Final Practical Physiological Effects

High rate IFC/TENS/Premod

decrease pain through gate control theory

low rate IFC/TENS/premod

decrease pain through endogenous opioid system

NMES/FES/EMS

Muscle strengthening

muscle endurance

slow/prevent atrophy

restore function

reduce spasm/spasticity

HVPC/iontophoresis

galvanotaxis

cell activation

antimicrobial effects

control edema

enhanced circulation

thermal US

- increased metabolic rate (promotes healing)

- pain modulation via gate control theory (reduce muscle spasms and alters NCV)

- decrease joint stiffness

- increased circulation

- increased soft tissue extensibility

nonthermal US

- increase cell and skin membrane permeability

- increase intracellular calcium levels

- facilitation of tissue repair

- promotes normal cell function

- all occurs through acoustic streaming, microstreaming

thermal diathermy

- vasodilation to increase circulation

- increase collagen extensibility

- altered NCV to decrease pain

- increased enzyme activity to promote healing

nonthermal diathermy

- increased microvascular perfusion (oxygenation, nutrition, and phagocytosis)

- altered cell membrane function and cellular activity

- promote tissue healing

- growth factor and macrophage activation

- myosin phosphorylation

- ATP stimulation/protein synthesis

spinal traction

- joint distraction (increased space intervertebral foramina)

- soft tissue stretching (increased joint mobility, reduce disc protrusion, increased ROM)

- muscle relaxation (interrupt pain-spasm-pain cycle)

- joint mobilization (increased joint mobility, decreased joint-related pain through mechanoreceptors being stimulated)

- decreased disc protrusion (decrease pain/radicular sx. and decreased intradiscal pressure)

compression

- controls peripheral edema by improving venous/lymph return

- limits shape and size of tissue

- increases tissue temperature (promotes break down of collagen and limits scar formation)

biofeedback

neuromuscular facilitation

- decrease AMI effect increasing muscle's ability to generate force

- increase motor unit recruitment

- decrease latency of motor unit recruitment

- increase neural excitability and voluntary activation

neuromuscular inhibition

- inhibits myoelectric activity of muscle

- decrease muscle force by decreasing activation of motor units

neuromuscular coordination

- improves timing and recruitment of muscle activity

laser/light therapy

- promotes ATP production

- promotes collagen production

- modulates inflammation

- inhibits growth of microorganisms

- promotes vasodilation

- alters NCV to modulate pain