Week 8 - Therapeutic Modalities Flashcards
What is a TM?
any physical agent applied to produce therapeutic changes to biological tissues –> thermal, acoustic, light, mechanical, electric energy
- Different types available for different scopes of practice
- Must be appropriate for injury and stages of healing
TMs in AT’s scope?
Thermotherapy
Cryotherapy
Massage
Thermotherapy?
Heat therapy
- topical solutions (capsaicin)
- pads/ packs
- Hot Tubs
- Ultrasound
- Parafin wax
Physiological Effects of Thermotherapy?
Raise tissue temp.
Increase cell metabolism
Increase capillary permeability
Vasodilation (histamine and bradykinin released)
Increased HR/ BR, decreased BP (w/ whole body exposure)
Benefits of heat?
Collagen tissue extensibility
warmed up/ decreased stiffness
Decreased pain (Gate-control theory)
Decreased joint stiff
Increased Blood flow
Reduce msc guarding
Effects depend on type of heat, depth of penetration, time applied
Thermotherapy Indications?
subacute/ chronic injury
- 2-4 days post up to 4-6 weeks post injury
- reduce pain
- decrease msc guarding/ tightness/ stiffness
- Joint contractures
- Hematoma/ edema
- Scar tissue
Thermotherapy Contraindications?
Acute Injuries
- skin conditions
- open lesions
- mucous membranes
- CV insufficiencies
- Deep vein thrombosis (blood clot)
- Poor thermal regulation
- Neoplasm (tumor)
Indications vs Contraindications
Indications
- Why we would want to use a certain TM
Contraindications
- Why we wouldn’t want to use a certain TM
Precautions w/ Thermotherapy?
No direct contact for heat packs
Don’t lie on heat packs
Cryotherapy?
Topical gels
Ice packs
Ice bags
Cold tubs
Physiological Effects of Cryotherapy?
< 10 degrees for up to 20 minutes causes vasoconstrictions
If applied for greater than 20-30 minutes = Hunting Response = 5 min of increased temp as body tries to avoid frost bite
- Lowers cell metabolism
- Decreased waste products in spastic msc
- decrease inflammatory response
- Decrease nerve excitability/ conduction velocity (analgesia - pain)
What is the Hunting Response?
If ice is applied for greater than 20-30 minutes = Hunting Response = 5 min of increased temp as body tries to avoid frost bite
Therapeutic benefits of Cryotherapy?
Decreases msc guarding, blood flow, inflammatory response, pain
Effects depend on method, tissue conductivity (msc is good cold conductor, fat is bad), time length
Indications for Cryotherapy?
Decrease pain
Reduce msc guarding
Post exercise recovery
Contraindications for Cryotherapy?
If they have decreased sensation
Raynauds phenomenon
Allergy
Open wound
Ice precautions?
Don’t apply for over 20-30 minutes
Use insulate layers w/ chemical packs
Most effective treatment for Cryotherapy?
Real crushed ice in bag on skin
Reach skin temp of 10 degrees for pain reduction
No towels or padding
15-20 minutes
Don’t re-ice until skin returns to normal temperature
Raynauds Phenomenon?
Massage?
Systematic manipulation of soft tissues to produce specific responses
5 types of strokes
5 strokes of massage?
Effleurage = circular strokes
Petrissage = kneading
Friction = Thumb and finger - used over scar tissue or ligament - deep pressure, small mvms
Tapotement = chopping hands - rapid/ repeated striking
Vibration = quick shaking/ rocking hand,
Effects of Massage?
Relaxation
Venous/ lymphatic drainage
Increased circulation
Reduced scar rigidity (friction massage)
Mechanisms of Massage?
Physiological
Biomechanical
Neurological
Psychological
Immunologic
Massage Indication?
Msc guarding
Scar tissue
Subacute inflammation (but not in first few days of healing)
Massage Contraindications
Decreased Sensitization
Acute injury
Contusions
Infection
