be applied for approximately _ _, which reduces the the temperature of the skin and subcutaneous tissues up _ _ in depth.

A

Cold packs should be cooled for at least 30 MINUTES in between uses or for more than 2 HOURS prior to initial use

Should be applied for approximately 20 MINUTES, which reduces the temperature of the skin and subcutaneous tissues up to 2 CM in depth

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11
Q

A Cold bath is commonly used for? Temperature of water should be in the - _ _ range. Body part should be immersed for - _ to attain the desired therapeutic effect

A

Commonly used for DISTAL EXTREMITIES

Temperature of water should be in the 55-64 DEGREES FAHRENHEIT range

Body part should be immersed for 15-20 MINUTES to attain . . .

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12
Q

A _ _ _ _ circulates cooled water through a sleeve that is applied to an extremity. Water can be maintained at temperatures ranging from - _ _. _ is applied intermittently by inflating the sleeve with air. Goal of treatment?

A

A CONTROLLED COLD COMPRESSION UNIT circulates cooled . . .

Water can be maintained at temperatures ranging from 50-77 DEGREES FAHRENHEIT.

COMPRESSION IS applied intermittently . . .

Goal of treatment is to CONTROL INFLAMMATION and REDUCE EDEMA

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13
Q

A _ _ is a cold water circulating unit that combines compression with the benefits of cold therapy. Water flows into the sleeve from the container when the container is placed approximately - _ _ the sleeve via _. It is drained from the sleeve via _ by placing the container _ the _ of the sleeve. Water in container must be?

A

A CRYO CUFF is a cold . . . .

Water flows into the sleeve from the container when the contain is placed approximately 15-18 INCHES ABOVE the sleeve via GRAVITY

It is drained from the sleeve via GRAVITY by playing the container BELOW THE LEVEL of the sleeve

Water in the container must be re-cooled periodically.

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14
Q

Cryo cuff is commonly used - with the goal of _ _ and the need for _ _. Provides _ of _ cooling.

A

Is commonly used POST-OPERATIVELY with the goal of DECREASING PAIN and the need for PAIN MEDICATION

Provides HOURS of MILD cooling

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15
Q

The primary therapeutic benefits of hot packs include: decreased _, increased _ _, and reduced _ _. Hot packs are stored in water that is kept between - _ _.

A

Primary benefits include: decreased PAIN, increased TISSUE EXTENSIBLITY, and reduced MUSCLE SPASM

Hot packs are stored in water that is kept between 158-167 DEGREES FAHRENHEIT

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16
Q

How many layers of towel are required between hot pack and patient? How many towel layers is a hot pack cover equivalent to?

A

6-8 layers

It is equivalent to 2-3 layers of toweling

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17
Q

Skin checks for excessive redness, blistering or other signs of burn are required after _ _ on a hot pack. It is also a good idea to give patient a _ or other _ _ in case it gets too hot. What is the recommended time for hot pack use?

A

Skin checks . . . Are required after 5 MINUTES

Also good idea to give patient a BELL or other SIGNALING DEVICE

Recommended time: 15-20 minutes

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18
Q

_ consists of a container that circulates warm air and small cellulose particles. It generates _ heat through _ _. The dry cellulose medium does not _ _ and allows for _ _ _ than hydrotherapy.

A

FLUIDOTHERAPY . . .

It generates DRY heat through FORCED CONVECTION

Dry cellulose medium does not IRRITATE SKIN and allows for HIGHER TREATMENT TEMPERATURES than hydrotherapy

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19
Q

Temperature for fluidotherapy should be set at - _ _. The maximum temperature rise during treatment occurs after approximately _ _, total treatment time is usually - minutes.

A

Temperature should be set at 100-118 DEGREES FAHRENHEIT

The max temperature rise during treatment occurs after approximately 15 MINUTES, total treatment time is usually 15-20 MINUTES

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20
Q

Therapeutic effect of fluidotherapy include the promotion of _ _, skin _, and _ managment.

