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Orthopedics > Physiotherapy > Flashcards

Physiotherapy Flashcards

1
Q

Low Voltage Galvinism (iontophoresis)

A

Indications:

1) Reduce Pain (lidocaine)
2) Muscle hypertonicity (calcium)

Contraindications:

1) Electronic implants
2) Over pregnant uterus

Physiological Effects:

1) Decrease local pain via nerve block (lidocaine)
2) Stabilize excitable membrane (calcium)

Application:

1) Active (small) pad on tx area, dispersive (large) pad 4-6 inches away
2) Polarity of active pad same as tx substance
3) 3-4 minute initial treatment time (check for irritation)
4) Dosage: 40 mA * min (10-20 min)
5) Current: DC continuous

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2
Q

High Voltage Pulsed Current (Reduce Pain)

A

Indications:

1) Reduce pain
2) Reduce muscle hypertonicity

Contraindications:

1) Electronic implant
2) Over pregnant uterus

Physiological effects

1) Mechanical local pumping
2) Prolonged muscle contraction -> fatigue

Application:

1) Active pad on tx area, dispersive pad placed proximally
2) Cycle time: continuous (to override pain)
3) Frequency: 80-150
4) Intensity: sensory
5) Time: 15 min
6) No polarity concerns

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2
Q

High Voltage Pulsed Current (reduce muscle hypertonicity)

A

Indications:

1) Reduce pain
2) Reduce muscle hypertonicity

Contraindications:

1) Electronic implant
2) Over pregnant uterus

Physiological effects

1) Mechanical local pumping
2) Prolonged muscle contraction -> fatigue

Application:

1) Active pad on tx area, dispersive pad placed proximally
2) Cycle time: continuous (to fatigue muscle quicker)
3) Frequency: 80-150
4) Intensity: motor
5) Time: 15 min
6) No polarity concerns

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2
Q

High Voltage Pulsed Current (decrease edema)

A

Indications:

1) Reduce pain
2) Reduce muscle hypertonicity

Contraindications:

1) Electronic implant
2) Over pregnant uterus

Physiological effects

1) Mechanical local pumping
2) Fluid shift

Application:

1) Active pad on tx area, dispersive pad placed proximally
2) For acute edema, (-) pad is placed over tx area to repel (-) blood proteins
3) Cycle time: continuous (acute), continuous or surge (chronic)
4) Frequency: 80-150 (acute edema), 10/10 (chronic - surge), 1-10 pps (chronic - continuous)
5) Intensity: motor (chronic), sensory (acute)
6) Time: 15-20 min

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2
Q

Microcurrent (reduce edema)

A

Indications:

1) Reduce edema
2) Reduce pain

Contraindications:

1) Electronic implant
2) Over pregnant uterus

Physiological effects:

1) Increase cell wall permeability
2) Increased fibroblast activity (collagen synthesis)

Applications

1) Pads placed on either side of tx area
2) Wave form: AC (“alt”)
3) Frequency: 30 pps
4) Intensity: 50 uA
5) Time: 15-20 min
6) Press Start 2x

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3
Q

Microcurrent (reduce pain)

A

Indications:

1) Reduce edema
2) Reduce pain

Contraindications:

1) Electronic implant
2) Over pregnant uterus

Physiological effects:

1) Increase cell wall permeability
2) Increased fibroblast activity (collagen synthesis)

Applications

1) Pads placed on either side of tx area
2) Wave form: DC (-) for chronic, (+) for acute
3) Frequency: 3 pps
4) Intensity: 50 uA
5) Time: 15-20 min
6) Press Start 2x

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4
Q

Microcurrent (soft tissue healing)

A

Indications:

1) Reduce edema
2) Reduce pain

Contraindications:

1) Electronic implant
2) Over pregnant uterus

Physiological effects:

1) Increase cell wall permeability
2) Increased fibroblast activity (collagen synthesis)

Applications

1) Pads placed on either side of tx area
2) Wave form: AC (“alt”)
3) Frequency: .3 pps
4) Intensity: 50 uA
5) Time: 15-20 min
6) Press Start 2x

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5
Q

TENS (conventional - acute radicular pain)

A

Indications:

1) Acute radicular pain
2) Low back pain

Contraindications:

1) Electronic implant
2) Over pregnant uterus

Physiological effects:

1) Gate-control (conventional)
2) Opiate release (low freq.)

