1
Q
Adverse effects of heat
A
- Burns:
Erythema ab igne: staining of the skin/ irritation
Blisters
- Fainting
- Bleeding
- Increased edema
2
Q
Contraindications of thermotherapy
A
- Recent or potential hemorrhage
- Thrombophlebitis
- Impaired sensation
- Impaired mentation
- Malignant tumor
3
Q
Indications for use of thermotherapy
A
- Pain control
- Increase tissue extensibility to increase ROM and flexibility
- Accelerate healing of injured tissues
- Reduce muscle guarding or spasms
4
Q
Capillary refilling should start within ____, so we know there is no frostbite
A
2 secs
5
Q
Unintended effects of cryotherapy
A
- Reduced ROM
- Reduced strength
- Psychological effects
6
Q
Clinical indications for cryotherapy: Cryokinetics and cryostretch
A
- Early intervention following injury
- Initiating new therpeutic exercise program for patient in chronic pain
- Increase muscle performance for athletes in training
7
Q
How long should you apply a cold treatment to facilitate a muscle contraction?
A
5 mins
8
Q
What is the depth of penetration for cooling agents?
A
1-3cm
9
Q
What is cold- induced vasodilation?
A
Apply cryotherapy to the region, if it cools to more than 1 deg C and it is maintained for more than 15mins. This can result in edema
10
Q
How long does it take for the hunting response to happen?
A
15 mins
11
Q
What is hunting response?
A
A cycling of temp(heating and cooling) in the human body directly underneath the area where a cold agent is applied.
12
Q
What are the effects of cyrotherapy?
A
- Hemodynamic effects
- Vasconstriction
- Hunting response
- Cold induced vasodilation
13
Q
____ results in an increase collagen production which forms thicker tissues and adhesion
A
Chronic inflammation
14
Q
Chronic inflammation occurs due to ____
A
- persistent force producing re-injury
2. immune response from infection or reaction to implant
15
Q
Chronic inflammation occurs in which phase of healing?
A
Maturation
16
Q
Cold bath or whirlpool
A
• Immerse part in 13-18 deg C (55-65 deg F) water
• Can use water and crushed ice
• Time – colder water, less time (few seconds to 10 minutes – leave until a little after numbness is achieved)
• Toe cap may make foot more
comfortable
17
Q
How long should an ice massage be done?
A
5-15 minutes or until beyond numbness
18
Q
How much area does an ice massage cover?
A
Cover an area about 3-6 inches in diameter
19
Q
How long should cold packs be used for
A
- 15-30 minutes (colder the source, the shorter the time)
- Longer time for patients with more subcutaneous fat
20
Q
What are the normal sensations a person should get during a cold treatment?
A
- Cold
- Warm, burning
- Aching, tingling
- Numbness
21
Q
Contraindications of cold treatments
A
Cold hypersensitivity • Compromised local circulation • Cold intolerance • Cryoglobulinemia •Raynouds disease • Paroxysmal cold hemoglobinuria • On regenerating superficial nerves
22
Q
Precautions for cold treatments
A
- Skin sensation which is not normal
- Previous frostbite to area
- Anesthesia from ice could mask exercise induced pain
- Prolonged applications
- Hypertensive patient
- Packs or ice stored at 0 deg F or -17 deg C should not be applied directly to the skin
- Decreased cognitive level
- Very old/very young individuals
- Over the superficial main branch of a nerve
- Directly over an open wound( can be around it)
23
Q
What is the goal of a cold treatment on an acute injury
A
– Controls inflammation through vasoconstriction and
decreased permeability of vessels
– Decreases pain, numbs the injured area
– Prevents secondary hypoxic ischemia, which is a result of
increased distance for oxygen to diffuse from blood vessel
to tissues.
24
Q
When is Cold treatment on an acute injury is thought to be most effective?
