Active and Passive Board Review
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| Contraindications to all modalities? | Hemorrhage, Infection, Malignancy
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| Contraindications to all heating modalities? | DM, TB, Encapsulated swellings, Decreased thermal sensation, Abdomen or Low back during pregnancy
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| Contraindications to all electrical modalities? | Brain, eyes, heart, carotid sinuses, pacemaker, pregnancy (LB and Abs), open wounds, decreased sensation (LVG only)
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| The best modality to increase circulation? | IR
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| The deepest heating modality? | Ultrasound
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| Used to treat superficial infections? | UV
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| Contraindications to massage therapy? | *Vascular problems (phlebitis, thrombosis, Varicosities, local acute inflammation, ulcerations
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| Transverse friction massage is not recommended for what conditions? | Calcific tendonitis or Bursitis
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| What are the indications for traction therapy? | Disc syndromes, Foraminal encroachment, hyperlordosis, chronic spasms, fibrotic adhesions
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| What are the contraindications for traction? | Bone weakening conditions (osteoporosis, rickets, osteomalacia), pregnancy, RA, acute spasm, FX, hypertensive disorders
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| What are the traction recommendations for the cervical spine? | Begin @ 5% BW and increase 2pds each Tx (max of 50pds). Never extend the cervical spine.
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| What are the traction recommendations for the lumbar spine? | Begin @ 25% BW, increase 5pds each Tx (max 150pds). Patient is supine w/ legs flexed (90/90)
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| Vasoconstriction followed by Vasodilation while using cryotherapy is called? | Hunting-Lewis Rxn
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| Contraindications for cryotherapy? | Raynaud's/Buerger's, Chilbains, frostbite, vascular problems
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| What are the sensory reactions to cryotherapy? | Cold - Burning - Aching - Anesthesia (numbness)
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| Fingernail test? | Barouche
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| Cold wet towels? | Raspt
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| Physiological effects of IR? | increases vasodilation and lymph flowdecreases spasms, BP
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| Indications of IR? | Arthritis, contusions, Raynaud's, Bell's palsy, MSK conditions
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| Contraindications of IR? | Same as contraindications for heat
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| Short wave IR? | Emitted by heated bodies, 14-18" away, sunlight = heliotherapy
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| Long wave IR? | (Direct contact) Hydrocollator (6 towel layers), Hot water bottle, electric pads (170 F)
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| Too much radiation causing mottled, splotchy skin and redness is called what? | Erythema Ab igne
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| For every increase of 10 degrees celcius the rate of oxidation increases 2 1/2 times? | Van Hopf's Temperature Law
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| Best form of IR? | Hydrocollator pack (moist heat) 150-170 F
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| Best modality for superficial vascular? | IR high frequency
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| Transmission of heat in gas and liquids by circulation of heat? (hydrocollator, hot water bottle) | Convection
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| Transmission of heat without intervening medium getting warm? | Radiation (sun, UV lamp, IR lamp)
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| The conversion of electrical energy into heat or mechanical energy? | Conversion (SWD, MWD, US)
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| The transfer of heat through a substance? | Conduction (hydrocollator, paraffin bath)
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| What is the temp for a cold bath? hot bath? | Cold = 55-65, Hot = 98-105
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| What are some contraindications for baths? | vacular disorder or sensation loss
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| What type of bath would be used to treat Raynauds and Buerger's? | Start hot and end in cold bath
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| What bath would be used to treat hemorrhoids, dysmenorrhea, coccydynia, prostatitis? | Sitz
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| What can be a paraffin bath be used for? | Chronic OA or RA
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| What is a Hubbert Tank used for? | To Tx burn patients
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| What are the actions of UV? | thermal and photochemical
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| What causes erythema when UV is used? | Congestion of capillaries due to the release of histamine
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| Tanning of the skin is due to what? | movement of melanin (phototaxia)
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| What conditions are indicated for UV Tx? | Acne, fungus, herpes zoster, taenis pedis, taenia capitis, ulcers, rickets, osteomalacia
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| What are the the superficial modalities that only penetrate 1-2mm's? | UV, IR
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| What test is used to guage the pt tolerance to UV? | Erythema patch test aka Sleeve test
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| What is the wavelength of Short wave? Long wave? | short (near) = 180-270 long (far) = 270-390
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| The first two stages of burn include? | 0: suberythemal dose (SED) = No reddening, 1: minimal erythemal dose (MED) = reddening w/out desquamation
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| The last three stages include? | 2: 1st degree burn = reddening w/ sunburn, 3: 2nd degree burn = itching, redness, burning, desquamation (peeling), blisters, 4: 3rd degree burn = swelling, edema, blister
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| The optimum effect of radiation occurs when the part treated is at a right angle to the source? | Cosine Law aka Angulation of Rays
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| The intesity of radiation from any light source varies inversely with the square of the distance from the source? | Inverse Square Law (36" distance reduced by 1/2 increased the intensity 4x's)
