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Physical agents > Week 1 > Flashcards

Week 1 Flashcards

1
Q

What are physical agents?

A

Energy and materials applied to the body to help patients heal

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2
Q

Physical agents are generally described in ___ and ___

A

Categories of energy and types of physical agents

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3
Q

What are the categories of energy?

A

Thermal, mechanical, and electromagnetic

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4
Q

What are the types of physical agents?

A
  • Deep heating
  • Superficial heating
  • Cooling
  • Traction
  • Compression
  • Water
  • Ultrasound
  • Electromagnetic fields
  • Electrical currents
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5
Q

What do physical agents do/goals?

A
  • Modify tissue inflammation and healing
  • Relieve pain
  • Alter collagen extensibility
  • Modify muscle tone/contracting ability
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6
Q

What are the phases of healing?

A
  • Inflammatory phase (acute vs. chronic)
  • Proliferative phase
  • Maturation phase
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7
Q

Factors that can move modalities away or from usage?

A

• Pregnancy – Does modality (or energy from modality) reach
fetus?

• Malignancy – Can modality (or energy from modality)
accelerate growth/metastasis?

• Pacemaker or other implanted electronic device – Does
energy reach device?

• Impaired sensation/mentation – End point often report of
feeling and therefore an issue if patient has decreased
sensation.

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8
Q

Rank of priorities when choosing a physical agent for a patient

A
  • Highest/first: Primary underlying problem/problem most likely to respond to treatment
  • 2nd: treatments that address more than one problem simultaneously
  • Lowest/last: symptomatic treatment only
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9
Q

Thought process when choosing a physical agent

A
  • Goal and effects of treatment
  • Contradictions and precautions
  • Evidence for physical agent use
  • Cost, convenience, and availability of the physical agent
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10
Q

With physical agents, it is often ____ to find studies of the highest quallity

A

difficult

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11
Q

Combining complimentary physical agent types

A
  • RICE: Rest, Ice, Compressions, & Elevation
  • Heat & TENs (same time or one after the other)
  • TENs and Ice (same time or one after the other)
  • E-Stim (NMES) & heat
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12
Q

What happens in the inflammation phase of healing?

A

Prepares wound for healing.

- Days 1-6

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13
Q

What happens in the proliferation phase of healing?

A

Rebuilds damaged structures and strengthens the wound

  • Days 3-20
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14
Q

What happens in the maturation phase of healing?

A

Modifies the scar tissue into its mature form

  • Day 9 onward
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15
Q

What are the factors affecting the healing process?

A
  • Local factors
  • External factors
  • Systemic factors
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16
Q

What are the local factors affecting the healing process?

A

type, size, and location of injury. Whether or not there is an infection.

The vascular supply to the part of the body

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17
Q

What are the external factors affecting the healing process?

A

The use of physical agent come in to play to help complement the healing process

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18
Q

What are the systemic factors affecting the healing process?

A

The patient’s age (slower when older), disease factors that can impair healing, medication, nutrition

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19
Q

Important determinants of healing of specific tissues

A
  • Regenerative capacity of the tissue, vascular supply, or extent of damage.
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20
Q

Healing of cartilage

A
  • Limited ability to heal
  • Lacks lymphatics, blood vessels, and nerves
  • Cartilagenous injuries that also involve subchondral bone allow inflammatory cells from bone to gain access to repair the injured cartilage.
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21
Q

Healing of tendons and ligaments

A

• The potential for repair of these tissues depends on
the type of tendon or ligament, extent of damage,
vascular supply, and control of movement

• If healing occurs, tendons possess a unique scar
maturation phase that can achieve an advanced
state of repair

• Ligaments heal better with controlled passive
mobilization

(can still be 30-50% weaker after healing is done)

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22
Q

Healing of skeletal muscle

A

• Can be injured by trauma, strain, or muscle
diseases

• Healing can occur in some cases through stem cells
that can proliferate and differentiate

• After severe contusion, a calcified hematoma may
develop – myositis ossificans is rare complication

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23
Q

Healing process of bone

A

At least four stages of healing:

•Inflammation (begins shortly after impact)
- Creates hematoma, disrupts blood supply, lowers pH
• Soft callus (begins after swelling subsides)
- Stabilizes fracture, decreases pain, and reduces chance of fat embolism

• Hard callus (3 weeks to 4 months)
-Corresponds to clinical healing period

• Bone remodeling (takes months to years)
-Healed fibrous bone is converted to lamellar bone, and
medullary canal becomes patent again

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24
Q

The most common symptom prompting patients to seek medical attention and
rehabilitation is ____

A

Pain

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25
Q

Definition of pain

A

Pain is an unpleasant sensory and emotional experience

associated with actual or potential tissue damage, or described in terms of such damage.

