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OCCTH 584 > Modalities > Flashcards

Modalities Flashcards

1
Q

What are physical agents modalities (PAMs)?

A

Procedures and interventions that are systematically applied to produce a response in soft tissue through the use of light, water, temperature, sound, or electricity.

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2
Q

What are the goals of PAMs?

A 
Modulate pain
Modify tissue healing
Increased tissue extensibility
Modify skin and scar tissue
Decrease edema
Decrease inflamation
Improve occupational performance secondary to musculoskeletal or skin conditions
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3
Q

What are the argument against PAMs in OT?

A

Physical agents are not consistent with the philosophy of occupation, i.e. therapeutic use of purposeful activity/occupation.
PAMs are often done on the patient, not with the patient.

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4
Q

True or False: New OT graduates can use PAMs.

A

False. You need to demonstrate competence in order to use PAMs, and you need some degree of further education/training.

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5
Q

True or False: OTs should always use PAMs as an adjunctive method to the overall plan of treatment.

A

True.

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6
Q

What are the heat and cold precautions for heat and cold burn?

A

Ensure client has adequate sensation
Test on non-affected side first
Only use on intact skin
Provide layer between hot/cold pack and skin
Check skin
Do not apply for more than 15-20 minutes
Be mindful of temperature triggers (e.g. MS)

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7
Q

What is the cold or cryotherapy used in treatment for?

A 
Acute injuries or trauma
Decreasing spasticity
Decreasing spasms
Reducing edema
Reduce inflammation
Stimulation of CNS
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8
Q

What are the 3 methods of cold transfer, and how long should be used at once?

A

Convection - Cold whirlpool. Temperature at 13 to 18 degees Celsius for 15-20 mins
Conduction - Ice packs. 10-20 minutes wrapped in a towel or a cloth.
Evaporation - Cold sprays. As needed for immediate relief rather than longer term.

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9
Q

How deep do cold transfers affect tissues?

A

1-2 cm

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10
Q

What effects do cold transfers produce?

A

Analgesia, decreased edema, reduced muscle spasms, lower metabolic activity, reduced inflammation

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11
Q

What are the precautions for cold modalities?

A

Remove if pain or analgesia
Hypersensitivities, e.g. Raynaud’s disease
Temperature dysregulations, e.g. quadriplegia (autonomic asphyxia)
Circulatory problems, e.g. hypertension, vascular disease
Frostbite

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12
Q

What are heat modalities used for?

A

Chronic soft tissue damage
Increase circulation
Decrease pain
Relax soft tissue prior to stretching

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13
Q

Heat [increases/decreases] blood flow and capillary permeability.

A

Increases.

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14
Q

Heat [increases/decreases] rate of cell metabolism and oxygen consumption.

A

Increases.

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15
Q

Heat [increases/decreases] fluid viscosity.

A

Decreases.

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16
Q

Heat [increases/decreases] inflammation.

A

Increases.

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17
Q

Heat [increases/decreases] muscle contraction velocity.

A

Increases.

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18
Q

Heat [increases/decreases] pain.

A

Decreases.

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19
Q

Heat [increases/decreases] relaxation of soft tissue prior to stretching.

A

Increases.

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20
Q

Heat [increases/decreases] muscle spasms.

A

Decreases.

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21
Q

What are the 3 methods of heat transfer, and how long should they used at once?

A

Convection e.g. heated air or water - 10-20 mins.
Conduction, e.g. hot packs - Left on for 10-20 mins wrapped in a towel or cloth.
Radiation, e.g. heat lamps - 10-20 mins.

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22
Q

What is the optimal temperature for heat modalities? What happens if the temeprature goes over?

A

40-45 degrees Celsius.

> 45 degrees resulsts in catabolism (breakdown of tissue) and cell death

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23
Q

Which conditions is paraffin wax commonly used for?

A

Arthritis, healed amputations, strains/sprains.

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24
Q

What are the effects of paraffin wax?

A

Decrease pain and stiffness.

Increase ROM.

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25
Q

What temperature should paraffin wax be kept at?

A

Below 54 degrees. 52 degrees is ideal.

26
Q

Describe the process of paraffin wax application.

A

Client dips hand ~3-5 seconds in wax. Allow for wax to dry before repeating, and repeat 8-10 times for layers. Wrap hands in plastics and towel for insulation. Remove wax in a few minutes.

27
Q

What are the effects of contrast baths?

A

Decrease edema.
Improve peripheral blood flow.
Reduce pain and stiffness.
Aid in healing process.

28
Q

What temperatures should contrast baths be kept at?

