VCU DPT - Agents (Diathermy)

electric and magnetic fields are __________ to each other

perpindicular

t/f: human body can not detect many of them, but waves can have a physioloigcal effect when traveling through tissue

true

the longer the wavelength, the _______ energy the wave has

less

continous ultrasound and shortwave diathermy provide ___(superficial/deep)_____ tissue heating

deep

what do

SWD

MWD

stand for

short wave diathermy

microwave diathermy

can diathermy be develievered either pulsed or continous

yes

to have a thermal effect with diathermy, do we need

continous

OR

pulsed

continous

t/f:

Pulsed shortwave diathermy is thermal + non thermal

true

with shortwave diathermy, we can:

- give deep heat up to ______cm

- can heat ______ areas

- have _______ refelction of waves at tissue

- __(does/does not)___ reflect off bones

- tissue heating as deep as ultrasound, but ___________

3-5cm

larger

minimal

does not

longer lasting extensibility

- larger window to stretch

when would you choose ultrasound over diathermy

when the ligaments / tendons are closer to the surface

when the tissue is smaller

- diathermy good for large areas

what is the capacitive method of SWD

you have a device to store electrical charge, and the body serves as a device to create resistance between plates of machine and create tissue heating as a result

electric field method is also known as the ______ method w/ SWD

capacitve

in the capactive method for SWD...

- the ___(capacitor/dieletric)____ is a device that can store electrical charge

- the ___(capactor/dielectric)_______ is an insulating sheet that causes an increase in capacitance

WHICH ROLE DOES THE BODY PART SERVE AS

capacitor

dielectric

person acts as the dielectric

(diathermy)

fat has a greater resistance to current than muscle does

- what does this mean with capactive method

it means that we should use with caution over areas with a lot of subcutaneous fat

- will get too hot

(diathermy)

what happens if the bare metal of the capacitor machine touches skin

what is there to prevent this

severe electrical burn

physical guard plates are there to prevent burns

(diathermy)

why might it be important you give someone a layer of towel to wear over body part with capactive method

to help soak up sweat, to avoid the field focusing itself on the liquid

(diathermy)

explain what contraplanar and coplanar arrangements for capactive method

contraplanar:

person is physically between the sides

coplanar:

they are side by side

(diathermy)

distance between plates __________ plate diameter

must be greater than or equal to

inductive method for SWD is also known as ___________

how does it work

magnetic field method

a drum applicator creates an oscillating field to create an eddy current in tissue: makes heat

(diathermy)

what does it mean with the inductive method of SWD when it moves along eddy currents

the current flows along areas of high conductivity, low impedence (ex. muscle)

(diathermy)

with the SWD inductive method, current flows in high conductivity and low impedence. this is an example of what tissue type

muscle

(diathermy)

do we need to use a towel layer with the SWD inductive method?

YES

with diathermy thermal effects, we are:

________ blood flow

_____ metabolism

_______ tissue extensibility

______ pain

______ tissue healing

increase

increase

increase

decrease

improve

with diathermy nonthermal effects, we are:

________ microvascular perfusion

________ cullular activity

stimulate _______ production

stimulate ________ synthesis

helps with tissue ________

improve

alter

protein

ATP

healing

state which set of effects is from thermal or nonthermal diathermy

a) improved microvascular perfusion, alter cell activity, stimulate ATP/protein , tissue healing

b) increased blood flow, increased metabolism, increased tissue extensibility, decreased pain, improves tissue healing

a) nonthermal

b) thermal

name some indications for thermal diathermy

pain control

acelerated tissue healing

decreased joint stiffness

increased joint ROM

name some indications for nonthermal diathermy

control of pain and edema

soft tissue, nerve, bone healing

wounds, ulcers

(diathermy)

you would use ___(thermal/nonthermal)____ for pain control, joint stiffness, joint ROM

you would use ____(thermal/nonthermal)____ for pain, soft tissue/nerve/bone healing, wounds and ulcers

thermal

nonthermal

(diathermy)

with acute injuries, edema, cell repair:

do we want thermal or non thermal?

what tissue temp rise?

average Watt?

non thermal

none

N/A

(diathermy)

with subacute injuries and inflammation:

what type of temperature response do we want?

what tissue temp rise?

average Watt?

mild heat

1.8 deg F

12 W

(diathermy)

with pain, spasm, chronic inflammation:

what type of temperature response do we want?

what tissue temp rise?

average Watt?

moderate heat

3.6 deg F

24 W

(diathermy)

to increase blood flow and heat collagen for soft tissue stretch:

what type of temperature response do we want?

what tissue temp rise?

average Watt?

vigorous heat

7.2 deg F

48 W

what are some MAJOR diathermy contraindications

pacemakers or implanted devices

metal being in the treatment area

- you or the patient, or other object

metal/cement/synthetic implants

pregnancy

REST OF OTHER NORMAL STUFF

with diathermy, we must make sure

patient does not have _____________

there is no ______ in the treatment area

there are no _______________ implants

pacemakers

metal

cement/metal/synthetic

is chronic wounds a contraindication or precaution for diathermy?

