chapter 6 therapeutic modalities
TRANSCRIPT
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Therapeutic Modalities
Chapter 6 or 7
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Therapeutic Modalities
Indication: A condition that could benefit from a
specific modality.
Contraindication: A condition that could be
adversely affected if a particular modality is used.
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Electromagnetic Spectrum
Electromagnetic Radiation
Electromagnetic Spectrum Ionizing Range
Non-Ionizing Range
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Ionizing Range
Energy readily alters the components of atoms.
Used for X-rays and Treating Cancer.Not used by Athletic Trainers
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Non-Ionizing Range
Ultraviolet- Superficial tissue treatment
Infrared-Near Infrared- 5-10mm deep
Far Infrared-
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Transfer ofEnergy
Energy moves from an area of HIGH concentration
to an area of LOW concentration.Radiation
Conduction
ConvectionConversion
Evaporation
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Radiation
When the surrounding environment is hotter that
the body the radiant heat is absorbed. No-contactis made.
Short-wave Diathermy
Microwave Diathermy
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Conduction
Direct transfer of energy between two objects in
physical contact with each other.E
nergy istransferred from the area of high temp. to the area
of low temp.
Ice packs
Moist heat packs
Paraffin
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Convection
Much like conduction, but the medium moves
across the body causing variations. Fluidotherapy
Whirlpools
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Conversion
Changes other energy forms into Heat.
UltrasoundMicrowave
Liniments or Balms
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Evaporation
Heat is absorbed by the liquid on the skins surface
and cools the skin as it turns into a gaseous state.Vapocoolant sprays
Alcohol
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Factors Affecting Transfer ofEnergy
Density of Medium
ReflectionRefraction
Absorption
Law of Grotthus-Draper
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Energys Effect on Tissue
Cosine law +/- 10F is acceptable
Inverse Square Law E=Es/DE= Resulting Energy
Es= Source Energy
D= Distance Squared
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Cryotherapy
Heat Abstraction
Depth of 5cm can be
cooled
Change in Temperature
depends on:
Type of Agent Temp. difference between
agent and tissue
Amount of insulation
Thermal Conductivity
Limb circumference
Duration of application
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Cryotherapy
Leads to vasoconstriction
Decreases tissue metabolismDecreases tissue permeability
Decreases capillary permeability
Decreases painDecreases spasms
Analgesic relief of pain
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Cryotherapy
Ideal Temperature 32-65F
20-30 mins. (10-15 mins.) of treatment 30+ mins. If a towel is used
90 mins. Is the bodies rewarming period
Four progressive sensationsCold Burning Aching Analgesia
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Types of Cryotherapy Applications
Cryokinetics
Ice Massage Ice Packs
Cryocuffs
Ice Immersion (Whirlpool)Contrast Bath
Commercial Gel and Chemical Packs
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Types of Cryotherapy Applicationscont.Controlled Cold-Compression Units
Vapocoolant sprays
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Cryotherapy
Indications
Acute or chronic pain, or muscle spasm
Acute inflammation
Post surgical pain or edema
Superficial first-degree burns
Facilitate mobilizationRelieve Pain
Decrease Muscle spasiticity
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Cryotherapy Contraindications
Hypersensitivity
Cold Allergy Circulatory or sensory impairment
Reynauds disease
Hypertension
Open wounds Cardiac or respiratory disorders
Nerve palsy
Arthritis
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Thermotherapy
Increases circulation
Increases cellular metabolism
Produces analgesic or sedative effect
Helps resolve pain and muscle spasming
Vasodilatation:
Promotes Healing
Increases Oxygen concentration
Removes debris and waste products
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Thermotherapy
Modes of use
Conduction
Convection
Radiation
Types of Applications
Whirlpools Hot tubs
Jacuzzis
Moist heat packs
Paraffin baths
Ultrasound
Phonophoresis
Diathermy heat
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Ultrasound Indications
Increase deep tissue heat
Decrease inflammation Decrease muscle spasms
Decrease pain
Increase extensibility of
collagen tissue Decrease pain of neuromas
Decrease joint adhesions
Treat myositis ossificans
Contraindications
Hemorrhage
Infection Thrombophlebitis
Suspected malignancy
Impaired circulation or sensation
Stress fracture sites
Epiphyseal growth plates
Over the Eyes, Heart, Spine, or
genitals
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Ultrasound
Thermal effects
Non-thermal effectsApplication of Ultrasound
1MHz 3-5cm of penetration
3MHz superficial tissues and tendonsContinuous- 100%
Pulsed- 10-50%
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Phonophoresis
Ultrasound with drugs, used to increase absorptionand penetration of drugs up to 5 or 6 cms
Anti-inflammatorys
Cortisol
Dexamethasone
SalicylatesAnalgesics
Lidocaine
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Electrotherapy
Decrease pain
Increase blood flow Increase Range of Motion
Increase muscle strength
Muscle re-education Facilitate absorption of medicines
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Electricity
Flows between two points
DC- Direct-current
Continuous one directional flow
Used for pain modulation or muscular contraction alsoproduce ion movement
AC- Alternating-currentContinuous two directional flow of ions
Used for pain modulation or muscular contraction
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Electrotherapy
Amplitude
Frequency
Pulse duration
Pulse charge
Electrode set-up
Polarity
Mode
Duty cycle
Duration of Treatment
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Electrotherapy
TENS (transcutaneous
Electrical Nerve
Stimulation)
High-Voltage pulsed
stimulation
NeuromuscularE
lectricalStimulation
Interferential stimulation
Low-Intensity Stimulation
Galvanic Stimulation
Russian current
Faradic current
Iontophoresis
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Traction Indications
Herniated disc
Spinal nerve impingement Spinal nerve inflammation
Joint hypo-mobility
Narrowing of intervertebral
foramen
Degenerative joint disease
Spondylolisthesis
Muscle spasm and guarding
Joint pain
Contraindications
Unstable vertebrae
Acute lumbage
Gross emphysema
S4 nerve root signs
Temperomandibular joint
dysfunction
Patient discomfort
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Drugs
Anti-inflammatory (NSAIDS)
Anti-pyreticAnalgesics