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57 Cards in this Set
- Front
- Back
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Modalities for conduction, convection, radiation
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Conduction: heat, cold, paraffin
Convection: whirlpool, hubbard tank, fluidotherapy Radiation: infrared lamp |
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Physiological effects of heat applicaion
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Increased CO, metabolic rate, pulse, RR, vasodilation
Decreased BP, mm activity, blood to internal organs, blood to resting mm, stroke volume |
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How do cold and hot modalities decrease pain?
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Gait theory - block A delta and C fibers by facilitation alpha Beta fibers
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Indications for superficial heat
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pain, inc CT extensibility, accelerate rate of tissue healing, dec soft tissue and joint restriction, dec mm spasm
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Precautions for use of superficial heat
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cardiac insufficiency
Impaired circulation Metal Prego Dymyelinated nerves Open wounds |
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Contraindications for superficial heat
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Acute inflammation
decreased circulation Dec Sensation DVT Impaired cognitive function Tumors Hemorrhage (hemophiliac) Very young and very old |
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Temperature for hot pack?
Parafin? |
165 to 170 deg
125 to 127 deg |
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How many layers do you need between patient and hot pack?
How long should tx be? |
6-8
20-30 mins |
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How many times do you dip extremity in paraffin? How do you wrap it? Tx time?
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6 to 12, then wrapped in plastic wrap or waxed paper and covered with towels
15 to 20 min |
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Tx duration and temp for whirlpool and hubbard tank
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103-110 for whirlpool
100 for hubbard tank 20-30 minutes |
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Indications for hydrotherapy
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Decubius ulcers
Open burns and wounds Post-hip fx Post-surgical conditions of the hi Subacute and chronic msk conditions of neck, shoulders, back RA |
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Precautions for hydrotherapy
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Recent skin graft, impaired cognition (local immersion)
Confusion, meds, urinary incontinence, resp problems, prego, MS |
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Contraindications for hydrotherapy
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Bleeding, wound maceration
Cardiac instability Epilepsy Bowel incontinence Infections that can be spread by water |
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Pressure and tx time for pulsed lavage
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4-8 psi
5-15 mins |
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Abstraction
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Removal of heat by means of conduction or evaporation (vaso-coolant spray)
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Physiological effect of large surfce area cold application
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INC BF to internal organs, CO, stroke volume, arterial BP
DEC metabolic rate, pulse, RR, venous BP |
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Normal skin reaction to superficial cold
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Vasoconstriction of skin capillaried results in blanching of skin in center of contact area
Hyperemia due to dec rate in oxygen-hemoglobin dissociation around edge of contact area |
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Adverse physiological effecs of cold due to hypersensitivity
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Cold uricaria: erythema of teh skin with wheal formation, associated with severe itching due to distamin ereaction
Facial flush, puffiness of eyelids, Resp problems, anaphylaxi with syncope |
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Indications for cryotherapy
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Pain
Dec inflammation or swelling Dec mm spasm and spasticity Crystretch Manage MS symptoms |
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Contraindications for cryotherapy
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Cold hypersensitivity
PVD Raynaud's dx Regenrating nerves |
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Tx temp and time for cryotherapy
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0-10 deg
10-20 minutes |
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What are vasocoolant sprays primarily used for?
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REduce mm spasm
Densensitize trigger points Myofascial referred pain |
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What is contrast bath used for? Warm:cold?
Temp? |
Vascular ex thru vasodilation and vasoconstriction
4:1 warm water:cold water 100-110 deg and 55-65 deg |
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Frequencies for US?
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1 Mhz = deep. 3-5 cm
3 Mhz = superficial. 1-2 cm |
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Intensities for US?
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1 to 3 w/cm squared
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What is ERA and how big should tx area be?
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Size of faceplate
2x |
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Hot spot in relation to US?
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Peak spatial intensity
Usually in middle of of trasducer |
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Measurement usually used to document tx of US?
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Spatial average energy
Total power (watts) divided by the area (cm squared) |
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BNR
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Beam nonuniformity ratio
Ratio of spatial peak intensity to average spatial intensity Lower the ration, the more uniform the energy distribution |
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Temporal vs spatial characteristics of US?
