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Questions and Answers
Which of the following is NOT a contraindication for Extracorporeal Shockwave Therapy?
Which of the following is NOT a contraindication for Extracorporeal Shockwave Therapy?
What is the primary clinical application of Extracorporeal Shockwave Therapy?
What is the primary clinical application of Extracorporeal Shockwave Therapy?
Which of the following publicized effects is associated with shockwave therapy?
Which of the following publicized effects is associated with shockwave therapy?
Which energy sources can generate shockwaves for Extracorporeal Shockwave Therapy?
Which energy sources can generate shockwaves for Extracorporeal Shockwave Therapy?
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What is the minimum energy density for low-intensity shockwave treatment?
What is the minimum energy density for low-intensity shockwave treatment?
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Which condition is NOT indicated for the use of Pulsed Electromagnetic Field Therapy?
Which condition is NOT indicated for the use of Pulsed Electromagnetic Field Therapy?
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What aspect of physiological function does Pulsed Electromagnetic Field Therapy aim to improve?
What aspect of physiological function does Pulsed Electromagnetic Field Therapy aim to improve?
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Which of the following is a common side effect of Extracorporeal Shockwave Therapy?
Which of the following is a common side effect of Extracorporeal Shockwave Therapy?
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What is the original use of Extracorporeal Shockwave Therapy?
What is the original use of Extracorporeal Shockwave Therapy?
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Which physiological response associated with Extracorporeal Shockwave Therapy involves changes to cell permeability?
Which physiological response associated with Extracorporeal Shockwave Therapy involves changes to cell permeability?
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What is the primary purpose of Pulsed Electromagnetic Field Therapy (PEMF)?
What is the primary purpose of Pulsed Electromagnetic Field Therapy (PEMF)?
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What is NOT a contraindication for using PEMF therapy?
What is NOT a contraindication for using PEMF therapy?
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For which duration is PEMF therapy typically recommended for soft tissue treatment and osteoarthritis?
For which duration is PEMF therapy typically recommended for soft tissue treatment and osteoarthritis?
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Which frequency range is commonly associated with PEMF therapy?
Which frequency range is commonly associated with PEMF therapy?
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What was the conclusion of the systematic review by We et al regarding PEMF treatment for knee osteoarthritis?
What was the conclusion of the systematic review by We et al regarding PEMF treatment for knee osteoarthritis?
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What should be included in the documentation for electromagnetic therapy sessions?
What should be included in the documentation for electromagnetic therapy sessions?
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Which of the following outcome measures is used to assess the effectiveness of thermotherapy?
Which of the following outcome measures is used to assess the effectiveness of thermotherapy?
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What was the result of Dingemanse et al.'s systematic review regarding PEMF for epicondylitis treatment?
What was the result of Dingemanse et al.'s systematic review regarding PEMF for epicondylitis treatment?
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What does the speed of PEMF therapy refer to in the context given?
What does the speed of PEMF therapy refer to in the context given?
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Which of the following does not represent a benefit of PEMF therapy?
Which of the following does not represent a benefit of PEMF therapy?
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Study Notes
PTA 1009 - Modalities Week 6: Additional Physical Agents
- This week's focus is on extracorporeal shockwave therapy (ESWT) and pulsed electromagnetic fields (PEMF).
Extracorporeal Shockwave Therapy (ESWT)
- ESWT uses high-energy shockwaves.
- Originally used for lithotripsy (breaking up kidney stones).
- Gradually integrating into physical therapy.
- Different energies include reverse piezoelectric, electromagnetic, and electrohydraulic.
- Treatment area must be targeted using ultrasound or fluoroscopy.
- Treatment success depends on shockwave concentration.
ESWT Objectives
- Students should be able to describe types of ESWT.
- Understanding physical principles of ESWT and physiological responses.
- Knowing indications, contraindications, and side effects of ESWT.
- Recognizing the advantages and disadvantages.
- Learning about dosage and frequency for ESWT.
ESWT Physiological Effects
- Disintegrates calcium deposits.
- Produces hyperstimulation analgesia.
- Promotes neovascularization.
- Affects cell permeability.
ESWT Clinical Applications
- Number of shockwave pulses and energy density determine treatment energy.
- Low intensity: less than 0.1 mJ/mm².
- Moderate intensity: 0.1-0.2 mJ/mm².
- High intensity: greater than 0.2 mJ/mm².
- Treatment duration can be up to 30 minutes.
- Possible side effects include hematoma, redness, petechiae, local soft tissue swelling, and transient pain.
ESWT Contraindications
- Bleeding conditions.
- Pacemakers.
- Medications preventing blood clotting.
- Children.
- Pregnancy.
- Acute injuries.
ESWT Evidence
- Successful in treating conditions like plantar fasciopathy, noncalcific supraspinatus tendinopathy, calcifying shoulder tendonitis, Achilles tendonopathy, and lateral epicondylitis.
Pulsed Electromagnetic Fields (PEMF)
- Non-thermal treatment introduced in the mid-1970s.
- Primarily used for fracture healing (non-unions or delayed unions, 16 weeks or later).
- Other uses include soft tissue trauma, acute inflammation, osteoarthritis, and depression.
PEMF Therapy Mechanisms
- Every living cell produces an electromagnetic field, which helps cells communicate.
- Disruption in electromagnetic communication can impair cell metabolism.
- PEMFs deliver precisely targeted electromagnetic fields.
- These fields stimulate chemical and electrical processes.
- Cells improve cellular energy.
PEMF Intended Effects
- Reduce pain and inflammation.
- Improve energy, circulation, and tissue oxygenation.
- Enhance sleep quality, blood pressure, cholesterol levels, cell regeneration, and nutrient absorption/cellular detoxification.
- Balance the immune system.
- Stimulate RNA and DNA synthesis and repair.
- Accelerate bone and soft tissue repair.
- Relax muscles.
PEMF Contraindications
- Pacemakers.
- Insulin pumps.
PEMF Treatment Time and Frequency
- Fractures (non-unions): 8 hours/day.
- Soft tissue/osteoarthritis: 2 x 15 minutes/day.
- Frequency: usually 1-50 Hz (extremely low frequency).
- Speed: 50 T/sec (T=Tesla).
PEMF Evidence
- Studies including We et al. (2013) and Dingemanse et al. (2014) show PEMF improving knee function after treatment.
- Additional studies suggested PEMF might help with pain relief.
Electromagnetic Therapy Documentation
- Documentation should include modality used, method of application, duration, body area treated, patient position, special precautions/concerns, and patient response (especially adverse responses).
Electromagnetic Therapy Assessment
- Outcome measures to assess effectiveness include pain scales (VAS), range of motion (goniometry), and muscle guarding/flexibility (related to joint ROM).
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Description
This quiz covers the key concepts of extracorporeal shockwave therapy (ESWT) and pulsed electromagnetic fields (PEMF) as discussed in PTA 1009 Week 6. Students will learn about the types, physiological effects, and treatment principles of ESWT. Understanding indications, contraindications, and side effects is also essential for effective application in physical therapy.
