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83 Cards in this Set

  • Front
  • Back
cryo types
cryo indications
cryo effects
inflame stage
edema control
cryokinetics and stretch
decrease enzyme degrade
decrease spasticity
increase pain threshold
cryo parameters
no more than 45 min
no longer than 20 min, at least 1 hour apart
cryo contraindications
1. Cold hypersensitivity
2. Cold intolerance
3. Cryobulinemia
4. Paroxysmal cold hemoglobinuria
5. Raynaud’s disease/phenomenon
6. Over regenerating peripheral nerves
7. Over area with circulatory compromise/peripheral vascular disease
cryo precautions
1. Over superificials main branch of nerve
2. Over open wound
3. Hypertension
4. Poor sensation/mentation
5. Very young/old patients
thermo types
• Hot packs
• Paraffin
• Fluidotherapy
• Infrared lamps
thermo indications
joint stiffness
thermo effects
• Vasodilation
• Increased nerve conduction and velocity
• Increase pain threshold
• Increase muscle strength (during first 30 min)
• Increase metabolic rate
• Increased collagen extensibility
• Pain control
• Increased ROM and decreased joint stiffness
• Accelerate healing
thermo contraindications
1. Hemorrhage
2. Thrombophlebitis
3. Impaired sensation
4. Impaired mentation
5. Malignant tumor
6. IR irradiation of eyes
thermo precautions
1. Acute injury/inflammation
2. Pregnancy
3. Impaired circulation
4. Poor thermal regulation
5. Edema
6. Cardiac insufficiency
7. Metal in area
8. Over open wound
9. Topical counterirritants recently applied
10. Demyelinated nerves
U/S thermal indications
muscle spasm
U/S thermal effects
• Increased metabolic rate
• Decrease pain
• Reduced muscle spasm
• Altered nerve conduction velocity
• Increase circulation
• Increase extensibility
(Deeper reach)
U/S thermal parameters
1-2cm or <5cm
3MHz or 1MHz
0.5W/cm or 1.5-2W/cm
U/S non-thermal indications
• Ulcers
• Surgical skin incisions
• Bone fractures
• Carpal Tunnel Syndrome
U/S contraindications
1. Malignant tumor
2. Pregnancy
3. CNS tissue
4. Joint cement
5. Plastic components
6. Pacemaker
7. Thrombophlebitis
8. Eyes
9. Reproductive organs
U/S precautions
1. Acute inflammation
2. Epiphyseal plates
3. Fracture
4. Breast implants
U/S non thermal effects
• Increase intracellular calcium
• Increase skin and cell membrane permeability
• Increases mast cell degeneration and their release of histamine
• Promotes macrophage responsiveness
• Increase rate of protein synthesis by fibroblasts
• Increases NO synthesis
• Stimulate prosteoglycan synthesis
U/S non thermal
1-2cm or <5cm
3MHz or 1MHz
phono indications
topica drug preparation
phono effects
• US enhances delivery
• Increases permeability of skin
phono parameters
phono contraindications
1. Malignant tumor
2. Pregnancy
3. CNS tissue
4. Joint cement
5. Plastic components
6. Pacemaker
7. Thrombophlebitis
8. Eyes
9. Reproductive organs
phono precautions
1. Acute inflammation
2. Epiphyseal plates
3. Fracture
4. Breast implants
laser and light indications
• Soft tissue and bone healing
• Arthritis
• Pain
• Inflammation
• Ulcers
• Lymphedema
• Neurological conditions
laser and light effects
• Alter cell membrane function, permeability
• Promotes binding of chemicals to cell membrane
• Promotes ATP production
• Vasodilation
• Same as heat
laser and light parameters
• UV
• Short wave diathermy: deep tissue
• Microwave diathermy: deep tissue
• LED: wider delivery, superficial
• SLD: high intensity, wider area than laser, moderate depth
• Laser: deepest penetration
laser and light contraindications
1. Direct irradiation of eyes
2. Malignancy
3. 4-6 months after radiotherapy
4. Hemorrhaging regions
5. thyroid/ other endocrine glands
laser and light precautions
1. Low back/abdomen during pregnancy
2. Epiphyseal plates
3. Impaired sensation
4. Impaired mentation
5. Photophobia/abnormally high sensitivity to light
6. Pretreatment with one or more photosensitizers
traction indications
• Disc bulge or herniation
• Nerve root impingement
• Joint hypomobility
• Subacute joint inflammation
• Paraspinal muscle spasm
traction effects
• Separate joint surfaces and stretch soft tissues
• Reduction of disc protrusion
• Muscle relaxation
• Joint mobilization
traction parameters
Acute: 1-20kg

