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Modalities Spring Midterm > Principles and Application of Therapeutic Modalities > Flashcards

Principles and Application of Therapeutic Modalities Flashcards

1
Q

What are physical agents (modalities)?

A

energy and material applied to patient to assist in their rehab

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2
Q

What are the types of physical agents?

A

Heat
Cold
Water
Pressure
Sound
Electromagnetic radiation
Electrical currents

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3
Q

What are physical agents primarily used for?

A
  • accelerate tissue healing
  • pain management
  • alters collagen extensibility
  • Modifies muscle tone
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4
Q

What do thermal agents do?

A

transfer energy to a patient to increase or decrease tissue temperature

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5
Q

What is cryotherapy?

A

therapeutic application of cold

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6
Q

What is thermotherapy?

A

Therapeutic application of heat

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7
Q

What is ultrasound?

A

Both thermal and non thermal effects- mechanical form of energy composed of alternating compression and refraction waves

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8
Q

What do mechanical agents do?

A

apply force to increase or decrease pressure on the body

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9
Q

Why is hydrotherapy mechanical?

A

water can provide resistance, hydrostatic pressure, and buoyancy for exercise or can apply pressure to clean wounds

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10
Q

What does traction do?

A

decrease pressure between structures

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11
Q

What does compression do?

A

increases the pressure on and between structures

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12
Q

How do electromagnetic agents apply energy?

A

in the form of electromagnetic radiation or an electrical current

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13
Q

What do LASERs do as an electromagnetic agent?

A

output monochromatic, coherent, directional electromagnetic radiation that is generally in the frequency range of visible light or IR radiation

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14
Q

How does shortwave diathermy work as an electromagnetic agent?

A

produces heat in both superficial and deep tissues

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15
Q

What does estim do as an electromagnetic agent?

A

electric current induces muscle contraction, changes in sensation, reduces edema, or accelerates tissue healing

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16
Q

What modality can be classified as two different categories?

A

Ultrasound - thermal and mechanical

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17
Q

What are some effects of physical agents (modalities)?

A
  • reduce tissue inflammation
  • accelerate tissue healing
  • pain management
  • alters collagen extensibility
  • modifies muscle tone
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18
Q

Which domain of the ICF model do modalities directly effect?

A

Body function and structure

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19
Q

What are the steps to consider when using a therapeutic modalitiy?

A
  • goals and effects of treatment
  • contraindications and precautions
  • evidence for physical agent use
  • cost, convenience and availability
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20
Q

When in doubt, what should we use for evidence?

A

CPG

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21
Q

What is the goal for healing?

A

repair and restore function by eliminating pathology and replacing damaged tissue by promoting regeneration of normal tissue

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22
Q

When is the inflammation phase of healing?

A

1-6 days post injury

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23
Q

When is the proliferative/fibroblastic phase of healing?

A

3-20 days

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24
Q

When is the maturation/remodeling phase of healing?

A

9 days on

25
Q

What happens during the inflammation phase?

Immediate protective response that…

A

immediate protective response that attempts to destroy, dilute, or isolate the cells or agents that may be faulty

26
Q

What are some causes of the inflammation phase?

A

 Soft tissue trauma
 Fractures
 Foreign bodies
 Autoimmune diseases
 Microbial agents
 Chemical agents
 Thermal agents
 Irradiation

** not just trauma

27
Q

What are the 4 cardinal signs of inflammation? and the 5th later added?

A
  • heat
  • redness
  • swelling
  • pain
  • loss of function
28
Q

What are the 3 purposes of the inflammatory phase?

A
  • form a fibrin lattice that limits blood loss and provides strength
  • remove damaged tissue
  • recruit endothelial cells and fibroblasts
29
Q

What is hypermia?

A

increase blood flow to area (vasodilation)
- increases temp
- redness

30
Q

What causes vasodilation during clot formation?

A

histamines
- increase vascular permeability
- SWELLING

31
Q

What is chemotaxis?

A
  • migration of other cells to the area through the process of chemical attraction/recruitment
32
Q

What cells remove damaged tissue?

A
  • neutrophils (first on scene), phagocytosis
  • leukocytes: attracted through chemotaxis
  • macrophages (monocytes to macrophages, involved in phagocytosis and synthesis of the extracellular matrix)
33
Q

What causes fibroblasts to adhere to fibrin to make collagen?

A

Macrophages

34
Q

What are the general goals for PT during the inflammatory phase?

A
  • decrease swelling
  • decrease pain
  • improve PROM and AROM
  • more swelling = more time to heal
35
Q

What are inflammatory phase modalities?

A
  • cryotherapy
  • compression
36
Q

What is a marker that suggests a shift between phases? (inflammatory to proliferative)

A

acute neutrophil cell infiltration then the replacement by longer term macrophage corralates to the transition

37
Q

What is the purpose of the proliferative phase?

A
  • cover the wound and impart strength to the injury site
38
Q

What are the four processes in the proliferative phase?

A
  • epithelization (protective barrier)
  • collagen production
  • wound contraction
  • neovascularization (blood supply to injured area)
39
Q

What are the general goals during the proliferative phase?

A
  • improve ROM
  • decrease pain
  • increase circulation
  • decrease swelling
  • protect wound
  • promote alignment of collagen fibers, avoid contractures
40
Q

What is the goal of the maturation phase?

A
  • restoration of the prior function
41
Q

Which phase of healing is the longest?

A

maturation

42
Q

What are some goals of the maturation phase?

A

return to activity
- increase ROM
- increase strength
- decrease pain
- increase circulation

43
Q

How long does a normal acute inflammatory process last?

A
  • no more than 2 weeks
44
Q

How long does normal subacute inflammation last?

A

4+ weeks

45
Q

What are the two methods of chronic inflammation?

A
  • cumulative trauma or interference with normal healing
  • immune response to foreign material or result of an autoimmune disease
46
Q

What local factors affect the healing process?

A

 Type, size, location of injury
 Infection
 Vascular supply

47
Q

What external factors affect the healing process?

A

 Movement
 Application of physical agents

48
Q

What systemic factors affect the healing process?

A

 Age
 Disease
 Medications
 Nutrition

49
Q

What are the PT considerations for the maturation phase?

A

 Physiological loading important
 Promotes realignment
 Recover full, normal ROM after injury or surgical repair
 Normal strength human tissue by 40-50 wks post-op

50
Q

What are the PT considerations for the proliferation phase?

A

 Immobilization versus early controlled forces for tendons
 Collagen fibrils to random alignment to organized

51
Q

What should we know about articular cartilage?

A

Aneural, avascular = Limited ability to
heal.

52
Q

Can articular cartilage heal in adolescents?

A

yes, cartilage has some capacity to
heal

53
Q

Can articular cartilage heal in adults?

A

less ability to heal
- heals by development of scar tissue or not at all

54
Q

Can skeletal muscle regenerate?

A

yes, regenerates well

55
Q

Will muscle fibers regenerate?

A

Yes, may regenerate
- growth from undamaged fibers or development of new fibers

56
Q

What are the four distinct stages of bone fractures?

A
  • inflammatory
  • reparative/proliferative
    (soft tissue callus formation)
    (hard callus formation)
  • bone remodeling
57
Q

When does a soft callus happen?

A

begins when pain and swelling subside
- increases vascularity; hematoma becomes organized with fibrous tissue cartilage and bone formation

58
Q

When does a hard callus happen?

A
  • begins when bony fragments are united by fibrous tissue
59
Q

What is the maturation phase characterized by?

in regards to scar tissue

A
  • the changes in the size, form and strength of the scar tissue

Modalities Spring Midterm (6 decks)

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