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26
Q

A warning of actual or potential tissue damage is ___

A

Pain

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27
Q

Pain is a combination of what factors?

A

mechanical, neurological, psychological and

sociological factors

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28
Q

____ is often, but not always, a reliable indicator of location and severity of tissue damage

A

Pain

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29
Q

Pain is 100% from the ____

A

brain

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30
Q

Pain is a multiple system output, activated by an ____ which is activated whenever the brain ___

A

dividual’s specific pain
neural signature.

Perceives a threat

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31
Q

Assessing pain in patients

A
  • Visual analog and numeric scales
  • Comparison with a predefined stimulus
  • Be aware of cognitive issues
  • Semantic differential scales
  • Word lists and categories to describe pain
  • Daily activity/pain logs
  • Body diagrams
  • Open-ended, structured interviews
  • Physical examination and testing
  • Take cultural difference into consideration
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32
Q

Characteristics of the A-delta primary afferent neurons

A
  • respond to intense mechanical stimulation and heat or cold
  • short duration, sharp, stabbing, or pricking sensation
  • small and myelinated
  • 4-30 m/s
  • 20% of pain afferents
  • not blocked by opioids
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33
Q

Characteristics of the C-afferent primary afferent neurons

A

• longer duration, dull, throbbing, aching, burning, tingling, diffusely localized,
accompanied by sweating, increased heart rate and blood pressure, and nausea
• small and unmyelinated
• 0.5-2 m/s
• 80% of pain afferents
• can be blocked by opioid medication

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34
Q

Characteristics of the A-beta primary afferent neurons

A

• non-painful sensation related to vibration, stretching, and mechanical pressure

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35
Q

Types of pain found in the superficial/skin

A

Sharp/pricking/vibrating and easily located

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36
Q

Types of pain found in the musculoskeletal tissue

A

Dull/Achy/Heavy and more difficult to localize

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37
Q

Types of pain found in visceral tissue

A

Aching quality, frequently referred superficially

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38
Q

Two main things to think about in physical agents regarding pain control

A
  • Endogenous Opioid System

* Gate Control

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39
Q

Endogenous opioid system for pain control

A
  • Opiopeptins (a.k.a. Endorphins, Enkephalins, and
    Dynorphins) control pain by binding to specific opioid receptors

–Released in times of emotional stress and
result in raised pain threshold

–Possible explanation for noxious stimuli (i.e.
acupuncture) causing pain relief of preexisting pain

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40
Q

Gate control for pain control

A

A-delta & C-fibers open the gate that results in pain within the nervous system.

A-beta fibers closes the gate to decrease sensation of pain. (this is how TENs unit at a low level works)

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41
Q

Types of pain

A
  • Transient Pain
  • Acute pain
  • Chronic/persistent pain
  • Nociceptive
  • Neurpathic
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42
Q

What is transient pain?

A
  • Elicited by activation of nociceptive tissues in the body in the absence of tissue damage
  • Goes away without treatment
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43
Q

What is acute pain?

A
  • usually relatively short duration
  • defined etiology
  • may be localized
  • Reflex mechanism for protection from damage
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44
Q

What is chronic/persistent pain?

A
  • longer duration, often persisting longer than typical for a condition
  • often inadequate response to appropriate care
  • associated with more emotional reactions
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45
Q

What is nociceptive pain?

A

Has a clear stimulus-response relationship with the initial injury.

Can be acute and lead to chronic

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46
Q

What is neuropathic pain?

A
  • Burning or lancinating quality
  • Usually accompanied by signs or symptoms of neurological dysfunction, such as paresthesias, itching, anesthesia, weakness
  • Radicular vs. Referred pain

Can be acute and lead to chronic

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47
Q

What are the characteristics of pain?

A

Referred or Radicular

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48
Q

What is referred pain?

A
  • May be acute or chronic

* In many cases pain is away from origin/source of pain.

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49
Q

What is radicular pain?

A

Pain that travels along a nerve

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50
Q

What are the types of sensitization?