A

Include the promotion of TISSUE HEALING, skin DESENSITIZATION, and EDEMA managment

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21
Q

An _ _ produces superficial heat in of tissue via radiant heat. Uses a wavelength ranging from _ to _ _. Main therapeutic benefit is the enhancement of _ _ _.

A

AN INFRARED LAMP produces . . . .

Uses wavelength ranging from 780 to 1500 NANOMETERS

Main therapeutic benefit is the enhancement of SOFT TISSUE HEALING

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22
Q

_ _ should be worn by the patient and therapist when using infrared lamp to avoid? Patient should be positioned approximately _ _ for the source to provide a comfortable level of warmth. What is the usual length of treatment?

A

OPAQUE GOGGLES should be warn by patient and therapist to avoid POTENTIAL IRRADIATION of the eyes.

Patient should be positioned approximately 20 INCHES from the . . .

Usual treatment time is 15-30 minutes

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23
Q

_ _ is commonly used heating source for the distal extremities. It has a _ _ _ that can be _ _ by adding mineral oil.

A

PARAFFIN WAX is commonly . . .

It has a LOW MELTING POINT that can be LOWERED FURTHER by adding mineral oil.

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24
Q

Paraffin cannot be applied to areas _ _ _ or _ _ _. Temperature of paraffin should be maintained between _ and _ _ _. How many methods of application are there? Name them.

A

Cannot be applied to areas WITH OPEN WOUNDS or INFECTED SKIN LESIONS

Temperature of paraffin should be maintained between 113 and 122 DEGREES FAHRENHEIT

