TI week 4 summary.pdf

biophysical modalities: definition 4.1 intro to biophysical modalities “therapeautic modalities represent the administration of thermal, mechanical, electromagnetic and light energies for a specific therapeutic effect” therapeautic interventions therapeautic excercise manual therapy pt education *...

biophysical modalities: definition 4.1 intro to biophysical modalities “therapeautic modalities represent the administration of thermal, mechanical, electromagnetic and light energies for a specific therapeutic effect” therapeautic interventions therapeautic excercise manual therapy pt education **physical agents or therapeautic modality physical modalities: clinical decision making “clinical decision-making can be thought of as the process of using information, experience, and judgments to decide which clinical interventions will most likely improve the problems identified in the examination” hope to answer what do we want to achieve and what interventions and parameters of those interventions will most likely help us achieve a positive result or outcome? * selection of appropriate modality will impact the success of an outcome comprehensive management * treats whole person interventions work together to promote: - positive outcomes - meet fxnal and pt goals >> common interventions (pic) - * therapeutic modalities: no well established literature 2014 APTA “choose wisely” campaign stated therapeutic modalities are considered adjuvant interventions -meaning these types of interventions should only be used in conjunction w other more well-supported forms of management: therapeutic exercise, manual therapy & pt education * therapeutic mods still heavily used 2014 centers of medicaid and medicare services state ultrasound and e-stem are still used heavily * use literature to predicate when we use ther mobs biophysical modalities: types cryotherapy: use cold to induce a therapeutic/ physiological response in tissue result- decrease in temp thermal modalities: results in an increase in tissue temp (can be hot or cold) -in lecture he’s talking about heat for this one electrotherapy: results in depolarization or activation of peripheral n’s or creation of electrical gradients in tissue mechanical therapy: use mechanotransduction ultrasound: uses sound waves to promote physiological responses in tissue- result in thermal and non-thermal effects electromagnetic therapies: use radio waves to promote physiological responses and tissueresult either thermal or non-thermal effects biophysical modalities clinical application * varied clinical application what they have found: 1. pain modulation 2. skeletal muscle performance 3. inflammatory management and tissue 4. flexibility and range of motion healing keep in mind * when do we use modalities? * what parameters do we use when we utilize mods? considerations : stages of healing adherence of POC disease states fear avoidance behavior pts thoughts/beliefs (of modalities) biophysical modalities: assessment and outcomes adjuvant vs prim management (ex: therapeutic exercise) quantitative vs qualitative benefit (ex: changes in ROM or perceived pain) quality research physiological outcomes and pts condition biophysical modalities: precautions and contraindications precautions “reflect situations in which a pt is at some risk of experiencing an adverse event” contraindications “situation in which a drug, procedure or surgery should not be used bc it may be harmful to the pt” ex: DVT- cant use mechanical mod bc clots hemorrhagic conditions electronic implants bc of electrical currents pregnancy (they dont know why so its best not to use)- doesnt effect baby or mom malignancies bc we dont want to promote growth * we rely on pt to tell us if they’re having discomfort can be dangerous of they cant vocalize it take-aways 1. therapeutic modalities represent the administration of thermal, mechanical, electromagnetic and light energies for a specific therapeutic effect. 2. biophysical modalities are adjuvant treatments to a comprehensive plan of care 3. care should be taken in selecting a biophysical modality with special attention to its physiological effects on and potential harm to a patient 4.2 intro to thermal modalities thermal modality definitions cryotherapy: form of therapy uses cold to promote therapeutic and physiologic responses by decreasing tissue temperature, its a form of thermal ablation thermotherapy: uses heat to promote a therapeautic or physiological response by increase tissue temp * use of either cold or heat modalities will allow clinician to cause desired physiological change in tissue by altering tissues temp types of thermal modalities modes of cryo and thermal therapies therapeautic cold ice cold water cold gel-filled packs vapocoolant sprays therapeautic heat warm water heat packs light waves sound waves affected tissues • direct heat from thermal modalities will not penetrate deeper than 1cm into soft tissue • cold therapies may have potential to affect tissue deeper than heat • temp changes primarly affect superficial tissue and blood vessels factors of direct temperature change 1.temperature differential 2.surface area ex: the larger the area, the more energy that dissipates and a slower change we're going to see in temperature 3.time: more time exposure, the more communal energy transmission 4.conductivity: tissues w increased water content: more conductive • • more adipose tissue: less conductive deeper structure>harder to change tissue temp -tissue takes longer to cool and rewarm 5. activity level: predicate speed w which energy’s transport in body can resolve in increased cooling or heating 6.agent type: type of cooling or heating agents as the ability to maintain its temp and determine how quickly tissue temp will change. primary modes of energy transfer conduction: most common form of energy transfer -transfer heat bw 2 interacted molecules -energy will travel downstream -heat will travel to places that are cooler convection evaporation indirect temperature change • heat in circulated blood disperses quickly • loss of heat in circulated blood is harder to recover from • * deeper tissues can be affected by temp n changes thru circulation of warmed or cold blood * prim reason for difference in energy dissipation and gain is due to physiological changes and tissue following a temp change (blood vessels) consequence of temp in vascular system is vasodilation and vasoconstriction vasodilation: physiological effect of heat -greater volume of blood dispersing so heat is lost quickly (in image A) vasoconstriction: physiological effect of cooling -smaller volume of blood * recover from heat loss takes longer (image B) -greater potential for indirect temp change via cryotherapy and deeper tissue * indirect response and tissue of cold therapies thought to be reason modality can effect deeper tissue take-aways 1. cryotherapy cools tissue to promote therapeutic and physiologic responses. 2. thermotherapy heats tissue to promote a therapeutic or physiological response. 3. the depth of temperature change in tissue is thought to involve the rate of energy dissipation in the blood stream. 4. cold therapies are thought to be able to change the temperature in deeper tissues than heat therapies.