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TherEx > Practical > Flashcards

Practical Flashcards

1
Q

Order of Practical

A

Introduce
Explain procedure
Contraindications
Permission
Position/Draping
Set Up
Treatment
Check in w/ Pt
Check Skin
Clean Up

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2
Q

Containdications for Massage

A

-skin infections/open
-thrombosis/embolism or phlebitis, severe varicose veins
-new tendon transplant
-fracture/non union
-acute inflammation
-cellulitis
-synovitis
-absesses
-cancer
-fever

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3
Q

Rules of Massage

A

-table height (knuckles at table)
-build trust before touching
-draping
-position
-continuous muscle contact
-distal to procimal towards heart
-not over bones

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4
Q

Order of Massage

A

-skin rolling (no lotion)
-Light effleurage
-Deep effleurage
-Petrissage
-Friction (or other technique)
-petrissage
-Deep effleurage
-light effleurage

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5
Q

Skin Rolling

A

-evalutes skinn conectivity and underlying restrictions
-no lotion
-lifting skin

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6
Q

Light Effleurage

A

-warm up and cool down
-light, continuous pressure
-get used to contact

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7
Q

Deep Effleurage

A

-medium, continuous pressure distal (light) to heart (deeper)
-promotes relaxation
-decreases pain
-searching for spasms

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8
Q

Petrissage

A

-kneading, deeper
-grasp and lift muscle and skin toward heart
-push waste to increase lymphatic and venous return
-loosen tissue and increase elasticity

Effect:
-spreads fibers
-tension of connective tissue
-proprioceptive input
-reduce collagen cross-linking

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9
Q

Friction

A

-deep, circular or transverse mmts
-no skin mmt, move underlying tissues
-where a trigger point, adhesion or scar is felt
-realign collagen fibers

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10
Q

Transverse Friction

A

-intense perpendicular to tendon
-should be painful, explain
-used for chronic tendon inflammation

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11
Q

Trigger Point Massage

A

-related to acupressure
-find point until pain or jump sign
-press on point and maintain pressure (will increase pain then lessen)

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12
Q

Myofascial Release

A

-mid pressure and stretch
-move in direction of restriction
-superficial to deep
-relieves soft tissue from abnormal grip of tight fascia

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13
Q

Active Release Technique

A

-deep tissue to break down fibrotic adhesions that restrict movement and scar tissue
-apply pressure in direction of fibers while pt actively elongates muscle

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14
Q

ROM Contraindications

A

-disruptive to healing process (precautions)
-response or condition is life threatening

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15
Q

Russian Currents

A

-muscle strengthening*
-muscle re-education*
-increasing ROM
-Slow atrophy
-Edema control (via muscle)

-2,000-10,00z frequency
-burst mode
-fast oscillating AC current, burst

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16
Q

Interferential Currents

A

-IFC
-pain control*
-muscle stimulation
-2 bipolar configurations (relief where they cross)
-4000-4100Hz frequencies
-120usec pulse width

Sweep Mode: frequencies modulated to avoid accommodation

Scan Mode: amplitude can be modulated
-for poorly localized pain

Target Mode: move with finger

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17
Q

High-Volt Pulsed Current

A

-HVPC
-reducing edema
-muscle pump 1:1
-wound healing

-twin peaked monophasic
-unequal electrodes, small over treatment

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18
Q

Transcutaneous Electrical Nerve Stimulation: Conventional

A

-TENS
-acute pain relief; surgical, labor*
-gate control theory; A-Beta*
-asymmetric biphasic
-tingle with no contraction*

Settings:
-75-150msec Duration/Width
-80-125pps Frequency
-continuous*
- Starting: 100p/100f*
-30mins, til pain is gone*

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19
Q

Iontophoresis

A

-low volt, continuous direct current
-drive ions into body
-medicine
-less than 30min on big machines
-longer with home devices

Doses:
-40mA-min= 4.0 current x 10min
-40mA-min= 2.0 current x 20min

Meds:
-Acetate, -, calcium depositis
-Dexamethasone, -, tendonitis/bursitis
-Lidocaine, +, trigeminal neuralgia

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20
Q

Transcutaneous Electrical Nerve Stimulation: Low-Frequency/Acupuncture/Motor-Level

A

-TENS
-chronic pain relief*
-Descending Pain control theory: modulation; enkephalin*
-asymmetric biphasic
-tingle AND contraction*

