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705 - Exam #1
Terms in this set (93)
Cryotherapy impacts the circulatory, neuromuscular and metabolic systems. What effect does it have on each of these?
Hemodynamic - vasoconstriction, decreased blood flow
Neuromuscular - decreased nerve conduction, increased pain threshold
Metabolic - decreased metabolic rate
What are indications for the use of cryotherapy?
Explain cryokinetics & cryostretch.
Cryokinetics - after applying ice to the point of numbness, progressive stretching and strengthening exercises are done until sensation returns (repeat ice + exercise 5x)
Cryostretch - after applying ice to reduce muscle spasm, gentle stretching can be done
What are contraindication for cryotherapy?
In what situations can you use cryotherapy but should do so with caution?
Poor sensation or mentation
Very young or very old
Cold packs should be applied for how many minutes and will penetrate how deep?
When is ice massage preferred over cold packs?
For application to smaller areas
Controlled cold compression units should be set to what temperature range?
Define the following terms:
Conduction - heat is transferred through contact
Convection - heat is transferred through movement of a substance
Conversion - mechanical energy is converted to heat
Radiation - direct transfer of energy
Thermotherapy impacts the circulatory, neuromuscular and metabolic systems. What effect does it have on each of these?
Hemodynamic - vasodilation
Neuromuscular - increased nerve conduction increased pain threshold, temporary reduction in muscle strength
Metabolic - increased metabolic rate
Explain the gate control theory.
When applying heat or ice to a treatment area, thermoreceptors fire more quickly than pain receptors and reach the spinal cord first. Your brain detects the temperature change but not the pain sensation.
What are the contraindication for thermotherapy?
Impaired sensation or mentation
In what situations can thermotherapy be used but you should proceed with caution?
Poor thermal regulation
Metal in the area
How many layers need to be between the patient and a hot pack?
How many layers of wax need to be applied to the treatment area when doing a paraffin bath?
What substances are circulated through a fluidotherapy machine?
Corn cob particles
How long do contrast baths need to be done in order to cause fluctuations in blood flow?
True or False: US is able to heat deeper tissues than hot packs
True or False: There is a lot of evidence to support the use of US
US transfers heat through conversion. Explain this process.
Piezoelectric crystals (found inside bone) emit high frequency soundwaves which interact with the US to convert mechanical energy into electric energy which generates heat
True or False: The size of the US sound head has no impact on depth of tissue reached
True - the size of the sound head only varies to accommodate the size of the treatment area
Explain why the US head has to be moved around in order to prevent overheating/burning.
The amount of soundwaves emitted from the piezoelectric crystals is uneven which causes uneven amounts of heat to be produced
How do you calculate the intensity for an US treatment?
power (W) / ERA (cm^2)
What is the correlation between intensity and surface area?
As intensity gets larger, surface area gets smaller
True or False: Higher frequencies penetrate to deeper tissue
False - as frequency increases, depth decreases
List the effects of non-thermal US
Increased intracellular Ca
Increased cell function & tissue healing
Increased histamine release (increased cell permeability & inflammatory response)
List the contraindications for US
Abdomen/low back when pregnant
Growth plate in children
Cement or plastic joint replacements
In what situations are you able to use US but should proceed with caution?
What is phonophoresis?
The use of US to enhance medication delivery
How does phonophoresis work?
Because US increased cell membrane permeability, it can allow topical medications to penetrate into cells more rapidly
What are the 3 properties of lasers?
Coherent - same phase
Monochromatic - same wavelength
Collimation - in parallel to create a concentrated beam of light
What does laser stand for?
Light Amplification by Stimulated Emissions of Radiation
How do lasers work?
1. Activate electrons
2. Bring electrons to an excited state
3. Photons are emitted
4. Photons strike electrons and stimulate emission
5. Repeated stimulation of electrons = amplification
6. Max capacity is reached then photons are released from a light beam
Do PT's use high power or low power lasers in clinical settings?
Low power only
Which class of laser to PT's use in clinical settings?
Which of the following types of lasers can penetrate the deepest?
What are the physiological effects of treatment with low level laser therapy?
Increased ATP synthesis
Increase collagen synthesis
Increased histamine release
Modulates chemical mediators
List the contraindications to LLLT.
How do you calculate dosage (treatment time) for laser therapy?
Time = (Energy/Power) x Area
True or False: Higher intensity lasers are used for acute conditions
False - they're used for chronic conditions
Describe the following types of pain:
Nociceptive: tissue damage triggers pain receptors
Neuropathic: nerve damage
Central sensitization: neurons fire inappropriately, causing the sensation of pain even when no damage is present (chronic pain)
What is happening in the brain when someone experiences chronic pain?
Pain fibers stimulate too many sections of the brain & too a much larger degree
Pain is felt in inappropriate parts of the body due to over stimulation
Limbic system is overly stimulated
How should modalities (such as US, heat, ice) be used on patients with chronic pain?