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Spatial = continuous for thermal effects
Temporal = pulsed for nonthermal effects |
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Duty cycle
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Fraction of time the US energy is on over one pulse period
20% duty cycle = 2 msec on and 8 msec off |
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Temporal peak vs temporal average intensity
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Peak = peak intensity of US durin gthe on-time phase of the pulse period
Average = US power average over on pulse period |
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Attentutation? What effects it?
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Reduction of acoustical energy as it passes thru soft tissue. Absorption, reflection and refraction effect attenuation
Absorption highest in tissues with high collagen and protein content |
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Depth of penetration of US
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3-5 cm
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Cavitation
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Proposed explanation of mechanism of pulsed US
alterating compression and expansion of small gas bubbles in tissue fluids (pulsed) Stable or unstable |
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Acoustic streaming
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Proposed explanation of mechanism of pulsed US
Movt of fluds along cell membranes, produce alterations in cell membrane activity, inc'd cell wall permeability, inc'd intracellular calcium, increased macrophage resonse, increased protein synthesis |
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Indications for US
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Modulate pain
Inc CT extensibility Reduce inflammation (Pulsed) Accelerate tissue healing (pused) would healing (pulsed) Eliminate soft-tissue and joint restrictions Muscle spasm |
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Precautions for US
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Acute inflammation
Breast inplants Open epiphyses Healing fractures |
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Contraindications for US
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Impaired circulaton
Impaired cognitive function Impaired sensation Tumors Near thomboplebhitis Joint cememnt Over plastic areas In area of cardiac pacemaker U |
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3 types of US contacts
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1. Direct
2. Indirect water immersion 3. Indirect fluid filled bag |
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Phonophoresis:
Mode Tx intensity Tx time |
pulsed 20%
1-3 w/cm squared 5-10 minutes |
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Maximum % of BW for cervical and lumbar traction
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Cervical 7% (20-30 lbs)
Lumbar 50% (60-120 lbs) |
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Effects of mechanical traction
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Joint distraction
Reduction of disc protrusion (dec in intradiscal force, that creates suction like effect of nucleus) Soft-tissue stretching (lower traction forces needed) Muscle relaxation (interupt pain-muscle spasm cycle) Joint mobilizaiton at intermittent traction |
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Indications for traction
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Dec joint stiffness
Dec meniscoid blocking mm spasm DDD Disc protrusion Modulate pain Reduce N. root impingement |
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Contraindications to traction
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Acute strains, sprains, inflammation
Spondylolisthesis Fractures Hypermobility HTN N/T Dec myotomal strength and dec'd reflex response |
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Cervical flexion for c-traction? upper vs. lower
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0-5 deg of cervical flex for c1-c5
25-30 deg for c5-c7 Should be 0 degrees for disc dysfunction |
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Tx time for cervical traction
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5-10 mins for acuste and disc protrusion
15-30 mins for other conditions |
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When to use static traction for cervical?
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Disc protrusions or when symptoms are aggravated by motion
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What conditions will you use lower traction forces for?
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disc protrusion
Spasm elongation of soft tissue |
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Indications for intermittent mechanical compression (pneumatic)
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Amputation
Dec chronic edema lymphedema Stasis ulcer Venous insufficiency |
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Precautions for intermittent mechanical compression
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Impaired sesation
malignancy Uncontrolle HTN Near superficial nerve (fibular) |
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Contraindications for intermittent compression
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Acute inflammation
Trauma or fracture Acute DVT Obstructured lymph/venous system Arterial insufficiency pulmonary edema cancer cardiac/renal impairment Infection in area hypoproteinemia Very young or very old |
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How do you determine amt of pressue for intermittent compression
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Monitor blood pressure and stay between DBP and SBP
use 3:1 or 4:1 ratio Need to do at least 2 hours/day |
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Tilt table procedure
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30 degrees
Raiser 15 degrees at a time check BP each increase |
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Contraidnication to soft tissue massage
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Acute inflammation
severe atherosclerosis severe varicose veins plebitis cardiac arhythmia malignancy severe RA Heart failure Venous insufficiency |
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What % lumbar traction is required for joint distraction?
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50% is recommended
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Minimum % BW for lumbar traction?
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25%
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