Chapter 6 Therapeutic Modalities

8/7/2019 Chapter 6 Therapeutic Modalities

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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

Documents

Chapter 6 Therapeutic Modalities