Superficial Modalities Flashcards
Ultrasound Indications
-acute conditions
-calcium deosits
-chronic inflammation
-delayed healing
-ulcers
-contractures/spasms
-trigger points
-pain
-scar
-warts
Ultrasound Contraindications
-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
Ultrasound Function
-deep heating 5cm
-piezoelectric crystals vibrate to produce sound waves into tissues through transucer
-most waves reflect, need gel or water
Attenuation
-decrease in energy intensity due to absorption in tissues and dispersing of waves
Ultrasound Absorption
-penetration and absorption inversely related
-absorption increases with frequency
-high protein=high absorption
Bone: highest
Blood: least
ERA
-effective radiating area
-energy output is greatest at center, small than transducer
Treatment area= 2-3x ERA
Collimation
-focus of the beam
-larger tranducer and higher frequency=more collimation
Bean Nonuniformity Ratio
-BNR
-peak intensity:average intensity
-lower is better
-better BNR=less risk foor hot spots
Non-Thermal Ultrasound
Acute Injury, Edema, Healing Ultrasound
-superficial and deep (3-1MHz)
-non-thermal and pulsed
-20% Duty Cycle
-1 Intensity/ 8-10mins
Mid Thermal Ultrasound
Subacute Injury or Hematoma Ultrasound
-increase 1deg C
-continuous
Superficial (3MHz)
-0.5 in/ 3 mins
Deep (1MHz)
-1 in/ 5min
Moderate Thermal Ultrasound
-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
Vigorous Thermal Ultrasound
-stretching collagen, joint contractures
-increase 4 deg C
-continuous
Superficial (3MHz)
-1 in/ 6min
Deep (1MHz)
-2 in/ 10 min
Ultrasound Frequency
0.75-3MHz
-tissue depth
1Mhz= greater depth, 5cm
3MHz= superficial 1-3cm
Higher frequency= faster heating= shorter treatment
Ultrasound Intensity
Highe intensity=higher temp= shorter treatment
-treatment goals
Ultrasound Cautions
-tissue damage at 45 deg
-continue only improvement
-placebo
BFR
-Blood flow restriction
-3-4 sets of 20-30 with 30s breaks
Arms: 200mmHG, red cuff or 50%
Legs: 300mmhg, yellow cuff or 80%
Contraindications:
-severe HTN
-Compromised circulation
-Varicose veins
-IV drug use
-swelling
-trauma
-open fractures
-skin gradt
-direct nerve injury
-uncontrolled DM
-sickle cell
Heat Types
Conduction:
-contact with source
-hot/ice pack, cold spray
-1cm penetration (cold>hot)
Convection:
-air of liquid transfer
-whirlpool or cryotherapy
Radiation:
-no physical contact needed
-laser, UV
Conversion:
-energy changes when contact is made
-US
Cold
Uses:
-decrease inflammation/swelling/pain (gate control)
-decrease muscle activity
-decrease BF, temp, metabolic rate, nerve confuction
Contraindications:
-impaired circulation
-hypersensitivity
-skinn anesthesia
-open wounds/infections
-joint pain
-dont lay on top
Biofeedback
-used to measure motor unit action and pressure
-can be used to assess or to self educate pt
-Myotrac and Pressure cuff (neck=20, back=70)
Uses:
-relaxation
-neuromuscular re-ed
-coordination
Sensitivity:
-start low then progress for NMR
-start high for relaxattion
Physiological Responses to heat
Increased:
-CO, metabolism, pulse, breathing, vasodilation, BF, permeability, edema
Decreased:
-BP, muscle activity, SV, BF to resting structures, joint stiffness, spasms, pain
Heat Preparation/Contraindications
-40-45 celcius
-subacute to chronic
-less than 2cm of depth
-lot for long term outcomes
Contraindications:
-acute/subacute inflammation
-decresed circulation/sensation
-DVT
-cognitive
-cancer
-eldery/very young
Heat Modalities
Hot pack:
-160-170deg
-6-8 layers protection
-check skin @5
Parafin:
-dipping odd shaped parts
-126deg
-6 layers
-15-20min
Fluidotherapy:
-tank of warm air and corn husks
Whirlpool
Hyrdrotherapy
-immersion baths mixed with air
-Whirlpool and Aquatic Therapy
Effects:
-decreased tone
-increased BF, temp
-pain relief/relaxation
-vasodilation
-debridement
Contraindications:
-advanced Cardiopulm disease
-bleeding
-less sensation or circulation
-gangrene/infection
-maceration
-Peripheral vascular disease
Physiologic Response to Cold
-Cold
-Burning
-Aching
-Numbness
-redness, vasocontriction
Cold Modalities
Ice Pack:
-acute to subacute
-muscle spasms and inflammation
Cold Spray:
-acute or subacute
-pain, spasms
Cryo Cuff:
-provides cold and compression
-moves water/ needs 1 layers
Contrast Bath:
-subacute
-alternating hot and cold
-edema, DOMS, desensittation
