Week 1: Biophysical Agents, Contraindications, Healing, Interventions Flashcards
Define Biophysical Agents
- Physical Agents
- Modality
- Therapeutic Modality
PURPOSE of physical agents
- decrease pain
- decrease inflammation
- increase ROM
- improve tissue healing
- improve muscle activation
- to complement and facilitate HEALING!!!
Modality Choice is based on
- current best evidence
- information
- experience
- judgements
(indications, contraindications, patient preference)
What are the three categories of biophysical agents
- thermal
- electromagnetic
- mechanical
Cryotherapy Benefits
- reduced blood flow and tissue metabolism
- decrease bleeding
-reduce pain by desensitizing peripheral afferent nociceptors
Thermotherapy Benefits
- Facilitate tissue healing
- relax skeletal muscles
- decrease spasms and pain
- promote increased blood flow
- prepare tissues for exercise
Electrotherapy Benefits
- pain control
- facilitate muscle contraction in atrophied muscle
- stimulate contraction in denervated muscle
- deliver medication thru iontophoresis
- increasing blood flow
Mechanical modalities include
- compression
- traction
- hydrotherapy
- ultrasound - sound waves
Compression Benefits
- prevention,
- attenuation, or
- reversal of swelling,
- alter formation of scar tissue during proliferation and maturation phases of scarring,
List and Describe general contraindications and precautions for each biophysical agents
…
Active DVT precautions/contraindications
Active deep vein thrombosis or thrombophlebitis: energies applied to areas of thrombosis may dislodge or disrupt a thrombus which may lead to to occlusion of vital tissues
Hemorrhagic conditions precautions/contraindications
Hemorrhagic conditions: application of physical energies may disrupt platelet formation and uncontrolled bleeding
Impaired Sensation precautions/contraindications
- they cant feel sensation, temp, position, time properly so take precautions duhhhh
Impaired Cognition precautions/contraindications
- pt cant give proper feedback and consent
- its a precaution and may become contraindication
Electronic Implants precautions/contraindications
Contraindications: modalities that may interfere w/ the function of the electronic implant are contraindicated (Ultrasound, E-stim, Diathermy
Precaution: hot/cold packs, compression, traction
Pregnancy precautions/contraindications
Contraindication if energy delivered may reach low back, abdominal, and pelvic areas
- largely due to unknown effect on fetal development
Presence of Malignancy precautions/contraindications
Contraindication: if in LOCAL area if it may alter blood flow or metabolic activity in area of malignant tissue
- estim to manage cancer related pain is used in palliative care in late stage cancer
Phases of Tissue Healing: Homeostasis
0-6-8 hrs
- stop the bleeding
Phases of Tissue Healing: Inflammation
0-2-3 weeks
- clean up wound site
- prepare for healing
Phases of Tissue Healing: Proliferation
4-22 days (peak 2-3 weeks)
- rebuild damaged structures
- strengthen wound
Phases of Tissue Healing: Remodeling
days - 2 yrs
- modify the scar into its mature form
Acute Phase of Healing: Timeline, Symptoms, Goals, Tx
- Onset to 7-10 days
- Symptoms: Inflammation (pain & swelling, redness, heat, loss of function), chemical mediators and vascular changes, initial vasoconstriction and hypoxia leading to vasodilation
Goals: PROTECTION
- minimize pain & swelling
- ctrl inflammation and restore Full ROM
- prevent atrophy, maintain soft tissue joint integrity, enhance function
Tx: Cryotherapy, Compression, E-stim, Pulsed ultrasound, Iontophoresis (deliver meds) PRICEM-EM (protection, rest, ice, compression, elevation, manual therapy, early motion)
Subacute Phase of Healing: Timeline, Symptoms, Goals, Tx
- 10 days - 6 weeks
Symptoms: capillary growth and granulation tissue formation, fibroblast proliferation with collagen synthesis, increased macrophage and mast cell activity, development of wound tensile strength
Goals: increased mobility within a safe range, promote healing through progressively applied forces according to the SAID principle (specific adaptation to imposed demands)
Tx: thermotherapy, ultrasound, electrical stimulus, iontophoresis, diathermy ( also applies for chronic stage)
Chronic Phase of Healing: Timeline, Symptoms, Goals, Tx
- 6 weeks to months/yrs
Symptoms: includes healing to scar tissue, wound contraction, tissue remodeling, increasing tensile strength of the wound
Goals: progressive strengthening and endurance exercises, maximize independence and return to function
Tx: thermotherapy, ultrasound, electrical stimulus, iontophoresis, diathermy
Pain Impairment: what modalities & measurements
Modality: Cyro, Thermo, E-Stim, US
Measurement: Pain VAS, Functional measures
Swelling Impairment: what modalities & measurements
Modality: Cryo, Compression
Measurement: Girth, Volumetric
Decreased ROM: what modalities & measurements
Modality: Cryo, Compression, Thermo, US, E-Stim, Diathermy
Measurement: Goni, Incl, Muscle length
Decreased Strength/ atrophy: what modalities & measurements
Modality: E-Stim, Biofeedback
Measurement: MMT, Dynamometry
Tissue Healing: what modalities & measurements
Modality: Estim, US
Measurement: Wound assessment