Joint distraction: 50% body weight, 15/15, 20-30min

Decrease muscle spasm: 25% body weight, 5/5, 20-30min

Disc prob./stretch soft tissue: 25% body weight, 60/20, 20-30min.
traction contraindications
1. Where motion is contraindicated
2. Acute injury/inflammation
3. Joint hypermobility/instability
4. Peripheralization of symptoms with traction
5. Uncontrolled hypertension
traction precautions
1. Structural diseases affecting spine
2. Pressure of belts may be hazardous, pregnancy, hernia
3. Displaced anular fragment
4. Medial disc protrusion
5. Severe pain resolves with traction
6. Claustrophobia/psychological aversion to traction
7. Inability to tolerate prone/supine position
8. Disorientation
compression indications
• Edema
• Venous insufficiency
• Lymphedema
• Prevent DVT
• Venous stasis ulcers
• Scar modification
compression effects
• Improves venous and lymphatic circulation
• Limits shape/size of tissue
• Increases tissue temp.
compression parameters
tighter proximal
compression contraindications
1. Heart failure/pulmonary edema
2. Recent/acute DVT, thrombophlebitis, pulmonary embolism
3. Obstructed lymphatic/venous return
4. Severe peripheral arterial disease/ulcers resulting from arterial insufficiency
compression precautions
1. Impaired sensation/mentation
2. Uncontrolled hypertension
3. Cancer
4. Stroke/significant cerebrovascular insufficiency
5. Superficial peripheral nerves
diathermy thermal indications
• Pain control
• Tissue healing
• Joint stiffness
diathermy thermal effects
• Vasodilation
• Increase nerve conduction
• Increase pain threshold
• Alteration of muscle strength
• Accelerated enzyme activity
• Increase soft tissue extensibility
diathermy thermal parameters
• Inductive coil (shortwave & electromagnetic): deep & superficial
• Capactivie plate (shortwave & electric) superficial
• Magnetron (microwave 2450MHz & electro magnetic) small areas
diathermy thermal contra
1. Metal implants
2. Malignancy
3. Eyes
4. Testes
5. Growing

