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DOPS treatments

QuestionAnswer
Q: What are the precautions/contraindications for TENS? A: Avoid over broken skin, sensory loss, pacemakers, epilepsy (head/neck), pregnancy, and suspected cancer.
Q: What is the rationale for using TENS? A: To reduce pain without medication and improve movement.
Q: How does TENS work physiologically? A: Activates pain gate and releases endorphins to block pain signals.
Q: What structures does TENS affect? A: Sensory nerve fibres, spinal cord, and pain pathways.
Q: What are the key principles of TENS? A: Correct electrode placement, strong but comfortable intensity, individualised settings.
Q: What are the precautions/contraindications for NMES? A: Pacemakers, pregnancy, cancer, thrombosis, infection, epilepsy (head).
Q: What is the rationale for NMES? A: Strengthening, muscle re-education, and improving circulation.
Q: How does NMES work physiologically? A: Stimulates motor nerves to cause muscle contraction.
Q: What structures does NMES affect? A: Motor nerves, muscles, neuromuscular junction.
Q: What are the key principles of NMES? A: Place on muscle belly, match goal, encourage active contraction, progress gradually.
Q: What are the precautions/contraindications for ultrasound? A: Avoid over cancer, infection, pacemaker, acute inflammation, reduced sensation.
Q: What is the rationale for ultrasound? A: Reduce pain, improve healing, increase ROM.
Q: How does ultrasound work physiologically? A: Thermal + non-thermal effects improve tissue healing and extensibility.
Q: What structures does ultrasound affect? A: Tendons, ligaments, capsules, muscles, scar tissue.
Q: What are the key principles of ultrasound? A: Use gel, keep probe moving, match settings to goal.
Q: What settings should the ultrasound machine be on? time- 5mins per treatment head, mode- pulsed (we use this as its non-thermal), intensity- (0.4- acute, 0.6- sub-acute, 1- more/chronic), frequency- 3MHz or 1MHz (depending on depth, more superficial= 3)
Q: What settings should the TENS machine be on? conventional (high)- frequency 150Hz, pulse width- 50-80 us, - 8 hrs. +, tingling/ pins and needles feeling acupuncture (low)- frequency 1-4 Hz, pulse width 200 us, -30 mins, sharp prickling sensation (v. strong)
Q: What settings should the NMES machine be on? pulse duration- 300 us, frequency- 40 Hz, on/off time- 15/50 secs, treatment up to 4 times 15 mins daily
Q: What are the precautions/contraindications for heat? A: Impaired sensation, infection, DVT, cancer, poor circulation.
Q: What is the rationale for heat? A: Reduce pain, increase flexibility and blood flow.
Q: How does heat work physiologically? A: Vasodilation and increased metabolism.
Q: What structures does heat affect? A: Muscles, nerves, blood vessels.
Q: What are the key principles of heat? A: Use 8 layers, monitor skin, avoid burns.
Q: What are the precautions/contraindications for cold? A: Sensory loss, vascular disease, cold intolerance conditions.
Q: What is the rationale for cold? A: Reduce swelling, pain, and inflammation.
Q: How does cold work physiologically? A: Vasoconstriction and reduced metabolism.
Q: What structures does cold affect? A: Nerves, muscles, blood vessels.
Q: What are the key principles of cold? A: Use barrier, monitor skin, limit time.
Q: What are the precautions/contraindications of Stability & Trunk Control treatment? A: Acute injury, severe pain, neurological decline.
Q: What is the rationale behind Stability & Trunk Control? A: Improve spinal stability and reduce pain.
Q: How does Stability & Trunk Control work physiologically? A: Improves neuromuscular control and endurance of stabilisers.
Q: What structures are affected in Stability & Trunk Control? A: Core muscles, spine, CNS.
Q: What are the key principles for Stability & Trunk Control? A: Start low-load, progress gradually, focus on control and alignment.
Q: What are the precautions/contraindications for manual strengthening? A: Acute injury, inflammation, severe pain, infection.
Q: What is the rationale behind manual strengthening? A: Improve strength, stability, and control.
Q: How does manual strengthening work physiologically? A: Neural gains early, hypertrophy later, improved tendon strength.
Q: What structures are affected by manual strengthening? A: Muscles, tendons, joints, nervous system.