Settings:
-100-600msec Duration/Width
-<20pps Frequency
-Duty cycle: 30-60s*
- Starting: 180p/18f*
-15-60min*
-over motor point

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21
Q

Transcutaneous Electrical Nerve Stimulation: Noxious- Level

A

-TENS
-hyperstimulation analgesia
-chronic pain relief*
-Endogenous opiate pain control theory*
-asymmetric biphasic
-high intensity to noxious level; muscle contraction acceptable*

Settings:
-100-1000msec Duration/Width
-1-5pps Frequency
-Duty cycle: 30-45s
- Starting: 250p/2f*
-15-60min*
-over trigger point, until pain is no longer percieved

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22
Q

Transcutaneous Electrical Nerve Stimulation: Brief Intense

A

-TENS
-fast pain relief during procedure*
-Descending: peripheral and central anagelsia theory*
-asymmetric biphasic
-muscle fasciculation to sustain contraction*

Settings:
-100-600msec Duration/Width
-100 pps Frequency
-Duty cycle: 30-45s
- Starting: 250p/100f*
-15min*
-around wound

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23
Q

Premodulated (Bipolar)

A

-2 currents switch within the device
-only 2 electrodes
-pain control
-muscle stimulation/reeducation
-slow atrophy

-2 bipolar configurations (relief where they cross)
-duty 10:10, ramp 1-2s, 10-20min
-200-400usec pulse width

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24
Q

E-Stim Contraindications

A

-pacemaker/defib
-internal stimulators
-chest or heart area
-carotid
-thrombosis/vascular or arterial disease
-confusion
-seizure
-infection
-open wounds (unless treatin)
-cancer
-pregnancy
-high level SCI

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25
Q

Muscle Re-education

A

-Russian, NMES
-following surgery
-CNS inhibition of muscle
-improve motor control
-200-600 usec/ 35-55 pulse
-15min
-Duty 1:1

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26
Q

Muscle Pump Contractions

A

-HVPC, Russian, NMES
-increase circulation
-mimic normal contractions
-200-600usec/ 35-55 pulse
-comfortable muscle contraction
-20-30min
-duty 1:1
-elevatte the body part (can use AROM)

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27
Q

Edema Control

A

-HVPC
-elevate extremity*
-space electrodes far apart*
-negative polarity distal to swelling*
-driving forve to move plasma away
-30min
-best results immediately after injury
-80-120Hz/ low frequency*
-intensity as needed >60*

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28
Q

Muscle Strengthening

A

-Russian, NMES
-200-600usec/ 50-85pps
-gradual ramp
-duty 1:5
-to muscle fatigue 60% MVIC
-pt working with estim

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29
Q

Increasing ROM

A

-Russian, NMES
-200-600usec/ 35-55pps
-strong contraction
-interrupted current with gradual ramp
-antagonist muscles to joint contracture
-90min
-duty 1:1
-pt passive

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30
Q

Denervated Muscle

A

-lost peripheral nerve supply
-if reinnervation doesnt occur in 2 years connective tive replaces contractile elements so recovery not possible
-1st week <1ms duration
-2 weeks >10ms duration

-NMES

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31
Q

Slow Muscle Atrophy

A

-Russian, MNES, HVPC
-200-600usec/ 50-86pps
-15-20mins
-duty 1:5
-to muscle fatigue
-pt working with estim

32
Q

IONTO Indications

A

-analgesia
-bone spurs
-ulcers
-edema reduction
-fungal infections
-sweating
-muscle spasms
-tendonitis

33
Q

IONTO Contraindications

A

-estim rules
-impaired skin sensation
-allergy
-recent scar
-broken skin
-metal

34
Q

Ultrasound Contraindications

A

-active bleeding
-decreased sensation to temp
-decrease circulation
-DVT
-infecion
-malignancy
-breast implants
-carotid
-epiphyseal plates in young
-heart, eyes, genitalia
-cement or plastic
-pelvic and thrunk of pregnant
-pacemaker
-vascular insufficiency

35
Q

ERA

A

-effective radiating area
-energy output is greatest at center, small than transducer
Treatment area= 2-3x ERA

36
Q

Non-Thermal Ultrasound

A

Acute Injury, Edema, Healing Ultrasound
-superficial and deep (3-1MHz)
-non-thermal and pulsed
-20% Duty Cycle
-1 Intensity/ 8-10mins