There are 3 methods of application

  • dip-wrap
  • dip-reimmersion
  • paint application
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25
Describe process of dip-wrap paraffin application
Patient dips distal extremity into paraffin bath and removes, then waits for a brief period of time to allow wax to harden. Patient the re-dips 6-10 times, then body part is immediately placed in plastic bag and wrapped in a towel to minimize heat loss
26
How long is the paraffin left on with the dip-wrap application technique? Dip-reimmersion? Paint application?
Dip-wrap: 10-15 minutes Dip-reimmersion: up to 20 minutes Paint: approximately 20 minutes
27
Describe dip-reimmersion paraffin wax application. What should you be cautious of? Why?
Procedure is the same as dip-wrap, except after the initial 6-10 dips the distal extremity is reimmersed into the wax and stays there for remainder of treatment time. Should be cautious of temperature of wax since patient is leaving extremity immersed for duration of treatment time, may want to keep at lower limit of range, approximately 113 degrees
28
The paint application for paraffin wax is utilized when? Describe.
Is used when the body part cannot be immersed into paraffin bath. Layers of paraffin are applied to the body using a brush, wait briefly in between layer application to allow wax to harden. Apply 6-10 layers of wax, wrap in plastic bag and towel
29
Describe the removal procedure for paraffin. How often should wax be changed?
Should be pealed off after treatment no either placed back into the container to melt or discarded. Some baths are able to heat up to 212 degrees Fahrenheit in order to destroy any bacterial growth. Should be changed immediately if contaminated for any reason. In the absence of contamination, should be changed every 6 months.
30
_ is a common deep heating agent that transfers heat through conversion and elevates tissue temperature to depths of 5 cm.
Ultrasound
31
US uses high frequency acoustic mechanical vibrations to produce _ and _ effects. Frequency of therapeutic US? Explain how it works.
Uses high frequency acoustic mechanical vibrations to produce THERMAL and NONTHERMAL effects. Frequency is between .75-3 MHz Uses alternating electric current generated at same frequency to create mechanical vibration of the piezoelectric crystal in the transducer. Which coverts electrical energy to acoustical energy and generates US wave
32
Thermal effects of US include: acceleration of _ _, modulation of _, reduction of _ _, decreased _ _, alteration of _ _ velocity, increased _ and _ _ _.
Acceleration of METABOLIC RATE, modulation of PAIN, reduction of MUSCLE SPASM, decreased JOINT STIFFNESS, alteration of NERVE CONDUCTION VELOCITY, increased CIRCULATION and SOFT TISSUE EXTENSIBILITY
33
Non thermal effects of US include: increased _ and _ _ permeability, increase intracellular _ _, facilitation of _ _ and promotion of normal _ _. Occurs as a result of _ and _ _.
Effects include: increased CELL and SKIN MEMBRANE permeability, increased intracellular CALCIUM LEVELS, facilitation of TISSUE REPAIR, and promotion of normal CELL FUNCTION. Occurs as a result of CAVITATION and ACOUSTIC MICROSTREAMING
34
The extent of the thermal effects of US are dependent on _, _ and _ selected.
Dependent on INTENSITY, DURATION, AND FREQUENCY selected
35
_ refers to the formation of gas-filled bubbles that expand and compress secondary to pressure changes caused by US. Can be classified as _ or _.
CAVITATION refers to the formation . . . Can be classified as STABLE or UNSTABLE
36
During _ cavitation the bubbles oscillate in size in response to pressure change but do not burst. During _ cavitation the bubbles change in size over several cycles and then suddenly burst. _ cavitation is possible with high intensity, low frequency US however it not _ in therapeutic US.
During STABLE cavitation- DO NOT BURST UNSTABLE cavitation- SUDDENLY BURST UNSTABLE cavitation is possible with high intensity, low frequency US however is not TYPICAL in therapeutic US
37
_ _ refers to the unidirectional movement of fluids along the boundaries of cell membranes caused by US
ACOUSTIC MICROSTREAMING
38
Transducers for US vary in size, but most often range? _ _ are designed to decrease acoustical impedance by eliminating as much air as possible between the transducer and target area.
Range of transducer size: 5-10 cm2 COUPLING AGENTS are designed to . . .
39
If using the transducer in direct contact with skin/ using coupling agent it should be? If using it indirectly, such as _ _, where should the transducer be located in relation to the body part.
If directly on skin- transducer should be parallel to skin, so US waves are introduced at 90 degree angle If using indirectly, such as WATER IMMERSION, the transducer should be placed parallel to treatment surface and approximately .5-3 cm away from the skin
40
_ measure the quantity of energy delivered per unit area. The power generated from the US is not uniform and therefore some position of the US beams are more intense as it leaves the transducer, the _ _ _ (_) refers to the area of the transducer that transmits US energy.
INTENSITY measures the quantity of energy . . . . . . The EFFECTIVE RADIATING AREA (ERA) refers to the area. . .
41
The ERA is always _ than the total size of the _ _. _-_ _ refers to the intensity of US averaged over the area of the transducer. It is given by? And reported in?
ERA is always SMALLER than the total size of the TRANSDUCER HEAD SPATIAL-AVERAGED INTENSITY refers to the . . . Given by the manufacturer, and is labeled on unit Is reported in Watts/ cm2
42
_ determines the depth of US penetration. US at _ _ affects more superficial tissue, and _ _ affects deeper tissues. What is the setting of each?
