Therapeutic Modalities Ch1-3

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  1. Forms of energy
    • Electromagnetic
    • Acoustic
    • Thermal
    • Mechanical
  2. Spectrum of light low->high
    • Infrared
    • Red
    • Orange
    • Yellow
    • Green
    • Blue
    • Violet
    • Ultraviolet
  3. Relationship between wavelength and penetration
    longer wavelength=greater penetration
  4. Electromagnetic radiation can be:
    • Reflected
    • Refracted
    • Transmitted
    • Absorbed
  5. Arndt-Shultz Principle
    No Changes or reactions can occur in the tissues unless the amount of energy absorbed is sufficient to stimulate the absorbing tissues
  6. Law of Grotthus-Draper
    • If the energy is not absorbed, it must be transmitted to the deeper tissues
    • The greater the amount absorbed, the less transmitted and thus the less penetration
  7. Cosine Law
    The smaller the angle between the propagating radiation and the right angle, the less radiation reflected and the greater absorption
  8. Inverse Square Law
    the intensity of the radiation striking a surface varies inversely with the square of the distance from the source
  9. Electromagnetic Energy Modalities
    • Shortwave and Microwave Diathermy
    • Low-power LASERS
    • ultraviolet light
    • thermal infrared (thermotherapy and cryotherapy)
  10. Diathermy
    • High frequency electromagnetic energy
    • cannot depolarize nerve or muscle
    • Used primarily to generate heat in the tissues
    • short wave diathermy can also be used to produce non-thermal effects
  11. Low-power LASER
    • (Light Amplification by Stimulated Emission of Radiation)
    • produces no thermal effects
    • significant clinical effects on soft tissue and fracture healing
    • also effective for pain management
  12. Ultraviolet Therapy
    • Causes mainly physiologic effects that are chemical in nature
    • Effects occur entirely in cutaneous layers of the skin
  13. Electrical Stimulating currents
    • Can be used to:
    • Modulate pain through stimulation of cutaneous nerve fibers
    • Produce muscle contraction and relaxation
    • Facilitate soft-tissues and bone healing through micro-current low intensity stimulators
    • Produce net ion movement
  14. Extracorpoal Shock Wave Therapy
    • Relies on pulsed high-pressure short duration sound waves concentrated in a small focal area
    • Used to treat soft-tissue and bone injuries (plantar fasciitis, epicondylitis, non-union fractures)
  15. Mechanical Energy Modalities
    • Intermittent compression
    • Traction
    • Massage
  16. Macrotraumatic Injuries
    • Result of trauma, produce immediate pain and disability
    • Include fractures, dislocations, subluxations, sprains, strains and contusions
  17. Microtraumatic injuries
    • Often called overuse injuries- result of repetitive loading or incorrect mechanics
    • Tendinitis, tenosynovitis, bursitis
  18. Primary injuries
    • Occur from either trauma or overuse
    • Acute- trauma
    • Chronic- overuse
  19. Secondary Injury
    Inflammatory or hypoxia resulting from primary injury
  20. Phases of the healing process
    • Inflammatory-Response Phase
    • Fibroblastic-Repair Phase
    • Maturation- Remodeling Phase
  21. Signs of Inflammation
    • Redness
    • Swelling
    • Tenderness to touch
    • Increased Temperature
    • Loss of Function
  22. Inflammatory-Response phase
    • symptoms include swelling, pain, warmth, and crepitus
    • Lasts 2-4 days after initial injury
  23. Cellular response during Inflammatory-Response Phase
    • Process during which leukocytes, phagocytic cells are delivered to injured tissues
    • Chemical mediators:
    • Histamine --> vasodilation and increased cell permeability
    • Leucotaxin-> margination and increased cell permeability which leads to formation of exudate
    • Necrosin-> turns on phagocytes
  24. Chronic Inflammation
    • Occurs when acute response does not eliminate injuring agent
    • Low concentration of chemical mediators
    • Production of granulation tissues and fibrous connective tissue
    • Specific mechanism causes insufficient acute inflammatory response
  25. Fibroblastic-Repair Phase
    Proliferate, regenerative activity leading to a period of scar formation and repair of injured tissue
  26. Maturation-Remodeling Phase
    • Realignment of collagen fibers along lines of tensile force
    • Ongoing breakdown/synthesis of collagen
    • Increase in tensile strength of scar matrix
    • At 3-weeks a contracted, non-vascular scar exists
    • May require several years to complete
  27. Factors that may impede healing
    • Extent of injury
    • Edema
    • Hemorrhage
    • Poor vascular supply
    • Separation of tissues
    • Muscle spasm
    • Atrophy
    • Corticosteroids
    • Keloids and hypertrophic scars
    • Infection
    • Humidity/climate
    • Age, health, nutrition
  28. Goal for using therapeutic modalities
    • Assist the natural healing processes of the body while doing no harm
    • Modalities should serve as an adjunct to rehabilitative exercise
  29. Types of pain
    • Acute
    • Chronic
    • Persistent
    • Referred
    • Radiating
    • Sclerotomic (pain associated with a segment of bone innervated by a spinal segment that is a deep somatic pain)
  30. Types of pain assessment tools
    • Visual Analogue Scales
    • Pain Charts
    • McGill Pain Questionnaire
    • Activity Pain Indicators Profile
    • Numeric Pain Scales
  31. Accommodation
    • Decline in generator potential and reduction of frequency that occurs with prolonged or repetitive stimulus
    • Process by which receptors adapt to stimulus and reduce impulses
  32. Afferent Nerves
    transmit impulses from the sensory receptors towards the brain
  33. Efferent Nerves
    transmit impulses from the brain toward the periphery
  34. First order Neurons
    • Primary afferents
    • transmit impulses from the sensory receptor to the dorsal horn of the spinal cord
    • 4 types: A(alpha), A(beta), A(gamma), C
    • A (alpha) and A(beta) are characterized as being large in diameter afferents and A(gamma) and C fibers are small diameter afferents
  35. Second order neurons
    • carry sensory messages up the spinal cord to the brain
    • categorized as wide dynamic range or nociceptive specific
  36. Compounds which are not true neurotransmitters but can facilitate or inhibit synaptic activity
    • Serotonin
    • Norepinephrine
    • Substance P
    • Enkephalins
    • beta-endorphin
  37. 3 Mechanisms of Pain Control
    • Gate control theory
    • Descending mechanisms (Central biasing)
    • Release of endogenous opioids (beta-endorphin)
Card Set:
Therapeutic Modalities Ch1-3
2013-01-28 17:14:30
therapeutic modalities

ch 1-3
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