Transcript Modalities are Fun!

Modalities are Fun!
Sports Med 2
Therapeutic Modalities Guided notes
Cryokinetics.
• Modality: a physical technique or substance
administered to produce a therapeutic or pain
free affect.
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Legal concerns
Understand use of specific modalities
Accurate evaluation of injury
Avoid “shotgun” approach
Adhere to the law
Cryotherapy
• most common forms are; ice massages, cold
immersion, and ice packs.
• Physiological effects of cryotherapy:
• Muscle spasm
• pain reception
• blood flow up to 10-15 minutes
• metabolic rate
• joint stiffness
Therapeutic effects of cryotherapy:
• pain
• or prevent swelling
• inflammation
• Minimized secondary tissue damage.
Skin response to cryotherapy:
Stage 1
• Cold
Sensation
• 0 – 3 min
Stage 2
• Mild
burning,
aching
• 2-7 min
Stage 3
• Anesthesia
• 5-12 min
4. Adverse Conditions to Cryotherapy
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hypothermia
frostbite
cold allergies
Raynauds phenomenon
Contraindications for Cryotherapy
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lack of normal temperature sensibility
cold hypersensitivity
Raynaud’s disease
Coronary artery disease
Methods p 445…
http://youtu.be/9hQsymsi5xU
http://youtu.be/ucFQbSbKNJY
Ice massage
Equipment
Indications
Application
Considerations
Ice Immersion,
CWP
Ice Pack
Cryokinetics
• Numb the part to pain free
– Work toward regaining ROM
– 3-7 min.
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Ice until numb
Exercise 3-7 min.
Ice 3-5 min
Repeat 5 times
Thermotherapy is Hot
• Thermotherapy: application of heat to treat
injuries. Heat energy increases activity by
conduction, convection, and radiation.
• Modes are moist, dry, superficial and deep.
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Physiological Effects of thermotherapy:
muscle spasm
pain perception
blood flow
metabolic rate
collagen elasticity
joint stiffness
• Therapeutic effects of thermotherapy
• pain
• soft tissue extensibility
• Adverse Conditions to thermotherapy
• burns
• open wounds
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Contraindications of thermotherapy
loss of sensations
immediately after injury
impaired circulation
directly to eyes
during acute inflammation
Methods
Moist Heat Pack
Warm Whirlpool
Equipment
Hydrocullator packs, 160
degrees. Retain heat for
about 20-30min. Terry cloth
or towel
98-110 degressF. Heat 10 -20
min
Indication
Warms and relax, reduction
for spasm. Superficial only
convection, reduce swelling,
spasms, and pain.
Applications
Remove pack from water,
cover, treat
Fill tank, put extremity in
and heat
Considerations
Never! Let athlete sit or lay
on heat pack…burns
Light headedness, electrical
outlets, cleanliness
Therapeutic Modalities
Electrical stimulation
(electrotherapy)
• Electrotherapy: implies a flow of electrons between two
points.
• Electricity is a form of energy that displays magnetic,
chemical, mechanical, and thermal effects on tissue.
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Ampere: volume or amount
Ohm: resistance
Voltage: force
Watt: power.
• Electrical Stimulating Units: generate 3 different types of
currents, which produce specific physiological tissue
changes. AC, DC, and pulsed. All 3 send currents through
the body. Their purpose is to trigger the peripheral nerves
to stop pain.
Examples of Electric generators
• TENS: transcutaneous nerve stimulators
• NMES: neuromuscular electrical stimulators
• EMS: electrical muscle stimulator
• MENS: micro-current electrical nerve
stimulators
• Every nerve has an excitability threshold. This
is what we get to play with, with the electrical
stem. There are 3 types of nerve fibers:
sensory, motor, pain. It is possible to produce
different physiologic response by adjusting the
treatment parameters.
Definition
uses
DC
(Majority)
Flows in one direction from Muscle contraction,
positive to negative poles
movement
AC
Current flow reverses once
during each cycle
Pain control, muscle
contraction
Pulsed
3 or more pulses,
interrupted for short
periods of time
Pain control, muscle
rehab.
Waveforms: represents electrical current.
DC
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Waveforms: represents electrical current.
AC
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Waveforms: represents electrical current.
Pulsed
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Electrode Set up
• Electrode Setup:
• Pads: directly to skin, up to 4 in. Set up in an
“X” pattern with the desired stimulation area
in the center of the “X”.
Physiological effects of Electrical Stem.
• depolarization of peripheral nerves
Therapeutic effects of Electrical Stem.
• stop pain
Contraindication of electrical Stem.
• pregnancy
• electrical pace devices
• cardiac arrhythmia
Electrical Stimulation
Equipment
- Electrotherapy generator
-Water
-Pads
-Towel
Indication
-Pain perception
-Muscle contraction
-Strengthening
-Stop atrophy
-Muscle re-education
Application
-Spray pads with water
-Place pads securely
-Turn on machine
-Set parameters
-Have them tell you when they feel something
-Press start
Considerations
-Same as contraindications
Therapeutic
Modalities
Ultrasound
• Ultrasound: is an inaudible, acoustic sound
wave modality used in sport medicine for the
purpose of elevating tissue temperature,
repairing soft tissues, and relieving pain.
• Ultrasound can be used for thermal or nonthermal effects on soft tissue.
Physiological Effects of Ultrasound:
• Thermal:
• elevated tissue temperature
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blood flow
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tissue extensibility
• local metabolism
Non-thermal:
• cavitation
• fluid movement
• cellular permeability
Therapeutic Effects of Ultrasound:
• collagen tissues extensibility
• joint stiffness
• muscle spasm
• blood flow
Equipment descriptions
• generator: main piece of equipment for
delivering therapeutic ultrasound
• applicator/ultrasound head: has crystals the
rebound the acoustic waves.
• Piezoelectric effect: causes expansion and
contraction of the crystals
• Effective radiating area: the part where the
transducer produces sound waves.
• Ultrasound has a frequency range from 1 MHz
– 3.3 MHz.
• 1 MHZ: better if there is a layer of fat, or you
need to get to deeper tissue.
• 3MHz: better for superficial thermal/nonthermal effects
Ultrasound can be continuous or pulsed
Continuous
Pulsed
-Energy remains
constant 100% of the
time
-Thermal effects
-Energy is interrupted
-Non-thermal effects
Method
Equipment
Indications
Applications
Considerations
Ultrasound machine, coupling agent/method:
gel, water
Soft tissue injury: sprain, strain, contusion.
Decrease pain, increase blood flow for repair
-Put coupling agent on US head
-Continuous movement of sound head
-Use firm, steady overlapping motion
-2-8 min
-Not over large areas
-Impaired circulation
-Eyes
-Spinal cord
-Not over reproductive organs