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Modalities Final > Modalities Final > Flashcards

Modalities Final Flashcards

1
Q

Ultraviolet is classified as a ____________ modality.

A

Photochemical

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2
Q

Ultraviolet treatment time

A

15 seconds-3 minutes

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3
Q

UVC frequency

A

1,800-2,900 A; fastest frequency, shortest wavelength

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4
Q

UVB frequency

A

2,900-3,200 A

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5
Q

UVA frequency

A

3,200-4,000 A (visible light is ~4000)

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6
Q

Main applications of ultraviolet therapy

A

Wound care, psoriasis

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7
Q

Which ultraviolet wavelengths create inflammatory response in the skin?

A

UVB and UVC

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8
Q

Which wavelengths are best for enhanced production of vitamin D?

A

UVB/UVC

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9
Q

Which UV wavelength is bacterocidal?

A

UVC

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10
Q

Which UV wavelengths enhance the release of histamine?

A

UVB and UVC

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11
Q

Which UV wavelengths have an esophylactic effect? What does esophylactic mean?

A

UVA and UVB; esophylactic means something about enhanced WBC production and improved immune response. Edit this card if you understand it better!

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12
Q

What is the name of the test for UV light dosage? From this test, how is dosage determined?

A

Minimal erythemia dosage (MED) test for photosensitivity, uses paper with holes cut out; treatment time is when redness just begins.

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13
Q

UV contraindications

A

photosensitive medications and food, exacerbation of a medical condition (Lupus, connective tissue disease, diabetes, hyperthyroid), acute skin conditions (dermatitis, cellulitis), medical instability, intolerance, fever, other forms of radiation (cancer treatment), always protect eyes, genitalia, and sensitive areas

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14
Q

What does LASER stand for?

A 
Light 
Amplification by
Stimulated
Emission of
Radiation
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15
Q

What is the wavelength of laser band?

A

6,000-10,000 A (from red to infrared)

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16
Q

Indications for low level laser therapy

A

Scar reduction (increase cellular activity by enhancing the inflammatory response)

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17
Q

Describe the characteristics of laser radiation

A

monochromatic, concentrated and coherent (non dispersed), collimated (all waves parallel and in same phase)

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18
Q

Short wavelength (visible red) depth of penetration?

A

up to 1cm

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19
Q

Use of short wavelength laser

A

skin wounds, superficial trigger points

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20
Q

UVA and UVB stimulate new cells in which layer of skin?

A

Basilar layers are stimulated by UV radiation (skin cancer=uncontrolled cell division in this dermal layer)

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21
Q

What is the rationale for using laser therapy on scar tissue?

A

Immune response enhances cellular activity

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22
Q

LLLT physiological effects

A

absorption in mitochondria, increase in ATP synthesis, increase in protein synthesis and cell proliferation, allowing for tissue repair and pain control

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23
Q

T/F: LLLT decreases NCV better than cryotherapy

A

FALSE!

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24
Q

Define dosage for LLLT/cold laser

A

Dosage (j/cm2=power(W)xtime(sec)/A(cm2)

energy/area

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25
Q

appropriate dosage range for tissue healing

A

1.0-6.0 j/cm2

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26
Q

in laser therapy, how does power relate to penetration? how is tx time adjusted for power?

A

higher power enhances penetration; treatment time should be decreased if power is increased

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27
Q

Summarize findings regarding benefits of LLLT/cold laser based on the studies that were cited in lecture: LLLT for acute wound, soft tissue injury

A

Acute wounds: increased collagen formation, healing rate, decreased size of wound
Soft tissue injury: decreased pain, accelerated inflammatory response
Chronic soft tissue injury: decreased pain, accelerated inflammatory response

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28
Q

Is an MED test necessary for laser therapy?

A

NO!

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29
Q

T/F: LLLT could be used after vigorous treatment, such as deep friction massage for the treatment of soft tissue injury

A

TRUE!

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30
Q

General clinical guideline: treatment of superficial lesions using cold laser

A

600-700nm

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31
Q

What was a finding pertaining to the use of LLLT for trigger point?

A

Decreased pain, decreased trigger point activity, elevated beta endorphin levels, decrease in NCV

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32
Q

T/F: laser is applied similar to ultrasound, by moving the source continuously over the treatment area.

A

FALSE! Stationary technique, in contact with skin or within 1cm of skin

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33
Q

T/F: placing the laser source on the skin shunts blood away from the area, increasing penetration.

A

TRUE!

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34
Q

Contraindications of laser therapy

A

active cancerous tissue, acute infection, photophobia, photosensitivity, over thyroid gland, over fetus or uterus during pregnancy, over tattoos (prevents absorption, more power necessary to penetrate same depth), presence of other photosensitive mediation, direct eye contact

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35
Q

Grid technique

A

Laser: treatment area ~1cm2

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36
Q

In electrical stimulation, which is more excitable: nerve or muscle tissue?

A

NERVE!

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37
Q

Describe characteristics of nerve fiber that contributes to its excitability

A

nerve diameter, degree of myelination

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38
Q

At a short pulse width, is intensity lower or higher than at a wide pulse width?

