Overview of Therapeutic Modalities: Contraindications and Parameters

List three cold modality subsets.

ice massage, icepacks, cold compression

List the four indications for cold modalities.

inflammation, edema, pain control, spasticity

List 6 contraindications for cold modalities.

impaired sensation, cold hypersensitivity, cold intolerance, Raynauds, regenerating peripheral nerves, compromised circulation (PVD)

List the parameters for ice massage. (duration)

5-10 minutes

List the parameters for icepacks. (temperature, duration)

32-41 deg, 10-20 minutes

List the parameters for cold compression. (temperature, duration)

50-77 deg, 15 min sessions

List the three sensations during the progression of ice massage.

intense cold, burning/aching, analgesia/numbness

List three heat modality subsets.

contrast bath, hot packs, paraffin

List four heat modality indications.

pain control, decreased ROM, joint stiffness, healing

List five heat modality contraindications.

recent/potential hemorrhaging, thrombophlebitis, impaired sensation, malignant tumor, infrared radiation of eyes

List the parameters for the hot contrast bath. (temperature, duration)

100-111 deg, 3-10 minutes

List the parameters for the cold contrast bath. (temperature, duration)

50-64 deg, 1-3 min

List the general parameters for the contrast bath. (duration)

25-30 min

List the parameters for the hot packs. (temperature, layers, duration)

158-167 deg, 6-8 layers, 20 min

List the parameters for the paraffin. (temperature, duration)

126-134 deg, 10-15 min

What is the ideal temperature for hot packs?

160 deg

What is the ideal temperature for paraffin?

130 deg

List three ultrasound modality subsets.

deep thermal, superficial thermal, non-thermal

List three indications for deep and superficial thermal ultrasound.

soft tissue shortening, pain, scar adhesions

List three indications for non-thermal ultrasound.

tendon injuries, bone fractures; dermal ulcers, surgical incisions, phonophoresis

List nine contraindications for deep and superficial thermal ultrasound.

joint cement, plastic components, malignant tumors, pregnancy, CNS tissue, pacemaker, thrombophlebitis, eyes, reproductive organs

List seven contraindications for non-thermal ultrasound.

malignant tumors, pregnancy, CNS tissue, pacemaker, thrombophlebitis, eyes, reproductive organs

deep thermal ultrasound: frequency

1 MHz

deep thermal ultrasound: duty cycle

continuous

deep thermal ultrasound: intensity

1.5 W/cm2

deep thermal ultrasound: duration

5-10 min

superficial thermal ultrasound:

3 MHz

superficial thermal ultrasound: duty cycle

continuous

superficial thermal ultrasound: intensity

0.5 W/cm2

superficial thermal ultrasound: duration

5-10 min

non-thermal ultrasound (tendon, bone): frequency

1 MHz

non-thermal ultrasound (tendon, bone): duty cycle

20%

non-thermal ultrasound (tendon, bone): intensity

1.0 W/cm2

non-thermal ultrasound (tendon, bone): duration

5-10 min

non-thermal ultrasound (dermal ulcers, surgical incisions, phonophoresis): frequency

3 MHz

non-thermal ultrasound (dermal ulcers, surgical incisions, phonophoresis): duty cycle

20%

non-thermal ultrasound (dermal ulcers, surgical incisions, phonophoresis): intensity

0.5 W/cm2

non-thermal ultrasound (dermal ulcers, surgical incisions, phonophoresis): duration

5-10 min

List seven electrical stimulation modality subsets.

motor stimulation (Russian), motor stimulation (NMES), TENS (conventional), TENS (low rate), interferential current, HVPC, iontophoresis

List four indications for motor stimulation (Russian and NMES).

decreased strength, poor muscle coordination, edema control, retardation of atrophy

List two indications for TENS (conventional and low rate) and interferential current.

acute pain, chronic pain

List two indications for HVPC.

chronic wounds, edema control

List one indication for iontophoresis.

transdermal drug delivery

List 6 contraindications for electrical stimulation.

pacemaker, unstable arrhythmias, over carotid sinus, over arterial/venous, thrombosis, pregnancy

Russian motor stimulation: frequency

2500 Hz

Russian motor stimulation: pulse frequency

50 pps

Russian motor stimulation: on/off

10/50

Russian motor stimulation: duty cycle

50%

Russian motor stimulation: intensity

visible contraction

Russian motor stimulation: duration

15 min

NMES motor stimulation: frequency

35-50 Hz

NMES motor stimulation: pulse duration

150-200 microsec

NMES motor stimulation: rmp

2 sec

NMES motor stimulation: intensity

visible contraction

NMES motor stimulation: duration

15 min

conventional TENS: pulse frequency

100-150 pps

conventional TENS: pulse duration

50-80 microsec

conventional TENS: intensity

to sensation

conventional TENS: duration

as needed

low rate TENS: pulse frequency

2-10 pps

low rate TENS: pulse duration

150-300 microsec

low rate TENS: intensity

visible contraction

low rate TENS: duration

less than 40 min

interferential current: carrier frequency

4,000-5,000 Hz

interferential current: beat frequency

100-150 Hz

interferential current: duration

20-30 min

HVPC edema control: polarity

negative

HVPC edema control: pulse frequency

100-120 Hz

HVPC edema control: pulse duration

40-100 microsec

HVPC edema control: intensity

comfortable tingling

HVPC edema control: duration

20-30 min

HVPC tissue healing: polarity

depends on presence of inflammation

HVPC tissue healing: pulse frequency

60-125 Hz

HVPC tissue healing: pulse duration

40-100 microsec

HVPC tissue healing: intensity

comfortable tingling

HVPC tissue healing: duration

45-60 min

iontophoresis: dose

40 mA/min

iontophoresis: intensity

as tolerated, 1-4 mA

List two traction modality subtypes.

cervical, lumbar

List five indications for traction modalities.

disc herniation, radiculopathy, hypomobility, subacute inflammation, muscle spasm

List four contraindications for traction modalities.

acute injury/inflammation, hypermobility/instability, peripheralization of symptoms with tractions, uncontrolled hypertension

cervical traction: force

10-20 lbs

cervical traction: cycle

continuous or intermittent

cervical traction: duration

20-30 min

List the two common on/off cycles for cervical traction.

15/15 or 60/20

lumbar traction: force

25-50% BW

lumbar traction: cycle

continuous or intermittent

lumbar traction: duration

20-30 min