TI week 4 summary.pdf

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...

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 4.9 Therapeutic Ultrasound Define Explain- frequency intensity, duration, duty cycle Generating US waves Transmissivity and Attenuation for US waves Ultrasound waves are sound waves that are high frequency acoustic vibrations. Can be thermal and nonThermal A medium is needed to conduct for ultrasound to better penetrate the skin Frequency- cycles per second. Common ones- 1-3megaHZ Intensity- amount of energy delivered per unit of area Mode and Duty cycle- the total amount of energy emitted during treatment Beam Uniformity- Intensity of the ultrasound across a treatment area. Treatment area- area exposed to the ultrasound waves Generation of Waves Piezoelectric effect ability of an object to generate an electrical field from an applied mechanical stress Reverse Piezoelectric effect Using ultrasound. The creation of sound waves from the electrical currents shrinking and expanding the crystals in the ultrasound head. Attenuation The reduction of energy as it passes through tissue. Absorption and Dispersion and Reflection US head must be on the skin, because air will attenuate 100% Transmissivity-how much a coupling medium allows USwaves to pass through . The greater the transmissivity, the more waves pass through. Bad mediums will reflect or refract waves. 9.10 Indications for Therapeutic Ultrasound Obj: summarize the use precautions contraindication Indications for Ultrasound Very little evidence for consistent therapist benefit, parameters are poorly described Inflammation and pain were the main determining factors to indicate ultrasound treatment should be used however, most studies today have conflicting evidence disproving the positive benefits of US. Pain and Inflammation graph was based off of poor quality studies, and researcher bias. Conflicting findings and low physiological findings. Note: there are better treatment routes for pain and inflammation than ultrasound treatments Also no compelling evidence for use of pulse ultrasound Precaution and Contraindications 9.11 Ultrasound Parameters for Treatment Obj: how freq, intensity, mode, and duration affect thermal and non-thermal effects Relationship between mode and intensity with treatment dosage summarize basic techniques for US transducers, and retionale for size of treatment area Review Parameters- Freq, 1-3 mega hertz 3= superficial penetrations 1= deeper penetration Mode. Energy emitted during treatment pulsed- periodic interruptions in production continuous- no interruptions Normally in percentages. 20-50% ? Pulsed 100% continuous Intensity and Dosage Energy delivered per unit of area. watts/cm3 Duration- determined by freq, intensity, size of treatment area, and therapeutic goals Thermal outcomes- high intensity, short duration. OR low intensity , longer duration Treatment area should never be bigger than 3-4 times the size of the ultrasound head (ERA) Application Technique- maintain cotact Speed- 2-4cm/sec Record treatment description Record Patient position