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90 Cards in this Set
- Front
- Back
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What is the % there is Single leg support and Double leg support? |
Single Leg Support= 80%
Double Leg Support= 20% |
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What % of the gait cycle is stance phase? |
60 %
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What % of the gait cycle is swing phase? |
40% |
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What is the MIN ROM needed for hip flexion? |
0-30* |
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What is the MIN ROM needed for Hip extensio? |
0-10* |
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What is the MIN ROM needed for knee flexion? |
0-60* |
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What is the MIN ROM needed for knee extension? |
0* |
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What is the MIN ROM needed for Ankle dorsiflexion? |
0-10* |
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What is the MIN ROM needed for Ankle Plantarflexion? |
0-20* |
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When a pt has a weak muscle, what side will they lean towards? |
The weak side |
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Describe conduction |
-Direct contact between two materials at different temperatures
-Cold pack -Cryo cuff -Ice Massage -Hot Pack -Parrafin |
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Describe Convection |
-Water moving in a constant motion across the body
-Cold whirlpool -Fluidotherapy -Hot whirlpool |
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Describe conversion |
-Heating that occurs when non-thermal energy is absorbed into tissue & transformed into heat
-Diathermy -Ultrasound |
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Describe radiation |
-Direct trf of heat through radiating source of higher temperature to one of cooler temp.
-Infrared lamp -Laser -Ultraviolet light |
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Describe evaporation |
-Trf of heat that occurs as a liquid absorbs energy and changes form into a vapor.
-Vapocoolant spray |
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How long does a cold or hot pack need to be in a droculator or freezer initially before used on a patient? |
2 hours for first use |
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How long does a cold or hot pack need to be in droculator or freezer inbetween patients? |
at least 30 min |
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What are modalities used for? |
Used to increase function and range and decrease pain |
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What degrees does the hydroculator need to be set between? |
158-167* |
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If a hot pack is too hott what usually happens to the skin? |
- Blistering -Blanching -Marbling |
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How often do you need to check a person who is using a hot pack? |
every 5 min |
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What is the usually tx time of a hot pack? |
15-20 min |
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How many layers of towels do you use with a hot pack? |
6-8 towels |
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What is the proper documentation need to include when writing about hot pack? |
- pt position -tx time - layers used - areas treated - Skin being checked |
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What is the normal tx time for cold pack and why not any longer? |
- 10-15 min
-Anything longer turns into cold induced vasodialates and in turn will start to produce heat and can have tissue death
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When do you check the skin with using a cold pack? |
- before and after
- Do not want to see blanching, blistering or marbling |
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What is the purpose of using a cold modality? |
- To restrict blood flow (Stops production of histamin & prostangilins which is resp for swelling) -Prevents anymore swelling from happening |
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What is 1Hz(frequency) for ultrasound and how deep does it go? |
Deep tissue heating 3-5 cm |
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What is 3Hz(frequency) for ultrasound and how deep does it go? |
Shallow or more superficial 1-2 cm |
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What is the range for power/intensity on the ultrasound? |
0.5 w/cm2 - 2 w/cm2 ^^ Always start out low |
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When do you use continuous ultrasound? |
-When you want to elevate the thermal effects
-Never Acute or Subacute |
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When do you use pulsed ultrasound? |
-Can really use anything stage but generally used in the acute and chronic stage |
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What is the intensity generally used with pulsed ultrasound? |
0.5 w/cm2 - 1 w/cm2 |
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What is the on/off ratio of pulsed ultrasound? |
20% on/off 5:1 |
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Describe accustic microstreaming |
- The affects that pulsed ultrasound can give off to the tissue below. It increases the cell permeability which increased the metabolism and speeds up tissue healing |
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For ultrasound the tx area.... |
Needs to be 2 x's the sound head |
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For ultrasound what is the tx time.. |
5-8 min
5 min= min to get an affect
8 min= to get paid by insurance |
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Describe Biphasic |
- Most is biphasic (TENS, NMES, IFC) - Used in symmetrical pattern -Dont want to change polarity or net charge in the tissue -Start at +2 go to -2 then back to +2
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Describe monophasic |
-Could be positive or negative but only one or the other -Used when we want to change the polarity of the tissue -Pulsed -Iontophorisis high vult pulsed current (used for healing wounds) - Want to use the same charge so it force the meds into the skin. |
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Most of cortisones or steriods have what kind of charge? |
Negative |
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Most opiods like acidic acid etc. have what kind of charge? |
Postive |
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Monophasic is good for what? |
Wound healing since iontophoresis uses a monophasic current |
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How do you calculate Iontophoresis tx time? Ma min |
If tx goal is 60 min Tx goal is 40
1 Ma= 60 40
2 Ma= 30 20
3 Ma= 20 13.3
4 Ma= 15 10
**What ever the tx time goal is you multiply the Ma to get the same tx time goal |
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What kind of charge does a negative wound give off? |
Negative |
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If you have a chronic non healing wound what kind of charge would you want to use? and why? |
A positive charge because since the wound is negative charge and the med is positive charge it will suck up the bad, then you want to apply a negative charge medication to distribute the healing meds. |
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What do we use TENS for? |
PAin |
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Describe the TENS parameters |
Position PPS Duration Power
High Pt can 100-150 L Comf/tingl Rate move be act & wear 24hrs
