Thermotherapy

Question 1

Clinical Indications of heat

Answer 1

Pain management, improve ROM, improve tissue healing

Question 2

the goal of all thermal modalities is to increase tissue temperature to…

Answer 2

104-113 degrees F, if anything above 113 then it will result in tissue damage, below 104, is a waste of time/minimal heating effect

Question 3

General contraindications for all physical agents

Answer 3

1. Pregnancy (over fetus)
2. Malignancy (over tumor, concern for metastasis
3. pacemaker or other implanted device (directly over)
4. impaired sensation (unable to accurately feel applied injury)
5. impaired cognition (communication, consent, safety)

Question 4

Contraindications for heat

Answer 4

Recent or potential hemorrhage, fever, acute inflammation, devitalized tissue, peripheral vascular disease, thrombophlebitis/DVT, impaired sensation and mentation, malignant tumor, denervation or surgical repair

Question 5

Precautions for heat

Answer 5

over open wound, pregnancy, impaired circulation and poor thermal regulation, edema, cardiac insufficiency, metal in the area, over areas where topical counterirritants have recently been applied, demyelinated nerves, age extremes

Question 6

Continuous ultrasound (thermal)

Answer 6

heating of superficial and deeper tissues that have high collagen content, heats up to 2-5cm of depth. pt should feel gentle warmth

Question 7

Pulse ultrasound (non thermal)

Answer 7

creates non thermal effects to promote tissue healing/repair, pt should not feel warmth.

Question 8

Ultrasound Parameter: Frequency

Answer 8

3 MHz, surface to 2-2.5cm

1 MHz, 2.5-5cm

Question 9

Ultrasound Parameter: Duty Cycle

Answer 9

For thermal effects: 100% Continuous cycle is used

For non thermal effects: pulsed ultrasound @ 20% duty cycle is most commonly used

Question 10

Ultrasound Parameter: intensity

Answer 10

Thermal intensities, 1 MHz: 1.5-2.0 W/cm2, 3 MHz: 0.5 W/cm2

non thermal intensities, 0.5-1.0 W/cm2 for tissue healing, 0.15 W/cm2 for bone healing

Question 11

Ultrasound Duration

Answer 11

5-10 minutes for an area that is 2-3x the ERA of the transducer

Question 12

Ultrasound Contraindications

Answer 12

Malignant tumor, pregnancy, CNS tissue (laminectomy), joint cement or plastic componentary, pacemaker, thrombophlebitis (DVT), eyes, reproductive organs, acute infection, impaired circulation, acute hemorrhage, anesthetized areas.

Question 13

Ultrasound precautions

Answer 13

acute inflammation, epiphysisal plates, fractures, breast implants