Question | Answer |
What are the 4 contradictions of Heat? | 1. Acute truama
2. Open Wounds
3. Malignancy
4. Cardiac Insufficiency |
List some benefits of Heat Modalities : | Increased circualtion, increased tissue repair, increased joint movement, decreased muscle tone, decreased pain |
What are 3 Contraindications of Cold? | 1. Raynauds
2. Cold hypersensitivity
3. Severe HTN |
List the benefits of Cold Modalities? | decreased circulation, decreased post injury swelling, decreased muscle tone, decreased joint movement, decreased pain |
What are some Contraindications for Ultrasounding? | plastic implants, cancerous lesions, hemorrhagic regions, electronic implants and decreased sensation |
List some of the benefits of Thermal Ultrasounding: | pain management, fibrosis, breaking up scar tissue for stretching |
List some of the benefits of Athermal Ultrasounding: | tissue repair (sprains, strains, scars, remodelling) |
What are IFC's (Interferential Current) used for? | Pain and edema management |
List 4 contraindications of IFC's: | 1. Deep vein thrombosis
2. Pregnancy
3. Electronic implants
4. parasthesia |
What are 3 contraindications of TENS? | 1. pregnancy
2. Electronic implants
3. parasthesia |
What are some benefits of using NMES? | improve muscle strangthening, endurance and re-education |
What are 3 contraindications of NMES? | 1. preganacy
2. AROM restrictions
3. electronic implants |
When referring to Laser Treatment why is a low dose laser used? | for pain management |
Why would a high dose laser by used? | for wound healing |
List the 2 contraindictions of a Laser: | 1. eyes
2. Pregnancy |
List the five signs of Inflammations: | redness, swelling, pain, heat, loss of function |
What is the time frame of Phase 1 of tissue healing? | Phase 1 = acute to 2-6 days |
What is the time frame of Phase 2 of tissue healing? | Phase 2 = 2-6 days to 2-4 weeks |
What is the time frame of Phase 3 of tissue healing? | Phase 3 = 2-4 weeks to 6-12 months |
How many days does the inflammatory phase last? | 6 days |
What are contraindications if edema is present? | HEAT, resisted exercise, stretching and vigorous ROM |
How many days does the Fibroblastic phase last? | end of inflammatory stage for 4 weeks |
What are treatment techniques to help with fibroblastic phase? | many modalities, frictions, education, gentle stretching, progressive ROM, begin gentle resistance |
how many dayes does maturation phase last? | end of fribroblastic phase up to 12 months |
What is a contraindication in maturation phase? | disuse |
What is the therapeutic temperature range when using heat? | 40 - 45 degrees |
What physical changes happen to the skin/body when using heat modality? | increased circulation, swelling, increased motabolism, redness, increased joint movement |
How many layers of towel should be used when applying hot pack to a client? | 6-8 Layers |
The main effects of cold to the body are.. | decreased circulation, decreased swelling, decreased muscle tone, decreased joint movement, decreased pain. |
The goal when applying cold to skin is to reduce tissue temp by .. | 5-6 degrees |
Cardinal Signs of inflammation are: | redness,swelling, loss of function, pain, heat |
What is the target tissue temp. when applying heat? | 41-45 degrees |
The max depth that cryotherapy can penetrate is? | 1-4 cm |
cooling is? | The transfer of heat away from the bodies tissues |
The Theraputic Range for cooling is? | 5-6 degrees below core temp. |
List the sensation changes of cold: | 1. The first 3 mins, intense cold
2. 4-7 mins burning/aching pain
3. 8-15 mins local anaesthesia**
4. 15-30 mins numbness |
Icing is best during the ______ stage? | Acute |
Name the 8 physiological effects of cold: | decreased circulation,decreased post injury swelling,reduced metabolic rate,skin changes,delayed tissue repair,decreased joint movement, decreased tissue elasticity,Strength (increased when brief,prolonged will decrease)decreased muscle tone. |
What position should the muscle be when applying an ice massage? | The longest comfortable length. (use proximal to distal direction) |
When referring to ultrasound, What is the near feild? | the region of the ultrasonic beam closest to the transducer, where theraputic effects will occour on the tissues. |
BNR stands for: | Beam Non Uniformity Ratio |