A
5-10 min after injury, but can still be helpful for up to 72 hours after injury
25
Contraindications of a paraffin treatment
* Any condition in which heat is contraindicated
* Open wounds
* Draining lesions
* Rashes, infections which might be contagious
* New skin or recent scar tissue
* Water on skin – can cause a burn
* Jewelry – can cause a burn
26
Precautions of a paraffin treatment
* Any condition for which heat is to be used with caution
* Small scratches – should be covered with gauze
* Scar tissue
27
Indications of a paraffin treatment
* Arthritis
* Chronic orthopedic conditions
* Joint stiffness, contractures
* Scleroderma
28
Temperature range of paraffin
126 -130
29
How long should a hot pack be used for?
About 20 minutes for maximal results
30
What are the contradictions for heat
• Areas of arterial insufficiency or arterial disease
• Areas prone to hemorrhage
(hemophilia, acute trauma, long-term steroid use)
• Acute inflammatory site
• Elevating tissue temperature in area of malignancy
• Impaired cognitive function
31
Physiological effects of using heat on tissues are
- Vasodilation
- Brings in more nutrients
- Picks up more waste
- Increase in metabolism
- • For every 10 deg C rise in
temp., there is a
2-3 fold increase in the
rate of metabolism
- Pain relief
- Decrease stiffness
32
Human tissues function best between ___ - ___ deg c
35-38
33
Hypothermia is anything below ____
35 deg C
34
Hyperthermia is anything above ___
35 deg C
35
What is nociceptive pain?
Has a clear stimulus-response relationship with the initial injury.
Can be acute and lead to chronic
36
What is neuropathic pain?
* Burning or lancinating quality
* Usually accompanied by signs or symptoms of neurological dysfunction, such as paresthesias, itching, anesthesia, weakness
* Radicular vs. Referred pain
Can be acute and lead to chronic
37
Types of pain found in visceral tissue
Aching quality, frequently referred superficially
38
Types of pain found in the musculoskeletal tissue
Dull/Achy/Heavy and more difficult to localize
39
Types of pain found in the superficial/skin
Sharp/pricking/vibrating and easily located
40
Characteristics of the A-beta primary afferent neurons
• non-painful sensation related to vibration, stretching, and mechanical pressure
41
Characteristics of the C-afferent primary afferent neurons
• longer duration, dull, throbbing, aching, burning, tingling, diffusely localized,
accompanied by sweating, increased heart rate and blood pressure, and nausea
• 0.5-2 m/s
• 80% of pain afferents
• can be blocked by opioid medication
42
Characteristics of the A-delta primary afferent neurons
* respond to intense mechanical stimulation and heat or cold
* short duration, sharp, stabbing, or pricking sensation
* small and myelinated
* 4-30 m/s
* 20% of pain afferents
* not blocked by opioids
43
What happens in the maturation phase of healing?
Modifies the scar tissue into its mature form
- Day 9 onward
44
What happens in the proliferation phase of healing?
Rebuilds damaged structures and strengthens the wound
- Days 3-20
45
What happens in the inflammation phase of healing?
Prepares wound for healing.
| - Days 1-6
46
Thought process when choosing a physical agent
- Goal and effects of treatment
- Contradictions and precautions
- Evidence for physical agent use
- Cost, convenience, and availability of the physical agent
47
Rank of priorities when choosing a physical agent for a patient
- Highest/first: Primary underlying problem/problem most likely to respond to treatment
- 2nd: treatments that address more than one problem simultaneously
- Lowest/last: symptomatic treatment only
48
What is ultrasound?
a form of mechanical energy consisting of high frequency vibrations (> 20,000 Hz)
49
What is clinical US in PT ranges of ultrasound?
from 1-3 MHz
50
The higher the frequency of an ultrasound, the ____ the rate of absorption.
Higher (faster heating)
51
The higher frequency of of an ultrasound, the ____ the depth of penetration
lesser
52
Ultrasound works on ____ piezoelectric effect
reverse
53
What is a piezoelectric effect?
Electrical energy (AC current) applied to lead zirconate titanate crystal in sound head which is converted to mechanical energy
54
What is beam non-uniformity ratio (BNR)?
The ratio of the highest intensity in the field (spatial peak) to the average intensity indicated on the machine (spatial average).