if contra, why is it never allowed

if precation, when it is sometimes allowed

precaution

non-thermal diathermy is allowed

name some diathermy precautions

chronic wounds

active epiphysis

infection

superficial regenerating nerve

decreased sensation

impaired circulation

damaged skin

synthetic materials

if body part allows for either coplanar or contraplanar, which should you choose (diathermy)

coplanar

inductive diathermy results in the highest temp for ________ with slow decay of temp

capacitive diathermy results in the highest temp for _____ with slow decay of temp

inductive: muscle

capacitive: skin

if you want to heat skin, use ______ diathermy

if you want to heat muscle, use ______ diathermy

skin: capacitive

muscle: inductive

with MS patients, is it better to use thermal or non thermal diathermy

thermal (edit: might be wrong)

non thermal diathermy promotes __________ in children with burns

wound helaing

helps get granulated tisssue, clear necrotic tissue

which is better for Hamstring stretch

LLLD stretch plus thermal diathermy

LLLD stretch by itself

plus thermal

with LASER, define

monochromatic

coherent

directional

monochromatic: single wavelength

coherent: all waves are in phase with each other

directional: parallel waves in the same direction

what type of lasers do PTs use

low level laser therapy

LLLT

is low level laser therapy thermal or non thermal

non thermal

what are the 6 physiological effects of laser

ATP+RNa production stimulated

collagen production promoted

bacterial growth inhibited

decreased pain via chemical mediators

vasodilaiton promotoed

modulates inflammation

the physiological effects of LASER are:

__________ production stimulated

collagen production ____________

the growth of _________ is inhibited

pain is _________ via ____________

promotion of vaso___________

modulates __________

ATP + RNA production stimulated

collagen production STIMULATED

the growth of BACTERIA is inhibited

pain is DECREASED via CHEMICAL MODULATORS

promotion of vasoDILATION

modulates INFLAMMATION

what are some proposed clinical indications for laser

hey why did i say proposed

wound healing

lateral epicondylitis

carpal tunnel

diabetic peripheral neuropathy

spinal pain

trigger points

OA

all the evidence is conflicting

is LLLT effective in.....

- reducing MSK pain

- shoulder pain

- reducing low back pain

yes

not conclusive

yes

what are some contraindications for laser (7)

do not put it direcelty in eyes

active malignancy, hemorrage

over active epiphysis

over thyroid/endorcine gland

over reproductive organs

pregnancy

DVT

what are some precuations for LASER (4)

impaired metation, sensation

indirect eye exposure

recently radiated tissue

photosensitivity

what are some potential adverse effects of LASER (5)

transient tingling/burning

skin rash

higher pain, numbness

retinal damage if eye exposure

burns

what is a diode

it is comprised of anodes and cathods in clusters

what two things does laser dosing depend on

size of area to treat

target dosage

do we calculate the dosages for laser

nope, machine does

(bolded on her slides)

the more power you have, the _______ the laser will go

deeper

total energy = ______________ (formula)

total energy = target dosage (joule/cm^2) * treatment area

target dosage (joule/cm^2) * treatment area = _________

total energy

what is common way to measure laser dosing

joules per treatment session

higher the wavelength, the _____ the penetration

deeper

a machine you are working on has two settings for laser, 400 nm wavelength or 700 nm wavelength

you are trying to target piriformis and other deep rotators

which of the two options is more ideal

700 nm wavelength

the higher it is, deeper it penetrates

is ther good evidence on dosing via frequency (hz)

nope

basic laser application steps

explain what it is, patient eduction

clear contraindications, do skin check

put on protective eyewear to YOU and PATIENT

put applicator on skin perpinduclar to it

begin light output, keep applicatior in place

examine skin after

what does LED stand for

light emitting diode

what is a SLED

monochromatic, non cohrent diodes

emit infrared energy

penetrate 2.5 cm

what is a MIRE

monochromatic infrared energy

delivers infrared invisble light at high wavelength

what are proposed physiologicaic effects of light therapy

effects from photo chemical reaction

increased microcirculation

increased venous flow

why does light therapy have a theorized benefit of increased venous flow

nitric oxide release

t/f: basic science supports benefit of NO and has connected it direcetly to MIRe

false

benefit of NO is supported, but has not bee directly connected to MIRE

indiction for SLED

open wound

is there a lot of research on SLED

nope

contraindications and precuations for SLED is same as ______

superficial heat

indications for MIRE (5)

increasing circulation

pain decreased

open wound healing

improving diabetic neuropathy

fall decrease

contraindications/precautions for MIRe is same as _______

laser

MIRe is shown to help monofimlanent testing?

yes

does MIRe help planatar senstivity?

yes