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Therapeutic Modalities copy 2.pptx.......
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- 3. TYPES OF THERAPEUTICMODALITIES • Thermal • Electromagnetic • Electric • Magnetic • Mechanical
- 4. Thermal Modalities: Coldand Heat
- 5. How we canuse cold therapy application?
- 6. How we canuse heat for physical therapy?
- 7. Normal Stages, Phases,and Events of Inflammation and Repair • I Inflammatory • II Proliferative • III Maturation
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- 13. BIOPHYSICAL EFFECTS OF TEMPERATUREELEVATION • 1. Extent of the temperature increase • 2. Rate at which energy is being added to the tissue • 3. Volume of tissue exposed • 4. Composition of the absorbing tissue • 5. Capacity of the tissue to dissipate heat (largely a factor of blood supply)
- 14. CLINICAL APPLICATION: PRINCIPLES ANDINDICATIONS
- 17. CHARACTERISTICS OF THE ULTRASOUNDWAVE AND TREATMENT PARAMETERS • Frequency (1 MHz vs 3 MHz) • Intensity(1,5watts/cm2 vs 3 watts/cm2) • Mode(continuous vs pulsed )
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- 19. Common Uses ofTherapeutic Ultrasound • Soft tissue inflammation • Tissue extensibility • Scar tissue remodeling • Tissue healing • Pain • Soft tissue swelling • Meeting patient expectations • Placebo effect
- 20. NONTHERMAL EFFECTS OFUS • cavitation • acoustic streaming
- 21. Phonophoresis • The effectsof US to enhance the entry through skin of a topical agent has been attributed to both physical “pushing” of the agent through the skin and to an in- crease in the permeability of the dermal layer
- 22. CONTRAINDICATIONS AND PRECAUTIONS • Pregnancy •Active bone growth at the epiphysis • Cancer • Tuberculosis infection • Hemorrhagic conditions • Impaired circulation • Myositis ossificans • Deep vein thrombosis or thrombophlebitis • Acute injury • Recently irradiated tissue • Impaired sensation • Impaired cognition or communication • Skin disease • Reproductive organs • Eyes • Anterior neck—particularly over the carotid arteries, carotid sinus, and vagus and phrenic nerves
- 24. EXTRACORPOREAL SHOCK WAVE THERAPY •Chronic plantar fasciitis • Calcific tendonitis of the rotator cuff in the shoulDer although disintegration of calcium deposits may not correlate with improvements in pain and function • Lateral epicondylitis (“tennis elbow”) • Achilles tendinopathy • Chronic foot ulcers, either diabetic or nondiabetic • Osteoarthritis of the knees
- 25. contraindications • Bleeding conditions •Pacemakers • Medications that prolong blood clotting • Children • Pregnancy • Acute injuries
- 27. ELECTROMAGNETIC WAVES • quantumenergy • Frequency • wavelength
- 28. Waves of energycan be: • reflected, • Deflected and • absorbed by the media through which they travel.
- 29. LIGHT THERAPY • ultraviolet(UV) light • light-emitting diode (LED) • supraluminous light-emitting diode (SLED) • laser
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- 31. • 320 to400 (UVA) • 290 to 320 (UVB) • less than 290 nm (UVC)
- 32. Effects of Ultraviolet Radiation •Erythema Production UVB and UVA • Tanning • Epidermal Hyperplasia • Vitamin D Synthesis • Bactericidal Effects UVC • Wound Healing UVC
- 33. • UVB radiationaffects the immune system, reducing contact sensitivity, changing the distribution of circulating lymphocytes, and suppressing mast cell– mediated healing • psoralen with UVA (PUVA) • vitiligo UVB (PUVA)
- 34. Contraindications for Ultraviolet Radiation •• Irradiation of the eyes • • Skin cancer • • Pulmonary tuberculosis • • Cardiac, kidney, or liver disease • • Systemic lupus erythematosus • • Fever
- 35. ALSO: • Irradiation ofthe Eyes • Certain Systemic Conditions • Photosensitizing Medications and Dietary • Supplements • Photosensitivity • Recent X-Ray Therapy • Erythema From Prior Ultraviolet Dose
- 36. Physical Properties ofLasers • HeNe lasers • gallium and arsenide (GaAs lasers) • carbon dioxide (Co2 lasers) • Neodymium • Yttrium • aluminum • garnet (Nd-YAG lasers)
- 38. Physiological Effects ofLasers • Tissue Repair • Control of inflammation • Pain management