37
Q

Mid Thermal Ultrasound

A

Subacute Injury or Hematoma Ultrasound
-increase 1deg C
-continuous

Superficial (3MHz)
-0.5 in/ 3 mins

Deep (1MHz)
-1 in/ 5min

38
Q

Moderate Thermal Ultrasound

A

-chronic injury, inflammation, pain, trigger points
-increase 2 degree C
-continuous

Superficial (3MHz)
-0.5 in/ 6min

Deep (1MHz)
-1 in/ 10min
-1.5 in/ 6min
-2 in/ 5min

39
Q

Vigorous Thermal Ultrasound

A

-stretching collagen, joint contractures
-increase 4 deg C
-continuous

Superficial (3MHz)
-1 in/ 6min

Deep (1MHz)
-2 in/ 10 min

40
Q

Ultrasound Frequency

A

0.75-3MHz
-tissue depth

1Mhz= greater depth, 5cm
3MHz= superficial 1-3cm

Higher frequency= faster heating= shorter treatment

41
Q

D1 UE

A

-putting a seatbelt on

Flexion: reaching for seatbelt
-Shoulder: add, ER
-Scap: UR, abd
-Forearm: sup
-Wrist: flex, rad dev
-Fingers: flx, add

Extension: buckling it
-Shoulder: abd, IR
-Scap: DR, add
-Forearm: pronation
-Wrist: ext, ulnar dev
-Fingers: ext, abd

42
Q

D2 UE

A

-Sword and waiter

Flexion: waiter holding a tray
-Shoulder: flx, abd, ER
-Scap: elevat, UR, abd
-Forearm: sup
-Wrist: ext, rad dev
-Fingers: ext, abd

Extension: reaching for sword
-Shoulder: ext, add, IR
-Scap: depress, DR, add
-Forearm: pronation
-Wrist: flex, ular dev
-Fingers: flx, add

43
Q

D1 LE

A

-hacky sack and ballet

Flexion: hackey sack
-Hip: flx, ER, add
-Knee: flx
-Ankle: DF, inv
-Toes: extension

Extension: Ballet
-Hip: ext, ITR, abd
-Knee: ext
-Ankle: PF, ev
-Toes: flx

44
Q

D2 LE

A

-dog peeing and curtsey

Flexion: dog peeing
-Hip: flx, IR, abd
-Knee: flx
-Ankle: DF, ev
-Toes: extension

Extension: curtsey
-Hip: ext, ER, add
-Knee: ext
-Ankle: PF, inv
-Toes: flx

45
Q

Rhythmic Initiation

A

-PT guiding through ROM
-for pts with difficulting initiating
-improves controlled mmts
-AROM, PROM, AAROM

46
Q

Repeated Contractions

A

-jerking motions
-PT stretches in jerks pt while going through the RROM
-strengthens weak agonists
-need AROM and RROM

47
Q

Slow Reversal

A

-kind of reversal of antagonist
-function changes in agonist to antagonist mmt
-contant resistance applied through ROM
-strong concentric of agonist followed by less strong eccentric of antagonist

48
Q

Slow Reversal Hold

A

-kind of reversal of antagonist
-function changes in agonist to antagonist mmt
-contant resistance applied through ROM with isometric hold at end of range
-better detection of joint/space tension

49
Q

Alternating Isometrics

A

-most common
-isometric hold of agonist then antagonist
-alternatting resistance to opposite muscles
-no ROM, inproves stabilization

50
Q

Rhythmic Stabilization

A

-isometric hold of agonist AND antagonist (co-contraation)
-simultaneous multidirectional resistance to opposite muscles
-no ROM, inproves rotary stabilization

51
Q

Stretching Time

A

10-30s hold

52
Q

Stretch: Upper Traps

A

Postition: Supine

Stabilize: Shoulder

Movement: LSB, flexion away

Home:
-flex head and rotate away with one hand

53
Q

Stretch: Levator

A

Postition: Supine

Stabilize: Shoulder

Movement: Flex, LSB, Rotate away

Home:
-flexion and rotation away with one hand
-ipsi scap upward rotation and depression with other hannd

54
Q

Stretch: SCM

A

Postition: Sitting up

Stabilize: Clavicular head

Movement:
-Stand behind pt
-Pt actively Ext, LSB away and Rotate toward

55
Q

Stretch: Suboccipital

A

Postition: Supine

Stabilize: C2

Movement:
-lumbrical hold on C2
-Stabilize head @ shoulder
-touch chin
-slowly move back into stretch

