Physical Modalities

Question 1

What does combined use of heat and stretching do?

Answer 1

Significantly increase tendon extensibility

Question 2

Name a few contraindications to heat therapy

Answer 2

Ischemia (arterial insufficiency);
Impaired sensation;
Malignancy;
Scar tissue (can get ischemic necrosis)

Question 3

Examples of deep heat

Answer 3

U/S;
short wave diathermy;
microwave diathermy

Question 4

Where is absorption for U/S greatest?

Answer 4

At bone-muscle soft tissue interface

Question 5

When to use U/S?

Answer 5

Bursitis;
tendinitis;
MSK pain;
Degen arthritis and contractures (adhesive capsulitis, shoulder periarthritis)

Question 6

U/S contra’s?

Answer 6

Near pacemakers, tumors;
general heat contraindications;
Near heart, reproductive organs;
At infection sites, eyes;
Near laminectomy, spine, cervical ganglia;
Skeletal immaturity;
Prostheses with high-density polyethylene

Question 7

Freq and intensity for U/S? Penetration depth?

Answer 7

.8-1.1 MHz;
for tendinitis/bursitis, do 1.2-1.8 W/cm2;
8 cm, deepest of the three deep heating modalities

Question 8

Short wave diathermy mechanism? What is frequency? What is depth it goes to?

Answer 8

Conversion of radio wave electromagnetic energy to thermal energy;
27.12 MHz;
heat over a larger area and deep heat to 4-5 cm depth

Question 9

Why decreased spasticity to cold?

Answer 9

Decreased muscle spindle activity and Golgi tendon organ activity

Question 10

When is UV radiation (light therapy) indicated?

Answer 10

Psoriasis treatment;
aseptic and septic wounds;
acne, folliculitis

Question 11

Physiologic effects of UV light

Answer 11

Bactericidal;
increased vascularization of wound margins;
increased vit D production

Question 12

Most effective stimulation type for TENS unit?

Answer 12

High-freq, low-intensity stimulation

Question 13

Goal behind NMES use? Benefits?

Answer 13

Strengthens muscles and maintains muscle mass after immobilization;
increase muscle mass, stroke volume, cardiac output, reduce venous pooling

Question 14

Key physiologic and mechanical effect of massage?

Answer 14

Phys: Reflex vasodilation w/ improvement in circulation;
mech: assist in venous blood return from periphery

Question 15

Describe effleurage: method and goal

Answer 15

Gliding, rhythmic strokes of hand over skin going distal to proximal;
increase lymphatic drainage and reduce vascular congestion

Question 16

Describe petrissage: method and goal

Answer 16

“Kneading” technique where muscle is “pinched;’

helps break up tissue and muscle adhesions

Question 17

Describe tapotement: method and goal

Answer 17

Percussion;

can use for chest therapy

Question 18

Describe friction massage: method and goal

Answer 18

Prevent adhesions in acute muscle injuries and breaks adhesions;
useful for tendonitis and fasciitis

Question 19

Physiologic effects of traction

Answer 19

Vertebral joint distraction: C-spine elongates to 2-20 mm; can do with 25 lbs or more of tractive force

Question 20

Contraindications to C-spine traction

Answer 20

Cervical ligamentous instability;
Infectious spine process;
cervical spinal stenosis with cord compromise;
atlanto-axial subluxation;
vertebrobasilar insufficiency

Question 21

How much traction needed for C vs L spine?

Answer 21

For C-spine, at least 25 lbs needed for distraction, promote neck flexion with radic;
For L-spine, at least 50 lbs for posterior vertebral distraction, over 100 lbs for anterior separation

Question 22

What is constant with isotonic, isometric, isokinetic strengthening exercises?

Answer 22

Isotonic with constant external resistance;
Isometric with constant length;
Isokinetic with constant speed

Question 23

Open vs. closed kinetic chain exercises: what happens with distal segment of joint and goal?

Answer 23

Closed: Segment is fixed to object; try to activate both agonist and antagonist muscle groups;
Open: Distal segment free to move; focus on strengthening specific muscle groups for specific movement

Question 24

What properties of water does pool-based therapy take advantage of?

Answer 24

Buoyancy and viscosity of water

Question 25

Different stretching exercises

Answer 25

Static stretching: Hold position at end of ROM for 5-60 secs;
Reciprocal inhibition: move joint to end ROM and get symmetric contraction of antagonist group;
static stretching with contraction of agonist: joint moved to end ROM followed by isometric contraction of agonist muscle;
Ballistic stretching

Question 26

Immobilization decreases strength by _____-______ % per day; what is plateau reached in terms of weakness?
Percent muscle mass lost per week?

Answer 26

1-1.5;
25-40% original strength;
5-10%

Question 27

What happens with HR and SV with bedrest from cards standpoint?

Answer 27

Resting HR increases, SV decreases

Question 28

Define impairment, disability, handicap

Answer 28

Impairment: Physical/psychological abnormality, usually manifestation of disease or injury;
Disability: Inability to perform particular activity or function;
Handicap: Inability to perform or fulfill usual role/life activity as result of impairment and disability

Question 29

With getting older what happens with following parameters?

Max HR, LVESV, EF, CO, VO2 max

Answer 29

Max HR decreases;
LVESV increases with decreased EF;
CO decreases;
VO2 max decreases

Question 30

With getting older what happens with following parameters?

VC, PO2, FEV1, max minute ventilation, RV, FRC, TLC

Answer 30

VC: decreases;
PO2 decreases;
FEV1 decreases;
max minute vent decreases;
RV and FRC increases;
TLC does not change

Question 31

Digoxin toxicity can manifest with what?

Answer 31

N/V, anorexia, cardiac dysrhythmias, abdo pain, fatigue, headache, lethargy, ocular disturbances

Question 32

For elderly, why is nortriptyline preferred over other drugs in the class?

Answer 32

Fewer anti-Ch effects, decreased sedation effect, causes less orthostatic hypotension