TI week 4 summary.pdf

4.7 Modes & Assessment of Thermotherapy Modes - Moist Heat Packs - Offers moderate results w/ - Reducing Pain - Reducing Muscle Spasms - Increasing Tissue Extensibility KNOW THIS ( & KNOW THIS - Paraffin Wax - Conducts heat slowly, decreases risk of burn - Provides moist heat for sensitive skin &...

4.7 Modes & Assessment of Thermotherapy Modes - Moist Heat Packs - Offers moderate results w/ - Reducing Pain - Reducing Muscle Spasms - Increasing Tissue Extensibility KNOW THIS ( & KNOW THIS - Paraffin Wax - Conducts heat slowly, decreases risk of burn - Provides moist heat for sensitive skin & Scar Tissue - Combined w/ exercise, can improve stiffness, ROM, & grip function 4 - Electric Heating Pad - Used primarily as part of home exercise program to manage pain - Risk for wearing while falling asleep - Increased risk for burns KNOW THIS > - KNOW THIS - Fluidotherapy - Convection Modality - Has all advantages of normal heat as well - Additional Advantages - Will not increase inflammation in patients w/ edema - Can be used w/ open wound, dressed for protection - Additional Disadvantages - Limited body parts can be treated Outcomes - Pain - ROM - Muscle Grading - Documentation - Thermal Modality Used - Method of Application, including duration - Body Area Treated - Patient Position for Intervention - Special Precautions or Application Concerns Contraindications Take Aways - Different modes of thermotherapy have unique application, benefits, & risks to them - Each mode aims to treat pain, ROM, or muscle spasms - Affects are assessed as part of objective testing in form of degrees of ROM, pain, quality of guarding/funcitonal movement 7 4.8 Thermotherapy Application Indication - Thermotherapy usually used during remodeling phases of tissue healing - Best indicated to - Manage Pain - Reduce Muscle-Guarding Spasms - Increase ROM Modes - Many modes of thermal modality (Previous lecture) - To provide any therapeutic effect, tissue temps should be 104-113 - Exposure to tissue could be as long as 30 minutes before degree of temp change has occurred - To increase deep tissue, continuous ultrasound or shortwave diathermy should be used - Important Consideration - What the makeup of the soft tissue being treated - Presence of fat in tissue will decrease conductivity of energy transfer - Heat transfer most commonly completed via conduction/convection - Radiation also a method to transfer energy (Infrared Lamps) Pre-Exercise - Select populations may benefit from combo of heat exercise more than others - What’s been found in Thermotherapy - Increased blood flow & vasodilation - Increased functional outcomes & pain relief in lower back pain - Decreased pain & disability & increased walking speed in patients w/ knee osteoarthritis - Decreased strength & endurance initially after use Combined w/ Stretching - Consistent thermotherapy application w/ low loads of stretching over prolonged periods of time, results in greater tissue extensibility w/o tissue damage - Outcome - Plastic Deformation - Increased ROM - Muscle Relaxation - Decreased Joint Stiffness - Considerations - Degree of Temperature Elevation - Parameters of Stretch - Magnitude - Duration - Speed - Patient Tolerance Preparation & Expectations - Assessment - Assess patient’s medical status - Acuity of injury - Assess precautions/contraindications - Examine for hypersensitivity/hyposensitivity - Review precautions list - Align w/ goals - Patient Education - Mild to moderate heat sensation - Change is skin coloration - Frequency of skin checks - If part of home exercise program, they have to do it regularly Parameters - Treatment Time - Typically b/w 15-30 minutes - Session IItinerary - Heat prior to stretching or pain management at beginning or end of treatment is best supported - Application of heat prior to movement might cause increased therapeutic benefits - Low Back pain, Knee osteoarthritis - Patient Position/Tolerance - Position exposes treatment area & comfortable for patient - Muscle Spasms - Be careful w/ degree of stretch - Low level stretching w/ heat may elongate tissues - Avoid positions where patients lie on top of heat - Barriers - Need barriers b/w heat & patient to avoid burns - Says 6-8 layers - Heating Agent - Depends on the involved structure, pathophysiology, tissue being treated, degree of temperature elevation - Heat usually chosen during remodeling phase of tissue - Or when contractions persist Contraindications KNOW THESE Thermotherapy Application (Hot vs. Cold) - Cold Therapy - Best indicated for acute presentation - Musculoskeletal Injuries Heat Therapy - Best indicated for subacute/chronic stages - Soft tissue healing Take Aways - Thermotherapy primarily indicated for pain management, decrease muscle spasms, improve ROM - Many modes, most common form of energy transfer is conduction - Complete proper assessment/set expectations for patient prior to use - Several parameters to promote safety/insure therapeutic outcomes - Numerous contraindications, know them