What is the equation for BNR? | BNR= intensity of highest peak devided by the average intensity of all peaks. |
Ultrasound waves can do all three things: | Reflection/Refraction/ & Absorbtion |
What is reflection in ultrasound? | Where a % of the energy is reflected back at the tissue interfaces. ie. the more energy refected back the less energy that goes into the tissue. |
What is refraction in ultrasound? | Where the ultrasound wave changes direction as it crosses boundaries (muscle to bone etc.) |
What is absorbtion in ultrasound? | When US is applied to skin it is absorbed producing heat. The denser the tissue the more energy will be absorbed. |
What does the off time during ultrasound allow for? | Heat dissipation,therefore with pulsed ultrasound no heat should be fealt. |
In relation to ultrasound what is captivation? | Where little gas pockets in fluids develop into microscopic bubbles, they contract & expand with the frequency of the bubbles |
Microstreaming in ultrasound is? | Where there is a minute flow of fluid around the microscopic bubbles. Combined with capivation this alters cell membrane activity and therefore speeding up tissue healing. |
When would you use thermal ultrasound? | pain, breaking up scar tissue |
When would you use Athermal ultrasound? | tissue repair (sprains, strains, scar remodeling) |
What is TENS? | The use of electrical stimulation across the skin with the theraputic goal of pain management |
Name the 5 types of TENS | C-TENS, A-TENS, Brief intense, burst TENS, modulation TENS |
Describe C -TENS | high frequency- short duration with low to comfortable intensity. Works using the pain gait principle, 80-120 hz |
Describe A-TENS | low frequency - long duration with comfortable to tolerable intensity. Works off the opiate priciple. 2-4 hz |
Describe NMES | the use of electrical stimulation to activate muscles through stimulation of intact peripheral N. |
NMES tipically follows a _________ square-wave pulse | bi-phasic |
why does NMES recruit larger fibers first? | the larger fibers have less impedence and are more superficial |
What should the intensity for NMES be if you were trying to strengthen? | greater than 50 mA |
what should the intensity be for NMES when you are trying to work on endurance? | less than 50mA around 30 Hz |
Monochromatic lasers are: | Single wavelength beams |
T/F HeNe lasers have visible red light?? | T GaAs lasers have an artificial red light to help ensure acurate placement |
Laser energy is absorbed mostly in ___________ molecules called ____________ | photosensitive, chromophores |
wavelengths _____ - _______nm will penetrate the dermis and below. | 600-1200nm |
2 types of application of laser: | pencil like- monodiode, small beam area. Cluster diode - arranged in circular or rectangular fashion, large beam area, larger Rx area. |
T/F laser requires a coupling media? | F- the laser travels freely in space. No need for coupling. |
Which type of laser penetrates farther? HeNe or GaAs? | HeNe will penetrate less than GaAs. |
When referring to laser what is the energy density? | the actual amount of energy delivered at the level of the laser per square cm of tissue. |
What is the power density in laser?? | the amount of energy delivered under the beam area. |
Will excess fat effect laser treatment?? | Yes- the H20 in the fat will absorb most of the laser energy and treatment will be less effective. |
describe IFC | a method of using low frequency electrical stimulation on muscles & nerves with minimal unpleasant side effects |
How do we create a low frequency when using IFC? | We alternate 2 medium frequencies to create one low frequency |
Describe the Vector Scan System: | Where the amplitude in one circut varies, while the other is fixed, this creates a rotating pattern = treating a larger treatment area. (clover pattern) |
3 Main indications for IFC are: | pain management, edema management, urinary incontinence |
To treat pain using IFC we: | Use a high frequency to stimulate the pain gate mechanism (80-120 hz) |
To treat chronic pain using IFC we use: | a lower frequency to activate optiates and create longer pain relief 1-10 hz |
What are the 8 contraindications of IFC ? | Arterial disease, DVT, infectious conditions, pregnancy, open or fragile wound, cancer, pacemakers, dermatilogical conditions (fragile skin) |