In a limited fashion & with correct education (this might make you feel better but it's not correcting your pain)
Which intervention is most important when working with chronic pain patients?
"motion is lotion"
Define the following terms in relationship to aquatic therapy:
Buoyancy: upward force that allows you to float
Hydrostatic pressure: pressure exerted by the water on the body from all directions
Resistance: viscosity of the water
List the benefits of buoyancy during aquatic therapy.
Decreases weight bearing
Decreases compression forces
List the benefits of hydrostatic pressure during aquatic therapy.
Evens tactile input
Improves respiratory muscles
List the benefits of resistance during aquatic therapy.
Improved muscle balance
What is the temperature range for a therapeutic pool?
79-97 (92 is ideal)
What populations benefit from therapeutic pools?
What populations benefit from lower temperature pools?
What major changes occurs in the respiratory system during aquatic therapy?
Vital capacity decreases by 10% when submerged to the neck
True or False: Cardiac volume decreases during aquatic therapy.
False - it increases
True or False: Urine output increases during aquatic therapy.
What are the contraindications to aquatic therapy?
True or False: Aquatic therapy is more efficient than whirlpool
Whirlpool treatment is indicated for what conditions?
Why are therapeutic pools good for patients with asthma?
The high humidity (50%) makes it easier to breathe
When doing aquatic therapy for patients with cerebral palsy, why should you stay in the middle of the pool?
To avoid injury on the sides of the pool secondary to involuntary movements
Which aquatic therapy techniques are beneficial for patients with fibromyalgia?
What are the physiological effects of effleurage & petrissage?
What are the physiological effects of percussion and knuckling?
List the reflexive effects of massage.
Red flare/streaking on skin - due to vasodilation
Red wheal - due to release of histamine & prostaglandins
Decrease in pain - gate control theory
Increase in lymph flow
What are the indications that massage therapy can be used?
Loss of tissue extensibility
List the contraindications of massage therapy.
Describe the following massage techniques:
Effleurage: long, soft, preparing strokes
Petrissage: kneading, compress & relief movements
Friction: small, circular strokes w/ deep pressure
Tapotement: percussive strokes w/ alternating hands
Swedish: strokes apply pressure toward the heart
Ai chi uses slow movements and deep breathing in order to accomplish what goals?
If your patient suffers from chronic back pain and is post-op from a spinal fusion, what aquatic therapy technique would be best for them?
During which aquatic therapy technique do exercises start passively and progress to more active?
Which aquatic therapy technique can also be done on land?
The burdenko method focuses on what 2 things?
Which 2 aquatic therapy techniques are most commonly used with children?
Cradling one-on-one aquatic therapy technique that promotes relaxation and decreased pain
What is the ideal BNR? What is the max BNR?
The size of the treatment area should be ___ times larger than the ERA. The size of the treatment area should be no more than ___ times larger than the ERA.
What are the most commonly seen soundhead sizes?
Anywhere from 1-10 is possible
Math problem: If the power if 5W, calculate the intensity for the following soundhead sizes.
Why do skin and fat not have a significant temperature increase during US treatment?
High water content
Low protein content
Why do shorter wavelengths not penetrate as deep as longer wavelengths?
Shorter wavelengths require more energy to overcome friction (lose energy sooner = shorter duration/depth)
Math problem: Calculate the duration of US treatment.
I = 1W/cm^2
Temp change = 4 degrees
Rate = 0.3W
Duration = Temp change/Rate
Pulsed US with a 20% duty cycle should be done at what intensities?
Non-thermal US should be done at what intensities?
What should you be cautious of when doing phonophoresis?
Medications become systemic
Gas lasers use which 2 compounds? Diode lasers use which 2 compounds?
Gas - HeNe
Diode - GaAs
At what depth are gas and diode lasers absorbed?
How do you calculate dose for LLLT?
Dose = sum of dose per diode X number of applications
Describe the following classes of lasers:
Class I - cannot emit laser radiation
Class IA - not intended for viewing
Class II - very low power,
Class IIIA - pen lasers
Class IIIB - used by PTs, can damage the retina
Class IV - potential fire/skin hazard, high power
How deep do the following US intensities penetrate?
1MH - 2-5cm
3MH - 1-2cm
What needs to be documented when doing a modality like heat or ice?
Frequency (x per week)
What needs to be documented when doing a modality like US?
Pulsed vs Continuous
Sound head size
Treatments per week
What are the mechanical effects of soft tissue massage?
Decrease metabolic acids
Decrease scar tissue
How does massage therapy help reduce pulmonary congestion?
Vibrations loosen mucous plugs when combined with postural drainage
True or False: Work of breathing increases during aquatic therapy when submerged to the neck.
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