Ultrasound, Diathermy, Cold Laser Flashcards
What are the indications of ultrasound?
increase extensibility of collagen fibers of tendons and joint capsules
increase blood flow
increase cell metabolism
increased collagen synthesis
decreased joint stiffness
decreased muscle spasm
enhanced tendon, ligament, and muscle healing
What are the contraindications of ultrasound?
malignancy hemorrhage ischemia thrombus infection gonads eye pelvic, abdominal, and lumbar areas of pregnant women spinal cord after laminectomy plastic and cemented implants (metal is ok) near or over electronic implants unknown etiology
What are the precautions of ultrasound?
bony prominences (avoid, use indirect technique, smaller sound head) epiphyseal plate (may alter bone growth)
What happens when the tissue temperature is increased 1 degree Celsius when using ultrasound?
it is associated with an increase in metabolic activity
What happens when there is a 2-3 degree celsius increase in temperature while using ultrasound?
it reduces muscle spasm, increases blood flow and reduction of chronic inflammation
What happens when there is a tissue temperature increase of 4 degrees celsius while using ultrasound?
alters viscoelastic properties of collagen
Does pulsed or continuous US produce heat?
pulsed US does not produce heat, but continuous US does produce heat
Acute treatments for US are done at what duty cycle?
done at 50% duty cycle (no heat)
Chronic treatments of US are performed at what duty cycle?
performed at 100% duty cycle (heating)
1 MHz provides what type of penetration?
provides deep penetration, at 4-5cm
3 MHz (or 3.3MHz) is at what kind of penetration?
the most superficial, only going up to 2.5cm
Underwater US is preformed the same as what?
same as direct ultrasound (pulsed or continuous)
What are the indications of US and E-stim combo?
interferential (premod) for pain relief in combination with the mechanical (pulsed US) and/or thermal effects (continuous US) of ultrasound
What are the clinical rationale of US or E-stim combo therapy?
chronic tendonopathies such as lateral epicondylitis and achilles tendonosis are painful with ischemic and fibrotic changes of the tendon. Applying thermotherapy with US in combination with premod helps decrease pain and increase circulation
During US and E-Stim combo therapy what do you need to make sure to do with the channel?
be sure the lead is plugged into channel 2 and an electrode is connected to the black connector (black plug). the red connector is “dead.”
During direct pulsed ultrasound, what is the treatment area, clinical goal, intensity, frequency, duty cycle, and time?
treatment area: 2-3x size of ERA, move in slow circles
clinical goal: increase healing
intensity: 0.5-2.5 w/cm2
frequency: 1 MHz (deep) or 3.3 MHz (superficial)
duty cycle: 50% NO HEAT
time: 5-10 minutes
During Continuous US, what is the treatment area, clinical goal, intensity, frequency, duty cycle, and time?
treatment area: 2-3x size of ERA, move in slow circles
clinical goal: decrease chronic pain, or muscle spasm
intensity: 0.5-2.5 w/cm2
frequency: 1 MHz (deep), 3.3 MHz (superficial)
duty cycle: 100% HEAT
time: 5-10 minutes
During underwater US, what is the treatment area, clinical goal, intensity, frequency, duty cycle, and time?
treatment area: when the dead won’t contact the skin flat
clinical goal: increase healing, decrease pain
intensity: 0.5-2.5 w/cm2
frequency: 1 MHz (deep), 3.3 MHz (superficial)
50%-100% HEAT OR NO HEAT
time: 5-10 minutes
During combo of US and premod interferential, what is the treatment area, clinical goal, intensity, frequency, duty cycle, and time?
treatment time: 2-3x size of ERA, move in slow circles
clinical goal: chronic tendinosis, trigger points, acute or chronic pain
intensity: 0.5-2.5 w/cm2 premod, patient comfort
frequency: US- 1 or 3 MHZ; premod- 1-15Hz or 60-150 Hz
duty cycle: 50%-100% HEAT OR NO HEAT
time: 5-10 minutes
What are the contraindications of Cold Laser?
cancer pregnancy- over the abdomen and pelvic area avoid direct exposure to eyes over areas of active hemorrhage over the thyroid gland directly over open wounds unless covered with a clear protective barrier epileptic patients
What are the precautions of Cold Laser?
infections, testicles, sympathetic ganglia, vagus nerve, cardiac region in those with a heart disease, open growth plates, bruises, photosensitive
Which classes of cold laser do not require eye protection?
Class II (
Which classes of laser do require eye protection?
Class IIIb (5-500 mW)- can cause eye damage Class IV (>500 mW)- hazardous to eyes and skin
During cold laser with a pulse frequency of 1-5000Hz, what is the clinical goal, intensity, and time?
clinical goal: stimulate healing
intensity: low
time: 2-10 minutes
During cold laser pulse frequency 1000 Hz, what is the clinical goal, intensity and time?
clinical goal: inhibit swelling
Intensity: high
time: 1-3 minutes
During cold laser pulse frequency 1000-3000 Hz, what is the clinical goal, intensity, time?
clinical goal: acute pain
intensity: high
time: 3-5 minutes
During cold laser pulsed frequency, what is the clinical goal, intensity, time?
clinical goal: chronic pain
intensity: high
time: 5-10 minutes
If you have a pain level of 1-3, what frequency should cold laser be at?
1000 Hz
If you have pain 4-6, what cold laser frequency should you use?
1000-3000 Hz
If you have a pain level of 7-10, what frequency of cold laser should you use?
3000 Hz