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E & I 2 > Modality Basics > Flashcards

Modality Basics Flashcards

1
Q

Hydrotherapy Indications

A 
Superficial cooling or heating
Wound care (not in the whirl pool)
Water exercise
Pain control
Edema control
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2
Q

Hydrotherapy Contraindications

A

Local:
Maceration around the wound; bleeding
Full body:
Cardiac instability, infectious conditions that may be spread by water, bowel/bladder incontinence, severe epilepsy, suicidal thoughts/tendencies

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3
Q

What temperature of hydrotherapy reduces inflammation?

A

Cold

32-79 deg F

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4
Q

What temperature is medium for exercise?

Hydrotherapy

A

Tepid water

79-92 deg F

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5
Q

What is neutral warmth (92-96 deg F) used for?

Hydrotherapy

A

Control tone for neurologically based hypertonicity

Circulatory, sensory, cardiac disorders

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6
Q

What is the purpose for the application of mild warmth (96-98 deg F) hydrotherapy?

A

Burns after epithelialization has begun

Promotes mobility, relaxation

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7
Q

What is the purpose of hot (99-104 deg F) hydrotherapy?

A

Pain control
Increase soft tissue extensibility
Large areas of immersion

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8
Q

What is the purpose of applying very hot (104-110) hydrotherapy?

A

Pain control
Increase soft tissue extensibility
Limited body area
OA/RA Nona cute stage

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9
Q

Documentation of Hydrotherapy

A

Type: (thermal, cryotherapy, whirlpool, bath)
Patient position and types of movement
Water temperature
Duration
Patient response
Fluid pressure or additives if applicable

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10
Q

What are the different types of superficial heat?

A 
Hot packs
Paraffin- wax bath
Contrast bath
Fluidotherapy
Infrared lamps
Whirlpool
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11
Q

What are the indications for using superficial heat?

A 
Promotes soft tissue healing
Promotes general relaxation
Decrease joint stiffness
Pain- decrease/ control
May help to reduce the effects of skin conditions
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12
Q

What is the optimum dosage/ therapeutic range of superficial heat?

A

Tissue should be heated to 104-113 deg F

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13
Q

What are the methods of paraffin application?

A

Continuous immersion/ dip immersion
Dip immersion w/ wrapping
Paining/ brushing with wrapping

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14
Q

What are the contraindications of therapy?

A 
Area of recent or potential hemorrhage
Impaired sensation/ mentation
Over malignant area/ tumor
Thrombophlebitis 
Over abdominal, pelvic and low back areas of a pregnant woman
Infrared - irradiation of the eyes
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15
Q

Thermotherapy Documentation

A 
Area treated
Heating agent type
Treatment parameters (temp, power, insulation, distance)
Patient positioning
Response to intervention
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16
Q

Types of cryotherapy

A 
Ice pack, cup
Gel, chemical packs
Cryopressure units
Vapocoolant sprays
Cryohydrotherapy
Cooling suirs
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17
Q

What are the indications for cryotherapy?

A 
Abnormal tone
Acute or chronic pain
Acute or subacute inflammation 
Bursitis
Muscle spasm
Musculoskeletal trauma
Myofascial trigger points
Tendonitis
Tenosynovitis
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18
Q

What are the contraindications of cryotherapy

A 
Cold allergy/hypersensitivity (cold urticaria)
Cold intolerance
Raynaud's disease
Cryoglobulinemia
Paroxysmal cold hemoglobinuria 
Over regenerating peripheral nerves
Over areas of circulatory compromise
Inability to discriminate cold
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19
Q

Cryotherapy Documentation

A 
Area treated
Cooling agent
Treatment duration
Patient positioning 
Response to intervention
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20
Q

What are the indications for ultrasound?

