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Modalities
| Question | Answer |
|---|---|
| NEMS Indications | Muscle re-education Denervated muscle Maintain ROM Prevent Joint contracture and atrophy Increase Blood Flow Decrease swelling and scar tissue formation |
| NEMS Contraindications | Cardiac Disability Demand Pacemaker Pregnant Tumor Infection Exposed metal implants Sensitive nerve areas Carotid Sinus Esophagus Larynx Pharynx Eye Upper Thorax Temporal region CV or NV impairment DVT Fracture Seizures |
| Cryotherapy Effects | Vasoconstriction Decrease; pain, swelling, spasm, cell metabolism and waste, nerve conduction velocity, muscle force |
| Cryotherapy Indications | Acute injury, swelling, pain Chronic pain With rehab 1st degree burns Post surgical pain and edema Acute or chronic muscle spasm Neoplasm |
| Cryotherapy Contraindications | CV or Respiratory issues Raynauds Open wounds Advanced diabetes Circulation issues Cold allergy or urticaria Peripheral vascular disease lupus |
| Thermotherapy Effects | Vasodialation Remove metabolic waste Increase rate of cell metabolism, delivery of leukocytes, capillary permeability, venous/ lymph drainage, collagen elasticity, HR, resp, blood flow, body temp. Decrease BP, stiffness, muscle tone, spasm, sub swell |
| Thermotherapy Indications | Subacute and chronic pain, swelling, spasm ROM Hematoma Joint contracture |
| Thermotherapy Contraindications | Acute injuries Impaired Circulation Advanced Arthritis Poor temperature regulation Anasthesia Tumor DVT Active infections Mentally impaired High blood pressure |
| TENS Indications | Acute, chronic, post surgical, or post traumatic subacute pain |
| TENS Contraindications | Central or unknown pain Pacemaker Pregnancy Transthoracically Transcranially Eye Carotid Sinus Heart |
| Massage Indications | Break adhesions and pain spasm cycle Increase BF, lymph drainage, venous return, ROM, and muscle length Decrease edema and muscle tone Sedate nerve ends Relaxation |
| Massage Contraindications | Acute sprain or strain Active swelling Fracture CV or Circulatory issues Rash DVT Pulmonary embolism Open ulcer Vericose veins Infection Cancer Traumatic Arthritis RA Ossification Arterioclerosis Hemorrhage |
| Massage Precautions | If over an area of decreased sensation, decrease pressure. Do not massage if swelling is d/t CV insufficiency, kidney or liver disease, or pleaural effusion |
| Ultrasound Indications | Sprain Strain Contusion Enhance soft tissue and bone healing Phonophoresis |
| Ultrasound Contraindications | Impaired Circulation or sensation Epiphyseal Eyes, reproductive, heart, carotid sinus Spinal cord/laminectomy Cemented joint prosthesis Cancer Hemophiliac Large arteries Acute bursitis Arterio/atherosclerosis X-ray/radiation/isotope |
| Ultrasound Thermal Effects | Increases tissue temperature and elasticity, blood flow, metabolism, and nerve pain threshold |
| Ultrasound Non-Thermal Effects | Increases enzyme activity, metabolic rate, cell permeability (cavitation), blood flow, healing, tensile strength of collagen Waste removal Tissue regeneration Unidirectional flow of fluids Decreases pain and spasm |
| IFC Indications | Acute or Chronic pain Spasm |
| IFC Contraindications | Pregnant Thrombophlebitis CV disease Cancerous lesion 3 deg strains Demand pacemaker Bone implant Skin disease Transthoracically Transcranially Eyes Carotid sinus stellate ganglion Chronic pain without known cause |