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- 40. Indications for theUse of Lasers • Fibromyalgia and Myofascial Pain Syndrome • Painful Conditions of the Spine • Temporomandibular Dysfunction and Pain • Shoulder Pain and Dysfunction • Lateral Humeral Epicondylitis • Carpal Tunnel Syndrome • Degenerative Joint Disease • Achilles Tendonitis
- 41. Contraindications and Precautionsfor Lasers • Impaired sensation • Indirect eye exposure • Direct eye exposure • Pregnancy • Active malignancy • Active hemorrhage • Open growth plates • Endocrine system
- 42. DIATHERMY • shortwave diathermy(SWD) • microwave diathermy (MWD) • pulsed electromagnetic fields (PEMF) or pulsed radio frequency energy
- 43. Therapeutic Diathermy Devices: Deliveryof Electromagnetic Waves to the Patient
- 44. • Capacitive Method •Inductive Method
- 45. Dosages for DiathermyTreatments
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- 47. Precautions for Diathermy •Small pieces of metal or metal fixation devices (screws, plates, rods) • imbedded in the body Intrauterine contraceptive devices with copper Decreased sensation • Impaired circulation • Over growing epiphyses in children • Obese patients • Use of diathermy near other medical electrical devices, especially near patients who have electrodes attached to their skin Over the low back or pelvis in women who are menstruating • Atrophic, infected, or damaged skin
- 48. Contraindications for Diathermy •Any metallic object on the patient or within the electromagnetic field • Any metals imbedded in the body • Metal loops imbedded in the body • Cancerous tissues • Hemorrhage or increased tendency of hemorrhage • Cardiac pacemakers, implanted stimulators, including any device with lead wires attached or unattached • Acute injury or inflammation • Pregnancy • Joints or organs containing high levels of fluid, including the eyes or testes • Synthetic materials such as clothing, pillows, and bed coverings
- 49. Contraindications for Diathermy •Head, face, or TMJ for patients wearing contact lenses • Unconscious patients or patients who are mentally confused • Over moist clothes, dressings, or accumulations of perspiration on the skin • Loss of sensation in area of body to be treated Patients with severe circulatory impairment (peripheral vascular disease, etc.)
- 50. PRINCIPLES OF ELECTRICITY •Charge • Polarity and Creation of Electric Force Fields(cathode and anode) • Conductors and Insulators • Current • Ohm’s Law: Resistance, Capacitance, and Impedance
- 51. Current flows betweenelectrodes by passing through biological tissues
- 52. Charge • 1. Thereare two types of charge— positive and negative. • 2. Like charges repel while opposites attract. • 3. Charge is neither created nor destroyed. • 4. Charge can be transferred from one object to another
- 53. Polarity and Creationof Electric Force Fields(cathode and anode)
- 54. Current ( I) • The international unit for current is the ampere (amp or A/mA)
- 55. Conductors and Insulators •Materials in which ions or electrons move freely are termed conductors • Materials in which charged particles are not free to move or do not move easily are termed insulators
- 56. Ohm’s Law: Resistance, Capacitance,and Impedance (I = V/R) Resistance to Current Flow ■ Skin ■ Hair ■ Fascia ■ Ligament ■ Callus ■ Fat ■ Bone ■ Tendon ■ Scar
- 57. CURRENTS AND WAVEFORMS •direct current (DC) • alternating current (AC) • pulsed current, or pulsatile current
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- 61. Classification of waveformsand key parameters.
- 62. PHYSIOLOGICAL RESPONSE TO ELECTRICALCURRENT • Electrochemical Effects (anode attracts acid and cathode attracts base) • Electrothermal Effects • Electrophysical Effects
- 63. Levels of Responseto Electrical Stimulation • sensory • Motor • noxious
- 64. IONTOPHORESIS • Physiology ofIontophoresis • electromigration • Electroporation • electroosmosis • ionohydrokinesis
- 65. Electrotherapy for Activationof Skeletal Muscle • Strengthening: Neuromuscular and muscular Electrical Stimulation • Reeducation and Retraining: Functional Electrical Stimulation
- 66. Electrotherapy for painmodulation
- 67. Physical medicine andrehabilitation board review Sara J. Cuccurullo Third edition. PG. 621-639