Modalities: Physical Agents Study Guide (no first half stuff)

Which of the following best represents the standard set-repetition protocol for blood flow restriction (BFR) training?

30 reps, 15 reps, 15 reps, 15 reps

In aquatic therapy, which physical property of water primarily contributes to the reduction of gravitational forces on the body during rehabilitation?

Buoyancy

Which form of traction is typically applied directly by the therapist and is most often used for short-term symptom relief?

manual

What muscles are more active during immersion at the level of the umbilicus?

Rec fem & erector spinae

What is the most correct mechanism for the effects of BFR at the cellular level?

The occlusion causes release of metabolites, hormones, and cell signaling changes leading to hypertrophy

The biomechanical theory for traction states that traction is beneficial due to the separation between vertebrae and increasing space of the intervertebral foramina. What percent of body weight is necessary to obtain the separation/spacing between the vertebrae?

26% bodyweight or higher

Why does BFR produce similar results with low loads as compared to high load resistance training?

it induces earlier fatigue and recruits more motor units

Which modality is the most indicated for inducing therapeutic effects associated with reduction of motor nerve conduction?

cold water immersion

What rest time between sets is recommended for BFR for resistance training

30-60 seconds

When is theist beneficial time to do low load BFR post-op to reduce muscle atrophy?

1-2 weeks

What temperature is recommended for cold water immersion to reduce muscle soreness?

57 degrees F

in order to promote muscular hypertrophy with BFR, what percent range of 1RM should be utilized?

20-40%

For an extensor responder patient, how would they be positioned on the lumbar traction machine?

pone

Which of the following is the maximum LOP for the lower extremity to achieve muscular benefits?

80% LOP

A patient with congestive heart failure would best benefit from what kind of hydrotherapy?

Low temp sauna bathing at 60C (114F) for 15 mins

What type of back pain is traction best for?

low back pain with radicular symptoms

In blood flow restriction (BFR) therapy, what areas of the limb show increased motor unit recruitment due to a hypoxic and metabolic environment created by the cuff?

Both proximal and distal to the BFR cuff

How does hydrotherapy help reduce muscle fatigue and soreness through its effects on the nervous system?

It decreases alpha motor neuron excitability, leading to muscle relaxation and reduced fatigue

Which of the following best describes the difference between a flexion responder and an extension responder when determining positioning for mechanical lumbar traction?

A flexion responder benefits most from traction in supine with hips and knees sometimes flexed, typically used in conditions like spinal stenosis

Which of the following is the most appropriate placement for blood flow restriction (BFR) cuffs during lower extremity exercise?

as high as possible on the thigh

Which of the following therapeutic modalities is most indicated and effective for inducing therapeutic effects associated with the reduction of motor nerve conduction?

cold water immersion

For which of the following conditions is traction most commonly used in physical therapy?

LBP with or without lumbar radiculopathy

When doing BFR, what is the LOP when doing low load resistance on the lower extremity?

80%

How many feet (at minimum) must you be submerged in for water pressure to be higher than DBP, causing a fluid shift?

3ft

If your patient is a flexion responder, they would most likely benefit from traction in what position?

supine

When using BFR, limb occlusion pressure (LOP) for the lower extremity should be set at which value?

40-80%

Cold water immersion increases all of the following except?

cerebral blood flow

The patient presents with a flexion bias after a low back injury. How should the patient be positioned when performing lumbar traction?

supine

Immersion to the level of the xiphoid process offloads approximately what percentage of a patient’s body weight?

60%

In Vanti et al.'s systematic review and meta-analysis, what conclusion was drawn regarding the effectiveness of mechanical lumbar traction for chronic low back pain (CLBP)?

Not supported for use in patients with CLBP with / without leg symptoms

According to Cognetti et al., what is the recommended limb occlusion pressure (LOP) when applying blood flow restriction (BFR) therapy to the upper extremity?

50% LOP

What is the appropriate number of reps for isometric BFR?