1. Implanted/transcutaneous neural stimulators (cardiac pacemakers)
2. Pregnancy
diathermy thermal precautions
1. Near electronic/magnetic equipment
2. Obesity
3. Copper-bearing intrauterine contraceptive
diathermy non thermal indications
• Infection
• Pain
• edema
diathermy non thermal effects
• Modify ion binding and cellular function
• Increase microvascular perfusion
• Growth factor activation
• Accelerate cell growth
diathermy non thermal parameters
Pulsed shortwave (inductive coil drum 27.12MHz) electromagnetic, deep & superficial
diathermy non thermal contra
1. Deep tissues, internal organs
2. Substitute for conventional therapy for edema
3. Pacemakers, electronic devices, metal implants
diathermy non thermal precautions
1. Pregnancy
2. Skeletal immunity
UV radiation indications
• Erthema
• MED (minimal erythema dosage)
• Psoriasis, skin disorders
• Wound healing (UVC)
UV radiation effects
• UVC: germicidal
UV radiation parameters
UVA: longer wavelength
UVC: shorter wavelength
UV radiation contra
1. Irradiation of the eyes
2. Skin cancer
3. Pulmonary tuberculosis
4. Cardiac, kidney, or liver disease
5. Systematic lupus erythrematosus
6. fever
UV radiation precautions
7. Photosensitivity medications and dietary supplements
8. Photosensitivity
9. Recent x-ray therapy
10. No dose should be repeated until the first dose had disappeared
hydrotherapy indications
• Strengthening
• Cleansing effects; remove debris, dissolve surfactants/antimicrobials
• Decreased WB
• Pain control
• Edema control
hydrotherapy effects
• Effects on bone density loss
• Less fat loss
• Increase venous circulation
• Increase cardiac volume
• Increase cardiac output
• Decreased heart rate, systolic blood pressure, VO2
• Decreased vital capacity
• Increased work of breathing
• Decreased exercise-induced asthma
• Diuresis
• Increase sodium/potassium excretion
• Decrease pain
hydrotherapy parameters
Cold: 0-26 C
Tepid: 26-33C
Neutral Warmth: 33-35.5C
Mild warmth: 35.5-37C
Vey hot: 40-43C
hydrotherapy contra
1. Maceration around wound
2. Bleeding
Full Body
1. Cardiac instability
2. Infectious conditions
3. Bowel incontinence
4. Severe epilepsy
5. Suicidal pts
Negative Pressure
1. Necrotic tissue
2. Untreated osteomyelitis
3. Malignancy
4. Untreated malnutrition
5. Exposed arteries, veins, nerves, organs
6. Nonenteric/unexplored fistula
hydrotherapy precautions
1. Impaired thermal sensation
2. Infection in area
3. Confusion/impaired cognition
4. Recent skin grafts
Full Body-hot
1. Pregnancy
2. Multiple sclerosis
3. Poor thermal regulation
Full Body
1. Confusion/disorientation
2. Alcohol ingestion
3. Limited strength, endurance, balance, ROM
4. Medications
5. Urinary incontinence
6. Fear of water
7. Respiratory problems
Negative Pressure
1. Anticoagulant therapy
2. Difficult hemostasis
3. Confusion/disorientation
hydro cold
acute inflame
hydro tepid
med exercise
acute inflame
hydro neutral
open wounds
pts with circulatory problems
sensory disorders
decreased tone
hydro mild
increase mobility in burns pts
hydro hot
control pain
hydro very hot
increase extensibility
Muscle strengthening

EMS(dennervated use DC-at least 10sec.)


35-80 pps

150-200ms (small)

200-350 ms (large)

Overload Principle- at least 50% max. contraction
EMS(dennervated use DC-at least 10sec.)
over motor point

35-80 pps

150-200ms (small)

200-350 ms (large)

Overload Principle- at least 50% max. contraction
time mod AC

50 pps

100-150pps;10 sec. on/ 50 sec. off/ 10 min
short duration PC

50 pps

100-150pps;10 sec. on/ 50 sec. off/ 10 min
muscle reduction stim
25-50 pps

150-200ms(small) 200-350ms (large)
muscle spasm reduction stim
35-50 pps

150-200ms(small) 200-350ms (large)
pain modulation stim
conventional (high rate)

low rate (accupucnture like)


interferential (AC)

conventional (high rate) stim

50-80ms (depolarize only A-beta)

Gating at spinal cord
low rate (accupuncture like) stim
2-10 pps

200-300ms (depolarize motor nerves and A-beta)

endorphin release
burst stim
10 bursts

100-300 ms

endorphin release
2 currents at different freq

Reduce pain and swelling, increase ROM
Tissue heal stim
HVPC (negative polarity)

HVPC (positive polarity)
HVPC (negative polarity)
inflame phase



40-100 ms
HVPC (positive polarity)
proliferative phase


40-100 ms
edema control
HVPC (negative polarity)

HVPC (negative polarity)
edema associated with inflame

100-120 pps

40-100 ms

Produce comfortable tingling
edema associated with lack of motion

35-50 pps

150-350 ms

Produce visible contraction