Modalities Flashcards
Ice massage
Small and contoured areas
Small overlapping circles or strokes
10cm x 15 cm can be covered in 5-10 minutes
Cold pack
Moist towel
20 minutes
Cold bath
Distal extremities, however gravity dependent condition
55-64 degrees F
15-20 minutes
Cold compression unit
Circulates cold water through a sleeve
50-77 F
Cryo cuff
Gravity flow for compression, water in sleeve
Therapeutic effects of cryo
Decreased blood flow to area Decreased edema Decreased local temp Decreased metabolic rate Decreased nerve conduction velocity Decreased tone Increased pain threshold
Cryo indications
Abnormal tone Acute or chronic pain Acute or subacute inflammation Bursitis Muscle spasm Myofascial triger points Tendinitis Tenosynovitis
Cryo contras
Cold intolerance Cold urticaria Cryoglobulinemia, paroxysmal cold hemoglobinuria, PVD, raynaud’s Infection Compromised circulation Regenerating peripheral nerve Skin anesthesia
Superficial heat therapeutic effects
Decreased: muscle spasm, tone
Increased: blood flow, capillary permeability, collagen extensibility, local temp, metabolic rate, muscle elasticity, nerve conduction velocity, pain threshold
Superficial thermo indications
Abnormal tone Decreased ROM Muscle guarding Muscle spasm Myofascial trigger points Subacute or chronic pain Subacute or chronic inflammation
Superficial heat contras
Acute musculoskeletal trauma Arterial disease Bleeding or hemorrhage Over an area of compromised circulation Over an area of malignancy PVD Thrombophlebitis
Fluido
Circulates warm air and small cellulose particles
100-118 F
15-20 minutes
Can perform active exercise
Infrared lamp
First few mm human tissue Tissue temp increase proportional to amount of eradication that penetrates Wear opaque goggles 20 inches from source 15-30 minutes
Paraffin
113-122 deg Fahrenheit
Dip wrap, dip reimmersion, pain application
Deep thermal indications - US
Acute and post acute Ca deposits Chronic inflammation Delayed soft tissue healing Joint contracture, muscle spasm, myofacial trigger points Pain, scar tissue Tissue regeneration
US contras
No thermal on acute/post-acute Active bleeding Decreased temp sensation, or circulation DVT Infection Malignancy, breast implants, carotid sinus or cervical ganglia Epiphyseal in young children Eyes, heart, genitalia Methyl methacrylate cement or plastic Pregnancy Pacemaker Thrombophlebitis Vascular insufficiency
1 MHz US
Deeper tissue up to 5 cm
3 MHz US
Superficial tissue 1-2 cm
Duty cycle US
[On time / (on time + off time) ] * 100
Continuous, thermal effects
Pulsed less heating and nonthermal effects
Therapeutic effects of hydrotherapy
Decreased abnormal tone Increased: blood flow and core temp Pain relief Relaxation Vasodilation Wound debridement
Hydrotherapy indications
Arthritis Burn care Edema Decreased ROM Desensitization of residual limb Joint stiffness, muscle spasm, strain, sprain Wound care
Hydrotherapy contras
Advanced CV or pulm disease Active bleeding Diminished sensation Gangrene Impaired circulation Incontinence Maceration PVD Renal infection, severe infection serve mental disorders
Lumbar Traction
Force during relax is 50% of during hold 25% of total body weight for soft tissue stretch 50% BW for actual joint separation 5-30 minutes Disk 10
Cervical traction
7-10% BW soft tissue stretch
13-30% BW for joint separation
Do not exceed 30 lbs
5-30 minutes
Small electrodes
Increased current density
Increased impedance
Decreased current flow
Large electrodes
Decreased current density
Decreased impedance
Increased current flow
NMES
Facilitate muscle activity - 1 electrode over motor point Minimum of 2 inches apart Current- force of contraction Frequency of 35-50 pulses per second Off time 5x longer than on time Minimum of 10 contractions, max of 20
Conventional rate tens
Sensory response
High frequency 30-150 pops
Short duration 50-11
Variable
Acupuncture like TENS
Muscle twitch
Low frequency 2-4
Long duration 100-300
20-45 minutes
Brief intense TENS
Strong parenthesis or a motor response
High pulse frequency 60-200
Long duration 150-500
15 minutes
Noxious TENs
Highest tolerated stimulus
High or low pulse frequency
Long duration 250 to 1 second
30-60 seconds for each point
Iontophoresis indications
Pain Calcium deposits Fungal infection Hyper hydros is Inflammation Ischemia Keloids Muscle spasms Myositis ossificans Plantar warts Scar tissue Wounds
Iontophoresis contraindications
Drug allergies
Skin sensitivity reaction to specific ions
Iontophoresis acidic reaction
Hydrochoric acid forms under the positive electrode (anode)
Iontophoresis alkaline reaction
Sodium hydroxide forming under negative electron (cathode)
Acetic acid
Calcific deposits
Myositis ossificans
Negative
Calcium chloride
Scar tissue, keloids, muscle spasm
Negative
Copper sulfate
Fungal infection
Positive
Dexamthasone
Inflammation
Negative
Iodine
Scars, adhesive capsulitis
Negative
Lidocaine
Analgesia, inflammation
Positive
Magnesium sulfate
Muscle spasm, ischemia
Positive
Salicylates
Muscle and joint pain, plantar warts
Negative
Zinc oxide
Healing, dermal ulcers, wounds
Positive