A

higher

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39
Q

At what pulse width (wide or narrow) is sensory discrimination the best, meaning there is more time between each phase?

A

Short pulse width allows for greater discrimination between sensory, motor and pain

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40
Q

Ohm’s Law (intensity)

A

I=V/R
Intensity=voltage/resistance
unit: milliAmps (mA)

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41
Q

1mA=___A?

A

1mA=.001A

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42
Q

Direct current: define

A

current flows continuously in 1 direction, pulse width wide (i.e. greater than 1 second)

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43
Q

alternating current: define

A

current flows in 2 directions, each pulse is less than 1 second. measured in milliseconds

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44
Q

Pulsatile current: define

A

can be 1 or 2 directions, non continuous, microseconds; contain a pulse and an interpulse interval

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45
Q

pulse intensity

A

amplitude, height of pulse, dictates whether the stim is sensory, motor or painful to subject

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46
Q

pulse frequence

A

pulse rate (pps, bps, Hz)

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47
Q

pulse modulation

A

continuous, interrupted, ramped, duty cycle

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48
Q

how could pulse modulation be adjusted to avoid fatigue?

A

Increase off time, ramp the on time, avoid continuous modulation

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49
Q

unipolar technique

A

one small (“active”) electrode, one large (“disperser”); active electrode concentrates current in a small area; practical-used under 1st metatarsal head for wound healing

50
Q

T/F: ultrasound sound head can be used as an electrode

A

TRUE!

51
Q

Describe how DC current can be dangerous to the skin

A

Salt water in body attracted to the positive and negative charges of a DC current; hydrogen and chloride ions form HCl; Na and OH form NAOH. NAOH is harmful and leads to skin reaction

52
Q

electrical acupuncture point

A

area of strongest non-painful sensory stimulation at a given intensity

53
Q

motor point

A

strongest motor response at a given intensity

54
Q

trigger point

A

strongest painful sensation at a given intensity

55
Q

list contraindications for estim

A

near carotid sinus, active cancerous tissue, active infection, blood clot, hemorrhaging, cognitive impairment, lack of sensation, sensitivity or fear

56
Q

Can estim be used over recently sutured or unhealed tissue?

A

Yes, but avoid motor level intensity to avoid mechanical stress on healing tissue

57
Q

What areas would you avoid putting stim directly over?

A

area of severe edema, over implanted device (e.g. pacemaker), over superficial metal implants, joint replacement, over the uterus during pregnancy, over open would (for protocol OTHER than wound healing)

58
Q

In a lesion of the CNS, can peripheral nerves be e-stim-ed?

A

YES!

59
Q

Describe the Gate Theory of Pain

A

Stimulating A fibers (dorsal/sensory horn) with non-noxious stimuli activates the SG, allowing for presynaptic inhibition at the T cell (a “gateway” to the SC and brain that would allow for a pain signal if the SG is not activated)

60
Q

How is the Gate Theory of Pain applied in estim?

A

Use sensory-level intenstiy to stimulate non-noxious A fibers; Conventional TENS uses comfortable sensory stim at a high frequency and narrow pulse width (better sensory discrimination)

61
Q

Treatment rationale for low frequency TENS

A

release of endogenous opiates

62
Q

Electrode placement-low frequency TENS

A

electrical acupuncture points because they have less resistance

63
Q

hyper stim TENS: rationale

A

use of noxious but tolerable stimulation to activate descending serotonergic pathways

64
Q

Describe electrode placement for hyper stim TEnS

A

unipolar technique: small electrode on trigger point, large electrode out of the area

65
Q

Treatment time for hyper stim TENS

A

30-60 sec.

66
Q

Low frequency TENS: intensity

A

strong sensory local motor

67
Q

hyper stim TENS intensity

A

noxious but tolerable

68
Q

Conventional TENS intensity

A

comfortable sensory

69
Q

2 factors that influence pulse intensity

A

resistance and voltage

70
Q

bipolar technique

A

both electrodes active, same size

71
Q

anode attracts…?

A

anions, because the anode is positively charged

72
Q

cathode charge?

A

negative; attracts cations

73
Q

Rationale for muscle strengthening e stim protocol?

A

Better overall recruitment of muscles (stim plus active contraction); more selective recruitment of type II fibers (axons have a wider diameter); synchronous contraction excites everything, and may provide a more demanding exercise stimulus

74
Q

Muscle strengthening protocol: intensity

A

Strong motor, ~70% of max voluntary contraction

75
Q

At what frequency does a pulse become tetanizing?

A

About 30-35 pps

76
Q

Electrode placement for muscle strengthening

A

motor poitn

77
Q

Uses for neuromuscular electric stimulation

A

muscle strengthening, neuromuscular facilitation, functional e-stim

78
Q

Rationale for neuromuscular facilitation/activation NMES?