55
Tissues with more attenuation will show a ____
greater temperature rise
56
Attenuation values are higher for tissues with a ____
higher collagen content
57
Attenuation increases as frequency of US ____
increases
58
Attenuation is ____ related to penetration
Inversely
59
Attenuation is best for ____ tissues
Collagen rich tissues
60
Attenuation is worst for ____
Fat/Skin/Muscle
61
What is the duty cycle of a thermal effect?
100%
62
Thermal effects of an ultrasound at a 1 deg temperature rise
* Increases metabolism and healing
| * Roughly 13% increase in metabolism for every 1 deg C raise (or up to 2-3 fold increase for 10 deg C rise)
63
Thermal effects of an ultrasound at a 2-3 deg temperature rise
• Decreases pain and muscle spasm
64
Thermal effects of an ultrasound at a 4 deg C or greater temperature rise
Increases extensibility of collagen and scars, and decreases joint
stiffness, a 40-45 degrees C temperature is required for at least 5 minutes
65
Duty cycle is equal to
time on relative to time on + time off
66
Mechanical effects of a duty cycle occurs at ____
20%
67
1 MHz provides treatment of tissue up to ___ deep
5 cm
68
3 MHz provides treatment of tissue up to ___ deep
1-2 cm
69
With 1 MHz use intensity roughly
1.5 to 2.0 W/cm^2
70
With 3 MHz use intensity roughly
0.5 W/cm^2
71
If non-thermal ultrasound is desired intensities of about _____ have been shown to be beneficial
0.5 to 1.0 W/cm2
72
What is the average duration of an ultrasound?
5-10 minutes
73
For soft tissue shortening what type of effects of ultrasound should be used?
Thermal
74
For soft tissue shortening what type of duty cycle should be used?
100%
75
What level of ultrasound frequency should be used when the depth of a soft tissue shortening is 1-2cm?
3 MHz
76
What level of ultrasound frequency should be used when the depth of a soft tissue shortening is less than or equal to 5 cm?
1 MHz
77
What level of ultrasound intensity should be used when the depth of a soft tissue shortening is 1-2cm?
0.5 W/cm^2
78
What level of ultrasound intensity should be used when the depth of a soft tissue shortening is less than or equal to 5cm?
1.5-2.0 W/cm^2
79
For delayed tissue healing prolonged inflammation what type of effects of ultrasound should be used?
Nonthermal
80
For delayed tissue healing prolonged inflammation what type of duty cycle should be used?
20%
81
What level of ultrasound frequency should be used when the depth of a delayed tissue healing prolonged inflammation is 1-2cm?
3 MHz
82
What level of ultrasound frequency should be used when the depth of a delayed tissue healing prolonged inflammation is less than or equal to 5cm?
1 MHz
83
What level of ultrasound intensity should be used when the depth of a delayed tissue healing prolonged inflammation is 1-2 or less than or equal to 5cm
0.5 - 1.00 W/cm^2
84
The duration of treatment for any type of ultrasound for any impairment should be ____
5-10 mins/2 x ERA
85
What are the indications(things it helps with) for ultrasound?
* Soft tissue shortening
* Pain control
* Dermal ulcers
* Tendon and Ligament injuries
* Resorption of calcium deposits
* Bone fractures
* Carpal tunnel syndrome
* Phonophoresis (medication added to ultrasound waves to increase medicine penetration)
* Patient values
86
What are the contraindications of an ultrasound?
```
• Malignancy
• Pregnancy
• CNS tissue
• Joint cement
• Plastic
• Pacemaker
• Thrombophlebitis
• Eyes and reproductive
organs
```
87
Precautions to be taken when doing an ultrasound?
* Acute inflammation
* Epiphyseal plates
* Fractures
* Breast implants
88
What is a reverse piezoelectric effect?
An electrical current passes through a crystal inside the transducer causing it to expand and contract which generates the acoustic wave
89
What are the components that will determine the effect of ultrasound on heating tissues?
Frequency, intensity, and duty cycle
90
What determines the safety of the use of US?
