21. Modalities Flashcards by Mckenna Yarrows

thermal modalities increases

cardiac output
vasodilation
HR, RR,
metabolic rate

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thermal modalities decreases

muscle activity
BP
blood to internal organs
blood flow to resting muscle
stroke volume

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cryotherapy increases

joint stiffness
pain threshold
muscle activation

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cryotherapy decreases

collagen extensibility
blood flow
capillary permeability
local metabolism
spasticity
nerve conduction velocity

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how many layers for heat pack

6-8 layers

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tx temp and time for hot pack

stored at 158-167dg
20-30 min

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tx time and temp for cold pack

stored at 25dgF
10-20 mins

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stages of cold

CBAAN
intense Cold
Burning
Aching
Analgesia
Numbness

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superficial thermotherapy contraindications

arterial ds

bleeding or hemorrhage

over an area of compromised circulation, malignancy

thrombophlebitis,

impaired sensation or mentation,

infrared irradiation of they eyes

MC TIBIA
malignant, compromised circulation, thrombophlebitis, infrared, bleeding, impaired, arterial ds

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superficial cryotherapy contraindications

cold intolerance, cold hypersensitivity, cryoglobulnemia, paroxysmal cold hemoglobinuria, raynauds

over-regenerating peripheral nerves
circulatory compromise

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Estim parameters muscle strengthening

pulse frequency: 35-80pps
pulse duration: small muscles: 125-200us, large muscles 200-350us
amplitude: to >10% of MVIC in injured, >50% MVIC in uninjured
6-10s on, 50-120s off 1:5ratio
at least 2 sec ramp home
10-20 min to produce 10-20 repetitions
every 2-3 hrs

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Estim parameters for muscle reeducation

freq: 35-50 pps

pulse duration: 125-200 for small muscles, 200-250 for large muscles

amplitude sufficient for functional activity

at least 2 sec ramp time

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estim parameters for muscle spasm reduction

frequency: 35-50pps

pulse: 125-200 for small muscles, 200-350 for large muscles

amplitude to visible contraction

2-5 sec on, 2-5 sec off, equal
at least 1 sec ramp time

10-30 min
every 2-3 hours

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estim parameters for edema reduction using muscle pump

requency: 35-50pps

pulse: 125-200 for small muscles, 200-350 for large muscles

amplitude to visible contraction

2-5 sec on, 2-5 sec off, equal
at least 1 sec ramp Tim e

30 min, 2x/day

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how to increase patient comfort

increase ramp time
DDDD - decrease duration to decrease discomfort
larger sticky electrode size
increase pulse frequency and off time

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negative electrode

used to promote healing of the inflamed or infected wounds

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positive electrode

used to promote healing of the wounds without inflammation

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treatment time for high voltage pulsed galvanic current

at least 3-7 days/wk with tx sessions lasting 45-60 mins

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parameters for HVPC for tissue healing - inflammatory phase/infected

negative polarity
frequency: 100-150pps
usually 100us duration
amplitude: to produce comfortable tingling
45-60 mins
electrode placed in or around the wound area

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electrode for HVPC

bad, infected and inflamed

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+ electrode for HVPC

good, clean, granulation and proliferative

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electrical currents: contraindications

pacemaker
unstable arrythmias
carotid sinus
thrombosis or thrombophlebitis
near pregnant uterus

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parameter for tissue healing in the proliferate phase

positive polarity
100-150pps
usually 100us duration
amplitude: to produce comfortable tingling
45-60 mins
electrode placed in or around the wound area

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what is iontophoresis

using estimated to deliver subnormal medications

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what would you use iodine and what polarity

for scars negative

when would u use salicylate

as an analgesic negative polarity

when would u use acetate

for calcium deposits negative polarity

when would u use desamethasone

for MSK inflammation negative polarity

which medications would u use negative polarity on

ISAD = negative iodine salicylate acetate dexamethasone (water is neutral)

what are positive polarity medications

zinc lidocaine xylocaine copper hyaluronidase calcium magnesium

what's zinc used for

dermal ulcers

what's copper used for

fungal infections

what do you use for edema reduction

hyaluronidase

what do you use for muscle spasms

calcium or magnesium

parameters for TENS for acute pain

sensory stimulation mono or biphasic pulsed 100pps freq 50-100 usec comfortable tingling 20-30 min or during activities

TENSfor acupuncture like (low rate) chronic pain

motor stimulation mono or biphasic pulsed <10 pps freq >150 usec visible twitch 20-45 min

brief intense TENS

motor stimulation mono or biphasic pulsed 100pps freq >150 usec strong muscle twitch <15 min

noxious TENS

hyperstimulation DC or monophasic high - 100 pps low 1-5 pps >250 usec up to 1 sec highest tolerance/painful stimulus 30-60s per area

when do u use noxious TENS

for trigger point

when do u use acupuncture like (low rate TENS

chronic pain, adapted to high rate,, pain that isn't respond to high rate

when would u use conventional high rate TENS

pain, initial

ultrasound intensity

amount of energy delivered per unit area dependent on tx goal

frequency of ultrasound

cycles per second 1Hz for deep 3Hz for superficial

duty cycle

on time / (on time + off time) pulsed 30 or 50% continuous 100% thermal

inflammation

non thermal 20% 3 or 1Hz 0.5-1.00 W/cm2 5-10 min/2x ERA

soft tissue shortening pain for ultrasound parameters

thermal 100% 3 or 1Hz 0.5 W/cm2 5-10 min/2xERA

acute - US

up to 3 wk, pulsed, < 1W/cm2

chronic - US

>3 wks, continuous, >1W/cm2

ultrasound contraindications

malignancy pacemaker eyes organs of reproduction or pregnancy joint cement or plastic CNS tissue thrombophlebitis

EMG biofeedback treatment for muscle relaxation (decrease spasm, inhibit, decrease tightness, decrease muscle activity)

requires low sensitivity electrodes closely placed

EMG biofeedback to treat for muscle re-education (strength, facilitate, activate, increase tone)

requires a high sensitivity electrodes far apart

lumbar traction supine position

with pillow under knee - for intervertebral joints, facet joints, muscle elongation

lumbar traction prone position

for posterior disc herniation

for lumbar traction how do you treat L5-S1

supine with 45-60dg hip flexion

how do you treat L3-L4 with lumbar traction

supine with 75-90dg hip flexion

lumbar traction - jt distraction

50 lbs or 50% BW

lumbar traction for disc protrusion, spasm, elongation

25% BW

contraindications for mechanical traction

immobilization or acute injury or inflammation, joint hyper mobility or instability, peripheralization of symptoms with traction, uncontrollled HTN

cervical joint distraction traction parameters

20-29lbs max 7% BW

cervical disc protrusion, muscle spasms, elongation - traction parameters

11-15lbs

21. Modalities Flashcards

(61 cards)