Physical Modalities of Rehab Med Flashcards
major physiologic effects of cryotherapy
- 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)
target temps for cyrotherapy
- local tissue = 0-10
- large area 10-15
- whole body 18-27
indications for cryotherapy
- acute soft tissue injury
- acute inflammation of tenosynovitis, bursitis, oa or ra
- post op pain and edema
- chronic pain
contraindications to cryotherapy
- hypersensitivity to cold
- impaired local circulation
- peripheral vascular disease
- local skin infection
- impaired sensitivity
methods of applying cryotherapy
- ice massage (15-20 mins)
- cold packs (20 mins)
- cryotherapy compression units
- chemical cold spray
classification of various types of heating
read
hemodynamic effect of heat
- 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
neuromuscular effect of heat
- inc firing rates in group 1a and b fibers
- inc nerve conduction velocity
joint and ct effect of hear
- inc tendon extensibility
- inc collagenase activity
- dec joint stiffness
other effects of heat
- analgesic effect (wash out by vasodilation)
- general relaxation
precautions when using heat
- acute trauma, inflammation
- impaired circulation
- bleeding diathesis
- edema
- large scars
- impaired sensation
- malignancy
- cognitive or communication deficits
heat with depth penetration of <1 cm
superficial heat
what are hot packs and heating pads
- hydrocollator packs immersed in tanks at 74.5 c over several layers of insulating towels
- 30 mins
- erythema ab igne
precautions for hot packs and heating pads
- electric shock
- dont lie down on pad/pack
what is parrafin wax bath
- temp 52.2-54.4
- for small irregular areas (joints and hands)
- dipping, immersion, brushing
what is fluridotherapy
- superficial, dry heating modality that uses convective heating with forced hot air and bed of finely divided solid particles
indication of radiant heat
- if patients cannot take weight of hot baths (open wounds)
- uses infrared radiation: long, low, red light
main determinants of intensity of radiant heat
- distance: intensity varies inversely with square of distance from source (30-60 cm)
- angle of delivery: perpendicular = hotter
what is deep heat
- 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
most common deep heating modality
ultrasound
- >20,000 Hz (above audible range)
physiologic effects of ultrasound deep heat
thermal nonthermal (mechanical) - platelet aggregation, localized tissue damage, cell death, accelerates metabolic processes, focal heating - cavitation: gas bubbles - media motion - standing waves
precautions for ultrasound
- heat precautions
- near pacemaker
- near spine, laminectomy
- malignancy
- skeletal imaturity
- arthroplasties
whirlpool bath vs hubbaarb bath
whirlpool = limb or localized lesion
hubbaard tank = whole body (34-36 c)
physiologic effects of electrotherapy
- reduce muscle spasms
- slows or prevents disuse atrophy
- stimulates muscle and blood circulation
- improves joint rom
- promotes wound and tissue healing
types of electrotherapy
- tens
- iontophoresis
- neuromuscular electrical stimulation
types of traction
- continuous
- sustained (large force, short period, 30-60 mins)
- intermittent (greater force, shorter periods, 15-25 mins)
indicatiosn for traction
- nerve impingement
- muscle spasm
moa of extracorporeal shockwave therapy
high intensity pulsed mechanical waves with low repetition frequency to elicit neovascularization
indications for est
- plantar fascitis
- fractrues, bony non-union, tendinopathy