Q: What are the key principles of manual strengthening? A: Progressive overload, controlled resistance, pain monitoring.
Q: What are the precautions/contraindications of mechanical strengthening? A: Unstable injury, acute inflammation, severe pain, DVT.
Q: What is the rationale behind mechanical strengthening? A: Increase strength, function, and independence.
Q: How does mechanical strengthening work physiologically? A: Neural adaptation, hypertrophy, bone and tissue strengthening.
Q: What structures are affected by mechanical strengthening? A: Muscles, bones, joints, nervous system.
Q: What are the key principles in mechanical strengthening? A: Progressive overload, FITT, correct technique, recovery.
Q: What are the precautions/contraindications of Secretion Clearance Techniques? A: Severe respiratory or unstable conditions (e.g. pneumothorax).
Q: What is the rationale behind Secretion Clearance Techniques? A: Move mucus for easier clearance.
Q: How does Secretion Clearance Techniques work physiologically? A: Vibrations and airflow loosen and move secretions.
Q: What structures are affected by Secretion Clearance Techniques? A: Airways, lungs, mucus.
Q: What are the key principles when using Secretion Clearance Techniques? A: Correct positioning, timing with breathing, monitoring.
Q: What are the precautions/contraindications when positioning for VQ? A: Avoid unsafe positions in unstable patients.
Q: What is the rationale behind positioning for VQ? A: Improve gas exchange.
Q: How does positioning for VQ work physiologically? A: Improves ventilation-perfusion matching using gravity.
Q: What structures are affected when using positioning for VQ? A: Lungs, alveoli, blood vessels.
Q: What are the key principles behind positioning for VQ? A: Place healthier lung down, ensure comfort and safety.
Q: What are the precautions/contraindications of balance re-education? A: High fall risk, severe weakness—adapt tasks.
Q: What is the rationale behind balance re-education? A: Improve stability and independence.
Q: How does balance re-education work physiologically? A: Improves muscle control, coordination, and sensory integration.
Q: What structures are affected by balance re-education? A: Muscles, joints, CNS, sensory systems.
Q: What are the key principles of balance re-education? A: Functional tasks, gradual progression, safety, feedback.
Q: What are the precautions/contraindications of Positioning to Ease Breathlessness? A: No absolute contraindications, but the position must suit the patient’s condition, comfort, and presentation.
Q: What is the rationale for using Positioning to Ease Breathlessness? A: To reduce work of breathing by improving respiratory mechanics, diaphragm efficiency, and accessory muscle function.
Q: How does Positioning to Ease Breathlessness work physiologically? A: Improves breathing mechanics, reduces abdominal pressure on the diaphragm, and enhances muscle efficiency.
Q: What structures are affected during Positioning to Ease Breathlessness? A: Diaphragm, accessory breathing muscles, chest wall, and rib cage.
Q: What are the key principles in Positioning to Ease Breathlessness? A: Ensure safe and supported positioning, individualise the position, fix upper limbs, and monitor continuously.
Q: What is the process of Positioning to Ease Breathlessness? A: Explain and gain consent, position safely with support, ensure environment safety, monitor patient response, and leave them comfortable with appropriate advice.
Q: What are the key contraindications/precautions of using a Walking Aid Provision? A: Acute illness, dizziness, confusion, inability to follow instructions; check footwear, environment, and aid safety.
Q: What is the main rationale behind Walking Aid Provision? A: Improve safety, reduce falls, support weight-bearing, and increase independence.
Q: How does Walking Aid Provision work physiologically? A: Increases stability, offloads limbs, improves gait, reduces effort, and boosts confidence.
Q: What structures are affected by Walking Aid Provision? A: Lower limbs, upper limbs, trunk, and balance systems.
Q: What are the key principles of using a Walking Aid Provision? A: Risk assess, fit correctly, ensure safety, assist movement, and progress appropriately.
Q: What is the basic process of Walking Aid Provision as a treatment? A: Assess → fit → teach → monitor → progress/regress.
Q: Any extra info on walking aid provisions? how to fit a walking aid- Handle at wrist crease, slight elbow bend. How to start standing with crutches- hold both in one hand (H-shape). How to begin walking- Small steps → progress to step-through. stair rule- “Good up, bad down,” crutches stay below.
