PTA Modalities
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| What are the 4 contradictions of Heat? | 1. Acute truama
2. Open Wounds
3. Malignancy
4. Cardiac Insufficiency
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| List some benefits of Heat Modalities : | Increased circualtion, increased tissue repair, increased joint movement, decreased muscle tone, decreased pain
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| What are 3 Contraindications of Cold? | 1. Raynauds
2. Cold hypersensitivity
3. Severe HTN
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| List the benefits of Cold Modalities? | decreased circulation, decreased post injury swelling, decreased muscle tone, decreased joint movement, decreased pain
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| What are some Contraindications for Ultrasounding? | plastic implants, cancerous lesions, hemorrhagic regions, electronic implants and decreased sensation
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| List some of the benefits of Thermal Ultrasounding: | pain management, fibrosis, breaking up scar tissue for stretching
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| List some of the benefits of Athermal Ultrasounding: | tissue repair (sprains, strains, scars, remodelling)
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| What are IFC's (Interferential Current) used for? | Pain and edema management
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| List 4 contraindications of IFC's: | 1. Deep vein thrombosis
2. Pregnancy
3. Electronic implants
4. parasthesia
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| What are 3 contraindications of TENS? | 1. pregnancy
2. Electronic implants
3. parasthesia
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| What are some benefits of using NMES? | improve muscle strangthening, endurance and re-education
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| What are 3 contraindications of NMES? | 1. preganacy
2. AROM restrictions
3. electronic implants
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| When referring to Laser Treatment why is a low dose laser used? | for pain management
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| Why would a high dose laser by used? | for wound healing
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| List the 2 contraindictions of a Laser: | 1. eyes
2. Pregnancy
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| List the five signs of Inflammations: | redness, swelling, pain, heat, loss of function
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| What is the time frame of Phase 1 of tissue healing? | Phase 1 = acute to 2-6 days
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| What is the time frame of Phase 2 of tissue healing? | Phase 2 = 2-6 days to 2-4 weeks
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| What is the time frame of Phase 3 of tissue healing? | Phase 3 = 2-4 weeks to 6-12 months
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| How many days does the inflammatory phase last? | 6 days
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| What are contraindications if edema is present? | HEAT, resisted exercise, stretching and vigorous ROM
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| How many days does the Fibroblastic phase last? | end of inflammatory stage for 4 weeks
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| What are treatment techniques to help with fibroblastic phase? | many modalities, frictions, education, gentle stretching, progressive ROM, begin gentle resistance
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| how many dayes does maturation phase last? | end of fribroblastic phase up to 12 months
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| What is a contraindication in maturation phase? | disuse
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| What is the therapeutic temperature range when using heat? | 40 - 45 degrees
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| What physical changes happen to the skin/body when using heat modality? | increased circulation, swelling, increased motabolism, redness, increased joint movement
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| How many layers of towel should be used when applying hot pack to a client? | 6-8 Layers
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| The main effects of cold to the body are.. | decreased circulation, decreased swelling, decreased muscle tone, decreased joint movement, decreased pain.
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| The goal when applying cold to skin is to reduce tissue temp by .. | 5-6 degrees
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| Cardinal Signs of inflammation are: | redness,swelling, loss of function, pain, heat
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| What is the target tissue temp. when applying heat? | 41-45 degrees
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| The max depth that cryotherapy can penetrate is? | 1-4 cm
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| cooling is? | The transfer of heat away from the bodies tissues
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| The Theraputic Range for cooling is? | 5-6 degrees below core temp.
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| 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
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| Icing is best during the ______ stage? | Acute
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| 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.
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| What position should the muscle be when applying an ice massage? | The longest comfortable length. (use proximal to distal direction)
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| 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.
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| BNR stands for: | Beam Non Uniformity Ratio
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| What is the equation for BNR? | BNR= intensity of highest peak devided by the average intensity of all peaks.
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| Ultrasound waves can do all three things: | Reflection/Refraction/ & Absorbtion
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| 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.
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| What is refraction in ultrasound? | Where the ultrasound wave changes direction as it crosses boundaries (muscle to bone etc.)
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| 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.
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| What does the off time during ultrasound allow for? | Heat dissipation,therefore with pulsed ultrasound no heat should be fealt.
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| 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
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| 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.
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| When would you use thermal ultrasound? | pain, breaking up scar tissue
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| When would you use Athermal ultrasound? | tissue repair (sprains, strains, scar remodeling)
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| What is TENS? | The use of electrical stimulation across the skin with the theraputic goal of pain management
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| Name the 5 types of TENS | C-TENS, A-TENS, Brief intense, burst TENS, modulation TENS
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| Describe C -TENS | high frequency- short duration with low to comfortable intensity. Works using the pain gait principle, 80-120 hz
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| Describe A-TENS | low frequency - long duration with comfortable to tolerable intensity. Works off the opiate priciple. 2-4 hz
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| Describe NMES | the use of electrical stimulation to activate muscles through stimulation of intact peripheral N.
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| NMES tipically follows a _________ square-wave pulse | bi-phasic
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| why does NMES recruit larger fibers first? | the larger fibers have less impedence and are more superficial
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| What should the intensity for NMES be if you were trying to strengthen? | greater than 50 mA
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| what should the intensity be for NMES when you are trying to work on endurance? | less than 50mA around 30 Hz
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| Monochromatic lasers are: | Single wavelength beams
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| T/F HeNe lasers have visible red light?? | T GaAs lasers have an artificial red light to help ensure acurate placement
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| Laser energy is absorbed mostly in ___________ molecules called ____________ | photosensitive, chromophores
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| wavelengths _____ - _______nm will penetrate the dermis and below. | 600-1200nm
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| 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.
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| T/F laser requires a coupling media? | F- the laser travels freely in space. No need for coupling.
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| Which type of laser penetrates farther? HeNe or GaAs? | HeNe will penetrate less than GaAs.
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| 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.
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| What is the power density in laser?? | the amount of energy delivered under the beam area.
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| 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.
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| describe IFC | a method of using low frequency electrical stimulation on muscles & nerves with minimal unpleasant side effects
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| How do we create a low frequency when using IFC? | We alternate 2 medium frequencies to create one low frequency
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| 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)
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| 3 Main indications for IFC are: | pain management, edema management, urinary incontinence
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| To treat pain using IFC we: | Use a high frequency to stimulate the pain gate mechanism (80-120 hz)
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| To treat chronic pain using IFC we use: | a lower frequency to activate optiates and create longer pain relief 1-10 hz
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| What are the 8 contraindications of IFC ? | Arterial disease, DVT, infectious conditions, pregnancy, open or fragile wound, cancer, pacemakers, dermatilogical conditions (fragile skin)
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