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| Kromayer - water cooled device? | Hot Quartz
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| MC neon and mercury? | Cold Quartz
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| Goggles for both patient and operator, sore throats? | Orificial
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| UV filtered through nickel oxide glass used for fluorescence? | Wood's Light Lamp or Filter
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| What physiologic effects does short wave and microwave diathermy decrease? | BP, nerve pain, cramps, spasms
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| What are indications for diathermy? | Hip and chronic joint conditions, muscle, tendon, nerve inflammation, bone conditions, bronchitis, sinusitis
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| What are 2 specific conditions contraindicated for microwave diathermy? | sinusitis and otitis media
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| Why do you have to wear goggles to operate MWD? | To avoid cataracts
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| What are Butterfly electrodes used for? | SWD - for Tx sinusitis
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| What is diapulse used for? | Tx adrenals
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| What is the mode of action for MWD? SWD? | MWD = inside out, SWD = outside in
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| Generally what conditions are Tx w/ SWD? MWD? | SWD = bronchitis, sinusitis, PID, MWD = muscle strain
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| How deep does diathermy penetrate? | Deep = 2"
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| What is the Tx distance with SWD? MWD? | SWD = w/ towel directly on skin, MWD = 1-5" away w/ no towels (never direct contact)
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| What are the 3 best Tx's for pain? | IFC, Tens, High Volt
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| What are the modes of action for US? | Thermal = hyperemia, alkalosis, deep heat, Mechanical = removes exudates, Chemical = inc. gas exchange / chemical oxid., Neural = anesthesia (mild)
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| Contraindications for US? | vascular, TB, epiphyses, bony prominence (unless under water), spinal cord, ganglia, plexuses
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| Penetration for US? | Deep = 4-8cm (deepest heat modality)
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| US intensity w/ coupling agent: acute? chronic? | acute = 0.5-1.5 watts / cm2, chronic = 1.0-2.0 watts / cm2
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| US intensity w/ under water: acute? chronic? | acute = 1.0-2.0 w/cm2, chronic = 1.5-2.5 w/cm2
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| Pulsed US eliminates what? | Thermal effect (used for massage effect)
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| Continuous US does what? | Maximizes thermal effect
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| What do the piezoelectric crystals in the sound head of the US machine do? | Convert electrical energy to mechanical vibrations
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| What is phonophoresis? | chemical driven into skin (vit. A and E creams used as coupling medium)
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| What are the direct currents aka monophasic or unidirectional? | LVG, HV, Tens (all have polarity)
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| This law recognizes that an increase in current increases temp? | Joule's Law
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| This modality uses soluble ionic salts to drive a charge into the body's tissue? | Iontophoresis (anode = + cathode = -)
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| Negative Pole / cathode is used for? | adhesions, bursitis, bruises, scars, sprain/strain
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| Positive Pole/ anode is used for? | edema (Mg+), fibrositis, fungus (Cu+), neuritis
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| What is the mode of action for Galvanic? | electrokinetic/electrochemical
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| What are the physiologic effects of the positive pole? | attracts acid, oxygen, vasoconstricts, acute pain relief, contracts/hardens tissue
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| What is electrodiagnosis used for? | Tests for reaction of degeneration (RD), LMNL(injury that separates muscle from ant. horn cell)*NCV and EMG modalities used
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| What are the treatments for a partial RD? total RD? Absolute RD? | partial = slight faradic, increased galvanic, 2 weeks, Total = no faradic, athetoid (vermicular) galvanic, 3 wks to 1 year, Absolute = No response to anything, no recovery
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| What size is the active electrode, and where is it placed? Dispersal pad? | Active = small, on Tx site, Dispersal pad = large, proximal limb away from Tx site
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| High Volt has what mode of action? | electrokinetic
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| What are the physiologic effects of High Volt? | Pain control = endorphines and enkephalinesSpasm and Edema reducedExercises mucle (contraction)
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| Contraindications to High Volt? | heart, pacemakers, pregnancy**Decreased sensation is NOT contraindicated
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| What is the application of the + polarity? - polarity? | (+) = acute pain(-) = trigger point
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| What are the following high volt settings used for: 15-20? >20? 1-10? 70-100? | 15-20 = exercise, > 20 = tetanized, 1-10 = edema and endorphin production, 70-100 = enkephalin production
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| What are the following high volt rate modes used for: continuous mode? switch rate mode? interrupted mode? | continuous = inflammation and pain, switch = spasmsinterrupted - re-educate, strengthen
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| What is monopolar dispersal pad placement used for? | deep penetration and large area
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| What is bipolar dispersal pad placement used for? | (same size active and dispersal) small area/individual mm groups
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| What is the mode of action for TENS? | Gate theory and Opiate theory
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| What theory did Melzack and Wall develop? | Gate Pain theory
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| When is TENS indicated and what is the penetration level? | indicated for pain (not vascular)penetrates superficial
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| What is the size and function of A-beta fibers? | largest, fastest, proprioception