Depth, duty cycle, frequency and intensity
91
Nerves conducting information towards the spinal cord and brain are ____ nerves
Sensory nerves
92
Nerves conducting information away from the spinal cord and brain are ____ nerves
Motor nerves
93
The positive side of an electrode is called an ___ and is electron/ion ___
- Anode
| - deficient
94
The negative side of an electrode is called an ___ and is electron/ion ___
- Cathode
| - Rich
95
Indication of TENS
Control/relieve pain
96
Secondary benefits of TENS
- Reduce the amount of and dependency on pain medication
- Provide the patient a more active role in their pain management
- Increase functional movement and mobility with less discomfort
97
What is parameter for frequency of conventional TENS?
100-150 Hz (high frequency)
98
What is parameter for pulse duration of conventional TENS?
50-80 microseconds
99
What is parameter for amplitude of conventional TENS?
Strong but comfortable
100
What is parameter for treatment duration of conventional TENS?
20-30 mins, up to 24 hours
101
What is parameter for mechanism of action of conventional TENS?
Gate control
102
What is parameter for analgesia duration of conventional TENS?
Immediate relief with little residual effect
103
What is parameter for frequency of acupuncture TENS?
2-10 Hz (low frequency)
104
What is parameter for pulse duration of acupuncture TENS?
200-300 microseconds
105
What is parameter for amplitude of acupuncture TENS?
Strong, visible muscle contraction
106
What is parameter for treatment duration of acupuncture TENS?
20-30 mins
107
What is parameter for mechanism of action of acupuncture TENS?
Endogenous opiods release
108
What is parameter for analgesia duration of acupuncture TENS?
Up to 5 hours
109
How does TENS- acupuncture work?
Through brief sharp pain through repetitive muscle twitched and stimulation of A-delta fibers
110
Which fibers are sensory?
A-beta
111
Indication for IFC
Pain control
112
Secondary indication of IFC
- Edema control (weak evidence)
- Force production
- Modulation
- Treat larger region
113
Electrode placement for IFC is always ____
Criss-crossed
114
What are the electrode placements for TENS
- Criss cross
- Parallel
- Bracket
- Unilateral
115
Where should you avoid placing electrode for TENS?
- Transcranial
| - Over genitalia
116
What do you use a vector scan for in IFC?
For change in position of interference pattern (scan entire field)
117
What is the purpose of the sweep mode in IFC?
To decrease sensory habituation for longer treatment times
118
IFC provides pain relief over a _____ region with ____ body tissue involvement
IFC provides pain relief over a *larger* region with *multiple* body tissue involvement
119
When should pre-modulated current be used?
In small/narrow regions where the 4 electrode placement used in IFC is not possible
120
How many channels and electrode pads should be used in pre-mod?
- 1 channel
| - 2 large pads
121
How many channels and electrode pads should be used in IFC?
- 2 channels
| - 4 small pads
122
HVPC is a ___ current
Direct current
123
What are the indications of HVPC?
- Wound healing (supportive evidence)
| - Inflammation/edema (weak evidence)
124
Theoretical clinical use of HVPC
- Softening scar tissue
| - Increased tissue density
125
What is a side effect from HVPC?
Increased aching in the area of the dispersive pad (larger electrode)
126
What kind of polarity should be used when using HVPC to treat edema?
Negative polarity
127
What kind of polarity should be used when using HVPC to treat tissue healing?
Positive polarity
128
What color channel should be used at the treating/active pad?
Red channel
129
What color channel should be used at the dispersive pad?
Black channel
130
What is/are the indication(s) for russian?
Strengthening of muscle
131
What is/are the indication(s) for NMES?
- Stimulation of denervated muscles
- Improve/retrain motor control
- Strengthening
- Muscle pump for edema control
- Reduce spasticity by applying over the antagonist muscle (NMES)
132
Characteristic of a russian current
Burst modulation
133
Recommended parameter of a russian treatment?
- 50 bursts/ second
- Burst duration is 10 microsecs
- 10 secs contraction time
- 50 secs off time
- 10 repetitions
134
What are the precautions of HVPC?
- Cardiac disease
- Impaired sensation
- Malignant tumors
- Skin irritation or open wounds
135
What are the contraindications of HVPC?
