Transcript More Modalities B

Ultrasound
Ultrasound-therapeutic deep heating that uses
high frequency sound waves; also called
ultrasonic diathermy.
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High frequency sound
wave(1-3 MHz)
Affects tissue up to 5 cm
Ultrasound
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The sound wave is absorbed by high protein
tissues such as tendons, ligaments, joint
capsules and muscle.
A huge amount is absorbed by bone
Sound waves travel in a similar manner to
waves created by a stone thrown in water.
Ultrasound
Ultrasound can be done as a continuous mode
or a pulsed mode.
 Pulsed mode- nonthermal effects that will
accelerate the healing process, help break up
chronic inflammation.
 Continuous mode- thermal effects that will
increase scar mobility, and tissue
extensibility, reduce muscle spasm, increase
blood flow, and modulate pain.
Ultrasound
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1 Mega Hertz is used for Deep penetration
(5cm)
3 Megahertz is used for Superficial
penetration (2 cm)
Different types of coupling medium
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Gel/lotion
Water
Water balloon
Ultrasound
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Contraindications
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Areas of impaired pain, temp sensation,
circulation
Epiphysis areas of children
Reproductive organs
Eyes, heart, spinal cord
Prostheses
Malignancies
Ultrasound
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No more than 14 treatments in a row, then a
minimum of a 2 week break.
Can be combined with electric stimulation for
increase edema control.
Sound wave is created by the vibrating
synthetic crystal housed in the metal sound
head.
Phonophoresis
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Technique in which ultrasound is used to
drive a topical medication into the tissue.
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Greatest advantage is that it is a safe,
painless way of delivering a medication for
anti-inflammatory purposes.
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Pulsed ultrasound will be used for nonthermal
effects.
Paraffin Bath
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Paraffin provides a superficial heat, with a
depth of therapeutic heating of about 1 cm.
2 methods of application;
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Dip 7-10 times, put in plastic bag, sit for 10 min
Dip 1 time, resubmerge for 10 minutes
Paraffin Bath
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Effects:
 Decrease Pain
 Increase soft tissue
extensibility
 Vasodilation
 Specific heating all
encompassing
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Contraindications
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Lack of normal temp
sensibility
Over tumors
Open wounds
Vaporcoolant spray
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Flori-Methane and ethyl chloride are liquids
sprayed on the skin, as their thermal energy
are absorbed by the body, superficial cooling
results.
The sprays are used to treat trigger points
and to stretch tight musculotendinous tissue.
The spray is used to decrease pain during
the treatment.
Vaporcoolant
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Caution- this is a very
special modality used
for therapuetic cooling.
If sprayed for a too
long a period in one
spot it can cause
frostbite or serious
damage to tissue.
Topical Analgesics
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Type one
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Salicylates- inhibit
enzyme
cyclooxygenase from
producing
prostagladins which
is the messanger in
inflammation. So it
decreases
inflammation.
Topical Analgesics
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Type two
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Counterirritantscreates abnormal
sensation at the skin
level that overrides
pain impulses. This
distracts the central
nervous system by
overriding the pain
signals and
decreasing pain.
Electrical Stimulation
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Various types:
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Interferential/TENS-Pain control
Russian/Biphasic-Strengthening
Russian/Biofeedback-Reeducation
Iontophoresis-edema reduction
High Voltage/Russian- Control Muscle Spasm
Electrical Stimulation
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Interferential- crossing of two channels to
create a four petaled flower pattern.
The treatment is not exact, due to
nonhomogeneous body, but generally the
stimulation affects the center point strongest.
IFC is for pain control, swelling control and to
increase mobility.
Electrical Stimulation
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Russian-medium frequency current used for
reeducation, strengthening and to decrease
muscle spasm.
The intensity is high so it is packaged in burst
of 50 bursts/sec to make it comfortable.
It is an intermittent current, this on/off time
varies according to treatment purpose.
Electrical Stimulation
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Russian-Most often used during
rehabilitation. The intensity is set to just
below intolerable. The patient contracts the
muscle as the machine is on, and relaxes
when it goes off.
Electrical Stimulation
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Biofeedback-using electronic instruments to
measure and give feedback information via
auditory or visual signal to help develop
voluntary control of a muscle.
EMG or Measuring Electric Activity measures
the muscles contraction, not the activity.
Can be combined with Russian
On/off time is similar to Russian, 10/10 is my
favorite. Treatment time is from 5-15 minutes
Electric Stimulation
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Iontophoresis-therapeutic technique that
involves the introduction of ions into the body
tissues by means of a direct electrical current
typically used for edema control.
Continuous direct current needed, a specific
iontophoresis machine. The negative
eletrode will push in positive ions, ect.
10 minutes, 3-7 treatments
Traction
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Various Types
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Mechanical
Manual
Self
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Indications
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Elongation of muscle,
ligament and capsular
tissue
Separation of spinal
segments
Reduce intradiscal
pressure
Traction
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Contraindications
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Spinal infection
Rheumatoid arthritis
Osteoporosis
Spinal hypermobility
Acute-stage injury
pregnancy
Massage
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Oldest form of manual therapy for injury.
Involves applying mechanical force to various
tissues, usually with hands.
Too many varieties of massage to mention.
Massage
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Effects
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Increase in afferent neural input
Increase in venous outflow
Increase in lymph outflow
Decrease in pain
Decrease soft tissue swelling and congestion
Remodeling of collagen