A 
Soft tissue shortening
Pain control
Repair of soft tissue injuries
Dermal ulcers/ plantar warts
Tendon injuries
Resorption of calcium deposits
Bone fracture
Carpal runner syndrome
Anti-inflammatory

INCREASE EXTENSIBILITY OF COLLAGEN FIBERS (TENDONS, JOINT CAPSULES)

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21
Q

What are the effects of continuous ultrasound?

A

Thermal effects
Increasing tissue temperature

REDUCTION OF MUSCLE SPASM, PAIN MODULATION, INCREASED BLOOD FLOW, INCREASED METABOLIC RATE, INCREASED NERVE CONDUCTION VELOCITY

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22
Q

What are the effects of pulsed ultrasound?

A

Non-thermal effects
Acoustic streaming
Micro-streaming
Cavitation

INCREASE PROTEIN SYNTHESIS AND TISSUE REPAIR, INCREASE BLOOD FLOW AND BONE HEALING AND REPAIR OF NON UNION FRACTURES

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23
Q

Which ultrasound frequency penetrates tissue deeper?

A

1.0 MHz (2-5cm)

Vs 3.0 MHz (1-2 cm)

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24
Q

What are the two different modes of ultrasound delivery?

A

Continuous (thermal) and pulsed (non-thermal)

25
Q

How do you chose a ultrasound duty cycle?

A 
Thermal = 100%
Non-Thermal = 20 %
26
Q

What is the duration of ultrasound?

A

5-10 minutes

27
Q

What are the parameters of phonophoresis?

A

Frequency- 3MHz
Pulse 20% duty cycle
0.5-0.75 W/cm2 intensity
5-10 minutes

28
Q

What are ultrasound contraindications?

A 
Malignancy
Pelvis, abdomens and low back of pregnant woman
CNS issue
Joint cement
Plastic components 
Pacemaker
Thrombophlebitis 
Eyes and reproductive organs 
OPEN EPIPHYSEAL PLATES
29
Q

Ultrasound documentation

A 
Area treated
Ultrasound frequency
Ultrasound intensity
Ultrasound duty cycle
Treatment duration
If underwater
Response to intervention
30
Q

What is the intensity range for therapeutic ultrasound?

A

0.1-3 W/cm2

31
Q

When would you use higher intensities and when would you use lower intensities for ultrasound?

A

Higher intensities= continuous= chronic conditions and thick tissues

Lowe intensities= pulsed= acute conditions and thin tissue

32
Q

What is the pulse duration of most TENS units?

A

50-400 microseconds

33
Q

What is the pulse frequency of most TENS units?

A

1-200 Hz

Which is the pulse rate…

34
Q

What are the effects of pulse frequency?

A

Muscle contraction:
Twitch 1-10 Hz; Tetanic 20-50 Hz
Analgesic:
Enkephalins 40-150 Hz; Serotonin 15-100 Hz; Beta endorphins 2-5 Hz

35
Q

What is the intensity in most TENS units?

A

0-120 mA

Higher intensity the greater the penetration depth and greater number of fibers stimulated

36
Q

What are the 3 levels of responses to TENS?

A

Sensory- low amplitude
Motor- increased amplitude and duration
Noxious- more intense with long duration

37
Q

What are the electrical pulses of conventional TENS?

A

Short pulse duration (<150 microseconds)
High frequency (>80 Hz)
Current amplitude is sensory

ACUTE

38
Q

What are the electrical pulses of Acupuncture-like TENS?

A

Long pulse duration (>150 microseconds)
Low frequency (<10 Hz)
Sensory and motor current amplitudes

CHRONIC

39
Q

What are the electrical pulses of Brief-Intense TENS?

A 
Long duration (>150 microseconds)
High frequency (>80 Hz)
Sensory- motor- noxious current amplitude
40
Q

What are the electrical pulses of burst TENS?

A

Bursts of pulses instead of individual pulses
Low frequency (<10Hz)
Sensory- motor current amplitudes

41
Q

What are contraindications for TENS?

A

Over pelvis, abdomen, trunk, and low back area during pregnancy
Over carotid sinus
Demand pacemaker or unstable arrhythmia
Venous/ arterial thrombosis or thrombophlebitis

42
Q

What are some other contraindications of TENS?