45 second hold, 30 second hold, 30 second hold, 30 second hold

While utilizing BFR, where should the cuff be placed?

most proximal part of the limb

Which of the following effects of cold-water immersion therapy leads to a decrease in delayed onset muscle soreness (DOMS)?

decreased plasma lactate concentration

What type of muscle contractions are suggested when utilizing BFR for neuromuscular stimulation for post-operative maintenance/preventative therapy of collegiate and professional athletes?

isometric

According to Judovich et. al, what amount of traction force should be used to obtain a separation between vertebrae?

26%

What type of surgery has BFR had the most research on in the post-operative recovery and has been most often utilized for?

ACL reconstruction

How does the temperature and pressure of the water in hydrotherapy affect pain/nociception?

They block nociceptors by stimulating thermal and mechanoreceptors, modulating spinal segmental pathways.

What is considered to be “sham” traction?

Traction delivered at a force less than 25% of the patient's body weight

Which of the following best explains how Blood Flow Restriction (BFR) therapy enhances muscle hypertrophy even at low loads?

It promotes satellite cell proliferation and fast-twitch fiber recruitment under ischemic conditions.

Cold water immersion (CWI) induces what biomechanical and physiological changes?

decrease in cerebral blood flow

What level of evidence supports the short-term effectiveness of lumbar traction?

low to very low quality evidence

For neuro stimulation BFR, what is the recommended hold and rest time for isometrics?

45 sec, 30 sec, 30 sec, 30 sec with a 30 sec rest

: What is the main goal/benefit for contrast bath?

Alternating vasodilation and vasoconstriction resulting in muscle pump

For the patients who have a decreased standing ability due to pain, what set up position is best for them in traction?

supine

Leg immersion in warm water for 45 minutes before stretch-shortening exercise reduced most of the indirect markers of exercise induced muscle damage including which of the following?

muscle soreness

Which is NOT a reason that traction has been justified clinically in the past?

To maximize treatment time (increased efficiency)

Which of the following is a theory of blood flow restriction therapy?

muscle strengthening using low load resistance

Hydrotherapy benefits the musculoskeletal system by:

increasing joint mobility and ROM

Mechanical traction..

may create some improvement when paired with physical therapy

In what population is passive BFR particularly useful?

Patients in the early stages of immobilization or post-op recovery

According to the article, what combination of treatment was found to demonstrate improvements in symptoms and QOL for patients with fibromyalgia?

Sauna therapy and underwater exercise

Which of the following statements is true regarding hydrotherapy for the musculoskeletal system?

leg immersion in warm water for 45 min decreased exercise induced muscle damage

The benefits of low load or no load BFR for the post-op rehab population includes all of the following except:

hyperalgesia

Which of the following is a physiologic effect of a superficial cold application?

decrease in local edema

When applying ice/cold water hydrotherapy to increase joint proprioception before exercise, where is it best to place it?

only on the joint

BFR is acceptable to use for these types of exercises except

plyometric

What type of traction has better outcomes for cervical radiculating symptoms?

intermittent

Responses induced by cold are mainly due to

increased activity of the SNS

What is the most indicated, effective modality for inducing therapeutic effects associated with the reduction of motor nerve conduction?

cold water immersion

According to the Buckthorpe et al. article, warm water immersion improved functional reach in which of the following populations?

Parkinsons disease

According to the Cognetti et al. article, the general frequency prescription for BFR Low-Load Resistance Training (BFR-RE) is:

2-3 BFR session per week, up to 2x daily in early rehab phases

According to the Buckthorpe et al. article, which of the following is NOT a benefit of cold water hydrotherapy?

improved QOL and symptoms of OA

Which one of the following are NOT theorized to lead to muscular hypertrophy and strength adaptations with BFR?

tearing and rebuilding of actin-myosin crossbridges

Which is NOT a current form of BFR application

anaerobic exercise

Cold exposure has what effect on endocrine/hormonal system?

Release of norepinephrine to stimulate an increase in HR

True or False: Motor unit recruitment does not occur in the muscles proximal and distal to the area where BFR therapy is applied

False

What location of submersion would allow for a person's body weight to be off-loaded by 60% when using hydrotherapy?

xiphoid

Which of the following is a contraindication to performing traction as a modality?