Home:
-chin tuck with one hand
-slight flx of head with other hand

56
Q

Hold-Relax

A

-stretch msucle and maintain stretch
-isometrically contract against stetch

  1. Stretch muscle
  2. Isometrically Contract same muscle (being stretched)
  3. Hold and go into further stretch
57
Q

Contract-Relax

A

-stretch muscle and maintain stretch
-isotonically contract against stetch, moving

  1. Stretch muscle
  2. Isotonically Contract same muscle (being stretched)
  3. Hold and go into further stretch
58
Q

Hold-Relax w/ Agonist Contraction

A
  1. Stretch muscle
  2. Isometrically Contract same muscle (being stretched)
  3. Hold and go into further stretch
  4. Concentrically contract antagonist (move in opposite direction)
59
Q

Stretch: Pec Major

A

Postition: Supine

Stabilize: Anterior shoulder at pec insertion

Movement:
-abduct shoulder while adding pressure to pec insertion

Home: use wall to apply pressure and then rotate away for more stretch

60
Q

Stretch: Lats/Teres Major

A

Postition: Supine

Stabilize: Lower ribs and iliac crest (lats), inf angle of scap (teres major)

Movement:
-abduct shoulder while adding pressure on lat/teres major insertion

Home:
-Bilateral: prayer hands with elbows on table and sink down
-Unilateral: place arm up and adducted against wall, rotate torso in opp for more stretch
-Cat stretch with LSB away, ipsi shoulder abducted

61
Q

Stretch: Quadratus Lumborum

A

Postition: Side lying

Stabilize: Ribs and iliac crest with forearms

Movement:
-Stand in front of pt
-break the bread

Home:
-cat stretch with LSB away, ipsi shoulder abducted

62
Q

Stretch: ITB

A

Postition: Sidelying

Stabilize: Ribs

Movement:
-Stand behind pt
-extend and adduct leg off of table

Home:
-extend and adduct leg off of table
-use roller
also for QL

63
Q

Stretch: Hip Flexors

A

Postition: Supine or Prone (eliminates lordosis)

Stabilize: Anterior hip or Posterior hip

Movement:
-Flex contra hip and relax foot on pt
-extend ipsi leg off of table and stretch by pushing (or pull if prone) down on knee

Home:
-flex leg
-Lunge and stretch

also for quads

64
Q

Stretch: Piriformis

A

Postition: Supine

Stabilize: opp side flexed hip (still affect though)

Movement:
-Stand on opp side of pt
-Push flexed knee toward pt

Home:
-Supine: hip flexed and cross legs over with pressure
-Supine 2: hip flexed and foot held for stetch
-Prone: hip flexed and knee flexed and use body weight to stretch

65
Q

Stretch: Hamstrings

A

Postition: Supine

Stabilize: N/A

Movement:
-Stand in front of pt
-Flex hip with straight leg and push forward

Home: chair, wall, own arm

66
Q

Home Stretch: Scalene

A

-Cervical extension, rotation towards, and 1st rib depression

67
Q

Home Stretch: Biceps

A

-extension of shoulder with elbow extension

68
Q

Home Stretch: Triceps

A
  • touch back with hand (simulate washing)
    -flx shoulder further
69
Q

Home Stretch: Wrist Flexors

A

-stick arm out and extend elbow and wrist
-put more extension force on fingers with other hand

70
Q

Home Stretch: Wrist Extensors

A

-stick arm out and extend elbow and flex wrist
-put more flexion force on fingers with other hand

71
Q

Stretch: Thoracolumbar

A

Flexion: cat stretch
Extension: Cow stretch

72
Q

Stretch: Lumbar

A

Flexion: Supine, knees to chest
Extension: Prone, on elbows and push onto hand

73
Q

Home Stretch: Adductors

A

-ipsi side proped up while standing on contra leg
-drop ipsi pelvic for more stretch

or
-crossing legs and stretch

74
Q

Home Stretch: Gastroc/Soleus

A

-Long sit with towel behind foott
-stand against a wall tto stick leg out to stretch

75
Q

Stretching Contraindications

A

-hypermobile
-hypomobility provides stability
-bony block
-non union fracture
-inflammation
-pain
-tissue trauma

76
Q

Balance PNF Techniques

A

shoes on with gait belt

Stability:
-rhythmic stabilization
-alternating isometrics

Enhance Dynamic Balance:
-Isotonic contractions
-Slow and quick reversals

TherEx (20 decks)

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