Low Non-active 2-10 H Visual Rate pt; sitting contraction 20-40 min
Burst pt sitting pre set 20-40 min more comf for pt Burst and low- uses endogenous opoid theory High -uses Gait control theory |
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Describe the endogenous opiod theory |
Eleviates the affect of pain even 4 hours after off the TENS unit Verses gait control theory only works when on the TENS unit |
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Describe NMES for strengthening |
Tx time= 10-20 reps
Power= MVIC (maximum voluntary iso contr) -Contract of injured= 10-50% of MVIC - Contract of non-injured= above 50% of MVIC
Ratio= 10 sec on/ 50 sec off = 1:6
Ramp= 1
Frequency= Every 2-3 hrs |
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Describe NMES for Muscle re-ed |
Tx time= 20-30
Power= Functional
Ratio= Depends on function
Ramp= 1
Frequency= N/A
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Describe NMES for spasm |
Tx time= 20-30
Power= Visible contraction
Ratio= 1:1
Ramp= 2
Frequency= Every 2-3 hours
**Electricity stops the spasm by fatiguing the muscle. |
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Describe NMES for edema |
Tx time= 20-30
Power= Visible contraction
Ratio= 1:1
Ramp= 2
Frequency= BID
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What are the application of the pads for NMES |
The first one needs to be 2/3 up in the middle of the muscle belly
The second needs to be just distal |
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What is IFC good for? |
Acute back spasms and pain |
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What is the beat frequency? |
Created by taking the difference of the two frequencies They are never the same so a person will never get accustomed to it |
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How do you get the difference of the two beat frequencies? |
ex. if one beat is 5000 mHz other beat is 5100 mHz answer is = 100 ^ |
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How many pads does IFC use? |
four and the different channels cross |
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Whats the min distance inbetween the pads? |
2 in
Further the pad the deeper it will transmit |
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Describe pre-mod |
-Has two pads -Machine is pre-set |
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What is a contrast bath used for? |
It helps with chronic edema |
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What is the process of the contrast bath and the temperature ranges? |
You stick the limb in heat 3 min then cold 1 min.
Cold= 50-60 * Heat= 104-106* |
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Describe some things about hydrotherapy |
- Most functional way to achieve function in NWB pts - T4= 75% of body weight -T10= 50% of body weight - Biggest problem w/ pool therapy is pt getting in/out - Getting HR up is difficult to do in pool |
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What are contraindications to heat? |
-Poor circulation -Acute inflammation -Cancer -Thrombolitis -MS -Mentation/Sensation -Hemmorage/Bruising (increases) |
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What are some contraindications to cold? |
-Reynalds phenomenon -Regenerating peripheral nerve -Uticana (little purple dots) - Cold insensitivity |
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What are some ultrasound contraindications |
-Pregnancy -Cancer -Cemented jts & plastic -Poor circulation -Spine -Carotid artery |
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What are some electrotherapy contraindications |
-Pacemaker/arrythmias -Thrombophlibitis -Cancer -Pregnancy -Metal -Infection (cellulitis) |
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What is the results from putting in a metatarsal bar or pad in or on the bottom of a shoe? |
-It shifts the WB from the metatarsals heads and distributes WB to the metatarsal shaft |
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What is a scaphoid pad used for? |
Arch support |
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What do stirups do? |
-Allow PF and DF -No medial or lateral rotation |
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When asked any questions about what type of orthosis a patient should use, you should... |
Always go with the joint below to fix gait
ex. if a patient has knee problems you would want a AFO |
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What would be best for a patient who has genu recurvatum? |
AFO |
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What is a Anterior/Posterior AFO generally used for? |
Weakness of gastoc muscle - An anterior AFO assists in toe off if needed |
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What type of AFO would a functional active person use> |
A spiral AFO -Can hide it in shoe and allows movement in all direction and is shaped to the leg |
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What type of brace/orthosis is used for scoliosis |
TLSHKFO/ Milwakee brace |
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How many layers of socks does it take before an adjustment needs to be made on a prosthesis? |
-15 layers -Bc patient is still going through healing stage |
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What are the normal areas of WB with a prosthesis? |
- On the sides -Patella |
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Where do you not want to see redness or WB from a prosthesis? |
-Anteriortibial plateu -Fibular head -Poplitel fossa -Hamstring tendon - Distal end of nub |
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If a patient is a transtibial amputee and has a stage 1 (non-blanchible eruthema) what do you do? |
-discontinue use of prosthesis -inform PT (PT will call orthotist) -Treat symptoms
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What is the standard dept, height, width of a WC? |
Dept 16 pop fold to butt (-) 2 in.
Width 18 widest Cheek to cheek (+) 2
Height 20 seat chair to axilla (-) 4 in |
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What is the contraindication for Mechanical traction? |
-If motion is not allowed -Acute injury/inflammatiokn -Peripheralization w/ traction (Suppose to centralize) -Uncontrolled hypertension |
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What do you always want to build before starting strengtening? |
Endurance |
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When starting off a therax what is the reps and sets you want to start with? |
2 sets of 15 reps |
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How to you build strength and power? |
Low reps with high sets 80% |
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How do you build endurance? |
Lots of reps and low sets 60% |
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How many liters of O2 do we use with just normal breathing? |
6 liters |
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What prepares a patient for activity? |
A dynamic stretch |
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What is protocol for warm up and cool down? |
-all exercise should have a 5-10 min warm up and cool time -times must match; if you warm up for 10 min must cool down for 10 min or pt will hurt themselves |
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What is Stabilizing reversals and Rythmic stabilization used for? |
Postural training
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Stabilizing reversals emphasizes what chain? |
Open chain |
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Rhythimic stabilization emphasizes what chain? |
Closed chain |