A 
Malignant tumor
Epileptic patients
Over metal implants, eyes or testicles
Mucosal membranes
Undiagnosed pain
Implanted defibrillators
Thoracic and cranial areas
43
Q

TENS documentation

A 
Area treated
Patient positioning
Parameters (frequency, duration, amplitude)
Electrode placement
Duration
Response to intervention
44
Q

What are the parameters of laser?

A

Wavelength (visible light 600-700nm, infrared light >700-1100 nm)
Power
Energy density
Light sources

45
Q

When would an LED laser be used?

A 
Most diffuse light
Widest frequency range
Low power individually
BEST SUITED FOR TREATING LARGE, SUPERFICIAL AREAS
Power- 1-5mW can be 30-40mW
46
Q

When would SLD laser be used?

A 
Less diffuse light
Narrower wavelength
Emit more power than LEDs
BEST SUITED FOR SUPERFICIAL, MODERATELY DEEP AREAS BASED ON WAVELENGTH
Power: 5-35 mW can be >90mW
47
Q

When would Laser Diodes be used?

A 
Provide single wavelength
Very concentrated
Best suited to treat small areas
DELIVERS THE MOST DEEPEST LIGHT TO A SINGLE AREA OF TISSUE
5-500mW (power)
48
Q

What are the clinical indications for lasers?

A 
Soft tissue and bone healing
Arthritis
Lymphedema
Neurological conditions
Pain management
49
Q

What are contraindications of laser?

A 
Malignancy
Direct irradiation of the eyes
Within 4-6 month after radiotherapy
Hemorrhaging regions
Over the enterprise glands
PRECAUTIONS: pregnant women and growth plates
50
Q

Can laser be used for acute conditions?

A

Yes
It’s non-thermal
Can also be used for metal implants and pacemakers

51
Q

Laser Documentation

A 
Type of diode
Wavelength (on machine)
Power (on machine)
Area of body treated
Energy density (on machine) 
Position of patient 
Response to intervention
52
Q

What are the two types of shortwave diathermy and what are they used for?

A

Continuous- heating deep tissues
Pulsed- thermal physiological effects: increased microvascular perfusion, altered cell membrane function and cellular activity

53
Q

What are indications for short wave diathermy?

A 
Heating joint capsule before stretching/ mobs
Enhancement of soft tissue healing 
Musculoskeletal disorders (pain, muscle guarding, joint stiffness) 
Uneven or irregular treatment areas
Bursitis
degenerative joint disease
Decreased collagen extensibility 
Peripheral nerve regeneration
54
Q

What are the types of diathermy applicators in the United States?

A

Inductive coils, drum, garments

Capacitive plates

55
Q

Where is the heat produced during diathermy?

A

Capacitive plates: produce more heat in the skin and superficial tissue
Inductive applicators: produce more heat in deeper structures

56
Q

What is the duration of diathermy treatment?

A

Thermal- 15-20 minutes

Non-Therma 30-60 minutes

57
Q

What are the doses for CSWD?

A

Dose 1- no sensation of heat
Dose 2- mild heating sensation
Dose 3- moderate (comfortable heating sensation)
Dose 4- vigorous heating that iss tolerable below the pain threshold

58
Q

What are contraindications for diathermy?

A

Recent or potential hemorrhage
Thrombophlebitis
Impaired sensation/ mentation
Malignant tumor
Implanted or transcutaneous stimulators (pacemaker)
Pregnancy (pelvis, abdomen, low back)
CSWD- malignancy, eyes, testes, growth plates
PSWD- directly over deep tissue organs, closed loop plates and screws

59
Q

Diathermy Documentation

A 
Area treated
Frequency range
Average power or power setting
Pulse rate
Treatment duration
Type of applicator
Patient position and distance from applicator
Response to intervention

E & I 2 (5 decks)

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