Physical Therapy Modalities – Flashcards
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Thermotherapy Uses
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-Pain control -Increase joint ROM -Decrease joint stiffness -Accelerated healing -Infrared radiation for psoriasis
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Thermotherapy Contraindications
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-Hemorrhage -Thrombophlebitis -Impaired sensation/mentation -Malignancy -IR radiation of eyes
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Thermotherapy Precautions
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-Acute Injury/inflammation -Pregnancy -Impaired circulation -Poor thermal regulation -Edema -Cardiac insufficiency -Metal in area -Open wounds -Over topical counterirritants -Demyelinated nerves
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Hot Pack Parameters
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-10-15 min -6-8 layers of padding
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Paraffin Parameters
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-5-10 min (dip wrap method) -6-10 layers of wax
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Cryotherapy Uses
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-Inflammation Control -Edema Control -Pain Control -Spasticity of Muscles -Facilitation -Cyrokinetics/Cryostretch -MS symptom management
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Cryotherapy Contraindications
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-Cold hypersensitivity -Cold intolerance -Cryoglobulinemia -Paroxysmal cold hemoglobinuria -Reynaud's Phenomenon -Regenerating nerves -Area of circulatory compromise
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Cryotherapy Precautions
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-Superficial main branch of nerve -Open wound -Hypertension -Poor sensation/mentation -Very young/very old
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Cryotherapy Parameters
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-Quick Ice= 3-5 sec -Ice Massage= 5-10 minutes -Cold Pack= 10-20 minutes (spasticity= 30 minutes)
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Ultrasound Uses
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-Soft tissue shortening -Pain control -Dermal ulcers -Surgical skin incisions -Tendon & ligament injuries -Bone fractures -Carpal tunnel syndrome -Phonophoresis
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Ultrasound Contraindications
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-Malignancy (thermal) -Pregnancy -CNS tissue -Joint cement -Plastic components -Pacemaker -Thrombophlebitis -Eyes -Reproductive organs
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Ultrasound Precautions
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-Acute inflammation -Epiphyseal plates -Fractures -Breast implants
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Ultrasound Parameters
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5-10 minutes (at least 8 minutes for Medicare billing)
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Diathermy Uses
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Thermal: -Pain control -Accelerated tissue healing -Decrease joint stiffness -Increase joint ROM Non-Thermal: -Pain & edema control -Soft tissue, nerve, bone healing -Improved osteoarthritis symptoms
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Diathermy Contraindications
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-Implanted or transcutaneous stimulators (pacemakers) -Pregnancy Thermal: -Metal -Malignancy -Eyes -Testes -Growing epiphyses Non-Thermal: -Deep tissue/internal organs -Substitute for conventional therapy for edema & pain
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Diathermy Precautions
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-Near electronic or magnetic equipment -Obesity -Copper bearing IUD Non-Thermal: -Pregnancy -Skeletal immaturity
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Electrical Stimulation Uses
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-Improve strength/function -Improve motor control -CNS damage patients -Spinal cord injury -Stroke -Muscle contractions for correcting biomechanics -Reduce spasticity
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Electrical Stimulation Contraindications
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-Demand cardiac pacemaker -Unstable arrhythmia -Over carotid sinus -Over venous/ arteriothrombosis (Thrombophlebitis) -Pregnancy
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Electrical Stimulation Precautions
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-Cardiac disease -Impaired sensation or mentation -Malignancy -Skin irritation/open wound
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Laser Uses
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-Soft tissue and bone healing -Arthritis -Lymphedema -Neurological conditions -Pain Management
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Laser Contraindications
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-Direct radiation of eyes -Malignancy -4-6 months after radiotherapy -Hemorrhage -Thyroid or other endocrine glands
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Laser Precautions
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-Low back or abdomen during pregnancy -Epiphyseal plates in children -Impaired sensation/mentation -Photophobia/light sensitivity -Pretreatment w/ photosensitizer
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Mechanical Traction Uses
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- Joint distractions - Reduction of disc protrusions -Soft tissue injuries -Muscle relaxation -Joint mobilizations
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Mechanical Traction Contraindications