Application:

1) Pads placed above and below nerve root along radicular pain
2) Frequency: 85 pps
3) Pulse width: 75 usecs
4) Intensity: sensory
5) Burst or modulation can reduce accommodation
6) Time: 15-20 min, up to 20 hrs at home
7) A-beta fibers

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7
Q

Interferential (quadripolar - reduce pain)

A

Indications:

1) Reduce pain
2) Edema reduction

Containdications:

1) Electronic implants
2) Over pregnant uterus

Physiological effects

1) Gate-control
2) Mechanical pumping

Application:

1) 2 channels used, criss-cross pattern
2) Frequency: 80-150 pps
3) Intensity: sensory
4) Amp. mod: 100% (so pad placement doesn’t have to be exact)
5) Freq. sweep prevents nerve accommodation
6) Quad goes deeper than bi-polar
7) 15-20 min

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8
Q

Diathermy (inductive)

A

Indications:

1) Reduce pain
2) Edema reduction

Contraindications:

1) Cancer
2) Pregnancy

Physiological effects:

1) Increase blood flow
2) Increase cell metabolism

Application:

1) Place towel on tx area and place drum against towel.
2) Place towels where moisture may accumulate.
3) Penetrates 5 cm

Dosing:
I) Athermic
II) Barely detectable
III) Pleasant warmth
IV) Max. tolerable warmth
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9
Q

TENS (low freq. - low back pain)

A

Indications:

1) Acute radicular pain
2) Low back pain

Contraindications:

1) Electronic implant
2) Over pregnant uterus

Physiological effects:

1) Gate-control (conventional)
2) Opiate release (low freq.)

Application:

1) Pads placed in “criss-cross style” around tx area
2) Frequency: 5 pps
3) Pulse width: 200 usecs
4) Intensity: mild motor (5 twitch /sec)
5) Time: 15-20 min, up to 20 hrs at home
6) A-delta, C fibers

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11
Q

Infrared Lamps (luminous)

A

Indications:

1) Edema
2) Tissue healing

Contraindications:

1) CA
2) Over pregnant uterus

Physiological effects:

1) Increased blood flow
2) Increase cell metabolism

Application:

1) Range: 18-24”
2) 90˚ to skin (cosine law)
3) Inverse square law
4) Erythema ab igne possible
5) 5-10 mm deep

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12
Q

Ultrasound (chronic muscle strain)

A

Indications:

1) Chronic muscle strain
2) Acute strain / subacute bursitis

Contraindications:

1) Plastic implants
2) Over pregnant uterus

Physiological effects:

1) Increase blood flow
2) Increase cell metabolism

Application:

1) Always keep head moving
2) Output: 1.0 W/cm
3) Duty cycle: continuous
4) Time: 10 min
5) Area: 2-3x area of head
6) Method: gel
7) Freq: 1 MHz (deeper penetration)

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13
Q

Ultrasound (acute strain / subacute bursitis)

A

Indications:

1) Chronic muscle strain
2) Acute strain / subacute bursitis

Contraindications:

1) Plastic implants
2) Over pregnant uterus

Physiological effects:

1) Increase blood flow
2) Increase cell metabolism

Application:

1) Always keep head moving
2) Output: 0.5 (acute), 0.75 (subacute) W/cm
3) Duty cycle: 20% (bony areas, acute pain)
4) Time: 5-7.5 min
5) Area: 2-3x area of head
6) Method: water bath, bladder, or gel
7) Freq: 1 MHz (deeper penetration)

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15
Q

Infrared lamps (non-luminous)

A

Indications:

1) Edema
2) Tissue healing

Contraindications:

1) CA
2) Over pregnant uterus

Physiological effects:

1) Increased blood flow
2) Increase cell metabolism

Application:

1) Range: 29-36” (farther b/c thermoreceptors are superficial and tf, it is perceived as hotter
2) 90˚ to skin (cosine law)
3) Inverse square law
4) Erythema ab igne possible
5) 0.5-2mm deep

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16
Q

Low Voltage Alternating Current (reduce muscle hypertonicity)

A

Indications:

1) Reduce pain
2) Reduce muscle hypertonicity

Contraindications:

1) Electronic implants
2) Over pregnant uterus

Physiological Effects:

1) Mechanical local pumping
2) Prolonged muscle contraction -> fatigue

Application:

1) Both pads are placed on tx area
2) Tetanize (fatigue quicker)
3) Freq: 80-150 pps
4) Intensity: motor
5) No active pad, no polarity

17
Q

Low Voltage Alternating Current (reduce edema)

A

Indications:

1) Reduce pain
2) Reduce muscle hypertonicity

Contraindications:

1) Electronic implants
2) Over pregnant uterus

Physiological Effects:

1) Mechanical local pumping
2) Prolonged muscle contraction -> fatigue

Application:

1) Both pads are placed on tx area
2) Surge (6 surges / min)
3) Freq: 40-60 pps
4) Intensity: motor
5) No active pad, no polarity

18
Q

PreMod (interferential - acute tissue healing)

A

Indications:

1) Reduce pain
2) Reduce edema

Contraindications:

1) Electronic implants
2) Over pregnant uterus

Physiological Effects:

1) Gate-control pain reduction
2) Mechanical local pumping

Application:

1) 1 channel used, pads along muscle belly.
2) Freq: 80-150 pps
3) Intensity: motor
4) Amp Mod: No
5) Automatic freq. sweep to prevent nerve accomodation
6) Bipolar is more superficial than quadripolar
7) Time: 15-20 min

Orthopedics (3 decks)

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