Hand and Upper Extremity Conditions > Modalities > Flashcards

Modalities Flashcards

(54 cards)

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1
Q

Chemical activity in cells and metabolic rate will increase ___ for each ___ rise in temperature.

A

2-3 times; 10 deg C

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2
Q

temperature after which tissue will burn

A

45-50 deg C

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3
Q

use of heat modality (3)

A
  1. increase interstitial fluid and cause mild edema
  2. decrease pain
  3. in combination with stretch
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4
Q

superficial heat (3)

A

heats tissue within 0.5 cm from the surface

  1. hot packs
  2. paraffin
  3. fluidotherapy
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5
Q

moist heat pack

A

kept in ~160 deg F water
usual multiple layers of towel or cover and towel
needs 30 to reheat when returning to water
check after 5 min
15-20 min
DO NOT LIE ON TOP OFF

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6
Q

paraffin (4)

A

superficial, moist heat most commonly used for distal extremity

  1. dip and wrap - elevate hand
  2. dip and reimmerse - rarely used
  3. paraffin ‘packs’
  4. cooled paraffin - used for closed skin grafts
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7
Q

fluidotherapy

A

dry heat
temp and agitation can be controlled
usually 115-117 deg F
allows patient to exercise while heating

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8
Q

contraindications/precautions for superficial heat (5)

A
  1. circulatory impairment
  2. cancer at site of heat application
  3. sensation impairment
  4. easy bleeding
  5. infection
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9
Q

home program options - heat (3)

A
  1. heating pad
  2. microwave gel pads
  3. rice socks
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10
Q

use of cold modality (4)

A
  1. used in acute stages of inflammation
  2. reduction of muscle spasms
  3. reduction of pain
  4. decrease swelling
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11
Q

cold modalities (2)

A
  1. cold packs

2. ice massage

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12
Q

precautions for cold modalities (2)

A
  1. patients with cold-sensitivity (ex. Raynaud’s)

2. patients with circulatory-compromised areas

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13
Q

documentation of temperature modalities (4)

A
  1. thermal agent used
  2. duration
  3. body area treated
  4. position
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14
Q

ultrasound

A

deep heating agent

water-based gel used as a couple

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15
Q

uses of ultrasound (6)

A
  1. joint contracture
  2. scar tissue
  3. tendinitis
  4. bursitis
  5. muscle spasms
  6. pain
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16
Q

ultrasound - frequency

A

of oscillations a molecule undergoes in 1 second
1.0 MHz, 2.0 MHz, 3.0 MHz are used in therapy
frequency determines the depth of penetration

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17
Q

ultrasound depth with 1 MHz frequency

A

2-5 cm

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18
Q

ultrasound depth with 3 MHz frequency

A

up to 2 cm

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19
Q

ultrasound tissues (3)

A

US is absorbed in tissue high in protein (collagen)

  1. tendon
  2. ligament
  3. joint capsule
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20
Q

ultrasound wave settings (2)

A
  1. pulsed waves

2. continuous waves

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21
Q

pulsed ultrasound

A

used when the desired effect is non-thermal such as acute soft tissue injuries

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22
Q

US - duty cycle

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A

the percentage of time the power is on during one pulse period

23
Q

continuous ultrasound

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A

provides a thermal effect

24
Q

ultrasound - intensity

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A

the rate at which energy is delivered per unit area (strength of the beam)
w/cm^2
joints with superficial skin coverage are usually treated at 1.0 w/cm^2

25
ultrasound - moving technique
speed = ~4 cm/second (slow) | area covered = 2-3x size of the head for every 5 minutes
26
ultrasound - precautions (12)
1. DVT 2. hemorrhagic conditions 3. reproductive organs 4. infections 5. malignancy 6. skin disease 7. active epiphysis 8. over heart, eyes, anterior neck, carotid sinus 9. care over metal 10. impaired circulation/sensation 11. over plastic or cement implants 12. over electronic device
27
uses of electrotherapy modalities (3)
1. pain modulation 2. muscle re-education 3. facilitate tissue healing
28
therapeutic currents - direct (DC)
unidirectional flow of charged particles used in iontophoresis, wound healing, and stimulation of denervated muscle electrode should be large enough to cover target area and disperse the current evenly
29
therapeutic currents- alternating (AC)
bidirectional flow of charged particles IFC (interferential current) for pain modulation more comfortable than DC burst-modulated AC is used for muscle strengthening
30
therapeutic currents - pulsed
flow of charged particles, unidirectional or bidirectional, that is delivered in finite periods of time before the next electrical event used for pain modulation or neuromuscular reeducation
31
electrotherapy parameters (4)
1. amplitude 2. pulse and phase duration 3. frequency 4. current modulators
32
amplitude
intensity
33
pulse duration
the time that elapses from the beginning of the pulse to the end of the pulse
34
phase duration
the time that elapses from the beginning of the phase to the end of the phase
35
electrotherapy - frequency
of pulses (pulsed current), beat (IFC), cycles (AC) that are delivered in 1 second
36
current modulators
ramp-up to gradually increase to peak amplitude or clinical response
37
electrotherapy contraindications (5)
1. pacemakers or other implanted electrical devices 2. over a pregnant uterus 3. over carotid sinus 4. over thoracic region of body 5. within area of DVT
38
electrotherapy precautions (6)
1. pain that is serving as a protective function 2. area of infection, malignancy, PVD 3. excessive adipose tissue may require higher current amplitudes 4. decreased sensation 5. damaged or fragile skin or open skin surface 6. history of electrode reaction
39
NMES - current
pulsed or burst-modulated AC
40
NMES - frequency
between 30-80 pps
41
NMES - current modulators
2 second ramp up | 1 second ramp down
42
NMES - amplitude
needs to be set high enough to allow a strong contraction
43
NMES - time on/off
between 1:3 and 1:12 depending on muscle fatigue
44
uses of UE joint mobilization (3)
1. remodel connective tissue to improve joint extensibility/reduce stiffness 2. reduce pain and encourage relaxation 3. bathe the joint with synovial fluid, externally nourishing joint structures
45
joint mobilization contraindications (6)
1. joint replacement arthroplasties 2. any fracture adjacent to the joints which is not clinically healed 3. acute inflammatory or septic arthritis 4. bone disease (i.e. osteomyelitis) 5. bacterial infection 6. malignancy/neoplastic disease
46
joint mobilization precautions (8)
1. RA and OA 2. osteoporosis 3. fracture (acceptable once PROM is indicated) 4. hypermobility 5. inability for patient to relax 6. presence of protective muscle spasm 7. joint effusion/inflammation 8. general debilitation
47
indications for joint mobilizations (4)
1. hypomobility 2. when there is potential for joint limitation 3. whenever PROM is indicated (EXCEPT replacement arthroplasty) 4. to decrease pain
48
osteokinematics
bone movements produced by 2 adjacent bones (flex/ext)
49
arthrokinematics
articular movements produced by 2 adjacent joint surfaces (accessory motions - roll, spin, glide)
50
concave on convex
concave surface glides same direction the bone is moving
51
convex on concave
convex surface glides opposite direction the bone is moving
52
Grade I joint mob
loosening movement is an extremely small traction force
53
Grade II joint mob
tightening movement first takes up the slack in the surrounding tissues and then tightens the tissues
54
Grade III joint mob
stretching movement is applied after the slack has been taken up and all tissues become taut
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