Modalities Flashcards
What is the purpose of heat therapy? What are the indications?
Decrease pain, enhance tissue repair, increase joint ROM
Indications: pain, spasm, subacute soft tissue injury, late tissue healing, fibrosis/scar, joint stiffness
What are the contraindications of heat?
Acute injury/inflammation Prior to balance/strength training Pregnancy Clots Cancer Pacemaker Damaged skin Impaired circulation/sensation/cognition Infection TB Skin disease
What are 2 options for heat treatment and their basic application principles?
Hot packs:
6-8 layers to prevent burns (Teres cover = 4 layers)
20 min, check skin
Inspect skin at 5min intervals to look for blotching, mottled erythema
Paraffin Wax:
Assess for broken skin/wounds
Wash hands
Dip 4-6x for 5-6s, wait for wax to harden between
Wrap in plastic, then glove or towel
20 min, peel wax, wash hands
What is the purpose of cold therapy? What are the indications?
Decrease pain, increase clotting/decrease hemorrhage, decrease swelling formation, decrease risk of secondary injury, delay tissue repair, decrease joint ROM, increase tissue stiffness, decrease muscle strength
Indications: acute injury, spasm, pain
What are contraindications of cold?
Subacute/late tissue repair, fibrosis/scar, prior to balance and strength, joint stiffness, clots, TB, impaired sensation/circulation, hemorrhage, cold urticaria, hypersensitivity, Raynaud’s
What are 3 options for cold therapy and principles of each?
Ice pack:
1 layer wet cloth, inspect skin, 10-15 min, repeat every 2-4hrs
Contrast bath:
Cold bath 20°, warm bath 40-45°, immerse cold 4min -> warm 6min (x2) OR 1min cold -> 4min warm (x4)
For edema/recovery
Ice bath:
Crushed ice in container with water 8-10°
10-15min
What are the physiological effects of US?
Increase metabolic rate of tissue, extensibility of collagen, blood flow, tissue healing, ROM, decrease neural sensitivity, pain, spasm
What are the 2 types of US and their indications?
Thermal: pain, fibrotic condition, contracture, tendinosis, calcific tendonitis, arthrosis
Pulsed: tissue repair, wound healing, acute soft tissue injury, fractures, swelling
What are the contraindications of US? Pulsed and thermal
Thermal: pregnancy, pacemaker, clots, cancer, active bleeding, TB, radiation therapy, skin disease, infections, hemorrhage, impaired sensation/cognition/circulation
Pulsed: pregnancy, pacemaker, clots, cancer, hemorrhage, radiation therapy, TB
What are the parameters for pulsed and thermal US?
Thermal:
Continuous, 1MHz deep; 3MHz superficial, 0.8w/cm2, 5-10min
Pulsed:
20% duty cycle, 1 or 3 MHz, 1.0w/cm2, 5-10min
What are the contraindications for NMES?
Pregnancy, pacemaker, clots, cancer, active bleeding, anterior neck, skin damage, hemorrhage, infection, radiation therapy, TB, osteoporosis
What are the settings for NMES?
Frequency: 50Hz (5-25% MVC)
Amplitude: > 50mA = strength; < 50mA = endurance
Strength: biphasic 30-50Hz, PD 300us, 10sec on 50 sec off, 2 sec ramp on, 1 sec ramp off, amplitude as above, 15 contractions 3x/wk
Endurance: biphasic 30-50Hz, PD 200us, 10 sec on 12 sec off (progress to 30 on 2 off), 15 contractions 4x/day, 5x/wk
What are the contraindications of TENS?
Pregnancy, pacemaker, clots, cancer, active bleeding, anterior neck, damaged skin, hemorrhage, sensation/cognition, infection, radiation therapy, TB
What are the 2 types of TENS and the parameters?
A-TENS: Freq 3-5Hz, PD 250us, Amplitude non painful muscle twitch, 30min
C-TENS: Freq 80-120Hz, PD 150-200us, Amplitude strong buzzing sensation, 20-30min
What are the contraindications of IFC?
Pregnancy, pacemaker, clots, cancer, active bleeding, anterior neck, damaged skin, hemorrhage, sensation/cognition, infection, radiation therapy, TB
