temperatures greater than ______ to _____ or less than _____ can injure tissues
113-122F (45-50C)
< 32F (0C)
Name the 10 contraindications for heat therapy
- ischemia
- bleeding disorders
- impaired sensation
- inability to communicate or respond to pain
- malginancy
- acute trauma or inflammation
- scar tissue
- edema
- atrophic skin
10 poor thermal regulation
for every ______ degree F increase in skin temperature, there is a _____% increase in metabolic demand
10F; 100%
____ is the transfer of heat between two bodies at different temperatures through direct contact. Heat transfer occurs without movement of the conducting body.
conduction
- hot water, paraffin bath, hot packs (hydrocollator packs), kenny packs, heating pads
_____ is the transfer of heat by fluid circulation (typically liquid or gas) over the surface of a body. Fluid flows increase the temperature gradient between the surfaces, increasing heating and cooling.
Convection - more intense than conduction
- fluidotherapy
- contrast baths
- hydrotherapy (whirpool)
_____ is the transfer of heat through conversion of electromagnetic radiation (nonthermal energy) into heat energy.
conversion
- radiant heat (heat lamps)
- ultrasound
- shortwave diathermy
- microwave diathermy
superficial heat occurs at what depths?
1-2cm
three different ways to apply paraffin wax bath
- dipping
- immersion
- brushing
Fluidotherapy:
- peak temperature of hands and joint capsule is ____ degrees F
- peak temperature of foot and joint capsule is _____ degrees F
- 107.6
- 103.1
In contrast baths, distal limbs receive alternating heat and cold in a whirpool tank to produce _____
reflex hyperemia
distance from lamp to skin preferred for superficial heating with infrared lamp
45-60cm (18-24 inches)
proper positioning for cervical traction
neck flexed with patient in sitting or supine position; 20-30 degrees of flexion relieves symptoms on nerve root compression by opening the intervertebral foramina
proper positioning for lumbar traction
hips and knees flexed to 90 while patient is supine; reduces lordosis, and the spine is relatively flexed opening the intervertebral foramina
when to use continuous vs intermittent traction:
intermittent provides a greater pull, used for distraction when NF opening or retraction of herniated disc material is desired
continuous traction is used for prolonged muscle stretch, such as in muscle relaxation
duration 20 mins
amount of traction:
- cervical:
- lumbar:
- distraction requires > 25lbs
- posterior vertebral distraction > 50lbs, for anterior separation > 100lbs is needed
____ is elongation of the cervical spine of 2-20mm and can be achieved with 25lbs or more of tractive force
vertebral joint distraction
according to gate control theory, TENs stimulates _____ fibers that in turn stimulate _____ in the spinal cord, clsing the gate on pain transmission to Lissauers tract (posterior lateral tract of pain and temperature) and ultimately to the ______. As a result, pain signals can be blocked at the spinal cord before they are trasmitted to the brain
large Ia myelinated afferent nerve fibers
substantia gelatinosa
thalamus
Types of transcutaneous nerve stimulation: (5
- conventional
- acupuncture
- hyperstimulation
- burst
- modulated
____ TENs is high frequency, low intensity stimulation and is the most effective type
conventional
external neuromuscular electrical stimulation uses stimulation frequencies of _____
10-50hz
what are the two different systems of functional electrical stimulation?
- Open loop - feedback is provided manually, stimulation activated by switches, intensity adjusted based on response.
- closed loop - functional neuromuscular stimulation (FNS)more sophisticated, electrodes are activated by computer generated patterns of stimulation to cause functional movement. Feedback provided automatically through movemeent sensors