RA, Osteoporosis, Pregnancy

Which of the following is TRUE about blood flow restriction (BFR) therapy in rehabilitation?

It promotes muscle hypertrophy and recovery with low-load exercise.

What is one evidence-based benefit of hydrotherapy for the musculoskeletal system?

Pain relief in arthritis and fibromyalgia

What did the systematic review conclude about adding mechanical lumbar traction to physical therapy for low back pain?

Traction offered modest short-term pain relief regardless of type or intensity.

Which chemical increases the most as a result of cold-water immersion (14 degrees Celsius)?

dopamine

Increased activation of muscles proximal to the site of occlusion with BFR is theorized to be a result of what?

Muscles distal to the site of occlusion fatigue quickly resulting in increased recruitment of proximal muscle groups

A patient with radiculopathy that responds to the Mackenize Back Program should be in what position during lumbar traction?

prone

What are the current forms of BFR?

Low-load resistance training, aerobic exercise, passive BFR, neuromuscular stimulation

When performing hydrotherapy, at what anatomical level of the human body is the activity of the erector spinae and rectus femoris muscles increased or equal to that of walking on dry ground?

umbilical

According to a study concerning traction force, what is the minimum amount of force of the patient’s body weight (bw) that should be used to obtain a separation between vertebrae?

26%

The benefits of low load (or no load) BFR make them a great modality for which population? Pick the most correct option from the readings.

post surgical pts (especially after knee sugery)

Which of the following scenarios has shown to reduce waist circumference and body fat in obese persons?

Aqua-jogging w/out caloric restrictions for 6 weeks

Which type of traction was found to be significantly different based on studies?

No significant differences were found in results on pain/disability between traction types.

What type of muscle fibers are activated at lower loads under BFR conditions?

Type II fast-twitch fibers

Compared to walking on dry ground, what is the effect of walking in water at umbilical depth on muscle activation?

Increased activation of the erector spinae and rectus femoris

How long did the positive effects of traction typically last, according to the review?

short term only

True or False: The LOP needed for BFR on the UE must be greater than 80%.

False

Which of the following is a benefit of cold water hydrotherapy?

Increases in endorphins and noradrenaline in the blood and overall synaptic release of noradrenaline in the brain

Which of these is NOT an indication of traction?

increase muscle length

What was the primary finding of the study on cupping therapy and ankle dorsiflexion?

Both static and dynamic cupping increased dorsiflexion acutely, with dynamic cupping showing slightly greater improvement

Which of the following is a proposed benefit of utilizing cupping therapy?

enhances blood flow, lower lymphocyte count, removes toxins form skin and interstitium

Which mechanism of pain reduction describes the phenomena of "one pain masks another" or "pain inhibits pain" to help explain cupping therapy?

diffuse noxious inhibitory controls

Which type of cupping led to clinically significant improvements in ankle dorsiflexion?

dynamic cupping

According to current evidence, what is the effect of dry needling (DN) on pain across different body regions at short-term follow-up?

DN shows strong evidence for pain reduction across all body regions in the short term

What type of cupping shows MOST promise for ROM improvement?

dynamic cupping

Which is NOT a theory for proposed mechanisms of action regarding cupping physiology?

Sodium-potassium theory

Dry needling is consistently superior to what other treatment in the effectiveness of pain reduction?

dry needling is not superior to other treatments in the effectiveness of pain reduction

Based on the Umbrella review of dry needling, which body region was dry needling strongly recommended to decrease pain intensity

neck

These are some theories of how cupping can affect the immune system except

release of NO, activation of immune system theory, blood detox

True or False: Dynamic Cupping and Static cupping both showed equal amounts of AROM improvements in patients?

FALSE

The addition of movement during cupping therapy most closely resembles which type of stretching technique?

PNF

Dry needling demonstrates greater clinical effectiveness when combined with interventions such as therapeutic exercise, manual therapy, and neuromuscular re-education.

True