A

Peripheral and Central

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51
Q

_____ sensitization is due to the release of local chemical and sometimes no stimulus

A

Peripheral

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52
Q

Central sensitization occurs in the ___

A

CNS

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53
Q

Individuals with central sensitization have primary hyperalgesia which means ___

A

Increased duration and magnitude of CNS response for pain

54
Q

Individuals with central sensitization have secondary hyperalgesia which means ___

A

They have an enlarged receptor field, that might been previously localized but later spreads

55
Q

Individuals with central sensitization have allodynia which means ___

A

non-noxious stimuli becoming painful

56
Q

What are the goals of care for pain management?

A

• Resolving underlying pathology when possible
• Modifying discomfort and suffering
• Maximizing function within the limitations imposed by
patient’s condition

57
Q

For patients with persistent pain we may need ___, which include ____

A

integrated multidisciplinary treatment

Psychological and physiological therapies, physical agents, and
exercise

58
Q

What are the benefits of physical agents with helping pain?

A

• Directly moderates inflammation, modulates pain at the spinal cord, alters nerve conduction, or increases endorphins
• May also help resolve the underlying cause
• Allows patient to interact with their injured body-parts and
practice independent pain management skills
• Allow a movement/therapeutic window
• Avoids medication-related side-effects Avoids medication-related side-effects

59
Q

Most commonly used types of physical agents in PT

A
  • Cryotherapy (Ice, cold packs)
  • Thermotherapy (hot packs)
  • Ultrasound (used for mechanical and thermal effects)
  • Electrical stimulation (in the form of pain control with TENs)
  • Traction
60
Q

____ is an important component of pain management

A

Exercise

61
Q

Selecting appropriate exercises for patients with chronic pain
can be

A

Challenging

62
Q

What is the normal core temperature of the human body?

A

37 degrees C +/- 1

63
Q

Human tissues function best between ___ - ___ deg c

A

35-38

64
Q

Hypothermia is anything below ____

A

35 deg C

65
Q

Hyperthermia is anything above ___

A

35 deg C

66
Q

Skin and other peripheral tissues are slightly __ than the core temp

A

Less. (32-34deg)

67
Q

Ways that heat exchange occur between the skin and air

A

Evaporation and non-evaporation

68
Q

Via evaporation by the means of ___

A

Skin and respiratory passages

69
Q

Heat exchange between the skin and air via non-evaporation includes ____

A

Radiation, conduction, and convection

70
Q

What is radiation?

A

Energy being transferred from one surface to another in order to hit the surface. (sunlight)

71
Q

What is conduction?

A

Laying two surfaces together that have diff. temps on each other to change the body temp

72
Q

What is convection?

A

Rubbing two surfaces together that have diff. temps on each other to change the body temp

73
Q

How does heat exchange happen in the body?

A

Countercurrent exchange

74
Q

What is countercurrent exchange?

A

Cool venous blood from extremities being warmed by the arterial blood flow from the core

75
Q

What does the physiological effect of local heating depend on?

A

Depends on the degree of tissue temperature rise (TTR)

76
Q

Factors that determine how much there will be a TTR

A
  • Gradient
  • Specific heat
  • Volume
  • Rate
77
Q

A greater temp gradient will give a _____ TTR

A

Greater

78
Q

The higher specific heat = ____

A

More energy to heat, slower loss. Lowe degree of TTR

79
Q

The larger the volume of tissue is exposed the ____ TTR is

A

Higher

80
Q

In rate of heat applied, when a slow transfer of heat is applied, TTR_____ by blood carrying heat away

A

is balanced

81
Q

In rate of heat applied, when a fast transfer of heat transferred is faster than what the blood can carry, TTR is too ___, which results in pain and burn results

A

Great

82
Q

Physiological effects of using heat on tissues are

A
  • Vasodilation
    • Brings in more nutrients
    • Picks up more waste
  • Increase in metabolism
    • • For every 10 deg C rise in
      temp., there is a
      2-3 fold increase in the
      rate of metabolism
  • Pain relief
  • Decrease stiffness
83
Q

Additional physiological effects of using heat on tissues are

A 
• Enhance extensibility of tissue
      • Requires elevation of 
        tissue temp to 40-45 deg C
      • Stretch should be applied 
        after a tissue reaches 
        peak and then tissue 
        maintained in stretch 
        position until it cools back 
        down
• Reduce muscle spasms/decreased strength
      • Due to decreased firing 
        rates of type II ms spindle
        afferents and gamma 
        efferents, while increasing 
        firing rate of type Ib fibers 
        from Golgi tendon organs
      • All of this leads to 
        reduction of firing rate of 
        alpha motor neurons
      • This is same principle that 
        can help to break pain- 
        spasm cycle
      • Occurs for 1st 30 minutes 
       after application of heat, 
       and then increases again to 
       pre-treatment levels after 
       2hrs
84
Q