- Pacemakers, heart conditions (unstable arrythmias)
- Over the carotid sinus
- Venous or arterial thrombosis or thrombophlebitis
- Pelvis, abdomen, trunk, and low back during pregnancy(1st trimester), can be used for pain control during delivery
136
What are the contraindications of HVPC, TENS, IFC?
- Pacemakers, heart conditions (unstable arrythmias)
- Over the carotid sinus
- Venous or arterial thrombosis or thrombophlebitis
- Pelvis, abdomen, trunk, and low back during pregnancy(1st trimester), can be used for pain control during delivery
137
What are the risk of TENS, HVPC, NMES, russian, and IFC
discomfort
138
For immediate increased ROM, which frequency of IFC should be used?
High frequency (80-150)
139
If patient has a fear of movement, and will be performing movement for a short period of time post treatment, which frequency of IFC should be used?
High frequency (80-150)
140
If patient has a fear of movement, and will be performing movement for a long/extended period of time post treatment, which frequency of IFC should be used?
Low frequency (2-10)
141
What frequency should for a patient getting E-stim for the first time?
80-150
142
What is difference the feeling from IFC/TENS under high and low frequency?
They both feel pins needles, but a high frequency is a strong but comfortable feeling, while a low frequency is at a higher intensity, and a deeper level. It is a strong but comfortable feeling with a muscle twitch
143
When should you come back to check on a patient?
In 5 mins
144
What is frequency called on a TENS unit?
Pulse rate
145
What is pulse duration called on a TENS unit?
Pulse width
146
Indications of an ultrasound
- Pain control
- Dermal ulcers
- Tendon and ligament injuries
- Bone fractures
- Carpal tunnel syndrome
- Soft tissue inflammation
- Tissue extensibility
- Scar tissue remodeling
- Tissue healing
147
The higher the frequency, the ____ the absorption, hence ____ depth of penetration
The higher the frequency, the *higher* the absorption, hence *less* depth of penetration
148
When looking to get a mechanical effect of US, ___ duty cycle should be used
Lower duty cycle (20%)
149
When looking to get a thermal effect of US ___ duty cycle should be used
Higher duty cycle (100%)
150
At what temperature does US start to increase metabolism and healing?
1 deg C
151
What temperature does US start to decrease pain and muscle spasms?
2-3
152
What temperature does US increase extensibility, and decrease joint stiffness
4 deg C or higher
153
What frequency will you use for a tissue depth of up to 5cm?
1 MHz
154
What frequency will you use for a tissue depth of 1-2 cm deep?
3 MHz
155
What intensity should be used at 1 MHz?
1.5-2 W/cm^2
156
What intensity should be used at 3 MHz?
0.5 W/cm^2
157
What intensities should be used if a non-thermal effect is desired?
0.5-1.0
158
How long should all US be done?
5-10 min/2 x ERA
159
What waveform should be used in the tissue healing: inflammatory/infected parameter setting/goal
HVPC
160
What frequency(Hz) should be used in the tissue healing: inflammatory/infected parameter setting/goal?
60-125
161
What pulse duration should be used in the tissue healing: inflammatory/infected parameter setting/goal?
40-100 microseconds
162
What (I) should be used in the tissue healing: inflammatory/infected parameter setting/goal?
Tingling
163
What polarity should be used in the tissue healing: inflammatory/infected parameter setting/goal?
Negative
164
What treatment time should be used in the tissue healing: inflammatory/infected parameter setting/goal?
45-60 mins few times/day
165
What waveform should be used in the tissue healing/proliferation clean parameter setting/goal?
HVPC
166
What Hz should be used in the tissue healing/proliferation clean parameter setting/goal?
60-125
167
What pulse duration should be used in the tissue healing/proliferation clean parameter setting/goal?
40-100 microseconds
168
What (I) should be used in the tissue healing/proliferation clean parameter setting/goal?
Tingling
169
What polarity should be used in the tissue healing/proliferation clean parameter setting/goal?
Positive
170
What treatment time should be used in the tissue healing/proliferation clean parameter setting/goal?
