Physical Modalities of Rehab Med Flashcards

1
Q

major physiologic effects of cryotherapy

A
  • changing local sensation (dec excitability of free nerve endings = dec nerve conduction velocity)
  • muscle relaxation (dec spasticity, slow conduction velocity)
  • vasoconstriction then vasodilation (10 c = max constriction)
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2
Q

target temps for cyrotherapy

A
  • local tissue = 0-10
  • large area 10-15
  • whole body 18-27
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3
Q

indications for cryotherapy

A
  • acute soft tissue injury
  • acute inflammation of tenosynovitis, bursitis, oa or ra
  • post op pain and edema
  • chronic pain
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4
Q

contraindications to cryotherapy

A
  • hypersensitivity to cold
  • impaired local circulation
  • peripheral vascular disease
  • local skin infection
  • impaired sensitivity
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5
Q

methods of applying cryotherapy

A
  • ice massage (15-20 mins)
  • cold packs (20 mins)
  • cryotherapy compression units
  • chemical cold spray
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6
Q

classification of various types of heating

A

read

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7
Q

hemodynamic effect of heat

A
  • increased blood flow due to vasodilation (ingress of nutrients, leukocytes, and antibodies; egress of metabolic byproducts)
  • helps facilitate resolution of chronic inflammation
  • inc bleeding and edema
  • inc acute inflammatory rxns
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8
Q

neuromuscular effect of heat

A
  • inc firing rates in group 1a and b fibers

- inc nerve conduction velocity

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9
Q

joint and ct effect of hear

A
  • inc tendon extensibility
  • inc collagenase activity
  • dec joint stiffness
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10
Q

other effects of heat

A
  • analgesic effect (wash out by vasodilation)

- general relaxation

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11
Q

precautions when using heat

A
  • acute trauma, inflammation
  • impaired circulation
  • bleeding diathesis
  • edema
  • large scars
  • impaired sensation
  • malignancy
  • cognitive or communication deficits
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12
Q

heat with depth penetration of <1 cm

A

superficial heat

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13
Q

what are hot packs and heating pads

A
  • hydrocollator packs immersed in tanks at 74.5 c over several layers of insulating towels
  • 30 mins
  • erythema ab igne
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14
Q

precautions for hot packs and heating pads

A
  • electric shock

- dont lie down on pad/pack

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15
Q

what is parrafin wax bath

A
  • temp 52.2-54.4
  • for small irregular areas (joints and hands)
  • dipping, immersion, brushing
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16
Q

what is fluridotherapy

A
  • superficial, dry heating modality that uses convective heating with forced hot air and bed of finely divided solid particles
17
Q

indication of radiant heat

A
  • if patients cannot take weight of hot baths (open wounds)

- uses infrared radiation: long, low, red light

18
Q

main determinants of intensity of radiant heat

A
  • distance: intensity varies inversely with square of distance from source (30-60 cm)
  • angle of delivery: perpendicular = hotter
19
Q

what is deep heat

A
  • deposits energy to ligaments, tendons, muscles, and joint capsules
  • avoids excess heat on skin and subcutaneous fat
  • no skin burns (conversion)
  • target temp: 40-45 C
20
Q

most common deep heating modality

A

ultrasound

- >20,000 Hz (above audible range)

21
Q

physiologic effects of ultrasound deep heat

A
thermal
nonthermal (mechanical)
- platelet aggregation, localized tissue damage, cell death, accelerates metabolic processes, focal heating
- cavitation: gas bubbles
- media motion
- standing waves
22
Q

precautions for ultrasound

A
  • heat precautions
  • near pacemaker
  • near spine, laminectomy
  • malignancy
  • skeletal imaturity
  • arthroplasties
23
Q

whirlpool bath vs hubbaarb bath

A

whirlpool = limb or localized lesion

hubbaard tank = whole body (34-36 c)

24
Q

physiologic effects of electrotherapy

A
  • reduce muscle spasms
  • slows or prevents disuse atrophy
  • stimulates muscle and blood circulation
  • improves joint rom
  • promotes wound and tissue healing
25
Q

types of electrotherapy

A
  • tens
  • iontophoresis
  • neuromuscular electrical stimulation
26
Q

types of traction

A
  • continuous
  • sustained (large force, short period, 30-60 mins)
  • intermittent (greater force, shorter periods, 15-25 mins)
27
Q

indicatiosn for traction

A
  • nerve impingement

- muscle spasm

28
Q

moa of extracorporeal shockwave therapy

A

high intensity pulsed mechanical waves with low repetition frequency to elicit neovascularization

29
Q

indications for est

A
  • plantar fascitis

- fractrues, bony non-union, tendinopathy