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| What is the size and function of A-delta fibers? | smaller, slower, temperature, touch, pain
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| What is the size and function of C-fibers? | smallest, slowest, carry only pain
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| What is the mode of action for sinusoidal/faradic? | AC, low voltage, low frequency, electrokinetic
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| What is the difference between sinusoidal AC and faradic AC? | sinusoidal = each cycle is neutral/equal, faradic = high intensity pulse more effective
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| What modality has the deepest (intra-articular) penetration? | IFC
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| What is the mode of action for IFC? | electrokinetic, pain control
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| Russina stimulation (premodulated) increases what? | mucle size and strength
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| Modulation constantly changes what? | frequency (decreasing accomodation)
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| What is the difference between vectoring on and vectoring off? | on = large Tx areaoff = small Tx area
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| What is Wedensky inhibition? | Inhibition of muscle response resulting from application of a series of rapidly repeated stimuli to the motor nerve where slower frequency of stimulation results in muscle response
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| What are the rotator cuff muscles and actions? | Supraspinatus = abduction, Infraspinatus = ext. rotation, Teres Minor = ext. rotation, Subscapularis = internal rotation
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| What condition can be Tx through VMO (quad) rehabilitation? | chondromalacia patella (lateral tracking)
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| What is the action of the teres major? | adducts and medially rotates shoulder
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| What are the actions of the hamstrings? | Leg flexion, rotation of tibia
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| What is the action of the gasctrocnemius? | plantar flex, flex the leg at knee
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| What is the action of the soleus? | plantar flexion
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| What is the action of the tibialis anterior? | dorsiflexion and inversion
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| What is the action of the iliopsoas? | flexion of the thigh
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| When should passive exercised be utilized? | during joint inflammation (prevents contractures)
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| What is an isometric contraction? | no change in muscle length, no joint movement
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| What is an isotonic contraction? | muscle length is changed, joint moved
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| What is concentric contraction? | shortening
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| What is eccentric contraction? | lengthening
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| A Cybex machine changes muscle length while constantly changing pressure at a constant speed through a full ROM. What type of contraction does it utilize? | Isokinetic
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| Exercises used for peripheral vascular disease. Pt. sitting, legs elevated until blanching of extremity? | Buerger-Allen
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| Group of exercises to reduce low back pain. Pt. is in a sit-up position, iliopsoas not used, flexion exercises? | Williams's
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| Extension exercises for acute low back pain, disc problems? | McKenzie's
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| Exercise that strengthens shoulder girdle, but eliminates use of supraspinatus, frozen shoulder? | Codman's
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| A systematic approach to muscle strength gain by increaseing resistance? (wt. training) | DeLorme's
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| Exercise used to improve pelvic floor muscles, urinary incontinence? | Keagles
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| Stress exercises to aid in relaxation? | Jacobson's
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| Used to mobilize the spine, exercise muscles in scoliotic condition, cross-crawl? | Clayton's
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| Ataxic motion, wobble board, develops proprioception? | Frenkel's
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| This type of exercise shortens the muscle very quickly? | Ballistic
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| What is an example of an open chain exercise? | knee extension
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| What is an example of a closed chain exercise? | squats
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| What are Kayoki exercises used for? | Hip
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| What support would be indicated if George's line is disrupted, the patient can rotate head? | Firm Cervical Collar (moderate cervical laxity)
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| What support is indicated for severe laxity of the cervical spine? | Philadelphia Collar (no ROM)
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| If no cervical laxity is found what support should be used? | Soft foam collar
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| What brace is recommended for a Cobb's angle of 20-40 degrees? (scoliosis) | Milwaukee brace
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| This brace is indicated for SI hypermobility aka trochanteric belt? | Sacroiliac girdle
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| This brace is used for inversion ankle sprains? | Figure 8 aka Lousiana strap
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| This brace is used on the knee aka the De-rotational brace? | Lennox-Hill
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| This brace is used to keep the wrist out of flexion and for carpal tunnel syndrome? | Cockup Splint (worn at night)
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| What is the best modality for acute injury? | Pulsed US
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| What is the most indicated modality for fracture? | microcurrent
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| What are Bobath exercises used for? | Cerebral Palsy or UMNL
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| Force/Time = minutes of time to create a contraction, 2x's rheobase? | Chronaxie
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| Amount of time of muscle stimulation to create a contraction? | Rheobase
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