General precautions for heat

A

• Areas of decreased sensation and innervation
• Areas of decreased circulation
• Treating large volumes of tissue
• Poor thermal regulation – children and elderly
• During pregnancy
• Cardiac insufficiency
• Metal in the area
• Areas of watery edema – increased risk of burn
• Scars and new skin
• Over areas where topical counterirritants have
been recently applied
• Lying directly on the heat pack
• Heating bony prominences

85
Q

What are the contradictions for heat

A

• Areas of arterial insufficiency or arterial disease
• Areas prone to hemorrhage
(hemophilia, acute trauma, long-term steroid use)
• Acute inflammatory site
• Elevating tissue temperature in area of malignancy
• Impaired cognitive function

86
Q

Therapeutic effect of superficial heat

A

• Affect skin temp. w/o heating deeper tissues
• Penetrates about .5 cm w/peak temp. at 6-8
min
• Depth of penetration dependent on amount of
subcutaneous fat
• Possible to heat small joints of hand/foot
where little subcutaneous tissue is present
• Tissues at 1-2 cm require longer durations
(15-30 min)
• At 3 cm, only get about 1 deg C rise in temp.
• May affect deeper tissues through reflex mechanisms

87
Q

Physical agent: Hot pack

A

• Heat transfer by conduction (superficial)
• These are considered moist heat
• Use 6-10 layers of towels (hot pack covers equal 2-3
layers of towels)
• Heat typically for about 20 minutes for maximal results
• Always check patient after 5-6 minutes as the heat is
reaching max temp around that time.
• Prevents inadvertent burns
• Patient should feel warmth similar to towels fresh out
of the dryer

88
Q

Precautions and contradictions of a hot pack

A
  • Precautions
    • Any precautions for use of heat
    • Lying on the packs, especially when treating trunk
    • Heating bony prominences

• Contraindications
- Any condition where heat is contraindicated

89
Q

Advantages of a hot pack

A

• Easy to use.
• Inexpensive materials (packs and towels).
• Short use of clinician’s time.
• Low level of skill needed for application.
• Can be used to cover moderate to large areas.
• Safe because packs start cooling on removal from the
hydrocullator.
• Readily available for patient purchase and home use.

90
Q

Disadvantages of a hot pack

A

• Hot pack must be moved to observe the treatment
area during treatment.
• Patient may not tolerate the weight of the hot
pack.
• Pack may not be able to maintain good contact
with small or contoured areas.
• Active motion not practical during treatment.
• Moderately expensive equipment (heated water
cabinet)

91
Q

Physical agent: Paraffin treatment

A 
• Heat transfer by conduction
• Mineral oil added to paraffin
alters melting point and lowers
 specific heat making higher
 temperatures tolerable
• Specific heat (approx .65 Btu/lb.oF)
• Water specific heat = .938 Btu/lb.oF)
• Temp ranges from 126 -130 deg F
• Effects are those of superficial heating
92
Q

Indications of a paraffin treatment

A
  • Arthritis
  • Chronic orthopedic conditions
  • Joint stiffness, contractures
  • Scleroderma
93
Q

Precautions of a paraffin treatment

A
  • Any condition for which heat is to be used with caution
  • Small scratches – should be covered with gauze
  • Scar tissue
94
Q

Contraindications of a paraffin treatment

A
  • Any condition in which heat is contraindicated
  • Open wounds
  • Draining lesions
  • Rashes, infections which might be contagious
  • New skin or recent scar tissue
  • Water on skin – can cause a burn
  • Jewelry – can cause a burn
95
Q

Application of the paraffin treatment

A

• Before treatment
- Area to be treated must be clean and dry
- Metal must be removed from area to be treated (if it can’t be removed, cover with
several layers of gauze)
- ALWAYS check the temperature of paraffin
before applying treatment
- It is normal for paraffin to feel hottest around nail beds
- Warn patient not to touch areas of tank near
heating element

96
Q

Methods of applying a paraffin treatment

A

• Dip - Milder heating
• Body part relaxed and still, if moved after a layer is applied, it will crack and create hot spot
• Dip into tank, remove and repeat once dripping stops
• A thick “glove” should be applied (about 6-10 layers)
• Plastic bag is placed over glove followed by towel to reduce heat loss
• 10-15 minute treatment or until paraffin
cools