FREQUENCY determines depth US at HIGHER FREQUENCIES affects more superficial tissues (1-3 cm deep), and LOWER FREQUENCIES affects deeper tissues (up to 5 cm) 1 MHz is used for deeper tissues, 3 MHz is used for more superficial tissues
43
What 2 modes can US be administered in? Describe each.
Continuous and pulsed Continuous- US intensity remains constant throughout treatment Pulsed- US intensity if periodically interrupted
44
Continuous US generates constant US waves producing _ effects at higher intensities and _ effects at lower intensities. More effective at?
Generates constant US waves producing THERMAL effects at higher intensities and NON-THERMAL effects at lower intensities. More effective at ELEVATING TISSUE TEMPERATURE THAN PULSED US
45
Pulsed US results in reduced average _ of tissues and is therefore primarily used for _ _. The portion of the treatment time that US is generated during the entire treatment is refers to as the _ _. What is recommended?
Results in reduced average HEAT of tissues and is therefore primarily used for NONTHERMAL EFFECTS The position of the treatment time that US is generated is referred to as the DUTY CYCLE (duty cycle= on time/ total treatment time X 100 Most resources recommend a 20% or lower duty cycle
46
What is the duration of US? A positive response to US should occurs within _ sessions, if not what should you do?
Duration varies based on intensity, frequency and area to be covered (larger area/ lower intensity/ lower frequency= more time; smaller area/ high intensity/ higher frequency= less time) A positive response should occur within 3 SESSIONS, if not change US parameters or select alternate intervention
47
32-79 degree water is good to treat? 72-92 degrees?
32-79 degrees = acute inflammation of distal extremities 72-92 degrees= exercise
48
92-96 degree water is recommended for? 96-98 degree water?
92-96 degree= wound care, spasticity reduction 96-98 degree= cardiopulmonary compromise, treatment of burns
49
99-104 degree water is recommended for? 104-110 degree water?
99-104 degree= pain managment 104-110 degree= chronic rheumatoid or osteoarthritis, increase ROM
50
Small electrode characteristics: increased _ _, increased _, and decreased _ _.
Increased CURRENT DENSITY, increased IMPEDANCE, and decreased CURRENT FLOW
51
Large electrode characteristics: decreased _ _, decreased _, and increased _ _.
Decreased CURRENT DENSITY, decreased IMPEDANCE, and increased CURRENT FLOW
52
What the 2 type of electrode placement methods when using E-stim?
Monopolar and bipolar techniques
53
What electrode placement technique is being described: stimulating or active electrode is placed over target area. Second dispersive electrode is places at another side away from target area. Typically the active electrode is _.
Monopolar technique Typically the active electrode is SMALLER
54
Which electrode application technique is being described: two active electrodes are placed over the target area. Electrodes are typically _ in _.
Bipolar technique Electrodes are typically EQUAL IN SIZE
55
Which electrode placement technique is better for use with wounds, iontophoresis, and edema treatment?
Monopolar
56
Bipolar electrode treatment is used for muscle _, neuromuscular _, _ and _ of _.
Is used for muscle WEAKNESS, neuromuscular FACILITATION, SPASMS and RANGE OF MOTION
57
_ refers to the magnitude of current. The _ _ needs to large enough to exceed the threshold for the nerve or muscle cell. units of measure?
AMPLITUDE refers to the magnitude of current The PEAK AMPLITUDE needs to be large . . . Units: can be volts, micro volts or millivolts
58
The _ _ is the time it takes for the current to move from 0 to peak intensity within each phase. Typically are _ _ ranging from _ to _.
RISE TIME is the time . . . Typically are VERY SHORT ranging from NANOSECONDS TO MILLISECONDS
59
_ _ is the amount of time it takes for one phase of the pulse. The phase begins when the current _ from the zero line and ends as the current _ to the zero line.
PHASE DURATION is the amount . . . The phase begins when the current DEPARTS from the zero line and ends as the current RETURNS to the zero line
60
What type of e-stim is used to facilitate skeletal muscle activity? When using on patient which pulse duration do patients find more comfortable when targeting larger muscles?
NMES = neuromuscular electrical stimulation Patient find longer duration more comfortable when treating larger muscles and shorter duration for smaller muscles
61
Treatment time for NMES- patient should complete a minimum of _ contractions and a maximum of _ contractions. What is the approximate length of time for each?
Patients should complete a MINIMUM OF 10 CONTRACTIONS, MAXIMUM OF 20 CONTRACTIONS 10 contractions with typical on/ off times should take approximately 10 minutes, 20 contractions= 20 minutes
62
_ _ _ uses electrical stimulation to creat or enhance the performance of a functional activity.
FUNCTIONAL ELECTRICAL STIMULATION
63
When treating muscle spasm, stretching soft tissue, and for reduction of disk protrusion using cervical traction a force of _-_% of a patient's body weight is recommended.
. . . A force of 7-10% of BODY WEIGHT
64
A force of _-_% of a patient body weight may be necessary for joint distraction using cervical traction
Force of 13-20% of patient body weight
65
A force of _% of patients body weight may be desirable to treat muscle spasm, disk protrusion, and stretch soft tissue when using mechanical lumbar traction
Force of 25% of patient's body weight
66
A force of _% of a patient's body weight is required for actual separation of the vertebrae during lumbar traction.
50% of a patient's body weight

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