45-60 mins few times/day
171
What waveform should be used in the edema control: acute parameter setting/goal?
HVPC
172
What Hz should be used in the edema control: acute parameter setting/goal?
100-120
173
What pulse duration should be used in the edema control: acute parameter setting/goal?
40-100 microseconds
174
What (I) should be used in the edema control: acute parameter setting/goal?
Tingling
175
What polarity should be used in the edema control: acute parameter setting/goal?
Negative
176
What treatment time should be used in the edema control: acute parameter setting/goal?
20-30 mins
177
What waveform should be used in the edema control: chronic lack of motion parameter setting/goal
NMES/HVPC
178
What Hz should be used in the edema control: chronic lack of motion parameter setting/goal
35-50
179
What pulse duration should be used in the edema control: chronic lack of motion parameter setting/goal
150-350 microseconds
180
What (I) should be used in the edema control: chronic lack of motion parameter setting/goal
Visible motor response
181
What polarity should be used in the edema control: chronic lack of motion parameter setting/goal
N/A
182
What treatment time should be used in the edema control: chronic lack of motion parameter setting/goal
20-30 mins
183
Inflammatory phase use ____ electrode on affected area
Inflammatory phase use *negative electrode* on affected area
184
Proliferation phase use positive electrode to attract more _____ to the affected area
Proliferation phase use positive electrode to attract more *proteins* to the affected area
185
What should you do to an area during edema control?
Elevate the area
186
What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in the muscle fiber type?
PIC: Slow twitch type 1 first
ESC: fast twitch type 2 first
187
What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in the contraction force?
PIC: low
ESC: high
188
What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in the speed of contraction?
PIC: slow
ESC: fast
189
What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in fatigue?
PIC: fatigue resistance
ESC: fatigues quickly
190
What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in atrophy?
PIC: atrophy resistant
ESC: atrophies quickly
191
What is the difference between a physiologically initiated contraction(PIC) and an electrically stimulated contraction(ESC) in recruitment?
PIC: asynchronous
ESC: synchronous
192
What are the 2 ways that electrical stimulation strengthens muscles?
- Overload principle
| - Specificity
193
What is the overload principle?
Increased pulse duration, amplitude, electrode size, external resistance leads to higher load leads to higher force contraction leads to greater strengthening
194
What is specificity?
* Contractions specifically strengthen fibers that contract
* ES has more effect on type II muscle fibers than on type I
* Disuse atrophy is primarily present with type II fibers
195
What are the clinical application of electrically stimulated muscle contractions?
- Orthopedic conditions: increased strength after surgery, nonsurgical management of knee conditions
- Neurological disorders: stimulates intact peripheral nerves in patients with CNS damage, can integrate with performance of functional activities= functional electrical stimulation
- Functional electric stimulation (FES)
196
What does electric stimulation do for spinal cord injury?
- Counteract disuse muscle atrophy
- improve circulation
- contract muscle to assist with locomotion
- contract muscle to assist with hand grasp, respiration, conditioning, bowel and bladder voiding
197
What are requirements for ES for spinal cord injury?
* Sufficient force to carry out activity
* Not painful
* Can be controlled and repeated
* Acceptable to the user
198
What is the lower extremity stimulation of ES for stroke?
* Improved gait
* Increased ankle dorsiflexion torque
* Reduced agonist-antagonist co-contraction
* Increased probability of returning home
199
What are the advantages of adding NMES to strength training?
* Can enhance strength gains
* May or may not enhance functional performance
* Is not a substitute for sports-specific training
200
What frequency should generally be used on smaller muscles during russian ES?
20-30 pps
201
What frequency should generally be used on larger muscles during russian ES?
35-50pps
202
What are the contraindications of iontophoresis?
* Patient being allergic to drug or chemical being used
* Active bleeding in area to be treated
* Metallic implants in immediate vicinity of area to be treated
* Any condition where electric stimulation is contraindicated
203
What are the precautions of iontophoresis?
* Cardiac disease
* Malignant tumors
* Skin irritation or open wounds
* Lack of sensation in area to be treated
204
What are the factors affecting the efficacy of treatment for iontophoresis?