Q: What are the precautions/contraindications of massage? A: Skin damage, infection, DVT, cancer, acute inflammation, severe cardiac issues.
Q: What is the rationale behind massage? A: Reduces pain, improves circulation, decreases muscle tension, aids recovery.
Q: What are the physiological effects of massage? A: ↑ blood flow, ↑ lymph drainage, ↓ muscle tension, ↓ pain, promotes relaxation.
Q: What structures are affected by massage? A: Muscles, skin, fascia, blood/lymph vessels, nerves.
Q: Key principles of massage? A: Towards heart, start light → deeper, smooth continuous contact, relaxed positioning.
Q: Precautions/contraindications? A: Acute injury, fracture, inflammation, bony restriction, compensatory tightness.
Q: Rationale behind stretching? A: ↑ flexibility & ROM, reduce tightness, improve posture, prevent injury.
Q: Physiological effects of stretching? A: ↑ muscle length, ↓ tension, ↑ ROM, improved circulation, GTO activation.
Q: Structures affected by stretching? A: Muscles, tendons, joint capsule, fascia, nervous system.
Q: Principles of stretching? A: Slow, controlled, 15–30s hold, no bouncing, stretch to tension not pain, repeat.
Q: Precautions/contraindications of PAIVMs? A: Instability, fracture, inflammation, infection, malignancy.
Q: Rationales of PAIVMs? A: Restore joint play, reduce pain, improve ROM and function.
Q: Physiological effects of PAIVMs? A: ↓ pain (gate theory), ↑ ROM, ↓ stiffness, ↑ synovial fluid movement.
Q: Structures affected by PAIVMs? A: Joint capsule, ligaments, cartilage, muscles, mechanoreceptors.
Q: Principles of PAIVMs? A: Stabilise proximally, correct glide, pain-free, controlled oscillations.
Q: Precautions/contraindications of active assisted exercise? A: Pain, instability, recent surgery, inflammation, open wounds.
Q: Rationale behind active assisted exercise? A: Early muscle activation, maintain ROM, reduce stiffness, build confidence.
Q: Physiological effects of active assisted exercise? A: ↑ circulation, ↑ muscle activation, prevent atrophy, maintain mobility.
Q: What structures are affected by active assisted exercise? A: Muscles (activation, prevent atrophy), joints (maintain mobility), connective tissue (prevent stiffness), blood vessels (↑ circulation), nervous system (improves neuromuscular control).
Q: What principles are used for active assisted exercise? A: Patient-assisted movement, controlled and pain-free range, correct positioning and support, gradual progression, clear communication, monitor response throughout.
Q: Precautions/contraindications for accessory mobilisations of peripheral joint? A: Joint instability, fracture, acute inflammation, infection, malignancy, severe pain.
Q: Rationale behind accessory mobilisations of peripheral joint? A: Restore joint play, improve ROM, reduce pain, improve function.
Q: Physiological effects of accessory mobilisations of peripheral joint? A: ↓ pain (gate control), ↑ joint mobility, ↓ stiffness, ↑ synovial fluid movement, ↓ muscle guarding.
Q: What structures are affected by accessory mobilisations of peripheral joint? A: Joint capsule, ligaments, cartilage, synovial membrane, surrounding muscles, mechanoreceptors.
Q: What principles are used when doing accessory mobilisations of peripheral joint? A: Stabilise proximally, move distally, correct glide direction, pain-free range, controlled oscillations or holds, monitor response.
Q: Precautions/contraindications for positioning for gravity assisted drainage? A: Severe breathlessness, unstable cardiovascular status, recent surgery, reflux risk, raised ICP, intolerance to position, young children.
Q: Rationale behind positioning for gravity assisted drainage? A: Use gravity to assist movement of secretions from lungs to larger airways for easier clearance.
Q: Physiological effects behind positioning for gravity assisted drainage? A: ↑ secretion drainage, ↑ ventilation distribution, ↓ work of breathing, improved gas exchange.
Q: What structures are affected when positioning for gravity assisted drainage? A: Lungs (bronchi/airways), diaphragm, chest wall, respiratory muscles.
Q: What principles are used when positioning for gravity assisted drainage? A: Position specific lung segments correctly, use gravity (head up/down as needed), ensure patient comfort and safety, monitor tolerance, combine with breathing techniques if appropriate.
Created by: edhales
 

 



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