Therapeutic Modalities (electrical and U/S only + skin receptors)

Question 1

in order for extensibility of the tissue to occur ,in respect to thermotherapy, what must be paired?

Answer 1

heat and stretching

Question 2

what are the temperatures to avoid tissue damage - in terms of thermotherapy?

Answer 2

> 47 C

> 45 C (exposed for more than 30 mins)

Question 3

an athlete needs thermotherapy for their hands, what modality would be appropriate in this scenario?

Answer 3

paraffin bath

Question 4

at what temperature does the skin cool down to 4 cm below skin level?

Answer 4

3.5 C

Question 5

describe the hunting response

Answer 5

bouts of sudden vasodilation of vessels when exposed to cold - happens around 4-6 min after initial exposure to cold

Question 6

what factor affects how fast a person gets cooled using cryotherapy?

Answer 6

how much subcutaneous fat they have

Question 7

what’s more ideal for better conduction of cold?

Answer 7

wet ice **wet your towels on top of your ice packs

Question 8

in implementing cryotherapy with movement - what must be considered/ done first?

Answer 8

applying cold therapy initially for 12- 20 minutes until numbness sits in

**if patient still doesn’t feel numbness after the 12-20 min mark - proceed to movement anyway

movement should still be within person’s capacity to move and should not stretch too far from their current capabilities

Question 9

purpose of using monophasic (DC) current/ biphasic (AC) current? what’s the difference between the two?

Answer 9

pain modulation
mm contraction

DC - direct current - flow in one direction
AC - alternating current - direction of current changes

Question 10

def’n intensity, in terms of electrical modalities?

Answer 10

voltage output

Question 11

def’n duration, in terms of electrical modalities?

Answer 11

time it takes for voltage to be put out (pulse width/ pulse duration)

Question 12

what’s frequency measured in?

Answer 12

hertz

Question 13

def’n polarity

Answer 13

direction of current flow

Question 14

athlete is given IFC (80-150 hz for 15 minutes) - how does this modality modulate pain?

Answer 14

gate control theory - stimulate the the sensory nn fibres (beta) to block the perception of pain for a short period of time

Question 15

what’s the purpose to giving a noxious stimulus to a patient with chronic pain?

Answer 15

utilizes descending pathway control to decrease perception of pain

typically:
pulse width (short) - 10 msec
frequency ~ 80 hz

Question 16

typical set up for using a modality for opiate P control

Answer 16

pulse duration: max

intensity: high
frequency: 1-5 pulses/s

Question 17

if the injury is too small for a 4 pad IFC treatment - what can be done instead?

Answer 17

use pre-modulation (2 pad placement that brackets the injury)

Question 18

general set up for electrical muscle stimulation:

pulse width
frequency
time / duty cycle
intensity

Answer 18

pulse width - 200-300 HZ
frequency : 1-10 (if using it for muscle pump) / 30-50 Hz for tetany)
time/ duty cycle: typical ratio of 1:1 / 1:5 (depends on aim - preventing atrophy , muscle reeducation, russian etc. )
intensity: muscle twitch or tetany

Question 19

purpose of utilizing iontophoresis

Answer 19

putting ion into body via electrical stimulation

can be used for scar modification
analgesic effects
wound healing

Question 20

ultrasound use:

explain the purpose of using 1Mhz vs. 3 Mhz

Answer 20

lower frequencies are not absorbed as easily through the body - therefore sound waves can travel deeper and produce a heating effect (3/5 cm)

higher frequencies are absorbed quicker - for more superficial heat therapy, 3 Mhz is used (1/2cm)

Question 21

def’n the effective radiating area (ERA)

Answer 21

The area of a therapeutic ultrasound head that produces useful ultrasonic energy

Question 22

def’n beam-nonuniform ratio

Answer 22

ideally should be 1:1 - shows you how much the intensity can fluctuate

ratio of the average intensity of the ultrasound beam across the ERA divided by the peak intensity of the ultrasound beam; the lower the BNR, the more uniform the intensity of the sound wave.

Question 23

if using a duty cycle less than 100% (for ultrasound), it won’t produce a heating effect - what other non-thermal effects can it have?

Answer 23

cavitation - increase in gas bubbles and increase the flow of fluid

microstreaming - changes the permeability of the cell wall (may increase protein synthesis)

Question 24

minimum time to be at therapeutic temperature of 40-45 C once the tissue has sufficiently warmed up?

Answer 24

5 minutes (on top of the time it takes for the tissue to reach that temperature)

Question 25

typical medications for phonophoresis

Answer 25

diclofinac and lidocaine

Question 26

what do the ruffini corpuscles pick up?

Answer 26

joint position changes
light touch
tension

Question 27

what do the pacinian corpuscles monitor?

Answer 27

deep pressure (fast)

Question 28

what do the merkel corpuscles monitor?

Answer 28

deep pressure (slow speed)

Question 29

what do the meissner corpuscles montitor?

Answer 29

light touch