Passive Care Flashcards
Contras to all modalities
Hemorrhage
Infection w/ suppuration
Malignancy (except TENs)
Contras to all heating
DM Encapsulated swellings Active TB Decrease thermal sensations Edema Abdomen or LB during pregnancy Acute conditions
Acute =
Up to 72 hrs
Subacute =
Swelling limited but debris and discoloration prevents healing
During subacute, ____ in beneficial
Pumping
Chronic =
2 wks longer than anticipated
Contras to all electrical
Brain Eyes Heart Carotid sinuses Pacemaker Anesthesia Pregnancy LB Open wounds
PRICES
Protect Rest Ice Compression Elevate Support
Ultra low frequency causes
cellular healing
low frequency causes
contraction
medium frequency causes
depth
high frequency causes
heat
MENS is a _____ frequency
ultra low
Low frequency therapies
EMS High Volt LVG Sine Faradic Interference (IF & RS) TENS
Medium frequency therapies
IF (4,000)
RS (2,000)
High frequency therapies
Superficial heat (IR and UV) Deep heat (MWD, SWD, US)
Sine, Faradic, and Interferential waves are all ______ current and the polarity is
AC or Biphasic
no polarity
Galvanic and high volt waves are __ current and there __ polarity
DC/ Monophasic
there is polarity
Electrothermal
micro-vibration that leads to HEAT (Joule’s law)
Electrochemical
(ionto and opioids) Iontophoresis is DC current
Electrophysical
ions push other molecules around shifting the Na+/K+ pump resulting in contraction (kinetic)
increase frequency
deeper penetration
medium frequency
decreased skin impedance
if the dispersal pad is too small or active sides are too large
it causes a tingle
Duty cycle for exercise/ rehab
1:3 or 1:5
a weaker muscle needs more rest (1:5)
surge for exercise/ rehab
increased ramp time
duty cycle for fatigue/ spasm
1:1 and its pulsed/ tetanizing
Modulation is used to
avoid accommodation
Endorphin frequencies
1-20
Enkephalin frequencies
70-150
What burns the patient
Amps
EMG
used to test MUSCLE best
NCV
used to test NERVE best
Arndt-Schultz principle
energy of modality has to be absorbed by the body to stimulate physiological response
Law of Grotthus- Draper
inverse relationship between penetration and absorption of energy (Ultra Sound)
CBAN
Cold
Burn
Ache
Numb
Hunting-Lewis Reaction
not the desired “pumping”… goes from vasodilation to vasoconstriction off and on when iced for too long
Warm treatment temperatures
96-99
Hot treatment temperatures
99-104
Convection
transmission of heat by circulation of heat particles
baths and IR
convection
Radiation
transmission of heat without the intervening medium getting warm
MWD, IR, UV
through lamps, radiation
Conduction
transfer heat through a substance
Ice, hydrocollator, paraffin, IR
conduction
The only modality that uses conversion
ultrasound
Deep heat
MWD, SWD
Superficial heat
IR, UV, continuous US
modality for spasm
heat
modality for spasticity
cold
cryotherapy primary effect
decreases edema
Indications for cryotherapy
headaches (migraines)
spasticity- MFS (trigger points)
Contraindications for cryotherapy
chilblains and frostbite
tension headaches
spasm- FM
ice immersion (or bath) is
CONVECTION
- all other icing is conduction
how many towel layers need to be used with hydrocollator packs
6 layers
Hydrocollator temperature
150-170
Paraffin temperature
125-130
indications of hydrocollator
tension headaches, prior to adjustments, spasm (FibroMyalgia)
Contrast bath
convection
Indications for contrast bath
raynaud’s, Buerger’s, subacute
Whirlpool bath
used for debridement at 100-105 degrees.
SITZ bath
2-10 minutes. Temperature is 105-115 so it can burn faster
Paraffin ratio
7:1 paraffin to mineral oil
Purpose of mineral oil in paraffin
Lower boiling temp
Fluidotherapy is ___ and uses ___
Convection
Dry cellulose
Indications for fluidotherapy
Chronic arthritis
Increase ROM
RSDS/ CRPS
Open wounds
Photobiomodulation
Intracellular stimulation of mitochondrial activity
Photo bio stimulation
Wound healing
Photobioinhibition
Pain management
Contra to cold laser
Open growth plates ***
Recent scars
Irreversible effects of cold laser
Protein coagulation
Safety for cold laser
Both pt and dr wear goggles
Action of UV
Thermal
Photochemical
Germicidal
Antifungal
Results of UV
Increase Vit D synthesis
Increase reticulocytes
Indications for UV
Skin (fungal, wounds, psoriasis)
Bone (rickets, osteomalacia)
Contras to UV
HIM
Tetracycline
SLE (malar rash)
Safety of UV
Only pt wears goggles
Max UV treatment
3 min at 18 in
Diathermy safety
Unit must be 10 ft away from electrical modality
Treatment must be 4 ft from hearing aids, any metal on pt
Indications for SWD
Bronchitis
Neuritis
Otitis media
Indications for MWD
Otitis externa
Best for hip conditions
Neuritis
Contras to both diathermy
Any metal
Longitudinal condensor in SWD used for
Biceps/ triceps
Coplanar condensor in SWD used for
Paraspinals
Transverse condensor in SWD used for
Joints
SWD heats __ first
Fat
MWD heats __ first
Muscles
Result of US
Micro massage
Contra to US
Over spinal cord (including laminectomy)
Over epiphyseal growth plates
Bony prominences
Fx
Duration of US
Acute = 3-5 min
Chronic = 5-10 min
Best coupling agent for US
Water
US distance from skin
1 in
US measured in
W/Cm2
Thin skin for US generally means
Sacrum
SI
Upper extremity
Knee
__ is used when US massage is desired without heat
Pulsed
Cavitation and shearing are ___ when using US
Bad
US depth
1 MHz = less heat more depth
3 MHz = more heat less depth
Is low volt a good contractor?