97
Q

Other method of applying paraffin treatment

A

• Immersion – more vigorous (may have easier time reaching 40-45 deg C)
• Involves placing body part back into tank once 1-layer “glove” has been formed
(allow 5-15 seconds to harden before placing back into tank) and glove may (or may not) melt during treatment

98
Q

Advantages of paraffin

A
  • Covers irregular surface
  • Gives good hyperemia
  • Easy to use
  • Inexpensive
  • Body part can be elevated if using the dip-wrap method
  • Oil lubricates and conditions the skin
  • Can be used by patient at home
99
Q

Disadvantages of paraffin

A
  • Can be messy, especially if spilled
  • Not good for large areas
  • Cannot use with open lesion
  • Cannot exercise during treatment
  • Cannot see the part during treatment
  • Flammable
  • Risk of cross-contamination if the paraffin is reused
  • Part in dependent position for dip-immersion method
100
Q

Physical agents: cold treatment

A

• Ideal Tissue Temperature for Treatment
• 15-25 deg C (59-77 deg F)
• Magnitude of temperature change depends on
• Temperature difference between tissue and cold source
• NOTE: temp of freezer or cold pack unit may be
difference between safe treatment and damage
• Crushed ice machine is not as cold as home freezer • Exposure time
• Conductivity of area being treated (eg. Fat is an insulator
and will hinder cooling of deeper muscle tissue)
• Type of cooling agent (ice vs water) • Effect of blood flow in the area

101
Q

Methods of cooling or removal of heat from an object

A 
• Conduction
    - Cold packs, ice massage, cold towels
• Convection
     - Fan
• Evaporation
     - Vapocoolant spray
102
Q

Physiological effects of cooling treatments

A

• Vasoconstriction
• Decrease metabolism
• Pain relief
- Decrease in nerve conduction velocity
• Augment muscle contraction
- <5 min ice massage has been shown to increase isometric strength
- Due to facilitated motor nerve excitability and psychological motivation

• However, can decrease muscle strength if > 30 min
- Due to decreased blood flow and nerve conduction, and
increase ms viscosity and soft tissue stiffness.

103
Q

Cold treatment on an acute injury is thought to be most effective _____

A

5-10 min after injury, but can still be helpful for up to 72 hours after injury

104
Q

What is the goal of a cold treatment on an acute injury

A

– Controls inflammation through vasoconstriction and
decreased permeability of vessels
– Decreases pain, numbs the injured area
– Prevents secondary hypoxic ischemia, which is a result of
increased distance for oxygen to diffuse from blood vessel
to tissues.

105
Q

Why prevent inflammation?

A

• Leukocytes and macrophages “clean up” the site
• Swelling increases sensitivity to pain and restricts movement
to prevent further injury
• Allows inflammation phase to progress and repair

106
Q

Precautions for cold treatments

A

• Skin sensation which is not normal
• Previous frostbite to area
• Anesthesia from ice could mask exercise induced pain
• Prolonged applications
• Hypertensive patient
- Blood pressure should be monitored because it goes up with cold immersion
• Packs or ice stored at 0 deg F or -17 deg C should not be applied directly to the skin
• Decreased cognitive level
• Very old/very young individuals
• Over the superficial main branch of a nerve
• Directly over an open wound( can be around it)

107
Q

Contraindications of cold treatments

A 
Cold hypersensitivity
• Compromised local circulation
   - Particularly arterial PVD
    - If tissue is ischemic and you further reduce blood flow, tissue damage may result
• Cold intolerance
• Cryoglobulinemia
•Raynouds disease
• Paroxysmal cold hemoglobinuria
• On regenerating superficial nerves
108
Q

Sensations during cold treatments

A
  • Cold
  • Warm, burning
  • Aching, tingling
  • Numbness
109
Q

Types of cold treatment: Cold packs

A

• Gel
- Temperature usually 23 deg F (-5 deg C)
- Must be chilled 2 hours to acquire proper temp (4-5 hours for new pack)
• Chemical
- One use
- Chemicals can cause skin burn if pack leaks
- Generally, not as good as other options as it does not maintain its coldness long
enough

110
Q

Types of cold packs continued

A

• Water:Alcohol homemade pack
- Use 2:1 ratio of water to alcohol and freeze in plastic bag
• Crushed Ice
- If using in combination with
compression, evacuate as much air as possible

