Professional Documents
Culture Documents
part 1
Introduction
Modality the application of a form of energy to the body that elicits an involuntary response Therapeutic having healing properties
Result inflammatory mediator, hemorraghe, and edema Wound healing phases inflamatory phase, proliferation phase, and maturation phase
Chronic Pain
Nociceptive chronic pain continual activates nociceptors ex: arthritis Neuropathic chronic pain abnormality neuron of the pain system Characteristics : last longer than 6 months, difficulty in sleeping, depression, etc.
Thermal Modalities
Skin thermoreceptors high responsive to heat and cold Mechanisme :
Conduction : e.g ice pack, moist heat pack Convection : e.g warm or cold whirlpol Radiation : e.g infrared lamp Evaporation : e.g vapocoolant spray Conversion : e.g short wave diathermy, ultrasound
Thermal Modalities
Systemic Effect
Increased body temperature Increased pulse rate Increased respiratory rate Decreased blood pressure
Oxygen consumptiom
Cell wastes Fluid viscosity Capillary permeability Inflammation Pain Muscle spasm Muscle contraction
(reduced sensitivity of muscle spindles and decrease pain) (reduced nerve conduction and increased viscosity)
(reduced ischemia and pain) (increased nerve conduction and decreased viscosity)
Highlights
Heat exchange is based on a temperature gradient, with energy always moving from high concentration to low concentration (from hot to cold) Heat exchange by conduction, convection, radiation, and evaporation. Therapeutic cold decreases cell metabolism; therapeutic heat increases cell metabolism Cold modalities can be safely used for acute, subacute, and chronic condition. Heat should not be used while acute stage Cold vasoconstriction, heat vasodilation
Therapeutic Modalities
part 2 The Applications
COLD PACKS
Used for :
Acute trauma Pain Muscle spasm Postsurgical care
Primary effects :
Reducing secondary trauma Limits formation of edema with compression & elevation
Indications
Acute injury or inflammation Acute or chronic pain Postsurgical pain & edema
Contraindications
Cardiac or respiratory involvement Uncovered open wounds Circulatory insufficiency Cold allergy and/or hypersensitivity Anesthetized pain
Ice massage
Used for :
Muscle spasm Trigger points Prior to ROM exercise Rapid cooling of the skin
Primary effects :
Decrease sensitivity of cutaneous nerve receptors Decreases pain
Indications
Subacute injury or inflammation Acute or chronic pain Muscle strains and contusion
Contraindications
Cases in wich pressure on the injury Suspected fractures Uncovered open wounds Circulatory insufficiency Cold allergy and/or hypersensitivity Anesthetized pain
Ice Immersion
Used for :
The body part, usually the foot and ankle or elbow, wrist, and hand
Primary effects :
Decrease cell metabolism prevent secondary hipoxic injury reduces release inflammatory mediators Decrease pain
Indications
Acute injury or inflammation Acute, chronic, or postsurgical pain Prior to ROM exercise
Contraindications
Cardiac or respiratory involvement Uncovered open wounds Circulatory insufficiency Cold allergy and/or hypersensitivity/ intolerate cold temperature Anesthetized pain
CRYOSTRETCH
Used for :
Vapocoolant spray skin quickly evaporates and cools the skin
Primary effects :
Cools the skin and desensitizes nerve endings Elongates muscle fibers and other soft tissue, breaking muscle spasm
Indications
Trigger points Muscle spasm Decreased ROM
Contraindications
Allergy to the spray Acute and/or postsurgical injury Open wounds Contraindications relating to cold applications Contraindications relating to passive stretching Use around the eyes
Primary effects :
Indications
Contraindications
Fever (in hot whirlpools) Patients requiring postural support during treatment Skin conition
Duration : 5- 10 minutes (initial phase), 20-30 minutes (treatment phase) Temperature : cold (10-15 C), hot (32-49 C)
Primary effects :
Increasing bloood flow (vasodilatioan) Increased cell metabolism Muscular relaxation to reduce muscle spindle sensitivity
Indications
Reduction of subacute or chronic pain Subacute or chronic inflammatory condition Hematoma resolution Decreased ROM Reduction of joint contractures Infection Acute condition Peripheral vascular disease Impaired circulation Poor thermal regulation
Contraindications
Duration : 20 30 minutes
Paraffin Bath
Used for :
Delivered heat to small Warm temperatures
Primary effects :
Increasing bloood flow (vasodilatioan) Increased prespiration Increased cell metabolism
Indications
Subacute or chronic inflammatory condition(e.g arthritis of the fingers) Limitation of motion after immobilization
Contraindications
Open wounds : wax and oils would irritate the tissues Skin infection : the warm excellent for breeding bacteria Sensory loss Peripheral vascular disease
Appendiks
Fluidotherapy Contrast therapy
Heat modalities
Deep-Heating Agents : Therapeutic ultrasound Shortwave diathermy Electrical stimulation Transcutaneus Electrical Nerve Stimulation (TENS) Neuromuscular Electrical Stimulation Iontophoresis Microcurrental Electrical Stimulation
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