- Skin integrity
- Polarity of treatment electrode and drug ion. need to use lower currents with (-) ions
- pH of drug solution
- Concentration of drug in solution – Relatively low concentrations seem to be most successful
- Presence of competing ions in the solution - Application of other treatments prior to or after – ie. heat or ultrasound
- Parameter settings
205
The ____ electrode is placed over a remote location
The *dispersive (larger)* electrode is placed over a remote location
206
The ____electrode is the one that has the medication and is placed over the treatment area
The *delivery* electrode is the one that has the medication and is placed over the treatment area
207
The ____ electrode depends on the polarity of ion to be delivered
The *active* electrode depends on the polarity of ion to be delivered
208
An anode (+) will repel ___ ions
Positive ions
209
A cathode (-) will repel ___ ions
Negative ions
210
What is the treatment time range to keep a dupel (blue) machine and why?
Treatment times should be less than 30 minutes.
This is because as the duration of the treatment increases, skin resistance decreases and therefore risk of burns increases
211
The duration of treatment of iontophoresis depends on...?
The current amplitude and dosage
212
What is the max current amplitude of most machines?
4.0 mA
213
When should the 40 mA min and 80 mA min be used?
Begin with 40 mA min on first treatment, increase towards 80 mA min as quickly as tolerated over future sessions for increased therapeutic affect
214
What is the typical range of dosage of iontophoresis?
40-80 mA min
215
How is the dose calculated for iontophoresis?
Intensity x time
216
What is the maximum current density when the delivery electrode is positive?
Less than or equal to 1
217
What is the maximum current density when the delivery electrode is negative?
Less than or equal to 0.5
218
How is the current density of iontophoresis calculated?
Current amplitude/ surface area of delivery electrode
219
What is the purpose of iontophoresis?
Alternative to phonophoresis, oral, and injection methods of drug delivery
220
The tissue treated by iontophoresis should be ___
Should be relatively small, superficial and localized
221
How are ions created in iontophoresis?
Ions are created by dissolving an intended drug or chemical compound that must be ionized, stable in condition, not altered by electrical current and small or moderate in size
222
What is iontophoresis?
The transcutaneous delivery of ions into the body using low amplitude direct current to insure unidirectional flow of the ions
223
____ provides sensory stimulation in addition for the benefits of heat
Fluidotherapy
224
What is the temperature range for fluidotherapy?
110-120
225
___ is a dry heating agent that transfers heat via convection, and allows patients to perform AROM while being heated at the same time
Fluidotherapy
226
In an IR lamp, the intensity of radiation reaching target changes in proportion to ____
The inverse square of the distance
227
IR lamp needs to be imparted as close to ____ to skin surface as possible
IR lamp needs to be imparted as close to *perpendicular* to skin surface as possible
228
____ is an electromagnetic radiation within range that gives rise to heat when absorbed
IR lamp
229
What are some other options for superficial heat?
- IR lamp
| - Fluidotherapy
230
What are the adverse effects of laser and light?
- Exposure of eyes to laser can cause retinal damage
- Transient tingling
- Mild erythema
- Rash
- Burning sensation
- Increased pain/numbness
- Burns from war diode
231
What are the precautions of laser and light?
- Low back or abdomen during pregnancy
- Epiphyseal plates in children
- Impaired sensation
- Impaired mentation
- Photophobia/light sensitivity
- Pretreatment with photosensitizer
232
What are the contraindications of laser and light?
- Direct radiation of eyes; patients and clinicians should wear provided goggles
- Malignancy
- Within 4-6 months after radiotherapy
- Hemorrhage
- Thyroid or other endocrine glands
233
What are the clinical indications for laser and light?
- Soft tissue and bone healing
- Arthritis
- Lymphedema
- Neurological conditions
- Pain management
234
What are the effects of lasers and light?
- Promote ATP production by mitochondria
- Promote collagen production by fibroblasts
- Modulate inflammation
- Inhibit bacterial growth
235
What is power?
The rate of energy flow, mW
Physical agents
flashcards
Decks in class (7)
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