111
Q

Application of cold packs

A

• Time
- 15-30 minutes (colder the source, the shorter the time)
- Longer time for patients with more subcutaneous fat
- Not necessarily removed once numbness is reached
as that is only skin that has reached optimal temp., but must be removed before frostbite (occurs at 3-10 deg C/ 39-50 deg F)
- For first 24 hours of musculoskeletal injuries, Knight
recommends applying for 30 minutes of every 2 hours
• Use wet towel, paper towel, or “handiwipe” to preserve sanitation of pack, and to enhance transfer of cold

112
Q

Ice massage

A

• Before the first treatment, check sensitivity to cold by using ice massage in an area about 1½ inches squared for just a couple minutes
• If hypersensitive, the skin blanches, has a leather texture, and an elevated surface
• Cover an area about 3-6 inches in diameter
• Time – 5-15 minutes or until beyond numbness (again, numbness only means skin temperature is ideal, not necessarily the tissues we are treating)
• Using overlapping circles, cover area in a systematic
way
• Do not let drips run down patient’s skin (wipe after
every 5-10 strokes – do so carefully as to not irritate
skin)

113
Q

Cold bath or whirlpool

A

• Immerse part in 13-18 deg C (55-65 deg F) water
• Can use water and crushed ice
• Time – colder water, less time (few seconds to 10 minutes – leave until a little after numbness is achieved)
• Toe cap may make foot more
comfortable

114
Q

Cold-compression units

A

• Cryocuff – “thermos” type
container full of water and
attached to cuff. Applies compression also

115
Q

Documentation for physical agents should include ____

A
  • Heating/Cooling agent used (type and size)
  • Patient positioning
  • Area treated (location and size)
  • Number/Type of layers between agent and skin
  • Treatment duration
  • Response to intervention (pre-test/post-test)
  • Should be reproducible for future visits
116
Q

Chronic inflammation occurs in which phase of healing?

A

Maturation

117
Q

Chronic inflammation occurs due to ____

A
  1. persistent force producing re-injury

2. immune response from infection or reaction to implant

118
Q

____ results in an increase collagen production which forms thicker tissues and adhesion

A

Chronic inflammation

119
Q

What are the effects of cyrotherapy?

A
  • Hemodynamic effects
    • Vasconstriction
    • Hunting response
    • Cold induced vasodilation
120
Q

What is hunting response?

A

A cycling of temp(heating and cooling) in the human body directly underneath the area where a cold agent is applied.

121
Q

How long does it take for the hunting response to happen?

A

15 mins

122
Q

What is cold- induced vasodilation?

A

Apply cryotherapy to the region, if it cools to more than 1 deg C and it is maintained for more than 15mins. This can result in edema

123
Q

What is the depth of penetration for cooling agents?

A

1-3cm

124
Q

How long should you apply a cold treatment to facilitate a muscle contraction?

A

5 mins

125
Q

Clinical indications for cryotherapy: Cryokinetics and cryostretch

A
  • Early intervention following injury
  • Initiating new therpeutic exercise program for patient in chronic pain
  • Increase muscle performance for athletes in training
126
Q

Application of a vapocoolant spray used for cryostretch

A
  • Management of trigger points
  • Spray along the muscle fibers
  • Apply a progressive stretch
127
Q

Cryokinetics ice bath protocol:

A
  • Apply cold agent x 20 mins or until region is numb
  • Stretching/strengthening x 3-5 mins until sensation returns
  • Reapply cooling agent until numbness returns
  • Repeat stretching/stregthening
  • Sequence repeated approximately 5x
128
Q

Unintended effects of cryotherapy

A
  • Reduced ROM
  • Reduced strength
  • Psychological effects
129
Q

Capillary refilling should start within ____, so we know there is no frostbite

A

2 secs

130
Q

Indications for use of thermotherapy

A
  • Pain control
  • Increase tissue extensibility to increase ROM and flexibility
  • Accelerate healing of injured tissues
  • Reduce muscle guarding or spasms
131
Q

Contraindications of thermotherapy

A
  • Recent or potential hemorrhage
  • Thrombophlebitis
  • Impaired sensation
  • Impaired mentation
  • Malignant tumor
132
Q

Adverse effects of heat

A 
- Burns: 
     Erythema ab igne: staining of the skin/ irritation
     Blisters
- Fainting
- Bleeding
- Increased edema

Physical agents (7 decks)

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