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-Where motion is contraindicated -Acute injury/inflammation -Joint hypermobility or instability -Peripheralization of symptoms with traction -Uncontrolled hypertension
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Mechanical Traction Precautions
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-Structural diseases or conditions affecting the spine -When pressure belts may be hazardous -Displaced annular fragments -Medical disc protrusion -When severe pain fully resolves with traction -Claustrophobia or other psychological aversion to traction -Inability to tolerate the prone or supine position -Disorientation Cervical Traction: -TMJ problems -Dentures
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Mechanical Traction Parameters (Lumbar)
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-Hold: 40% BW -Off Time: 20% BW -10 minutes
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Mechanical Traction Parameters (Cervical)
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-Hold: 12 lbs. -Off Time: 6 lbs. -15 minutes
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Compression Bandage Uses
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-Improve venous circulation -Improve rate of healing of venous stasis ulcers -Help prevent DVT -Increases extravascular (external) hydrostatic pressure -Residual limb shaping after amputation -Control hypertrophic scarring -Increase tissue temperature
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Compression Bandage Contraindications
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- Heart failure or pulmonary edema - DVT, Thrombophlebitis, or pulmonary embolism -Obstructed lymphatic or venous return -Severe peripheral arterial disease or ulcers from arterial insufficiency -Acute local skin infection -Significant hypoproteinemia -Acute traumatic or fracture -Arterial revascularization
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Compression Bandage Precautions
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-Impaired sensation/mentation -Uncontrolled hypertension -Cancer -Stroke/significant cerebrovascular insufficiency -Superficial peripheral nerves
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Types of Compression Bandages
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-Compression bandages (single and multiple layers) -Compression garments -Velcro closure compression devices -Intermittent pneumatic compression pump
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Hydrotherapy Uses
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-Superficial heating/cooling -Water exercise -Pain control -Edema control -Wound care
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Hydrotherapy Contraindications - Local Immersion
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-Maceration around wound -Bleeding
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Hydrotherapy Contraindications - Full Body
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-Cardiac instability -Infectious conditions that may spread by water - Bowel/Incontinence -Severe epilepsy -Suicidality
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Hydrotherapy Contraindications - Negative Pressure Wound
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-Necrotic tissue -Untreated osteomyelitis -Malignancy in wound -Untreated malnutrition -Exposed vessels, nerves, organs -Nonenteric /unexplained fistulas -Exposed anastomotic sites
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Hydrotherapy Precautions - Local Immersion
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-Impaired thermal sensation in immersed area -Infection in immersed area -Confusion/impaired cognition -Recent skin grafts
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Hydrotherapy Precautions - Full Body (Very Warm/Hot Water)
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-Pregnancy -Multiple sclerosis -Poor thermal regulation
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Hydrotherapy Precautions - Full Body (Any Temp)
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-Confusion/disorientation -Alcohol ingestion -Limited strength, endurance, balance, ROM -Medications -Urinary incontinence -Fear of water -Respiratory problems
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Hydrotherapy Precautions - Nonimmersion
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-Maceration -May be ineffective
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Hydrotherapy Precautions - Negative Pressure Wound Healing
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-Anticoagulant therapy -Difficult hemostasis -Confusion, disorientation
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Hydrotherapy Effects - Cleansing
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-Softens materials -Exerts pressure -Debriding agent
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Hydrotherapy Effects - Musculoskeletal
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-Decrease weight bearing -Resistance for strengthening -Hydrostatic pressure increases resting muscle blood flow
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Hydrotherapy Effects - Cardiovascular
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-Enhanced venous return -Central blood volume increases -Cardiac volume increases -Less HR response to exercise
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Hydrotherapy Effects - Respiratory
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-Increased chest wall compression -Increased circulation in chest cavity -Humidity reduces exercise-induced asthma
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Hydrotherapy Effects - Renal
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-Increased urine production -Increased renal blood flow -Increased central blood volume -Decreased ADH and Aldosterone
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Hydrotherapy Effects - Psychological
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-Relaxing/Invigorating