No
Is low volt a good electrochemical pusher
Yes
Anode in LV acts like
Ice
Cathode in LV acts like
Heat
Acute positive pole in LV actions
Vasoconstriction Acid reaction in skin Repel alkaline Attract O2 Repel H Cause ischemia Hardens tissue Pain relief Astringent
Positive pole used for __ conditions
Acute
Negative pole used for __ conditions
Chronic
Positive pole in LV repels
Metals
Mg
Ca
Cu
Zn
Negative pole in LV repels
Non metals
Salicylate
Acetate
High volt used in acute and subacute injuries to
Reduce edema, pain, spasms
Reduce muscle atrophy
Frequency actions of high volt
3-5 edema
15-25 muscle exercise
> 50 fatigue
Continuous mode of HV beneficial for
Edema
Pain
Neuritis
Reciprocal mode of HV limits
Accommodation
HV modes for acute conditions
Continuous
Reciprocal
Indications for sine waves
Hysterical paralysis
Muscle tension
UMNL with LMN intact
Indications for faradic waves
Stimulating weak or paralyzed muscles 1:5 duty cycle
Electrodiagnosis (rxn of degeneration)
Result of TENS
Pain control
Some contraction
A beta Nerve
Size:
Speed:
Job:
Large
Fastest
Proprio
A delta nerve
Size:
Speed:
Job:
Small
Fast
Sharp pain
C nerve
Size:
Speed:
Job:
Small
Slow
Dull pain
Primary effect of MENS
Tissue healing
MENS current ____ electrical flow
Reverses
MENS causes ___ contraction of muscle
Non
MENS generally increases things, but the one thing it decreases
Prostaglandins and decrease pain
MENS pads are over
Involved site
Result of interferential
Deep muscle contraction
Fatigue
Edema reduction
Pain control
Sweeping/ sensory of IF bone by
Machine
Vectoring/ motor of IF
Increases treatment area
Done by dr
IF
Muscle strengthening duty cycle
1 on : 5 off
IF
Muscle spasm duty ratio
1:1
Myofascial dysfunction cause of
Neurological irritability
Trigger points definition
Small regions of metabolic distress caused by combo of increased energy demand and impairment of oxygen and energy supply due to local restriction of circulation
Biofeedback used to modulate
Autonomic functions
Indications for biofeedback
HTN Migraines Stress ADD Incontinence
Philadelphia collar used for
ER transport
Soft foam collar limited
Stabilization
Milwaukee brace is for the ____ region and used for
Thoracolumbosacral
Scoliosis
Boston brace used for
Juvenile scoliosis
Lumbosacral corset used for
Spondylolisthesis , L/S disc
SI belt/ Williams used for
SI dysfunction
Intertrochanteric girdle used for
Hip lesions
Wider = more successful
Cho pat brace used for
Chondromalacia patella
Parts of gait
STANCE
- heel strike
- mid stance
- toe off
SWING
- acceleration
- mid swing
- deceleration
Cane should be on what side
Opposite involved side
Most stable gait
4 pt (both legs weak) 3 stable points at all times
Fastest gait
Swing through
Crutch fitting rules
6” lateral, 2 fingers below axilla, 6” in front of feet
Crutch palsy effects what nerve
Radial N
Effleurage
Method and purpose
Stroking
Sedate
Petrissage
Method and purpose
Deep kneading
Spasm
Tapotement
Method and purpose
Percussion
Congestion
Friction TFM
Method and purpose
Deep rubbing POWDER
Adhesion -> lateral epicondylitis
Vibration
Method and purpose
Shaking
Congestion
Deep pressure
Method and purpose
Nimmo
Adhesion, trigger points
Vibration therapy used for
Congestion
Result of traction
Decrease intra-discal pressure
Indications for traction
Acute and chronic disc syndromes
Chronic IVF encroachment
DJD
Chronic muscle spasms
Contra to traction
Protective muscle spasms
Cervical traction dosage
Min of 10 lbs
Max of 30-50 lbs
Position of C traction
C3-6 flexion 20-28 degrees
C0-2 natural
Dosage of lumbar traction
Min of 25%
Max of 50% or 120 lbs
Contra to inversion traction
High BP
Stoke
DM
With over the door C traction, make sure to
Face door with 28 degrees of C flexion
Hydrotherapy traction may be helpful for
Elderly