Modalities

Front 1

Sequence of cryotherapy

Back 1

Cold, burn, aching, analgesia, numbness

Front 2

Cryotherapy and chronic inflammation

Back 2

Should be applied no longer than 20 minutes and at least 1 hour apart (OA, RA)

Front 3

What do Ruffini and Krause and bulbs cells sense ?

Back 3

R- Hot

K- cold

Front 4

Cryotherapy contraindication

Back 4

Cold intolerance, cold urticaria (like hives), cryoglobulinemia (form of vasculitis), over regenerating peripheral nerves, paroxysmal cold hemoglobinuria, peripheral vascular disease, raynaud's phenomenon, Infection and poor circulation

Front 5

Iontophoresis indications

Back 5

Hyperhidrosis (water +/-), analgesia (salicylate -), calcium deposits (acetate -), msk inflammation (dexamethasone -), sclerotic scars (iodine -), dermal ulcers (zinc +), fungal infection (copper +), edema reduction (hyaluronidase +), muscle spasm (calcium magnesium ++)

I SAD -ve

Front 6

Current ⚡characteristics

Back 6

Intensity, frequency, pulse duration, duty cycle (on time/(on time+off time)), MVIC

Front 7

Electrical stimulation parameters for muscle contractions

Back 7

Pulse frequency (35-80 pps)

Pulse duration (150-200ms for small muscles, 200-350ms for larger muscles)

Amplitude (>10% of MVC in injured, >50% of MVC in uninjured)

On:off time (6-10 seconds on, 50-120 seconds off OR ratio of 1:5)

Ramp time (at least 2 seconds)

Treatment time (10-20 minutes to produce 10-20 repetitions)

Times per day (every 2-3 hours when awake)

Front 8

High voltage pulsed galvanic current HVPC

Back 8

For wound healing

Negative electrode used to promote healing of the inflamed or infected wound

Positive electrode used to promote healing of the wounds without inflammation

Frequency (60-125 pps)

Pulse duration (40-100ms)

Treatment time (45-60 mins)

Front 9

TENS acute pain

Back 9

sensory level stimulation, mono or biphasic pulsed current, high frequency 100pps, short pulse duration 50-100msec, amplitude to comfortable sensory perception, duration 20-30 minutes or longer if doing activity

Front 10

Acupuncture TENS

Back 10

Motor level stimulation, mono or biphasic pulsed current, short frequency less than 10pps, high pulse duration 150msec, amplitude to visible muscle twitch, duration 20-45 minutes

Front 11

Brief-intense stimulation TENS

Back 11

Rapid onset, short term relief for pain used before painful procedures like debridmentand joint mobilization. Motor level stimulation, mono or biphasic pulsed current, high frequency 100pps, higher pulse duration greater than 150msec, amplitude to visible strong muscle twitching, duration less than 15 minutes

Front 12

Noxious-level stimulation TENS

Back 12

Hyperstimulation stimulation, DC or mono pulsed current, high frequency 100pps or low 1-5pps, long pulse duration greater than 250msec up to 1 sec, amplitude to highest tolerated painful stimulus, duration 30-60 seconds to each area

Front 13

Ultrasound parameters

Back 13

Frequency: superficial 3MHz, deep 1MHz

Intensity:

- Pulsed (acute conditions (< 3 weeks), non-thermal, less than 1W/cm2)

- Continuous (chronic conditions (> 3weeks), thermal, greater than 1W/cm2)

Front 14

Supraspinatus tendon is deep

Back 14

To expose it, extension, adduction and IR

Front 15

Ultrasound head size

Back 15

5cm is the typical head size, 2cm is for smaller joints like fingers

Front 16

Phonophoresis

Back 16

The use of ultrasound for transdermal delivery of medication (anti-inflammatory like dexamethasone or analgesic like methyl salicylate, lidocaine)

Duty cycle is 20% pulsed

Treatment time is 5-19 minutes

Front 17

Lumbar traction

Back 17

Supine: pillow under knee, for intervertebral joints, facet joints, muscle elongation

Prone: for posterior disc herniation

Increase intervertebral space of

L5-S1: 45-60 degree hip flexion

L3-L4: 75-90 degree hip flexion

Disc protrusion, spasm, elongation: 25% body weight

Joint distraction: 50lbs or 50% body weight

Front 18

EMG biofeedback

Back 18

Sensitivity: the treatment for muscle relaxation requires low sensitivity, the treatment for muscle re-education requires a high sensitivity

Electrodes placement: closely placed for muscle relaxation, far apart for muscle re-education

Front 19

Duty cycle

Back 19

Should allow for the rest period to be 5x as long as the hold cycle