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Mechanical Modalities

Mechanical Modalities. Chapter 14-15 ,p. 280. Intermittent Compression-p.280. Compression through alternating inflation cycles Air or fluid may produce compression Useful in prevention or reduction of edema Commonly used to reduce “pitting edema”

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Mechanical Modalities

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  1. Mechanical Modalities Chapter 14-15 ,p. 280

  2. Intermittent Compression-p.280 • Compression through alternating inflation cycles • Air or fluid may produce compression • Useful in prevention or reduction of edema • Commonly used to reduce “pitting edema” • Contraindicated with suspected fx or compression syndromes • Sequential or Circumferential compression units available (fig. 14-1, p. 281)

  3. Effects of IC on Injury Response • Combined with elevation, venous flow velocity increase 175% - 336% • Pressure of compression measured in mmHg • May increase blood flow post tx as well (?) • Pressure should not be more than patient’s diastolic BP value

  4. Indications for Intermittent Compression—p. 284 • Post-traumatic edema • Post-surgical edema • Venous stasis ulcers • Prevention of deep vein thrombosis

  5. Contraindications of IC—p. 282 • Possible fx • Possible compression syndrome • Peripheral vascular disease • Deep vein thrombosis/Thrombophlebitis • Gangrene/infections

  6. Intermittent Compression Parameters—p. 283-285 • Pressure ranges: • UE: 40-60 mmHg • LE: 60-100 mmHg • ON-OFF times: Usually 3:1 ratio • Duration: 20 min- several hours • May be combined with other modalities

  7. Precautions with Intermittent Compression—p. 284 • Protect skin when using cold packs • Avoid wrinkles when using stockinette • Monitor sensory/motor function

  8. Continuous Passive Motion (CPM)—Chapter 15, p. 287 • Combats effects of immobilization • Passive modality—often applied in Recovery Room • Most commonly applied to knee • Indications: • Need for postsurgical controlled mobility • Thrombophlebitis • Contraindications: When mobilization may interfere with healing processes

  9. Goals of CPM—p. 311 • Enhances nutrition of articular cartilage and synovial tissue • Remodeling of articular cartilage surfaces • Decreased stiffness in elastic tissues through ordered deposition of collagen • Maintains ROM by preventing lost ROM

  10. Effects of CPM—pp. 289-290 • ROM—improves through avoiding lost ROM • Joint Nutrition—articular cartilage is nourished through currents of synovial fluid • Edema Reduction—Mimics muscle pump mechanism to flush edema from joint • Pain Reduction—through Gate Control and decreased edema; Decreased apprehension

  11. Advantages & Disadvantages of CPM • Advantages: • Useful with apprehensive patients • Applied in Recovery Room • May be applied with other modalities • Disadvantages: • Cost vs. Benefit • Active vs. Passive Modality

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