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Therapeutic Modalities

Therapeutic Modalities. Therapeutic Modalities. What are they? Technique that aids healing Important adjunct to therapeutic exercise Why do we use them? Crease optimal environment for injury to heal Limit inflammatory process Break pain-spasm cycle How do you select a modality?

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Therapeutic Modalities

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  1. Therapeutic Modalities

  2. Therapeutic Modalities • What are they? • Technique that aids healing • Important adjunct to therapeutic exercise • Why do we use them? • Crease optimal environment for injury to heal • Limit inflammatory process • Break pain-spasm cycle • How do you select a modality? • Site, type, severity

  3. Therapeutic Modalities • Indication • Condition that could benefit from a specific modality • Contraindication • Condition that could be adversely affected from a specific modality

  4. Therapeutic Modalities • All about ENERGY • Electromagnetic Energy- Electromagnetic spectrum Frequency and Wavelength • Inverse relationship between wavelength and frequency • Infrared Modalities • Cryotherapy • Thermotherapy • Acoustic Energy • Needs medium for transmission • Ultrasound • Other • Massage, traction, medication

  5. Electromagnetic Spectrum • Infrared (Thermal Changes) • Cold packs • Cold whirlpool • Hot whirlpool • Paraffin • Hydrocollator

  6. Transmission • Radiation • Heat is transferred through space • Laser • Conduction • Heating or cooling through direct contact • Hot or ice pack • Convection • Heating or cooling indirectly through air or water • whirlpool • Conversion • Heating through other forms of energy • ultrasound • Evaporation • Icey Hot

  7. Cryotherapy

  8. Cryotherapy (cold) • Infrared Modality • Ice packs • Ice massage • Cold whirlpool • Ice immersion • Cold sprays

  9. Cryotherapy • Indications • Acute injuries (24-72 hrs) • Pain control • Reduction of spasm • Contraindications • Allergies (Cold uticaria) or Hypersensitivity • Uncovered wounds • Arthritis

  10. Cryotherapy • Transmission of Energy’ • Conduction, convection, evaporation • Tissue cooling • Temperature dependent • Tissue dependent • Fat, muscle • Time dependent • Type of cooling agent (ice vs. water) • Limb circumference • Ice pack is better than the chemical pack

  11. Physiological Response to Cryotherapy • Vasoconstrition of small blood vessels • Cooled blood circulates and vasocontriction continues • Hunting Response • Intermittent period of vasodilation after 15-30 minutes of cold application • Lasts for 4-6 minutes • Protection form tissue damage- but DOES NOT raise temperature to pre-application levels • Causes the redness

  12. Changes • Decreases in… • Blood flow • Metabolic rate • Inflammation • Pain perception • Muscle spasm • Muscle fatigue • Collagen elasticity • Increases in… • Blood viscosity

  13. Techniques • Ice packs • 20 min • Chemical packs • 15 min • Ice massage • 5-10 min • Ice immersion/whirlpool • 5-20 min • Vapocoolant sprays • Contrast bath

  14. Stages of Cooling • Stage 1: (0-3 min) • Cold sensation • Stage 2: (2-7 min) • Mild burning and aching • Stage 3: (5-12 min • Skin anesthesia

  15. Cryokinetics • Alternating ice and exercise • Anesthesia allows for pain-free exercise

  16. Thermotherapy

  17. Thermotherapy • Forms- Superficial and Deep • Indications • Chronic injuries and pain • Muscle spasm/joint stiffness • Contraindications • Acute injuries • Impaired sensations • Decreased circulation • Impaired thermal regulation

  18. Changes • Increases in… • Blood flow • Metabolic rate • Collagen elasticity • Capillary permeability • Decreases in… • Pain perception • Muscle spasm • Joint stiffness • Blood viscosity

  19. Techniques • Moist Hot Packs • Water temp. 158- 170 degrees • 10 min • Whirlpools • 96-104 degrees • 20 min • Paraffin Bath • 118-126 degrees • Dip and soak OR dip and wrap • Contrast Bath

  20. Ultrasound • Acoustical energy transmitted to tissues via a medium • High frequency causes vibrations • Just like waves in the ocean

  21. Electrotherapy • Indications • Pain modulation • Muscle contraction • Contraindications • Loss of sensation • Over heart, brain, or spinal cord

  22. Massage • Mechanical responses • Venous and lymphatic drainage • Stretching of tissue • Physiological responses • Increase circulation, metabolism, waste removal • Body relaxation • Psychological responses • Humans respond to being touched

  23. Traction • Putting tensions on a body segment • Indications • Joint hypomobility • Muscle spasm • Herniated disc • Nerve impingement or inflammation • Contraindications • Unstable bony structures • Patient discomfort

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