Practical Exam Flashcards
NMES Indications
incontinence, neurologic conditions, orthopedic surgery
NMES expectations for pts
should be strong but comfortable. will help to gain muscle strength and ROM as we do an exercise with stimulation
Goals for NMES
restoring muscle function, inhibit spasms, increase ROM
Application of NMES
Frequency = 50-80 hz.
Pulse duration = 300 ms.
5-20 min for 2-5x/week.
Higher frequency & longer duration = larger muscles.
Longer off time = stronger contraction, Shorter off time = more reps.
Low frequency = small muscles.
Start with 1:5 ratio and then go to 1:1 ratio
Post-intervention NMES
MMT, pain
Precautions of NMES
impaired sensation, decreased circulation
Contraindications of NMES
malignancy, active bleeding, 3rd trimester pregnancy
Indications of TENS
RA, OA, DOMS, pain
TENS expectations for pt
Strong but comfortable. Tingling sensation. Will help muscles to relax
TENS goals
Decreases pain, stops muscle spasms, increase blood flow to muscles
TENS application
Wider spacing allows for deeper penetration.
Acute pain = lower pulse (50-80 uSec) and higher frequency (100-150 hz), continuous duration (can be on for hours) .
Chronic = higher pulse (150-300 uSec) and lower frequency (2-10 Hz), phasic duration (30-60 min on and off)
TENS post intervention
Rate pain, ROM?
Precautions of TENS
impaired circulation, infection
Contraindications of TENS
malignancy, impaired communication, damaged skin
Ultrasound indications
Acute pain, wound healing, carpal tunnel syndrome
Ultrasound expectations of treatment
increases blood flow, thermal effects that would help to decrease pain. Increases cellular activity for wound healing. 3-5 min window after done for thermal effects drop
Goals of ultrasound
helps increase quality of inflammation phase, stimulates cellular growth w/protein synthesis in proliferative phase, enhances collagen maturation in remodeling phase. INCREASES blood flow and tissue extensibility
Application of ultrasound
superficial tissue = 3 MHz, continuous duty, 5-10 min @ .5 intensity.
Deep = 1 MHz, continuous duty, 5-10 min, 1.5-2.0 intensity.
Max of 15 min, movement should be small slow circles
Post intervention of ultrasound
Exercise! Rate pain, ROM
precautions of ultrasound
breast implants, acute inflammation
contraindications of ultrasound
active bleeding, lack of sensation, malignancy
indications of cyrotherapy
pain, inflammation, swelling, DOMS
expectations for pt for cyrotherapy
Stages: Cold, Burning, Aching, Numbness
goals of cyrotherapy
improving pain, increases pain threshold, reduction in DOMS
Application of cyrotherapy
barrier to the skin
small area = 3-5 min
large area= 15 min
inflammation = 10 min on/off
post intervention for cyrotherapy
have patient rate pain, rate edema
precautions of cyrotherapy
damaged skin, very young/old patient
contraindications of cyrotherapy
impaired circulation, impaired sensation, malignancy
indications for thermotherapy
muscle guarding, pain, muscle spasms
pt expectations for thermotherapy
comfortable and warm, not hot or burning
goals of thermotherapy
relax muscle spasms, increased pain threshold, increase extensibility
application of thermotherapy
No set time, 10-20 min is the best. Protect from burns with barrier to skin
post intervention for thermotherapy
have patient rate pain, ask about muscle spasms, ROM. MMT
precautions of thermotherapy
chronic wound, damaged skin
contraindications of thermotherapy
impaired circulation, impaired sensation, malignancy
Cervical traction indications
pain, tight joint capsule
cervical traction expectations for pt
pulling sensation, should be comfortable stretch
goals of cervical traction
distracting joints, soft tissue stretch, reducing disc herniation, reduce pain, muscle relaxation
Application of cervical traction
Supine, 15-20 degrees.
Joint = 20 to 30 lbs, Disc = 10-15 lbs.
Acute = 5-10 min, chronic = 15-30 min.
Can do static (disc/motion aggravated pain) or intermittent (disc/joint distraction)
Post intervention cervical traction
ROM, rate pain
Precautions of cervical traction
claustrophobia, pregnancy
contraindications of cervical traction
fractures, worsening neural signs, acute inflammation
iontophoresis indications
inflammation, tendonitis/bursitis
ionto expectations for pt
little sting, should not be painful. helping to deliver drugs deeper into the skin.
goals of ionto
reduce inflammation, break up scar tissue, decrease pain/muscle spasms. All dependent on medication
Application of ionto
applied with a medication, like dexamethasone.
Clean skin, trim hair.
Longer treatment = more comfortable and more meds.
Usually worn on avg for an hour
Post intervention for ionto
reduction of pain w/ADLs?
ionto precautions
obesity, metal implants
ionto contraindications
impaired sensation, impaired cognition, malignancy
