Therapeutic modalities Flashcards
What are the types of heat transfer and an example of each?
- Convection ie. whirlpool (liquid or gas past body part)
- Evaporation ie. Spray and stretch (liquid –> Gas)
- Conversion ie. US/ SWD (one energy to another)
- Radiation ie. Radiation therapy ( elecromagnetic wave)
- Conduction ie. Heat packs
(heat between two objects in contact with one another)
What are the physiological effects of heat therapy
- increased blood flow
- decreased muscle spasm
- Increased capillary permeability and cell activity
- Analgesia
- increased tissue extensibility
What are the contraindications of heat therapy
- decreased sensation
- decreased circulation
- open wounds
- acute injury
- malignancy
What is the temperature used for fluidotherapy? How long does treatment last?
100-118F
15-20 minutes
What is the temperature used for paraffin therapy
113-122F
What are the desired effects of cooling therapy? And what are the indications?
- Vasoconstriction, reduced blood flow to the area
- Decreased metabolic rate
Indications:
- edema, pain, spasticity, facilitate contraction
What are the contraindications to cooling therapy?
- cold sensitivity
- poor circulation
- superficial or regenerating peripheral nerves
- hypertension
- reduced sensation
- very young/ very old
What is the temperature used for a cold bath?
55-64F
15-20 mins
What is the temperature for the controlled cold compression unit?
50-77F
Cold plus intermittent compression
What is the safe limit for active electrodes in iontophoresis?
Anode 1mA/cm2
Cathode 0.5mA/cm2
10-40 minutes
What are the contraindications of TENS
- Pacemaker
- epilepsy
- first trimester
- Lower abd/uterus during pregnancy
What is the difference between IFC and TENS
IF targets deeper tissue using high frequency and 2 x biphasic electrodes. IFC is C/I in malignancy.
What is the difference between premod and IFC?
Premod is for smaller areas as it uses a bipolar technique.
What are the two main medications used with PHONOPHORESIS? What are the parameters used?
Lidnocaine - pain modulation
Dexamethasone / salicylates - antiinflamm
5-10 mins 1-3 W/cm2
Ultrasound can effect deeper and more superficial tissue. How do you use the parameters to alter this?
1mHz for deeper tissue up to 5cm
3mHz for less than 2cm
What are the contraindications of ultrasound
- over eyes
- over pregnant uterus
- cemented prosthetic joints
- reduced sensation
- reduced circulation
- over heart
- over testes
- over epiphyseal areas in children
- infection
- over malignancy
What are the contraindications of traction?
- Acute inflamm/sprain/strain
- Dislocation / #
- hernia
- increasing symptoms or peripheralisation of symptoms
- meningitis
- osteoporosis
- positive alar ligament test
- positive VBI testing
- pregnancy
- RA
- Tumors
- Vascular condition
What is the limit for cervical traction in the first session? What does it change to if targeting the facet joints? or targeting soft tissue/vertebral body separation?
First session: 8-10lb
Facets 7% body weight 20-30lb
Vertebral body/spasm 12-15Lb
What is the limit for lumbar traction in the first session? What does it change to if targeting the facet joints? or targeting soft tissue/vertebral body separation?
First session: 30-40lb
Vertebral body or Facet separation 50% body weight
Muscle Spasm 25% body weight
Prone position for disc
Electromagnetic radiation aims to
increase collagen extensibility, increase metabolic rate, increase muscle elasticity, increase pain threshold, cause vasodilation
Contraindications for electromagnetic radiation include
- Low back/abdo of pregnant woman
- ext or int metal
- malignancy
- IUD
- Pacemaker
- sensory defects
- moist wound dressing
- acute inflammation
- ischemic tissue
- testes
Procedure for pneumatic compression is as follows:
- check blood pressure
- elevate limb 45 degrees and abd 20-70 degrees
- 3:1 for oedema and 4:1 for limb shaping
2-3 hours for lymphodema, 2 hours for traumatic oedema
Venous ulcers 2-5 hours x 3 per week
Contraindications for pneumatic compression is as follows
- Malignancy
- DVT
- unstable or acute #
- infection
- heart failure
- pulmonary oedema
- Circulatory obstruction
Biofeedback uses visual and auditory feedback to aid the following
- reduced accessory muscle use
- reduce muscle spasm
- reduce pain
- increase muscle strength
- muscle relaxation
- improve NM control
Iontophoresis is..
Where does the active electrode go? and the dispersive electrode?
What are the safe limits for cathode and anode?
Which medications use the cathode?
The application of continuous direct current for the purpose of transporting healing agents.
Surface are of cathode = twice the size of the anode
Active electrode over the target area and dispersive electrode as far away as possible.
Safe limits: Cathode 0.5mA/cm2, anode 1mA/cm2
10-40 mins.
Salicylate, citrate (RA) and dexamathasone are all -ve.