A

Warm bath - 38-43 degrees

Cold bath - 10-21 degrees

29
Q

Describe the process of using contrast baths?

A

First start with 10 mins warm then 1 min cold. Then use a 4:1 protocol - 4 mins warm then 1 min cold.

30
Q

How long in total does using contrast baths usually take?

A

30 minutes.

31
Q

What are the different types of edema?

A 
Acute injury
Trauma to tissues
Cardiovascular problems
Secondary impairments
Inflammatory processes
Congenital
32
Q

What are the considerations to make when treating edema?

A 
Understand underlying diagnosis.
Ensure medical stability (e.g. controlled CHF levels).
(Retrograde) Massage
Positioning
Movement
33
Q

What does the movement of lymph depend on?

A

The peristaltic motions of lymph vessels, arterial pulsation, and adjacent skeletal muscle.

34
Q

What is lymphedema?

A

Edema due to compromised or damaged lymphatic system.

35
Q

True or False: Lymphedema is lifelong.

A

True.

36
Q

What are the consequences of lymphedema?

A 
Dermatological changes
Impaired extremity function
Infection
Wounds
Pain
37
Q

What are the assessment methods for edema?

A 
"Finger test" for depression, rebound, and pitting.
Tape measurements.
Edema volumeter
Skin - Color and intactness
ROM
38
Q

What are the characteristics of low grade lymphedema (grades 0-1)?

A

Edema is not visible.

Extremity feels heavier and has decreased ROM.

39
Q

What are the modalities that are suitable for low grade lymphedema (grades 0-1)?

A

Retrograde massage
Positioning
Moderate exercise
Elastic therapeutic tape

40
Q

How is elastic therapeutic tape or K-tape theorized to work?

A

Gently lift the upper layers of the skin, creaing a negative pressure that encourages the removal of excess fluid through the lymphatic pathways

41
Q

Which is more effective: elastic therapeutic tape (K-tape), or high compression therapy?

A

High compression therapy

42
Q

What are the benefits of elastic therapeutic tape or K-tape over high compression therapy?

A

More comfortable and convenience.

May work when other therapies will not (e.g. compression garments on hot day)

43
Q

What is the indication that the compression garment fits well?

A

Snug but not tight - Fingertips should stay warm even after wearing it for a bit.

44
Q

Is active or passive positioning more effective for reducing edema?

A

Active

45
Q

What are the indications for the use of Tubigrip?

A

Mild amount of compression (5-15 mmHg).

Lower grade edema.

46
Q

What are the indications for the use of Coban wrapping?

A

Moderate to severe upper extremity lymphedema.
Compression of 20-30 mmHg.
Plan for longer-term compression garment.

47
Q

Why does Tubigrip not work well with moderate-severe edema?

A

Can tourniquet the area and trap the fluids in the extremity.

48
Q

What are the treatments for lymphedema?

A 
Hand massage to reduce edema and PROM to massage joints.
Coban wrap.
Elevation of UE with pillows.
Follow up for skin and tolerance checks
Rewrap every 5 days
49
Q

True or False: Gradient compression garments are usually worn temporarily.

A

False. They are usually worn 24/7 and for longer-term treatment to prevent worsening of edema.

50
Q

What are the effects of Kinesio taping?

A 
Support of weaker/injured muscles.
Relaxation/inhibition of muscle.
Joint instability/correction.
Pain management.
Edema management.
51
Q

What are the skin precautions for Kinesio taping?

A

Allergies/sensitivities or other irritation.
Do not use on open wounds.
Limited adhesion on hair/lotions.
Difficult to remove.

52
Q

What is transcutaneous electrical nerve stimulation (TENS)?

A

Low voltage electrical stimulation over the skin.

53
Q

What effect does TENS have?

A

Pain relief

54
Q

What are the theories for how TENS works?

A

Stimulation of nerve, disrupting/interfering signals for pain.
Activation of nerves sends endorphins.

55
Q

What are the contraindications for TENS?

A

Pregnancy, cancer, pacemaker, circulatory deficits, DVTs, open areas, blood disorders

56
Q

What is functional electrical stimulation (FES)?

A

Electrical simtulation of motor units or nerve, accompanied by “thought” of moving muscles

57
Q

What is FES used for?

A

Strengthening
Subluxation and wrist extension (stroke)
Decrease Spasticity
Wound healing

58
Q

Which conditions is FES commonly used for?

A

Leg strength/innervation deficits, e.g. stroke, MS, foot drop

59
Q

FES in combination with what treatment results in good effect?

A

Botox

60
Q

True or False: FES can also help with both bone and tissue healing.

A

True.

OCCTH 584 (10 decks)

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