Therapeutic Modalities

Question 1

What phases of wound healing do you want to utilize therapeutic modalities?

Answer 1

consolidation and organizational phase

Question 2

What should your patient be doing in the inflammatory phase (0-5 days)

Answer 2

RICE
rest, ice, compression, elevation

Question 3

When does your patient have a high risk of reinjury?

Answer 3

fibroplastic repair/subacute phase (5-21 days)

this is when the body begins to repair damage and new collagen fibers form scar tissue

Question 4

What is pain gate theory?

Answer 4

Application of a non-noxious stimulus activates closed gate mechanism–> reduces pain

Question 5

Which type of Es-stim is used for pain relief?

Answer 5

TENS

Question 6

Which type of E-STIM is used for muscular weakness?

Answer 6

NMES

Question 7

NMES recruits which type of muscle fibers first and mostly effects what kind?

Answer 7

Type 2 first
Mostly affects type 1

Question 8

What are indications for NMES estim?

Answer 8

disuse atrophy and early post-op (edema)

Question 9

Is high frequency, low pulse duration used for acute or chronic pain?

Answer 9

acute

Question 10

Is low frequency, high pulse duration used for acute or chronic pain?

Answer 10

chronic

Question 11

What is EWST used for?

Answer 11

reducing inflammation, short term analgesia, increase neovascularization, increase osteoblast activity, realigns fibers, more parallel healing

Question 12

What are the indications for EWST?

Answer 12

OA
tendon/ligamentous injuries
non-union or delayed fracture

Question 13

What are contraindications for EWST?

Answer 13

infectious arthritis
immune mediated joint disease
immature bone
cancer
unstable fx
neurological deficits, neural tissue
lung tissue

Question 14

Therapeutic Ultrasound is better for tissues with high protein or low protein content?

Answer 14

high

Question 15

Ultrasound waves cannot travel well through _______

Answer 15

air or fur–> ideally shave patient and use coupling gel

Question 16

What are the indications for therapeutic ultrasound?

Answer 16

break down scar tissue
increase elasticity of muscles
aid healing
increases circulation
reduces pain and spasm

Question 17

For ultrasound using thermal affects, what temperature does tissue have to be maintained at?

Answer 17

104-112 F for at least 5 minutes

Question 18

Shorter wavelengths penetrate _____ into the body than longer wavelengths

Answer 18

less (higher frequency waves w/ shorter wavelengths penetrate less and require lower intensities)

Question 19

What are contraindications of therapeutic ultrasound?

Answer 19

neoplasia
hemorrhage or immediate injury
eyes, gonads, or gravid uterus
Application to ischemic tissue, DVT
spinal cord following laminectomy
recent incision sites (wait 14 days post-op)

Question 20

What therapeutic modality can go home with the patient?

Answer 20

PEMF–> use of electrical currents to improve healing

loop is a delivery system for inducing electrical current flow in the conductor

Question 21

What are indications for PEMF?

Answer 21

wound healing
pain management
inflammation
post-surgical healing
OA

Question 22

Which modality is described by the following: Sound waves produce deep tissue heating, improves elasticity, promotes bone/tissue healing and tensile strength

Answer 22

Ultrasound

Question 23

Which modality is described by the following: Wound healing, non-pharmaceutical anti-inflammatory, pain management of OA

Answer 23

PEMF

Question 24

Which modality is described by the following: Sound waves promote bone healing and soft tissue healing

Answer 24

ECSWT