A

enhance cortical reorganization minimize atrophy, maintain ROM, prevent disuse

79
Q

Electro osmosis rationale

A

use polarity to mobilize edema

80
Q

Electro osmosis intensity

A

anything submotor

81
Q

T/F: electro osmosis can be twitching or tetanic frequency

A

TRUE! 1pps twitches 50pps tetanizes

82
Q

median nerve: cutaneous innervation in hand

A

digits 1,2,3 plus radial half of digit 4

83
Q

ulnar nerve lesion: sensory innervation

A

ulnar, palmar aspect of forearm, to pinky and half marriage finger

84
Q

ulnar nerve lesion motor loss if injury occurred at elbow

A

adductor pollicis and a lot of intrinsics will be weak (DAB, PAD), hypothenar eminence muscles weak, 4 and 5 lumbricals would be weak, FDP – 4 and 5 DIP flexion will be weak or absent

85
Q

radial nerve damage sensory loss

A

dorsum of forearm and hand

86
Q

radial nerve lesion motor impairment

A

wrist extensors, triceps depending on the level of injury

87
Q

What type of waveform would you use to conduct an R/D test?

A

pulsatile or AC current

88
Q

R/D test: unipolar or bipolar?

A

unipolar

89
Q

R/D test: if muscle responds with PC, result is called

A

no R/D

90
Q

what is partial R/D?

A

when a muscle responds to PC, but only weakly

91
Q

if no response is observed with PC in an R/D test, what next?

A

use DC

92
Q

Using DC current in an R/D test, the muscle is excitable. what is this result called?

A

full R/D

93
Q

A muscle does not respond to a DC current. What is this called? what does this mean?

A

absolute R/D; muscle atrophy severe enough that there is enough fibrotic tissue to interfere with the electrical stimulation

94
Q

T/F: nerve is more excitable to short duration currents

A

TRUE!

95
Q

Using a DC current for an R/D test, what are the 2 possible outcomes (assuming the PC current produced no contraction?)

A

Full R/D: response with DC

Absolute R/D: no contraction with DC

96
Q

Using a PC current for an R/D test, what are the 2 possible outcomes?

A

No R/D: full contraction with PC

Partial R/D: weak contraction with PC

97
Q

What is rheobase intensity?

A

Intensity required to produce a minimal visible contraction at a pulse width of 300 millisec (very wide); normal: 2-8mA

98
Q

Chronaxie setting

A

Twice the rheobase value (individual)

99
Q

What is a chronaximeter?

A

Machine, has a rheobase setting which locks the pulse wide at 300msec. When rheobase intensity is determine (between about 2-8milliAmps) “chronaxie” setting doubles the rheobase intensity but brings the pulse width to 0. Bring up pulse duration (intensity locked at rheobase value) and observe MVC. In normal individuals, MVC will occur within 1 millisec.

100
Q

On a strength duration curve (PI vs. PW), how is a deinnervated muscle slope different from a normally innervated muscle?

A

A denervated muscle slope is shifted UP and RIGHT, indicating that at any pulse width, greater intensity is needed and that wider pulse widths are necessary to excite muscle

101
Q

What questions does chronaxie test answer?

A

What pulse width is required to elecit a contraction?

102
Q

If chronaxie gets lower, peripheral nerve is…

A

regenerating!

103
Q

What type of current is used in iontophoresis?

A

Direct current only!

104
Q

Iontophoresis dosage

A

dosage=intensityxtime
ex) dosage=1mAx40min=40mAmin
(to avoid skin irritation, lower intensity and increase treatment time, same dosage)

105
Q

charge of Mg, therapeutic effects

A

+POSITIVE+! vasodilator, analgesic, anti-spasmatic

106
Q

charge of Iodine, therapeutic effects

A

-NEGATIVE-! loosens scar tissue

107
Q

hydrocortisone: charge and therapeutic effect

A

+POSITIVE+! anti-inflammatory, inhibits prostaglandin production

108
Q

Licocaine: charge, therapeutic effect

A

+POSITIVE+! numbing agent/anesthetic

109
Q

Salicylate: charge and therapeutic effect

A

-NEGATIVE-! non-steroidal analgesic/anti-inflammatory

110
Q

Acetate: charge, therapeutic effect

A

-NEGATIVE! breaks down calcium deposits, beneficial in acute stage

111
Q

Iontophoresis rationale

A

use direct current to drive the ions of a medication into skin using polarity

112
Q

Iontophoresis: does the medication go on the electrode with the like charge or the opposite charge?

A

Medication goes on the like charge electrode! Electrode will repel medication away from itself–through the skin

113
Q

Iontophoresis intensity

A

Never exceed 4milliAmps!

114
Q

Wound healing e-stim rationale

A

use polarity to stimulate cells through the inflammatory and proliferative phases of healing; add electrical potential to attract cells to area (chronic wounds)

115
Q

Wound healing: type of current

A

unipolar: positive electrode over wound

116
Q

Treatment time: wound healing estim

A

1-2 hours

117
Q

define biofeedback

A

use of external cues (auditory/visual) to help shape a physiological response

118
Q

T/F: EMG biofeedback can only be used when the goal is increasing muscle recruitment

A

FALSE!

119
Q

what are the 3 electrode placements for EMG biofeedback?

A

active electrode: on muscle belly
reference electrode: distal to active
ground: somewhere in between or adjacent

120
Q

what is the role of the ground electrode in EMG biofeedback?

A

eliminates noise in the environment

Modalities Final (1 decks)

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